Lewis A. Reis

Biodegradable scaffold with built-in vasculature for organ-on-a-chip engineering and direct surgical anastomosis

We report the fabrication of a scaffold (hereafter referred to as AngioChip) that supports the assembly of parenchymal cells on a mechanically tunable matrix surrounding a perfusable, branched, three-dimensional microchannel network coated with endothelial cells. The design of AngioChip decouples the material choices for the engineered vessel network and for cell seeding in the parenchyma, enabling extensive remodelling while maintaining an open-vessel lumen. The incorporation of nanopores and micro-holes in the vessel walls enhances permeability, and permits intercellular crosstalk and extravasation of monocytes and endothelial cells on biomolecular stimulation. We also show that vascularized hepatic tissues and cardiac tissues engineered by using AngioChips process clinically relevant drugs delivered through the vasculature, and that millimeter-thick cardiac tissues can be engineered in a scalable manner. Moreover, we demonstrate that AngioChip cardiac tissues implanted via direct surgical anastomosis to the femoral vessels of rat hindlimbs establish immediate blood perfusion.

A peptide-modified chitosan–collagen hydrogel for cardiac cell culture and delivery

Myocardial infarction (MI) results in the death of cardiomyocytes (CM) followed by scar formation and pathological remodeling of the heart. We propose that chitosan conjugated with the angiopoietin-1 derived peptide, QHREDGS, and mixed with collagen I forms a thermoresponsive hydrogel better suited for the survival and maturation of transplanted cardiomyocytes in vitro compared to collagen and chitosan-collagen hydrogels alone. Conjugation of QHREDGS peptide to chitosan does not interfere with the gelation, structure or mechanical properties of the hydrogel blends. The storage modulus of 2.5 mg ml(-1) 1:1 mass:mass (m:m) chitosan-collagen was measured to be 54.9 ± 9.1 Pa, and the loss modulus 6.1±0.9 Pa. The dose-response of the QHREDGS peptide was assessed and it was found that CMs encapsulated in High-peptide gel (651 ± 8 nmol peptide ml-gel(-1)) showed improved morphology, viability and metabolic activity in comparison to the Low-peptide (100 ± 30 nmol peptide ml-gel(-1)) and Control (No Peptide) groups. Construct (CMs in hydrogel) functional properties were not significantly different between the groups; however, the success rate of obtaining a beating construct was improved in the hydrogel with the High amount of QHREDGS peptide immobilized compared to the Low and Control groups. Subcutaneous injection of hydrogel (Control, Low and High) with CMs in the back of Lewis rats illustrated its ability to localize at the site of injection and retain cells, with CM contractile apparati identified after seven days. The hydrogel was also able to successfully localize at the site of injection in a mouse MI model.

Engineered cardiac tissues.

Cardiac tissue engineering offers the promise of creating functional tissue replacements for use in the failing heart or for in vitro drug screening. The last decade has seen a great deal of progress in this field with new advances in interdisciplinary areas such as developmental biology, genetic engineering, biomaterials, polymer science, bioreactor engineering, and stem cell biology. We review here a selection of the most recent advances in cardiac tissue engineering, including the classical cell-scaffold approaches, advanced bioreactor designs, cell sheet engineering, whole organ decellularization, stem cell-based approaches, and topographical control of tissue organization and function. We also discuss current challenges in the field, such as maturation of stem cell-derived cardiac patches and vascularization.

Biomaterials in myocardial tissue engineering.

Cardiovascular disease is the leading cause of death in the developed world, and as such there is a pressing need for treatment options. Cardiac tissue engineering emerged from the need to develop alternative sources and methods of replacing tissue damaged by cardiovascular diseases, as the ultimate treatment option for many who suffer from end‐stage heart failure is a heart transplant. In this review we focus on biomaterial approaches to augmenting injured or impaired myocardium, with specific emphasis on: the design criteria for these biomaterials; the types of scaffolds – composed of natural or synthetic biomaterials or decellularized extracellular matrix – that have been used to develop cardiac patches and tissue models; methods to vascularize scaffolds and engineered tissue; and finally, injectable biomaterials (hydrogels) designed for endogenous repair, exogenous repair or as bulking agents to maintain ventricular geometry post‐infarct. The challenges facing the field and obstacles that must be overcome to develop truly clinically viable cardiac therapies are also discussed. Copyright

