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Lupon E, Acun A, Taveau CB, Oganesyan R, Lancia HH, Andrews AR, Randolph MA, Cetrulo CL, Lellouch AG, Uygun BE. Optimized Decellularization of a Porcine Fasciocutaneaous Flap. Bioengineering (Basel) 2024; 11:321. [PMID: 38671744 PMCID: PMC11047669 DOI: 10.3390/bioengineering11040321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/13/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
Reconstructive techniques to repair severe tissue defects include the use of autologous fasciocutaneous flaps, which may be limited due to donor site availability or lead to complications such as donor site morbidity. A number of synthetic or natural dermal substitutes are in use clinically, but none have the architectural complexity needed to reconstruct deep tissue defects. The perfusion decellularization of fasciocutaneous flaps is an emerging technique that yields a scaffold with the necessary composition and vascular microarchitecture and serves as an alternative to autologous flaps. In this study, we show the perfusion decellularization of porcine fasciocutaneous flaps using sodium dodecyl sulfate (SDS) at three different concentrations, and identify that 0.2% SDS results in a decellularized flap that is efficiently cleared of its cellular material at 86%, has maintained its collagen and glycosaminoglycan content, and preserved its microvasculature architecture. We further demonstrate that the decellularized graft has the porous structure and growth factors that would facilitate repopulation with cells. Finally, we show the biocompatibility of the decellularized flap using human dermal fibroblasts, with cells migrating as deep as 150 µm into the tissue over a 7-day culture period. Overall, our results demonstrate the promise of decellularized porcine flaps as an interesting alternative for reconstructing complex soft tissue defects, circumventing the limitations of autologous skin flaps.
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Affiliation(s)
- Elise Lupon
- Department of Plastic and Reconstructive Surgery, Institut Universitaire Locomoteur et du Sport, Pasteur 2 Hospital, University Côte d’Azur, 06300 Nice, France;
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (C.B.T.); (H.H.L.); (A.R.A.); (M.A.R.); (C.L.C.J.); (A.G.L.)
- Shriners Children’s Boston, Boston, MA 02114, USA; (A.A.); (R.O.)
| | - Aylin Acun
- Shriners Children’s Boston, Boston, MA 02114, USA; (A.A.); (R.O.)
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Department of Biomedical Engineering, Widener University, Chester, PA 19013, USA
| | - Corentin B. Taveau
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (C.B.T.); (H.H.L.); (A.R.A.); (M.A.R.); (C.L.C.J.); (A.G.L.)
- Shriners Children’s Boston, Boston, MA 02114, USA; (A.A.); (R.O.)
| | - Ruben Oganesyan
- Shriners Children’s Boston, Boston, MA 02114, USA; (A.A.); (R.O.)
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Hyshem H. Lancia
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (C.B.T.); (H.H.L.); (A.R.A.); (M.A.R.); (C.L.C.J.); (A.G.L.)
- University of Grenoble Alpes, CNRS, TIMC UMR 5525, EPSP, 38000 Grenoble, France
| | - Alec R. Andrews
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (C.B.T.); (H.H.L.); (A.R.A.); (M.A.R.); (C.L.C.J.); (A.G.L.)
- Shriners Children’s Boston, Boston, MA 02114, USA; (A.A.); (R.O.)
| | - Mark A. Randolph
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (C.B.T.); (H.H.L.); (A.R.A.); (M.A.R.); (C.L.C.J.); (A.G.L.)
- Shriners Children’s Boston, Boston, MA 02114, USA; (A.A.); (R.O.)
| | - Curtis L. Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (C.B.T.); (H.H.L.); (A.R.A.); (M.A.R.); (C.L.C.J.); (A.G.L.)
- Shriners Children’s Boston, Boston, MA 02114, USA; (A.A.); (R.O.)
- Department of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Alexandre G. Lellouch
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (C.B.T.); (H.H.L.); (A.R.A.); (M.A.R.); (C.L.C.J.); (A.G.L.)
- Shriners Children’s Boston, Boston, MA 02114, USA; (A.A.); (R.O.)
- Innovative Therapies in Haemostasis, INSERM UMR-S 1140, University of Paris, 75015 Paris, France
| | - Basak E. Uygun
- Shriners Children’s Boston, Boston, MA 02114, USA; (A.A.); (R.O.)
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
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Fan Y, Yuh J, Lekkala S, Asik MD, Thomson A, McCanne M, Randolph MA, Chen AF, Oral E. The efficacy of vitamin E in preventing arthrofibrosis after joint replacement. Animal Model Exp Med 2024. [PMID: 38525803 DOI: 10.1002/ame2.12388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/10/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Arthrofibrosis is a joint disorder characterized by excessive scar formation in the joint tissues. Vitamin E is an antioxidant with potential anti-fibroblastic effect. The aim of this study was to establish an arthrofibrosis rat model after joint replacement and assess the effects of vitamin E supplementation on joint fibrosis. METHODS We simulated knee replacement in 16 male Sprague-Dawley rats. We immobilized the surgical leg with a suture in full flexion. The control groups were killed at 2 and 12 weeks (n = 5 per group), and the test group was supplemented daily with vitamin E (0.2 mg/mL) in their drinking water for 12 weeks (n = 6). We performed histological staining to investigate the presence and severity of arthrofibrosis. Immunofluorescent staining and α2-macroglobulin (α2M) enzyme-linked immunosorbent assay (ELISA) were used to assess local and systemic inflammation. Static weight bearing (total internal reflection) and range of motion (ROM) were collected for functional assessment. RESULTS The ROM and weight-bearing symmetry decreased after the procedure and recovered slowly with still significant deficit at the end of the study for both groups. Histological analysis confirmed fibrosis in both lateral and posterior periarticular tissue. Vitamin E supplementation showed a moderate anti-inflammatory effect on the local and systemic levels. The vitamin E group exhibited significant improvement in ROM and weight-bearing symmetry at day 84 compared to the control group. CONCLUSIONS This model is viable for simulating arthrofibrosis after joint replacement. Vitamin E may benefit postsurgical arthrofibrosis, and further studies are needed for dosing requirements.
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Affiliation(s)
- Yingfang Fan
- Harris Orthopaedic Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Jean Yuh
- Harris Orthopaedic Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sashank Lekkala
- Harris Orthopaedic Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Mehmet D Asik
- Harris Orthopaedic Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew Thomson
- Harris Orthopaedic Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Madeline McCanne
- Harris Orthopaedic Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Mark A Randolph
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts, USA
- Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Antonia F Chen
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ebru Oral
- Harris Orthopaedic Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts, USA
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King NC, McGuire KR, Bejar-Chapa M, Hoftiezer YAJ, Randolph MA, Winograd JM. Photochemical Tissue Bonding of Amnion Allograft Membranes for Peripheral Nerve Repair: A Biomechanical Analysis. J Reconstr Microsurg 2024; 40:232-238. [PMID: 37696294 DOI: 10.1055/s-0043-1772670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
BACKGROUND Photochemical tissue bonding (PTB) is a technique for peripheral nerve repair in which a collagenous membrane is bonded around approximated nerve ends. Studies using PTB with cryopreserved human amnion have shown promising results in a rat sciatic nerve transection model including a more rapid and complete return of function, larger axon size, and thicker myelination than suture repair. Commercial collagen membranes, such as dehydrated amnion allograft, are readily available, offer ease of storage, and have no risk of disease transmission or tissue rejection. However, the biomechanical properties of these membranes using PTB are currently unknown in comparison to PTB of cryopreserved human amnion and suture neurorrhaphy. METHODS Rat sciatic nerves (n = 10 per group) were transected and repaired using either suture neurorrhaphy or PTB with one of the following membranes: cryopreserved human amnion, monolayer human amnion allograft (crosslinked and noncrosslinked), trilayer human amnion/chorion allograft (crosslinked and noncrosslinked), or swine submucosa. Repaired nerves were subjected to mechanical testing. RESULTS During ultimate stress testing, the repair groups that withstood the greatest strain increases were suture neurorrhaphy (69 ± 14%), PTB with crosslinked trilayer amnion (52 ± 10%), and PTB with cryopreserved human amnion (46 ± 20%), although the differences between these groups were not statistically significant. Neurorrhaphy repairs had a maximum load (0.98 ± 0.30 N) significantly greater than all other repair groups except for noncrosslinked trilayer amnion (0.51 ± 0.27 N). During fatigue testing, all samples repaired with suture, or PTBs with either crosslinked or noncrosslinked trilayer amnion were able to withstand strain increases of at least 50%. CONCLUSION PTB repairs with commercial noncrosslinked amnion allograft membranes can withstand physiological strain and have comparable performance to repairs with human amnion, which has demonstrated efficacy in vivo. These results indicate the need for further testing of these membranes using in vivo animal model repairs.
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Affiliation(s)
- Nicholas C King
- Peripheral Nerve Research Laboratory, Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kalyn R McGuire
- Peripheral Nerve Research Laboratory, Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Maria Bejar-Chapa
- Peripheral Nerve Research Laboratory, Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Yannick A J Hoftiezer
- Peripheral Nerve Research Laboratory, Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mark A Randolph
- Peripheral Nerve Research Laboratory, Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jonathan M Winograd
- Peripheral Nerve Research Laboratory, Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Berkane Y, Jain R, Ajenu EO, Shamlou AA, Nguyen K, McCarthy M, Uygun BE, Lellouch AG, Cetrulo CL, Uygun K, Randolph MA, Tessier SN. A Swine Burn Model for Investigating the Healing Process in Multiple Depth Burn Wounds. J Vis Exp 2024. [PMID: 38465950 DOI: 10.3791/66362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
Burn wound healing is a complex and long process. Despite extensive experience, plastic surgeons and specialized teams in burn centers still face significant challenges. Among these challenges, the extent of the burned soft tissue can evolve in the early phase, creating a delicate balance between conservative treatments and necrosing tissue removal. Thermal burns are the most common type, and burn depth varies depending on multiple parameters, such as temperature and exposure time. Burn depth also varies in time, and the secondary aggravation of the "shadow zone" remains a poorly understood phenomenon. In response to these challenges, several innovative treatments have been studied, and more are in the early development phase. Nanoparticles in modern wound dressings and artificial skin are examples of these modern therapies still under evaluation. Taken together, both burn diagnosis and burn treatments need substantial advancements, and research teams need a reliable and relevant model to test new tools and therapies. Among animal models, swine are the most relevant because of their strong similarities in skin structure with humans. More specifically, Yucatan minipigs show interesting features such as melanin pigmentation and slow growth, allowing for studying high phototypes and long-term healing. This article aims to describe a reliable and reproducible protocol to study multi-depth burn wounds in Yucatan minipigs, enabling long-term follow-up and providing a relevant model for diagnosis and therapeutic studies.
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Affiliation(s)
- Yanis Berkane
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston; Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University; SITI Laboratory, UMR, INSERM, Université de Rennes
| | - Rohil Jain
- Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Emmanuella O Ajenu
- Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Austin A Shamlou
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston
| | - Khanh Nguyen
- Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Michelle McCarthy
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Basak E Uygun
- Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston; Innovative Therapies in Haemostasis, INSERM UMR-S, University of Paris
| | - Curtis L Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston
| | - Korkut Uygun
- Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Mark A Randolph
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston
| | - Shannon N Tessier
- Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School;
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Monteiro JL, Takusagawa T, Sampaio GC, He H, de Oliveira E Silva ED, Vasconcelos BCE, McCain JP, Redmond RW, Randolph MA, Guastaldi FPS. Gelatin methacryloyl hydrogel with and without dental pulp stem cells for TMJ regeneration: An in vivo study in rabbits. J Oral Rehabil 2024; 51:394-403. [PMID: 37830126 DOI: 10.1111/joor.13608] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/21/2023] [Accepted: 10/04/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND In the last decade, tissue-engineering strategies for regenerating the temporomandibular joint (TMJ) have been investigated. This may be a promising strategy for the minimally invasive restoration of joint integrity. OBJECTIVES To evaluate whether dental pulp stem cells (DPSCs) loaded in a light-occured hydrogel made of gelatin methacryloyl (GelMA) enhance the regeneration of osteochondral defects in the rabbit TMJ. MATERIALS AND METHODS Defects were filled with GelMA alone (control group; n = 4) or filled with GelMA loaded with rabbit DPSCs (experimental group; n = 4), In one group, the TMJ capsule was opened without creating a defect (sham group; n = 2). The following micro-CT parameters were analysed: bone volume to total volume ratio (BV/TV%) and bone mineral density (BMD). Histological evaluation was performed to assess cartilage regeneration features. A semi-quantitative scoring system was also used to evaluate the defects. RESULTS All groups had no statistical difference regarding the micro-CT parameters. The highest mean healing score was found for the experimental group. After 4 weeks, there were no signs of hydrogel in either group or no signs of inflammation in the adjacent tissues. The tissue formed in the defect was dense fibrous connective tissue. CONCLUSION Adding DPSCs to GelMA did not provide a regenerative enhancement in TMJ osteochondral defects. This resulted in similar micro-CT parameters after 4 weeks of healing, with improved signs of subchondral bone regeneration but no cartilage regeneration.
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Affiliation(s)
- Joao Luiz Monteiro
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Department of Oral and Maxillofacial Surgery, Universidade de Pernambuco, Recife, Pernambuco, Brazil
| | - Toru Takusagawa
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Gerhilde C Sampaio
- Department of Oral Medicine, Universidade de Pernambuco, Recife, Pernambuco, Brazil
| | - Helen He
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | | | - Belmiro C E Vasconcelos
- Department of Oral and Maxillofacial Surgery, Universidade de Pernambuco, Recife, Pernambuco, Brazil
| | - Joseph P McCain
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Robert W Redmond
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Mark A Randolph
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Fernando P S Guastaldi
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Mei S, Alchahin AM, Tsea I, Kfoury Y, Hirz T, Jeffries NE, Zhao T, Xu Y, Zhang H, Sarkar H, Wu S, Subtelny AO, Johnsen JI, Zhang Y, Salari K, Wu CL, Randolph MA, Scadden DT, Dahl DM, Shin J, Kharchenko PV, Saylor PJ, Sykes DB, Baryawno N. Single-cell analysis of immune and stroma cell remodeling in clear cell renal cell carcinoma primary tumors and bone metastatic lesions. Genome Med 2024; 16:1. [PMID: 38281962 PMCID: PMC10823713 DOI: 10.1186/s13073-023-01272-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/11/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Despite therapeutic advances, once a cancer has metastasized to the bone, it represents a highly morbid and lethal disease. One third of patients with advanced clear cell renal cell carcinoma (ccRCC) present with bone metastasis at the time of diagnosis. However, the bone metastatic niche in humans, including the immune and stromal microenvironments, has not been well-defined, hindering progress towards identification of therapeutic targets. METHODS We collected fresh patient samples and performed single-cell transcriptomic profiling of solid metastatic tissue (Bone Met), liquid bone marrow at the vertebral level of spinal cord compression (Involved), and liquid bone marrow from a different vertebral body distant from the tumor site but within the surgical field (Distal), as well as bone marrow from patients undergoing hip replacement surgery (Benign). In addition, we incorporated single-cell data from primary ccRCC tumors (ccRCC Primary) for comparative analysis. RESULTS The bone marrow of metastatic patients is immune-suppressive, featuring increased, exhausted CD8 + cytotoxic T cells, T regulatory cells, and tumor-associated macrophages (TAM) with distinct transcriptional states in metastatic lesions. Bone marrow stroma from tumor samples demonstrated a tumor-associated mesenchymal stromal cell population (TA-MSC) that appears to be supportive of epithelial-to mesenchymal transition (EMT), bone remodeling, and a cancer-associated fibroblast (CAFs) phenotype. This stromal subset is associated with poor progression-free and overall survival and also markedly upregulates bone remodeling through the dysregulation of RANK/RANKL/OPG signaling activity in bone cells, ultimately leading to bone resorption. CONCLUSIONS These results provide a comprehensive analysis of the bone marrow niche in the setting of human metastatic cancer and highlight potential therapeutic targets for both cell populations and communication channels.
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Affiliation(s)
- Shenglin Mei
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA.
