Micro-CT evaluation of high pressure-decellularized cardiovascular tissues transplanted in rat subcutaneous accelerated-calcification model

Application of decellularized tissue for soft-hard interregional regeneration

Decellularized tissue refers to extracellular matrix (ECM) derived from living tissue by removing the cellular components and is used for tissue regeneration. Various decellularized tissue sheets and powders, such as the dermis, urinary bladder matrix, and small intestinal submucosa, have been clinically used as covering and prosthetic materials. Moreover, there is growing interest in the use of decellularized tissue for soft-hard interregional tissue regeneration, including in the ligament-bone, tendon-bone, and periodontal ligament-bone interfaces. The focus in these applications lies in the mechanical properties of the decellularized tissue. Decellularized ligaments and tendons have been developed using various decellularization methods, with a focus on maintaining their shape and mechanical properties, and have been applied orthotopically or ectopically to ligaments and tendons. In the ligament-bone interface, it is suggested that decellularized ligament and tendon are regenerated through the migration and rearrangement of host cells, which is referred to as "in situ tissue regeneration." It is also proposed that decellularized tissue can be used to prepare the complex structure of soft-hard interregional tissue, which consists of an ECM and cell populations with gradual change. In this case, the decellularized soft tissues of ligaments, tendons, pericardium, and others are fabricated and modified with hard tissue components to mimic the gradual structure of soft-hard interregional tissue. In this review, we present a detailed discussion of the regeneration of soft-hard interregional tissue using decellularized tissue.

Comparison of decellularization protocols for cultured cell-derived extracellular matrix-Effects on decellularization efficacy, extracellular matrix retention, and cell functions

The in vitro reconstruction of the extracellular matrix (ECM) is required in tissue engineering and regenerative medicine because the ECM can regulate cell functions in vivo. For ECM reconstruction, a decellularization technique is used. ECM reconstructed by decellularization (dECM) is prepared from tissues/organs and cultured cells. Although decellularization methods have been optimized for tissue-/organ-derived dECM, the methods for cultured cell-derived dECM have not yet been optimized. Here, two physical (osmotic shocks) and five chemical decellularization methods are compared. The decellularization efficacies were changed according to the decellularization methods used. Among them, only the Triton X-100 and Tween 20 treatments could not decellularize completely. Additionally, when the efficacies were compared among different types of cells (monolayered cells with/without strong cell adhesion, multilayered cells), the efficacies were decreased for multilayered cells or cells with strong cell adhesion. Retained ECM contents tended to be greater in the dECM prepared by osmotic shocks than in those prepared by chemical methods. The contents impacted cell adhesion, shapes, growth and intracellular signal activation on the dECM. The comparison would be helpful for the optimization of decellularization methods for cultured cells, and it could also provide new insights into developing milder decellularization methods for tissues and organs.

Improved hemocompatibility by modifying acellular blood vessels with bivalirudin and its biocompatibility evaluation

The incidence rate of cardiovascular diseases is increasing year by year. The demand for coronary artery bypass grafting has been very large. Acellular blood vessels have potential clinical application because of their natural vascular basis, but their biocompatibility and anticoagulant energy need to be improved. We decellularized the abdominal aorta of SD rats, and then modified with bivalirudin via polydopamine. The mechanical properties, blood compatibility, cytocompatibility, immune response, and anticoagulant properties were evaluated, and then the bivalirudin-modified acellular blood vessels were implanted into rats for remodeling evaluation in vivo. The results we got show that the bivalirudin-modified acellular blood vessels showed good cytocompatibility and blood compatibility, and its anti-inflammatory trend was dominant in the immune response. After 3 months of transplantation, the bivalirudin-modified acellular blood vessels did not easily form thrombus. It was not easy to form calcification and could make the host cells grow better. Through vascular stimulation and immunofluorescence test, we found that vascular smooth muscle cells and endothelial cells proliferated well in the bivalirudin group. Bivalirudin-modified acellular blood vessels provided new idea for small diameter tissue engineering blood vessels, and may become a potential clinical substitute for small-diameter vascular grafts.

Whole Heart Engineering: Advances and Challenges

Bioengineering a solid organ for organ replacement is a growing endeavor in regenerative medicine. Our approach - recellularization of a decellularized cadaveric organ scaffold with human cells - is currently the most promising approach to building a complex solid vascularized organ to be utilized in vivo, which remains the major unmet need and a key challenge. The 2008 publication of perfusion-based decellularization and partial recellularization of a rat heart revolutionized the tissue engineering field by showing that it was feasible to rebuild an organ using a decellularized extracellular matrix scaffold. Toward the goal of clinical translation of bioengineered tissues and organs, there is increasing recognition of the underlying need to better integrate basic science domains and industry. From the perspective of a research group focusing on whole heart engineering, we discuss the current approaches and advances in whole organ engineering research as they relate to this multidisciplinary field's 3 major pillars: organ scaffolds, large numbers of cells, and biomimetic bioreactor systems. The success of whole organ engineering will require optimization of protocols to produce biologically-active scaffolds for multiple organ systems, and further technological innovation both to produce the massive quantities of high-quality cells needed for recellularization and to engineer a bioreactor with physiologic stimuli to recapitulate organ function. Also discussed are the challenges to building an implantable vascularized solid organ.

Extracorporeal high-pressure therapy (EHPT) for malignant melanoma consisting of simultaneous tumor eradication and autologous dermal substitute preparation

Surgical resection of skin tumors leads to large defects in surrounding normal tissues, which should be reconstructed thereafter using the patient's own tissues taken from the other site. Our challenge is to solve this problem in dermal malignant melanoma (MM) by a novel process, named extracorporeal high pressure therapy (EHPT), in which the tissue containing tumor is resected and pressurized, and the treated tissue is re-transplant back to the same position as a tumor-free autologous dermal substitute. The key points are complete tumor death and preservation of native extra cellular matrix (ECM) by the hydrostatic pressure. We found that high hydrostatic pressure at 200 MPa for 10 min at room temperature is completely cytocidal against MM cells in suspension form, in monolayer form, and even in the solid tumor form. MM tumor-bearing nude mice were established by injected human MM cells intradermally and treated by EHTP. The denaturation of the dermal extra cellular matrices was so mild that the pressurized skin was well engrafted as tumor free autologous dermal tissues, resulting in the complete eradication of the MM without any unnecessary skin reconstruction surgery. This very simple and short pressing treatment was proved to make the tumor tissue to the transplantable and tumor-free autologous dermal substitute, which can be applicable to the other temporally resectable tissues.

Airway reconstruction using decellularized tracheal allografts in a porcine model

PURPOSE

Tracheal cartilage reconstruction is an essential approach for the treatment of tracheal congenital abnormalities or injury. Here, we evaluated the use of allogeneic decellularized tracheas as novel support scaffolds.

METHODS

Six weaned pigs (4-week-old domestic males) were transplanted with allogeneic tracheal graft patches (three decellularized and three fresh tracheal scaffolds) onto artificial defects (approximately 15 × 15 mm). After 11 weeks, the tracheas were evaluated by bronchoscopy and histological studies.

RESULTS

No pigs displayed airway symptoms during the observation period. Tracheal lumen restored by fresh graft patches showed more advanced narrowing than that treated with decellularized grafts by bronchoscopy. Histologically, fresh grafts induced typical cellular rejection; this was decreased with decellularized grafts. In addition, immunohistochemistry demonstrated regenerating foci of recipient cartilage along the adjacent surface of decellularized tracheal grafts.

CONCLUSION

Decellularized allogeneic tracheal scaffolds could be effective materials for restoring impaired trachea.