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Kalle F, Stadler VP, Brach JK, Grote VF, Pohl C, Schulz K, Seidenstuecker M, Jonitz-Heincke A, Bader R, Mlynski R, Strüder D. High hydrostatic pressure treatment for advanced tissue grafts in reconstructive head and neck surgery. J Biomed Mater Res A 2024. [PMID: 39295278 DOI: 10.1002/jbm.a.37791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 08/19/2024] [Accepted: 08/23/2024] [Indexed: 09/21/2024]
Abstract
The increasing importance of regenerative medicine has resulted in a growing need for advanced tissue replacement materials in head and neck surgery. Allo- and xenogenic graft processing is often time-consuming and can deteriorate the extracellular matrix (ECM). High hydrostatic pressure (HHP)-treatment could allow specific devitalization while retaining the essential properties of the ECM. Porcine connective tissue and cartilage were HHP-treated at 100-400 MPa for 10 min. Structural modifications following HHP-exposure were examined using electron microscopy, while devitalization was assessed through metabolism and cell death analyses. Furthermore, ECM alterations and decellularization were evaluated by histology, biomechanical testing, and DNA content analysis. Additionally, the inflammatory potential of HHP-treated tissue was evaluated in vivo using a dorsal skinfold chamber in a mouse model. The devitalization effects of HHP were dose-dependent, with a threshold identified at 200 MPa for fibroblasts and chondrocytes. At this pressure level, HHP induced structural alterations in cells, with a shift toward late-stage apoptosis. HHP-treatment preserved ECM structure and biomechanical properties, but did not remove cell debris from the tissue. This study observed a pressure-dependent increase of markers suggesting the occurrence of immunogenic cell death. In vivo investigations revealed an absence of inflammatory responses to HHP-treated tissue, indicating a favorable biological response to HHP. In conclusion, application of HHP devitalizes fibroblasts and chondrocytes at 200 MPa while retaining the essential properties of the ECM. Prospectively, HHP may simplify the preparation of allo- and xenogenic tissue replacement materials and increase the availability of grafts in head and neck surgery.
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Affiliation(s)
- Friederike Kalle
- Department of Otorhinolaryngology, Head and Neck Surgery "Otto Körner", Rostock University Medical Center, Rostock, Germany
| | - Valentin Paul Stadler
- Department of Otorhinolaryngology, Head and Neck Surgery "Otto Körner", Rostock University Medical Center, Rostock, Germany
| | - Julia Kristin Brach
- Department of Otorhinolaryngology - Head and Neck Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Vivica Freiin Grote
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Christopher Pohl
- Department of General Surgery, Visceral, Thoracic and Vascular Surgery, University Medical Center Greifswald, Greifswald, Germany
| | - Karoline Schulz
- Medical Biology and Electron Microscopy Center, Rostock University Medical Center, Rostock, Germany
| | - Michael Seidenstuecker
- G.E.R.N. Center for Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Anika Jonitz-Heincke
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Rainer Bader
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery "Otto Körner", Rostock University Medical Center, Rostock, Germany
| | - Daniel Strüder
- Department of Otorhinolaryngology, Head and Neck Surgery "Otto Körner", Rostock University Medical Center, Rostock, Germany
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Winiecki M, Stepczyńska M, Moraczewski K, Skowronski L, Trzcinski M, Rerek T, Malinowski R. Effect of Low-Temperature Oxygen Plasma Treatment of Titanium Alloy Surface on Tannic Acid Coating Deposition. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1065. [PMID: 38473537 DOI: 10.3390/ma17051065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024]
Abstract
In this study, the effect of low-temperature oxygen plasma treatment with various powers of a titanium alloy surface on the structural and morphological properties of a substrate and the deposition of a tannic acid coating was investigated. The surface characteristics of the titanium alloy were evaluated by X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), atomic force microscopy (AFM), and contact angle measurements. Following this, the tannic acid coatings were deposited on the titanium alloy substrates and the structural and morphological properties of the tannic acid coatings deposited were subject to characterization by XPS, SEM, and spectroscopic ellipsometry (SE) measurements. The results show that the low-temperature oxygen plasma treatment of titanium alloys leads to the formation of titanium dioxides that contain -OH groups on the surface being accompanied by a reduction in carbon, which imparts hydrophilicity to the titanium substrate, and the effect increases with the applied plasma power. The performed titanium alloy substrate modification translates into the quality of the deposited tannic acid coating standing out by higher uniformity of the coating, lower number of defects indicating delamination or incomplete bonding of the coating with the substrate, lower number of cracks, thinner cracks, and higher thickness of the tannic acid coatings compared to the non-treated titanium alloy substrate. A similar effect is observed as the applied plasma power increases.
