Amniotic fluid-derived extracellular vesicles: characterization and therapeutic efficacy in an experimental model of bronchopulmonary dysplasia.

BACKGROUND AIMS: Extracellular vesicles (EVs) are being tested for their use as novel therapeutics. However, the optimal source of EVs is currently under investigation. Amniotic fluid (AF) is a natural source of EVs that can be easily obtained for use in regenerative medicine, yet AF-EV characterization has not been fully explored. METHODS: Here the authors demonstrate AF as a rich source of EVs and identify the microRNA and proteomic cargo. Bioinformatics analysis of this cargo revealed multiple pathway targets, including immunomodulatory, anti-inflammatory and free radical scavenging networks. The authors further demonstrated the therapeutic potential of this EV product as a novel preventative agent for bronchopulmonary dysplasia (BPD). RESULTS: Intra-tracheal administration of AF-EVs preserved alveolar development, attenuated vascular remodeling and pulmonary hypertension, decreased lung pro-inflammatory cytokine expression and reduced macrophage infiltration in an experimental BPD model. CONCLUSIONS: The authors' results suggest that AF is a viable biological fluid for EV harvest and that AF-EVs have strong therapeutic potential for pulmonary diseases, such as BPD, warranting further development to transition this novel EV product into the clinic.

Fibroblasts influence muscle progenitor differentiation and alignment in contact independent and dependent manners in organized co-culture devices.

Myoblasts are precursor muscle cells that lie nascent to mature skeletal muscle. Once muscle is damaged, these cells migrate, fuse, and regenerate the muscle tissue. It is known that skeletal muscle can partially regenerate in vivo after muscle tissue damage. However, this regeneration does not always occur, especially in more severe injuries. Cellular therapy using tissue-engineering approaches has been shown to improve organ repair and function. To exploit potential benefits of using cell therapy as an avenue for skeletal muscle repair, it is important to understand the cellular dynamics underlying skeletal myocyte formation and growth. Cardiac fibroblasts have been shown to have a major influence on cardiomyocyte function, repair, and overall spatial distribution. However, little is known regarding fibroblasts' role on skeletal myocyte function. In this study, we utilized a reconfigurable co-culture device to understand the contact and paracrine effects of fibroblasts on skeletal myocyte alignment and differentiation using murine myoblast and fibroblast cell lines. We demonstrate that myotube alignment is increased by direct contact with fibroblasts, while myotube differentiation is reduced both in the gap and contact configurations with fibroblasts after 6 days of co-culture. Furthermore, neutralizing antibodies to FGF-2 can block these effects of fibroblasts on myotube differentiation and alignment. Finally, bi-directional signaling is critical to the observed myoblast-fibroblast interactions, since conditioned media could not reproduce the same effects observed in the gap configuration. These findings could have direct implications on cell therapies for repairing skeletal muscle, which have only utilized skeletal myoblasts or stem cell populations alone.

Case Report: Administration of Amniotic Fluid-Derived Nanoparticles in Three Severely Ill COVID-19 Patients.

Rationale/Objectives: A human coronavirus (HCoV-19) has caused the novel coronavirus disease (COVID-19) outbreak worldwide. There is an urgent need to develop new interventions to suppress the excessive immune response, protect alveolar function, and repair lung and systemic organ damage. Zofin (previously known as Organicell Flow) is a novel therapeutic that is derived from the soluble and nanoparticle fraction (extracellular vesicles and exosomes) of human amniotic fluid. Here within, we present the clinical outcomes after Zofin treatment in three critically ill patients suffering from severe, multi-organ complications induced by COVID-19 infection. All patients were diagnosed with COVID-19, developed respiratory failure, and were hospitalized for more than 40 days. Methods: Zofin was administered to patients concurrently with ongoing medical care who were monitored for 28-days post-therapy. SOFA score assessment, chest X-rays, and inflammatory biomarker testing was performed. Main Results: There were no adverse events associated with the therapy. The patients showed improvements in ICU clinical status and experienced respiratory improvements. Acute delirium experienced by patients completely resolved and inflammatory biomarkers improved. Conclusions: Primary outcomes demonstrate the therapy was safe, accessible, and feasible. This is the first demonstration of human amniotic fluid-derived nanoparticles as a safe and potentially efficacious therapeutic treatment for respiratory failure induced by COVID-19 infection.

Graphene nanoplatelet-reinforced silicone for the valvular prosthesis application.

Newly developed elastomer heart valves have been shown to better re-create the flow physics of native heart valves, resulting in preferable hemodynamic responses. This emergence has been motivated in part by the recent introduction of percutaneous valve approaches in the clinic. Unfortunately, elastomers such as silicone are prone to structural failure, which drastically limits their applicability the development of a valve prosthesis. To produce a mechanically more robust silicone substrate, we reinforced it with graphene nanoplatelets (GNPs). The nanoplatelets were introduced into a two-part silicone mixture and allowed to cure. Cytotoxicity and hemocompatibility tests revealed that the incorporation of GNPs did not adversely affect cell proliferation or augment adhesion of platelets on the surface of the composite materials. Static mechanical characterization by loading in the tensile direction subsequently showed no observable effect when graphene was utilized. However, cyclic tensile testing (0.05 Hz) demonstrated that silicone samples containing 250 mg graphene/L of uncured silicone significantly improved (p<0.05) material fatigue properties compared with silicone-only controls. This finding suggests that for the silicone-graphene composite, static loads were principally transferred onto the matrix. On the other hand, in cyclic loading conditions, the GNPs were recruited effectively to delay failure of the bulk material. We conclude that application of GNPs to extend silicone durability is useful and warrants further evaluation at the trileaflet valve configuration.

Utility of magneto-electropolished ternary nitinol alloys for blood contacting applications.

The thrombogenicity of a biomaterial is mainly dependent on its surface characteristics, which dictates its interactions with blood. Surface properties such as composition, roughness wettability, surface free energy, and morphology will affect an implant material's hemocompatibility. Additionally, in the realm of metallic biomaterials, the specific composition of the alloy and its surface treatment are important factors that will affect the surface properties. The utility of magneto-electropolished (MEP) ternary Nitinol alloys, NiTiTa, and NiTiCr as blood contacting materials was investigated. The hemcompatibility of these alloys were compared to mechanically polished (MP) metallic biomaterial counterparts. In vitro thrombogenicity tests revealed significantly less platelet adherence on ternary MEP Nitinol, especially MEP NiTi10Ta as compared to the MP metals (p < 0.05). The enhanced anti-platelet-adhesive property of MEP NiTi10Ta was in part, attributed to the Ta2 O5 component of the alloy. Furthermore, the formation of a dense and mixed hydrophobic oxide layer during MEP is believed to have inhibited the adhesion of negatively charged platelets. In conclusion, MEP ternary Nitinol alloys can potentially be utilized for blood-contacting devices where, complications resulting from thrombogenicity can be minimized.