Maintaining Moderate Platelet Aggregation and Improving Metabolism of Endothelial Progenitor Cells Increase the Patency Rate of Tissue-Engineered Blood Vessels

Wu, Yangxiao; Li, Li; Chen, Wen; Zeng, Wen; Zeng, Lingqin; Wen, Can; Zhu, Chuhong

doi:10.1089/ten.tea.2015.0013

Cited by 10 publications

(13 citation statements)

References 26 publications

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“…Moreover, peptides such as TPS, RGD, and YIGSR were applied to cross‐link with small‐diameter vascular grafts to capture EPCs . Other modification methods, such as polymer cross‐linking and coating with specific EPC capturing aptamers, have also been reported …”

Section: Unipotent Stem Cellsmentioning

confidence: 99%

“…[151][152][153] Other modification methods, such as polymer cross-linking and coating with specific EPC capturing aptamers, have also been reported. 154,155 In addition, many studies showed that EPCs are helpful for neovascularization of bone grafts. Eldesoqi et al 10 demonstrated that using EPC-seeded composite biomaterials to repair calvarial defects significantly improved neovascularization 1 week after implantation.…”

Section: Unipotent Stem Cellsmentioning

confidence: 99%

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Cell‐based strategies for vascular regeneration

Zou

Fan

Fartash

et al. 2016

J Biomedical Materials Res

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Vascular regeneration is known to play an essential role in the repair of injured tissues mainly through accelerating the repair of vascular injury caused by vascular diseases, as well as the recovery of ischemic tissues. However, the clinical vascular regeneration is still challenging. Cell-based therapy is thought to be a promising strategy for vascular regeneration, since various cells have been identified to exert important influences on the process of vascular regeneration such as the enhanced endothelium formation on the surface of vascular grafts, and the induction of vessel-like network formation in the ischemic tissues. Here are a vast number of diverse cell-based strategies that have been extensively studied in vascular regeneration. These strategies can be further classified into three main categories, including cell transplantation, construction of tissue-engineered grafts, and surface modification of scaffolds. Cells used in these strategies mainly refer to terminally differentiated vascular cells, pluripotent stem cells, multipotent stem cells, and unipotent stem cells. The aim of this review is to summarize the reported research advances on the application of various cells for vascular regeneration, yielding insights into future clinical treatment for injured tissue/organ.

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Section: Unipotent Stem Cellsmentioning

confidence: 99%

Section: Unipotent Stem Cellsmentioning

confidence: 99%

Cell‐based strategies for vascular regeneration

Zou

Fan

Fartash

et al. 2016

J Biomedical Materials Res

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“…23 Various strategies to improve EC retention on the lumenal surface and prolong graft patency after implantation include treatment with surface coatings and shear stress preconditioning to strengthen EC adhesion, 23,24 and treatment of grafts with molecules to improve EPC recruitment and in situ endothelialization. 25,26 Although recent advances in stem cell technology offer significant potential, controlling differentiation and the subsequent maintenance of a mature, functional EC phenotype-especially for rapid seeding of grafting materials-remains a challenge.…”

mentioning

confidence: 99%

Physiologically Modeled Pulse Dynamics to Improve Function inIn Vitro-Endothelialized Small-Diameter Vascular Grafts

Uzarski

Cores

McFetridge

2015

Tissue Engineering Part C: Methods

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The lack of a functional endothelium on small-diameter vascular grafts leads to intimal hyperplasia and thrombotic occlusion. Shear stress conditioning through controlled hydrodynamics within in vitro perfusion bioreactors has shown promise as a mechanism to drive endothelial cell (EC) phenotype from an activated, pro-inflammatory wound state toward a quiescent functional state that inhibits responses that lead to occlusive failure. As part of an overall design strategy to engineer functional vascular grafts, we present a novel two-phase shear conditioning approach to improve graft endothelialization. Axial rotation was first used to seed uniform EC monolayers onto the lumenal surface of decellularized scaffolds derived from the human umbilical vein. Using computer-controlled perfusion circuits, a flow-ramping paradigm was applied to adapt endothelia to arterial levels of fluid shear stress and pressure without graft denudation. The effects of constant pulse frequencies (CF) on EC quiescence were then compared with pulse frequencies modeled from temporal fluctuations in blood flow observed in vivo, termed physiologically modeled pulse dynamics (PMPD). Constructs exposed to PMPD for 72 h expressed a more functional transcriptional profile, lower metabolic activity (39.8% ± 8.4% vs. 62.5% ± 11.5% reduction, p = 0.012), and higher nitric oxide production (80.42 ± 23.93 vs. 48.75 ± 6.93 nmol/10(5) cells, p = 0.028) than those exposed to CF. By manipulating in vitro flow conditions to mimic natural physiology, endothelialized vascular grafts can be stimulated to express a nonactivated phenotype that would better inhibit peripheral cell adhesion and smooth muscle cell hyperplasia, conditions that typically lead to occlusive failure. Development of robust, functional endothelia on vascular grafts by modulation of environmental conditions within perfusion bioreactors may ultimately improve clinical outcomes in vascular bypass grafting.

