Saito Junichi, Kaneko Makoto, Ishikawa Yoshihiro, Yokoyama Utako
Department of Physiology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.
Cardiovascular Research Institute, Yokohama City University, Yokohama, Kanagawa, Japan.
Cyborg Bionic Syst. 2021 Feb 18;2021:1532103. doi: 10.34133/2021/1532103. eCollection 2021.
There is urgent demand for biologically compatible vascular grafts for both adult and pediatric patients. The utility of conventional nonbiodegradable materials is limited because of their thrombogenicity and inability to grow, while autologous vascular grafts involve considerable disadvantages, including the invasive procedures required to obtain these healthy vessels from patients and insufficient availability in patients with systemic atherosclerosis. All of these issues could be overcome by tissue-engineered vascular grafts (TEVGs). A large body of evidence has recently emerged in support of TEVG technologies, introducing diverse cell sources (e.g., somatic cells and stem cells) and novel fabrication methods (e.g., scaffold-guided and self-assembled approaches). Before TEVG can be applied in a clinical setting, however, several aspects of the technology must be improved, such as the feasibility of obtaining cells, their biocompatibility and mechanical properties, and the time needed for fabrication, while the safety of supplemented materials, the patency and nonthrombogenicity of TEVGs, their growth potential, and the long-term influence of implanted TEVGs in the body must be assessed. Although recent advances in TEVG fabrication have yielded promising results, more research is needed to achieve the most feasible methods for generating optimal TEVGs. This article reviews multiple aspects of TEVG fabrication, including mechanical requirements, extracellular matrix components, cell sources, and tissue engineering approaches. The potential of periodic hydrostatic pressurization in the production of scaffold-free TEVGs with optimal elasticity and stiffness is also discussed. In the future, the integration of multiple technologies is expected to enable improved TEVG performance.
无论是成人还是儿童患者，对生物相容性血管移植物都有迫切需求。传统的不可生物降解材料由于其血栓形成性和无法生长，其效用有限，而自体血管移植物存在相当多的缺点，包括从患者获取这些健康血管所需的侵入性操作以及全身动脉粥样硬化患者中可用的健康血管不足。所有这些问题都可以通过组织工程血管移植物（TEVG）来克服。最近出现了大量支持TEVG技术的证据，引入了多种细胞来源（例如体细胞和干细胞）和新颖的制造方法（例如支架引导和自组装方法）。然而，在TEVG能够应用于临床之前，该技术的几个方面必须得到改进，例如获取细胞的可行性、它们的生物相容性和机械性能以及制造所需的时间，同时必须评估补充材料的安全性、TEVG的通畅性和非血栓形成性、它们的生长潜力以及植入的TEVG在体内的长期影响。尽管最近TEVG制造方面的进展已经产生了有希望的结果，但仍需要更多研究来实现生成最佳TEVG的最可行方法。本文综述了TEVG制造的多个方面，包括机械要求、细胞外基质成分、细胞来源和组织工程方法。还讨论了周期性静水压力在生产具有最佳弹性和刚度的无支架TEVG中的潜力。未来，多种技术的整合有望改善TEVG的性能。
