Transcriptomic Regulation of Macrophages by Matrix-Bound Nanovesicle-Associated Interleukin-33.

The innate immune response, particularly the phenotype of responding macrophages, has significant clinical implications in the remodeling outcome following implantation of biomaterials and engineered tissues. In general, facilitation of an anti-inflammatory (M2-like) phenotype is associated with tissue repair and favorable outcomes, whereas pro-inflammatory (M1-like) activation can contribute to chronic inflammation and a classic foreign body response. Biologic scaffolds composed of extracellular matrix (ECM) and, more recently, matrix-bound nanovesicles (MBV) embedded within the ECM are known to direct macrophages toward an anti-inflammatory phenotype and stimulate a constructive remodeling outcome. The mechanisms of MBV-mediated macrophage activation are not fully understood, but interleukin-33 (IL-33) within the MBV appears critical for M2-like activation. Previous work has shown that IL-33 is encapsulated within the lumen of MBV and stimulates phenotypical changes in macrophages independent of its canonical surface receptor stimulation-2 (ST2). In the present study, we used next-generation RNA sequencing to determine the gene signature of macrophages following exposure to MBV with and without intraluminal IL-33. MBV-associated IL-33 instructed an anti-inflammatory phenotype in both wild-type and st2-/- macrophages by upregulating M2-like and downregulating M1-like genes. The repertoire of genes regulated by ST2-independent IL-33 signaling were broadly related to the inflammatory response and crosstalk between cells of both the innate and adaptive immune systems. These results signify the importance of the MBV intraluminal protein IL-33 in stimulating a pro-remodeling M2-like phenotype in macrophages and provides guidance for the designing of next-generation biomaterials and tissue engineering strategies. Impact statement The phenotype of responding macrophages is predictive of the downstream remodeling response to an implanted biomaterial. The clinical impact of macrophage phenotype has motivated studies to investigate the factors that regulate macrophage activation. Matrix-bound nanovesicles (MBV) embedded within the extracellular matrix direct macrophages toward an anti-inflammatory (M2)-like phenotype that is indicative of a favorable remodeling response. Although the mechanisms of MBV-mediated macrophage activation are not fully understood, the intraluminal protein interleukin-33 (IL-33) is clearly a contributing signaling molecule. The present study identifies those genes regulated by MBV-associated IL-33 that promote a pro-remodeling M2-like macrophage activation state and can guide future therapies in regenerative medicine.

Material Characterisation and Stratification of Conjunctival Epithelial Cells on Electrospun Poly(ε-Caprolactone) Fibres Loaded with Decellularised Tissue Matrices.

The conjunctiva, an under-researched yet incredibly important tissue, plays key roles in providing protection to the eye and maintaining homeostasis of its ocular surface. Multiple diseases can impair conjunctival function leading to severe consequences that require surgical intervention. Small conjunctival defects can be repaired relatively easily, but larger defects rely on tissue grafts which generally do not provide adequate healing. A tissue engineering approach involving a biomaterial substrate capable of supporting a stratified epithelium with embedded, mucin-secreting goblet cells offers a potential solution. As a first step, this study aimed to induce stratification of human conjunctival epithelial cells cultured on electrospun scaffolds composed from poly(ε-caprolactone) (PCL) and decellularised tissue matrix (small intestinal submucosa (SIS) or urinary bladder matrix (UBM)) and held at the air/liquid interface. Stratification, up to 5 cell layers, occurred more frequently on scaffolds containing PCL + UBM. Incorporation of these decellularised tissue matrices also impacted material properties, with significant changes occurring to their fibre diameter, tensile properties, and chemical composition throughout the scaffold structure compared to PCL alone. These matrix containing scaffolds warrant further long-term investigation as a potential advanced therapy medicinal product for conjunctiva repair and regeneration.

Role of 4-hydroxybutyrate in increased resistance to surgical site infections associated with surgical meshes.

