Abstract
Myocardial infarction causes cardiac tissue damage and the release of damage-associated molecular patterns leads to activation of the immune system, production of inflammatory mediators, and migration of various cells to the site of infarction. This complex response further aggravates tissue damage by generating oxidative stress, but it eventually heals the infarction site with the formation of fibrotic tissue and left ventricle remodeling. However, the limited self-renewal capability of cardiomyocytes cannot support sufficient cardiac tissue regeneration after extensive myocardial injury, thus, leading to an irreversible decline in heart function. Approaches to improve cardiac tissue regeneration include transplantation of stem cells and delivery of inflammation modulatory and wound healing factors. Nevertheless, the harsh environment at the site of infarction, which consists of, but is not limited to, oxidative stress, hypoxia, and deficiency of nutrients, is detrimental to stem cell survival and the bioactivity of the delivered factors. The use of biomaterials represents a unique and innovative approach for protecting the loaded factors from degradation, decreasing side effects by reducing the used dosage, and increasing the retention and survival rate of the loaded cells. Biomaterials with loaded stem cells and immunomodulating and tissue-regenerating factors can be used to ameliorate inflammation, improve angiogenesis, reduce fibrosis, and generate functional cardiac tissue. In this review, we discuss recent findings in the utilization of biomaterials to enhance cytokine/growth factor and stem cell therapy for cardiac tissue regeneration in small animals with myocardial infarction.
Highlights
Cardiovascular diseases (CVD) are the leading cause of mortality worldwide [1,2]
Awada and colleagues demonstrated that sequential delivery of vascular endothelial growth factor (VEGF) followed by platelet-derived growth factor (PDGF) using a fibrin gel/heparin coacervate delivery system improves angiogenesis and cardiac function and reduces scar formation and inflammation at two and four weeks after myocardial infarction (MI) Iinnt. aJ. rMaotl.mSocid. 2e0l20[5, 271],.5M95e2chanistically, VEGF promotes angiogenesis by activating or affecting diff5eorfe2n0t pathways and proteins, including phosphatidylinositide 3-kinase (PI3K), VRAP, Src tyrosine kinase, MAPK, and phospholipase C g[5ro8w]. tRhefcaecntotrsreapnodrtcsytsohkoiwnest,hseeccreritteidcabl yrohluemoafn maduilptiopslee-dteyrpivesedosftetmyrocesilnlse(AanDdSCsse)r,iwnee/rtehrleooandiende ipnhtooslpahpaotnaistes/g, elsautcinh haysdrSohgpel2anadndinjleocwtedminotloectuhlearpewrie-ingfhatrctproegteiionn itnyraonsinaecutpehMosIprhaattamseo,deiln, wnehgicahtivres/puoltseidtivine irnecgruelaasteiodnaonfgVioEgGenFeRs-i2s saingdnarleidnguc[e5d9]fi
Biomaterials can serve as a good platform for the controlled and sustained delivery of growth factors and cytokines to ameliorate inflammation, improve angiogenesis, reduce fibrosis, and generate functional cardiac tissue
Summary
Cardiovascular diseases (CVD) are the leading cause of mortality worldwide [1,2]. In 2017, about 17.8 million deaths globally were attributed to CVD and in the U.S alone, CVD, which include heart disease and stroke, were among the top ten causes of death, accounting for 74% of total deaths [3]. Treatment with IL-10 suppresses inflammation, polarizes macrophages towards M2 phenotype, activates fibroblasts, and improves left ventricle remodeling [47] Another important growth factor is VEGF, which can be released from cardiac macrophages to simulate angiogenesis and heart muscle repair by regulating endothelial cell proliferation, migration, and apoptosis [43,48]. Awada and colleagues demonstrated that sequential delivery of VEGF followed by platelet-derived growth factor (PDGF) using a fibrin gel/heparin coacervate delivery system improves angiogenesis and cardiac function and reduces scar formation and inflammation at two and four weeks after MI in a rat model [57]. Biomaterials loaded with growth factors/cytokines have been shown to enhance angiogenesis and tissue regeneration, reduce cardiac cell death and scar size, ameliorate inflammation, and improve cardiac function (Table 1). The combination of factors reduced apoptosis and increased proliferation of transplanted cardiomyocytes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
