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A Novel Window into Angiogenesis-Intravital Microscopy in the AV-Loop-Model. Cells 2023; 12:cells12020261. [PMID: 36672196 PMCID: PMC9857023 DOI: 10.3390/cells12020261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
Due to the limitations of current in vivo experimental designs, our comprehensive knowledge of vascular development and its implications for the development of large-scale engineered tissue constructs is very limited. Therefore, the purpose of this study was to develop unique in vivo imaging chambers that allow the live visualization of cellular processes in the arteriovenous (AV) loop model in rats. We have developed two different types of chambers. Chamber A is installed in the skin using the purse sting fixing method, while chamber B is installed subcutaneously under the skin. Both chambers are filled with modified gelatin hydrogel as a matrix. Intravital microscopy (IVM) was performed after the injection of fluorescein isothiocyanate (FITC)-labeled dextran and rhodamine 6G dye. The AV loop was functional for two weeks in chamber A and allowed visualization of the leukocyte trafficking. In chamber B, microvascular development in the AV loop could be examined for 21 days. Quantification of the microvascular outgrowth was performed using Fiji-ImageJ. Overall, by combining these two IVM chambers, we can comprehensively understand vascular development in the AV loop tissue engineering model¯.
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Paré A, Charbonnier B, Veziers J, Vignes C, Dutilleul M, De Pinieux G, Laure B, Bossard A, Saucet-Zerbib A, Touzot-Jourde G, Weiss P, Corre P, Gauthier O, Marchat D. Standardized and axially vascularized calcium phosphate-based implants for segmental mandibular defects: A promising proof of concept. Acta Biomater 2022; 154:626-640. [PMID: 36210043 DOI: 10.1016/j.actbio.2022.09.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/09/2022] [Accepted: 09/28/2022] [Indexed: 12/14/2022]
Abstract
The reconstruction of massive segmental mandibular bone defects (SMDs) remains challenging even today; the current gold standard in human clinics being vascularized bone transplantation (VBT). As alternative to this onerous approach, bone tissue engineering strategies have been widely investigated. However, they displayed limited clinical success, particularly in failing to address the essential problem of quick vascularization of the implant. Although routinely used in clinics, the insertion of intrinsic vascularization in bioengineered constructs for the rapid formation of a feeding angiosome remains uncommon. In a clinically relevant model (sheep), a custom calcium phosphate-based bioceramic soaked with autologous bone marrow and perfused by an arteriovenous loop was tested to regenerate a massive SMD and was compared to VBT (clinical standard). Animals did not support well the VBT treatment, and the study was aborted 2 weeks after surgery due to ethical and animal welfare considerations. SMD regeneration was successful with the custom vascularized bone construct. Implants were well osseointegrated and vascularized after only 3 months of implantation and totally entrapped in lamellar bone after 12 months; a healthy yellow bone marrow filled the remaining space. STATEMENT OF SIGNIFICANCE: Regenerative medicine struggles with the generation of large functional bone volume. Among them segmental mandibular defects are particularly challenging to restore. The standard of care, based on bone free flaps, still displays ethical and technical drawbacks (e.g., donor site morbidity). Modern engineering technologies (e.g., 3D printing, digital chain) were combined to relevant surgical techniques to provide a pre-clinical proof of concept, investigating for the benefits of such a strategy in bone-related regenerative field. Results proved that a synthetic-biologics-free approach is able to regenerate a critical size segmental mandibular defect of 15 cm3 in a relevant preclinical model, mimicking real life scenarii of segmental mandibular defect, with a full physiological regeneration of the defect after 12 months.
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Affiliation(s)
- Arnaud Paré
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; Department of Maxillofacial and Plastic surgery, Burn Unit, University Hospital of Tours, Trousseau Hospital, Avenue de la République, Chambray lès Tours 37170, France
| | - Baptiste Charbonnier
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; Mines Saint-Étienne, Univ Jean Monnet, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France
| | - Joëlle Veziers
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Caroline Vignes
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Maeva Dutilleul
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Gonzague De Pinieux
- Department of Pathology, University Hospital of Tours, Trousseau Hospital, Avenue de la République, Chambray lès Tours 37170, France
| | - Boris Laure
- Department of Maxillofacial and Plastic surgery, Burn Unit, University Hospital of Tours, Trousseau Hospital, Avenue de la République, Chambray lès Tours 37170, France
| | - Adeline Bossard
- ONIRIS Nantes-Atlantic College of Veterinary Medicine, Research Center of Preclinical Invesitagtion (CRIP), Site de la Chantrerie, 101 route de Gachet, Nantes 44307, France
| | - Annaëlle Saucet-Zerbib
- ONIRIS Nantes-Atlantic College of Veterinary Medicine, Research Center of Preclinical Invesitagtion (CRIP), Site de la Chantrerie, 101 route de Gachet, Nantes 44307, France
| | - Gwenola Touzot-Jourde
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; ONIRIS Nantes-Atlantic College of Veterinary Medicine, Research Center of Preclinical Invesitagtion (CRIP), Site de la Chantrerie, 101 route de Gachet, Nantes 44307, France
| | - Pierre Weiss
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Pierre Corre
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; Clinique de Stomatologie et Chirurgie Maxillo-Faciale, Nantes University Hospital, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Olivier Gauthier
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; ONIRIS Nantes-Atlantic College of Veterinary Medicine, Research Center of Preclinical Invesitagtion (CRIP), Site de la Chantrerie, 101 route de Gachet, Nantes 44307, France
| | - David Marchat
- Mines Saint-Étienne, Univ Jean Monnet, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France.
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Tsiklin IL, Shabunin AV, Kolsanov AV, Volova LT. In Vivo Bone Tissue Engineering Strategies: Advances and Prospects. Polymers (Basel) 2022; 14:polym14153222. [PMID: 35956735 PMCID: PMC9370883 DOI: 10.3390/polym14153222] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/25/2022] [Accepted: 08/04/2022] [Indexed: 12/12/2022] Open
Abstract
Reconstruction of critical-sized bone defects remains a tremendous challenge for surgeons worldwide. Despite the variety of surgical techniques, current clinical strategies for bone defect repair demonstrate significant limitations and drawbacks, including donor-site morbidity, poor anatomical match, insufficient bone volume, bone graft resorption, and rejection. Bone tissue engineering (BTE) has emerged as a novel approach to guided bone tissue regeneration. BTE focuses on in vitro manipulations with seed cells, growth factors and bioactive scaffolds using bioreactors. The successful clinical translation of BTE requires overcoming a number of significant challenges. Currently, insufficient vascularization is the critical limitation for viability of the bone tissue-engineered construct. Furthermore, efficacy and safety of the scaffolds cell-seeding and exogenous growth factors administration are still controversial. The in vivo bioreactor principle (IVB) is an exceptionally promising concept for the in vivo bone tissue regeneration in a predictable patient-specific manner. This concept is based on the self-regenerative capacity of the human body, and combines flap prefabrication and axial vascularization strategies. Multiple experimental studies on in vivo BTE strategies presented in this review demonstrate the efficacy of this approach. Routine clinical application of the in vivo bioreactor principle is the future direction of BTE; however, it requires further investigation for overcoming some significant limitations.
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Affiliation(s)
- Ilya L. Tsiklin
- Biotechnology Center “Biotech”, Samara State Medical University, 443079 Samara, Russia
- City Clinical Hospital Botkin, Moscow Healthcare Department, 125284 Moscow, Russia
- Correspondence: ; Tel.: +7-903-621-81-88
| | - Aleksey V. Shabunin
- City Clinical Hospital Botkin, Moscow Healthcare Department, 125284 Moscow, Russia
| | - Alexandr V. Kolsanov
- Biotechnology Center “Biotech”, Samara State Medical University, 443079 Samara, Russia
| | - Larisa T. Volova
- Biotechnology Center “Biotech”, Samara State Medical University, 443079 Samara, Russia
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Vaghela R, Arkudas A, Gage D, Körner C, von Hörsten S, Salehi S, Horch RE, Hessenauer M. Microvascular development in the rat arteriovenous loop model in vivo-A step by step intravital microscopy analysis. J Biomed Mater Res A 2022; 110:1551-1563. [PMID: 35484827 DOI: 10.1002/jbm.a.37395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/27/2022] [Accepted: 04/18/2022] [Indexed: 12/21/2022]
Abstract
The arteriovenous (AV) loop model is a key technique to solve one of the major problems of tissue engineering-providing adequate vascular support for a tissue construct of significant size. However, the molecular and cellular mechanisms of vascularization and factors influencing the generation of new tissue in the AV loop are still poorly understood. We previously established a novel intravital microscopy approach to study these events. In this study, we implanted our observation chamber filled with two types of hydrogels such as fibrin and methacrylate gelatin (GelMA) and performed intravital microscopy (IVM) on days 7, 14, and 21. Initial microvessel formation was observed in GelMA on day 14, while the vessel network showed clear indicators of network rearrangement and maturation on day 21. No visible microvessels were observed in fibrin. The chambers were explanted on day 21. Histological examination revealed higher numbers of microvessels in GelMA compared to fibrin, while the AV loop was thrombosed in all fibrin constructs, possibly due to matrix degradation. GelMA proved to be an ideal matrix for IVM studies in the AV loop model due to its slow degradation and transparency. This IVM model can be employed as a novel tool for live and thus faster comprehension of crucial events in the tissue regeneration process, which can improve tissue engineering application.
