Biocompatibility study of biological tissues fixed by a natural compound (reuterin) produced by Lactobacillus reuteri

Glutaraldehyde-fixed biological tissues have been used extensively to fabricate various bioprostheses. However, the tendency for glutaraldehyde to markedly alter tissue stiffness and promote tissue calcification is a well-recognized drawback of this crosslinking agent. To overcome the aforementioned deficiency with the glutaraldehyde-fixed bioprostheses, a fixation technique using a natural compound (reuterin) produced by Lactobacillus reuteri to crosslink biological tissues was developed by our group. It was reported that reuterin inhibits the growth of gram-positive and gram-negative bacteria as well as yeasts, fungi, and protozoa. The study was conducted to evaluate the biocompatibility of the reuterin-fixed tissues with or without ethanol sterilization implanted subcutaneously in a growing rat model. Fresh and the glutaraldehyde-fixed counterparts were used as controls. The results showed that both glutaraldehyde and reuterin are effective antimicrobial agents in the sterilization of biological tissues. The degrees in inflammatory reaction for the reuterin-fixed tissues with or without ethanol sterilization were significantly less than their glutaraldehyde-fixed counterparts throughout the entire course of the study. Additionally, the reuterin-fixed tissues have comparable tensile strengths and resistance against degradation as the glutaraldehyde-fixed tissues. The results obtained at 12-month postoperatively showed that the glutaraldehyde-fixed tissue without ethanol sterilization became significantly stiff and calcified. However, it was found that ethanol sterilization of the glutaraldehyde-fixed tissue may inhibit calcification. Additionally, reuterin fixation may inhibit tissue calcification as compared to glutaraldehyde fixation. These observations implied that the biocompatibility of the reuterin-fixed tissue is superior to the glutaraldehyde-fixed tissue.     

A natural compound (reuterin) produced by Lactobacillus reuteri for biological-tissue fixation

The study was undertaken to examine the degree of tissue fixation by reuterin, a natural compound produced by Lactobacillus reuteri, at distinct fixation conditions (pH, temperature, and fixative concentration). Additionally, the rate of tissue fixation by reuterin was investigated using glutaraldehyde as a control. It was found by the Fourier transformed infrared spectroscopy and nuclear magnetic resonance spectroscopy that both mono- and di-aldehyde reuterin oligomers may be present in the acidic and basic aqueous reuterin solutions. Therefore, reuterin may crosslink biological tissues as glutaraldehyde (a di-aldehyde agent). The degree of tissue fixation by reuterin is significantly affected by its fixation conditions. Generally, with increasing the pH, temperature, or fixative concentration, the reduction in free-amino-group content, denaturation temperature, tensile strength, and resistance against enzymatic degradation of the reuterin-fixed tissue increased significantly. Also, the rate of tissue fixation by reuterin is significantly slower than that by glutaraldehyde. However, after fixation, it was noted that the reuterin-fixed tissue has comparable free-amino-group content, denaturation temperature, tensile strength, and resistance against enzymatic degradation as the glutaraldehyde-fixed tissue.     

In vitro surface characterization of a biological patch fixed with a naturally occurring crosslinking agent

The study was designed to characterize the surface properties (including water contact angle, surface tension, protein adsorption, platelet adhesion, and cellular compatibility) of a biological patch fixed with genipin, a naturally occurring crosslinking agent. Fresh and glutaraldehyde-fixed counterparts were used as controls. It was found that both glutaraldehyde and genipin are effective crosslinking agents for biological tissue fixation. Fixation of biological tissue with glutaraldehyde or genipin significantly increased its hydrophilicity and surface tension and reduced its mol ratio of adsorbed fibrinogen to adsorbed albumin as well as the amount of adhered platelet. There were no significant differences in hydrophilicity, surface tension, the mole ratio of adsorbed fibrinogen to adsorbed albumin, and the amount of platelet adhesion between the glutaraldehyde- and genipin-fixed tissues. However, the cellular compatibilities of fresh and the genipin-fixed tissues were significantly superior to the glutaraldehyde-fixed tissue.     

Crosslinking characteristics and mechanical properties of a bovine pericardium fixed with a naturally occurring crosslinking agent.