Flexible shape-memory scaffold for minimally invasive delivery of functional tissues

Despite great progress in engineering functional tissues for organ repair, including the heart, an invasive surgical approach is still required for their implantation. Here, we designed an elastic and microfabricated scaffold using a biodegradable polymer (poly(octamethylene maleate (anhydride) citrate)) for functional tissue delivery via injection. The scaffolds shape memory was due to the microfabricated lattice design. Scaffolds and cardiac patches (1 cm × 1 cm) were delivered through an orifice as small as 1 mm, recovering their initial shape following injection without affecting cardiomyocyte viability and function. In a subcutaneous syngeneic rat model, injection of cardiac patches was equivalent to open surgery when comparing vascularization, macrophage recruitment and cell survival. The patches significantly improved cardiac function following myocardial infarction in a rat, compared with the untreated controls. Successful minimally invasive delivery of human cell-derived patches to the epicardium, aorta and liver in a large-animal (porcine) model was achieved.

Bioreactor for modulation of cardiac microtissue phenotype by combined static stretch and electrical stimulation

We describe here a bioreactor capable of applying electrical field stimulation in conjunction with static strain and on-line force of contraction measurements. It consisted of a polydimethylsiloxane (PDMS) tissue chamber and a pneumatically driven stretch platform. The chamber contained eight tissue microwells (8.05 mm in length and 2.5 mm in width) with a pair of posts (2.78 mm in height and 0.8 mm in diameter) in each well to serve as fixation points and for measurements of contraction force. Carbon rods, stimulating electrodes, were placed into the PDMS chamber such that one pair stimulated four microwells. For feasibility studies, neonatal rat cardiomyocytes were seeded in collagen gels into the microwells. Following 3 days of gel compaction, electrical field stimulation at 3-4 V cm(-1) and 1 Hz, mechanical stimulation of 5% static strain or electromechanical stimulation (field stimulation at 3-4 V cm(-1), 1 Hz and 5% static strain) were applied for 3 days. Cardiac microtissues subjected to electromechanical stimulation exhibited elevated amplitude of contraction and improved sarcomere structure as evidenced by sarcomeric α-actinin, actin and troponin T staining compared to microtissues subjected to electrical or mechanical stimulation alone or non-stimulated controls. The expression of atrial natriuretic factor and brain natriuretic peptide was also elevated in the electromechanically stimulated group.

Controlled release of thymosin β4 from injected collagen-chitosan hydrogels promotes angiogenesis and prevents tissue loss after myocardial infarction.

AIMS Acute myocardial infarction (MI) leads to fibrosis and severe left ventricular wall thinning. Enhancing vascularization within the infarct reduces cell death and maintains a thick left ventricular wall, which is essential for proper cardiac function. Here, we evaluated the controlled delivery of thymosin β4 (Tβ4), which supports cardiomyocyte survival by inducing vascularization and upregulating Akt activity, in the treatment of MI. MATERIALS & METHODS We injected collagen-chitosan hydrogel with controlled release of Tβ4 into the infarct after performing left anterior descending artery ligation in rats. RESULTS Tβ4-encapsulated hydrogel (thymosin) significantly reduced tissue loss post-MI (13 ± 4%), compared with 58 ± 3% and 30 ± 8% tissue loss for no treatment (MI only) and Tβ4-free hydrogel (control). Significantly more Factor VIII-positive blood vessels with diameter >50 µm were in the thymosin group compared with both MI only and control (p < 0.0001), showing Tβ4-induced vascularization. Wall thickness was positively correlated with the mature blood vessel density (r = 0.9319; p < 0.0001). CONCLUSION Controlled release of Tβ4 within the infarct enhances angiogenesis and presence of cardiomyocytes that are necessary for cardiac repair.

Hydrogels modified with QHREDGS peptide support cardiomyocyte survival in vitro and after sub-cutaneous implantation