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Affiliation(s)
- Ravikumar Vaghela
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Daniel Gage
- Department of Materials Science and Engineering for Metals, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Carolin Körner
- Department of Materials Science and Engineering for Metals, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Stephan von Hörsten
- Department of Experimental Therapy, University Hospital Erlangen and Preclinical Experimental Animal Center, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Sahar Salehi
- Department of Biomaterials, University of Bayreuth, Bayreuth, Germany
| | - Raymund E Horch
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Maximilian Hessenauer
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Erlangen, Germany
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Steiner D, Reinhardt L, Fischer L, Popp V, Körner C, Geppert CI, Bäuerle T, Horch RE, Arkudas A. Impact of Endothelial Progenitor Cells in the Vascularization of Osteogenic Scaffolds. Cells 2022; 11:cells11060926. [PMID: 35326377 PMCID: PMC8946714 DOI: 10.3390/cells11060926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 02/06/2023] Open
Abstract
The microvascular endothelial network plays an important role in osteogenesis, bone regeneration and bone tissue engineering. Endothelial progenitor cells (EPCs) display a high angiogenic and vasculogenic potential. The endothelialization of scaffolds with endothelial progenitor cells supports vascularization and tissue formation. In addition, EPCs enhance the osteogenic differentiation and bone formation of mesenchymal stem cells (MSCs). This study aimed to investigate the impact of EPCs on vascularization and bone formation of a hydroxyapatite (HA) and beta-tricalcium phosphate (ß-TCP)–fibrin scaffold. Three groups were designed: a scaffold-only group (A), a scaffold and EPC group (B), and a scaffold and EPC/MSC group (C). The HA/ß–TCP–fibrin scaffolds were placed in a porous titanium chamber permitting extrinsic vascularization from the surrounding tissue. Additionally, intrinsic vascularization was achieved by means of an arteriovenous loop (AV loop). After 12 weeks, the specimens were explanted and investigated by histology and CT. We were able to prove a strong scaffold vascularization in all groups. No differences regarding the vessel number and density were detected between the groups. Moreover, we were able to prove bone formation in the coimplantation group. Taken together, the AV loop is a powerful tool for vascularization which is independent from scaffold cellularization with endothelial progenitor cells’ prior implantation.
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Affiliation(s)
- Dominik Steiner
- Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.R.); (L.F.); (R.E.H.); (A.A.)
- Correspondence:
| | - Lea Reinhardt
- Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.R.); (L.F.); (R.E.H.); (A.A.)
| | - Laura Fischer
- Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.R.); (L.F.); (R.E.H.); (A.A.)
| | - Vanessa Popp
- Preclinical Imaging Platform Erlangen (PIPE), Institute of Radiology, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (V.P.); (T.B.)
| | - Carolin Körner
- Department of Materials Science and Engineering, Institute of Science and Technology of Metals, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91058 Erlangen, Germany;
| | - Carol I. Geppert
- Institute of Pathology, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany
| | - Tobias Bäuerle
- Preclinical Imaging Platform Erlangen (PIPE), Institute of Radiology, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (V.P.); (T.B.)
| | - Raymund E. Horch
- Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.R.); (L.F.); (R.E.H.); (A.A.)
| | - Andreas Arkudas
- Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.R.); (L.F.); (R.E.H.); (A.A.)
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Zhao ZH, Ma XL, Ma JX, Kang JY, Zhang Y, Guo Y. Sustained release of naringin from silk-fibroin-nanohydroxyapatite scaffold for the enhancement of bone regeneration. Mater Today Bio 2022; 13:100206. [PMID: 35128373 PMCID: PMC8808263 DOI: 10.1016/j.mtbio.2022.100206] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 12/14/2022] Open
Abstract
Bone defects are a common challenge in the clinical setting. Bone tissue engineering (BTE) is an effective treatment for the clinical problem of large bone defects. In this study, we fabricated silk fibroin (SF)/hydroxyapatite (HAp) scaffolds inlaid with naringin poly lactic-co-glycolic acid (PLGA) microspheres, investigating the feasibility of their application in BTE. Naringin PLGA microspheres were manufactured and adhered to the SF/HAp scaffold. Bone mesenchymal stem cells (BMSCs) were inoculated onto the SF/HAp scaffold containing naringin PLGA microsphere to examine the biocompatibility of the SF/HAp scaffolds. A rabbit femoral distal bone defect model was used to evaluate the in vivo function of the SF/HAp scaffolds containing naringin-loaded PLGA microspheres. The current study demonstrated that SF/HAp scaffolds containing naringin-loaded PLGA microspheres show promise as osteo-modulatory biomaterials for bone regeneration.
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Key Words
- ALP, Alkaline phosphatase activity
- ANOVA, one-way analysis of variance
- BMSCs, Bone mesenchymal stem cells
- BP, biological process
- BTE, Bone tissue engineering
- Bone defect
- CC, cellular component
- CCK-8, Cell count kit-8
- DAVID, database for annotation, visualization, and integrated discovery
- GO, Gene ontology
- HAp, hydroxyapatite
- HUVEC, human umbilical endothelial cells
- Hydroxyapatite
- KEGG, Kyoto Encyclopedia of Genes and Genomes
- MF, molecular function
- Microsphere
- Naringin
- PLGA
- PLGA, poly lactic-co-glycolic acid
- PVA, Polyvinyl alcohol
- RNA-Seq, RNA sequencing
- RT-PCR, real-time quantitative polymerase chain reaction
- SEM, scanning electron microscopy
- SF, silk fibroin
- Silk
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Affiliation(s)
- Zhi-hu Zhao
- Department of Orthopaedics, Tianjin Hospital, No. 406, Jiefangnan Road, Hexi District, Tianjin, 300000, China
| | - Xin-long Ma
- Department of Orthopaedics, Tianjin Hospital, No. 406, Jiefangnan Road, Hexi District, Tianjin, 300000, China
| | - Jian-xiong Ma
- Tianjin Institute of Orthopedics in Traditional Chinese and Western Medicine, No. 122, Munan Road, Tianjin, 300050, China
| | - Jia-yu Kang
- Department of Orthopedics, Jinhua Municipal Central Hospital, Jinhua, Zhejiang Province, China
| | - Yang Zhang
- Tianjin Institute of Orthopedics in Traditional Chinese and Western Medicine, No. 122, Munan Road, Tianjin, 300050, China
| | - Yue Guo
- Tianjin Institute of Orthopedics in Traditional Chinese and Western Medicine, No. 122, Munan Road, Tianjin, 300050, China
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Rottensteiner-Brandl U, Bertram U, Lingens LF, Köhn K, Distel L, Fey T, Körner C, Horch RE, Arkudas A. Free Transplantation of a Tissue Engineered Bone Graft into an Irradiated, Critical-Size Femoral Defect in Rats. Cells 2021; 10:cells10092256. [PMID: 34571907 PMCID: PMC8467400 DOI: 10.3390/cells10092256] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 01/09/2023] Open
Abstract
Healing of large bone defects remains a challenge in reconstructive surgery, especially with impaired healing potential due to severe trauma, infection or irradiation. In vivo studies are often performed in healthy animals, which might not accurately reflect the situation in clinical cases. In the present study, we successfully combined a critical-sized femoral defect model with an ionizing radiation protocol in rats. To support bone healing, tissue-engineered constructs were transferred into the defect after ectopic preossification and prevascularization. The combination of SiHA, MSCs and BMP-2 resulted in the significant ectopic formation of bone tissue, which can easily be transferred by means of our custom-made titanium chamber. Implanted osteogenic MSCs survived in vivo for a total of 18 weeks. The use of SiHA alone did not lead to bone formation after ectopic implantation. Analysis of gene expression showed early osteoblast differentiation and a hypoxic and inflammatory environment in implanted constructs. Irradiation led to impaired bone healing, decreased vascularization and lower short-term survival of implanted cells. We conclude that our model is highly valuable for the investigation of bone healing and tissue engineering in pre-damaged tissue and that healing of bone defects can be substantially supported by combining SiHA, MSCs and BMP-2.
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Affiliation(s)
- Ulrike Rottensteiner-Brandl
- Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (U.R.-B.); (U.B.); (L.F.L.); (K.K.); (R.E.H.)
- Emil-Fischer Zentrum, Institute of Biochemistry, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Ulf Bertram
- Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (U.R.-B.); (U.B.); (L.F.L.); (K.K.); (R.E.H.)
- Department of Neurosurgery, RWTH Aachen University, 52074 Aachen, Germany
| | - Lara F. Lingens
- Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (U.R.-B.); (U.B.); (L.F.L.); (K.K.); (R.E.H.)
- Hand Surgery—Burn Center, Department of Plastic Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Katrin Köhn
- Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (U.R.-B.); (U.B.); (L.F.L.); (K.K.); (R.E.H.)
| | - Luitpold Distel
- Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Tobias Fey
- Department of Materials Science and Engineering, Institute of Glass and Ceramics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
- Frontier Research Institute for Materials Science, Nagoya Institute of Technology, Nagoya 466-8555, Japan
| | - Carolin Körner
- Department of Materials Science and Engineering, Institute of Science and Technology of Metals, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Raymund E. Horch
- Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (U.R.-B.); (U.B.); (L.F.L.); (K.K.); (R.E.H.)