An increased resistance to surgical site infections has been associated with surgical meshes composed of naturally occurring materials, including poly-4-hydroxybutrate (4HB). 4HB is a naturally occurring short-chain fatty acid that has been shown to promote endogenous expression of the Cramp gene coding for the antimicrobial peptide (AMP) cathelicidin LL-37 in murine bone marrow-derived macrophages. The molecular pathways involved in the 4HB-induced cathelicidin LL-37 expression have not yet been identified. The present study showed that transcriptional activation of the Cramp gene by 4HB is independent of inhibition of histone deacetylase (HDAC) activity, and that upregulation of Cramp is modulated by the G-protein coupled receptor GPR109A. Furthermore, an intracellular signaling cascade that promotes the activation of the MAP kinases, p38 and JNK, and a subsequent NF-κB phosphorylation downstream from p38 is essential for the AMP transcriptional response in 4HB-stimulated macrophages. The findings provide a solid scientific basis and rationale for the decreased incidence of surgical site infections with the use of this type of surgical meshes. Further clinical significance is found in the fact that the 4HB activated molecular pathway includes common targets of frequently used nonsteroidal anti-inflammatory drugs (NSAIDs) and other FDA approved drugs recognizing G-protein coupled receptors.

Matrix-Bound Nanovesicles: The Effects of Isolation Method upon Yield, Purity, and Function.

Identification of matrix-bound nanovesicles (MBV) as ubiquitous components of the extracellular matrix (ECM) raises questions regarding their biologic functions and their potential theranostic application. Unlike liquid-phase extracellular vesicles (e.g., exosomes), MBV are tightly bound to the ECM, which makes their isolation and harvesting more challenging. The indiscriminate use of different methods to harvest MBV can alter or disrupt their structural and/or functional integrity. The objective of the present study was to compare the effect of various MBV harvesting methods upon yield, purity, and biologic activity. Combinations of four methods to solubilize the ECM (collagenase [COL], liberase [LIB], or proteinase K [PK] and nonenzymatic elution with potassium chloride) and four isolation methods (ultracentrifugation, ultrafiltration [UF], density barrier, and size exclusion chromatography [SEC]) were used to isolate MBV from urinary bladder-derived ECM. All combinations of solubilization and isolation methods allowed for the harvesting of MBV, however, distinct differences were noted. The highest yield, purity, cellular uptake, and biologic activity were seen with MBV isolated by a combination of liberase or collagenase followed by SEC. The combination of proteinase K and UF was shown to have detrimental effects on bioactivity. The results show the importance of selecting appropriate MBV harvesting methods for the characterization and evaluation of MBV and for analysis of their potential theranostic application. Impact statement Identification of matrix-bound nanovesicles (MBV) as ubiquitous components of the extracellular matrix (ECM) has raised questions regarding their biologic functions and their potential theranostic application. This study demonstrates that the harvesting methods used can result in samples with physical and biochemical properties that are unique to the isolation and solubilization methods used. Consequently, developing harvesting methods that minimize sample contamination with ECM remnants and/or solubilization agents will be essential in determining the theranostic potential of MBV in future studies.

Host macrophage response to injectable hydrogels derived from ECM and α-helical peptides.

Tissue engineering materials play a key role in how closely the complex architectural and functional characteristics of native healthy tissue can be replicated. Traditional natural and synthetic materials are superseded by bespoke materials that cross the boundary between these two categories. Here we present hydrogels that are derived from decellularised extracellular matrix and those that are synthesised from de novo α-helical peptides. We assess in vitro activation of murine macrophages to our hydrogels and whether these gels induce an M1-like or M2-like phenotype. This was followed by the in vivo immune macrophage response to hydrogels injected into rat partial-thickness abdominal wall defects. Over 28 days we observe an increase in mononuclear cell infiltration at the hydrogel-tissue interface without promoting a foreign body reaction and see no evidence of hydrogel encapsulation or formation of multinucleate giant cells. We also note an upregulation of myogenic differentiation markers and the expression of anti-inflammatory markers Arginase1, IL-10, and CD206, indicating pro-remodelling for all injected hydrogels. Furthermore, all hydrogels promote an anti-inflammatory environment after an initial spike in the pro-inflammatory phenotype. No difference between the injected site and the healthy tissue is observed after 28 days, indicating full integration. These materials offer great potential for future applications in regenerative medicine and towards unmet clinical needs. STATEMENT OF SIGNIFICANCE: Materials play a key role in how closely the complex architectural and functional characteristics of native healthy tissue can be replicated in tissue engineering. Here we present injectable hydrogels derived from decellularised extracellular matrix and de novo designed α-helical peptides. Over 28 days in the rat abdominal wall we observe an increase in mononuclear cell infiltration at the hydrogel-tissue interface with no foreign body reaction, no evidence of hydrogel encapsulation and no multinucleate giant cells. Our data indicate pro-remodelling and the promotion of an anti-inflammatory environment for all injected hydrogels with evidence of full integration with healthy tissue after 28 days. These unique materials offer great potential for future applications in regenerative medicine and towards designing materials for unmet clinical needs.