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, 02115, USA.
| | - Adele M Alchahin
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, 17176, Stockholm, Sweden
| | - Ioanna Tsea
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, 17176, Stockholm, Sweden
| | - Youmna Kfoury
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Stem Cell Institute, Cambridge, MA, 02138, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, 02138, USA
| | - Taghreed Hirz
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Stem Cell Institute, Cambridge, MA, 02138, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, 02138, USA
| | - Nathan Elias Jeffries
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Stem Cell Institute, Cambridge, MA, 02138, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, 02138, USA
| | - Ting Zhao
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Stem Cell Institute, Cambridge, MA, 02138, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, 02138, USA
| | - Yanxin Xu
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Stem Cell Institute, Cambridge, MA, 02138, USA
| | - Hanyu Zhang
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Stem Cell Institute, Cambridge, MA, 02138, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, 02138, USA
| | - Hirak Sarkar
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, 02115, USA
| | - Shulin Wu
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Alexander O Subtelny
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - John Inge Johnsen
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, 17176, Stockholm, Sweden
| | - Yida Zhang
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, 02115, USA
| | - Keyan Salari
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Chin-Lee Wu
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Mark A Randolph
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - David T Scadden
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Stem Cell Institute, Cambridge, MA, 02138, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, 02138, USA
| | - Douglas M Dahl
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - John Shin
- Department of Neurosurgery, Harvard Medical School, Boston, MA, 02115, USA.
| | - Peter V Kharchenko
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, 02115, USA.
- Harvard Stem Cell Institute, Cambridge, MA, 02138, USA.
- Present: Altos Labs, San Diego, CA, 92121, USA.
| | - Philip J Saylor
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, 02114, USA.
| | - David B Sykes
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA.
- Harvard Stem Cell Institute, Cambridge, MA, 02138, USA.
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, 02138, USA.
| | - Ninib Baryawno
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, 17176, Stockholm, Sweden.
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7
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Berkane Y, Kostyra DM, Chrelias T, Randolph MA, Lellouch AG, Cetrulo CL, Uygun K, Uygun BE, Bertheuil N, Duisit J. The Autonomization Principle in Vascularized Flaps: An Alternative Strategy for Composite Tissue Scaffold In Vivo Revascularization. Bioengineering (Basel) 2023; 10:1440. [PMID: 38136031 PMCID: PMC10740989 DOI: 10.3390/bioengineering10121440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/28/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Autonomization is a physiological process allowing a flap to develop neo-vascularization from the reconstructed wound bed. This phenomenon has been used since the early application of flap surgeries but still remains poorly understood. Reconstructive strategies have greatly evolved since, and fasciocutaneous flaps have progressively replaced muscle-based reconstructions, ensuring better functional outcomes with great reliability. However, plastic surgeons still encounter challenges in complex cases where conventional flap reconstruction reaches its limitations. Furthermore, emerging bioengineering applications, such as decellularized scaffolds allowing a complex extracellular matrix to be repopulated with autologous cells, also face the complexity of revascularization. The objective of this article is to gather evidence of autonomization phenomena. A systematic review of flap autonomization is then performed to document the minimum delay allowing this process. Finally, past and potential applications in bio- and tissue-engineering approaches are discussed, highlighting the potential for in vivo revascularization of acellular scaffolds.
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Affiliation(s)
- Yanis Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Rennes University, 16 Boulevard de Bulgarie, 35000 Rennes, France (T.C.); (N.B.)
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; (M.A.R.); (A.G.L.); (C.L.C.J.)
- Shriners Children’s Boston, 51 Blossom Street, Boston, MA 02114, USA; (K.U.); basa (B.E.U.)
- SITI Laboratory, UMR1236, INSERM, Rennes University, 2 Rue Henri le Guillou, 35000 Rennes, France
| | - David M. Kostyra
- Plastic Surgery Research Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA;
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA
| | - Theodoros Chrelias
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Rennes University, 16 Boulevard de Bulgarie, 35000 Rennes, France (T.C.); (N.B.)
| | - Mark A. Randolph
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; (M.A.R.); (A.G.L.); (C.L.C.J.)
- Shriners Children’s Boston, 51 Blossom Street, Boston, MA 02114, USA; (K.U.); basa (B.E.U.)
- Plastic Surgery Research Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA;
| | - Alexandre G. Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; (M.A.R.); (A.G.L.); (C.L.C.J.)
- Shriners Children’s Boston, 51 Blossom Street, Boston, MA 02114, USA; (K.U.); basa (B.E.U.)
| | - Curtis L. Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; (M.A.R.); (A.G.L.); (C.L.C.J.)
- Shriners Children’s Boston, 51 Blossom Street, Boston, MA 02114, USA; (K.U.); basa (B.E.U.)
| | - Korkut Uygun
- Shriners Children’s Boston, 51 Blossom Street, Boston, MA 02114, USA; (K.U.); basa (B.E.U.)
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA
| | - Basak E. Uygun
- Shriners Children’s Boston, 51 Blossom Street, Boston, MA 02114, USA; (K.U.); basa (B.E.U.)
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Rennes University, 16 Boulevard de Bulgarie, 35000 Rennes, France (T.C.); (N.B.)
- SITI Laboratory, UMR1236, INSERM, Rennes University, 2 Rue Henri le Guillou, 35000 Rennes, France
| | - Jérôme Duisit
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Rennes University, 16 Boulevard de Bulgarie, 35000 Rennes, France (T.C.); (N.B.)
- IRIS Sud Hospitals, Rue Baron Lambert 38, 1040 Etterbeek, Belgium
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8
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Berkane Y, Lellouch AG, Goudot G, Shamlou A, Filz von Reiterdank I, Goutard M, Tawa P, Girard P, Bertheuil N, Uygun BE, Randolph MA, Duisit J, Cetrulo CL, Uygun K. Towards Optimizing Sub-Normothermic Machine Perfusion in Fasciocutaneous Flaps: A Large Animal Study. Bioengineering (Basel) 2023; 10:1415. [PMID: 38136006 PMCID: PMC10740951 DOI: 10.3390/bioengineering10121415] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Machine perfusion has developed rapidly since its first use in solid organ transplantation. Likewise, reconstructive surgery has kept pace, and ex vivo perfusion appears as a new trend in vascularized composite allotransplants preservation. In autologous reconstruction, fasciocutaneous flaps are now the gold standard due to their low morbidity (muscle sparing) and favorable functional and cosmetic results. However, failures still occasionally arise due to difficulties encountered with the vessels during free flap transfer. The development of machine perfusion procedures would make it possible to temporarily substitute or even avoid microsurgical anastomoses in certain complex cases. We performed oxygenated acellular sub-normothermic perfusions of fasciocutaneous flaps for 24 and 48 h in a porcine model and compared continuous and intermittent perfusion regimens. The monitored metrics included vascular resistance, edema, arteriovenous oxygen gas differentials, and metabolic parameters. A final histological assessment was performed. Porcine flaps which underwent successful oxygenated perfusion showed minimal or no signs of cell necrosis at the end of the perfusion. Intermittent perfusion allowed overall better results to be obtained at 24 h and extended perfusion duration. This work provides a strong foundation for further research and could lead to new and reliable reconstructive techniques.
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Affiliation(s)
- Yanis Berkane
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Université de Rennes, 35000 Rennes, France; (P.G.); (N.B.); (J.D.)
- Shriners Children’s Boston, Boston, MA 02114, USA
- SITI Laboratory, UMR1236, INSERM, Université de Rennes, 35000 Rennes, France
| | - Alexandre G. Lellouch
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- Innovative Therapies in Haemostasis, INSERM UMR-S 1140, University of Paris, 75006 Paris, France
| | - Guillaume Goudot
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA;
- INSERM U970 PARCC, Université Paris Cité, 75000 Paris, France
| | - Austin Shamlou
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
| | - Irina Filz von Reiterdank
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA 02115, USA
- University Medical Center Utrecht, 3584 Utrecht, The Netherlands
| | - Marion Goutard
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- SITI Laboratory, UMR1236, INSERM, Université de Rennes, 35000 Rennes, France
| | - Pierre Tawa
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
| | - Paul Girard
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Université de Rennes, 35000 Rennes, France; (P.G.); (N.B.); (J.D.)
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Université de Rennes, 35000 Rennes, France; (P.G.); (N.B.); (J.D.)
- SITI Laboratory, UMR1236, INSERM, Université de Rennes, 35000 Rennes, France
| | - Basak E. Uygun
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA 02115, USA
| | - Mark A. Randolph
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
| | - Jérôme Duisit
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Université de Rennes, 35000 Rennes, France; (P.G.); (N.B.); (J.D.)
- Iris South Hospitals, 1040 Brussels, Belgium
| | - Curtis L. Cetrulo
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
| | - Korkut Uygun
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA 02115, USA
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9
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Tawa P, Goutard M, Andrews AR, de Vries RJ, Rosales IA, Yeh H, Uygun B, Randolph MA, Lellouch AG, Uygun K, Cetrulo CL. Response Regarding: Continuous Versus Pulsatile Flow in 24-h Vascularized Composite Allograft Machine Perfusion in Swine: A Pilot Study. J Surg Res 2023; 291:751-753. [PMID: 37517972 DOI: 10.1016/j.jss.2023.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/27/2023] [Indexed: 08/01/2023]
Affiliation(s)
- Pierre Tawa
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts
| | - Marion Goutard
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts
| | - Alec R Andrews
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts
| | - Reinier J de Vries
- Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Boston, Massachusetts; Department of Surgery, Amsterdam University Medical Centers-location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ivy A Rosales
- Harvard Medical School, Boston, Massachusetts; Immunopathology Research Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, Massachusetts
| | - Heidi Yeh
- Harvard Medical School, Boston, Massachusetts; Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Basak Uygun
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Mark A Randolph
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts
| | - Alexandre G Lellouch
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts; Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Korkut Uygun
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Boston, Massachusetts.
| | - Curtis L Cetrulo
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts.
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10
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Rossi N, Hadad H, Bejar-Chapa M, Peretti GM, Randolph MA, Redmond RW, Guastaldi FPS. Bone Marrow Stem Cells with Tissue-Engineered Scaffolds for Large Bone Segmental Defects: A Systematic Review. Tissue Eng Part B Rev 2023; 29:457-472. [PMID: 36905366 DOI: 10.1089/ten.teb.2022.0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Critical-sized bone defects (CSBDs) represent a significant clinical challenge, stimulating researchers to seek new methods for successful bone reconstruction. The aim of this systematic review is to assess whether bone marrow stem cells (BMSCs) combined with tissue-engineered scaffolds have demonstrated improved bone regeneration in the treatment of CSBD in large preclinical animal models. A search of electronic databases (PubMed, Embase, Web of Science, and Cochrane Library) focused on in vivo large animal studies identified 10 articles according to the following inclusion criteria: (1) in vivo large animal models with segmental bone defects; (2) treatment with tissue-engineered scaffolds combined with BMSCs; (3) the presence of a control group; and (4) a minimum of a histological analysis outcome. Animal research: reporting of in Vivo Experiments guidelines were used for quality assessment, and Systematic Review Center for Laboratory animal Experimentation's risk of bias tool was used to define internal validity. The results demonstrated that tissue-engineered scaffolds, either from autografts or allografts, when combined with BMSCs provide improved bone mineralization and bone formation, including a critical role in the remodeling phase of bone healing. BMSC-seeded scaffolds showed improved biomechanical properties and microarchitecture properties of the regenerated bone when compared with untreated and scaffold-alone groups. This review highlights the efficacy of tissue engineering strategies for the repair of extensive bone defects in preclinical large-animal models. In particular, the use of mesenchymal stem cells, combined with bioscaffolds, seems to be a successful method in comparison to cell-free scaffolds.
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Affiliation(s)
- Nicolò Rossi
- Wellman Center for Photomedicine and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Henrique Hadad
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Maria Bejar-Chapa
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Giuseppe M Peretti
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Mark A Randolph
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert W Redmond
- Wellman Center for Photomedicine and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Fernando P S Guastaldi
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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11
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Massengale M, Massengale JL, Benson CR, Baryawno N, Oki T, Steinhauser ML, Wang A, Balani D, Oh LS, Randolph MA, Gill TJ, Kronenberg HM, Scadden DT. Adult Prg4+ progenitors repair long-term articular cartilage wounds in vivo. JCI Insight 2023; 8:e167858. [PMID: 37681409 PMCID: PMC10544199 DOI: 10.1172/jci.insight.167858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 07/17/2023] [Indexed: 09/09/2023] Open
Abstract
The identity and origin of the stem/progenitor cells for adult joint cartilage repair remain unknown, impeding therapeutic development. Simulating the common therapeutic modality for cartilage repair in humans, i.e., full-thickness microfracture joint surgery, we combined the mouse full-thickness injury model with lineage tracing and identified a distinct skeletal progenitor cell type enabling long-term (beyond 7 days after injury) articular cartilage repair in vivo. Deriving from a population with active Prg4 expression in adulthood while lacking aggrecan expression, these progenitors proliferate, differentiate to express aggrecan and type II collagen, and predominate in long-term articular cartilage wounds, where they represent the principal repair progenitors in situ under native repair conditions without cellular transplantation. They originate outside the adult bone marrow or superficial zone articular cartilage. These findings have implications for skeletal biology and regenerative medicine for joint injury repair.
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Affiliation(s)
- Mei Massengale
- Spaulding Rehabilitation Network at Mass General Brigham, Cambridge, Massachusetts, USA
- Department of Medicine, Endocrine Unit, and
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Stem Cell Institute, and
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Justin L. Massengale
- Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | | | - Ninib Baryawno
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Stem Cell Institute, and
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Toshihiko Oki
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Stem Cell Institute, and
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Matthew L. Steinhauser
- Aging Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Medicine, Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | | | | | - Mark A. Randolph
- Department of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Thomas J. Gill
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
| | | | - David T. Scadden
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Stem Cell Institute, and
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
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12
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Charlès L, Agius T, Filz von Reiterdank I, Hagedorn J, Berkane Y, Lancia HH, Uygun BE, Uygun K, Cetrulo CL, Randolph MA, Lellouch AG. Modified Tail Vein and Penile Vein Puncture for Blood Sampling in the Rat Model. J Vis Exp 2023:10.3791/65513. [PMID: 37458471 PMCID: PMC10910861 DOI: 10.3791/65513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Blood samples are required in most experimental animal designs to assess various hematological parameters. This paper presents two procedures for blood collection in rats: the lateral tail vein puncture and the dorsal penile vein puncture, which offer significant advantages over other previously described techniques. This study shows that these two procedures allow for fast sampling (under 10 min) and yield sufficient blood volumes for most assays (202 μL ± 67.7 μL). The dorsal penile vein puncture must be done under anesthesia, whereas the lateral tail vein puncture can be done on a conscious, restrained animal. Alternating these two techniques, therefore, enables blood draw in any situation. While it is always recommended for an operator to be assisted during a procedure to ensure animal welfare, these techniques require only a single operator, unlike most blood sampling methods that require two. Moreover, whereas these previously described methods (e.g., jugular stick, subclavian vein blood draw) require extensive prior training to avoid harm to or death of the animal, tail vein and dorsal penile vein puncture are rarely fatal. For all these reasons, and according to the context (e.g., for studies including male rats, during the perioperative or immediate postoperative period, for animals with thin tail veins), both techniques can be used alternately to enable repeated blood draws.
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Affiliation(s)
- Laura Charlès
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston
| | - Thomas Agius
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital; Department of Vascular Surgery, Centre Hospitalier Universitaire Vaudois and University of Lausanne
| | - Irina Filz von Reiterdank
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht
| | - Janna Hagedorn
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston
| | - Yanis Berkane
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center (CHU de Rennes), Rennes 1 University
| | - Hyshem H Lancia
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston
| | - Basak E Uygun
- Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital
| | - Korkut Uygun
- Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital
| | - Curtis L Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Plastic Surgery Research Laboratory, Massachusetts General Hospital
| | - Mark A Randolph
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Plastic Surgery Research Laboratory, Massachusetts General Hospital
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital;
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13
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Goutard M, de Vries RJ, Tawa P, Pendexter CA, Rosales IA, Tessier SN, Burlage LC, Lantieri L, Randolph MA, Lellouch AG, Cetrulo CL, Uygun K. Exceeding the Limits of Static Cold Storage in Limb Transplantation Using Subnormothermic Machine Perfusion. J Reconstr Microsurg 2023; 39:350-360. [PMID: 35764315 PMCID: PMC10848168 DOI: 10.1055/a-1886-5697] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND For 50 years, static cold storage (SCS) has been the gold standard for solid organ preservation in transplantation. Although logistically convenient, this preservation method presents important constraints in terms of duration and cold ischemia-induced lesions. We aimed to develop a machine perfusion (MP) protocol for recovery of vascularized composite allografts (VCA) after static cold preservation and determine its effects in a rat limb transplantation model. METHODS Partial hindlimbs were procured from Lewis rats and subjected to SCS in Histidine-Tryptophan-Ketoglutarate solution for 0, 12, 18, 24, and 48 hours. They were then either transplanted (Txp), subjected to subnormothermic machine perfusion (SNMP) for 3 hours with a modified Steen solution, or to SNMP + Txp. Perfusion parameters were assessed for blood gas and electrolytes measurement, and flow rate and arterial pressures were monitored continuously. Histology was assessed at the end of perfusion. For select SCS durations, graft survival and clinical outcomes after transplantation were compared between groups at 21 days. RESULTS Transplantation of limbs preserved for 0, 12, 18, and 24-hour SCS resulted in similar survival rates at postoperative day 21. Grafts cold-stored for 48 hours presented delayed graft failure (p = 0.0032). SNMP of limbs after 12-hour SCS recovered the vascular resistance, potassium, and lactate levels to values similar to limbs that were not subjected to SCS. However, 18-hour SCS grafts developed significant edema during SNMP recovery. Transplantation of grafts that had undergone a mixed preservation method (12-hour SCS + SNMP + Txp) resulted in better clinical outcomes based on skin clinical scores at day 21 post-transplantation when compared to the SCS + Txp group (p = 0.01613). CONCLUSION To date, VCA MP is still limited to animal models and no protocols are yet developed for graft recovery. Our study suggests that ex vivo SNMP could help increase the preservation duration and limit cold ischemia-induced injury in VCA transplantation.