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (U.R.-B.); (U.B.); (L.F.L.); (K.K.); (R.E.H.)
- Correspondence: ; Tel.: +49-9131-8533277
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8
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The Adipose-Derived Stem Cell and Endothelial Cell Coculture System-Role of Growth Factors? Cells 2021; 10:cells10082074. [PMID: 34440843 PMCID: PMC8394058 DOI: 10.3390/cells10082074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/10/2021] [Indexed: 01/17/2023] Open
Abstract
Adequate vascularization is a fundamental prerequisite for bone regeneration, formation and tissue engineering applications. Endothelialization of scaffold materials is a promising strategy to support neovascularization and bone tissue formation. Besides oxygen and nutrition supply, the endothelial network plays an important role concerning osteogenic differentiation of osteoprogenitor cells and consecutive bone formation. In this study we aimed to enhance the growth stimulating, proangiogenic and osteogenic features of the ADSC and HUVEC coculture system by means of VEGFA165 and BMP2 application. We were able to show that sprouting phenomena and osteogenic differentiation were enhanced in the ADSC/HUVEC coculture. Furthermore, apoptosis was unidirectionally decreased in HUVECs, but these effects were not further enhanced upon VEGFA165 or BMP2 application. In summary, the ADSC/HUVEC coculture system per se is a powerful tool for bone tissue engineering applications.
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Hessenauer M, Vaghela R, Körner C, von Hörsten S, Pobel C, Gage D, Müller C, Salehi S, Horch RE, Arkudas A. Watching the Vessels Grow: Establishment of Intravital Microscopy in the Arteriovenous Loop Rat Model. Tissue Eng Part C Methods 2021; 27:357-365. [PMID: 33906430 DOI: 10.1089/ten.tec.2021.0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Tissue engineering in reconstructive surgery seeks to generate bioartificial tissue substitutes. The arteriovenous (AV) loop allows the generation of axially vascularized tissue constructs. Cellular mechanisms of this vascularization process are largely unclear. In this study, we developed two different chamber models for intravital microscopy and imaging of the AV loop in the rat. Multiple design variations were implanted and the stability of the chamber and AV loop patency was tested in vivo. Our novel chamber facilitates repetitive observation of the AV loop using fluorescence-enhanced intravital microscopy. This technique can be used for daily evaluation of leukocyte-endothelial cell interactions, vascularization, and tissue formation in the AV loop model on 14 consecutive days. Therefore, our newly developed model for intravital microscopy will provide better understanding of cellular and molecular processes in tissue engineering in the AV loop. Moreover, it supports initiation of the novel approaches for therapeutic applications. Impact statement In the Arteriovenous (AV) loop, axially vascularized tissue can be generated and modified using different tissue engineering approaches. Cellular mechanisms of this vascularization process are largely unclear. We managed to develop an intravital microscopy model for long-term observation of intravascular and perivascular events in the AV loop. Leukocyte-endothelial cell interactions, vascularization, and tissue formation in the AV loop can now be evaluated on a day-to-day basis. This will provide better understanding of cellular and molecular processes happening during tissue engineering within the AV loop.
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Affiliation(s)
- Maximilian Hessenauer
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ravikumar Vaghela
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Carolin Körner
- Department of Materials Science and Engineering for Metals, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Stephan von Hörsten
- Department of Experimental Therapy, University Hospital Erlangen and Preclinical Experimental Animal Center, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Christoph Pobel
- Department of Materials Science and Engineering for Metals, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Daniel Gage
- Department of Materials Science and Engineering for Metals, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Claudia Müller
- Department of Biomaterials, University of Bayreuth, Bayreuth, Germany
| | - Sahar Salehi
- Department of Biomaterials, University of Bayreuth, Bayreuth, Germany
| | - Raymund E Horch
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Erlangen, Germany
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10
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Horch RE, Schmitz M, Kreuzer M, Arkudas A, Ludolph I, Müller-Seubert W. External Screw-Threaded Traction Device Helps Optimize Finger Joint Mobility in Severe Stage III and IV Dupuytren Disease. Med Sci Monit 2021; 27:e929814. [PMID: 33883543 PMCID: PMC8078024 DOI: 10.12659/msm.929814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Treating advanced finger joint contractures from Dupuytren disease remains a challenge. We evaluated the effectiveness of a skeletal distraction device versus alternative treatment options. Material/Methods We analyzed the surgical treatment of contracted finger joints in stage III and stage IV Dupuytren’s disease over a 10-year period. Data were obtained from inpatient and outpatient medical records, including postoperative clinical examinations and extended Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire scores. Complications of infection, postoperative pain, and wound healing disorders were recorded. Results A total of 79 patients (83 hands) were assigned to 2 treatment groups. Patients in group 1 underwent an initial open transection of the main fibrous cord, Z-plasty, distraction with the Erlangen external distraction device, and fasciectomy. The distraction period was 13 to 81 days (mean 31 days). Group 2 underwent a conventional single-stage fasciectomy and arthrolysis. DASH scores and subjective patient satisfaction were lower in group 1 (20.7/33%) than in group 2 (10.3/50%). However, the staged approach of group 1 to treat proximal interphalangeal joint contractures in the long term (improvement >40%) was more effective than the approach of group 2 (>33%). Distraction device pin infections occurred in 20% of hands. Postoperative pain and complex regional pain syndrome type I occurred in 25% of hands in group 1 and 3% in group 2. Conclusions A screw thread driven external fixation device is useful in end-stage Dupuytren’s finger joint contractures. It is indicated when joint contractures are advanced and simple arthrolysis is insufficient.
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Affiliation(s)
- Raymund E Horch
- Department of Plastic and Hand Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Marweh Schmitz
- Department of Plastic and Hand Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Maria Kreuzer
- Department of Geriatric Medicine, Klinikum St. Marien Amberg, Amberg, Germany
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ingo Ludolph
- Department of Plastic and Hand Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Wibke Müller-Seubert
- Department of Plastic and Hand Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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11
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Cai H, Zou J, Wang W, Yang A. BMP2 induces hMSC osteogenesis and matrix remodeling. Mol Med Rep 2020; 23:125. [PMID: 33300084 PMCID: PMC7751477 DOI: 10.3892/mmr.2020.11764] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 11/04/2020] [Indexed: 12/16/2022] Open
Abstract
With increasing age, the microenvironment in the bone marrow is altered, leading to a decrease in bone marrow mesenchymal stem cell (BMSC) differentiation, which reduces the number of bone cells and weakens osteogenic capacity, resulting in osteoporosis (OP). The clinical manifestations of OP include bone loss, bone microstructural destruction and altered bone quality. Bone morphogenetic protein 2 (BMP2) serves an important role in inducing the osteogenic differentiation of mesenchymal stem cells (MSCs). Regulating the bone marrow matrix microenvironment and promoting osteogenic differentiation of BMSCs is of significance for both the prevention and treatment of OP. In the present study, isobaric tags for relative and absolute quantification (iTRAQ) high‑throughput proteomics technology was combined with bioinformatics analysis to screen 249 differentially expressed proteins in human MSCs overexpressing BMP2, of which 173 were upregulated and 76 proteins were downregulated. The proteins were also involved in signaling pathways associated with extracellular matrix organization, osteoblast differentiation, ossification, bone development, chondrocyte differentiation and bone morphogenesis. By carefully screening the proteins, N‑cadherin (CDH2), a protein with osteogenic differentiation potential, was verified by perturbations in the background of BMP2 overexpression. The role of CDH3 in the osteogenic differentiation of MSCs was confirmed by the regulation of several cognate osteogenic markers, suggesting CDH2 as a promising candidate in the field of osteogenesis.
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Affiliation(s)
- Hantao Cai
- Department of First Clinical College, Hubei University of Chinese Medicine, Wuhan, Hubei 430061, P.R. China
| | - Ji Zou
- Department of First Clinical College, Hubei University of Chinese Medicine, Wuhan, Hubei 430061, P.R. China
| | - Wei Wang
- Department of First Clinical College, Hubei University of Chinese Medicine, Wuhan, Hubei 430061, P.R. China
| | - Aofei Yang
- Department of Orthopedics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei 430061, P.R. China
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12
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Winkler S, Mutschall H, Biggemann J, Fey T, Greil P, Körner C, Weisbach V, Meyer-Lindenberg A, Arkudas A, Horch RE, Steiner D. Human Umbilical Vein Endothelial Cell Support Bone Formation of Adipose-Derived Stem Cell-Loaded and 3D-Printed Osteogenic Matrices in the Arteriovenous Loop Model. Tissue Eng Part A 2020; 27:413-423. [PMID: 32723066 DOI: 10.1089/ten.tea.2020.0087] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Introduction: For the regeneration of large volume tissue defects, the interaction between angiogenesis and osteogenesis is a crucial prerequisite. The surgically induced angiogenesis by means of an arteriovenous loop (AVL), is a powerful methodology to enhance vascularization of osteogenic matrices. Moreover, the AVL increases oxygen and nutrition supply, thereby supporting cell survival as well as tissue formation. Adipose-derived stem cells (ADSCs) are interesting cell sources because of their simple isolation, expansion, and their osteogenic potential. This study targets to investigate the coimplantation of human ADSCs after osteogenic differentiation and human umbilical vein endothelial cells (HUVECs), embedded in a vascularized osteogenic matrix of hydroxyapatite (HAp) ceramic for bone tissue engineering. Materials and Methods: An osteogenic matrix consisting of HAp granules and fibrin has been vascularized by means of an AVL. Trials in experimental groups of four settings were performed. Control experiments without any cells (A) and three cell-loaded groups using HUVECs (B), ADSCs (C), as well as the combination of ADSCs and HUVECs (D) were performed. The scaffolds were implanted in a porous titanium chamber, fixed subcutaneously in the hind leg of immunodeficient Rowett Nude rats and explanted after 6 weeks. Results: In all groups, the osteogenic matrix was strongly vascularized. Moreover, remodeling processes and bone formation in the cell-containing groups with more bone in the coimplantation group were proved successful. Conclusion: Vascularization and bone formation of osteogenic matrices consisting of ADSCs and HUVECs in the rat AVL model could be demonstrated successfully for the first time. Hence, the coimplantation of differentiated ADSCs with HUVECs may therefore be considered as a promising approach for bone tissue engineering.