Currently available crosslinking agents used in fixing bioprostheses are all highly (or relatively highly) cytotoxic, which may induce an adverse inflammatory reaction in vivo. It is therefore desirable to provide a crosslinking agent that is of low cytotoxicty and may form stable and biocompatible crosslinked products. To achieve this goal, a naturally occurring crosslinking agent-genipin-was used by our group to fix biological tissues. Genipin may be obtained from its parent compound, geniposide, which may be isolated from the fruits of Gardenia jasminoides Ellis. In our previous studies, it was found that the cytotoxicity of genipin is significantly lower than both glutaraldehyde and an epoxy compound. Also, it was shown that genipin can form stable and biocompatible crosslinked products. The present study further investigates the crosslinking characteristics and mechanical properties of a genipin-fixed bovine pericardium. Fresh and glutaraldehyde- and epoxy-fixed counterparts were used as controls. It was found that the denaturation temperatures of the glutaraldehyde- and genipin-fixed tissues were significantly greater than the epoxy-fixed tissue, although their fixation indices were comparable. The mechanical properties of fresh bovine pericardium are anisotropic. However, fixation tended to eliminate tissue anisotropy. The tendency in the elimination of tissue anisotropy for the genipin-fixed tissue was more remarkable than for the glutaraldehyde- and epoxy-fixed tissues. In addition, the genipin-fixed tissue had the greatest ultimate tensile strength and toughness among all the fixed tissues. Distinct patterns in rupture were observed in the study: The torn collagen fibers of the genipin- and glutaraldehyde-fixed tissues appeared to be bound together, while those of fresh and the epoxy-fixed tissues stayed loose. The results obtained in the study suggests that tissue fixation in glutaraldehyde, epoxy compound, and genipin may produce distinct crosslinking structures. The differences in crosslinking structure may affect the crosslinking characteristics and mechanical properties of the fixed tissues.     

Mechanical properties of a porcine aortic valve fixed with a naturally occurring crosslinking agent.

The study investigates the mechanical properties of porcine aortic valve leaflets fixed with a naturally occurring crosslinking agent, genipin, at distinct pressure heads. Fresh and the glutaraldehyde-fixed counterparts were used as controls. Subsequent to fixation, the changes in leaflet collagen crimps and its surface morphology were investigated by light microscopy and scanning electron microscopy (SEM). Also, the crosslinking characteristics of each studied group were determined by measuring its fixation index and denaturation temperature. In the mechanical testing, tissue strips made from each studied group were examined in both the circumferential and radial directions. Histological and SEM comparisons between fresh porcine aortic valve leaflet and those fixed at medium or high pressure revealed that the following changes may occur: elimination of the natural collagen crimping, and extensive loss of the endothelial layer. The denaturation temperatures of the glutaraldehyde-fixed leaflets were significantly greater than the genipin-fixed leaflets; however, their fixation indices were comparable. Generally, fixation pressure did not affect the crosslinking characteristics of the genipin- and glutaraldehyde-fixed leaflets. It was found that fixation of porcine aortic valves in genipin or glutaraldehyde did not alter the mechanical anisotropy observed in fresh valve leaflets. This indicated that the intramolecular and intermolecular crosslinks introduced into the collagen fibrils during fixation is of secondary importance to the presence of structural and mechanical anisotropy in fresh leaflet. Tissue fixation in genipin or glutaraldehyde may produce distinct crosslinking structures. However, the difference in crosslinking structure between the genipin- and glutaraldehyde-fixed leaflets did not seem to cause any significant discrepancies in their mechanical properties when compared at the same fixation pressure. Nevertheless, regardless of the crosslinking agent used, changes in mechanical properties and ruptured patterns were observed when the valve leaflets were fixed at distinct pressures.     

