Extracellular matrix scaffold for cardiac repair
Extracellular matrix scaffold for cardiac repair
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DOI：
10.1161/circulationaha.104.525436
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发表时间：
2005-08-30
期刊：
影响因子：
37.8
通讯作者：
Badylak, SF
中科院分区：
文献类型：
--
作者：
Robinson, KA;Li, JS;Badylak, SF
背景-心力衰竭仍然是一个重要的问题。组织工程心脏补片提供治疗严重心力衰竭的潜力。我们研究了细胞外基质支架修复梗死leftventricular.Methods和Results-Pigs（n=42）进行了左心室（LV）梗死。在6 - 8周时，植入4层多层膀胱来源的细胞外基质或膨胀聚乙烯（ePTFE）作为全层LV壁补片置换。每隔1周、1个月或3个月，处死猪。肉眼检查后，制备组织样本进行组织学、免疫细胞化学和流式细胞术细胞比例分析。1周和1个月贴剂完整，有血栓和炎症; 1个月时，在富含蛋白聚糖和胶原基质中也有组织具有梭形细胞。膀胱基质（UBM）中的α-平滑肌肌动蛋白阳性细胞多于ePTFE（22.2 +/- 3.3% vs 8.4 +/- 2.7%; P=0.04）。在3个月时，UBM被生物吸收，并且存在富含胶原的血管化组织和大量肌成纤维细胞。孤立区域的α-肌节肌动蛋白阳性，强烈的α-平滑肌肌动蛋白免疫阳性，横纹细胞进行了观察。ePTFE在3个月时出现异物反应，伴坏死和钙化。流式细胞仪显示的相似性，从UBM正常心肌细胞，而ePTFE有有限的心肌细胞marker. Conclusions的纤维细胞组织，包括收缩细胞的出现伴随着生物降解的UBM时，作为LV无壁梗死补丁植入。UBM在心脏修补方面上级合成材料，并且在3个月时有心肌置换的趋势。
Background-Heart failure remains a significant problem. Tissue-engineered cardiac patches offer potential to treat severe heart failure. We studied an extracellular matrix scaffold for repairing the infarcted left ventricle.Methods and Results-Pigs (n=42) underwent left ventricular (LV) infarction. At 6 to 8 weeks, either 4-layer multilaminate urinary bladder-derived extracellular matrix or expanded polytetrafluoroethlyene (ePTFE) was implanted as full-thickness LV wall patch replacement. At 1-week, 1-month, or 3-month intervals, pigs were terminated. After macroscopic examination, samples of tissue were prepared for histology, immunocytochemistry, and analysis of cell proportions by flow cytometry. One-week and 1-month patches were intact with thrombus and inflammation; at 1 month, there was also tissue with spindle-shaped cells in proteoglycan-rich and collagenous matrix. More alpha-smooth muscle actin-positive cells were present in urinary bladder matrix (UBM) than in ePTFE (22.2 +/- 3.3% versus 8.4 +/- 2.7%; P=0.04). At 3 months, UBM was bioresorbed, and a collagen-rich vascularized tissue with numerous myofibroblasts was present. Isolated regions of alpha-sarcomeric actin-positive, intensely a-smooth muscle actin-immunopositive, and striated cells were observed. ePTFE at 3 months had foreign-body response with necrosis and calcification. Flow cytometry showed similarities of cells from UBM to normal myocardium, whereas ePTFE had limited cardiomyocyte markers.Conclusions-Appearance of a fibrocellular tissue that included contractile cells accompanied biodegradation of UBM when implanted as an LV-free wall infarction patch. UBM appears superior to synthetic material for cardiac patching and trends toward myocardial replacement at 3 months.