纤维蛋白胶为载体构建人羊膜上皮细胞植片的实验研究

目的： 探讨利用纤维蛋白胶作为支架构建组织工程人羊膜上皮细胞(HAECs)植片重建眼表的可行性。方法：取足月剖宫产胎盘羊膜,经胶原酶和胰蛋白酶消化后,获得HAECs。在体外构建的纤维蛋白胶片上培养HAECs，细胞融合成片后，利用气液界面复层化，采用倒置显微镜、组织切片、HE 染色、细胞角蛋白免疫组织化学染色和扫描电子显微镜观察HAECs的生长情况。结果：HAECs在纤维蛋白胶表面生长良好，细胞呈圆形或多角形,长满后呈上皮细胞特有的铺路石样外观，扫描电镜观察细胞表面有丰富的微绒毛，细胞广谱角蛋白单克隆抗体染色阳性。细胞有复层生长趋势，植片较为透明。结论：以纤维蛋白胶为载体构建组织工程人 HAECs 植片，具有眼表重建的潜在运用价值。     

A new approach to completely autologous cardiovascular tissue in humans

In cardiovascular tissue engineering, synthetic or biologic scaffolds serve as templates for tissue development. Currently used scaffolds showing toxic degradation and immunogenic reactions are still far from ideal. We present a new alternative method to develop completely autologous human tissue without using any scaffold materials. Human vascular cells of arterial and venous origin were cultured to form cell sheets over a 4 week period under standard conditions. Thereafter, cell sheets of each origin were folded and cultured in a newly developed frame device for an additional 4 weeks. Controls remained under standard culture conditions. Tissue development was evaluated by morphology and biochemical assays. The formation of multilayered cell sheets and production of extracellular matrix were observed in all groups. Folded and framed neo-tissue showed a solid structure, with increased matrix formation and tissue organization when compared with the control groups. DNA content indicated significantly lower cell proliferation, and hydroxyproline assay indicated significantly higher collagen content in the framed cell sheets. We present a new approach to the engineering of cardiovascular tissue without the use of biodegradable scaffold material. Three-dimensional, completely autologous human tissue may be developed on the basis of this structure, thus avoiding scaffold induced toxic degradation or inflammatory reaction.     

Creation of mouse embryonic stem cell-derived cardiac cell sheets

Research on heart tissue engineering is an exciting and promising area. Although we previously developed bioengineered myocardium using cell sheet-based tissue engineering technologies, the issue of appropriate cell sources remained unresolved. In the present study, we created cell sheets of mouse embryonic stem (ES) cell-derived cardiomyocytes after expansion in three-dimensional stirred suspension cultures. Serial treatment of the suspension cultures with noggin and granulocyte colony-stimulating factor significantly increased the number of cardiomyocytes by more than fourfold compared with untreated cultures. After drug selection for ES cells expressing the neomycin-resistance gene under the control of the α-myosin heavy chain promoter, almost all of the cells showed spontaneous beating and expressed several cardiac contractive proteins in a fine striated pattern. When ES-derived cardiomyocytes alone were seeded onto temperature-responsive culture dishes, cell sheets were not created, whereas cocultures with cardiac fibroblasts promoted cell sheet formation. The cardiomyocytes in the cell sheets beat spontaneously and synchronously, and expressed connexin 43 at the edge of adjacent cardiomyocytes. Furthermore, when the extracellular action potential was recorded, unidirectional action potential propagation was observed. The present findings suggest that stirred suspension cultures with appropriate growth factors are capable of producing cardiomyocytes effectively and easily, and that ES-derived cardiac cell sheets may be a promising tool for the development of bioengineered myocardium.     

