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一种可灌注的多功能心外膜装置可改善心功能和组织修复。

A perfusable, multifunctional epicardial device improves cardiac function and tissue repair.

机构信息

Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Belt and Road Joint Laboratory of Advanced Fiber and Low-dimension Materials (Donghua University), College of Materials Science and Engineering, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, Donghua University, Shanghai, China.

出版信息

Nat Med. 2021 Mar;27(3):480-490. doi: 10.1038/s41591-021-01279-9. Epub 2021 Mar 15.

Abstract

Despite advances in technologies for cardiac repair after myocardial infarction (MI), new integrated therapeutic approaches still need to be developed. In this study, we designed a perfusable, multifunctional epicardial device (PerMed) consisting of a biodegradable elastic patch (BEP), permeable hierarchical microchannel networks (PHMs) and a system to enable delivery of therapeutic agents from a subcutaneously implanted pump. After its implantation into the epicardium, the BEP is designed to provide mechanical cues for ventricular remodeling, and the PHMs are designed to facilitate angiogenesis and allow for infiltration of reparative cells. In a rat model of MI, implantation of the PerMed improved ventricular function. When connected to a pump, the PerMed enabled targeted, sustained and stable release of platelet-derived growth factor-BB, amplifying the efficacy of cardiac repair as compared to the device without a pump. We also demonstrated the feasibility of minimally invasive surgical PerMed implantation in pigs, demonstrating its promise for clinical translation to treat heart disease.

摘要

尽管在心肌梗死后的心脏修复技术方面取得了进展,但仍需要开发新的综合治疗方法。在这项研究中,我们设计了一种可灌注的多功能心外膜装置(PerMed),它由可生物降解的弹性贴片(BEP)、可渗透的层次微通道网络(PHMs)和一个从皮下植入的泵中输送治疗剂的系统组成。在将其植入心外膜后,BEP 旨在为心室重构提供机械线索,而 PHMs 旨在促进血管生成并允许修复细胞渗透。在心肌梗死大鼠模型中,植入 PerMed 可改善心室功能。当与泵连接时,PerMed 能够靶向、持续和稳定地释放血小板衍生生长因子-BB,与没有泵的装置相比,增强了心脏修复的疗效。我们还证明了在猪中进行微创外科 PerMed 植入的可行性,为将其临床转化为治疗心脏病提供了希望。

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