Cardiac tissue engineering: current state-of-the-art materials, cells and tissue formation

Abstract

Cardiovascular diseases are the major cause of death worldwide. The heart has limited capacity of regeneration, therefore, transplantation is the only solution in some cases despite presenting many disadvantages. Tissue engineering has been considered the ideal strategy for regenerative medicine in cardiology. It is an interdisciplinary field combining many techniques that aim to maintain, regenerate or replace a tissue or organ. The main approach of cardiac tissue engineering is to create cardiac grafts, either whole heart substitutes or tissues that can be efficiently implanted in the organism, regenerating the tissue and giving rise to a fully functional heart, without causing side effects, such as immunogenicity. In this review, we systematically present and compare the techniques that have drawn the most attention in this field and that generally have focused on four important issues: the scaffold material selection, the scaffold material production, cellular selection and in vitro cell culture. Many studies used several techniques that are herein presented, including biopolymers, decellularization and bioreactors, and made significant advances, either seeking a graft or an entire bioartificial heart. However, much work remains to better understand and improve existing techniques, to develop robust, efficient and efficacious methods.

CPCs and ECM: A Good Mix for Cardiac Regeneration

“…In general, polymers can be classified in synthetic or natural (Table 1). Briefly, synthetic materials, such as Polyglycolic acid (PGA), polylactic-lacid (PLLA), polylactic glycolic acid (PLGA) and polyurethane (PU), that are extremely malleable, are not always biodegradable and often prevent vascular and parenchymal cell attachment and infiltration [78,79] . Besides, natural polymers, or biopolymers, such as collagen, elastin, chitosan, cellulose and hyaluronic acid, even if exhibit a higher degree of biocompatibility and promote cell migration and differentiation, present a low mechanical strength for cardiovascular application [80] .…”

“…Besides, natural polymers, or biopolymers, such as collagen, elastin, chitosan, cellulose and hyaluronic acid, even if exhibit a higher degree of biocompatibility and promote cell migration and differentiation, present a low mechanical strength for cardiovascular application [80] . Therefore, it has been proposed the combination of synthetic and natural biomaterials to improve the weakness of each polymer to create a scaffold with better properties [79,81] . Nowadays, one of the most promising approaches investigated for cardiac tissue engineering involves the use of bioactive glasses (BGs) [82] .…”

<p>Biodegradable Nanopolymers in Cardiac Tissue Engineering: From Concept Towards Nanomedicine</p>

“…These include the ability of scaffolds to preserve mechanical properties during tissue growth, their gradual degradation into biocompatible products, and their ability to receive cells, growth factors and so on. [18][19][20] Biodegradable polymers are classified into two main categories: natural and synthetic polymers. Natural polymers can be defined as polymers which are found in nature.…”

Mechanical Considerations of Electrospun Scaffolds for Myocardial Tissue and Regenerative Engineering

“…Cardiac tissue and regenerative engineering, via the use of biomaterials with or without cells/molecules to repair heart tissue, is an emerging, interdisciplinary field that aims to improve outcomes and quality of life for these patients [ 3 ]. This new field has presented the opportunity to renew and restore the diseased heart [ 4 , 5 , 6 ].…”