Fabrication of transferable micropatterned-co-cultured cell sheets with microcontact printing

The purpose of the present study is to develop a novel method for the fabrication of transferable micropatterned cell sheets for tissue engineering. To achieve this development, microcontact printing of fibronectin on commercially available temperature-responsive dishes was employed. Primary rat hepatocytes were seeded on the dish surfaces printed with fibronectin. Under serum-free conditions, hepatocytes were attached onto fibronectin domains selectively. Then, a second cell type of endothelial cells was seeded in the presence of serum. Double fluorescent staining revealed that endothelial cells successfully adhered to the intervals of hepatocyte domains. Finally, all the cells were harvested as a single contiguous micropatterned cell sheet upon temperature-reduction. With a cell sheet manipulator having a gelatin layer for the support of harvested cell sheets, harvested micropatterned cell sheets were transferred to new dish surfaces. This technique would be useful for the fabrication of thick tissue constructs having a complex microarchitecture.     

Connective tissue spectrum abnormalities associated with spontaneous cerebrospinal fluid leaks: a prospective study

We aimed to assess the frequency of connective tissue abnormalities among patients with cerebrospinal fluid (CSF) leaks in a prospective study using a large cohort of patients. We enrolled a consecutive group of 50 patients, referred for consultation because of CSF leak. All patients have been carefully examined for the presence of connective tissue abnormalities, and based on findings, patients underwent genetic testing. Ancillary diagnostic studies included echocardiography, eye exam, and histopathological examinations of skin and dura biopsies in selected patients. We identified nine patients with heritable connective tissue disorders, including Marfan syndrome, Ehlers–Danlos syndrome and other unclassified forms. In seven patients, spontaneous CSF leak was the first noted manifestation of the genetic disorder. We conclude that spontaneous CSF leaks are associated with a spectrum of connective tissue abnormalities and may be the first noted clinical presentation of the genetic disorder. We propose that there is a clinical basis for considering spontaneous CSF leak as a clinical manifestation of heritable connective tissue disorders, and we suggest that patients with CSF leaks should be screened for connective tissue and vascular abnormalities.     

Reconstruction of functional tissues with cell sheet engineering

The field of tissue engineering has yielded several successes in early clinical trials of regenerative medicine using living cells seeded into biodegradable scaffolds. In contrast to methods that combine biomaterials with living cells, we have developed an approach that uses culture surfaces grafted with the temperature-responsive polymer poly(N-isoproplyacrylamide) that allows for controlled attachment and detachment of living cells via simple temperature changes. Using cultured cell sheets harvested from temperature-responsive surfaces, we have established cell sheet engineering to create functional tissue sheets to treat a wide range of diseases from corneal dysfunction to esophageal cancer, tracheal resection, and cardiac failure. Additionally, by exploiting the unique ability of cell sheets to generate three-dimensional tissues composed of only cultured cells and their deposited extracellular matrix, we have also developed methods to create thick vascularized tissues as well as, organ-like systems for the heart and liver. Cell sheet engineering therefore provides a novel alternative for regenerative medicine approaches that require the re-creation of functional tissue structures.     

Comparison of different techniques to measure air leaks during CPAP treatment in neonates

Continuous positive airway pressure (CPAP) is routinely used for respiratory support in neonates. Air leaks are not uncommon and can hinder treatment. This study compared leak flow data obtained using different leak definitions through modeling and in vitro measurements.MethodsUsing a computer simulation of an ideal CPAP system, the relationship between leak flow and three leak definitions was investigated. The leak flow was based on the measured inspiratory, expiratory and averaged breathing flow as commonly used in neonates. The theoretical results were compared with in vitro measurements using a commercial CPAP device for neonates (Leoni, Heinen &; Löwenstein, Germany). Spontaneous breathing was simulated using a mechanical lung model, and defined air leaks were simulated using open silicone tubes of different lengths.ResultsComputer simulations showed that leak calculations were affected by leak flow and breathing pattern, and that the relationships were mostly non-linear. There were large differences in the results between the three leak definitions. The in vitro measurements correlated strongly with the theoretical modeling results. The derived numerical volume correction reduced the leak-dependent volume error in the mean (S.D.) to ?1.6 (4.6)%.ConclusionIt is difficult to compare different measuring conditions and different CPAP devices due to the variation in results depending on the leak definition and the breathing pattern. Leak flow displays would provide superior air leak monitoring.     