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Affiliation(s)
- Sophie Winkler
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University Munich, München, Germany
| | - Hilkea Mutschall
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Jonas Biggemann
- Department of Materials Science and Engineering, Institute of Glass and Ceramics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Tobias Fey
- Department of Materials Science and Engineering, Institute of Glass and Ceramics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Frontier Research Institute for Materials Science, Nagoya Institute of Technology, Nagoya, Japan
| | - Peter Greil
- Department of Materials Science and Engineering, Institute of Glass and Ceramics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Carolin Körner
- Department of Materials Science and Engineering, Institute of Science and Technology of Metals, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Volker Weisbach
- Department of Transfusion Medicine and Hemostaseology, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andrea Meyer-Lindenberg
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University Munich, München, Germany
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Raymund E Horch
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Dominik Steiner
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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13
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Menger MM, Laschke MW, Orth M, Pohlemann T, Menger MD, Histing T. Vascularization Strategies in the Prevention of Nonunion Formation. TISSUE ENGINEERING PART B-REVIEWS 2020; 27:107-132. [PMID: 32635857 DOI: 10.1089/ten.teb.2020.0111] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Delayed healing and nonunion formation are major challenges in orthopedic surgery, which require the development of novel treatment strategies. Vascularization is considered one of the major prerequisites for successful bone healing, providing an adequate nutrient supply and allowing the infiltration of progenitor cells to the fracture site. Hence, during the last decade, a considerable number of studies have focused on the evaluation of vascularization strategies to prevent or to treat nonunion formation. These involve (1) biophysical applications, (2) systemic pharmacological interventions, and (3) tissue engineering, including sophisticated scaffold materials, local growth factor delivery systems, cell-based techniques, and surgical vascularization approaches. Accumulating evidence indicates that in nonunions, these strategies are indeed capable of improving the process of bone healing. The major challenge for the future will now be the translation of these strategies into clinical practice to make them accessible for the majority of patients. If this succeeds, these vascularization strategies may markedly reduce the incidence of nonunion formation. Impact statement Delayed healing and nonunion formation are a major clinical problem in orthopedic surgery. This review provides an overview of vascularization strategies for the prevention and treatment of nonunions. The successful translation of these strategies in clinical practice is of major importance to achieve adequate bone healing.
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Affiliation(s)
- Maximilian M Menger
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Homburg, Germany
| | - Matthias W Laschke
- Institute for Clinical & Experimental Surgery, Saarland University, Homburg, Germany
| | - Marcel Orth
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Homburg, Germany
| | - Tim Pohlemann
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Homburg, Germany
| | - Michael D Menger
- Institute for Clinical & Experimental Surgery, Saarland University, Homburg, Germany
| | - Tina Histing
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Homburg, Germany
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14
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Mutschall H, Winkler S, Weisbach V, Arkudas A, Horch RE, Steiner D. Bone tissue engineering using adipose-derived stem cells and endothelial cells: Effects of the cell ratio. J Cell Mol Med 2020; 24:7034-7043. [PMID: 32394620 PMCID: PMC7299704 DOI: 10.1111/jcmm.15374] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/06/2020] [Accepted: 04/22/2020] [Indexed: 12/29/2022] Open
Abstract
The microvascular endothelial network is essential for bone formation and regeneration. In this context, endothelial cells not only support vascularization but also influence bone physiology via cell contact-dependent mechanisms. In order to improve vascularization and osteogenesis in tissue engineering applications, several strategies have been developed. One promising approach is the coapplication of endothelial and adipose derived stem cells (ADSCs). In this study, we aimed at investigating the best ratio of human umbilical vein endothelial cells (HUVECs) and osteogenic differentiated ADSCs with regard to proliferation, apoptosis, osteogenesis and angiogenesis. For this purpose, cocultures of ADSCs and HUVECs with ratios of 25%:75%, 50%:50% and 75%:25% were performed. We were able to prove that cocultivation supports proliferation whereas apoptosis was unidirectional decreased in cocultured HUVECs mediated by a p-BAD-dependent mechanism. Moreover, coculturing ADSCs and HUVECs stimulated matrix mineralization and the activity of alkaline phosphatase (ALP). Increased gene expression of the proangiogenic markers eNOS, Flt, Ang2 and MMP3 as well as sprouting phenomena in matrigel assays proved the angiogenic potential of the coculture. In summary, coculturing ADSCs and HUVECs stimulates proliferation, cell survival, osteogenesis and angiogenesis particularly in the 50%:50% coculture.
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Affiliation(s)
- Hilkea Mutschall
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Sophie Winkler
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Volker Weisbach
- Department of Transfusion Medicine, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Raymund E Horch
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Dominik Steiner
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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15
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Rnjak‐Kovacina J, Gerrand Y, Wray LS, Tan B, Joukhdar H, Kaplan DL, Morrison WA, Mitchell GM. Vascular Pedicle and Microchannels: Simple Methods Toward Effective In Vivo Vascularization of 3D Scaffolds. Adv Healthc Mater 2019; 8:e1901106. [PMID: 31714024 DOI: 10.1002/adhm.201901106] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/03/2019] [Indexed: 12/28/2022]
Abstract
Poor vascularization remains a key limiting factor in translating advances in tissue engineering to clinical applications. Vascular pedicles (large arteries and veins) isolated in plastic chambers are known to sprout an extensive capillary network. This study examined the effect vascular pedicles and scaffold architecture have on vascularization and tissue integration of implanted silk scaffolds. Porous silk scaffolds with or without microchannels are manufactured to support implantation of a central vascular pedicle, without a chamber, implanted in the groin of Sprague Dawley rats, and assessed morphologically and morphometrically at 2 and 6 weeks. At both time points, blood vessels, connective tissue, and an inflammatory response infiltrate all scaffold pores externally, and centrally when a vascular pedicle is implanted. At week 2, vascular pedicles significantly increase the degree of scaffold tissue infiltration, and both the pedicle and the scaffold microchannels significantly increase vascular volume and vascular density. Interestingly, microchannels contribute to increased scaffold vascularity without affecting overall tissue infiltration, suggesting a direct effect of biomaterial architecture on vascularization. The inclusion of pedicles and microchannels are simple and effective proangiogenic techniques for engineering thick tissue constructs as both increase the speed of construct vascularization in the early weeks post in vivo implantation.
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Affiliation(s)
- Jelena Rnjak‐Kovacina
- Department of Biomedical EngineeringTufts University Medford MA 02155 USA
- Graduate School of Biomedical EngineeringUniversity of New South Wales Sydney NSW 2052 Australia
| | - Yi‐wen Gerrand
- O'Brien Institute DepartmentSt Vincent's Institute for Medical Research Melbourne VIC 3065 Australia
| | - Lindsay S. Wray
- Department of Biomedical EngineeringTufts University Medford MA 02155 USA
| | - Beryl Tan
- O'Brien Institute DepartmentSt Vincent's Institute for Medical Research Melbourne VIC 3065 Australia
| | - Habib Joukhdar
- Graduate School of Biomedical EngineeringUniversity of New South Wales Sydney NSW 2052 Australia
| | - David L. Kaplan
- Department of Biomedical EngineeringTufts University Medford MA 02155 USA
| | - Wayne A. Morrison
- O'Brien Institute DepartmentSt Vincent's Institute for Medical Research Melbourne VIC 3065 Australia
- Department of Surgery at St Vincent's HospitalUniversity of Melbourne Melbourne VIC 3065 Australia
- Health Sciences FacultyAustralian Catholic University Melbourne VIC 3065 Australia
| | - Geraldine M. Mitchell
- O'Brien Institute DepartmentSt Vincent's Institute for Medical Research Melbourne VIC 3065 Australia
- Department of Surgery at St Vincent's HospitalUniversity of Melbourne Melbourne VIC 3065 Australia
- Health Sciences FacultyAustralian Catholic University Melbourne VIC 3065 Australia
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16
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Paré A, Bossard A, Laure B, Weiss P, Gauthier O, Corre P. Reconstruction of segmental mandibular defects: Current procedures and perspectives. Laryngoscope Investig Otolaryngol 2019; 4:587-596. [PMID: 31890875 PMCID: PMC6929581 DOI: 10.1002/lio2.325] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/02/2019] [Accepted: 10/21/2019] [Indexed: 11/11/2022] Open
Abstract
Background The reconstruction of segmental mandibular defects remains a challenge for the reconstructive surgeon, from both a functional and an esthetic point of view. Methods This clinical review examines the different techniques currently in use for mandibular reconstruction as related to a range of etiologies, including the different bone donor sites, the alternatives to free flaps (FFs), as well as the contribution of computer‐assisted surgery. Recent progress and the perspectives in bone tissue engineering (BTE) are also discussed. Results Osseous FF allows reliable and satisfying outcomes. However, locoregional flap, distraction osteogenesis, or even induced membrane techniques are other potential options in less favorable cases. Obtaining an engineered bone with satisfactory mechanical properties and sufficient vascular supply requires further investigations. Conclusions Osseous FF procedure remains the gold standard for segmental mandible reconstruction. BTE strategies offer promising alternatives.
