Current Progress in Vascular Engineering and Its Clinical Applications.

Hatem Jouda,Luis Larrea Murillo,Tao Wang

doi:10.3390/cells11030493

Hatem Jouda, Luis Larrea Murillo + Show 1 more

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https://doi.org/10.3390/cells11030493

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Journal: Cells	Publication Date: Jan 31, 2022
Citations: 11	License type: CC BY 4.0

Affiliation: University of Manchester

Abstract

Coronary heart disease (CHD) is caused by narrowing or blockage of coronary arteries due to atherosclerosis. Coronary artery bypass grafting (CABG) is widely used for the treatment of severe CHD cases. Although autologous vessels are a preferred choice, healthy autologous vessels are not always available; hence there is a demand for tissue engineered vascular grafts (TEVGs) to be used as alternatives. However, producing clinical grade implantable TEVGs that could healthily survive in the host with long-term patency is still a great challenge. There are additional difficulties in producing small diameter (<6 mm) vascular conduits. As a result, there have not been TEVGs that are commercially available. Properties of vascular scaffolds such as tensile strength, thrombogenicity and immunogenicity are key factors that determine the biocompatibility of TEVGs. The source of vascular cells employed to produce TEVGs is a limiting factor for large-scale productions. Advanced technologies including the combined use of natural and biodegradable synthetic materials for scaffolds in conjunction with the use of mesenchyme stem cells or induced pluripotent stem cells (iPSCs) provide promising solutions for vascular tissue engineering. The aim of this review is to provide an update on various aspects in this field and the current status of TEVG clinical applications.

Highlights

Healthy blood vessels are integral to body function
Endothelial damages caused by smoking, obesity, and aging lead to atherosclerosis, which can manifest into coronary heart disease (CHD) or ischaemic heart disease (IHD) [5]
The engineered vascular grafts still have not matched the performance of autologous vessels, there have not been commercially available small-diameter grafts [19]

Summary

Introduction

Healthy blood vessels are integral to body function. They provide tissues with nutrients and oxygen, as well as remove waste products such as carbon dioxide and metabolites. With the exception of capillaries, all blood vessels are composed of three main cellular layers: the tunica intima, tunica media and tunica adventitia (Figure 1) [1,2]. The major cell types that compose these layers are endothelial cells (ECs) for the intima, vascular smooth muscle cells (VSMCs) for the media and fibroblasts for the adventitia. There are structural differences among different types of vessels, e.g., arteries versus veins, small resistance arteries versus large conduit arteries, in addition to different compositions of the extracellular matrix (ECM), which support and regulate specific functions of blood vessels [3,4]. Certain risk factors induce pathological changes in blood vessels, leading to common cardiovascular conditions. Endothelial damages caused by smoking, obesity, and aging lead to atherosclerosis, which can manifest into coronary heart disease (CHD) or ischaemic heart disease (IHD) [5]

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