Center for Biomedical Engineering, School of Engineering, Brown University, Providence, Rhode Island 02912, United States.
ACS Appl Bio Mater. 2022 Jun 20;5(6):2461-2480. doi: 10.1021/acsabm.2c00174. Epub 2022 May 27.
Despite numerous advances in treatments for cardiovascular disease, heart failure (HF) remains the leading cause of death worldwide. A significant factor contributing to the progression of cardiovascular diseases into HF is the loss of functioning cardiomyocytes. The recent growth in the field of cardiac tissue engineering has the potential to not only reduce the downstream effects of injured tissues on heart function and longevity but also re-engineer cardiac function through regeneration of contractile tissue. One leading strategy to accomplish this is via a cellularized patch that can be surgically implanted onto a diseased heart. A key area of this field is the use of tissue scaffolds to recapitulate the mechanical and structural environment of the native heart and thus promote engineered myocardium contractility and function. While the strong mechanical properties and anisotropic structural organization of the native heart can be largely attributed to a robust extracellular matrix, similar strength and organization has proven to be difficult to achieve in cultured tissues. Polycaprolactone (PCL) is an emerging contender to fill these gaps in fabricating scaffolds that mimic the mechanics and structure of the native heart. In the field of cardiovascular engineering, PCL has recently begun to be studied as a scaffold for regenerating the myocardium due to its facile fabrication, desirable mechanical, chemical, and biocompatible properties, and perhaps most importantly, biodegradability, which make it suitable for regenerating and re-engineering function to the heart after disease or injury. This review focuses on the application of PCL as a scaffold specifically in myocardium repair and regeneration and outlines current fabrication approaches, properties, and possibilities of PCL incorporation into engineered myocardium, as well as provides suggestions for future directions and a roadmap toward clinical translation of this technology.
尽管心血管疾病的治疗方法有了很多进展，但心力衰竭（HF）仍然是全球范围内的主要死亡原因。导致心血管疾病发展为 HF 的一个重要因素是功能失调的心肌细胞的丧失。心脏组织工程领域的最近发展有潜力不仅减轻受损组织对心脏功能和寿命的下游影响，而且通过再生收缩组织来重新构建心脏功能。实现这一目标的一种主要策略是通过可以手术植入患病心脏的细胞化贴片。该领域的一个关键领域是使用组织支架来再现天然心脏的机械和结构环境，从而促进工程心肌的收缩性和功能。尽管天然心脏的强大机械性能和各向异性结构组织可以在很大程度上归因于强大的细胞外基质，但在培养组织中已经证明很难实现类似的强度和组织。聚己内酯（PCL）是一种新兴的竞争者，可以在制造模仿天然心脏力学和结构的支架方面填补这些空白。在心血管工程领域，由于其易于制造、理想的机械、化学和生物相容性以及最重要的可生物降解性，PCL 最近开始作为再生心肌的支架进行研究，使其适合在疾病或损伤后再生和重新构建心脏功能。本综述重点介绍了 PCL 作为支架在心肌修复和再生中的应用，并概述了当前的制造方法、特性以及将 PCL 纳入工程心肌的可能性，并为该技术的未来方向和临床转化提供了建议。
