Manipulation of cellular spheroid composition and the effects on vascular tissue fusion.

Cellular spheroids were investigated as tissue-engineered building blocks that can be fused to form functional tissue constructs. While spheroids can be assembled using passive contacts for the fusion of complex tissues, physical forces can be used to promote active contacts to improve tissue homogeneity and accelerate tissue fusion. Understanding the mechanisms affecting the fusion of spheroids is critical to fabricating tissues. Here, manipulation of the spheroid composition was used to accelerate the fusion process mediated by magnetic forces. The Janus structure of magnetic cellular spheroids spatially controls iron oxide magnetic nanoparticles (MNPs) to form two distinct domains: cells and extracellular MNPs. Studies were performed to evaluate the influence of extracellular matrix (ECM) content and cell number on the fusion of Janus magnetic cellular spheroids (JMCSs). Results showed that the integration of iron oxide MNPs into spheroids increased the production of collagen over time when compared to spheroids without MNPs. The results also showed that ring tissues composed of JMCSs with high ECM concentrations and high cell numbers fused together, but exhibited less contraction when compared to their lower concentration counterparts. Results from spheroid fusion in capillary tubes showed that low ECM concentrations and high cell numbers experienced more fusion and cellular intermixing over time when compared to their higher counterparts. These findings indicate that cell-cell and cell-matrix interactions play an important role in regulating fusion, and this understanding sets the rationale of spheroid composition to fabricate larger and more complex tissue-engineered constructs.

Matrix metalloproteinases in the pathology of natural and bioprosthetic cardiac valves.

Degenerative dysfunction of cardiac valves may be accounted for by uncontrolled extracellular matrix degradation processes in which matrix metalloproteinases could play a major role. In this study, 24 pathologic human valves and 26 pericardial-derived bioprostheses were analysed for metalloproteinases by gelatin zymography. Compared to controls, human stenotic valves and bioprostheses explanted because of either calcifying or noncalcifying degeneration revealed three notable biochemical aspects: (1) an amplification in the levels of metalloproteinase 9 (gelatinase B), suggestive of its active role in valvular pathology; (2) minimal modifications in the gelatinolytic levels of metalloproteinase 2 (gelatinase A), indicative of a constitutive secretion; and (3) activation products derived from both gelatinase A and B. All gelatinolytic activities identified in pathologic specimens were inhibited in vitro by zinc and calcium chelators (captopril, doxycycline, dithiothreitol, and ethylenediaminotetraacetic acid), suggesting potential therapeutic approaches. High levels of beta-glucuronidase (a lysosomal marker enzyme for phagocytic cells) were found in human calcified stenotic valves and in ruptured and calcified pericardial-derived bioprostheses. Mononuclear recruitment was minimal to moderate in pathologic human valves, and in noncalcified ruptured bioprostheses infiltrating mononuclear cells were concentrated in large numbers at the cuspal free edge. These findings suggest the involvement of infiltrating phagocytic cells and putative common mechanisms in the degeneration of both the natural and the bioprosthetic valvular extracellular matrix (ECM).

New evolution in mitral physiology and surgery: mitral stentless pericardial valve.

The human adult mitral valve, with a mean diastolic area of up to 7.6 cm2, excess leaflet surface area for coaptation in systole, mitral annulus-papillary muscle continuity, and systolic constriction of the posterior left ventricular wall around the mitral annulus functions in concert with other components of the left side of the heart. Mitral valve replacement with an artificial valve that interferes with the normal physiology could account for less than adequate late results. A stentless biologic mitral valve substitute has been designed, constructed, and tested. The size of the valve is selected according to the circumference of the excised valve within certain limits. The valve is manufactured of two square or trapezoidal pieces of selected stabilized human autologous or bovine pericardium. The pericardial pieces are sutured together by their lateral margins, thus creating a frusto-conical valvular body. The upper circumference of the valvular body is sutured at the mitral annulus and the lower margin with the new chordae is attached by suture at each papillary muscle. In vitro testing of six stentless bovine pericardial valves in a Rowan-Ash fatigue tester at 1,200 cycles/min revealed a durability of more than 320 million cycles. Clinical use of described technique initiated in 1989 was performed in 18 patients by one surgeon (30 patients in the same institution). The mean valve size was 29 mm circularized diameter. There was no mortality in this group of patients up to 70 months of follow-up. Valve competence was obtained in every case by adequate sizing of the valve.(ABSTRACT TRUNCATED AT 250 WORDS)

Biochemical pathways of tissue degeneration in bioprosthetic cardiac valves. The role of matrix metalloproteinases.