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Affiliation(s)
- Arnaud Paré
- Service de Chirurgie Maxillo Faciale Plastique et Brulés, Hôpital Trousseau, CHU de Tours Tours France.,Laboratoire Regenerative Medicine and Skeleton RMeS, France INSERM, U 1229 Nantes France.,UFR Médecine Université de Tours Tours France.,UFR Odontologie Université́ de Nantes Nantes France
| | - Adeline Bossard
- ONIRIS Nantes-Atlantic College of Veterinary Medicine Centre de Rechecherche et D'investigation Préclinique (CRIP) Nantes France
| | - Boris Laure
- Service de Chirurgie Maxillo Faciale Plastique et Brulés, Hôpital Trousseau, CHU de Tours Tours France
| | - Pierre Weiss
- Laboratoire Regenerative Medicine and Skeleton RMeS, France INSERM, U 1229 Nantes France.,UFR Odontologie Université́ de Nantes Nantes France
| | - Olivier Gauthier
- Laboratoire Regenerative Medicine and Skeleton RMeS, France INSERM, U 1229 Nantes France.,ONIRIS Nantes-Atlantic College of Veterinary Medicine Centre de Rechecherche et D'investigation Préclinique (CRIP) Nantes France
| | - Pierre Corre
- Laboratoire Regenerative Medicine and Skeleton RMeS, France INSERM, U 1229 Nantes France.,UFR Odontologie Université́ de Nantes Nantes France.,Service de Chirurgie Maxillo-Faciale et Stomatologie CHU de Nantes Nantes France
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17
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Steiner D, Lang G, Fischer L, Winkler S, Fey T, Greil P, Scheibel T, Horch RE, Arkudas A. Intrinsic Vascularization of Recombinant eADF4(C16) Spider Silk Matrices in the Arteriovenous Loop Model. Tissue Eng Part A 2019; 25:1504-1513. [DOI: 10.1089/ten.tea.2018.0360] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Dominik Steiner
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Gregor Lang
- Biopolymer Processing, Faculty of Engineering Science, University of Bayreuth, Bayreuth, Germany
| | - Laura Fischer
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Sophie Winkler
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Tobias Fey
- Department of Materials Science and Engineering, Institute of Glass and Ceramics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
- Frontier Research Institute for Materials Science, Nagoya Institute of Technology, Nagoya, Japan
| | - Peter Greil
- Department of Materials Science and Engineering, Institute of Glass and Ceramics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Thomas Scheibel
- Department for Biomaterials, Faculty of Engineering Science, University of Bayreuth, Bayreuth, Germany
- Bayreuth Center for Colloids and Interfaces, University of Bayreuth, Bayreuth, Germany
- Bavarian Polymer Institute, University of Bayreuth, Bayreuth, Germany
- Bayreuther Zentrum für Molekulare Biowissenschaften (BZMB), University of Bayreuth, Bayreuth, Germany
- Bayreuther Materialzentrum (BayMAT), University of Bayreuth, Bayreuth, Germany
| | - Raymund E. Horch
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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18
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Charbonnier B, Baradaran A, Sato D, Alghamdi O, Zhang Z, Zhang Y, Gbureck U, Gilardino M, Harvey E, Makhoul N, Barralet J. Material-Induced Venosome-Supported Bone Tubes. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2019; 6:1900844. [PMID: 31508287 PMCID: PMC6724474 DOI: 10.1002/advs.201900844] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/06/2019] [Indexed: 05/03/2023]
Abstract
The development of alternatives to vascular bone grafts, the current clinical standard for the surgical repair of large segmental bone defects still today represents an unmet medical need. The subcutaneous formation of transplantable bone has been successfully achieved in scaffolds axially perfused by an arteriovenous loop (AVL) and seeded with bone marrow stromal cells or loaded with inductive proteins. Although demonstrating clinical potential, AVL-based approaches involve complex microsurgical techniques and thus are not in widespread use. In this study, 3D-printed microporous bioceramics, loaded with autologous total bone marrow obtained by needle aspiration, are placed around and next to an unoperated femoral vein for 8 weeks to assess the effect of a central flow-through vein on bone formation from marrow in a subcutaneous site. A greater volume of new bone tissue is observed in scaffolds perfused by a central vein compared with the nonperfused negative control. These analyses are confirmed and supplemented by calcified and decalcified histology. This is highly significant as it indicates that transplantable vascularized bone can be grown using dispensable vein and marrow tissue only. This is the first report illustrating the capacity of an intrinsic vascularization by a single vein to support ectopic bone formation from untreated marrow.
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Affiliation(s)
- Baptiste Charbonnier
- Department of Mechanical EngineeringMcGill University817 Sherbrooke Street WestMontrealH3A 0C3QuebecCanada
| | - Aslan Baradaran
- Experimental Surgery DivisionDepartment of SurgeryFaculty of MedicineMontreal General Hospital1650 Cedar AvenueMontrealH3G 1A4QuebecCanada
| | - Daisuke Sato
- Department of Implant DentistryShowa University Dental Hospital2 Chome‐1‐1 KitasenzokuOta CityTokyo145‐8515Japan
| | - Osama Alghamdi
- Division of Oral & Maxillofacial SurgeryMcGill UniversityMontreal General Hospital1650 Cedar AvenueMontrealH3G 1A4QuebecCanada
| | - Zishuai Zhang
- Faculty of DentistryMcGill University3640, Strathcona Anatomy and Dentistry Building, University StreetMontrealH3A 0C7QuebecCanada
| | - Yu‐Ling Zhang
- Faculty of DentistryMcGill University3640, Strathcona Anatomy and Dentistry Building, University StreetMontrealH3A 0C7QuebecCanada
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and DentistryUniversity of WürzburgPleicherwall 2D‐97070WürzburgGermany
| | - Mirko Gilardino
- Experimental Surgery DivisionDepartment of SurgeryFaculty of MedicineMontreal General Hospital1650 Cedar AvenueMontrealH3G 1A4QuebecCanada
| | - Edward Harvey
- Experimental Surgery DivisionDepartment of SurgeryFaculty of MedicineMontreal General Hospital1650 Cedar AvenueMontrealH3G 1A4QuebecCanada
| | - Nicholas Makhoul
- Division of Oral & Maxillofacial SurgeryMcGill UniversityMontreal General Hospital1650 Cedar AvenueMontrealH3G 1A4QuebecCanada
| | - Jake Barralet
- Experimental Surgery DivisionDepartment of SurgeryFaculty of MedicineMontreal General Hospital1650 Cedar AvenueMontrealH3G 1A4QuebecCanada
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19
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Cheng G, Yin C, Tu H, Jiang S, Wang Q, Zhou X, Xing X, Xie C, Shi X, Du Y, Deng H, Li Z. Controlled Co-delivery of Growth Factors through Layer-by-Layer Assembly of Core-Shell Nanofibers for Improving Bone Regeneration. ACS NANO 2019; 13:6372-6382. [PMID: 31184474 DOI: 10.1021/acsnano.8b06032] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The regeneration of bone tissue is regulated by both osteogenic and angiogenic growth factors which are expressed in a coordinated cascade of events. The aim of this study was to create a dual growth factor-release system that allows for time-controlled release to facilitate bone regeneration. We fabricated core-shell SF/PCL/PVA nanofibrous mats using coaxial electrospinning and layer-by-layer (LBL) techniques, where bone morphogenetic protein 2 (BMP2) was incorporated into the core of the nanofibers and connective tissue growth factor (CTGF) was attached onto the surface. Our study confirmed the sustained release of BMP2 and a rapid release of CTGF. Both in vitro and in vivo experiments demonstrated improvements in bone tissue recovery with the dual-drug release system. In vivo studies showed improvement in bone regeneration by 43% compared with single BMP2 release systems. Time-controlled release enabled by the core-shell nanofiber assembly provides a promising strategy to facilitate bone healing.