Stability of a biological tissue fixed with a naturally occurring crosslinking agent (genipin)

The study was undertaken to investigate the stability of a biological tissue fixed with a naturally occurring crosslinking agent (genipin) at distinct elapsed storage durations. The glutaraldehyde-fixed counterpart was used as a control. Porcine pericardia procured from a slaughterhouse were used as raw materials. After fixation, the fixed tissues were sterilized in a graded series of ethanol solutions and thoroughly rinsed in phosphate buffered saline for 1 day, and then stored in a jar containing sterilized water. The samples were taken out and tested for their stability during the durations of 1day through 6 months after storage. The stability of each study group was tested by measuring its tensile strength, free-amino-group content, and denaturation temperature. Additionally, the cytotoxicity of each test sample and its corresponding storage solution were investigated in vitro using 3T3 fibroblasts. The results were examined using a microscope and 3-(4,5-dimethylthiazol-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. It was found that the stability of the genipin-fixed tissue during storage was superior to its glutaraldehyde-fixed counterpart. The differences in stability between the genipin- and glutaraldehyde-fixed tissues during storage may be caused by their differences in crosslinking structure. There was no apparent cytotoxicity for both the genipin-fixed tissue and its corresponding storage solution throughout the entire course of the study, whereas significant cytotoxicity was observed for both the glutaraldehyde-fixed tissue and its storage solution. However, the cytotoxicity of the glutaraldehyde-fixed tissue decreased with increasing elapsed storage duration, whereas that of its corresponding storage solution increased. This suggested that the toxic residues remaining in the glutaraldehyde-fixed tissue leached out slowly into its corresponding storage solution during the course of storage.     

Fixation of biological tissues with a naturally occurring crosslinking agent: fixation rate and effects of pH, temperature, and initial fixative concentration

In an attempt to overcome the cytotoxicity problem of the glutaraldehyde-fixed tissues, a naturally occurring crosslinking agent (genipin) was used by our group to fix biological tissues. The study was intended to investigate the rate of tissue fixation by genipin. Glutaraldehyde was used as a control. In addition, the degrees of tissue fixation by genipin at different pHs (pH 4.0, pH 7. 4, pH 8.5, or pH 10.5), temperatures (4 degrees C, 25 degrees C, 37 degrees C, or 45 degrees C), and initial fixative concentrations (0.250%, 0.625%, or 1.000%) were examined. The results obtained revealed that the rate of tissue fixation by glutaraldehyde was significantly faster than that by genipin. The degree of tissue fixation by genipin may be controlled by adjusting its fixation duration or fixation conditions. The order in degree of tissue fixation by genipin at different pHs, from high to low, was: at nearly neutral pH (pH 7.4 or pH 8.5) > at basic pH (pH 10.5) > at acidic pH (pH 4.0). The degrees of tissue fixation by genipin at different temperatures were about the same, except for that at 4 degrees C. In contrast, the initial fixative concentration did not seem to affect the degree of tissue fixation by genipin, if only the amount of genipin in the fixation solution was sufficient to complete tissue fixation. The concentrations of genipin in the aqueous solutions at different pHs, temperatures, and initial fixative concentrations tended to decrease with time with or without the occurrence of tissue fixation. This indicated that genipin was not stable in the aqueous solution. The instability of aqueous genipin was more remarkable with increasing pH or temperature. The results obtained in this study may be used to optimize the fixation process for developing bioprostheses fixed by genipin.     

氧化海藻酸钠交联改性脱细胞基质材料及其细胞相容性研究

运用高碘酸钠氧化法制备新型的生物交联剂—氧化海藻酸钠(ADA)并将之用于交联改性脱细胞基质材料,通过检测一些交联指标及交联后材料的性能特征来研究ADA交联改性脱细胞基质材料的特点。实验中采用了目前典型的两类交联剂(戊二醛(GA)和京尼平(GP))作为实验对照组。用三种交联剂处理血管组织15min～72h,测定交联过程中的交联指数,并对彻底交联后材料的力学性能以及细胞相容性进行研究。结果表明,ADA交联脱细胞基质材料的交联速率、交联程度不亚于GA,明显优于GP;交联后的材料也具有更适宜的力学性能;在细胞相容性方面,ADA交联的材料也具有明显优于GA、与GP相当的这样非常理想的效果。综上所述,ADA是一种具有很大发展前景的生物组织交联剂。     

In vitro evaluation of cytotoxicity of a naturally occurring cross-linking reagent for biological tissue fixation