Tissue engineered epithelial cell sheets for the creation of a bioartificial trachea

To successfully engineer a bioartificial tracheal replacement, it is believed that the regeneration of a functional epithelial lining is a key requirement. In the present study, rabbit tracheal epithelial cells were cultured on temperature-responsive culture dishes, under normal culture conditions at 37 degrees C. By simple temperature reduction to 20 degrees C, the cultured epithelial cells were noninvasively harvested as intact sheets, without the use of any proteolytic enzymes. Support Dacron grafts that had been subcutaneously implanted for 4 weeks to allow for host tissue and vessel infiltration were then opened, and the tracheal epithelial cell sheets were transplanted to the luminal surface without sutures. These fabricated constructs were then used as tracheal replacements, in a rabbit model. Four weeks after transplantation, results showed that the tracheal grafts were covered by a mature, pseudostratified columnar epithelium. In contrast, control constructs that did not receive cell sheet transplantation demonstrated only a thin, immature epithelium at the center of the replacement graft. These results therefore demonstrate that these tracheal epithelial cell sheets can create an epithelial lining on the luminal surface of a bioartificial trachea.     

A tissue engineering approach for prenatal closure of myelomeningocele: comparison of gelatin sponge and microsphere scaffolds and bioactive protein coatings

Myelomeningocele (MMC) is a common and devastating malformation. As an alternative to fetal surgical repair, tissue engineering has the potential to provide a less invasive approach for tissue coverage applicable at an earlier stage of gestation. We have previously evaluated the use of gelatin hydrogel composites composed of gelatin sponges and sheets as a platform for tissue coverage of the MMC defect in the retinoic acid induced fetal rat model of MMC. In the current study, we compare our previous composite with gelatin microspheres as a scaffold for tissue ingrowth and cellular adhesion within the amniotic fluid environment. We also examine the relative efficacy of various bioactive protein coatings on the adhesion of amniotic fluid cells to the construct within the amniotic cavity. We conclude from this study that gelatin microspheres are as effective as gelatin sponges as a scaffold for cellular ingrowth and amniotic fluid cell adhesion and that collagen type I and fibronectin coatings enhance amniotic fluid cell adhesion to the gelatin-based scaffolds. These findings support the potential for the development of a tissue-engineered injectable scaffold that could be applied by ultrasound-guided injection, much earlier and less invasively than sponge or sheet-based composites.     

Development of cell-selective films for layered co-culturing of vascular progenitor cells

Cell-sheet assemblies are currently being studied for tissue engineering. However, tissues engineered from completely biological cell sheets lack substrate cues and possess poor mechanical strength. Recent studies demonstrate the use of synthetic bioresorbable films as scaffolds that may address these issues. Here, we describe the application of a micro-thin, biaxially-stretched polycaprolactone (μXPCL) with surface modifications for layered tissue engineering, and present the results of biphasic cell-sheet constructs using surfaces optimised for specific cell types. Polyacrylic acid (PAAc) was grafted onto μXPCL film surfaces by low-pressure plasma immobilisation. This provided a surface suitable for perivascular cells, forming the medial compartment. Subsequently, endothelial progenitor cell (EPC)-selective CD34 antibody was conjugated onto the reverse surface (intimal compartment) to select and anchor EPCs for improved adhesion and proliferation. Using the blood vessel as a model, a biphasic culture system was then setup to represent a tunica intima (endothelial cells) and tunica media (smooth muscle cells). When suitable cell types were cultured in the corresponding compartments, confluent layers of the respective populations were achieved distinctively from each other. These results demonstrate the use of μXPCL films with cell-selective modifications for layered co-cultures towards the generation of stratified tissue.     

