Current advances in biodegradable synthetic polymer based cardiac patches

McMahan, Sara R.; Taylor, Alan M.; Copeland, Katherine M.; Pan, Zui; Liao, Jun; Hong, Yi

doi:10.1002/jbm.a.36874

Cited by 48 publications

(40 citation statements)

References 61 publications

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“…To note, as an alternative to local injection more physiological methods of administration could be employed. A promising example is offered by cardiac patches made of natural materials with specific biodegradable and biocompatible properties emulating closely the myocardial microenvironment (Albertario et al, 2019;McMahan et al, 2020), to be implanted upon corrective cardiac surgery. Such patches could be used as a matrix for storage and controlled release of agrin with different modalities.…”

Section: Protein Therapy Dosage and Costmentioning

confidence: 99%

Agrin-Mediated Cardiac Regeneration: Some Open Questions

Bigotti

Skeffington

Jones

et al. 2020

Front. Bioeng. Biotechnol.

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After cardiac injury, the mammalian adult heart has a very limited capacity to regenerate, due to the inability of fully differentiated cardiomyocytes (CMs) to efficiently proliferate. This has been directly linked to the extracellular matrix (ECM) surrounding and connecting cardiomyocytes, as its increasing rigidity during heart maturation has a crucial impact over the proliferative capacity of CMs. Very recent studies using mouse models have demonstrated how the ECM protein agrin might promote heart regeneration through CMs de-differentiation and proliferation. In maturing CMs, this proteoglycan would act as an inducer of a specific molecular pathway involving ECM receptor(s) within the transmembrane dystrophin-glycoprotein complex (DGC) as well as intracellular Yap, an effector of the Hippo pathway involved in the replication/regeneration program of CMs. According to the mechanism proposed, during mice heart development agrin gets progressively downregulated and ultimately replaced by other ECM proteins eventually leading to loss of proliferation/ regenerative capacity in mature CMs. Although the role played by the agrin-DGC-YAP axis during human heart development remains still largely to be defined, this scenario opens up fascinating and promising therapeutic avenues. Herein, we discuss the currently available relevant information on this system, with a view to explore how the fundamental understanding of the regenerative potential of this cellular program can be translated into therapeutic treatment of injured human hearts.

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Section: Protein Therapy Dosage and Costmentioning

confidence: 99%

Agrin-Mediated Cardiac Regeneration: Some Open Questions

Bigotti

Skeffington

Jones

et al. 2020

Front. Bioeng. Biotechnol.

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“…Synthetic materials are usually readily available with reproducible fabrication processes. Additionally, synthetic materials may offer greater customizability in terms of degradation profile and mechanical strength by controlling the proportions of the individual constituents [7,159]. Synthetic materials such as poly lactic-co-glycolic acid (PLGA), poly ε-caprolactone (PCL) and poly glycerol sebacate (PGS) are commonly used in cardiac tissue engineering [159].…”

Section: Synthetic Materialsmentioning

confidence: 99%

Bioresorbable Polymeric Scaffold in Cardiovascular Applications

Toong

Toh

et al. 2020

IJMS

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Advances in material science and innovative medical technologies have allowed the development of less invasive interventional procedures for deploying implant devices, including scaffolds for cardiac tissue engineering. Biodegradable materials (e.g., resorbable polymers) are employed in devices that are only needed for a transient period. In the case of coronary stents, the device is only required for 6–8 months before positive remodelling takes place. Hence, biodegradable polymeric stents have been considered to promote this positive remodelling and eliminate the issue of permanent caging of the vessel. In tissue engineering, the role of the scaffold is to support favourable cell-scaffold interaction to stimulate formation of functional tissue. The ideal outcome is for the cells to produce their own extracellular matrix over time and eventually replace the implanted scaffold or tissue engineered construct. Synthetic biodegradable polymers are the favoured candidates as scaffolds, because their degradation rates can be manipulated over a broad time scale, and they may be functionalised easily. This review presents an overview of coronary heart disease, the limitations of current interventions and how biomaterials can be used to potentially circumvent these shortcomings in bioresorbable stents, vascular grafts and cardiac patches. The material specifications, type of polymers used, current progress and future challenges for each application will be discussed in this manuscript.