A recognized drawback of the currently available chemical cross-linking reagents used to fix bioprostheses is the potential toxic effects a recipient may be exposed to from the fixed tissues and/or the residues. It is, therefore, desirable to provide a cross-linking reagent which is of low cytotoxicity and may form stable and biocompatible cross-linked products. To achieve this goal, a naturally occurring cross-linking reagent -- genipin -- which has been used in herbal medicine and in the fabrication of food dyes, was used by our group to fix biological tissues. The study was to assess the cytotoxicity of genipin in vitro using 3T3 fibroblasts (BALB/3T3 C1A31-1-1). Glutaraldehyde, the most commonly used cross-linking reagent for tissue fixation, was used as a control. The cytotoxicity of the glutaraldehyde- and genipin-fixed tissues and their residues was also evaluated and compared. The observation in the light microscopic examination revealed that the cytotoxicity of genipin was significantly lower than that of glutaraldehyde. Additionally, the results obtained in the MTT assay implied that genipin was about 10000 times less cytotoxic than glutaraldehyde. Moreover, the colony forming assay suggested that the proliferative capacity of cells after exposure to genipin was approximately 5000 times greater than that after exposure to glutaraldehyde. It was noted that the cells seeded on the surface of the glutaraldehyde-fixed tissue were not able to survive. In contrast, the surface of the genipin-fixed tissue was found to be filled with 3T3 fibroblasts. Additionally, neocollagen fibrils made by these fibroblasts were observed on the genipin-fixed tissue. This fact suggested that the cellular compatibility of the genipin-fixed tissue was superior to its glutaraldehyde-fixed counterpart. Also, the residues from the glutaraldehyde-fixed tissue markedly reduced the population of the cultured cells, while those released from the genipin-fixed tissue had no toxic effect on the seeded cells. In conclusion, as far as cytotoxicity is concerned, genipin is a promising cross-linking reagent for biological tissue fixation.     

Crosslinking of Bovine Pericardia Using Procyanidins

The aim of this study was to evaluate the crosslinking effect of a naturally crosslinking reagent-procyanidins (PA)-on the materials of bioprosthetic heart valves. After fixing bovine pericardial tissues by procyanidins, crosslikng characteristics, mechanical properties, in vitro enzymatic degradation resistance, the hydrophilicity and hemolysis tests were examined. The results showed that the fixation of biological tissue with glutaraldehyde (GA) or procyanidins increased its denaturation temperature, the surface hydrophilicity and mechanical properties as well as in vitro enzymatic degradation resistance. There were no significant differences in denaturation temperature, mechanical properties, the hydrophilicity and the in vitro enzymatic degradation between the glutaraldehyde and procyanidins fixed tissues. However, the ultimate tensile strength of the procyanidins fixed tissues was significantly superior to the glutaraldehyde fixed tissues. The hemolysis tests showed that hemolysis rate of the procyanidins fixed tissues was lower than that of the glutaraldehyde fixed tissues. This study shows that procyanidins can crosslink which bovine pericardiaa effectively without toxicity. Our results suggest that this method might be a useful approach for the preparation of bioprosthetic heart valve.     

Physical properties of a porcine internal thoracic artery fixed with an epoxy compound

This study aimed to investigate the physical properties of a porcine internal thoracic artery fixed with an epoxy compound. Fresh and glutaraldehyde-fixed porcine arteries were used as controls. Both the epoxy-fixed and glutaraldehyde-fixed porcine arteries showed significant increases in fixation index and denaturation temperature as compared to the fresh one. Additionally, the resistance of porcine arteries against bacterial collagenase In vitro degradation increased significantly after cross-linking with the epoxy compound or glutaraldehyde. The reduction of the tensile strength of the epoxy-fixed artery after bacterial collagenase degradation was more severe than in its glutaraldehyde-fixed counterpart. Generally, with increasing pH, temperature or fixative concentration, the fixation indices and denaturation temperatures of the epoxy-fixed porcine arteries increased. The results obtained in this study may be used to optimize the fixation process for developing a small-diameter biological vascular graft fixed by an epoxy compound.     