Construction and delivery of tissue-engineered human retinal pigment epithelial cell sheets, using magnetite nanoparticles and magnetic force

Choroidal neovascularization (CNV) is the most severe form of age-related macular degeneration (AMD), which causes rapid visual loss. Transplantation of cultured retinal pigment epithelium (RPE) cell sheet by tissue engineering is a possible approach to the treatment of CNV. In the present study, we investigated the possibility of using magnetite nanoparticles and magnetic force to construct and deliver RPE cell sheets in vitro. When magnetite cationic liposomes (MCLs), having a positive charge at the surface, were added to ARPE-19 human RPE cells at a concentration of 25 or 50 pg of magnetite per cell, the cells took up 40 to 55% of the MCLs. The magnetically labeled ARPE-19 cells (8 x 10(3) cells/mm(2), which corresponds to 10-fold the confluent concentration against the culture area [4 mm(2)]) were seeded into an ultra-low-attachment plate and a magnet (4000 G) was placed under the well. The magnetically labeled ARPE-19 cells formed an approximately 15-layered cell sheet after a 24 h of culture. When the magnet was removed, the sheets were detached from the bottom of the plate and then harvested and transferred to a tissue culture dish, using a magnet. Subsequently, the cell sheets were attached onto the dish, and the cells growing on the sheets were observed. This novel methodology, termed "magnetic force-based tissue engineering" (Mag-TE), is a possible approach for CNV treatment.     

Mass transit: epithelial morphogenesis in the Drosophila egg chamber.

Epithelial cells use a striking array of morphogenetic behaviors to sculpt organs and body plans during development. Although it is clear that epithelial morphogenesis is largely driven by cytoskeletal rearrangements and changes in cell adhesion, little is known about how these processes are coordinated to construct complex biological structures from simple sheets of cells. The follicle cell epithelium of the Drosophila egg chamber exhibits a diverse range of epithelial movements in a genetically accessible tissue, making it an outstanding system for the study of epithelial morphogenesis. In this review, we move chronologically through the process of oogenesis, highlighting the dynamic movements of the follicle cells. We discuss the cellular architecture and patterning events that set the stage for morphogenesis, detail individual cellular movements, and focus on current knowledge of the cellular processes that drive follicle cell behavior.     

Cell sheet engineering: recreating tissues without biodegradable scaffolds

While tissue engineering has long been thought to possess enormous potential, conventional applications using biodegradable scaffolds have limited the field's progress, demonstrating a need for new methods. We have previously developed cell sheet engineering using temperature-responsive culture dishes in order to avoid traditional tissue engineering approaches, and their related shortcomings. Using temperature-responsive dishes, cultured cells can be harvested as intact sheets by simple temperature changes, thereby avoiding the use of proteolytic enzymes. Cell sheet engineering therefore allows for tissue regeneration by either direct transplantation of cell sheets to host tissues or the creation of three-dimensional structures via the layering of individual cell sheets. By avoiding the use of any additional materials such as carrier substrates or scaffolds, the complications associated with traditional tissue engineering approaches such as host inflammatory responses to implanted polymer materials, can be avoided. Cell sheet engineering thus presents several significant advantages and can overcome many of the problems that have previously restricted tissue engineering with biodegradable scaffolds.     