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Affiliation(s)
- Marion Goutard
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts
- Department of Surgery, Harvard Medical School, Harvard Medical School, Boston, Massachusetts
- Department of Research, Shriners Children’s, Boston, Massachusetts
- Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Reinier J. de Vries
- Department of Surgery, Harvard Medical School, Harvard Medical School, Boston, Massachusetts
- Department of Research, Shriners Children’s, Boston, Massachusetts
- Department of Surgery, Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Boston, Massachusetts
- Department of Surgery, Amsterdam University Medical Centers – location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Pierre Tawa
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts
- Department of Surgery, Harvard Medical School, Harvard Medical School, Boston, Massachusetts
- Department of Research, Shriners Children’s, Boston, Massachusetts
| | - Casie A. Pendexter
- Department of Surgery, Harvard Medical School, Harvard Medical School, Boston, Massachusetts
- Department of Research, Shriners Children’s, Boston, Massachusetts
- Department of Surgery, Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Ivy A. Rosales
- Immunopathology Research Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, Massachusetts
| | - Shannon N. Tessier
- Department of Surgery, Harvard Medical School, Harvard Medical School, Boston, Massachusetts
- Department of Research, Shriners Children’s, Boston, Massachusetts
- Department of Surgery, Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Laura C. Burlage
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts
- Department of Surgery, Harvard Medical School, Harvard Medical School, Boston, Massachusetts
- Department of Research, Shriners Children’s, Boston, Massachusetts
- Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands
- Division of Plastic and Reconstructive Surgery within the Department of Surgery, Radboudumc, Radboud University, Nijmegen, the Netherlands
| | - Laurent Lantieri
- Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Mark A. Randolph
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts
- Department of Surgery, Harvard Medical School, Harvard Medical School, Boston, Massachusetts
- Department of Research, Shriners Children’s, Boston, Massachusetts
| | - Alexandre G. Lellouch
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts
- Department of Surgery, Harvard Medical School, Harvard Medical School, Boston, Massachusetts
- Department of Research, Shriners Children’s, Boston, Massachusetts
- Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Curtis L. Cetrulo
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts
- Department of Surgery, Harvard Medical School, Harvard Medical School, Boston, Massachusetts
- Department of Research, Shriners Children’s, Boston, Massachusetts
| | - Korkut Uygun
- Department of Surgery, Harvard Medical School, Harvard Medical School, Boston, Massachusetts
- Department of Research, Shriners Children’s, Boston, Massachusetts
- Department of Surgery, Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Boston, Massachusetts
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14
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Oganesyan RV, Lellouch AG, Acun A, Lupon E, Taveau CB, Burlage LC, Lantieri LA, Randolph MA, Cetrulo CL, Uygun BE. Acellular Nipple Scaffold Development, Characterization, and Preliminary Biocompatibility Assessment in a Swine Model. Plast Reconstr Surg 2023; 151:618e-629e. [PMID: 36472499 PMCID: PMC10859846 DOI: 10.1097/prs.0000000000009998] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The standard in nipple reconstruction remains the autologous skin flap. Unfortunately, the results are not satisfying, with up to 75% loss of nipple projection over time. Existing studies investigated the use of primates as a source of implants. The authors hypothesized that the porcine nipple can serve as a perfect shape-supporting implant because of functional similarities to the human nipple. A decellularization protocol was developed to obtain an acellular nipple scaffold (ANS) for nipple reconstruction. METHODS Tissue samples were collected from eight disease-free female Yorkshire pigs (60 to 70 kg) and then decellularized. The decellularization efficiency and extracellular matrix characterization was performed histologically and quantitatively (DNA, total collagen, elastin, and glycosaminoglycan content). In vitro and in vivo biocompatibility was determined by human dermal fibroblast culture and subcutaneous implantation of six ANSs in a single Yorkshire pig (60 to 70 kg), respectively. Inflammation and adverse events were monitored daily based on local clinical signs. RESULTS The authors showed that all cellular structures and 96% of DNA [321.7 ± 57.6 ng DNA/mg wet tissue versus 11.7 ± 10.9 ng DNA/mg wet tissue, in native and ANS, respectively ( P < 0.001)] can be successfully removed. However, this was associated with a decrease in collagen [89.0 ± 11.4 and 58.8 ± 9.6 μg collagen/mg ( P < 0.001)] and elastin [14.2 ± 1.6 and 7.9 ± 2.4 μg elastin/mg ( P < 0.05)] and an increase in glycosaminoglycan content [5.0 ± 0.7 and 6.0 ± 0.8 ng/mg ( P < 0.05)]. ANS can support continuous cell growth in vitro and during preliminary biocompatibility tests in vivo. CONCLUSION This is a preliminary report of a novel promising ANS for nipple reconstruction, but more research is needed to validate results. CLINICAL RELEVANCE STATEMENT Breast cancer is very common among women. Treatment involves mastectomy, but its consequences affect patient mental well-being, and can lead to depression. Nipple-areola complex reconstruction is critical, and existing methods lead to unsatisfactory outcomes.
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Affiliation(s)
- Ruben V. Oganesyan
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
- Shriners Children’s Boston
| | - Alexandre G. Lellouch
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School
- Department of Plastic Surgery, European George Pompidou Hospital, University of Paris
- Shriners Children’s Boston
| | - Aylin Acun
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
- Shriners Children’s Boston
- Department of Biomedical Engineering, Widener University
| | - Elise Lupon
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School
- University Institute of Locomotor and Sport (IULS), Pasteur Hospital
- Shriners Children’s Boston
| | - Corentin B. Taveau
- Department of Plastic Surgery, European George Pompidou Hospital, University of Paris
| | - Laura C. Burlage
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School
- Shriners Children’s Boston
- Department of Plastic Surgery, Amsterdam University Medical Center
| | - Laurent A. Lantieri
- Department of Plastic Surgery, European George Pompidou Hospital, University of Paris
| | - Mark A. Randolph
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School
- Shriners Children’s Boston
| | - Curtis L. Cetrulo
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School
- Shriners Children’s Boston
| | - Basak E. Uygun
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
- Shriners Children’s Boston
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Tawa P, Goutard M, Andrews AR, de Vries RJ, Rosales IA, Yeh H, Uygun B, Randolph MA, Lellouch AG, Uygun K, Cetrulo CL. Continuous versus Pulsatile Flow in 24-Hour Vascularized Composite Allograft Machine Perfusion in Swine: A Pilot Study. J Surg Res 2023; 283:1145-1153. [PMID: 36915006 PMCID: PMC10867902 DOI: 10.1016/j.jss.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 10/12/2022] [Accepted: 11/02/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Multiple perfusion systems have been investigated on vascularized composite allografts, with various temperatures and different preservation solutions, most using continuous flow (CF). However, physiological flow is pulsatile and provides better outcomes in kidney and lung ex vivo perfusions. The objective of this pilot study is to compare pulsatile flow (PF) with CF in our 24-h subnormothermic machine perfusion protocol for swine hindlimbs. METHODS Partial hindlimbs were harvested from Yorkshire pigs and perfused with a modified Steen solution at 21°C for 24 h either with CF (n = 3) or with pulsatile flow (PF) at 60 beats/min (n = 3). Perfusion parameters, endothelial markers, and muscle biopsies were assessed at different timepoints. RESULTS Overall, lactate levels were significantly lower in the PF group (P = 0.001). Glucose uptake and potassium concentration were similar in both groups throughout perfusion. Total nitric oxide levels were significantly higher in the PF group throughout perfusion (P = 0.032). Nitric oxide/endothelin-1 ratio also tends to be higher in the PF group, reflecting a potentially better vasoconductivity with PF, although not reaching statistical significance (P = 0.095). Arterial resistances were higher in the PF group (P < 0.001). Histological assessment did not show significant difference in muscular injury between the two groups. Weight increased quicker in the CF group but reached similar values with the PF after 24 h. CONCLUSIONS This pilot study suggests that PF may provide superior preservation of vascularized composite allografts when perfused for 24 h at subnormothermic temperatures, with potential improvement in endothelial function and decreased ischemic injury.
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Affiliation(s)
- Pierre Tawa
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts; Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Marion Goutard
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts; Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Alec R Andrews
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts
| | - Reinier J de Vries
- Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts; Department of Surgery, Amsterdam University Medical Centers - Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Ivy A Rosales
- Harvard Medical School, Boston, Massachusetts; Immunopathology Research Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, Massachusetts
| | - Heidi Yeh
- Harvard Medical School, Boston, Massachusetts; Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Basak Uygun
- Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Mark A Randolph
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts
| | - Alexandre G Lellouch
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts; Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Korkut Uygun
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Boston, Massachusetts.
| | - Curtis L Cetrulo
- Division of Plastic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Shriners Hospital for Children, Boston, Massachusetts.
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Matheus HR, Hadad H, Monteiro JLGC, Takusagawa T, Zhang F, Ye Q, He Y, Rosales IA, Jounaidi Y, Randolph MA, Guastaldi FPS. Photo-crosslinked GelMA loaded with dental pulp stem cells and VEGF to repair critical-sized soft tissue defects in rats. J Stomatol Oral Maxillofac Surg 2023; 124:101373. [PMID: 36584767 DOI: 10.1016/j.jormas.2022.101373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Tissue engineering of skin and mucosa is essential for the esthetic and functional reconstruction of individuals disfigured by trauma, resection surgery, or severe burns while overcoming the limited amount of autograft and donor site morbidity. PURPOSE We aimed to determine whether a combination of Gelatin-methacryloyl (GelMA) hydrogel scaffold alone or loaded with either dental pulp stem cells (DPSCs) and/or vascular endothelial growth factor (VEGF) could improve skin wound healing in rats. MATERIALS AND METHODS Four 10 mm full-thickness skin defects were created on the dorsum of 15 Sprague-Dawley rats. The wounds were treated with GelMA alone, GelMA+DPSCs, or GelMA+DPSCs+VEGF. Unprotected wounds were used as controls. Animals were euthanized at 1-, 2-, and 4 weeks post-surgery, and the healing wounds were harvested for clinical, histological, and RT-PCR analysis. RESULTS No signs of clinical inflammation were observed among all groups. Few and sparse mononuclear inflammatory cells were observed in GelMA+DPSCs and GelMA+DPSCs+VEGF groups at 2 weeks, with complete epithelialization of the wounds. At 4 weeks, the epidermis in GelMA+DPSCs and GelMA+DPSCs+VEGF groups was indistinguishable from the empty defect and GelMA groups. The decrease in cellularity and increase in density of collagen fibers were observed over time in both GelMA+DPSCs and GelMA+DPSCs+VEGF groups but were more evident in the GelMA+DPSCs+VEGF group. The GelMA+DPSCs+VEGF group showed a higher expression of the KER 10 gene at all time points compared with the other groups. Expression of Col1 A1 and TGFβ-1 were not statistically different over time neither among the groups. CONCLUSION GelMA scaffolds loaded with DPSCs, and VEGF accelerated the re-epithelialization of skin wounds.
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Affiliation(s)
- Henrique R Matheus
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, United States of America; Department of Diagnosis and Surgery, Periodontics Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Henrique Hadad
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, United States of America; Department of Diagnosis and Surgery, Oral & Maxillofacial Surgery Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Joao L G C Monteiro
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, United States of America
| | - Toru Takusagawa
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, United States of America
| | - Fugui Zhang
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, United States of America
| | - Qingsong Ye
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, United States of America
| | - Yan He
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, United States of America
| | - Ivy A Rosales
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Youssef Jounaidi
- Department of Anaesthesia, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Mark A Randolph
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Fernando P S Guastaldi
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, United States of America.
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Berkane Y, Alana Shamlou A, Reyes J, Lancia HH, Filz von Reiterdank I, Bertheuil N, Uygun BE, Uygun K, Austen WG, Cetrulo CL, Randolph MA, Lellouch AG. The Superficial Inferior Epigastric Artery Axial Flap to Study Ischemic Preconditioning Effects in a Rat Model. J Vis Exp 2023:10.3791/64980. [PMID: 36779623 PMCID: PMC10910865 DOI: 10.3791/64980] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Fasciocutaneous flaps (FCF) have become the gold standard for complex defect reconstruction in plastic and reconstructive surgery. This muscle-sparing technique allows transferring vascularized tissues to cover any large defect. FCF can be used as pedicled flaps or as free flaps; however, in the literature, failure rates for pedicled FCF and free FCF are above 5%, leaving room for improvement for these techniques and further knowledge expansion in this area. Ischemic preconditioning (I.P.) has been widely studied, but the mechanisms and the optimization of the I.P. regimen are yet to be determined. This phenomenon is indeed poorly explored in plastic and reconstructive surgery. Here, a surgical model is presented to study the I.P. regimen in a rat axial fasciocutaneous flap model, describing how to safely and reliably assess the effects of I.P. on flap survival. This article describes the complete surgical procedure, including suggestions to improve the reliability of this model. The objective is to provide researchers with a reproducible and reliable model to test various ischemic preconditioning regimens and assess their effects on flap survivability.
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Affiliation(s)
- Yanis Berkane
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center (CHU de Rennes), University of Rennes 1; Shriners Children's Boston
| | - Austin Alana Shamlou
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Plastic Surgery Research Laboratory, Massachusetts General Hospital; Shriners Children's Boston
| | - Jose Reyes
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School
| | - Hyshem H Lancia
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston
| | - Irina Filz von Reiterdank
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital; Department of Plastic Surgery and Hand Surgery, University Medical Center Utrecht
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center (CHU de Rennes), University of Rennes 1
| | - Basak E Uygun
- Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital
| | - Korkut Uygun
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital
| | - William G Austen
- Harvard Medical School; Plastic Surgery Research Laboratory, Massachusetts General Hospital
| | - Curtis L Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Plastic Surgery Research Laboratory, Massachusetts General Hospital; Shriners Children's Boston
| | - Mark A Randolph
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Plastic Surgery Research Laboratory, Massachusetts General Hospital; Shriners Children's Boston
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital; Department of Plastic, Reconstructive, and Aesthetic Surgery, Groupe Almaviva Santé, Clinique de l'Alma;
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Lellouch AG, Andrews AR, Saviane G, Ng ZY, Schol IM, Goutard M, Gama AR, Rosales IA, Colvin RB, Lantieri LA, Randolph MA, Benichou G, Cetrulo CL. Tolerance of a Vascularized Composite Allograft Achieved in MHC Class-I-mismatch Swine via Mixed Chimerism. Front Immunol 2022; 13:829406. [PMID: 35619720 PMCID: PMC9128064 DOI: 10.3389/fimmu.2022.829406] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/15/2022] [Indexed: 11/26/2022] Open
Abstract
Background Vascularized composite allografts (VCAs) allow reconstruction of devastating injuries and amputations, yet require lifelong immunosuppression that is associated with significant morbidity. Induction of immune tolerance of VCAs would permit widespread use of these procedures. VCAs are acquired from deceased donors most likely to be fully-MHC-mismatched (in contrast to living-related renal transplant donor-recipient pairs matched at one MHC haplotype). After achieving VCA tolerance in a swine model equivalent to clinical living-related renal transplants (single-haplotype MHC mismatches: e.g., “mother-daughter”/haploidentical), we tested our protocol in MHC class I, class II, and fully-MHC-mismatched pairs. Although class II mismatched swine demonstrated similar results as the haploidentical scenario (stable mixed chimerism and tolerance), our protocol failed to prevent rejection of class I and full mismatch VCAs. Here, we describe a new adapted conditioning protocol that successfully achieved tolerance across MHC class-I-mismatch barriers in swine. Methods Swine were treated with non-myeloablative total body and thymic irradiation two days prior to infusion of bone marrow cells from an MHC class I-mismatched donor. They also received a short-term treatment with CTLA4-Ig (Belatacept®) and anti-IL6R mAb (Tociluzimab®) and were transplanted with an osteomyocutaneous VCA from the same donor. Results Stable mixed chimerism and tolerance of MHC class-I-mismatched VCAs was achieved in 3 recipients. Allograft tolerance was associated with a sustained lack of anti-donor T cell response and a concomitant expansion of double negative CD4-CD8- T cells producing IL-10. Conclusions This study demonstrates the first successful mixed chimerism-induced VCA tolerance in a large animal model across a MHC class-I-mismatch. Future studies aimed at fully-mismatched donor-recipient pairs are under investigation with this protocol.