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Affiliation(s)
- Mariusz Winiecki
- Department of Constructional Materials and Biomaterials, Faculty of Materials Engineering, Kazimierz Wielki University, Chodkiewicza 30, 85-064 Bydgoszcz, Poland
| | - Magdalena Stepczyńska
- Department of Polymer Materials Engineering, Faculty of Materials Engineering, Kazimierz Wielki University, Chodkiewicza 30, 85-064 Bydgoszcz, Poland
| | - Krzysztof Moraczewski
- Department of Polymer Materials Engineering, Faculty of Materials Engineering, Kazimierz Wielki University, Chodkiewicza 30, 85-064 Bydgoszcz, Poland
| | - Lukasz Skowronski
- Division of Surface Science, Faculty of Chemical Technology and Engineering, Bydgoszcz University of Science and Technology, Kaliskiego 7, 85-796 Bydgoszcz, Poland
| | - Marek Trzcinski
- Division of Surface Science, Faculty of Chemical Technology and Engineering, Bydgoszcz University of Science and Technology, Kaliskiego 7, 85-796 Bydgoszcz, Poland
| | - Tomasz Rerek
- Division of Surface Science, Faculty of Chemical Technology and Engineering, Bydgoszcz University of Science and Technology, Kaliskiego 7, 85-796 Bydgoszcz, Poland
| | - Rafał Malinowski
- Łukasiewicz Research Network-Institute for Engineering of Polymer Materials and Dyes, Marii Skłodowskiej-Curie 55, 87-100 Torun, Poland
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3
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Gu L, Huang R, Ni N, Gu P, Fan X. Advances and Prospects in Materials for Craniofacial Bone Reconstruction. ACS Biomater Sci Eng 2023; 9:4462-4496. [PMID: 37470754 DOI: 10.1021/acsbiomaterials.3c00399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
The craniofacial region is composed of 23 bones, which provide crucial function in keeping the normal position of brain and eyeballs, aesthetics of the craniofacial complex, facial movements, and visual function. Given the complex geometry and architecture, craniofacial bone defects not only affect the normal craniofacial structure but also may result in severe craniofacial dysfunction. Therefore, the exploration of rapid, precise, and effective reconstruction of craniofacial bone defects is urgent. Recently, developments in advanced bone tissue engineering bring new hope for the ideal reconstruction of the craniofacial bone defects. This report, presenting a first-time comprehensive review of recent advances of biomaterials in craniofacial bone tissue engineering, overviews the modification of traditional biomaterials and development of advanced biomaterials applying to craniofacial reconstruction. Challenges and perspectives of biomaterial development in craniofacial fields are discussed in the end.
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Affiliation(s)
- Li Gu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Rui Huang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Ni Ni
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Ping Gu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Xianqun Fan
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
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4
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Nalbach L, Müller D, Wrublewsky S, Metzger W, Menger MD, Laschke MW, Ampofo E. Microvascular fragment spheroids: Three-dimensional vascularization units for tissue engineering and regeneration. J Tissue Eng 2021; 12:20417314211035593. [PMID: 34471514 PMCID: PMC8404660 DOI: 10.1177/20417314211035593] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/12/2021] [Indexed: 11/29/2022] Open
Abstract
Adipose tissue-derived microvascular fragments (MVF) serve as vascularization units in tissue engineering and regenerative medicine. Because a three-dimensional cellular arrangement has been shown to improve cell function, we herein generated for the first time MVF spheroids to investigate whether this further increases their vascularization potential. These spheroids exhibited a morphology, size, and viability comparable to that of previously introduced stromal vascular fraction (SVF) spheroids. However, MVF spheroids contained a significantly higher number of CD31-positive endothelial cells and α-smooth muscle actin (SMA)-positive perivascular cells, resulting in an enhanced angiogenic sprouting activity. Accordingly, they also exhibited an improved in vivo vascularization and engraftment after transplantation into mouse dorsal skinfold chambers. These findings indicate that MVF spheroids are superior to SVF spheroids and, thus, may be highly suitable to improve the vascularization of tissue defects and implanted tissue constructs.