Degeneration processes that affect bioprosthetic heart valves made from glutaraldehyde treated bovine pericardium are poorly understood. The present study undertook the identification and characterization of matrix metalloproteinases (MMPs) in extracts obtained from 28 pericardial derived bioprosthetic heart valves explanted at surgery. A lysosomal marker was used to assess the incidence of infiltrating extracellular matrix degrading cells. The major biochemical features that were associated with tissue degeneration and bioprosthetic heart valve failure were increased levels of MMP 9, high levels of beta-glucuronidase, and constant levels of active collagenase and MMP 2. The MMPs extracted from ruptured bioprostheses were inhibited by calcium chelators and zinc binding compounds. These data suggest that tissue failure, in addition to known mechanical and calcification related factors, may be contributed to by the intervention of proteolytic enzymes. A schematic working model was proposed that described the major biochemical pathways underlying tissue degeneration, starting from bioprostheses preparation and ending with clinical failure.

Matrix metalloproteinases and tissue valve degeneration.

Bioprosthetic heart valves have been used as replacements for diseased heart valves for over 30 years. More than 50% of bioprosthetic valves fail within 15 years because of structural deterioration. The role of proteolytic degradation, with particular reference to the matrix metalloproteinases (MMPs) in the degeneration of aortic bioprostheses, is appraised in this minireview. It is clear that both the intrinsic and host-derived proteolytic activities present in heart-valve bioprostheses may combine with mechanical stress to bring about valve failure.

Skeletal deterioration induced by RANKL infusion: a model for high-turnover bone disease.

UNLABELLED: RANKL was administered continuously to rats for 28 days to investigate its potential as a disease model for the skeletal system. Bone turnover rates, bone material, structural and mechanical properties were evaluated. RANKL infusion caused overall skeletal complications comparable to those in high bone-turnover conditions, such as postmenopausal osteoporosis. INTRODUCTION: RANKL is an essential mediator for osteoclast development. No study has examined in detail the direct skeletal consequences of excess RANKL on bone turnover, mineralization, architecture, and vascular calcification. We, therefore, administrated soluble RANKL continuously into mature rats and created a bone-loss model. METHODS: Six-month-old Sprague-Dawley (SD) rats were assigned to three groups (n = 12) receiving continuous administration of saline (VEH) or human RANKL (35 microg/kg/day, LOW or 175 microg/kg/day, HI) for 28 days. Blood was collected routinely during the study. At sacrifice, hind limbs and aorta were removed and samples were analyzed. RESULTS: High dose RANKL markedly stimulated serum osteocalcin and TRAP-5b levels and reduced femur cortical bone volume (-7.6%) and trabecular volume fraction (BV/TV) at the proximal tibia (-64% vs. VEH). Bone quality was significantly degraded in HI, as evidenced by decreased femoral percent mineralization, trabecular connectivity, and increased endocortical bone resorption perimeters. Both cortical and trabecular bone mechanical properties were reduced by high dose RANKL. No differences were observed in the mineral content of the abdominal aorta. CONCLUSIONS: Continuous RANKL infusion caused general detrimental effects on rat skeleton. These changes are comparable to those commonly observed in high-turnover bone diseases such as postmenopausal osteoporosis.

Differentiated distribution of the cell surface charge on the alveolar-capillary unit. Characteristic paucity of anionic sites on the air-blood barrier.

The distribution of the surface charge on the cells which constitute the air-blood barrier was investigated by perfusing cationized ferritin (CF) into the vasculature or into the airways of the mouse lung. Binding of CF is selective and defines highly differentiated domains. The most salient finding is that the air-blood barrier proper that includes type I epithelial cell and part of the corresponding avesicular area of the endothelial cell has very few or lacks anionic sites. In the vesicular area of endothelial cells the plasma membrane binds CF homogenously, with the exception of the membrane of plasmalemmal vesicles and transendothelial channels and their associated diaphragms. In contradistinction to the luminal surface of the type I epithelial cell, which is virtually devoid of anionic sites, CF decorates heavily the luminal surface of type II epithelial cells, up to the level of the junction with type I epithelial cells. Extruded lamellar bodies and tubular myelin also binds CF, presumably due to the phosphate groups of the dipalmitoyl phosphatidylcholine. The cell surface of the alveolar macrophages has relatively few binding sites for CF, but significant internalization of the latter occurs at early time intervals. The preferential distribution of anionic sites on cell surfaces of the alveolar-capillary unit may be influential in the transport of molecules and gases across various regions of the air-blood barrier.