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Affiliation(s)
- Alexandre G Lellouch
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France.,Shriners Hospitals for Children, Harvard Medical School, Boston, MA, United States
| | - Alec R Andrews
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Shriners Hospitals for Children, Harvard Medical School, Boston, MA, United States
| | - Gaelle Saviane
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Shriners Hospitals for Children, Harvard Medical School, Boston, MA, United States.,Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Zhi Yang Ng
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Ilse M Schol
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Marion Goutard
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France.,Shriners Hospitals for Children, Harvard Medical School, Boston, MA, United States
| | - Amon-Ra Gama
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Ivy A Rosales
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Robert B Colvin
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Laurent A Lantieri
- Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Mark A Randolph
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Shriners Hospitals for Children, Harvard Medical School, Boston, MA, United States
| | - Gilles Benichou
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Curtis L Cetrulo
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Shriners Hospitals for Children, Harvard Medical School, Boston, MA, United States.,Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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Scott BB, Randolph MA, Guastaldi FPS, Wu RC, Redmond RW. Light-Activated Vascular Anastomosis. Surg Innov 2022:15533506221104382. [DOI: 10.1177/15533506221104382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. There have been few advances in technique since vascular anastomosis was performed with silk suture on a curved needle in 1902. This technique results in disruption of the endothelium with exposed intraluminal suture, both of which may lead to thrombocyte aggregation, intimal hyperplasia, and vascular stenosis. A variety of alternative techniques have been explored, with limited success. Photochemical tissue bonding (PTB) is a light-activated methodology of rapidly cross-linking tissue interfaces at the molecular level. Herein, we describe a new technique for anastomosis of venous interposition graft in an ovine model of femoral artery bypass utilizing PTB. Methods. Polypay specific pathogen free sheep (n = 5; 40-45 kg) underwent femoral artery bypass utilizing saphenous vein. The femoral artery was transected and reversed saphenous vein was implanted as an interposition graft. The proximal anastomosis was created as a vein-over-artery cuff utilizing PTB, and the distal anastomosis was created with standard interrupted 8-0 polypropylene suture. Four weeks post-index operation, femoral angiogram was performed to evaluate patency, tortuosity, and luminal diameter. All bypass grafts were harvested and longitudinal and transverse histological sections from the proximal anastomosis were analyzed. Results. The PTB anastomoses (n = 5) were immediately watertight and patent. All animals survived the 28-day study duration. Angiography revealed patent grafts with no aneurysm or stenosis (n = 5). Histologic examination revealed integration of the venous endothelium with the arterial adventitia. Conclusion. Photochemical tissue bonding creates an immediate strong, watertight vascular anastomosis that can withstand physiologic arterial pressure and remains patent at 28 days without the need for intraluminal suture.
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Affiliation(s)
- Benjamin B. Scott
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
- Plastic Surgery Research Laboratory, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Mark A. Randolph
- Plastic Surgery Research Laboratory, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Fernando P. S. Guastaldi
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Ruby C. Wu
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Robert W. Redmond
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
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20
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Pozzo V, Romano G, Goutard M, Lupon E, Tawa P, Acun A, Andrews AR, Taveau CB, Uygun BE, Randolph MA, Cetrulo CL, Lellouch AG. A Reliable Porcine Fascio-Cutaneous Flap Model for Vascularized Composite Allografts Bioengineering Studies. J Vis Exp 2022. [DOI: 10.3791/63557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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21
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Scott BB, Wang Y, Wu RC, Randolph MA, Redmond RW. Light-activated photosealing with human amniotic membrane strengthens bowel anastomosis in a hypotensive, trauma-relevant swine model. Lasers Surg Med 2022; 54:407-417. [PMID: 34664720 DOI: 10.1002/lsm.23485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/27/2021] [Accepted: 10/04/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Gastrointestinal anastomotic leakage is a dreaded complication despite advancements in surgical technique. Photochemical tissue bonding (PTB) is a method of sealing tissue surfaces utilizing photoactive dye. We evaluated if crosslinked human amniotic membrane (xHAM) photosealed over the enteroenterostomy would augment anastomotic strength in a trauma-relevant swine hemorrhagic shock model. METHODS Yorkshire swine (40-45 kg, n = 14) underwent midline laparotomy and sharp transection of the small intestine 120 cm proximal to the ileocecal fold. Immediately following intestinal transection, a controlled arterial bleed was performed to reach hemorrhagic shock. Intestinal repair was performed after 60 minutes and autotransfusion of the withdrawn blood was performed for resuscitation. Animals were randomized to small intestinal anastomosis by one of the following methods (seven per group): suture repair (SR), or SR with PTB augmentation. Animals were euthanized at postoperative Day 28 and burst pressure (BP) strength testing was performed on all excised specimens. RESULTS Mean BP for SR, PTB, and native tissue groups were 229 ± 40, 282 ± 21, and 282 ± 47 mmHg, respectively, with the SR group statistically significantly different on analysis of variance (p = 0.02). Post-hoc Tukey all-pairs comparison demonstrated a statistically significant difference in burst pressure strength between the SR only and the PTB group (p = 0.04). All specimens in SR group ruptured at the anastomosis upon burst pressure testing, while all specimens in the PTB group ruptured at least 2.5 cm from the anastomosis. CONCLUSION Photosealing with xHAM significantly augments the strength of small intestinal anastomosis performed in a trauma porcine model.
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Affiliation(s)
- Benjamin B Scott
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
- Plastic Surgery Research Laboratory, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ying Wang
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ruby C Wu
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Mark A Randolph
- Plastic Surgery Research Laboratory, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Robert W Redmond
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
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Burlage LC, Lellouch AG, Taveau CB, Tratnig-Frankl P, Pendexter CA, Randolph MA, Porte RJ, Lantieri LA, Tessier SN, Cetrulo CL, Uygun K. Optimization of Ex Vivo Machine Perfusion and Transplantation of Vascularized Composite Allografts. J Surg Res 2022; 270:151-161. [PMID: 34670191 PMCID: PMC8712379 DOI: 10.1016/j.jss.2021.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 08/30/2021] [Accepted: 09/16/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Machine perfusion is gaining interest as an efficient method of tissue preservation of Vascularized Composite Allografts (VCA). The aim of this study was to develop a protocol for ex vivo subnormothermic oxygenated machine perfusion (SNMP) on rodent hindlimbs and to validate our protocol in a heterotopic hindlimb transplant model. METHODS In this optimization study we compared three different solutions during 6 h of SNMP (n = 4 per group). Ten control limbs were stored in a preservation solution on Static Cold Storage [SCS]). During SNMP we monitored arterial flowrate, lactate levels, and edema. After SNMP, muscle biopsies were taken for histology examination, and energy charge analysis. We validated the best perfusion protocol in a heterotopic limb transplantation model with 30-d follow up (n = 13). As controls, we transplanted untreated limbs (n = 5) and hindlimbs preserved with either 6 or 24 h of SCS (n = 4 and n = 5). RESULTS During SNMP, arterial outflow increased, and lactate clearance decreased in all groups. Total edema was significantly lower in the HBOC-201 group compared to the BSA group (P = 0.005), 4.9 (4.3-6.1) versus 48.8 (39.1-53.2) percentage, but not to the BSA + PEG group (P = 0.19). Energy charge levels of SCS controls decreased 4-fold compared to limbs perfused with acellular oxygen carrier HBOC-201, 0.10 (0.07-0.17) versus 0.46 (0.42-0.49) respectively (P = 0.002). CONCLUSIONS Six hours ex vivo SNMP of rodent hindlimbs using an acellular oxygen carrier HBOC-201 results in superior tissue preservation compared to conventional SCS.
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Affiliation(s)
- Laura C. Burlage
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital/ Harvard Medical School, Boston, MA, USA,Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA,Division of Plastic and Reconstructive Surgery within the Department of Surgery, Massachusetts General Hospital/ Harvard Medical School, Boston, MA, USA,Shriners Hospitals for Children, Boston, MA USA,Corresponding author:
| | - Alexandre G. Lellouch
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA,Division of Plastic and Reconstructive Surgery within the Department of Surgery, Massachusetts General Hospital/ Harvard Medical School, Boston, MA, USA,Division of Plastic and Reconstructive Surgery within the Department of Surgery, European George Pompidou Hospital, University of Paris, Paris, France,Shriners Hospitals for Children, Boston, MA USA
| | - Corentin B. Taveau
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA,Division of Plastic and Reconstructive Surgery within the Department of Surgery, Massachusetts General Hospital/ Harvard Medical School, Boston, MA, USA,Division of Plastic and Reconstructive Surgery within the Department of Surgery, European George Pompidou Hospital, University of Paris, Paris, France,Shriners Hospitals for Children, Boston, MA USA
| | - Philipp Tratnig-Frankl
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA,Division of Plastic and Reconstructive Surgery within the Department of Surgery, Massachusetts General Hospital/ Harvard Medical School, Boston, MA, USA,Shriners Hospitals for Children, Boston, MA USA
| | - Casie A. Pendexter
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital/ Harvard Medical School, Boston, MA, USA,Shriners Hospitals for Children, Boston, MA USA
| | - Mark A. Randolph
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA,Division of Plastic and Reconstructive Surgery within the Department of Surgery, Massachusetts General Hospital/ Harvard Medical School, Boston, MA, USA,Shriners Hospitals for Children, Boston, MA USA
| | - Robert J. Porte
- Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Laurent A. Lantieri
- Division of Plastic and Reconstructive Surgery within the Department of Surgery, European George Pompidou Hospital, University of Paris, Paris, France
| | - Shannon N. Tessier
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital/ Harvard Medical School, Boston, MA, USA,Shriners Hospitals for Children, Boston, MA USA
| | - Curtis L. Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA,Division of Plastic and Reconstructive Surgery within the Department of Surgery, Massachusetts General Hospital/ Harvard Medical School, Boston, MA, USA,Shriners Hospitals for Children, Boston, MA USA
| | - Korkut Uygun
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital/ Harvard Medical School, Boston, MA, USA,Shriners Hospitals for Children, Boston, MA USA
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23
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Kfoury Y, Baryawno N, Severe N, Mei S, Gustafsson K, Hirz T, Brouse T, Scadden EW, Igolkina AA, Kokkaliaris K, Choi BD, Barkas N, Randolph MA, Shin JH, Saylor PJ, Scadden DT, Sykes DB, Kharchenko PV. Human prostate cancer bone metastases have an actionable immunosuppressive microenvironment. Cancer Cell 2021; 39:1464-1478.e8. [PMID: 34719426 PMCID: PMC8578470 DOI: 10.1016/j.ccell.2021.09.005] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 07/15/2021] [Accepted: 09/14/2021] [Indexed: 02/06/2023]
Abstract
Bone metastases are devastating complications of cancer. They are particularly common in prostate cancer (PCa), represent incurable disease, and are refractory to immunotherapy. We seek to define distinct features of the bone marrow (BM) microenvironment by analyzing single cells from bone metastatic prostate tumors, involved BM, uninvolved BM, and BM from cancer-free, orthopedic patients, and healthy individuals. Metastatic PCa is associated with multifaceted immune distortion, specifically exhaustion of distinct T cell subsets, appearance of macrophages with states specific to PCa bone metastases. The chemokine CCL20 is notably overexpressed by myeloid cells, as is its cognate CCR6 receptor on T cells. Disruption of the CCL20-CCR6 axis in mice with syngeneic PCa bone metastases restores T cell reactivity and significantly prolongs animal survival. Comparative high-resolution analysis of PCa bone metastases shows a targeted approach for relieving local immunosuppression for therapeutic effect.
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Affiliation(s)
- Youmna Kfoury
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Stem Cell Institute, Cambridge, MA, USA; Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Ninib Baryawno
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Stem Cell Institute, Cambridge, MA, USA; Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA; Childhood Cancer Research Unit, Department of Women's Health and Children's, Karolinska Institutet, Stockholm, Sweden.
| | - Nicolas Severe
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Stem Cell Institute, Cambridge, MA, USA; Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Shenglin Mei
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Karin Gustafsson
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Stem Cell Institute, Cambridge, MA, USA; Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Taghreed Hirz
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Stem Cell Institute, Cambridge, MA, USA; Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Thomas Brouse
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Elizabeth W Scadden
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Anna A Igolkina
- St. Petersburg Polytechnical University, St. Petersburg, Russia
| | - Konstantinos Kokkaliaris
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Stem Cell Institute, Cambridge, MA, USA; Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Bryan D Choi
- Department of Neurosurgery, Harvard Medical School, Boston, MA, USA
| | - Nikolas Barkas
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Mark A Randolph
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - John H Shin
- Department of Neurosurgery, Harvard Medical School, Boston, MA, USA
| | - Philip J Saylor
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, USA
| | - David T Scadden
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Stem Cell Institute, Cambridge, MA, USA; Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - David B Sykes
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Stem Cell Institute, Cambridge, MA, USA; Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Peter V Kharchenko
- Harvard Stem Cell Institute, Cambridge, MA, USA; Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
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24
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Schoonraad SA, Fischenich KM, Eckstein KN, Crespo-Cuevas V, Savard LM, Muralidharan A, Tomaschke AA, Uzcategui AC, Randolph MA, McLeod RR, Ferguson VL, Bryant SJ. Biomimetic and mechanically supportive 3D printed scaffolds for cartilage and osteochondral tissue engineering using photopolymers and digital light processing. Biofabrication 2021; 13. [PMID: 34479218 DOI: 10.1088/1758-5090/ac23ab] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 09/03/2021] [Indexed: 02/08/2023]
Abstract
Successful 3D scaffold designs for musculoskeletal tissue engineering necessitate full consideration of the form and function of the tissues of interest. When designing structures for engineering cartilage and osteochondral tissues, one must reconcile the need to develop a mechanically robust system that maintains the health of cells embedded in the scaffold. In this work, we present an approach that decouples the mechanical and biochemical needs and allows for the independent development of the structural and cellular niches in a scaffold. Using the highly tuned capabilities of digital light processing-based stereolithography, structures with complex architectures are achieved over a range of effective porosities and moduli. The 3D printed structure is infilled with mesenchymal stem cells and soft biomimetic hydrogels, which are specifically formulated with extracellular matrix analogs and tethered growth factors to provide selected biochemical cues for the guided differentiation towards chondrogenesis and osteogenesis. We demonstrate the ability to utilize these structures to (a) infill a focal chondral defect and mitigate macroscopic and cellular level changes in the cartilage surrounding the defect, and (b) support the development of a stratified multi-tissue scaffold for osteochondral tissue engineering.