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Affiliation(s)
- Lisa Nalbach
- Institute for Clinical & Experimental Surgery, Saarland University, Homburg, Germany
| | - Danièle Müller
- Institute for Clinical & Experimental Surgery, Saarland University, Homburg, Germany
| | - Selina Wrublewsky
- Institute for Clinical & Experimental Surgery, Saarland University, Homburg, Germany
| | - Wolfgang Metzger
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Homburg, Germany
| | - Michael D Menger
- Institute for Clinical & Experimental Surgery, Saarland University, Homburg, Germany
| | - Matthias W Laschke
- Institute for Clinical & Experimental Surgery, Saarland University, Homburg, Germany
| | - Emmanuel Ampofo
- Institute for Clinical & Experimental Surgery, Saarland University, Homburg, Germany
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5
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TNF-α-Inhibition Improves the Biocompatibility of Porous Polyethylene Implants In Vivo. Tissue Eng Regen Med 2021; 18:297-303. [PMID: 33515166 PMCID: PMC8012447 DOI: 10.1007/s13770-020-00325-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/07/2020] [Accepted: 11/18/2020] [Indexed: 11/04/2022] Open
Abstract
Background:
To improve the biocompatibility of porous polyethylene (PPE) implants and expand their application range for reconstructive surgery in poorly vascularized environments, implants were coated with tumor necrosis factor α (TNFα) inhibitor Etanercept. While approved for systemic application, local application of the drug is a novel experimental approach. Microvascular and mechanical integration as well as parameters of inflammation were analyzed in vivo. Methods:
PPE implants were coated with Etanercept and extracellular matrix (ECM) components prior to implantation into dorsal skinfold chambers of C57BL/6 mice. Fluorescence microscopy analyses of angiogenesis and local inflammatory response were thrice performed in vivo over a period of 14 days to assess tissue integration and biocompatibility. Uncoated implants and ECM-coated implants served as controls. Results:
TNFα inhibition with Etanercept led to a reduced local inflammatory response: leukocyte-endothelial cell adherence was significantly lowered compared to both control groups (n = 6/group) on days 3 and 14, where the lowest values were reached: 3573.88 leukocytes/mm-2 ± 880.16 (uncoated implants) vs. 3939.09 mm-2 ± 623.34 (Matrigel only) vs. 637.98 mm-2 + 176.85 (Matrigel and Etanercept). Implant-coating with Matrigel alone and Matrigel and Etanercept led to significantly higher vessel densities 7 and 14 days vs. 3 days after implantation and compared to uncoated implants. Mechanical implant integration as measured by dynamic breaking strength did not differ after 14 days. Conclusion:
Our data show a reduced local inflammatory response to PPE implants after immunomodulatory coating with Etanercept in vivo, suggesting improved biocompatibility. Application of this tissue engineering approach is therefore warranted in models of a compromised host environment. Electronic supplementary material The online version of this article (10.1007/s13770-020-00325-w) contains supplementary material, which is available to authorized users.
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6
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Biazar E, Kamalvand M, Avani F. Recent advances in surface modification of biopolymeric nanofibrous scaffolds. INT J POLYM MATER PO 2021. [DOI: 10.1080/00914037.2020.1857383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Esmaeil Biazar
- Department of Biomaterials Engineering, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran
| | - Mahshad Kamalvand
- Department of Biomaterials Engineering, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran
| | - Farzaneh Avani
- Biomedical Engineering Faculty, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
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7
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Nalbach L, Roma LP, Schmitt BM, Becker V, Körbel C, Wrublewsky S, Pack M, Später T, Metzger W, Menger MM, Frueh FS, Götz C, Lin H, EM Fox J, MacDonald PE, Menger MD, Laschke MW, Ampofo E. Improvement of islet transplantation by the fusion of islet cells with functional blood vessels. EMBO Mol Med 2021; 13:e12616. [PMID: 33135383 PMCID: PMC7799357 DOI: 10.15252/emmm.202012616] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 12/12/2022] Open
Abstract
Pancreatic islet transplantation still represents a promising therapeutic strategy for curative treatment of type 1 diabetes mellitus. However, a limited number of organ donors and insufficient vascularization with islet engraftment failure restrict the successful transfer of this approach into clinical practice. To overcome these problems, we herein introduce a novel strategy for the generation of prevascularized islet organoids by the fusion of pancreatic islet cells with functional native microvessels. These insulin-secreting organoids exhibit a significantly higher angiogenic activity compared to freshly isolated islets, cultured islets, and non-prevascularized islet organoids. This is caused by paracrine signaling between the β-cells and the microvessels, mediated by insulin binding to its corresponding receptor on endothelial cells. In vivo, the prevascularized islet organoids are rapidly blood-perfused after transplantation by the interconnection of their autochthonous microvasculature with surrounding blood vessels. As a consequence, a lower number of islet grafts are required to restore normoglycemia in diabetic mice. Thus, prevascularized islet organoids may be used to improve the success rates of clinical islet transplantation.