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Affiliation(s)
- Gu Cheng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology , Wuhan University , Wuhan 430079 , China
| | - Chengcheng Yin
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology , Wuhan University , Wuhan 430079 , China
| | - Hu Tu
- Hubei International Scientific and Technological Cooperation Base of Sustainable Resource and Energy, Hubei Key Lab of Biomass Resource Chemistry and Environmental Biotechnology, School of Resource and Environmental Science , Wuhan University , Wuhan 430079 , China
| | - Shan Jiang
- Department of Materials Science and Engineering , Iowa State University , Ames , Iowa 50011 , United States
| | - Qun Wang
- Department of Chemical and Biological Engineering , Iowa State University , Ames , Iowa 50011 , United States
| | - Xue Zhou
- School of Public Health , Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430030 , China
| | - Xin Xing
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology , Wuhan University , Wuhan 430079 , China
| | - Congyong Xie
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology , Wuhan University , Wuhan 430079 , China
| | - Xiaowen Shi
- Hubei International Scientific and Technological Cooperation Base of Sustainable Resource and Energy, Hubei Key Lab of Biomass Resource Chemistry and Environmental Biotechnology, School of Resource and Environmental Science , Wuhan University , Wuhan 430079 , China
| | - Yuming Du
- Hubei International Scientific and Technological Cooperation Base of Sustainable Resource and Energy, Hubei Key Lab of Biomass Resource Chemistry and Environmental Biotechnology, School of Resource and Environmental Science , Wuhan University , Wuhan 430079 , China
| | - Hongbing Deng
- Hubei International Scientific and Technological Cooperation Base of Sustainable Resource and Energy, Hubei Key Lab of Biomass Resource Chemistry and Environmental Biotechnology, School of Resource and Environmental Science , Wuhan University , Wuhan 430079 , China
| | - Zubing Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology , Wuhan University , Wuhan 430079 , China
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Yap KK, Yeoh GC, Morrison WA, Mitchell GM. The Vascularised Chamber as an In Vivo Bioreactor. Trends Biotechnol 2018; 36:1011-1024. [DOI: 10.1016/j.tibtech.2018.05.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 05/25/2018] [Accepted: 05/29/2018] [Indexed: 02/06/2023]
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21
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Steiner D, Lingens L, Fischer L, Köhn K, Detsch R, Boccaccini AR, Fey T, Greil P, Weis C, Beier JP, Horch RE, Arkudas A. Encapsulation of Mesenchymal Stem Cells Improves Vascularization of Alginate-Based Scaffolds. Tissue Eng Part A 2018; 24:1320-1331. [DOI: 10.1089/ten.tea.2017.0496] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Dominik Steiner
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Lara Lingens
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Plastic Surgery, Hand and Burn Surgery, University Hospital of Aachen, RWTH University of Aachen, Aachen, Germany
| | - Laura Fischer
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Katrin Köhn
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Rainer Detsch
- Department of Materials Science and Engineering, Institute for Biomaterials, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Aldo R. Boccaccini
- Department of Materials Science and Engineering, Institute for Biomaterials, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Tobias Fey
- Department of Materials Science and Engineering, Institute of Glass and Ceramics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Peter Greil
- Department of Materials Science and Engineering, Institute of Glass and Ceramics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christian Weis
- Center for Medical Physics and Technology. Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
- Siemens Healthcare GmbH, Sales In Vivo, Stuttgart, Germany
| | - Justus P. Beier
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Plastic Surgery, Hand and Burn Surgery, University Hospital of Aachen, RWTH University of Aachen, Aachen, Germany
| | - Raymund E. Horch
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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22
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Yuan Q, Arkudas A, Horch RE, Hammon M, Bleiziffer O, Uder M, Seuss H. Vascularization of the Arteriovenous Loop in a Rat Isolation Chamber Model—Quantification of Hypoxia and Evaluation of Its Effects. Tissue Eng Part A 2018; 24:719-728. [DOI: 10.1089/ten.tea.2017.0262] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Quan Yuan
- Department of Plastic and Hand Surgery, Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University, Erlangen-Nuernberg (FAU), Erlangen, Germany
- Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery, Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University, Erlangen-Nuernberg (FAU), Erlangen, Germany
| | - Raymund E. Horch
- Department of Plastic and Hand Surgery, Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University, Erlangen-Nuernberg (FAU), Erlangen, Germany
| | - Matthias Hammon
- Department of Radiology, University Hospital Erlangen, Friedrich Alexander University, Erlangen-Nuernberg (FAU), Erlangen, Germany
| | - Oliver Bleiziffer
- Department of Plastic and Hand Surgery, Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University, Erlangen-Nuernberg (FAU), Erlangen, Germany
- Department of Plastic and Hand Surgery, Inselspital Bern, Universität Bern, Bern, Switzerland
| | - Michael Uder
- Department of Radiology, University Hospital Erlangen, Friedrich Alexander University, Erlangen-Nuernberg (FAU), Erlangen, Germany
| | - Hannes Seuss
- Department of Radiology, University Hospital Erlangen, Friedrich Alexander University, Erlangen-Nuernberg (FAU), Erlangen, Germany
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Slezak P, Slezak C, Hartinger J, Teuschl AH, Nürnberger S, Redl H, Mittermayr R. A Low Cost Implantation Model in the Rat That Allows a Spatial Assessment of Angiogenesis. Front Bioeng Biotechnol 2018; 6:3. [PMID: 29468155 PMCID: PMC5807912 DOI: 10.3389/fbioe.2018.00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 01/15/2018] [Indexed: 11/13/2022] Open
Abstract
There is continual demand for animal models that allow a quantitative assessment of angiogenic properties of biomaterials, therapies, and pharmaceuticals. In its simplest form, this is done by subcutaneous material implantation and subsequent vessel counting which usually omits spatial data. We have refined an implantation model and paired it with a computational analytic routine which outputs not only vessel count but also vessel density, distribution, and vessel penetration depth, that relies on a centric vessel as a reference point. We have successfully validated our model by characterizing the angiogenic potential of a fibrin matrix in conjunction with recombinant human vascular endothelial growth factor (rhVEGF165). The inferior epigastric vascular pedicles of rats were sheathed with silicone tubes, which were subsequently filled with 0.2 ml of fibrin and different doses of rhVEGF165, centrically embedding the vessels. Over 4 weeks, tissue samples were harvested and subsequently immunohistologically stained and computationally analyzed. The model was able to detect variations over the angiogenic potentials of growth factor spiked fibrin matrices. Adding 20 ng of rhVEGF165 resulted in a significant increase in vasculature while 200 ng of rhVEGF165 did not improve vascular growth. Vascularized tissue volume increased during the first week and vascular density increased during the second week. Total vessel count increased significantly and exhibited a peak after 2 weeks which was followed by a resorption of vasculature by week 4. In summary, a simple implantation model to study in vivo vascularization with only a minimal workload attached was enhanced to include morphologic data of the emerging vascular tree.
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Affiliation(s)
- Paul Slezak
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria
| | | | - Joachim Hartinger
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria
| | - Andreas Herbert Teuschl
- Department of Biochemical Engineering, University of Applied Sciences Technikum Wien, Vienna, Austria
| | - Sylvia Nürnberger
- Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria
| | - Rainer Mittermayr
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria
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24
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Arkudas A, Lipp A, Buehrer G, Arnold I, Dafinova D, Brandl A, Beier JP, Körner C, Lyer S, Alexiou C, Kneser U, Horch RE. Pedicled Transplantation of Axially Vascularized Bone Constructs in a Critical Size Femoral Defect. Tissue Eng Part A 2017; 24:479-492. [PMID: 28851253 DOI: 10.1089/ten.tea.2017.0110] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Axial vascularization represents a mandatory requirement for clinically applied larger scale vascularized bone grafts. The aim of this study was to combine the arteriovenous (AV) loop model in the rat with a critically sized femoral bone defect and to successfully transplant axially vascularized bone constructs into the defect. MATERIALS AND METHODS In Groups A and C, an AV loop together with a clinically approved hydroxyapatite and beta-tricalcium phosphate (HA/β-TCP) matrix, mesenchymal stem cells, and recombinant human bone morphogenetic protein 2 were implanted into a newly designed porous titanium chamber with an integrated osteosynthesis plate in the thighs of rats, whereas in Groups B and D, the same matrix composition without AV loop and, in Group E, only the HA/β-TCP matrix were implanted. After 6 weeks, the constructs were transplanted into a 10 mm femoral defect created in the same leg, in Groups A and C, under preservation of the AV loop pedicle. Group F served as a control group with an empty chamber. Ten days (Groups A and B) and 12 weeks (Groups C-F) after transplantation, the femora together with the constructs were explanted and investigated using computed tomography (CT), micro-CT, X-ray, histology, and real-time polymerase chain reaction (RT-PCR). RESULTS Ten days after transplantation, Group A showed a maintained vascular supply leading to increased vascularization, cell survival in the scaffold center, and bone generation compared to Group B. After 12 weeks, there was no difference detectable among all groups regarding total vessel number, although Group C, using the AV loop, still showed increased vascularization of the construct center compared to Groups D and E. In Group C, there was still enhanced bone generation detectable compared to the other groups and increased bony fusion rate at the proximal femoral stump. CONCLUSIONS This study shows the combination of the AV loop model in the rat with a critically sized femoral defect. By maintenance of the vascular supply, the constructs initially showed increased vascularization, leading to increased bone formation and bony fusion in the long term.