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Affiliation(s)
- Sarah A Schoonraad
- Materials Science and Engineering Program, University of Colorado at Boulder, Boulder, CO 80309, United States of America
| | - Kristine M Fischenich
- Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO 80309, United States of America
| | - Kevin N Eckstein
- Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO 80309, United States of America
| | - Victor Crespo-Cuevas
- Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO 80309, United States of America
| | - Lea M Savard
- Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO 80309, United States of America
| | - Archish Muralidharan
- Materials Science and Engineering Program, University of Colorado at Boulder, Boulder, CO 80309, United States of America
| | - Andrew A Tomaschke
- Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO 80309, United States of America
| | - Asais Camila Uzcategui
- Materials Science and Engineering Program, University of Colorado at Boulder, Boulder, CO 80309, United States of America
| | - Mark A Randolph
- Department of Orthopaedic Surgery, Laboratory for Musculoskeletal Tissue Engineering, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States of America
| | - Robert R McLeod
- Materials Science and Engineering Program, University of Colorado at Boulder, Boulder, CO 80309, United States of America.,Department of Electrical, Computer and Energy Engineering, University of Colorado at Boulder, Boulder, CO 80309, United States of America
| | - Virginia L Ferguson
- Materials Science and Engineering Program, University of Colorado at Boulder, Boulder, CO 80309, United States of America.,Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO 80309, United States of America.,BioFrontiers Institute, University of Colorado at Boulder, Boulder, CO 80309, United States of America
| | - Stephanie J Bryant
- Materials Science and Engineering Program, University of Colorado at Boulder, Boulder, CO 80309, United States of America.,BioFrontiers Institute, University of Colorado at Boulder, Boulder, CO 80309, United States of America.,Department of Chemical and Biological Engineering, University of Colorado at Boulder, Boulder, CO 80309, United States of America
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25
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Lellouch AG, Taveau CB, Andrews AR, Molde J, Ng ZY, Tratnig-Frankl P, Rosales IA, Goutard M, Lupon E, Lantieri LA, Colvin RB, Randolph MA, Kohn J, Cetrulo CL. Local FK506 implants in non-human primates to prevent early acute rejection in vascularized composite allografts. Ann Transl Med 2021; 9:1070. [PMID: 34422982 PMCID: PMC8339839 DOI: 10.21037/atm-21-313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/28/2021] [Indexed: 11/13/2022]
Abstract
Background Previous vascularized composite allograft (VCA) studies from our laboratory have shown that topical FK506 delivery in non-human primates (NHPs) was limited by inadequate dermal penetration and rejection persisted. Herein, we report the first utilization of FK506 via subcutaneously implanted discs to mitigate VCA rejection in NHPs. Methods Full major histocompatibility complex (MHC)-mismatched NHP pairs underwent partial-face VCA and FK506 disc implantation along the suture line. All allotransplants were maintained post-operatively for two months on the FK506 discs, methylprednisolone, mycophenolate mofetil, and supplemented with intramuscular FK506 if necessary. Group 1 (n=4) was used for optimization of the implant, while Group 2 (n=3) underwent delayed bone marrow transplantation (DBMT) after two months. VCA skin biopsies and peripheral blood samples were obtained for serial assessment of rejection and mixed chimerism by histopathology and flow cytometry respectively. Results In Group 1, two technical failures occurred. Of the remaining two NHPs, one developed supratherapeutic levels of FK506 (50–120 ng/mL) and had to be euthanized on postoperative day (POD) 12. Reformulation of the implant resulted in stable FK506 levels (20–30 ng/mL) up to POD12 when further intramuscular (IM) FK506 injections were necessitated. In Group 2, two NHPs survived to undergo conditioning and one successfully developed chimerism at 2–3 weeks post-DBMT (96–97% granulocytes and 7–11% lymphocytes of recipient-origin). However, all three NHPs had to be terminated from study at POD64, 77 and 86 due to underlying post-transplant lymphoproliferative disorder. All VCAs remained rejection-free up to study endpoint otherwise. Conclusions This study shows preliminary results of local FK506 implants in potentially mitigating VCA acute rejection for tolerance protocols based on mixed chimerism approach.
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Affiliation(s)
- Alexandre G Lellouch
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Corentin B Taveau
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Alec R Andrews
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Joseph Molde
- Department of Life Sciences, The New Jersey Center for Biomaterials, Rutgers-The State University of New Jersey, Piscataway, NJ, USA
| | - Zhi Yang Ng
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Plastic Surgery, School of Surgery, Oxford, UK
| | - Philipp Tratnig-Frankl
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Plastic, Reconstructive and Aesthetic Surgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Ivy A Rosales
- MGH Transplant Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Marion Goutard
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Elise Lupon
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Laurent A Lantieri
- Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Robert B Colvin
- MGH Transplant Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark A Randolph
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Joachim Kohn
- Department of Life Sciences, The New Jersey Center for Biomaterials, Rutgers-The State University of New Jersey, Piscataway, NJ, USA
| | - Curtis L Cetrulo
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Shriners Hospital for Children, Boston, MA, USA
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26
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Goutard M, Randolph MA, Taveau CB, Lupon E, Lantieri L, Uygun K, Cetrulo CL, Lellouch AG. Partial Heterotopic Hindlimb Transplantation Model in Rats. J Vis Exp 2021. [PMID: 34180905 DOI: 10.3791/62586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Vascularized composite allotransplantations (VCA) represent the most advanced reconstruction option for patients without autologous surgical possibilities after a complex tissue defect. Face and hand transplantations have changed disfigured patients' lives, giving them a new aesthetic and functional social organ. Despite promising outcomes, VCA is still underperformed due to life-long immunosuppression comorbidities and infectious complications. The rat is an ideal animal model for in vivo studies investigating immunological pathways and graft rejection mechanisms. Rats are also widely used in novel composite tissue graft preservation techniques, including perfusion and cryopreservation studies. Models used for VCA in rats must be reproducible, reliable, and efficient with low postoperative morbidity and mortality. Heterotopic limb transplantation procedures fulfill these criteria and are easier to perform than orthotopic limb transplants. Mastering rodent microsurgical models requires solid experience in microsurgery and animal care. Herein is reported a reliable and reproducible model of partial heterotopic osteomyocutaneous flap transplantation in rats, the postoperative outcomes, and the means of prevention of potential complications.
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Affiliation(s)
- Marion Goutard
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School; Shriners Hospital for Children
| | - Mark A Randolph
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School; Shriners Hospital for Children
| | - Corentin B Taveau
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School; Shriners Hospital for Children; Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris
| | - Elise Lupon
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School; Shriners Hospital for Children
| | - Laurent Lantieri
- Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris
| | - Korkut Uygun
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School; Shriners Hospital for Children
| | - Curtis L Cetrulo
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School; Shriners Hospital for Children
| | - Alexandre G Lellouch
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School; Shriners Hospital for Children; Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris;
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27
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Taveau CB, Lellouch AG, Chin LY, Mamane O, Tratnig-Frankl P, Lantieri LA, Randolph MA, Uygun K, Cetrulo CL, Parekkadan B. In Vivo Activity of Genetically Modified Cells Preseeded in Rat Vascularized Composite Allografts. Transplant Proc 2021; 53:1751-1755. [PMID: 33985799 DOI: 10.1016/j.transproceed.2021.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 02/25/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Transplantation of the hand or face, known as vascularized composite allotransplantation (VCA), has revolutionized reconstructive surgery. Notwithstanding, there are still several areas of improvement to mitigate immune rejection while sparing systemic adverse effects. The goal of this study was to evaluate the engraftment and viability of a genetically modified cell population pre-engrafted into a VCA transplant, to potentially act as a local biosensor to report and modify the graft in vivo. A rat fibroblast cell line genetically modified to secrete Gaussia-Luciferase (gLuc), which served as a constitutive biomarker of cells, was incorporated into a VCA to study the viability of biosensor cells in a syngeneic rat heterotopic partial hindlimb transplantation model. RESULTS Five perfusions were first performed as engineering runs to have a stable limb perfusion protocol, followed by 3 perfusions to analyze the cell engraftment during machine perfusion, and finally 4 perfusions to study in vivo persistence of the cell biosensors. Blood samples were collected to monitor gLuc secretion during perfusion and postoperatively. A time-dependent increase in gLuc secretion in the limb perfusion outflow during machine perfusion indirectly verified the presence of biosensors within the graft. After the ex vivo perfusion, VCA hindlimbs were analyzed for near infrared fluorescence emission that showed a presence of dyed engineered cells in all areas of the limbs. Postoperatively, gLuc was detectable 4 to 5 days after transplantation (W = 16, P = .02857). This study demonstrated that engineered cells could be successfully preimplanted into VCAs-an important step toward development of an in vivo biosensor platform to use in modulating acute VCA outcomes.
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Affiliation(s)
- Corentin B Taveau
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, Massachusetts; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts; Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France; Shriners Hospitals for Children, Boston, Massachusetts
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, Massachusetts; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts; Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France; Shriners Hospitals for Children, Boston, Massachusetts
| | - Ling-Yee Chin
- Shriners Hospitals for Children, Boston, Massachusetts; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Olivia Mamane
- Shriners Hospitals for Children, Boston, Massachusetts; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Philipp Tratnig-Frankl
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, Massachusetts; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Laurent A Lantieri
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, Massachusetts; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts; Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, Paris, France; Shriners Hospitals for Children, Boston, Massachusetts
| | - Mark A Randolph
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, Massachusetts; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts; Shriners Hospitals for Children, Boston, Massachusetts
| | - Korkut Uygun
- Shriners Hospitals for Children, Boston, Massachusetts; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Curtis L Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, Massachusetts; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts; Shriners Hospitals for Children, Boston, Massachusetts
| | - Biju Parekkadan
- Shriners Hospitals for Children, Boston, Massachusetts; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Department of Biomedical Engineering, Rutgers University, Piscataway, New Jersey.
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28
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Richardson BM, Walker CJ, Maples MM, Randolph MA, Bryant SJ, Anseth KS. Mechanobiological Interactions between Dynamic Compressive Loading and Viscoelasticity on Chondrocytes in Hydrazone Covalent Adaptable Networks for Cartilage Tissue Engineering. Adv Healthc Mater 2021; 10:e2002030. [PMID: 33738966 PMCID: PMC8785214 DOI: 10.1002/adhm.202002030] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/17/2021] [Indexed: 12/17/2022]
Abstract
Mechanobiological cues influence chondrocyte biosynthesis and are often used in tissue engineering applications to improve the repair of articular cartilage in load-bearing joints. In this work, the biophysical effects of an applied dynamic compression on chondrocytes encapsulated in viscoelastic hydrazone covalent adaptable networks (CANs) is explored. Here, hydrazone CANs exhibit viscoelastic loss tangents ranging from (9.03 ± 0.01) 10-4 to (1.67 ± 0.09) 10-3 based on the molar percentages of alkyl-hydrazone and benzyl-hydrazone crosslinks. Notably, viscoelastic alkyl-hydrazone crosslinks improve articular cartilage specific gene expression showing higher SOX9 expression in free swelling hydrogels and dynamic compression reduces hypertrophic chondrocyte markers (COL10A1, MMP13) in hydrazone CANs. Interestingly, dynamic compression also improves matrix biosynthesis in elastic benzyl-hydrazone controls but reduces biosynthesis in viscoelastic alkyl-hydrazone CANs. Additionally, intermediate levels of viscoelastic adaptability demonstrate the highest levels of matrix biosynthesis in hydrazone CANs, demonstrating on average 70 ± 4 µg of sulfated glycosaminoglycans per day and 31 ± 3 µg of collagen per day over one month in dynamic compression bioreactors. Collectively, the results herein demonstrate the role of matrix adaptability and viscoelasticity on chondrocytes in hydrazone CANs during dynamic compression, which may prove useful for tissue engineering applications in load-bearing joints.
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Affiliation(s)
- Benjamin M Richardson
- Department of Chemical and Biological Engineering, University of Colorado Boulder, 3415 Colorado Ave, Boulder, CO, 80303, USA
- The BioFrontiers Institute, University of Colorado Boulder, 3415 Colorado Ave, Boulder, CO, 80303, USA
| | - Cierra J Walker
- The BioFrontiers Institute, University of Colorado Boulder, 3415 Colorado Ave, Boulder, CO, 80303, USA
- Materials Science and Engineering Program, University of Colorado Boulder, 4001 Discovery Drive, Boulder, CO, 80303, USA
| | - Mollie M Maples
- Department of Chemical and Biological Engineering, University of Colorado Boulder, 3415 Colorado Ave, Boulder, CO, 80303, USA
- The BioFrontiers Institute, University of Colorado Boulder, 3415 Colorado Ave, Boulder, CO, 80303, USA
| | - Mark A Randolph
- Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, WAC 435, Boston, MA, 02114, USA
- Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, 15 Parkman St, WACC 453, Boston, MA, 02114, USA
| | - Stephanie J Bryant
- Department of Chemical and Biological Engineering, University of Colorado Boulder, 3415 Colorado Ave, Boulder, CO, 80303, USA
- The BioFrontiers Institute, University of Colorado Boulder, 3415 Colorado Ave, Boulder, CO, 80303, USA
- Materials Science and Engineering Program, University of Colorado Boulder, 4001 Discovery Drive, Boulder, CO, 80303, USA
| | - Kristi S Anseth
- Department of Chemical and Biological Engineering, University of Colorado Boulder, 3415 Colorado Ave, Boulder, CO, 80303, USA
- The BioFrontiers Institute, University of Colorado Boulder, 3415 Colorado Ave, Boulder, CO, 80303, USA
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Goldstein RL, McCormack MC, Mallidi S, Runyan G, Randolph MA, Austen WG, Redmond RW. Photochemical Tissue Passivation of Arteriovenous Grafts Prevents Long-Term Development of Intimal Hyperplasia in a Swine Model. J Surg Res 2020; 253:280-287. [PMID: 32402853 DOI: 10.1016/j.jss.2020.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/27/2020] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The autologous vein remains the standard conduit for lower extremity and coronary artery bypass grafting despite a 30%-50% 5-y failure rate, primarily attributable to intimal hyperplasia (IH) that develops in the midterm period (3-24 mo) of graft maturation. Our group discovered that externally strengthening vein grafts by cross-linking the adventitial collagen with photochemical tissue passivation (PTP) mitigates IH in an arteriovenous model at 4 wk. We now investigate whether this effect is retained in the midterm period follow-up. METHODS Six Hanford miniature pigs received bilateral carotid artery interposition vein grafts. In each animal, the external surface of one graft was treated with PTP before grafting, whereas the opposite side served as the untreated control. The grafts were harvested after 3 mo. Ultrasound evaluation of all vein grafts was performed at the time of grafting and harvest. The grafts were also evaluated histomorphometrically and immunohistologically for markers of IH. RESULTS All vein grafts were patent at 3 mo except one graft in the PTP-treated group because of early technical failure. The control vein grafts had significantly greater IH than PTP-treated grafts at 3 mo, as evidenced by the intimal area (2.6 ± 1.0 mm2versus 1.4 ± 1.5 mm2, respectively, P = 0.045) and medial area (5.1 ± 1.9 mm2versus 2.7 ± 2.4 mm2, respectively, P = 0.048). The control grafts had an increased presence and proliferation of mural myofibroblasts with greater smooth muscle actin and proliferating cell nuclear antigen staining. CONCLUSIONS PTP treatment to the external surface of the vein grafts decreases IH at 3 mo after arteriovenous grafting and may prevent future graft failure.
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Affiliation(s)
- Rachel L Goldstein
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts; Plastic Surgery Research Laboratory, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Michael C McCormack
- Plastic Surgery Research Laboratory, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Srivalleesha Mallidi
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Gem Runyan
- Plastic Surgery Research Laboratory, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Mark A Randolph
- Plastic Surgery Research Laboratory, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - William G Austen
- Plastic Surgery Research Laboratory, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Robert W Redmond
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
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30
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Gama AR, Ng ZY, Shanmugarajah K, Mastroianni M, Randolph MA, Lellouch AG, Kohn J, Cetrulo CL. Local Immunosuppression for Vascularized Composite Allografts: Application of Topical FK506-TyroSpheres in a Nonhuman Primate Model. J Burn Care Res 2020; 41:1172-1178. [DOI: 10.1093/jbcr/iraa062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Abstract
Transplantation of vascularized composite allografts (VCAs) provides a means of restoring complex anatomical and functional units following burns and other disfigurement otherwise not amenable to conventional autologous reconstructive surgery. While short- to intermediate-term VCA survival is largely dependent on patient compliance with medication, the myriad of side effects resulting from lifelong systemic immunosuppression continue to pose a significant challenge. Topical immunosuppression is therefore a logical and attractive alternative for VCA. Current formulations are limited though, by poor skin penetration but this may be mitigated by conjugation of immunosuppressive drugs to TyroSpheres for enhanced delivery. Therefore, we investigated the topical application of FK506-TyroSpheres (in the form of a gel dressing) in a clinically relevant nonhuman primate VCA model to determine if allograft survival could be prolonged at reduced levels of maintenance systemic immunosuppression. Six Major Histocompatibility Complex (MHC)-mismatched cynomolgus macaques (Macaca fascicularis) served as reciprocal donors and recipients of radial forearm fasciocutaneous flaps. Standard Bacitracin ointment and FK506-TyroSpheres were applied every other day to the VCAs of animals in groups 1 (controls, n = 2) and 2 (experimental, n = 4), respectively, before gradual taper of systemic FK506. Clinical features of VCA rejection still developed when systemic FK506 fell below 10 ng/ml despite application of FK506-TyroSpheres and prolonged VCA survival was not achieved. However, unwanted systemic FK506 absorption was avoided with TyroSphere technology. Further refinement to optimize local drug delivery profiles to achieve and maintain therapeutic delivery of FK506 with TyroSpheres is underway, leveraging significant experience in controlled drug delivery to mitigate acute rejection of VCAs.