Lipidomics and RNA sequencing reveal a novel subpopulation of nanovesicle within extracellular matrix biomaterials.

Biomaterials composed of extracellular matrix (ECM) provide both mechanical support and a reservoir of constructive signaling molecules that promote functional tissue repair. Recently, matrix-bound nanovesicles (MBVs) have been reported as an integral component of ECM bioscaffolds. Although liquid-phase extracellular vesicles (EVs) have been the subject of intense investigation, their similarity to MBV is limited to size and shape. Liquid chromatography-mass spectrometry (LC-MS)-based lipidomics and redox lipidomics were used to conduct a detailed comparison of liquid-phase EV and MBV phospholipids. Combined with comprehensive RNA sequencing and bioinformatic analysis of the intravesicular cargo, we show that MBVs are a distinct and unique subpopulation of EV and a distinguishing feature of ECM-based biomaterials. The results begin to identify the differential biologic activities mediated by EV that are secreted by tissue-resident cells and deposited within the ECM.

4-Hydroxybutyrate Promotes Endogenous Antimicrobial Peptide Expression in Macrophages.

IMPACT STATEMENT: This study evaluated the biological activity of hydroxylated derivatives of butyrate as inductors of antimicrobial peptides (AMPs) in murine bone marrow-derived macrophages in vitro. A differential modulation of AMP expression by the hydroxylated derivatives of butyrate is shown. The ability of sodium 4-hydroxybutyrate to upregulate AMP expression through a histone deacetylase inhibitory-independent mechanism, and to promote increased resistance to bacterial contamination in vivo are also shown. The findings provide an alternative for prevention of bacterial contamination of implanted biomaterials. Functionalization of biomaterials with hydroxylated derivatives of butyrate can enhance the endogenous antimicrobial activity of the immune system through increased production of AMPs by host cells, thus providing protection against bacterial contamination.

Regulation of Tissue Engineered Devices in some Latin American Countries: Development and External Influences / Reglamentación de dispositivos de ingeniería tisular en algunos países Latinoamericanos: desarrollo e influencias externas

Antecedentes: El surgimiento de estrategias de ingeniería tisular para tratar enfermedades está cambiando la definición tradicional de dispositivos médicos. Los productos de ingeniería tisular, fabricados a partir de la combinación de biomateriales, células y factores bioactivos, remplazan temporalmente un órgano o tejido e inducen la producción de nuevo tejido. Los mecanismos de reglamentación de productos de ingeniería tisular necesitan agrupar las políticas que controlan cada uno de sus componentes: materiales, células humanas y moléculas activas. Objetivo: Revisar las políticas de reglamentación actuales para dispositivos médicos (y entre estos, los productos de ingeniería tisular), en un grupo de países latinoamericanos, y evaluar la influencia que organizaciones internacionales y países con poder tecnológico mundial ejercen en las políticas locales. Métodos: Se utilizaron modelos de difusión top-down y horizontal para identificar cómo las políticas de reglamentación han llegado a Brasil, Colombia, Ecuador, México y Perú. Resultados: La apropiación tecnológica empleada para clasificar los dispositivos médicos de manera integral difiere entre los países. Ninguno define el concepto productos de ingeniería tisular. Se encontró un patrón de difusión top-down asociado a las reglamentaciones empleadas. Se está aplicando una difusión horizontal como esfuerzo regional para facilitar la comercialización de productos médicos. Conclusión: El concepto de producto de ingeniería tisular está llegando lentamente a los países latinoamericanos. Cada país tiene el potencial de aprovechar las instituciones locales y las coaliciones regionales e interregionales para mejorar la regulación actual y preparar al sistema de salud para la llegada de productos de ingeniería tisular.

Background: Emergence of new technologies and advances in tissue engineering strategies to treat diseases are shifting the conventional conception of medical devices. Tissue engineered products, manufactured as a combination of biomaterials, cells, and/or bioactive factors, are intended to temporarily restore an organ or tissue function, and induce the generation of newly site-appropriate functional tissue. Regulatory pathways for tissue engineered products require grouping policies controlling each of the components: materials, human cells, and active molecules. Purpose: To review current regulatory policies for medical devices (and within this, tissue engineered products), in a subset of Latin American countries, and to analyze the influence of international organizations and technological world power countries on policies of that subset. Methods: Top-down and horizontal diffusion models were employed to identify how regulatory policies have moved to Brazil, Colombia, Ecuador, Mexico, and Peru. Results: There are differences in technological appropriation to comprehensively define and classify medical devices. None of the countries have a definition of tissue engineered products. A top-down diffusion pattern was found to be associated with the current regulations. A horizontal diffusion is being applied as a regional effort to facilitate commercialization of medical products within Latin America. Conclusion: The concept of tissue engineered products is slowly arriving into the evaluated Latin American countries. Each country has the potential to take advantage of local institutions and regional and inter-regional coalitions to improve current guidelines and prepare the health system to the introduction of tissue engineered products.

