Tissue-engineered vascular grafts for use in the treatment of congenital heart disease: from the bench to the clinic and back again.
Tissue-engineered vascular grafts for use in the treatment of congenital heart disease: from the bench to the clinic and back again.
复制标题
DOI：
10.2217/rme.12.12
复制
发表时间：
2012-05
影响因子：
2.7
通讯作者：
Breuer CK
中科院分区：
文献类型：
--
作者：
Patterson JT;Gilliland T;Maxfield MW;Church S;Naito Y;Shinoka T;Breuer CK
自从十多年前第一个组织工程血管移植物(TEVG)被植入儿童体内以来，临床对性能和耐用性类似于自体血管的血管假体的需求推动了血管组织工程领域的发展。利用经典的组织工程范式在儿童先天性心脏病手术中取得了长足的进步，体外支架的细胞种植仍然是新组织形成的基石。我们的第二代骨髓细胞种植的TEVG与组织工程学教条背道而驰，其设计是诱导受者在原位再生血管组织。新的见解表明，neovessel的发育是由来自种子细胞和渗入移植物的宿主炎症细胞的细胞信号引导的。对这些信号的识别以及在TEVG重塑过程中影响细胞迁移、表型和细胞外基质沉积的调控相互作用正在产生下一代TEVG，该细胞被设计成在不使用种子细胞的情况下指导肿瘤组织的再生。这些进展代表着我们朝着为儿童先天性心脏病手术提供现成的组织工程血管管道的目标稳步前进。
Since the first tissue-engineered vascular graft (TEVG) was implanted in a child over a decade ago, growth in the field of vascular tissue engineering has been driven by clinical demand for improved vascular prostheses with performance and durability similar to an autologous blood vessel. Great strides were made in pediatric congenital heart surgery using the classical tissue engineering paradigm, and cell seeding of scaffolds in vitro remained the cornerstone of neotissue formation. Our second-generation bone marrow cell-seeded TEVG diverged from tissue engineering dogma with a design that induces the recipient to regenerate vascular tissue in situ. New insights suggest that neovessel development is guided by cell signals derived from both seeded cells and host inflammatory cells that infiltrate the graft. The identification of these signals and the regulatory interactions that influence cell migration, phenotype and extracellular matrix deposition during TEVG remodeling are yielding a next-generation TEVG engineered to guide neotissue regeneration without the use of seeded cells. These developments represent steady progress towards our goal of an off-the-shelf tissue-engineered vascular conduit for pediatric congenital heart surgery.