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Affiliation(s)
- Andreas Arkudas
- 1 Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Amelie Lipp
- 1 Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Gregor Buehrer
- 1 Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Isabel Arnold
- 1 Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Diana Dafinova
- 1 Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Andreas Brandl
- 1 Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU) , Erlangen, Germany .,2 IZKF Research Group for Experimental Stem Cell Transplantation Medical Clinic and Policlinic II, Center for Experimental Molecular Medicine (ZEMM), University Clinic of Würzburg , Würzburg, Germany
| | - Justus P Beier
- 1 Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU) , Erlangen, Germany .,3 Department of Plastic Surgery, Hand and Burn Surgery, University Hospital of Aachen, RWTH University of Aachen, Germany
| | - Carolin Körner
- 4 Department of Materials Science and Engineering, Institute of Science and Technology of Metals, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Stefan Lyer
- 5 Section of Experimental Oncology and Nanomedicine (SEON), Department of Otorhinolaryngology-Head and Neck Surgery, Else Kröner-Fresenius-Stiftung-Professorship, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christoph Alexiou
- 5 Section of Experimental Oncology and Nanomedicine (SEON), Department of Otorhinolaryngology-Head and Neck Surgery, Else Kröner-Fresenius-Stiftung-Professorship, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ulrich Kneser
- 1 Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU) , Erlangen, Germany .,6 Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg , Heidelberg, Germany
| | - Raymund E Horch
- 1 Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
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25
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Schmidt VJ, Wietbrock JO, Leibig N, Hernekamp JF, Henn D, Radu CA, Kneser U. Haemodynamically stimulated and in vivo generated axially vascularized soft-tissue free flaps for closure of complex defects: Evaluation in a small animal model. J Tissue Eng Regen Med 2017; 12:622-632. [PMID: 28509443 DOI: 10.1002/term.2477] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 05/05/2017] [Accepted: 05/09/2017] [Indexed: 12/25/2022]
Abstract
The arteriovenous (AV) loop model permits the creation of significant volumes of axially vascularized tissue that represents an alternative to conventional free flaps, circumventing their common limitations. However, such AV loop-based flaps have never before been examined in standardized animal models with respect to their suitability for reconstruction of critical bone-exposing defects. In the course of our preliminary studies, we implemented a novel defect model in rats that provides standardized and critical wound conditions and evaluated whether AV loop-generated flaps are suitable for free microsurgical transfer and closure of composite defects. We compared three groups of rodents with similar scapular defects: one received the AV flap, whereas controls were left to heal by secondary intention or with supplementary acellular matrix alone. To create the flaps, AV loops were placed into subcutaneous Teflon chambers filled with acellular matrix and transferred to the thigh region. Flap maturation was evaluated by histological analysis of angiogenesis and cell migration at days 14 and 28 after loop creation. Flap transfer to the scapular region and microsurgical anastomoses were performed after 14 days. Postoperative defect closure and perfusion were continually compared between groups. Within the AV flap chamber, the mean vessel number, cell count and the proportion of proliferating cells increased significantly over time. The novel defect model revealed that stable wound coverage with homogeneous vascular integration was achieved by AV loop-vascularized soft-tissue free flaps compared with controls. In summary, our study indicates for the first time that complex composite defects in rats can successfully be treated with AV loop-based free flaps.
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Affiliation(s)
- Volker J Schmidt
- Department of Hand, Plastic, and Reconstructive Surgery, Trauma Center Ludwigshafen, Ludwigshafen, Germany
| | - Johanna O Wietbrock
- Department of Hand, Plastic, and Reconstructive Surgery, Trauma Center Ludwigshafen, Ludwigshafen, Germany
| | - Nico Leibig
- Department of Hand, Plastic, and Reconstructive Surgery, Trauma Center Ludwigshafen, Ludwigshafen, Germany
| | - Jochen F Hernekamp
- Department of Hand, Plastic, and Reconstructive Surgery, Trauma Center Ludwigshafen, Ludwigshafen, Germany
| | - Dominic Henn
- Department of Hand, Plastic, and Reconstructive Surgery, Trauma Center Ludwigshafen, Ludwigshafen, Germany
| | - Christian A Radu
- Department of Hand, Plastic, and Reconstructive Surgery, Trauma Center Ludwigshafen, Ludwigshafen, Germany
| | - Ulrich Kneser
- Department of Hand, Plastic, and Reconstructive Surgery, Trauma Center Ludwigshafen, Ludwigshafen, Germany
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26
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The impact of various scaffold components on vascularized bone constructs. J Craniomaxillofac Surg 2017; 45:881-890. [DOI: 10.1016/j.jcms.2017.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 01/23/2017] [Accepted: 02/14/2017] [Indexed: 01/01/2023] Open
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27
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Flow-Induced Axial Vascularization: The Arteriovenous Loop in Angiogenesis and Tissue Engineering. Plast Reconstr Surg 2017; 138:825-835. [PMID: 27673517 DOI: 10.1097/prs.0000000000002554] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Fabrication of a viable vascular network providing oxygen supply is identified as one crucial limiting factor to generate more complex three-dimensional constructs. The arteriovenous loop model provides initial blood supply and has a high angioinductive potency, making it suitable for vascularization of larger, tissue-engineered constructs. Also because of its angiogenic capabilities the arteriovenous loop is recently also used as a model to evaluate angiogenesis in vivo. This review summarizes the history of the arteriovenous loop model in research and its technical and surgical aspects. Through modifications of the isolation chamber and its containing matrices, tissue generation can be enhanced. In addition, matrices can be used as release systems for local application of growth factors, such as vascular endothelial growth factor and basic fibroblast growth factor, to affect vascular network formation. A special focus in this review is set on the assessment of angiogenesis in the arteriovenous loop model. This model provides good conditions for assessment of angiogenesis with the initial cell-free environment of the isolation chamber, which is vascularized by the arteriovenous loop. Because of the angiogenic capabilities of the arteriovenous loop model, different attempts were performed to create functional tissue in the isolation chamber for potential clinical application. Arteriovenous loops in combination with autologous bone marrow aspirate were already used to reconstruct large bone defects in humans.
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28
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Eweida A, Frisch O, Giordano FA, Fleckenstein J, Wenz F, Brockmann MA, Schulte M, Schmidt VJ, Kneser U, Harhaus L. Axially vascularized tissue-engineered bone constructs retain their in vivo angiogenic and osteogenic capacity after high-dose irradiation. J Tissue Eng Regen Med 2017; 12:e657-e668. [PMID: 27696709 DOI: 10.1002/term.2336] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 07/28/2016] [Accepted: 09/26/2016] [Indexed: 11/07/2022]
Abstract
In order to introduce bone tissue engineering to the field of oncological reconstruction, we are investigating for the first time the effect of various doses of ionizing irradiation on axially vascularized bone constructs. Synthetic bone constructs were created and implanted in 32 Lewis rats. Each construct was axially vascularized through an arteriovenous loop made by direct anastomosis of the saphenous vessels. After 2 weeks, the animals received ionizing irradiation of 9 Gy, 12 Gy and 15 Gy, and were accordingly classified to groups I, II and III, respectively. Group IV was not irradiated and acted as a control. Tissue generation, vascularity, cellular proliferation and apoptosis were investigated either 2 or 5 weeks after irradiation through micro-computed tomography, histomorphometry and real-time polymerase chain reaction (PCR). At 2 weeks after irradiation, tissue generation and central vascularity were significantly lower and apoptosis was significantly higher in groups II and III than group IV, but without signs of necrosis. Cellular proliferation was significantly lower in groups I and II. After 5 weeks, the irradiated groups showed improvement in all parameters in relation to the control group, indicating a retained capacity for angiogenesis after irradiation. PCR results confirmed the expression of osteogenesis-related genes in all irradiated groups. Dense collagen was detected 5 weeks after irradiation, and one construct showed discrete islands of bone indicating a retained osteogenic capacity after irradiation. This demonstrates for the first time that axial vascularization was capable of supporting a synthetic bone construct after a high dose of irradiation that is comparable to adjuvant radiotherapy. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Ahmad Eweida
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.,Department of Head, Neck and Endocrine Surgery, Faculty of Medicine, University of Alexandria, Egypt
| | - Oliver Frisch
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Frank A Giordano
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jens Fleckenstein
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Frederik Wenz
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marc A Brockmann
- Department of Neuroradiology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Neuroradiology, University Medical Center Mainz, Mainz, Germany
| | - Matthias Schulte
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Volker J Schmidt
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Ulrich Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Leila Harhaus
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
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29
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Weigand A, Beier JP, Schmid R, Knorr T, Kilian D, Götzl R, Gerber T, Horch RE, Boos AM. Bone Tissue Engineering Under Xenogeneic-Free Conditions in a Large Animal Model as a Basis for Early Clinical Applicability. Tissue Eng Part A 2017; 23:208-222. [PMID: 27998239 DOI: 10.1089/ten.tea.2016.0176] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
For decades, researchers have been developing a range of promising strategies in bone tissue engineering with the aim of producing a significant clinical benefit over existing therapies. However, a major problem concerns the traditional use of xenogeneic substances for the expansion of cells, which complicates direct clinical transfer. The study's aim was to establish a totally autologous sheep model as a basis for further preclinical studies and future clinical application. Ovine mesenchymal stromal cells (MSC) were cultivated in different concentrations (0%, 2%, 5%, 10%, and 25%) of either autologous serum (AS) or fetal calf serum (FCS). With an increase of serum concentration, enhanced metabolic activity and proliferation could be observed. There were minor differences between MSC cultivated in AS or FCS, comparing gene and protein expression of osteogenic and stem cell markers, morphology, and osteogenic differentiation. MSC implanted subcutaneously in the sheep model, together with a nanostructured bone substitute, either in stable block or moldable putty form, induced similar vascularization and remodeling of the bone substitute irrespective of cultivation of MSC in AS or FCS and osteogenic differentiation. The bone substitute in block form together with MSC proved particularly advantageous in the induction of ectopic bone formation compared to the cell-free control and putty form. It could be demonstrated that AS is suitable for replacement of FCS for cultivation of ovine MSC for bone tissue engineering purposes. Substantial progress has been made in the development of a strictly xenogeneic-free preclinical animal model to bring future clinical application of bone tissue engineering strategies within reach.