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Affiliation(s)
- Lisa Nalbach
- Institute for Clinical & Experimental SurgerySaarland UniversityHomburg/SaarGermany
| | - Leticia P Roma
- Biophysics DepartmentCenter for Human and Molecular BiologySaarland UniversityHomburg/SaarGermany
| | - Beate M Schmitt
- Institute for Clinical & Experimental SurgerySaarland UniversityHomburg/SaarGermany
| | - Vivien Becker
- Institute for Clinical & Experimental SurgerySaarland UniversityHomburg/SaarGermany
| | - Christina Körbel
- Institute for Clinical & Experimental SurgerySaarland UniversityHomburg/SaarGermany
| | - Selina Wrublewsky
- Institute for Clinical & Experimental SurgerySaarland UniversityHomburg/SaarGermany
| | - Mandy Pack
- Institute for Clinical & Experimental SurgerySaarland UniversityHomburg/SaarGermany
| | - Thomas Später
- Institute for Clinical & Experimental SurgerySaarland UniversityHomburg/SaarGermany
| | - Wolfgang Metzger
- Department of Trauma, Hand and Reconstructive SurgerySaarland UniversityHomburgGermany
| | - Maximilian M Menger
- Institute for Clinical & Experimental SurgerySaarland UniversityHomburg/SaarGermany
- Departement of Trauma and Reconstructive SurgeryEberhar Karls University TuebingenTuebingenGermany
| | - Florian S Frueh
- Division of Plastic Surgery and Hand SurgeryUniversity Hospital ZurichUniversity of ZurichZurichSwitzerland
| | - Claudia Götz
- Medical Biochemistry and Molecular BiologySaarland UniversityHomburgGermany
| | - Haopeng Lin
- Department of PharmacologyAlberta Diabetes InstituteUniversity of AlbertaEdmontonABCanada
| | - Joseline EM Fox
- Department of PharmacologyAlberta Diabetes InstituteUniversity of AlbertaEdmontonABCanada
| | - Patrick E MacDonald
- Department of PharmacologyAlberta Diabetes InstituteUniversity of AlbertaEdmontonABCanada
| | - Michael D Menger
- Institute for Clinical & Experimental SurgerySaarland UniversityHomburg/SaarGermany
| | - Matthias W Laschke
- Institute for Clinical & Experimental SurgerySaarland UniversityHomburg/SaarGermany
| | - Emmanuel Ampofo
- Institute for Clinical & Experimental SurgerySaarland UniversityHomburg/SaarGermany
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Später T, Mariyanats AO, Syachina MA, Mironov AV, Savelyev AG, Sochilina AV, Menger MD, Vishnyakova PA, Kananykhina EY, Fatkhudinov TK, Sukhikh GT, Spitkovsky DD, Katsen-Globa A, Laschke MW, Popov VK. In Vitro and in Vivo Analysis of Adhesive, Anti-Inflammatory, and Proangiogenic Properties of Novel 3D Printed Hyaluronic Acid Glycidyl Methacrylate Hydrogel Scaffolds for Tissue Engineering. ACS Biomater Sci Eng 2020; 6:5744-5757. [PMID: 33320574 DOI: 10.1021/acsbiomaterials.0c00741] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
In this study, we prepared hydrogel scaffolds for tissue engineering by computer-assisted extrusion three-dimensional (3D) printing with photocured (λ = 445 nm) hyaluronic acid glycidyl methacrylate (HAGM). The developed product was compared with the polylactic-co-glycolic acid (PLGA) scaffolds generated by means of the original antisolvent 3D printing methodology. The cytotoxicity and cytocompatibility of the scaffolds were analyzed in vitro by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide tests, flow cytometry, and scanning electron microscopy. Anti-inflammatory and proangiogenic properties of the scaffolds were evaluated in the dorsal skinfold chamber mouse model by means of intravital fluorescence microscopy, histology, and immunohistochemistry throughout an observation period of 14 days. In vitro, none of the scaffolds revealed cytotoxicity on days 1, 2, and 5 after seeding with umbilical cord-derived multipotent stromal cells, and the primary cell adhesion to the surface of HAGM scaffolds was low. In vivo, implanted HAGM scaffolds showed enhanced vascularization and host tissue ingrowth, and the inflammatory response to them was less pronounced compared with PLGA scaffolds. The results indicate excellent biocompatibility and vascularization capacity of the developed 3D printed HAGM scaffolds and position them as strong candidates for advanced tissue engineering applications.