In vivo evaluation of cellular and acellular bovine pericardia fixed with a naturally occurring crosslinking agent (genipin)

A cell extraction process was employed in the study to remove the cellular components from bovine pericardium, leaving a framework of largely insoluble collagen and elastin. It was hypothesized in the literature that this process may decrease the antigenic load (or increase the biocompatibility) within the material. Additionally, acellular tissues may provide a natural microenvironment for host-cell migration to regenerate the tissue. The study was to evaluate the biocompatibility of cellular and acellular bovine pericardia fixed with a naturally occurring crosslinking agent (genipin) implanted subcutaneously in a growing rat model. Additionally, the tissue regeneration rate in the genipin-fixed acellular tissue was investigated. The glutaraldehyde-fixed counterparts were used as controls. The results indicated that the degrees in inflammatory reaction for the genipin-fixed cellular and acellular tissues were significantly less than their glutaraldehyde-fixed counterparts. Additionally, it was noted that the inflammatory reactions for the glutaraldehyde-fixed cellular and acellular tissues lasted much longer than their genipin-fixed counterparts. The tissue regeneration rate for the genipin-fixed acellular tissue was significantly faster than its glutaraldehyde-fixed counterpart. The calcium content of each studied group, analyzed by atomic absorption. did not change significantly until at the 52nd week, postoperatively. The differences in calcium content between the cellular and acellular tissues were insignificant for both the glutaraldehyde- and genipin-fixed groups throughout the entire course of the study. In summary, the biocompatibility of the genipin-fixed cellular and acellular tissues was superior to their glutaraldehyde-fixed counterparts. The genipin-fixed acellular tissue provided a better microenvironment for tissue regeneration than its glutaraldehyde-fixed counterpart, due to its low cytotoxicity. These results suggested that the genipin-fixed acellular tissue might be used as a tissue-engineering matrix in the clinical applications.     

Crosslinking of biological tissues using genipin and/or carbodiimide

The study was to investigate the crosslinking characteristics, mechanical properties, and resistance against enzymatic degradation of biological tissues after fixation with genipin (a naturally occurring crosslinking agent) and/or carbodiimide. Fresh tissue was used as a control. It was found that both genipin and carbodiimide are effective crosslinking agents for tissue fixation and genipin crosslinking is comparatively slower than carbodiimide crosslinking. Additionally, tissue fixation in genipin and/or carbodiimide may produce distinct crosslinking structures. Carbodiimide may form intrahelical and interhelical crosslinks within or between tropocollagen molecules, whereas genipin may further introduce intermicrofibrillar crosslinks between adjacent collagen microfibrils. The stability (denaturation temperature and resistance against enzymatic degradation) of the fixed tissue is mainly determined by its intrahelical and interhelical crosslinks. In contrast, intermicrofibrillar crosslinks significantly affect the mechanical properties (tissue shrinkage during fixation, tensile strength, strain at break, and ruptured pattern) of the fixed tissue. Moreover, the degree of enzymatic degradation of the fixed tissue may be influenced by three factors: the availability, to the enzyme, of recognizable cleavage sites, the degree of crosslinking, and the extent of helical integrity of tropocollagen molecules in tissue.     

Mechanism of crosslinking of proteins by glutaraldehyde III. Reaction with collagen in tissues

Bovine pericardium, a dense collagenous connective tissue, was crosslinked with glutaraldehyde using different modalities of fixation. The degree of crosslinking was evaluated as a function of the ability of CNBr and pronase to solubilize collagen. Our results suggest that glutaraldehyde fixes primarily the surface of the fibers and creates a polymeric network which hinders the further crosslinking of the interstitium of the fiber. When a low concentration of glutaraldehyde was used, a slow time-dependent crosslinking process was observed. This slow process is maintained over a long period of time, greatly beyond that required for the actual penetration of glutaraldehyde to occur.     