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Affiliation(s)
- Annika Weigand
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Justus P Beier
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Rafael Schmid
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Tobias Knorr
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - David Kilian
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Rebekka Götzl
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Thomas Gerber
- 2 Institute of Physics, University of Rostock , Rostock, Germany
| | - Raymund E Horch
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Anja M Boos
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
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30
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Weigand A, Beier JP, Arkudas A, Al-Abboodi M, Polykandriotis E, Horch RE, Boos AM. The Arteriovenous (AV) Loop in a Small Animal Model to Study Angiogenesis and Vascularized Tissue Engineering. J Vis Exp 2016. [PMID: 27842348 DOI: 10.3791/54676] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A functional blood vessel network is a prerequisite for the survival and growth of almost all tissues and organs in the human body. Moreover, in pathological situations such as cancer, vascularization plays a leading role in disease progression. Consequently, there is a strong need for a standardized and well-characterized in vivo model in order to elucidate the mechanisms of neovascularization and develop different vascularization approaches for tissue engineering and regenerative medicine. We describe a microsurgical approach for a small animal model for induction of a vascular axis consisting of a vein and artery that are anastomosed to an arteriovenous (AV) loop. The AV loop is transferred to an enclosed implantation chamber to create an isolated microenvironment in vivo, which is connected to the living organism only by means of the vascular axis. Using 3D imaging (MRI, micro-CT) and immunohistology, the growing vasculature can be visualized over time. By implanting different cells, growth factors and matrices, their function in blood vessel network formation can be analyzed without any disturbing influences from the surroundings in a well controllable environment. In addition to angiogenesis and antiangiogenesis studies, the AV loop model is also perfectly suited for engineering vascularized tissues. After a certain prevascularization time, the generated tissues can be transplanted into the defect site and microsurgically connected to the local vessels, thereby ensuring immediate blood supply and integration of the engineered tissue. By varying the matrices, cells, growth factors and chamber architecture, it is possible to generate various tissues, which can then be tailored to the individual patient's needs.
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Affiliation(s)
- Annika Weigand
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU);
| | - Justus P Beier
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU)
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU)
| | - Majida Al-Abboodi
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU); Genetic Engineering and Biotechnology Institute for Postgraduate Studies, Baghdad University
| | | | - Raymund E Horch
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU)
| | - Anja M Boos
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU)
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Huang RL, Kobayashi E, Liu K, Li Q. Bone Graft Prefabrication Following the In Vivo Bioreactor Principle. EBioMedicine 2016; 12:43-54. [PMID: 27693103 PMCID: PMC5078640 DOI: 10.1016/j.ebiom.2016.09.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 08/11/2016] [Accepted: 09/16/2016] [Indexed: 01/31/2023] Open
Abstract
Large bone defect treatment represents a great challenge due to the difficulty of functional and esthetic reconstruction. Tissue-engineered bone grafts created by in vitro manipulation of bioscaffolds, seed cells, and growth factors have been considered potential treatments for bone defect reconstruction. However, a significant gap remains between experimental successes and clinical translation. An emerging strategy for bridging this gap is using the in vivo bioreactor principle and flap prefabrication techniques. This principle focuses on using the body as a bioreactor to cultivate the traditional triad (bioscaffolds, seed cells, and growth factors) and leveraging the body's self-regenerative capacity to regenerate new tissue. Additionally, flap prefabrication techniques allow the regenerated bone grafts to be transferred as prefabricated bone flaps for bone defect reconstruction. Such a strategy has been used successfully for reconstructing critical-sized bone defects in animal models and humans. Here, we highlight this concept and provide some perspective on how to translate current knowledge into clinical practice. The in vivo bioreactor principle and flap prefabrication technique is a promising strategy for bone defect reconstruction. The in vivo bioreactor principle focuses on using the body’s self-regenerative capacity to regenerate new tissue. This strategy has been successfully used to reconstruct critical-sized bone defects in humans.
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Affiliation(s)
- Ru-Lin Huang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Eiji Kobayashi
- Department of Organ Fabrication, Keio University School of Medicine, Tokyo, Japan
| | - Kai Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Qingfeng Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China.
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Wang Z, Hu H, Li Z, Weng Y, Dai T, Zong C, Liu Y, Liu B. Sheet of osteoblastic cells combined with platelet-rich fibrin improves the formation of bone in critical-size calvarial defects in rabbits. Br J Oral Maxillofac Surg 2016; 54:316-21. [DOI: 10.1016/j.bjoms.2015.12.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 12/17/2015] [Indexed: 01/01/2023]
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Weigand A, Horch RE, Beier JP, Arkudas A, Boos AM. Comment on 'Basic concepts regarding fractures healing and the current options and future directions in managing bone fractures'. Int Wound J 2015; 13:1080-2. [PMID: 26663542 DOI: 10.1111/iwj.12556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 11/16/2015] [Indexed: 11/30/2022] Open
Affiliation(s)
- Annika Weigand
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg FAU, Erlangen, Germany.
| | - Raymund E Horch
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg FAU, Erlangen, Germany
| | - Justus P Beier
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg FAU, Erlangen, Germany
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg FAU, Erlangen, Germany
| | - Anja M Boos
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg FAU, Erlangen, Germany
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Distal Row Carpectomy-A Possible Salvage Procedure of Severe Carpal Trauma. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2015; 3:e480. [PMID: 26495193 PMCID: PMC4560213 DOI: 10.1097/gox.0000000000000404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 04/29/2015] [Indexed: 11/25/2022]
Abstract
Complex fracture dislocations of the wrist often result in posttraumatic arthrosis. In trying to avoid total arthrodesis, alternative treatment strategies have been investigated. For this purpose, we present the case of a 56-year-old male patient who sustained a direct trauma during a circular saw accident, resulting in the destruction of the distal carpal row among other things. However, the proximal carpal row was found completely intact. We indicated an emergency distal row carpectomy. Eighteen months postoperatively, the patient showed very good range of movement with no pain, and radiologically, the proximal carpal row was still intact, with no signs of an incipient radiocarpal arthrosis. This case demonstrates the successful removal of the distal carpal row in terms of a distal row carpectomy.
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Weigand A, Beier JP, Hess A, Gerber T, Arkudas A, Horch RE, Boos AM. Acceleration of vascularized bone tissue-engineered constructs in a large animal model combining intrinsic and extrinsic vascularization. Tissue Eng Part A 2015; 21:1680-94. [PMID: 25760576 DOI: 10.1089/ten.tea.2014.0568] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
During the last decades, a range of excellent and promising strategies in Bone Tissue Engineering have been developed. However, the remaining major problem is the lack of vascularization. In this study, extrinsic and intrinsic vascularization strategies were combined for acceleration of vascularization. For optimal biomechanical stability of the defect site and simplifying future transition into clinical application, a primary stable and approved nanostructured bone substitute in clinically relevant size was used. An arteriovenous (AV) loop was microsurgically created in sheep and implanted, together with the bone substitute, in either perforated titanium chambers (intrinsic/extrinsic) for different time intervals of up to 18 weeks or isolated Teflon(®) chambers (intrinsic) for 18 weeks. Over time, magnetic resonance imaging and micro-computed tomography (CT) analyses illustrate the dense vascularization arising from the AV loop. The bone substitute was completely interspersed with newly formed tissue after 12 weeks of intrinsic/extrinsic vascularization and after 18 weeks of intrinsic/extrinsic and intrinsic vascularization. Successful matrix change from an inorganic to an organic scaffold could be demonstrated in vascularized areas with scanning electron microscopy and energy dispersive X-ray spectroscopy. Using the intrinsic vascularization method only, the degradation of the scaffold and osteoclastic activity was significantly lower after 18 weeks, compared with 12 and 18 weeks in the combined intrinsic-extrinsic model. Immunohistochemical staining revealed an increase in bone tissue formation over time, without a difference between intrinsic/extrinsic and intrinsic vascularization after 18 weeks. This study presents the combination of extrinsic and intrinsic vascularization strategies for the generation of an axially vascularized bone substitute in clinically relevant size using a large animal model. The additional extrinsic vascularization promotes tissue ingrowth and remodeling processes of the bone substitute. Extrinsic vessels contribute to faster vascularization and finally anastomose with intrinsic vasculature, allowing microvascular transplantation of the bone substitute after a shorter prevascularization time than using the intrinsic method only. It can be reasonably assumed that the usage of perforated chambers can significantly reduce the time until transplantation of bone constructs. Finally, this study paves the way for further preclinical testing for proof of the concept as a basis for early clinical applicability.
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Affiliation(s)
- Annika Weigand
- 1 Department of Plastic and Hand Surgery, University Hospital of Erlangen , Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
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