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“…In fact, it has been estimated that more than 90% of injected cells as suspension do not engraft in cardiac site and are easily lost after injection, leading to treatment failure [ 58 ]. Moreover, the cell-injection therapy could be effective only if carried out at the beginning of the acute damage, but at the same time the cells would be exposed to a very hostile environment, due to high immune response and high inflammatory process that occur in the infarcted area soon after insult, thus compromising the viability of injected cells [ 59 , 60 ]. So, a suitable delivery system appears necessary to increase the engraftment of the cells in the heart microenvironment, thus fostering their regenerative potential, while improving their survival upon transplantation ( Figure 1 ).…”

Section: Cardiac Tissue Regenerationmentioning

confidence: 99%

“…So, up-to-date cutting-edge nanotechnology aims to associate the use of biomaterials, as patches or injectable hydrogels, with the incorporation of CSCs. The use of these technologies for cardiac tissue regeneration is potentially advantageous because they could obtain a better engraftment of delivered stem cells, but to date several limits and critical issues remain to be resolved ( Table 1 ) [ 58 , 59 , 60 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 ].…”

Section: Cardiac Tissue Regenerationmentioning

confidence: 99%

“…When designing a patch as delivery system for CSCs (and their progeny) and/or biological components, the right choice of the stem cells population is fundamental, but also and above all, the choice of materials to be used, from the technological-formulative point of view, is equally important. Several materials are available for tissue engineering, each one with their pros and cons; in any case, the selected material should create a fully integrated patch, able to support biological activity, avoid adverse host immune response, and support the contraction, shear stress and other dynamic forces of the heart [ 60 ]. Generally, the materials used for cardiac patches can be classified in natural and synthetic materials [ 73 ].…”

Section: Epicardial Implanted Cardiac Patchesmentioning

confidence: 99%

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Cardiac Stem Cell-Loaded Delivery Systems: A New Challenge for Myocardial Tissue Regeneration

Mancuso

Barone

Cristiano

et al. 2020

IJMS

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Cardiovascular disease (CVD) remains the leading cause of death in Western countries. Post-myocardial infarction heart failure can be considered a degenerative disease where myocyte loss outweighs any regenerative potential. In this scenario, regenerative biology and tissue engineering can provide effective solutions to repair the infarcted failing heart. The main strategies involve the use of stem and progenitor cells to regenerate/repair lost and dysfunctional tissue, administrated as a suspension or encapsulated in specific delivery systems. Several studies demonstrated that effectiveness of direct injection of cardiac stem cells (CSCs) is limited in humans by the hostile cardiac microenvironment and poor cell engraftment; therefore, the use of injectable hydrogel or pre-formed patches have been strongly advocated to obtain a better integration between delivered stem cells and host myocardial tissue. Several approaches were used to refine these types of constructs, trying to obtain an optimized functional scaffold. Despite the promising features of these stem cells’ delivery systems, few have reached the clinical practice. In this review, we summarize the advantages, and the novelty but also the current limitations of engineered patches and injectable hydrogels for tissue regenerative purposes, offering a perspective of how we believe tissue engineering should evolve to obtain the optimal delivery system applicable to the everyday clinical scenario.

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Current advances in biodegradable synthetic polymer based cardiac patches

Cited by 48 publications

References 61 publications

Agrin-Mediated Cardiac Regeneration: Some Open Questions

Agrin-Mediated Cardiac Regeneration: Some Open Questions

Bioresorbable Polymeric Scaffold in Cardiovascular Applications

Cardiac Stem Cell-Loaded Delivery Systems: A New Challenge for Myocardial Tissue Regeneration

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