原花青素交联牛心包材料的研究

本研究针对天然交联剂原花青素处理牛心包材料的性能进行研究.采用原花青素交联牛心包组织,制备人工生物心脏瓣膜材料,并对其交联特性、力学特性、抗酶降解性能、亲疏水性能、细胞毒性试验以及溶血试验等进行分析.结果显示:原花青素或戊二醛处理的牛心包组织变性温度、力学特性、表面亲水性能和抗酶降解能力都明显提高;与传统交联剂戊二醛相比组织稳定性、亲水性能和抗酶降解能力未见显著性差异,但是最大断裂强度显著提高(原花青素交联组织最大断裂强度(13.863 0 MPa)明显高于戊二醛交联组织(10.784 2 MPa);溶血试验结果表明原花青素处理固定组织的溶血率(2.61%)远低于戊二醛处理的组织(12.54%);细胞毒性试验结果表明原花青素交联组织在1、3、5 d的细胞增殖率分别为76.19%、88.96%、100.12%,而戊二醛在相同的时间点的细胞增殖率分别为63.15%、57.28%、48.74%.原花青素交联的瓣膜材料组织结构稳定、亲水性好、毒性小且能维持较好的力学性能,作为人工生物瓣膜材料具有很好的研究前景.     

Extracellular matrix degrading enzymes are active in porcine stentless aortic bioprosthetic heart valves

Glutaraldehyde-fixed porcine aortic valve tissues are widely used for heart valve replacement surgery in the form of bioprosthetic heart valves (BHVs). The durability of BHVs in the clinical setting is limited by tissue degeneration, mechanical failure, and calcification. BHVs rely on the putative ability of glutaraldehyde to render biologic tissues metabolically inert and fully resistant to enzymatic attack. In the present study, we detected and partially characterized the activity of collagen and elastin-degrading enzymes in unimplanted, glutaraldehyde-fixed porcine aortic cusp and wall tissues and compared enzyme activities with those extracted from fresh tissues. Active enzymes capable of degrading extracellular matrix were found to be present in soluble form as well as immobilized on glutaraldehyde-crosslinked tissue matrix. Total levels of collagenolytic activities were evaluated to approximately 0.25 microg of degraded collagen/mg of dry tissue/24 h for both glutaraldehyde-fixed wall and cusp tissues. A major finding of this study was the ability of soluble tissue enzymes to partially degrade glutaraldehyde-fixed collagen and particularly large amounts of glutaraldehyde-fixed elastin. These calcium-dependent gelatinases share many biochemical similarities with matrix metalloproteinases. These data strongly indicate that glutaraldehyde-fixed porcine valvular tissues are not metabolically inert and are not entirely resistant to enzymatic attack, thereby rendering BHVs vulnerable to biologic degeneration and subsequent chronic failure.     

Genipin-crosslinked gelatin microspheres as a drug carrier for intramuscular administration: in vitro and in vivo studies

Gelatin microspheres have been widely evaluated as a drug carrier. Nevertheless, gelatin dissolves rather rapidly in aqueous environments, making the use of the polymer difficult for the production of long-term delivery systems. This adverse aspect requires the use of a crosslinking agent in forming nonsoluble networks in microspheres. However, the use of crosslinking agents such as formaldehyde and glutaraldehyde can lead to toxic side effects owing to residual crosslinkers. In an attempt to overcome this problem, a naturally occurring crosslinking agent (genipin) was used to crosslink gelatin microspheres as a biodegradable drug-delivery system for intramuscular administration. Glutaraldehyde was used as a control. In the in vitro study, the morphology, dynamic swelling, and antienzymatic degradation of test microspheres were evaluated. In the in vivo study, the biocompatibility and degradability of test microspheres were implanted in the skeletal muscle of a rat model via intramuscular injection. The results obtained in the study suggested that crosslinking of gelatin microspheres with glutaraldehyde or genipin may produce distinct crosslinking structures. The water transport mechanism in both the glutaraldehyde- and genipin-crosslinked gelatin microspheres exhibit anomalous behavior ranging from Fickian to Case-II extremes. The increase of the swelling diameter for the genipin-crosslinked microspheres was significantly less than that observed for the glutaraldehyde-crosslinked microspheres. In the animal study, it was found that the degree in inflammatory reaction for tissues implanted with the genipin-crosslinked microspheres was significantly less than that implanted with the glutaraldehyde-crosslinked microspheres. Additionally, the degradation rate of the genipin-crosslinked microspheres was significantly slower than their glutaraldehyde-crosslinked counterparts. These results indicated that the genipin-crosslinked gelatin microspheres may be used as a long-acting drug carrier for intramuscular administration.     