Matrix-Bound Nanovesicles Recapitulate Extracellular Matrix Effects on Macrophage Phenotype.

The early macrophage response to biomaterials has been shown to be a critical and predictive determinant of downstream outcomes. When properly prepared, bioscaffolds composed of mammalian extracellular matrix (ECM) have been shown to promote a transition in macrophage behavior from a proinflammatory to a regulatory/anti-inflammatory phenotype, which in turn has been associated with constructive and functional tissue repair. The mechanism by which ECM bioscaffolds promote this phenotypic transition, however, is poorly understood. The present study shows that matrix-bound nanovesicles (MBV), a component of ECM bioscaffolds, are capable of recapitulating the macrophage activation effects of the ECM bioscaffold from which they are derived. MBV isolated from two different source tissues, porcine urinary bladder and small intestinal submucosa, were found to be enriched in miRNA125b-5p, 143-3p, and 145-5p. Inhibition of these miRNAs within macrophages was associated with a gene and protein expression profile more consistent with a proinflammatory rather than an anti-inflammatory/regulatory phenotype. MBV and their associated miRNA cargo appear to play a significant role in mediating the effects of ECM bioscaffolds on macrophage phenotype.

CONSTRUCCIÓN DE MATRICES COMO SUSTITUTOS DÉRMICOS: APLICACIÓN POTENCIAL EN LA REGENERACIÓN DE PIEL / MATRIX CONSTRUCTION AS DERMAL SUBSTITUTES: POTENTIAL APPLICATION IN SKIN REGENERATION

La pérdida de grandes porciones de piel limita su capacidad de regeneración, haciendo difícil su tratamiento. Mediante la ingeniería de tejidos se han desarrollado sustitutos dérmicos que promueven la regeneración; sin embargo, es necesario hallar un material para el crecimiento de fibroblastos que sea un sustituto dérmico adecuado. En este trabajo se construyeron matrices tridimensionales porosas de colágeno y colágeno-ácido hialurónico evaluando su potencial como sustituto dérmico. Las matrices se entrecruzaron con 1-etil-3-(3-dimetilaminopropil) carbodiimida hidrocloruro. Se evaluó la porosidad, se realizaron pruebas de degradación, evaluación de adherencia celular con fibroblastos humanos y, ensayos de viabilidad y proliferación. Las matrices presentaron poros de 50 µm de diámetro uniformemente distribuidos. Las matrices de colágeno y colágeno-ácido hialurónico (2:8 y 4:6) presentaron una degradación progresiva con pesos similares. Luego de 24 horas en cultivo, los resultados de la prueba de MTT mostraron que los fibroblastos en colágeno proliferaron; mientras que los fibroblastos en colágeno-ácido hialurónico no evidenciaron proliferación. Aunque la estructura porosa y la tasa de degradación de las matrices son similares, las de colágeno brindan mejores condiciones de adhesión y proliferación a los fibroblastos cultivados en comparación con las que tienen ácido hialurónico como adición, convirtiéndose en el mejor andamio para ser empleado como sustituto dérmico entre las matrices evaluadas.

Wounds can cause loss of skin that limits the skin regeneration, making the treatment more difficult to address. The tissue engineering has developed skin substitutes that promote skin regeneration; however, it is imperative to find materials that allow fibroblast growth in order to find an appropriate skin substitute. The construction of tridimensional porous collagen and collagenhyaluronic acid matrixes crosslinked with 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide hydrochloride is presented in order to evaluate their potential use in skin regeneration therapies. Matrix porosity was evaluated. Degradation tests, human fibroblast adherence, viability and proliferation tests were performed. Matrixes had a uniform distributed porosity with mean diameters of 50 µm. Both collagen and collagen-hyaluronic acid (2:8 and 4:6) matrixes presented a progressive degradation rate with similar weight. After 24 hours under culture, the number of fibroblasts seeded on collagen matrixes were doubled, while the number of fibroblast seeded on collagen-hyaluronic acid matrixes remained similar. Even though porous structure and degradation rate of different types of constructed matrixes in this study are similar, collagen matrixes offer better adhesion and proliferation conditions for seeded fibroblasts in comparison with hyaluronic acid added matrixes, making them the best scaffold to be employed as a dermic substitute among the matrixes compared here.

