Abstract

Cardiovascular tissue engineering is a promising approach to develop grafts that, in contrast to current replacement grafts, have the capacity to grow and remodel like native tissues. This approach largely depends on cell-driven tissue growth and remodeling, which are highly complex processes that are difficult to control inside the scaffolds used for tissue engineering. For several tissue engineering approaches, adverse tissue growth and remodeling outcomes were reported, such as aneurysm formation in vascular grafts, and leaflet retraction in heart valve grafts. It is increasingly recognized that the outcome of tissue growth and remodeling, either physiological or pathological, depends at least partly on the establishment of a homeostatic mechanical state, where one or more mechanical quantities in a tissue are maintained in equilibrium. To design long-term functioning tissue engineering strategies, understanding how scaffold parameters such as geometry affect the mechanical state of a construct, and how this state guides tissue growth and remodeling, is therefore crucial. Here, we studied how anisotropic versus isotropic mechanical loading—as imposed by initial scaffold geometry—influences tissue growth, remodeling, and the evolution of the mechanical state and geometry of tissue-engineered cardiovascular constructs in vitro. Using a custom-built bioreactor platform and nondestructive mechanical testing, we monitored the mechanical and geometric changes of elliptical and circular, vascular cell-seeded, polycaprolactone-bisurea scaffolds during 14 days of dynamic loading. The elliptical and circular scaffold geometries were designed using finite element analysis, to induce anisotropic and isotropic dynamic loading, respectively, with similar maximum stretch when cultured in the bioreactor platform. We found that the initial scaffold geometry-induced (an)isotropic loading of the engineered constructs differentially dictated the evolution of their mechanical state and geometry over time, as well as their final structural organization. These findings demonstrate that controlling the initial mechanical state of tissue-engineered constructs via scaffold geometry can be used to influence tissue growth and remodeling and determine tissue outcomes.

Highlights

  • IntroductionEnd-stage diseased cardiovascular tissues like heart valves or blood vessels require replacement

  • When conventional treatments fail, end-stage diseased cardiovascular tissues like heart valves or blood vessels require replacement

  • Constructs enlarged during dynamic loading (Figure 3A), which was confirmed by the ultrasound data of a representative construct at zero pressure right before (Figure 3C) and on the last day of dynamic loading (Figure 3D)

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Summary

Introduction

End-stage diseased cardiovascular tissues like heart valves or blood vessels require replacement. Such prostheses, like bioprosthetic and mechanical valves, or synthetic vascular grafts, have several shortcomings, but most importantly lack the ability to grow, repair and remodel in response to changes in their environment. Like bioprosthetic and mechanical valves, or synthetic vascular grafts, have several shortcomings, but most importantly lack the ability to grow, repair and remodel in response to changes in their environment This aspect is problematic for pediatric patients, as it requires them to undergo multiple re-operations (Ackermann et al, 2007; Lee et al, 2011; Brown et al, 2012) that reduce life expectancy (Puvimanasinghe et al, 2001). We believe that by understanding the interplay between tissue growth, remodeling, the mechanical state of tissue-engineered constructs, and different external loading conditions, we are able to optimize and steer growth and remodeling via the rational design of scaffold geometry, creating long-term functioning grafts

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