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Affiliation(s)
- Thomas Später
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Aleksandra O Mariyanats
- Institute of Photon Technologies of Federal Scientific Research Centre "Crystallography and Photonics" of Russian Academy of Sciences, 108840 Moscow, Russia
| | - Maria A Syachina
- Institute of Photon Technologies of Federal Scientific Research Centre "Crystallography and Photonics" of Russian Academy of Sciences, 108840 Moscow, Russia
| | - Anton V Mironov
- Institute of Photon Technologies of Federal Scientific Research Centre "Crystallography and Photonics" of Russian Academy of Sciences, 108840 Moscow, Russia
| | - Alexander G Savelyev
- Institute of Photon Technologies of Federal Scientific Research Centre "Crystallography and Photonics" of Russian Academy of Sciences, 108840 Moscow, Russia.,Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Anastasia V Sochilina
- Institute of Photon Technologies of Federal Scientific Research Centre "Crystallography and Photonics" of Russian Academy of Sciences, 108840 Moscow, Russia.,Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry of the Russian Academy of Sciences, 117997 Moscow, Russia
| | - Michael D Menger
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Polina A Vishnyakova
- Kulakov Scientific Center for Obstetrics, Gynecology and Perinatology of Ministry of Health of the Russian Federation, 117198 Moscow, Russia
| | | | | | - Gennady T Sukhikh
- Kulakov Scientific Center for Obstetrics, Gynecology and Perinatology of Ministry of Health of the Russian Federation, 117198 Moscow, Russia
| | - Dmitry D Spitkovsky
- Kulakov Scientific Center for Obstetrics, Gynecology and Perinatology of Ministry of Health of the Russian Federation, 117198 Moscow, Russia
| | - Alisa Katsen-Globa
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Matthias W Laschke
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Vladimir K Popov
- Institute of Photon Technologies of Federal Scientific Research Centre "Crystallography and Photonics" of Russian Academy of Sciences, 108840 Moscow, Russia
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9
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Später T, Menger MD, Laschke MW. Vascularization Strategies for Porous Polyethylene Implants. TISSUE ENGINEERING PART B-REVIEWS 2020; 27:29-38. [PMID: 32524897 DOI: 10.1089/ten.teb.2020.0077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Porous polyethylene (pPE) is a frequently implanted biomaterial in craniofacial reconstructive surgery. Its rapid vascularization and tissue incorporation are major prerequisites to prevent complications, such as material infection, migration, and extrusion. To achieve this, several sophisticated strategies have been introduced and evaluated during the last 20 years. These include (i) the angiogenic stimulation of the host tissue with epidermal growth factor, basic fibroblast growth factor or macrophage-activating lipopeptide-2, (ii) material modifications, such as increase of surface roughness and incorporation of bioactive glass particles, (iii) surface coatings with growth factors, glycoproteins, acrylic acid, arginine/glycine/aspartic acid peptide as well as components of the plasminogen activation system and autologous clotted blood or serum, and (iv) the seeding with fibroblasts, chondrocytes, stem cells, or adipose-tissue-derived microvascular fragments. The majority of these approaches showed promising results in experimental studies and, thus, may be capable of improving the success rates after pPE implantation in future clinical practice.