OBTENCIÓN DE CÉLULAS MADRE DEL TEJIDO ADIPOSO Y SU POTENCIAL DE DIFERENCIACIÓN OSTEOGÉNICO / ADIPOSE TISSUE DERIVED MESENCHYMAL STEM CELLS, ISOLATION AND DIFFERENTIATION INTO THE OSTEOGENIC LINEAGE

El tejido adiposo es una de las principales fuentes de células madre de fácil obtención y con alto potencial de diferenciación hacia linajes celulares especializados. Con el objetivo de estandarizar la obtención de estas células y dirigir su diferenciación hacia el linaje osteogénico, se utilizó tejido adiposo procedente de liposucción y de abdominoplastia. Se aplicaron métodos de disgregación mecánica y enzimática del tejido para obtener las células. La morfología celular obtenida fue similar a fibroblastos y a células madre reportadas por otros autores. Se encontró una mayor eficiencia en el procesamiento del lipoaspirado en comparación con el tejido resultante de abdominoplastia, y la disgregación enzimática del tejido permitió una mayor liberación de células y una temprana adhesión al plato de cultivo. La inducción de las células madre derivadas de lipoaspirado hacia el linaje osteogénico permitió la observación, mediante tinción con alizarina roja S, de depósitos de calcio en la matriz extracelular en las células bajo condiciones de diferenciación, pero no en aquellas sin suplementos osteogénicos. Se obtuvieron cultivos de células madre derivadas de lipoaspirado con capacidad de diferenciación hacia el linaje osteogénico, a través de inducción controlada, que podrían ser utilizadas en la ingeniería de tejido óseo.

Adipose tissue is one of the main sources of stem cells readily available and with a high potential to differentiate into specific mesenchymal and non-mesenchymal lineages. Therefore, to standardize the collection of these cells, adipose tissue from surgical liposuctions and abdominoplasty was used. Methods of enzymatic and mechanical digestion were used to release the cells. With regard to cell morphology, the cells displayed a fibroblast-like spindleshaped morphology as cited by other authors. There was a higher efficiency in processing tissue from liposuctions compared with tissue from abdominoplasty. Likewise, the enzymatic digestion allowed faster initial cell adhesion than the mechanical digestion. Finally, calcium deposits were observed by alizarin red staining in cultures under osteogenic conditions, but were absent in cultures lacking osteogenic supplements. In conclusion, isolated adiposedderived stem cells were capable of osteogenic differentiation and therefore with potential applications in bone tissue engineering.

SOLUCIONES TERAPÉUTICAS PARA LA RECONSTRUCCIÓN DE LA DERMIS Y LA EPIDERMIS. OPORTUNIDADES EN EL MEDIO ANTIOQUEÑO

En Antioquia, es necesario buscar una solución disponible, efectiva y económicamente viable para afrontar los problemas de la piel de los pacientes que, por accidentes o enfermedades, han disminuido su calidad de vida y se encuentran aislados a la espera de tratamientos que les permitan recuperar la funcionalidad de su cuerpo y les reduzcan los riesgos por la exposición de los tejidos internos. Las diferentes soluciones existentes en el mercado todavía no han llegado a superar algunos obstáculos tales como el cubrimiento de todas las extensiones, los altos costos, la funcionalidad de los tejidos restaurados, los rechazos de tipo inmune y la escasez de los sitios donantes. Este artículo presenta una revisión literaria que busca mostrar las diferentes alternativas de solución para pacientes con problemas de piel, dando énfasis en las soluciones clásicas aplicables y económicamente viables desde la ingeniería de tejidos en el sector antioqueño.

In Antioquia (Colombia), there are many patients who suffer dermal injuries caused by accident or disease. Therefore, it is necessary to pursue available, effective and affordable solutions to overcome dermal problems. Physicians and patients are both expecting corrective treatments that can reduce inner tissue exposition and allow the possibility of recovering skin functionality. Although there are many solutions for skin replacement, some obstacles remain, such as: high costs, limited availability of skin for implantation in extended areas, adequate functionality of the restored tissue and immunological rejection. Due to these issues, this article presents some of the existing alternative solutions for patients with skin injuries, considering the histology and physiology of the skin, and regarding the classical and economically attainable solutions to be used in Antioquia.