Jin Dawei, Yang Shuofei, Wu Shuting, Yin Meng, Kuang Haizhu
Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dong Fang Road, Shanghai, 200127, People's Republic of China.
Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, People's Republic of China.
Bioact Mater. 2021 Aug 19;10:355-366. doi: 10.1016/j.bioactmat.2021.08.013. eCollection 2022 Apr.
Pericardial barrier destruction, inflammatory cell infiltration, and fibrous tissue hyperplasia, trigger adhesions after cardiac surgery. There are few anti-adhesion materials that are both functional and sutureable for pericardial reconstruction. Besides, a few studies have reported on the mechanism of preventing pericardial adhesion. Herein, a functional barrier membrane with sutureability was developed via a modified electrospinning method. It was composed of poly(l-lactide--caprolactone) (PLCL) nanofibers, poly(vinyl alcohol) (PVA) aerogel, and melatonin, named PPMT. The PPMT had a special microstructure manifested as a staggered arrangement of nanofibers on the surface and a layered macroporous aerogel structure in a cross-section. Besides providing the porosity and hydrophilicity obtained from PVA, the structure also had suitable mechanical properties for stitching due to the addition of PLCL nanofibers. Furthermore, it inhibited the proliferation of fibroblasts by suppressing the activation of and , and achieved anti-inflammatory effects by affecting the activity of inflammatory cells and reducing the release of pro-inflammatory factors, such as interleukin 8 (IL-8) and tumor necrosis factor α (TNF-α). Finally, transplantation showed that it up-regulated the expression of matrix metalloproteinase-1 (MMP1) and tissue inhibitor of metalloproteinase-1 (TIMP1), and down-regulated the expression of Vinculin and transforming growth factor β (TGF-β) in the myocardium, thereby reducing the formation of adhesions. Collectively, these results demonstrate a great potential of PPMT membrane for practical application to anti-adhesion.
心包屏障破坏、炎性细胞浸润和纤维组织增生会引发心脏手术后的粘连。目前几乎没有兼具功能性和可缝合性用于心包重建的抗粘连材料。此外,关于预防心包粘连的机制仅有少数研究报道。在此,通过改进的静电纺丝方法制备了一种具有可缝合性的功能性屏障膜。它由聚(L-丙交酯-ε-己内酯)(PLCL)纳米纤维、聚乙烯醇(PVA)气凝胶和褪黑素组成,命名为PPMT。PPMT具有特殊的微观结构,表现为表面纳米纤维交错排列,横截面为层状大孔气凝胶结构。该结构除了具有PVA赋予的孔隙率和亲水性外,由于添加了PLCL纳米纤维,还具有适合缝合的机械性能。此外,它通过抑制 和 的激活来抑制成纤维细胞的增殖,并通过影响炎性细胞活性和减少促炎因子如白细胞介素8(IL-8)和肿瘤坏死因子α(TNF-α)的释放来实现抗炎作用。最后, 移植表明它上调了心肌中基质金属蛋白酶-1(MMP1)和金属蛋白酶组织抑制剂-1(TIMP1)的表达,下调了纽蛋白和转化生长因子β(TGF-β)的表达,从而减少粘连的形成。总的来说,这些结果表明PPMT膜在抗粘连实际应用中具有巨大潜力。