Implanted In-Body Tissue-Engineered Heart Valve Can Adapt the Histological Structure to the Environment.
Implanted In-Body Tissue-Engineered Heart Valve Can Adapt the Histological Structure to the Environment.
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植入体内的组织工程心脏瓣膜可以使组织学结构适应环境。
DOI：
10.1097/mat.0000000000000769
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发表时间：
2018
期刊：
影响因子：
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et al.
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作者：
Takewa Y;et al.
组织工程心脏瓣膜（TEHV）有望成为可行的移植物。然而，尚不清楚它们在植入后是否通过其组织学结构。我们开发了一种新的自体TEHV（命名为支架生物瓣膜），用于经导管植入，使用基于组织包裹现象的体内组织工程。在这项研究中，一个时间过程中的组织学转变的植入生物瓣膜在山羊进行了调查。通过将安装有金属支架的塑料模具嵌入皮下空间2个月来制备三种类型的支架生物瓣膜。在提取具有组织的模具并仅移除模具后，支架生物瓣膜完全由结缔组织构成。另1只山羊经导管在主动脉瓣或肺动脉瓣处植入支架生物瓣。在每只动物中，支架生物瓣膜在1个月（从1个月到6个月）或尽可能长的时间内植入。共12只山羊（主动脉5只，肺动脉7只）成功植入。因此，最长期限变成了19个月。即使如此，生物瓣膜的瓣叶仍保持其形状和弹性，在任何病例和持续时间内均未观察到钙化或血栓。组织学显示，即使在1个月后，受体细胞也像内皮一样覆盖瓣叶的层状表面。细胞也逐渐在小叶内迁移，最终形成具有天然小叶特征的三层组织。植入的支架生物瓣膜可以使其组织结构适应环境。它们有潜力作为可行的移植物，保持更好的功能和生物相容性。
Tissue-engineered heart valves (TEHVs) are expected to be viable grafts. However, it is unknown whether they transit their histological structure after implantation. We developed a novel autologous TEHV (named stent biovalve) for transcatheter implantation, using in-body tissue engineering based on a tissue encapsulation phenomenon. In this study, a time-course histological transition of implanted biovalves was investigated in goats. Three types of stent biovalves were prepared by 2 month embedding of plastic molds mounted with metallic stents, in the subcutaneous spaces. After extracting the molds with tissue and removing the molds only, stent biovalves were constituted entirely from the connective tissues. Stent biovalves were implanted in the aortic or pulmonary valve position of other goats with transcatheter technique. In each animal, the stent biovalve was explanted at 1 month step (from 1 to 6 months) or as long as possible. Total 12 goats (five for aortic and seven for pulmonary) were successfully implanted. The maximum duration became 19 months as a result. Even then the leaflets of the biovalves kept their shape and elasticity, and neither calcification nor thrombi were observed in any cases and duration. Histology showed the recipients’ cells covering the laminar surface of the leaflets like the endothelium even after 1 month. The cells have also migrated in the leaflets gradually and finally constructed characteristic 3 layered tissues like native leaflets. Implanted stent biovalves can adapt their histological structure to the environment. They have a potential as viable grafts keeping better function and biocompatibility.