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Affiliation(s)
- Amon-Ra Gama
- Department of Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston
- Division of Plastic and Reconstructive Surgery University, Rutgers New Jersey Medical School, Newark
| | - Zhi Yang Ng
- Department of Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Kumaran Shanmugarajah
- Department of Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Melissa Mastroianni
- Department of Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Mark A Randolph
- Department of Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Alexandre G Lellouch
- Department of Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
- Department of Plastic, Reconstructive and Aesthetic Surgery. Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Joachim Kohn
- Department of Life Sciences, The New Jersey Center for Biomaterials, Rutgers—The State University of New Jersey, Piscataway
| | - Curtis L Cetrulo
- Department of Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
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Richardson BM, Walker CJ, Macdougall LJ, Hoye JW, Randolph MA, Bryant SJ, Anseth KS. Viscoelasticity of hydrazone crosslinked poly(ethylene glycol) hydrogels directs chondrocyte morphology during mechanical deformation. Biomater Sci 2020; 8:3804-3811. [DOI: 10.1039/d0bm00860e] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Adaptable dynamic covalent crosslinks temporally modulate the biophysical transmission of physiologically relevant compressive strains to encapsulated chondrocytes for cartilage tissue engineering.
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Affiliation(s)
- Benjamin M. Richardson
- Department of Chemical and Biological Engineering
- University of Colorado Boulder
- Boulder
- USA
- The BioFrontiers Institute
| | - Cierra J. Walker
- The BioFrontiers Institute
- University of Colorado Boulder
- Boulder
- USA
- Materials Science and Engineering Program
| | | | - Jack W. Hoye
- Department of Chemical and Biological Engineering
- University of Colorado Boulder
- Boulder
- USA
| | - Mark A. Randolph
- Department of Orthopedic Surgery
- Massachusetts General Hospital
- Harvard Medical School
- Boston
- USA
| | - Stephanie J. Bryant
- Department of Chemical and Biological Engineering
- University of Colorado Boulder
- Boulder
- USA
- The BioFrontiers Institute
| | - Kristi S. Anseth
- Department of Chemical and Biological Engineering
- University of Colorado Boulder
- Boulder
- USA
- The BioFrontiers Institute
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32
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Schneider MC, Chu S, Randolph MA, Bryant SJ. An in vitro and in vivo comparison of cartilage growth in chondrocyte-laden matrix metalloproteinase-sensitive poly(ethylene glycol) hydrogels with localized transforming growth factor β3. Acta Biomater 2019; 93:97-110. [PMID: 30914256 DOI: 10.1016/j.actbio.2019.03.046] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 12/25/2022]
Abstract
While matrix-assisted autologous chondrocyte implantation has emerged as a promising therapy to treat focal chondral defects, matrices that support regeneration of hyaline cartilage remain challenging. The goal of this work was to investigate the potential of a matrix metalloproteinase (MMP)-sensitive poly(ethylene glycol) (PEG) hydrogel containing the tethered growth factor, transforming growth factor β3 (TGF-β3), and compare cartilage regeneration in vitro and in vivo. The in vitro environment comprised chemically-defined medium while the in vivo environment utilized the subcutaneous implant model in athymic mice. Porcine chondrocytes were isolated and expanded in 2D culture for 10 days prior to encapsulation. The presence of tethered TGF-β3 reduced cell spreading. Chondrocyte-laden hydrogels were analyzed for total sulfated glycosaminoglycan and collagen contents, MMP activity, and spatial deposition of aggrecan, decorin, biglycan, and collagens type II and I. The total amount of extracellular matrix (ECM) deposited in the hydrogel constructs was similar in vitro and in vivo. However, the in vitro environment was not able to support long-term culture up to 64 days of the engineered cartilage leading to the eventual breakdown of aggrecan. The in vivo environment, on the other hand, led to more elaborate ECM, which correlated with higher MMP activity, and an overall higher quality of engineered tissue that was rich in aggrecan, decorin, biglycan and collagen type II with minimal collagen type I. Overall, the MMP-sensitive PEG hydrogel containing tethered TGF-β3 is a promising matrix for hyaline cartilage regeneration in vivo. STATEMENT OF SIGNIFICANCE: Regenerating hyaline cartilage remains a significant clinical challenge. The resultant repair tissue is often fibrocartilage, which long-term cannot be sustained. The goal of this study was to investigate the potential of a synthetic hydrogel matrix containing peptide crosslinks that can be degraded by enzymes secreted by encapsulated cartilage cells (i.e., chondrocytes) and tethered growth factors, specifically TGF-β3, to provide localized chondrogenic cues to the cells. This hydrogel led to hyaline cartilage-like tissue growth in vitro and in vivo, with minimal formation of fibrocartilage. However, the tissue formed in vitro, could not be maintained long-term. In vivo this hydrogel shows great promise as a potential matrix for use in regenerating hyaline cartilage.
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Goldstein RL, Tsui JM, Runyan G, Randolph MA, McCormack MC, Mihm MC, Redmond RW, Austen WG. Photochemical Tissue Passivation Prevents Contracture of Full Thickness Wounds in Mice. Lasers Surg Med 2019; 51:910-919. [DOI: 10.1002/lsm.23128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Rachel L. Goldstein
- Division of Plastic and Recontructive Surgery, Department of Surgery, Harvard Medical SchoolMassachusetts General Hospital 55 Fruit Street Boston Massachusetts 02114
| | - Jane M. Tsui
- Division of Plastic and Recontructive Surgery, Department of Surgery, Harvard Medical SchoolMassachusetts General Hospital 55 Fruit Street Boston Massachusetts 02114
| | - Gem Runyan
- Division of Plastic and Recontructive Surgery, Department of Surgery, Harvard Medical SchoolMassachusetts General Hospital 55 Fruit Street Boston Massachusetts 02114
| | - Mark A. Randolph
- Division of Plastic and Recontructive Surgery, Department of Surgery, Harvard Medical SchoolMassachusetts General Hospital 55 Fruit Street Boston Massachusetts 02114
- Wellman Center for Photomedicine, Harvard Medical SchoolMassachusetts General Hospital 55 Fruit Street Boston Massachusetts 02114
| | - Michael C. McCormack
- Division of Plastic and Recontructive Surgery, Department of Surgery, Harvard Medical SchoolMassachusetts General Hospital 55 Fruit Street Boston Massachusetts 02114
| | - Martin C. Mihm
- Department of Dermatology, Harvard Medical SchoolBrigham and Women's Hospital 75 Francis St Boston Massachusetts 02115
| | - Robert W. Redmond
- Wellman Center for Photomedicine, Harvard Medical SchoolMassachusetts General Hospital 55 Fruit Street Boston Massachusetts 02114
| | - William G. Austen
- Division of Plastic and Recontructive Surgery, Department of Surgery, Harvard Medical SchoolMassachusetts General Hospital 55 Fruit Street Boston Massachusetts 02114
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34
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Aisenbrey EA, Tomaschke AA, Schoonraad SA, Fischenich KM, Wahlquist JA, Randolph MA, Ferguson VL, Bryant SJ. Assessment and prevention of cartilage degeneration surrounding a focal chondral defect in the porcine model. Biochem Biophys Res Commun 2019; 514:940-945. [PMID: 31088681 DOI: 10.1016/j.bbrc.2019.05.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 05/04/2019] [Indexed: 10/26/2022]
Abstract
Focal defects in articular cartilage are unable to self-repair and, if left untreated, are a leading risk factor for osteoarthritis. This study examined cartilage degeneration surrounding a defect and then assessed whether infilling the defect prevents degeneration. We created a focal chondral defect in porcine osteochondral explants and cultured them ex vivo with and without dynamic compressive loading to decouple the role of loading. When compared to a defect in a porcine knee four weeks post-injury, this model captured loss in sulfated glycosaminoglycans (sGAGs) along the defect's edge that was observed in vivo, but this loss was not load dependent. Loading, however, reduced the indentation modulus of the surrounding cartilage. After infilling with in situ polymerized hydrogels that were soft (100 kPa) or stiff (1 MPa) and which produced swelling pressures of 13 and 310 kPa, respectively, sGAG loss was reduced. This reduction correlated with increased hydrogel stiffness and swelling pressure, but was not affected by loading. This ex vivo model recapitulates sGAG loss surrounding a defect and, when infilled with a mechanically supportive hydrogel, degeneration is minimized.
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Affiliation(s)
- Elizabeth A Aisenbrey
- Department of Chemical and Biological Engineering, 3415 Colorado Ave, University of Colorado at Boulder, Boulder, CO, 80309, USA
| | - Andrew A Tomaschke
- Department of Mechanical Engineering, 1111 Engineering Dr, University of Colorado at Boulder, Boulder, CO, 80309, USA
| | - Sarah A Schoonraad
- Materials Science and Engineering Program, 3415 Colorado Ave, University of Colorado at Boulder, Boulder, CO, 80309, USA
| | - Kristine M Fischenich
- Department of Mechanical Engineering, 1111 Engineering Dr, University of Colorado at Boulder, Boulder, CO, 80309, USA
| | - Joseph A Wahlquist
- Department of Mechanical Engineering, 1111 Engineering Dr, University of Colorado at Boulder, Boulder, CO, 80309, USA
| | - Mark A Randolph
- Department of Orthopaedic Surgery, Laboratory for Musculoskeletal Tissue Engineering, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Virginia L Ferguson
- Department of Mechanical Engineering, 1111 Engineering Dr, University of Colorado at Boulder, Boulder, CO, 80309, USA; Materials Science and Engineering Program, 3415 Colorado Ave, University of Colorado at Boulder, Boulder, CO, 80309, USA; BioFrontiers Institute, 3415 Colorado Ave, University of Colorado at Boulder, Boulder, CO, 80309, USA
| | - Stephanie J Bryant
- Department of Chemical and Biological Engineering, 3415 Colorado Ave, University of Colorado at Boulder, Boulder, CO, 80309, USA; Materials Science and Engineering Program, 3415 Colorado Ave, University of Colorado at Boulder, Boulder, CO, 80309, USA; BioFrontiers Institute, 3415 Colorado Ave, University of Colorado at Boulder, Boulder, CO, 80309, USA.
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35
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Ng ZY, Lellouch AG, Rosales IA, Geoghegan L, Gama AR, Colvin RB, Lantieri LA, Randolph MA, Cetrulo CL. Graft vasculopathy of vascularized composite allografts in humans: a literature review and retrospective study. Transpl Int 2019; 32:831-838. [PMID: 30829423 DOI: 10.1111/tri.13421] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/29/2019] [Accepted: 02/26/2019] [Indexed: 01/10/2023]
Abstract
Mechanisms of chronic rejection of vascularized composite allografts (VCA) remain poorly understood and likely present along a spectrum of highly varied clinicopathological findings. Across both animal and human VCA however, graft vasculopathy (GV) has been the most consistent pathological finding resulting clinically in irreversible allograft dysfunction and eventual loss. A literature review of all reported clinical VCA cases with documented GV up to December 2018 was thus performed to elucidate the possible mechanisms involved. Relevant data extracted include C4d deposition, donor-specific antibody (DSA) formation, extent of human leukocyte antigen (HLA) mismatch, pretransplant panel reactive antibody levels, induction and maintenance immunosuppression used, the number of preceding acute rejection episodes, and time to histological confirmation of GV. Approximately 6% (13 of 205) of all VCA patients reported to date developed GV at a mean of 6 years post-transplantation. 46% of these patients have either lost or had their VCAs removed. Neither C4d nor DSA alone was predictive of GV development; however, when both are present, VCA loss appears inevitable due to progressive GV. Of utmost concern, GV in VCA does not appear to be abrogated by currently available immunosuppressive treatment and is essentially irreversible by the time of diagnosis with allograft loss a likely eventuality.
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Affiliation(s)
- Zhi Yang Ng
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA.,Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA.,Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, USA.,Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Ivy A Rosales
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Luke Geoghegan
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA
| | - Amon-Ra Gama
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA
| | - Robert B Colvin
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Laurent A Lantieri
- Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Mark A Randolph
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA.,Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Curtis L Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA.,Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, USA
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36
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Burlage LC, Lellouch AG, Saviane GG, Randolph MA, Lantieri L, Porte RJ, Tessier SN, Uygun K, Cetrulo Jr CL. 312 First Vascularized Composite Allotransplantations in Rats after 6 Hours of Ex Vivosubnormothermic Machine Perfusion Using an Hemoglobin Oxygen Carrier: A Proof of Concept Study. J Burn Care Res 2019. [DOI: 10.1093/jbcr/irz013.226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- L C Burlage
- Massachusetts General Hospital/Shriners Hospital for Children, Boston, MA; European George Pompidou Hospital, Paris, France; University Medical Center Groningen, Groningen, Netherlands
| | - A G Lellouch
- Massachusetts General Hospital/Shriners Hospital for Children, Boston, MA; European George Pompidou Hospital, Paris, France; University Medical Center Groningen, Groningen, Netherlands
| | - G G Saviane
- Massachusetts General Hospital/Shriners Hospital for Children, Boston, MA; European George Pompidou Hospital, Paris, France; University Medical Center Groningen, Groningen, Netherlands
| | - M A Randolph
- Massachusetts General Hospital/Shriners Hospital for Children, Boston, MA; European George Pompidou Hospital, Paris, France; University Medical Center Groningen, Groningen, Netherlands
| | - L Lantieri
- Massachusetts General Hospital/Shriners Hospital for Children, Boston, MA; European George Pompidou Hospital, Paris, France; University Medical Center Groningen, Groningen, Netherlands
| | - R J Porte
- Massachusetts General Hospital/Shriners Hospital for Children, Boston, MA; European George Pompidou Hospital, Paris, France; University Medical Center Groningen, Groningen, Netherlands
| | - S N Tessier
- Massachusetts General Hospital/Shriners Hospital for Children, Boston, MA; European George Pompidou Hospital, Paris, France; University Medical Center Groningen, Groningen, Netherlands
| | - K Uygun
- Massachusetts General Hospital/Shriners Hospital for Children, Boston, MA; European George Pompidou Hospital, Paris, France; University Medical Center Groningen, Groningen, Netherlands
| | - C L Cetrulo Jr
- Massachusetts General Hospital/Shriners Hospital for Children, Boston, MA; European George Pompidou Hospital, Paris, France; University Medical Center Groningen, Groningen, Netherlands
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37
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Westman AM, Goldstein RL, Bradica G, Goldman SM, Randolph MA, Gaut JP, Vacanti JP, Hoganson DM. Decellularized extracellular matrix microparticles seeded with bone marrow mesenchymal stromal cells for the treatment of full-thickness cutaneous wounds. J Biomater Appl 2019; 33:1070-1079. [PMID: 30651054 DOI: 10.1177/0885328218824759] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Extracellular matrix materials mechanically dissociated into submillimeter particles have a larger surface area than sheet materials and enhanced cellular attachment. Decellularized porcine mesothelial extracellular matrix microparticles were seeded with bone marrow-derived mesenchymal stromal cells and cultured in a rotating bioreactor. The mesenchymal stromal cells attached and grew to confluency on the microparticles. The cell-seeded microparticles were then encapsulated in varying concentrations of fibrin glue, and the cells migrated rapidly off the microparticles. The combination of microparticles and mesenchymal stromal cells was then applied to a splinted full-thickness cutaneous in vivo wound model. There was evidence of increased cell infiltration and collagen deposition in mesenchymal stromal cells-treated wounds. Cell-seeded microparticles have potential as a cell delivery and paracrine therapy in impaired healing environments.