Myocardial cell injection and tissue engineering could provide novel treatment options for heart diseases; however both approaches are limited by the loss of the transplanted myogenic cells. We hypothesized that novel hydrogels could promote cardiomyocyte survival and remedy this critical limitation. The hydrogel described here is based on a photocrosslinked form of chitosan, Az-chitosan, which was covalently bound to the QHREDGS peptide to promote cell survival. The QHREDGS amino acid sequence is thought to be the integrin binding site in angiopoietin-1, a growth factor which has cardioprotective properties. Covalent immobilization was performed using 1-ethyl-3-(-3-dimethylaminopropyl)carbodiimide chemistry. Elastic moduli of the Az-chitosan hydrogel were within the lower physiological range for the neonatal rat heart (1.9 ± 0.2 kPa for 10 mg/ml and 3.5 ± 0.6 kPa for 20 mg/ml). After 6 days of cultivation of neonatal rat heart cells encapsulated with the hydrogels, cell viability and elongation was significantly higher in the peptide modified groups compared to the Az-chitosan control. No significant differences were found in the ability of RGDS and QHREDGS hydrogels to support contractile function in vitro. After subcutaneous implantation of cardiomyocyte hydrogel-peptide constructs in Lewis rats for 7 days, both QHREDGS and RGDS similarly recruited endothelial cells. However, Az-chitosan-QHREDGS gel had a higher percentage of smooth muscle actin (SMA)-positive myofibroblasts. The QHREDGS peptide gel promoted cardiomyocyte elongation and assembly of contractile apparatus and reduced cardiomyocyte apoptosis significantly better than the RGDS peptide. The new Az-chitosan-QHREDGS hydrogel may markedly improve cardiac regeneration by cell therapy.

Diabetic wound regeneration using peptide-modified hydrogels to target re-epithelialization

Significance Current treatments for diabetic chronic wounds fail to achieve effective therapeutic outcomes. The majority of these treatments focus on angiogenesis, but diabetes often involves endothelial dysfunction. A hallmark of regenerative wound healing is rapid, effective re-epithelialization. In this study, we present QHREDGS (glutamine-histidine-arginine-glutamic acid-aspartic acid-glycine-serine), a prosurvival peptide derived from angiopoietin-1, as a therapeutic candidate that targets re-epithelialization. Immobilized QHREDGS peptide promoted cell survival against hydrogen peroxide stress and collective cell migration of both normal and diabetic human keratinocytes in vitro. The clinical relevance was demonstrated further in type 2 diabetic mice: A single treatment with a low QHREDGS dose immobilized in chitosan–collagen was effective in promoting wound healing, and a single high-dose peptide treatment outperformed a clinically approved porous collagen dressing. There is a clinical need for new, more effective treatments for chronic wounds in diabetic patients. Lack of epithelial cell migration is a hallmark of nonhealing wounds, and diabetes often involves endothelial dysfunction. Therefore, targeting re-epithelialization, which mainly involves keratinocytes, may improve therapeutic outcomes of current treatments. In this study, we present an integrin-binding prosurvival peptide derived from angiopoietin-1, QHREDGS (glutamine-histidine-arginine-glutamic acid-aspartic acid-glycine-serine), as a therapeutic candidate for diabetic wound treatments by demonstrating its efficacy in promoting the attachment, survival, and collective migration of human primary keratinocytes and the activation of protein kinase B Akt and MAPKp42/44. The QHREDGS peptide, both as a soluble supplement and when immobilized in a substrate, protected keratinocytes against hydrogen peroxide stress in a dose-dependent manner. Collective migration of both normal and diabetic human keratinocytes was promoted on chitosan–collagen films with the immobilized QHREDGS peptide. The clinical relevance was demonstrated further by assessing the chitosan–collagen hydrogel with immobilized QHREDGS in full-thickness excisional wounds in a db/db diabetic mouse model; QHREDGS showed significantly accelerated and enhanced wound closure compared with a clinically approved collagen wound dressing, peptide-free hydrogel, or blank wound controls. The accelerated wound closure resulted primarily from faster re-epithelialization and increased formation of granulation tissue. There were no observable differences in blood vessel density or size within the wound; however, the total number of blood vessels was greater in the peptide-hydrogel–treated wounds. Together, these findings indicate that QHREDGS is a promising candidate for wound-healing interventions that enhance re-epithelialization and the formation of granulation tissue.

Modifications of collagen-based biomaterials with immobilized growth factors or peptides.

In order to provide an instructive microenvironment to facilitate cellular behaviors and tissue regeneration, biomaterials can be modified by immobilizing growth factors or peptides. We describe here our procedure for modification of collagen-based biomaterials, both porous scaffolds and hydrogel systems, with growth factors or peptides by covalent immobilization. Characterizations of the modified biomaterials (immobilization efficiency, release profile, morphology, mechanical strength, and rheology) and in vitro testing with cells are also discussed.