Effect of alternative crosslinking methods on the low strain rate viscoelastic properties of bovine pericardial bioprosthetic material

Early failures of bovine pericardial heart valves have been due to leaflet perforation/tearing and calcification. Since glutaraldehyde fixation has been shown to produce marked changes in leaflet mechanics and has been linked to the development of calcification, alternative crosslinking techniques have been suggested as means to overcome these obstacles. We have examined the low strain rate viscoelastic behavior of bovine pericardium: (1) fresh; (2) chemically treated with glutaraldehyde, cyanimide, or polyglycidyl ether; or (3) physically treated by freeze-drying or heat-drying. Shrinkage temperature tests were conducted to assess intrahelical crosslinking. Polyglycidyl ether and glutaraldehyde both produced substantial crosslinking, with the shrinkage temperature rising above 80 degrees C. Mechanical changes were nearly equivalent, both showing decreased stress relaxation and increased extensibility consistent with intrahelical crosslinking and shrinkage during fixation. Cyanimide, known to crosslink pure collagen materials, showed no evidence of crosslinking intact tissue. Heat-drying, also effective in pure collagen preparations, produced an increase in UTS and tissue modulus, but otherwise left the tissue unchanged. Freeze-drying had no mechanical effect, and therefore provides an attractive means for the storage of connective tissues for later mechanical testing.     

In vitro study of enzymatic degradation of biological tissues fixed by glutaraldehyde or epoxy compound

The study, using bacterial collagenase, was to investigate the changes in characteristics of a collagen-rich tissue, porcine pericardium, fixed by glutaraldehyde or epoxy compound (ethylene glycol diglycidyl ether) during the course of degradation. Fresh porcine pericardium was used as a control. During degradation, the heat released by the reaction of collagenase with a test sample was monitored by a highly sensitive microcalorimeter. Also, the degree of degradation of each test sample was determined by measuring its increment in free amino group content and changes in denaturation temperature and tensile strength. Microcalorimetric analysis of collagenase degradation of fresh, epoxy-fixed, and glutaraldehyde-fixed tissues revealed that the heat released during degradation correlates well with the degree of tissue degraded. The cleaving of peptide bonds in biological tissue by collagenase degradation may increase its free amino group content and reduce its denaturation temperature and tensile strength. It was noted that the fresh tissue cannot resist bacterial collagenase degradation, while the glutaraldehyde-fixed tissue had a relatively better resistance to degradation than its epoxy-fixed counterpart.     

Periodate-mediated glycosaminoglycan stabilization in bioprosthetic heart valves

Bioprosthetic heart valves (BPHVs) derived from glutaraldehyde-crosslinked porcine aortic valves are frequently used in heart valve replacement surgeries. However, the majority of bioprostheses fail clinically because of calcification and degeneration. We have recently shown that glycosaminoglycan (GAG) loss may be in part responsible for degeneration of glutaraldehyde-crosslinked bioprostheses. In the present studies, we used a mild reaction of periodate-mediated crosslinking to stabilize glycosaminoglycans in the bioprosthetic tissue. We demonstrate the feasibility of periodate reaction by crosslinking major components of extracellular matrix of bioprosthetic heart valve tissue, namely type I collagen and hyaluronic acid (HA). Uronic acid assay of periodate-fixed HA-collagen matrices showed 48% of HA disaccharides were bound to collagen. Furthermore, we show that such reactions are also feasible to fix glycosaminoglycans present in the middle spongiosa layer of bioprosthetic heart valves. The periodate reactions were compatible with conventional glutaraldehyde crosslinking and showed adequate stabilization of extracellular matrix as demonstrated by thermal denaturation temperature and collagenase assays. Moreover, uronic acid assays of periodate-fixed BPHV cusps showed 36% reduction in the amount of unbound GAG disaccharides as compared with glutaraldehyde-crosslinked cusps. We also demonstrate that calcification of BPHV cusps was significantly reduced in the periodate-fixed group as compared with the glutaraldehyde-fixed group in 21-day rat subdermal calcification studies (periodate-fixed tissue Ca 72.01 +/- 5.97 microg/mg, glutaraldehyde-fixed tissue Ca 107.25 +/- 6.56 microg/mg). We conclude that periodate-mediated GAG fixation could reduce structural degeneration of BPHVs and may therefore increase the useful lifetime of these devices.