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Affiliation(s)
- Amanda M Westman
- 1 Plastic Surgery Research Laboratory, Massachusetts General Hospital, MA, USA
| | - Rachel L Goldstein
- 1 Plastic Surgery Research Laboratory, Massachusetts General Hospital, MA, USA
| | | | | | - Mark A Randolph
- 6 Laboratory of Musculoskeletal Tissue Engineering, Massachusetts General Hospital, Boston, MA USA
| | - Joseph P Gaut
- 3 Department of Pathology, Washington University in St. Louis, St. Louis, MO, USA
| | - Joseph P Vacanti
- 4 Laboratory for Tissue Engineering and Organ Fabrication, Massachusetts General Hospital, Boston, MA, USA
| | - David M Hoganson
- 5 Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA
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38
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Richardson BM, Wilcox DG, Randolph MA, Anseth KS. Hydrazone covalent adaptable networks modulate extracellular matrix deposition for cartilage tissue engineering. Acta Biomater 2019; 83:71-82. [PMID: 30419278 PMCID: PMC6291351 DOI: 10.1016/j.actbio.2018.11.014] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/15/2018] [Accepted: 11/08/2018] [Indexed: 01/18/2023]
Abstract
Cartilage tissue engineering strategies often rely on hydrogels with fixed covalent crosslinks for chondrocyte encapsulation, yet the resulting material properties are largely elastic and can impede matrix deposition. To address this limitation, hydrazone crosslinked poly(ethylene glycol) hydrogels were formulated to achieve tunable viscoelastic properties and to study how chondrocyte proliferation and matrix deposition vary with the time-dependent material properties of covalent adaptable networks. Hydrazone equilibrium differences were leveraged to produce average stress relaxation times from hours (4.01 × 103 s) to months (2.78 × 106 s) by varying the percentage of alkyl-hydrazone (aHz) and benzyl-hydrazone (bHz) crosslinks. Swelling behavior and degradation associated with adaptability were characterized to quantify temporal network changes that can influence the behavior of encapsulated chondrocytes. After four weeks, mass swelling ratios varied from 36 ± 3 to 17 ± 0.4 and polymer retention ranged from 46 ± 4% to 92 ± 5%, with higher aHz content leading to loss of network connectivity with time. Hydrogels were formulated near the Flory-Stockmayer bHz percolation threshold (17% bHz) to investigate chondrocyte response to distinct levels of covalent architecture adaptability. Four weeks post-encapsulation, formulations with average relaxation times of 3 days (2.6 × 105s) revealed increased cellularity and an interconnected articular cartilage-specific matrix. Chondrocytes embedded in this adaptable formulation (22% bHz) deposited 190 ± 30% more collagen and 140 ± 20% more sulfated glycosaminoglycans compared to the 100% bHz control, which constrained matrix deposition to pericellular space. Collectively, these findings indicate that incorporating highly adaptable aHz crosslinks enhanced regenerative outcomes. However, connected networks containing more stable bHz bonds were required to achieve the highest quality neocartilaginous tissue. STATEMENT OF SIGNIFICANCE: Covalently crosslinked hydrogels provide robust mechanical support for cartilage tissue engineering applications in articulating joints. However, these materials traditionally demonstrate purely elastic responses to deformation despite the dynamic viscoelastic properties of native cartilage tissue. Here, we present hydrazone poly(ethylene glycol) hydrogels with tunable viscoelastic properties and study covalent adaptable networks for cartilage tissue engineering. Using hydrazone equilibrium and Flory-Stockmayer theory we identified average relaxation times leading to enhanced regenerative outcomes and showed that extracellular matrix deposition was biphasic as a function of the hydrazone covalent adaptability. We also showed that the incorporation of highly adaptable covalent crosslinks could improve cellularity of neotissue, but that a percolating network of more stable bonds was required to maintain scaffold integrity and form the highest quality neocartilaginous tissue.
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Affiliation(s)
- Benjamin M Richardson
- Dept. Chemical and Biological Engineering, University of Colorado Boulder, Jennie Smoly Caruthers Biotechnology Building, 3415 Colorado Ave, Boulder, CO 80303, USA; The BioFrontiers Institute, University of Colorado Boulder, Jennie Smoly Caruthers Biotechnology Building, 3415 Colorado Ave, Boulder, CO 80303, USA.
| | - Daniel G Wilcox
- Dept. Chemical and Biological Engineering, University of Colorado Boulder, Jennie Smoly Caruthers Biotechnology Building, 3415 Colorado Ave, Boulder, CO 80303, USA.
| | - Mark A Randolph
- Dept. Orthopedic Surgery, Musculoskeletal Tissue Engineering Labs, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, WAC 435, Boston, MA 02114, USA; Div. Plastic Surgery, Plastic Surgery Research Laboratory, Massachusetts General Hospital, Harvard Medical School, 15 Parkman St, WACC 453, Boston, MA 02114, USA.
| | - Kristi S Anseth
- Dept. Chemical and Biological Engineering, University of Colorado Boulder, Jennie Smoly Caruthers Biotechnology Building, 3415 Colorado Ave, Boulder, CO 80303, USA; The BioFrontiers Institute, University of Colorado Boulder, Jennie Smoly Caruthers Biotechnology Building, 3415 Colorado Ave, Boulder, CO 80303, USA.
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Wahlquist JA, DelRio FW, Randolph MA, Aziz AH, Heveran CM, Bryant SJ, Neu CP, Ferguson VL. Indentation mapping revealed poroelastic, but not viscoelastic, properties spanning native zonal articular cartilage. Acta Biomater 2017; 64:41-49. [PMID: 29037894 DOI: 10.1016/j.actbio.2017.10.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 09/07/2017] [Accepted: 10/03/2017] [Indexed: 02/07/2023]
Abstract
Osteoarthrosis is a debilitating disease affecting millions, yet engineering materials for cartilage regeneration has proven difficult because of the complex microstructure of this tissue. Articular cartilage, like many biological tissues, produces a time-dependent response to mechanical load that is critical to cell's physiological function in part due to solid and fluid phase interactions and property variations across multiple length scales. Recreating the time-dependent strain and fluid flow may be critical for successfully engineering replacement tissues but thus far has largely been neglected. Here, microindentation is used to accomplish three objectives: (1) quantify a material's time-dependent mechanical response, (2) map material properties at a cellular relevant length scale throughout zonal articular cartilage and (3) elucidate the underlying viscoelastic, poroelastic, and nonlinear poroelastic causes of deformation in articular cartilage. Untreated and trypsin-treated cartilage was sectioned perpendicular to the articular surface and indentation was used to evaluate properties throughout zonal cartilage on the cut surface. The experimental results demonstrated that within all cartilage zones, the mechanical response was well represented by a model assuming nonlinear biphasic behavior and did not follow conventional viscoelastic or linear poroelastic models. Additionally, 10% (w/w) agarose was tested and, as anticipated, behaved as a linear poroelastic material. The approach outlined here provides a method, applicable to many tissues and biomaterials, which reveals and quantifies the underlying causes of time-dependent deformation, elucidates key aspects of material structure and function, and that can be used to provide important inputs for computational models and targets for tissue engineering. STATEMENT OF SIGNIFICANCE Elucidating the time-dependent mechanical behavior of cartilage, and other biological materials, is critical to adequately recapitulate native mechanosensory cues for cells. We used microindentation to map the time-dependent properties of untreated and trypsin treated cartilage throughout each cartilage zone. Unlike conventional approaches that combine viscoelastic and poroelastic behaviors into a single framework, we deconvoluted the mechanical response into separate contributions to time-dependent behavior. Poroelastic effects in all cartilage zones dominated the time-dependent behavior of articular cartilage, and a model that incorporates tension-compression nonlinearity best represented cartilage mechanical behavior. These results can be used to assess the success of regeneration and repair approaches, as design targets for tissue engineering, and for development of accurate computational models.
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Affiliation(s)
- Joseph A Wahlquist
- Department of Mechanical Engineering, University of Colorado, Boulder, CO, United States
| | - Frank W DelRio
- Applied Chemicals and Materials Division, Material Measurement Laboratory, National Institute of Standards and Technology, Boulder, CO, United States
| | - Mark A Randolph
- Department of Orthopaedic Surgery, Laboratory for Musculoskeletal Tissue Engineering, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Division of Plastic Surgery, Plastic Surgery Research Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Aaron H Aziz
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, CO, United States; BioFrontiers Institute, University of Colorado, Boulder, CO, United States
| | - Chelsea M Heveran
- Department of Mechanical Engineering, University of Colorado, Boulder, CO, United States
| | - Stephanie J Bryant
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, CO, United States; BioFrontiers Institute, University of Colorado, Boulder, CO, United States; Material Science and Engineering Program, University of Colorado, Boulder, CO, United States
| | - Corey P Neu
- Department of Mechanical Engineering, University of Colorado, Boulder, CO, United States; BioFrontiers Institute, University of Colorado, Boulder, CO, United States
| | - Virginia L Ferguson
- Department of Mechanical Engineering, University of Colorado, Boulder, CO, United States; BioFrontiers Institute, University of Colorado, Boulder, CO, United States; Material Science and Engineering Program, University of Colorado, Boulder, CO, United States.
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Goldstein RL, Runyan G, Randolph MA, McCormack MC, Redmond RW, Austen WG. Photochemical Tissue Passivation Prevents Contracture of Full Thickness Wounds. J Am Coll Surg 2017. [DOI: 10.1016/j.jamcollsurg.2017.07.773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Shanmugarajah K, Powell H, Leonard DA, Mallard C, Albritton A, Harrington E, Randolph MA, Farkash E, Sachs DH, Kurtz JM, Cetrulo CL. The Effect of MHC Antigen Matching Between Donors and Recipients on Skin Tolerance of Vascularized Composite Allografts. Am J Transplant 2017; 17:1729-1741. [PMID: 28035752 DOI: 10.1111/ajt.14189] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 12/16/2016] [Accepted: 12/22/2016] [Indexed: 01/25/2023]
Abstract
The emergence of skin-containing vascularized composite allografts (VCAs) has provided impetus to understand factors affecting rejection and tolerance of skin. VCA tolerance can be established in miniature swine across haploidentical MHC barriers using mixed chimerism. Because the deceased donor pool for VCAs does not permit MHC antigen matching, clinical VCAs are transplanted across varying MHC disparities. We investigated whether sharing of MHC class I or II antigens between donors and recipients influences VCA skin tolerance. Miniature swine were conditioned nonmyeloablatively and received hematopoietic stem cell transplants and VCAs across MHC class I (n = 3) or class II (n = 3) barriers. In vitro immune responsiveness was assessed, and VCA skin-resident leukocytes were characterized by flow cytometry. Stable mixed chimerism was established in all animals. MHC class II-mismatched chimeras were tolerant of VCAs. MHC class I-mismatched animals, however, rejected VCA skin, characterized by infiltration of recipient-type CD8+ lymphocytes. Systemic donor-specific nonresponsiveness was maintained, including after VCA rejection. This study shows that MHC antigen matching influences VCA skin rejection and suggests that local regulation of immune tolerance is critical in long-term acceptance of all VCA components. These results help elucidate novel mechanisms underlying skin tolerance and identify clinically relevant VCA tolerance strategies.
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Affiliation(s)
- K Shanmugarajah
- Transplantation Biology Research Center, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA.,Department of Plastic Surgery, Massachusetts General Hospital, Boston, MA
| | - H Powell
- Transplantation Biology Research Center, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - D A Leonard
- Transplantation Biology Research Center, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA.,Department of Plastic Surgery, Massachusetts General Hospital, Boston, MA
| | - C Mallard
- Transplantation Biology Research Center, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - A Albritton
- Transplantation Biology Research Center, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - E Harrington
- Transplantation Biology Research Center, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - M A Randolph
- Department of Plastic Surgery, Massachusetts General Hospital, Boston, MA
| | - E Farkash
- Transplantation Biology Research Center, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - D H Sachs
- Transplantation Biology Research Center, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - J M Kurtz
- Transplantation Biology Research Center, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA.,Department of Biology, Emmanuel College, Boston, MA
| | - C L Cetrulo
- Transplantation Biology Research Center, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA.,Department of Plastic Surgery, Massachusetts General Hospital, Boston, MA
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Fairbairn NG, Ng-Glazier J, Meppelink AM, Randolph MA, Valerio IL, Fleming ME, Kochevar IE, Winograd JM, Redmond RW. Erratum: Light-Activated Sealing of Acellular Nerve Allografts following Nerve Gap Injury. J Reconstr Microsurg 2016; 32:e1. [PMID: 27341523 DOI: 10.1055/s-0036-1584882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Neil G Fairbairn
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Joanna Ng-Glazier
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Amanda M Meppelink
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Mark A Randolph
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Ian L Valerio
- Plastic Surgery Service, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Mark E Fleming
- Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Irene E Kochevar
- Wellman Centre for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Jonathan M Winograd
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Robert W Redmond
- Wellman Centre for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
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Goldstone RN, McCormack MC, Khan SI, Salinas HM, Meppelink A, Randolph MA, Watkins MT, Redmond RW, Austen WG. Photochemical Tissue Passivation Reduces Vein Graft Intimal Hyperplasia in a Swine Model of Arteriovenous Bypass Grafting. J Am Heart Assoc 2016; 5:JAHA.116.003856. [PMID: 27464790 PMCID: PMC5015302 DOI: 10.1161/jaha.116.003856] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background Bypass grafting remains the standard of care for coronary artery disease and severe lower extremity ischemia. Efficacy is limited by poor long‐term venous graft patency secondary to intimal hyperplasia (IH) caused by venous injury upon exposure to arterial pressure. We investigate whether photochemical tissue passivation (PTP) treatment of vein grafts modulates smooth muscle cell (SMC) proliferation and migration, and inhibits development of IH. Methods and Results PTP was performed at increasing fluences up to 120 J/cm2 on porcine veins. Tensiometry performed to assess vessel elasticity/stiffness showed increased stiffness with increasing fluence until plateauing at 90 J/cm2 (median, interquartile range [IQR]). At 90 J/cm2, PTP‐treated vessels had a 10‐fold greater Young's modulus than untreated controls (954 [IQR, 2217] vs 99 kPa [IQR, 63]; P=0.03). Each pig received a PTP‐treated and untreated carotid artery venous interposition graft. At 4‐weeks, intimal/medial areas were assessed. PTP reduced the degree of IH by 66% and medial hypertrophy by 49%. Intimal area was 3.91 (IQR, 1.2) and 1.3 mm2 (IQR, 0.97; P≤0.001) in untreated and PTP‐treated grafts, respectively. Medial area was 9.2 (IQR, 3.2) and 4.7 mm2 (IQR, 2.0; P≤0.001) in untreated and PTP‐treated grafts, respectively. Immunohistochemistry was performed to assess alpha‐smooth muscle actin (SMA) and proliferating cell nuclear antigen (PCNA). Objectively, there were less SMA‐positive cells within the intima/media of PTP‐treated vessels than controls. There was an increase in PCNA‐positive cells within control vein grafts (18% [IQR, 5.3]) versus PTP‐treated vein grafts (5% [IQR, 0.9]; P=0.02). Conclusions By strengthening vein grafts, PTP decreases SMC proliferation and migration, thereby reducing IH.
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Affiliation(s)
- Robert N Goldstone
- Division of Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Michael C McCormack
- Division of Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Saiqa I Khan
- Division of Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Harry M Salinas
- Division of Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Amanda Meppelink
- Division of Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Mark A Randolph
- Division of Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Michael T Watkins
- Division of Vascular and Endovascular Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Robert W Redmond
- Department of Dermatology, and Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - William G Austen
- Division of Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA
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Meppelink AM, Zhao X, Griffin DJ, Erali R, Gill TJ, Bonassar LJ, Redmond RW, Randolph MA. Hyaline Articular Matrix Formed by Dynamic Self-Regenerating Cartilage and Hydrogels. Tissue Eng Part A 2016; 22:962-70. [PMID: 27324118 DOI: 10.1089/ten.tea.2015.0577] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Injuries to the articular cartilage surface are challenging to repair because cartilage possesses a limited capacity for self-repair. The outcomes of current clinical procedures aimed to address these injuries are inconsistent and unsatisfactory. We have developed a novel method for generating hyaline articular cartilage to improve the outcome of joint surface repair. A suspension of 10(7) swine chondrocytes was cultured under reciprocating motion for 14 days. The resulting dynamic self-regenerating cartilage (dSRC) was placed in a cartilage ring and capped with fibrin and collagen gel. A control group consisted of chondrocytes encapsulated in fibrin gel. Constructs were implanted subcutaneously in nude mice and harvested after 6 weeks. Gross, histological, immunohistochemical, biochemical, and biomechanical analyses were performed. In swine patellar groove, dSRC was implanted into osteochondral defects capped with collagen gel and compared to defects filled with osteochondral plugs, collagen gel, or left empty after 6 weeks. In mice, the fibrin- and collagen-capped dSRC constructs showed enhanced contiguous cartilage matrix formation over the control of cells encapsulated in fibrin gel. Biochemically, the fibrin and collagen gel dSRC groups were statistically improved in glycosaminoglycan and hydroxyproline content compared to the control. There was no statistical difference in the biomechanical data between the dSRC groups and the control. The swine model also showed contiguous cartilage matrix in the dSRC group but not in the collagen gel and empty defects. These data demonstrate the survivability and successful matrix formation of dSRC under the mechanical forces experienced by normal hyaline cartilage in the knee joint. The results from this study demonstrate that dSRC capped with hydrogels successfully engineers contiguous articular cartilage matrix in both nonload-bearing and load-bearing environments.
