Chester Adrian H, Grande-Allen K Jane
Heart Science Centre, The Magdi Yacoub Institute, Harefield, United Kingdom.
Department of Bioengineering, Rice University, Houston, TX, United States.
Front Cardiovasc Med. 2020 Apr 21;7:63. doi: 10.3389/fcvm.2020.00063. eCollection 2020.
Over the last 20 years, the designs of tissue engineered heart valves have evolved considerably. An initial focus on replicating the mechanical and structural features of semilunar valves has expanded to endeavors to mimic the biological behavior of heart valve cells as well. Studies on the biology of heart valves have shown that the function and durability of native valves is underpinned by complex interactions between the valve cells, the extracellular matrix, and the mechanical environment in which heart valves function. The ability of valve interstitial cells to synthesize extracellular matrix proteins and remodeling enzymes and the protective mediators released by endothelial cells are key factors in the homeostasis of valve function. The extracellular matrix provides the mechanical strength and flexibility required for the valve to function, as well as communicating with the cells that are bound within. There are a number of regulatory mechanisms that influence valve function, which include neuronal mechanisms and the tight regulation of growth and angiogenic factors. Together, studies into valve biology have provided a blueprint for what a tissue engineered valve would need to be capable of, in order to truly match the function of the native valve. This review addresses the biological functions of heart valve cells, in addition to the influence of the cells' environment on this behavior and examines how well these functions are addressed within the current strategies for tissue engineering heart valves , and .
在过去20年里，组织工程心脏瓣膜的设计有了相当大的发展。最初专注于复制半月瓣的机械和结构特征，如今已扩展到努力模拟心脏瓣膜细胞的生物学行为。对心脏瓣膜生物学的研究表明，天然瓣膜的功能和耐久性是由瓣膜细胞、细胞外基质以及心脏瓣膜发挥功能所处的机械环境之间复杂的相互作用所支撑的。瓣膜间质细胞合成细胞外基质蛋白和重塑酶的能力以及内皮细胞释放的保护性介质是瓣膜功能稳态的关键因素。细胞外基质提供了瓣膜发挥功能所需的机械强度和柔韧性，同时也与其中的细胞进行通讯。有许多调节机制影响瓣膜功能，包括神经机制以及对生长和血管生成因子的严格调控。总之，对瓣膜生物学的研究为组织工程瓣膜真正匹配天然瓣膜功能所需具备的能力提供了一个蓝图。本综述除了探讨细胞环境对心脏瓣膜细胞这种行为的影响外，还阐述了心脏瓣膜细胞的生物学功能，并研究了在当前组织工程心脏瓣膜策略中这些功能的实现程度。
