The use of acellular matrices for the tissue engineering of cardiac valves.

Tissue-engineering approaches to cardiac valve replacement have made considerable advances over recent years and it is likely that this application will realize clinical success in the near future. Research in this area has been driven by the inadequacy of the currently available cardiac valve prostheses for younger patients who require multiple reoperations as they grow and develop. Tissue engineering has the potential to provide a valve capable of the same growth, repair, and regeneration as a natural valve and could improve outcomes for patients of all ages. Owing to the function and physical environment of the cardiac valve, the development of tissue-engineered replacements is unusual in that the biomechanical properties of the construct must dominate the biological properties in order for the valve to be functional at the time of implantation. As a result of this, conventional tissue-engineering scaffolds based on biodegradable polymers or collagen may not at present be suitable in this situation because of their initial limited strength. Research into the use of acellular xenogeneic and allogeneic matrices for tissue-engineered heart valves has consequently become extremely popular since the biomechanical properties of the valve can potentially be preserved with an optimal decellularization technique that removes the cells without damaging the matrix. A number of acellular scaffolds have already been tested clinically both unseeded and preseeded with cells and these have met with variable results. This article reviews the concepts involved and the advantages and disadvantages of the different approaches to tissue engineering a living cardiac valve.

Resolution of inflammatory acne vulgaris may involve regulation of CD4+ T-cell responses to Propionibacterium acnes.

BACKGROUND: Propionibacterium acnes has been strongly implicated in inflammatory acne. However, its role in the disease is unclear. It has been hypothesized that an immune response to P. acnes and/or P. acnes heat shock proteins (HSPs) may play a role in the pathogenesis of inflammatory acne. OBJECTIVES: To compare the cell-mediated immune response to P. acnes and HSPs in acne patients, nonacne controls and individuals with resolved acne. METHODS: The proliferative response of peripheral blood mononuclear cells (PBMC) from acne patients, resolved acne donors and healthy controls to P. acnes, P. acnes HSP60 and HSP70, and mycobacterial HSPs was assessed by lymphocyte transformation assay (LTA). The proliferative response of purified CD4+ T cells was further analysed by limiting dilution analysis (LDA). Contingency tables (G-test) were used to analyse the proportion of individuals in each group showing a positive proliferative response for LTA or data fitting single-hit kinetics for LDA. RESULTS: Analysis of stimulation of PBMC with P. acnes, P. acnes HSP60 and HSP70 in the LTA showed the proportion of positive responders to be independent of subject group. However, the proportion of acne patients with a positive response to mycobacterial HSPs was significantly higher than those for the other subject groups. Analysis of LDA data showed the proportion of resolved donors with responses to P. acnes fitting the single-hit kinetics model to be significantly lower than those of the other groups. There were no significant differences in responses to other antigens. CONCLUSIONS: The significantly lower proportion of resolved donors demonstrating a single-hit kinetics response to P. acnes by LDA may represent negative regulation of the CD4+ T-cell response to P. acnes in these subjects.

Passive protection of segmented swine colonic loops against swine dysentery.

Swine-ligated loops were used to demonstrate passive protection against swine dysentery. Loops inoculated with immune sera containing complement and with homologous Treponema hyodysenteriae were normal at necropsy. Loops inoculated with heat-inactivated immune sera and heterologous T hyodysenteriae were not protected. Loops inoculated with heat-inactivated immune sera and homologous T hyodysenteriae were partially protected. Positive control loops inoculated with isolate B204 (88%) or B234 (44%) T hyodysenteriae and normal sera developed lesions typical of swine dysentery, whereas negative control loops inoculated with nonexposed sera only were normal.