Challenges in vascular tissue engineering for diabetic patients.
Challenges in vascular tissue engineering for diabetic patients.
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DOI：
10.1016/j.actbio.2018.01.008
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发表时间：
2018-04-01
影响因子：
9.7
通讯作者：
Simionescu A
中科院分区：
文献类型：
--
作者：
Dhulekar J;Simionescu A
高血糖和血脂异常在糖尿病中共存，导致炎症、变性和组织重塑受损，这些过程不利于组织工程产品与周围组织的预期整合。血管组织工程有几个挑战，如非血栓性、足够的破裂压力和顺应性、可缝合性、适当的重塑反应和血管活性，但是，在糖尿病条件下，需要考虑一个额外的挑战：由高葡萄糖和脂质浓度产生的侵略性氧化环境，导致血管壁形成晚期糖基化终产物（AGEs）。细胞外基质支架具有足够的物理性能和生物相容性，然而，这些支架在糖尿病中由于age的形成和胶原降解受损而发生改变，从而增加血管壁硬度。此外，血管细胞通过血管壁的病理重塑来检测和响应来自基质的改变的刺激。由于间充质干细胞（MSCs）的免疫调节作用，它们经常被用于组织工程，以保护支架免受炎症的影响。MSCs结合抗氧化处理的支架有望保护血管移植物免受糖尿病诱导的改变。综上所述，由于糖尿病患者血管组织工程中使用的细胞和支架可能会破坏ECM及其与细胞的相互作用，因此我们建议在糖尿病动物模型中进行测试，以获得有关其对糖尿病逆境的抗性的有价值的结果。
Hyperglycemia and dyslipidemia coexist in diabetes and result in inflammation, degeneration, and impaired tissue remodeling, processes which are not conducive to the desired integration of tissue engineered products into the surrounding tissues. There are several challenges for vascular tissue engineering such as non-thrombogenicity, adequate burst pressure and compliance, suturability, appropriate remodeling responses, and vasoactivity, but, under diabetic conditions, an additional challenge needs to be considered: the aggressive oxidative environment generated by the high glucose and lipid concentrations that lead to the formation of advanced glycation end products (AGEs) in the vascular wall. Extracellular matrix-based scaffolds have adequate physical properties and are biocompatible, however, these scaffolds are altered in diabetes by the formation AGEs and impaired collagen degradation, consequently increasing vascular wall stiffness. In addition, vascular cells detect and respond to altered stimuli from the matrix by pathological remodeling of the vascular wall. Due to the immunomodulatory effects of mesenchymal stem cells (MSCs), they are frequently used in tissue engineering in order to protect the scaffolds from inflammation. MSCs together with antioxidant treatments of the scaffolds are expected to protect the vascular grafts from diabetes-induced alterations. In conclusion, as one of the most daunting environments that could damage the ECM and its interaction with cells is progressively built in diabetes, we recommend that cells and scaffolds used in vascular tissue engineering for diabetic patients are tested in diabetic animal models, in order to obtain valuable results regarding their resistance to diabetic adversities.
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