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Affiliation(s)
- Thomas Später
- Institute for Clinical & Experimental Surgery, Saarland University, Homburg, Germany
| | - Michael D Menger
- Institute for Clinical & Experimental Surgery, Saarland University, Homburg, Germany
| | - Matthias W Laschke
- Institute for Clinical & Experimental Surgery, Saarland University, Homburg, Germany
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10
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Später T, Tobias AL, Menger MM, Nickels RM, Menger MD, Laschke MW. Biological coating with platelet-rich plasma and adipose tissue-derived microvascular fragments improves the vascularization, biocompatibility and tissue incorporation of porous polyethylene. Acta Biomater 2020; 108:194-206. [PMID: 32194259 DOI: 10.1016/j.actbio.2020.03.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/12/2020] [Accepted: 03/12/2020] [Indexed: 01/12/2023]
Abstract
Porous polyethylene (pPE) is a commonly used biomaterial in craniofacial reconstructive surgery. However, implant failure due to insufficient vascularization represents a major issue. To overcome this problem, we herein introduce an effective strategy to improve the vascularization and incorporation of pPE. Adipose tissue-derived microvascular fragments (MVF) from transgenic green fluorescent protein (GFP)+ mice were suspended in platelet-rich plasma (PRP) for the coating of pPE. PRP/MVF-coated pPE as well as PRP-coated and uncoated controls were subsequently implanted into the dorsal skinfold chamber and the flanks of GFP- wild-type mice to analyze their in vivo performance throughout 2, 4 and 8 weeks by means of intravital fluorescence microscopy, histology and immunohistochemistry. The GFP+/GFP- cross-over design allowed the identification of GFP+ MVF within the implants. Shortly after implantation, they rapidly reassembled into new blood-perfused microvascular networks, resulting in a significantly accelerated vascularization of PRP/MVF-coated pPE when compared to both controls. The overall numbers of rolling and adherent leukocytes within the microcirculation as well as macrophages, multi-nucleated giant cells and mast cells around the implants did not differ between the three groups. However, in contrast to uncoated controls, PRP/MVF-coated and PRP-coated pPE promoted pro-angiogenic M2 macrophage polarization at the implantation site. These findings demonstrate that PRP/MVF-coating represents a highly effective strategy to enhance the vascularization, biocompatibility and tissue incorporation of pPE. STATEMENT OF SIGNIFICANCE: The clinical in vivo performance of implanted biomaterials is crucially dependent on their adequate incorporation into the body. To achieve this, we herein introduce an effective biological coating strategy. Our results demonstrate that coating with PRP and MVF accelerates and enhances the vascularization, biocompatibility and tissue incorporation of porous polyethylene. Because this type of biological coating is easily applicable on any type of biomaterial, our approach may rapidly be translated into clinical practice to improve the outcome of various regenerative approaches.
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Affiliation(s)
- Thomas Später
- Institute for Clinical and Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Anne L Tobias
- Institute for Clinical and Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Maximilian M Menger
- Institute for Clinical and Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany; Department of Trauma, Hand and Reconstructive Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Ruth M Nickels
- Institute for Clinical and Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Michael D Menger
- Institute for Clinical and Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Matthias W Laschke
- Institute for Clinical and Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany.
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11
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Vollkommer T, Henningsen A, Friedrich RE, Felthaus OH, Eder F, Morsczeck C, Smeets R, Gehmert S, Gosau M. Extent of Inflammation and Foreign Body Reaction to Porous Polyethylene In Vitro and In Vivo. In Vivo 2019; 33:337-347. [PMID: 30804110 DOI: 10.21873/invivo.11479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM High-density porous polyethylene (PP) offers possibilities for reconstruction in craniofacial surgery. The purpose of this study was to evaluate the extent of inflammation and foreign body reactions to PP in vitro and in vivo. MATERIALS AND METHODS Cell attachment, proliferation and expression of inflammatory cytokines were assessed using murine macrophages (RAW 264.7) on two different PP materials in vitro. In vivo, Balb/c mice received PP implants at their dorsum. After sacrifice, samples were analyzed histologically and real-time PCR was used to assess expression of inflammatory cytokines. RESULTS Cells showed a significantly decreased proliferation (p<0.001) after 48 h and a significantly increased expression of TNF-α (p<0.05) at 24, 48 and 72 h. All animals showed foreign body cell reactions and signs of chronic inflammation. Expression of all but one of the investigated cytokines dropped to non-significant levels after an initial increase. CONCLUSION Application of porous polyethylene can cause local chronic inflammatory reactions. Although clinical application seems to be immunologically safe, indication and risks should be evaluated carefully when using PP implants.