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Affiliation(s)
- Amanda M Meppelink
- 1 Plastic Surgery Research Laboratory, Department of Surgery, Massachusetts General Hospital , Boston, Massachusetts
| | - Xing Zhao
- 1 Plastic Surgery Research Laboratory, Department of Surgery, Massachusetts General Hospital , Boston, Massachusetts
| | - Darvin J Griffin
- 2 Meinig School of Biomedical Engineering, Cornell University , Ithaca, New York
| | - Richard Erali
- 3 Laboratory of Musculoskeletal Tissue Engineering, Massachusetts General Hospital , Boston, Massachusetts
| | - Thomas J Gill
- 4 Boston Sports Medicine and Research Institute , Dedham, Massachusetts
| | - Lawrence J Bonassar
- 2 Meinig School of Biomedical Engineering, Cornell University , Ithaca, New York
| | - Robert W Redmond
- 5 Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital , Boston, Massachusetts
| | - Mark A Randolph
- 3 Laboratory of Musculoskeletal Tissue Engineering, Massachusetts General Hospital , Boston, Massachusetts
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Zhao X, Papadopoulos A, Ibusuki S, Bichara DA, Saris DB, Malda J, Anseth KS, Gill TJ, Randolph MA. Articular cartilage generation applying PEG-LA-DM/PEGDM copolymer hydrogels. BMC Musculoskelet Disord 2016; 17:245. [PMID: 27255078 PMCID: PMC4891826 DOI: 10.1186/s12891-016-1100-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 05/26/2016] [Indexed: 12/04/2022] Open
Abstract
Background Injuries to the human native cartilage tissue are particularly problematic because cartilage has little to no ability to heal or regenerate itself. Employing a tissue engineering strategy that combines suitable cell sources and biomimetic hydrogels could be a promising alternative to achieve cartilage regeneration. However, the weak mechanical properties may be the major drawback to use fully degradable hydrogels. Besides, most of the fully degradable hydrogels degrade too fast to permit enough extracellular matrix (ECM) production for neocartilage formation. In this study, we demonstrated the feasibility of neocartilage regeneration using swine articular chondrocytes photoencapsualted into poly (ethylene glycol) dimethacrylate (PEGDM) copolymer hydrogels composed of different degradation profiles: degradable (PEG-LA-DM) and nondegradable (PEGDM) macromers in molar ratios of 50/50, 60/40, 70/30, 80/20, and 90/10. Methods Articular chondrocytes were isolated enzymatically from juvenile Yorkshire swine cartilage. 6 × 107 cells cells were added to each milliliter of macromer/photoinitiator (I2959) solution. Nonpolymerized gel containing the cells (100 μL) was placed in cylindrical molds (4.5 mm diameter × 6.5 mm in height). The macromer/photoinitiator/chondrocyte solutions were polymerized using ultraviolet (365 nm) light at 10 mW/cm2 for 10 mins. Also, an articular cartilaginous ring model was used to examine the capacity of the engineered cartilage to integrate with native cartilage. Samples in the pilot study were collected at 6 weeks. Samples in the long-term experimental groups (60/40 and 70/30) were implanted into nude mice subcutaneously and harvested at 6, 12 and 18 weeks. Additionally, cylindrical constructs that were not implanted used as time zero controls. All of the harvested specimens were examined grossly and analyzed histologically and biochemically. Results Histologically, the neocartilage formed in the photochemically crosslinked gels resembled native articular cartilage with chondrocytes in lacunae and surrounded by new ECM. Increases in total DNA, glycosaminoglycan, and hydroxyproline were observed over the time periods studied. The neocartilage integrated with existing native cartilage. Conclusions Articular cartilage generation was achieved using swine articular chondrocytes photoencapsulated in copolymer PEGDM hydrogels, and the neocartilage tissue had the ability to integrate with existing adjacent native cartilage.
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Affiliation(s)
- Xing Zhao
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, WACC 435, 15 Parkman Street, Boston, MA, 02114, USA.,Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anestis Papadopoulos
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Shinichi Ibusuki
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David A Bichara
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, WACC 435, 15 Parkman Street, Boston, MA, 02114, USA
| | - Daniel B Saris
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.,MIRA Institute for Biotechnology and Technical Medicine, University Twente, Enschede, The Netherlands
| | - Jos Malda
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Equine Science, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Kristi S Anseth
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, CO, USA
| | - Thomas J Gill
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark A Randolph
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. .,Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, WACC 435, 15 Parkman Street, Boston, MA, 02114, USA.
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Senthil-Kumar P, Ni T, Randolph MA, Velmahos GC, Kochevar IE, Redmond RW. A light-activated amnion wrap strengthens colonic anastomosis and reduces peri-anastomotic adhesions. Lasers Surg Med 2016; 48:530-7. [PMID: 26996284 DOI: 10.1002/lsm.22507] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Colonic anastomotic failure is a dreaded complication, and multiple surgical techniques have failed to eliminate it. Photochemical tissue bonding (PTB) is a method of sealing tissue surfaces by light-activated crosslinking. We evaluated if a human amniotic membrane (HAM), sealed over the anastomotic line by PTB, increases the anastomotic strength. STUDY DESIGN Sprague-Dawley rats underwent midline laparotomy followed by surgical transection of the left colon. Animals were randomized to colonic anastomosis by one of the following methods (20 per group): single-layer continuous circumferential suture repair (SR); SR with a HAM wrap attached by suture (SR+ HAM-S); SR with HAM bonded photochemically over the anastomotic site using 532 nm light (SR+ HAM-PTB); approximation of the bowel ends with only three sutures and sealing with HAM-PTB (3+ HAM-PTB). A control group underwent laparotomy alone with no colon resection (NR). Sub-groups (n = 10) were sacrificed at days 3 and 7 post-operatively and adhesions were evaluated. A 6 cm section of colon was then removed and strength of anastomosis evaluated by burst pressure (BP) measurement. RESULTS A fourfold increase in BP was observed in the SR+ HAM-PTB group compared to suture repair alone (94 ± 3 vs. 25 ± 8 mm Hg, P < 0.0001) at day 3. At day 7 the burst pressures were 165 ± 40 and 145 ± 31 mm Hg (P = 1), respectively. A significant decrease in peri-anastomotic adhesions was observed in the SR+ HAM-PTB group compared to the SR group at both time points (P < 0.001). CONCLUSION Sealing sutured colonic anastomotic lines with HAM-PTB increases the early strength of the repair and reduces peri-anastomotic adhesions. Lasers Surg. Med. 48:530-537, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Prabhu Senthil-Kumar
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, 02114.,Plastic Surgery Research Laboratory, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, 02114
| | - Tao Ni
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, 02114.,Department of Burns and Plastic Surgery, No. 3 People's Hospital, and Institute of Traumatic Medicine, School of Medicine, Shanghai Jiao Tong University, Shanghai, 201900, P.R. China
| | - Mark A Randolph
- Plastic Surgery Research Laboratory, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, 02114
| | - George C Velmahos
- Division of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, 02114
| | - Irene E Kochevar
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, 02114
| | - Robert W Redmond
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, 02114
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Pomerantseva I, Bichara DA, Tseng A, Cronce MJ, Cervantes TM, Kimura AM, Neville CM, Roscioli N, Vacanti JP, Randolph MA, Sundback CA. Ear-Shaped Stable Auricular Cartilage Engineered from Extensively Expanded Chondrocytes in an Immunocompetent Experimental Animal Model. Tissue Eng Part A 2015; 22:197-207. [PMID: 26529401 DOI: 10.1089/ten.tea.2015.0173] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Advancement of engineered ear in clinical practice is limited by several challenges. The complex, largely unsupported, three-dimensional auricular neocartilage structure is difficult to maintain. Neocartilage formation is challenging in an immunocompetent host due to active inflammatory and immunological responses. The large number of autologous chondrogenic cells required for engineering an adult human-sized ear presents an additional challenge because primary chondrocytes rapidly dedifferentiate during in vitro culture. The objective of this study was to engineer a stable, human ear-shaped cartilage in an immunocompetent animal model using expanded chondrocytes. The impact of basic fibroblast growth factor (bFGF) supplementation on achieving clinically relevant expansion of primary sheep chondrocytes by in vitro culture was determined. Chondrocytes expanded in standard medium were either combined with cryopreserved, primary passage 0 chondrocytes at the time of scaffold seeding or used alone as control. Disk and human ear-shaped scaffolds were made from porous collagen; ear scaffolds had an embedded, supporting titanium wire framework. Autologous chondrocyte-seeded scaffolds were implanted subcutaneously in sheep after 2 weeks of in vitro incubation. The quality of the resulting neocartilage and its stability and retention of the original ear size and shape were evaluated at 6, 12, and 20 weeks postimplantation. Neocartilage produced from chondrocytes that were expanded in the presence of bFGF was superior, and its quality improved with increased implantation time. In addition to characteristic morphological cartilage features, its glycosaminoglycan content was high and marked elastin fiber formation was present. The overall shape of engineered ears was preserved at 20 weeks postimplantation, and the dimensional changes did not exceed 10%. The wire frame within the engineered ear was able to withstand mechanical forces during wound healing and neocartilage maturation and prevented shrinkage and distortion. This is the first demonstration of a stable, ear-shaped elastic cartilage engineered from auricular chondrocytes that underwent clinical-scale expansion in an immunocompetent animal over an extended period of time.
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Affiliation(s)
- Irina Pomerantseva
- 1 Department of Surgery, Massachusetts General Hospital , Boston, Massachusetts.,2 Harvard Medical School , Boston, Massachusetts
| | - David A Bichara
- 2 Harvard Medical School , Boston, Massachusetts.,3 Plastic Surgery Research Laboratory, Massachusetts General Hospital , Boston, Massachusetts
| | - Alan Tseng
- 1 Department of Surgery, Massachusetts General Hospital , Boston, Massachusetts
| | - Michael J Cronce
- 1 Department of Surgery, Massachusetts General Hospital , Boston, Massachusetts
| | - Thomas M Cervantes
- 1 Department of Surgery, Massachusetts General Hospital , Boston, Massachusetts
| | - Anya M Kimura
- 1 Department of Surgery, Massachusetts General Hospital , Boston, Massachusetts
| | - Craig M Neville
- 1 Department of Surgery, Massachusetts General Hospital , Boston, Massachusetts.,2 Harvard Medical School , Boston, Massachusetts
| | | | - Joseph P Vacanti
- 1 Department of Surgery, Massachusetts General Hospital , Boston, Massachusetts.,2 Harvard Medical School , Boston, Massachusetts
| | - Mark A Randolph
- 2 Harvard Medical School , Boston, Massachusetts.,3 Plastic Surgery Research Laboratory, Massachusetts General Hospital , Boston, Massachusetts
| | - Cathryn A Sundback
- 1 Department of Surgery, Massachusetts General Hospital , Boston, Massachusetts.,2 Harvard Medical School , Boston, Massachusetts
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Sridhar. BV, Dailing EA, Brock JL, Stansbury JW, Randolph MA, Anseth KS. A Biosynthetic Scaffold that Facilitates Chondrocyte-Mediated Degradation and Promotes Articular Cartilage Extracellular Matrix Deposition. Regen Eng Transl Med 2015; 1:11-21. [PMID: 26900597 PMCID: PMC4758520 DOI: 10.1007/s40883-015-0002-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Articular cartilage remains a significant clinical challenge to repair because of its limited self-healing capacity. Interest has grown in the delivery of autologous chondrocytes to cartilage defects, and combining cell-based therapies with scaffolds that capture aspects of native tissue and allow cell-mediated remodeling could improve outcomes. Currently, scaffold-based therapies with encapsulated chondrocytes permit matrix production; however, resorption of the scaffold often does not match the rate of matrix production by chondrocytes, which can limit functional tissue regeneration. Here, we designed a hybrid biosynthetic system consisting of poly (ethylene glycol) (PEG) endcapped with thiols and crosslinked by norbornene-functionalized gelatin via a thiol-ene photopolymerization. The protein crosslinker was selected to facilitate chondrocyte-mediated scaffold remodeling and matrix deposition. Gelatin was functionalized with norbornene to varying degrees (~4-17 norbornenes/gelatin), and the shear modulus of the resulting hydrogels was characterized (<0.1-0.5 kPa). Degradation of the crosslinked PEG-gelatin hydrogels by chondrocyte-secreted enzymes was confirmed by gel permeation chromatography. Finally, chondrocytes encapsulated in these biosynthetic scaffolds showed significantly increased glycosaminoglycan deposition over just 14 days of culture, while maintaining high levels of viability and producing a distributed matrix. These results indicate the potential of a hybrid PEG-gelatin hydrogel to permit chondrocyte-mediated remodeling and promote articular cartilage matrix production. Tunable scaffolds that can easily permit chondrocyte-mediated remodeling may be useful in designing treatment options for cartilage tissue engineering applications.
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Affiliation(s)
- Balaji V. Sridhar.
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, Colorado
- BioFrontiers Institute, University of Colorado, Boulder, Colorado
| | - Eric A. Dailing
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, Colorado
| | - J. Logan Brock
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, Colorado
- BioFrontiers Institute, University of Colorado, Boulder, Colorado
| | - Jeffrey W. Stansbury
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, Colorado
- Department of Craniofacial Biology, School of Dental Medicine, University of Colorado, Aurora, Colorado
| | - Mark A. Randolph
- Department of Orthopedic Surgery, Laboratory for Musculoskeletal Tissue Engineering, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Plastic Surgery Research Laboratory, Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kristi S. Anseth
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, Colorado
- BioFrontiers Institute, University of Colorado, Boulder, Colorado
- Howard Hughes Medical Institute, University of Colorado, Boulder, Colorado
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Navarro Alvarez N, Zhu A, Arellano RS, Randolph MA, Duggan M, Scott Arn J, Huang CA, Sachs DH, Vagefi PA. Postnatal xenogeneic B-cell tolerance in swine following in utero intraportal antigen exposure. Xenotransplantation 2015; 22:368-78. [PMID: 26314946 DOI: 10.1111/xen.12186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 08/03/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND The objective of this study was to investigate the humoral immune response to xenogeneic antigens administered during the fetal state utilizing a baboon-to-pig model. METHODS Nine fetuses from an alpha-1,3-galactosyltransferase gene knockout (GalT-KO) MGH-miniature swine sow underwent transuterine ultrasound-guided intraportal injection of T-cell depleted baboon bone marrow (B-BM) at mid-gestation. Two juvenile GalT-KO swine undergoing direct B-BM intraportal injection were used as controls. RESULTS Postnatal humoral tolerance was induced in the long-term surviving piglets as demonstrated by the absence of any antibody response to baboon donor cells. In addition, a second intraportal B-BM administration at 2.5 months post-birth led to no antibody formation despite re-exposure to xenogeneic antigens. This B-cell unresponsiveness was abrogated only when the animal was exposed subcutaneously to third-party xenogeneic and allogeneic antigens, suggesting that the previously achieved humoral non-responsiveness was donor specific. In comparison, the two juvenile GalT-KO control swine demonstrated increasing anti-baboon IgM and IgG levels following intraportal injection. CONCLUSIONS In summary, xenogeneic B-cell tolerance was induced through in utero intraportal exposure to donor cells and this tolerance persisted following postnatal rechallenge with donor B-BM, but was lost on exposure to third-party antigen, possibly as a result of cross-reactive antibody formation.
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Affiliation(s)
- Nalu Navarro Alvarez
- Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexander Zhu
- Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ronald S Arellano
- Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark A Randolph
- Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael Duggan
- Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - John Scott Arn
- Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Christene A Huang
- Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David H Sachs
- Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Parsia A Vagefi
- Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Otto IA, Melchels FPW, Zhao X, Randolph MA, Kon M, Breugem CC, Malda J. Auricular reconstruction using biofabrication-based tissue engineering strategies. Biofabrication 2015. [PMID: 26200941 DOI: 10.1088/1758-5090/7/3/032001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Auricular malformations, which impose a significant social and psychological burden, are currently treated using ear prostheses, synthetic implants or autologous implants derived from rib cartilage. Advances in the field of regenerative medicine and biofabrication provide the possibility to engineer functional cartilage with intricate architectures and complex shapes using patient-derived or donor cells. However, the development of a successful auricular cartilage implant still faces a number of challenges. These challenges include the generation of a functional biochemical matrix, the fabrication of a customized anatomical shape, and maintenance of that shape. Biofabrication technologies may have the potential to overcome these challenges due to their ability to reproducibly deposit multiple materials in complex geometries in a highly controllable manner. This topical review summarizes this potential of biofabrication technologies for the generation of implants for auricular reconstruction. In particular, it aims to discuss how biofabrication technologies, although still in pre-clinical phase, could overcome the challenges of generating and maintaining the desired auricular shapes. Finally, remaining bottlenecks and future directions are discussed.
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Affiliation(s)
- I A Otto
- Department of Orthopaedics, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands. Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands
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