Tissue reorganization in response to mechanical load increases functionality

In the rapidly growing field of tissue engineering, the functional properties of tissue substitutes are recognized as being of the utmost importance. The present study was designed to evaluate the effects of static mechanical forces on the functionality of the produced tissue constructs. Living tissue sheets reconstructed by the self-assembly approach from human cells, without the addition of synthetic material or extracellular matrix (ECM), were subjected to mechanical load to induce cell and ECM alignment. In addition, the effects of alignment on the function of substitutes reconstructed from these living tissue sheets were evaluated. Our results show that tissue constructs made from living tissue sheets, in which fibroblasts and ECM were aligned, presented higher mechanical resistance. This was assessed by the modulus of elasticity and ultimate strength as compared with tissue constructs in which components were randomly oriented. Moreover, tissue-engineered vascular media made from a prealigned living tissue sheet, produced with smooth muscle cells, possessed greater contractile capacity compared with those produced from living tissue sheets that were not prealigned. These results show that the mechanical force generated by cells during tissue organization is an asset for tissue component alignment. Therefore, this work demonstrates a means to improve the functionality (mechanical and vasocontractile properties) of tissues reconstructed by tissue engineering by taking advantage of the biomechanical forces generated by cells under static strain.     

Two-dimensional manipulation of differentiated Madin-Darby canine kidney (MDCK) cell sheets: the noninvasive harvest from temperature-responsive culture dishes and transfer to other surfaces

A renal epithelial cell line, Madin-Darby canine kidney (MDCK) cells, adheres, spreads, and proliferates to confluency on our developed temperature-responsive culture dishes grafted with a poly(N-isopropylacrylamide) (PIPAAm) at 37 degrees C. In addition to other cell types, including hepatocytes and endothelial cells, MDCK cell sheets noninvasively were harvested from PIPAAm-grafted dishes merely by reducing the temperature. However, during the early stage of culture (up to 3 weeks), confluent MDCK cell detachment is greatly repressed. In the present study, we succeeded in the rapid harvest of confluent MDCK cell sheets and intact transfer to other culture dishes by utilizing hydrophilically modified poly(vinylidene difluoride) (PVDF) membranes as supporting materials. Immunocytochemistry with anti-beta-catenin antibody revealed that the functional cell-cell junctions were well organized in the transferred MDCK cell sheets. The viability assay showed that the transferred cells were not damaged during the two-dimensional cell-sheet manipulation. By transmission electron microscopy it was confirmed that the harvested MDCK cells retained differentiated phenotypes and had many microvilli and tight junctions at the apical and lateral plasma membranes, respectively. This two-dimensional cell-sheet manipulation technique promises to be useful in tissue engineering as well as in the investigation of epithelial cell sheets.     

Mesothelial cell sheets cultured on fibrin gel prevent adhesion formation in an intestinal hernia model

In the present study, we examined a novel technique to prevent adhesion formation in a rat intestinal hernia model with mesothelial cell sheets cultured on fibrin gel. Mesothelial cells were obtained from isologous rats by enzymatic disaggregation of mesentery and cultured on fibrin gel. Electron microscopy revealed that these cultured cells form contiguous monolayer cell sheets with well-developed microvilli. These tissue-engineered constructs were grafted in vivo to an intestinal hernia model that results in regular surgical adhesions without treatment. Five days postgrafting, rats were sacrificed. Adhesion formation was not observed in rats grafted with the constructs, whereas severe adhesions were observed in all control rats. Constructs seeded with mesothelial cells isolated from EGFP-transgenic rats clearly revealed that grafted mesothelial cells remained at the host tissue site even after fibrin scaffold degradation. These cells developed more abundant microvilli in vivo than those in vitro. These results show that cultured mesothelial cell sheets are effective in preventing adhesion formation and should reduce postoperative complications caused by adhesion formation.     

Long-term survival and growth of pulsatile myocardial tissue grafts engineered by the layering of cardiomyocyte sheets