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Affiliation(s)
- Tobias Vollkommer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anders Henningsen
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany .,Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Oral and Maxillofacial Surgery, German Armed Forces Hospital, Hamburg, Germany
| | - Reinhard E Friedrich
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Oliver Heinrich Felthaus
- Department of Plastic, Hand and Restoration Surgery, Caritas Hospital St. Josef, Regensburg, Germany
| | | | - Christian Morsczeck
- Department of Oral and Maxillofacial Surgery, University Medical Center-Regensburg, Regensburg, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Gehmert
- Department of Orthopaedics, University Children's Hospital Basel, Basel, Switzerland
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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12
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Dudenhöffer DW, Laschke MW, Giebels C, Karliova I, Schneider U, Menger MD, Schäfers HJ. In Vivo Biocompatibility of a Novel Expanded Polytetrafluoroethylene Suture for Annuloplasty. Thorac Cardiovasc Surg 2018; 68:575-583. [PMID: 30458569 DOI: 10.1055/s-0038-1675595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Expanded polytetrafluoroethylene (ePTFE) is a suture material for annuloplasty in aortic valve repair. For this particular application, it should induce minimal local stress and promote rapid tissue incorporation. To achieve this, a novel ePTFE suture with a larger diameter and high porosity in its midsection has been developed. Herein, we analyzed the acute and chronic tissue reaction to this suture material compared with a commercially available control ePTFE suture. METHODS Novel and control suture samples were implanted into dorsal skinfold chambers of BALB/c mice to analyze the early inflammatory response using intravital fluorescence microscopy over 14 days. Additional suture samples were implanted for 4 and 12 weeks in the flank musculature of mice and analyzed by histology and immunohistochemistry. RESULTS The implantation of novel and control ePTFE suture into the dorsal skinfold chamber did not induce an acute inflammation, as indicated by physiological numbers of rolling and adherent leukocytes in all analyzed venules. Chronic implantation into the flank musculature showed a better tissue incorporation of the novel ePTFE suture with more infiltrating cells and a higher content of Sirius red+ collagen fibers when compared with controls. Cell proliferation and viability as well as numbers of recruited CD68+ macrophages, myeloperoxidase+ neutrophilic granulocytes and CD3+ lymphocytes did not significantly differ between the groups. CONCLUSION The novel ePTFE suture exhibits a good in vivo biocompatibility which is comparable to that of the control suture. Due to its improved tissue incorporation, it may provide a better long-term stability during annuloplasty.
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Affiliation(s)
- Daniel W Dudenhöffer
- Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany
| | - Matthias W Laschke
- Institute for Clinical and Experimental Surgery, Saarland University, Homburg, Germany
| | - Christian Giebels
- Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany
| | - Irem Karliova
- Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany
| | - Ulrich Schneider
- Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany
| | - Michael D Menger
- Institute for Clinical and Experimental Surgery, Saarland University, Homburg, Germany
| | - Hans-Joachim Schäfers
- Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany
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13
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Später T, Frueh FS, Metzger W, Menger MD, Laschke MW. In vivo
biocompatibility, vascularization, and incorporation of Integra®
dermal regenerative template and flowable wound matrix. J Biomed Mater Res B Appl Biomater 2016; 106:52-60. [DOI: 10.1002/jbm.b.33813] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 10/05/2016] [Accepted: 10/27/2016] [Indexed: 12/24/2022]
Affiliation(s)
- Thomas Später
- Institute for Clinical & Experimental Surgery, Saarland University; 66421 Homburg/Saar Germany
| | - Florian S. Frueh
- Institute for Clinical & Experimental Surgery, Saarland University; 66421 Homburg/Saar Germany
- Division of Plastic Surgery and Hand Surgery; University Hospital Zurich; 8091 Zurich Switzerland
| | - Wolfgang Metzger
- Department of Trauma, Hand and Reconstructive Surgery; Saarland University; 66421 Homburg/Saar Germany
| | - Michael D. Menger
- Institute for Clinical & Experimental Surgery, Saarland University; 66421 Homburg/Saar Germany
| | - Matthias W. Laschke
- Institute for Clinical & Experimental Surgery, Saarland University; 66421 Homburg/Saar Germany
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