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“…Small-diameter tissue-engineered vascular grafts have been associated with low long-term patency rates because of acute thrombosis in early stages and an inability to achieve early endothelialization. 45 In the early postoperative phase, the vascular suture seems to trigger platelet aggregation and thereby induces acute thrombosis. In later periods, the lack of an endothelial lining promotes occlusion.…”

Section: Discussionmentioning

confidence: 99%

“…In later periods, the lack of an endothelial lining promotes occlusion. 45,46 Zilla et al 47 reported that prosthetic vascular grafts remain largely without an endothelium. However, this does not affect clinical performance of large prostheses in the aortic or iliac position but contributes significantly to high failure rates of small to medium-sized grafts.…”

Section: Discussionmentioning

confidence: 99%

Patency and in vivo compatibility of bacterial nanocellulose grafts as small-diameter vascular substitute

Weber

Reinhardt

Eghbalzadeh

et al. 2018

Journal of Vascular Surgery

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Objective: Despite the clinical success of large-diameter vascular grafts, synthetic grafts in small-diameter vessels are of limited use because of their poor patency rates. Previous experiments of our group provided evidence for good biocompatibility of bacterial nanocellulose (BNC) as a small-vessel graft in the carotid artery in sheep. However, the patency rate of our first-generation tubes after 3 months was only 50%. To advance our concept, we now used modified second-generation tubes with diminished wall thickness and a smoother inner surface to reduce the thrombogenic potential. The aim was to investigate mechanical characteristics of modified second-generation BNC tubes, to evaluate in vivo performance and biocompatibility, and to analyze patency rates.Methods: We replaced the right carotid artery of 23 sheep with second-generation BNC tubes. Compared with our firstgeneration tubes, tubes were modified with different surface properties and diminished wall thickness (inner diameter, 4.0-5.0 mm; wall thickness, 1.0-2.5 mm; length, 100 mm) to generate a smoother inner surface with reduced thrombogenic potential and a more porous outer zone, allowing easier cell immigration.Results: At the end of the investigational period, BNC tubes were explanted and grafts were processed for histopathologic analysis. Histologic analysis revealed no acute signs of foreign body reaction such as immigration of giant cells or other acute inflammatory reaction and therefore provided evidence for good biocompatibility of the second-generation tubes. However, all grafts of the sheep without antiplatelet therapy were occluded after 9 months, whereas grafts in sheep receiving dual platelet inhibition showed a patency rate of 67% (six of nine grafts). Further modified grafts revealed a patency rate of 80% (four of five grafts remained open).Conclusions: Patency rates of the second-generation tubes could be substantially improved compared with our firstgeneration tubes. However, poor patency rates of tissue-engineered blood vessels still limit their use in clinical studies. Further efforts in terms of in vitro and in vivo studies are essential to improve grafts of BNC.

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Maintaining Moderate Platelet Aggregation and Improving Metabolism of Endothelial Progenitor Cells Increase the Patency Rate of Tissue-Engineered Blood Vessels

Cited by 10 publications

References 26 publications

Cell‐based strategies for vascular regeneration

Cell‐based strategies for vascular regeneration

Physiologically Modeled Pulse Dynamics to Improve Function inIn Vitro-Endothelialized Small-Diameter Vascular Grafts

Patency and in vivo compatibility of bacterial nanocellulose grafts as small-diameter vascular substitute

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