Recently researchers have attempted to bioengineer three-dimensional (3-D) myocardial tissues using cultured cells in order to repair damaged hearts. In contrast to the conventional approach of seeding cells onto 3-D biodegradable scaffolds, we have explored a novel technology called cell sheet engineering, which layers cell sheets to construct functional tissue grafts. In this study, in vivo survival, function, and morphology of myocardial tissue grafts were examined. Neonatal rat cardiomyocytes were noninvasively harvested as contiguous cell sheets from temperature-responsive culture dishes simply by reducing the culture temperature. Cardiomyocyte sheets were then layered and transplanted into the subcutaneous tissues of athymic rats. The microvasculature of the grafts was rapidly organized within a few days with macroscopic graft beatings observed 3 days after transplantation and preserved up to one year. Size, conduction velocity, and contractile force of transplanted grafts increased in proportion to the host growth. Histological studies showed characteristic structures of heart tissue, including elongated cardiomyocytes, well-differentiated sarcomeres, and gap junctions within the grafts. In conclusion, long-term survival and growth of pulsatile myocardial tissue grafts fabricated by layering cell sheets were confirmed, demonstrating that myocardial tissue regeneration based on cell sheet engineering may prove useful for permanent myocardial tissue repair.     

Robust cell migration and neuronal growth on pristine carbon nanotube sheets and yarns

Carbon nanotubes (CNTs) have unique chemical and physical properties anticipated to enable broad novel biomedical applications. Yet the question concerning their biocompatibility remains controversial. We recently reported a method for rapidly preparing strong, highly electrically conducting sheets and yarns from multi-walled CNTs. The present studies demonstrate that highly oriented 50-nm-thick semi-transparent CNT sheets and yarns, produced with a minimal residual content of catalytic transition materials, support the long-term growth of a variety of cell types ranging from skin fibroblasts and Schwann cells, to postnatal cortical and cerebellar neurons. We show that CNT sheets stimulate fibroblast cell migration compared to plastic and glass culture substrates; entice neuronal growth to the level of those achieved on polyornithine-coated glass and can be used for directed cellular growth. These findings have positive implications for the use of CNTs in applications such as tissue engineering, wound healing, neural interfaces and biosensors.     

Air leaks in COVID-19

Coronavirus disease 2019 (COVID-19) continues to create havoc and may present with myriad complications involving many organ systems. However, the respiratory system bears the maximum brunt of the disease and continues to be most commonly affected. There is a high incidence of air leaks in patients with COVID-19, leading to acute worsening of clinical condition. The air leaks may develop independently of the severity of disease or positive pressure ventilation and even in the absence of any traditional risk factors like smoking and un-derlying lung disease. The exact pathophysiology of air leaks with COVID-19 remains unclear, but multiple factors may play a role in their development. A significant proportion of air leaks may be asymptomatic; hence, a high index of suspicion should be exercised for enabling early diagnosis to prevent further deterioration as it is associated with high morbidity and mortality. These air leaks may even develop weeks to months after the disease onset, leading to acute deterioration in the post-COVID period. Conservative management with close monitoring may suffice for many patients but most of the patients with pneumothorax may require intercostal drainage with only a few requiring surgical interventions for persistent air leaks.     

Cell sheet engineering for myocardial tissue reconstruction

Myocardial tissue engineering has now emerged as one of the most promising treatments for the patients suffering from severe heart failure. Tissue engineering has currently been based on the technology using three-dimensional (3-D) biodegradable scaffolds as alternatives for extracellular matrix. According to this most popular technique, several types of 3-D myocardial tissues have been successfully engineered by seeding cardiomyocytes into poly(glycolic acid), gelatin, alginate or collagen scaffolds. However, insufficient cell migration into the scaffolds and inflammatory reaction due to scaffold biodegradation remain problems to be solved. In contrast to these technologies, we now propose novel tissue engineering methodology layering cell sheets to construct 3-D functional tissues without any artificial scaffolds. Confluent cells on temperature-responsive culture surfaces can be harvested as a viable contiguous cell sheet only by lowering temperature without any enzymatic digestions. Electrical communications are established between layered cardiomyocyte sheets, resulting in simultaneous beating 3-D myocardial tissues. Layered cardiomyocyte sheets in vivo present long survival, macroscopic pulsation and characteristic structures of native heart tissue. Cell sheet engineering should have enormous potential for fabricating clinically applicable myocardial tissues and should promote tissue engineering research fields.