Cardiovascular Tissue Engineering Based on Fibrin-Gel-Scaffolds
Cardiovascular Tissue Engineering Based on Fibrin-Gel-Scaffolds
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基于纤维蛋白凝胶支架的心血管组织工程
DOI：
10.5772/19761
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发表时间：
2011
影响因子：
16.6
通讯作者：
T. Flanagan
中科院分区：
文献类型：
--
作者：
S. Jockenhoevel;T. Flanagan
心血管疾病是西方世界的一个主要死亡原因。新型药物和创新设备提高了心血管疾病患者的生活质量，但这些治疗方法并非没有局限性和并发症。目前这些治疗的主要限制是不能生长、修复和重塑结构。组织工程作为心血管疾病的一种替代疗法的出现，引发了对心血管系统许多组成部分的研究，包括心脏瓣膜、小口径血管移植物和生物支架材料。用于支持发展中的心血管结构的生物材料的组成是组织中细胞行为和功能的关键介质，并且用于开发成功的最终产品的理想支架生物材料仍然是一个有争议的问题。纤维蛋白是参与伤口愈合的主要结构蛋白，是快速合成自体组织工程心血管移植物的理想支架，因为其主要支架成分（纤维蛋白原和凝血酶）可以直接从需要移植物的患者的血液样本中分离出来。纤维蛋白凝胶支架可以立即提供高的细胞播种效率和凝胶包埋的均匀细胞分布，并且可以通过蛋白酶抑制剂（如氨甲环酸或抑肽蛋白）控制降解率。纤维蛋白还可以刺激种子细胞分泌增强的细胞外基质（ECM）蛋白。控制纤维蛋白聚合过程的潜力也为制造复杂的3-D结构提供了机会，如心脏瓣膜假体和嵌入多孔、纺织或金属（支架）结构。本章回顾了纤维蛋白的特性，使其成为心血管组织工程领域应用的理想支架候选人，并记录了基于纤维蛋白的心脏瓣膜，血管移植物和临床应用的生物支架的成功发展。
Cardiovascular disease is a major cause of death in the Western World. Novel drugs and innovative devices have enhanced the quality of life for patients with cardiovascular disease, but such treatments are not without limitations and complications. The major constraint with these current treatments is the inability for growth, repair and remodeling of the structure. The emergence of tissue engineering as an alternative therapy for cardiovascular disease has generated an intensity of research into the development of many components of the cardiovascular system, including heart valves, small-calibre vascular grafts and biological stent materials. The composition of the biomaterial used as a support for the developing cardiovascular structure is a key mediator of cell behaviour and function in the tissue, and the ideal scaffold biomaterial for development of a successful end-product continues to be a matter of debate. Fibrin, a major structural protein involved in wound healing, represents an ideal scaffold for the rapid synthesis of autologous tissue-engineered cardiovascular grafts, as its primary scaffold constituents (fibrinogen and thrombin) can be isolated directly from a blood sample of the patient requiring the graft. Fibrin gel scaffolds offer immediate high cell seeding efficiency and homogenous cell distribution by gelation entrapment, and have a degradation rate that can be controlled by protease inhibitors, e.g. tranexamic acid or aprotinin. Fibrin is also known to stimulate the secretion of reinforcing extracellular matrix (ECM) proteins by seeded cells. The potential to control the fibrin polymerisation process also offers the opportunity to produce complex 3-D structures, like heart valve prostheses and to embed porous, textile or metal (stent) structures. This book chapter reviews the properties of fibrin that make it an ideal scaffold candidate for applications in the area of cardiovascular tissue engineering, and documents the successful development of fibrin-based heart valves, vascular grafts and biostents for clinical application.