The biosynthesis of proteoglycans and interstitial collagens by bovine pericardial fibroblasts.

The biosynthesis of interstitial collagens (types I and III) and proteoglycans was studied in fibroblasts isolated from the parietal layer of bovine pericardium. Confluent cultures were labeled with Na2 35SO4 for proteoglycans or 14C-proline for collagens. The proteoglycans synthesized by pericardial fibroblasts were purified by DEAE-Sephacel chromatography and further fractionated into three components by gelfilitration. Two minor high molecular weight proteoglycans were shown by SDS-PAGE to be resistant to chondroitinase ABC and AC, and partially degraded by nitrous acid. The major, low molecular weight proteoglycan had a core protein of 45 kDa and is considered to be a dermatan sulfate/chondroitin sulfate proteoglycan since it was resistant to nitrous acid, but digested partially by chondroitinase AC and completely by ABC. The pericardial fibroblasts synthesized predominantly type I collagen and low amounts (about 10%) of type III collagen which was detected by delayed reduction on SDS-PAGE. The data show that pericardial fibroblasts synthesize the same macromolecules that can be extracted from the intact tissue and suggest that the proteoglycan may play a structural as well as physiological role.

Mapping of glutaraldehyde-treated bovine pericardium and tissue selection for bioprosthetic heart valves.

Glutaraldehyde-crosslinked bovine pericardium is widely used in bioprosthetic heart valve fabrication. In an attempt to set a scientific basis for more reproducible tissue selection, we produced and analyzed topographical maps of glutaraldehyde-treated bovine pericardium. Whole pericardia were divided into specific anatomical areas and their thickness was measured and mapped on templates. In each area, the suture holding power was determined in both parallel and perpendicular (to the base-apex line) directions; analyses of the tearing patterns in each fragment were used to evaluate predominant fiber orientation, and observations were confirmed by polarized light microscopy. Complete maps were superimposed graphically to aid in the selection of certain areas that would have known fiber orientation, high suture holding power, and suitable thickness. Our results describe regional heterogeneity of bovine pericardial structure and mechanical properties, specifically demonstrating variations in thickness, suture holding power, and collagen fiber orientation. Two areas of choice (representing about 35% of the total) were described as suitable for use in bioprosthetic heart valve fabrication.

Detection of remnant proteolytic activities in unimplanted glutaraldehyde-treated bovine pericardium and explanted cardiac bioprostheses.

The presence and activity of proteolytic enzymes has been investigated in vitro on soluble and insoluble preparations obtained from both unimplanted and implanted glutaraldehyde-treated bovine parietal pericardium. Using detection by colorimetric techniques, soluble preparations were shown to hydrolyze enzyme substrates that are characteristic for trypsin-like proteases, cathepsin-like proteases, and collagenase. As detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis in gradient gels and gel filtration on Sepharose CL-6B, insoluble (pellet) preparations degraded denatured type I collagen in a time-dependent pattern, producing low-molecular-weight fragments. These activities were partially inhibited by phenylmethylsulfonyl fluoride, N-ethyl maleimide, soybean trypsin inhibitor, para-chloromercuribenzoic acid, or ethylenediaminetetraacetic acid, suggesting the presence of a heterogeneous enzymatic mixture. Insoluble preparations incubated with pure pericardial dermatan sulfate proteoglycan detached the glycosaminoglycan chains from their core protein carrier, producing a digestion pattern similar to Cathepsin C. These findings demonstrate the presence of active proteases in glutaraldehyde-fixed bovine pericardium per se and in explanted pericardial bioprosthetic cardiac valves, an additional factor that might contribute to intrinsic extracellular matrix degeneration in pericardial bioprosthetic devices.

Lysine-enhanced glutaraldehyde crosslinking of collagenous biomaterials.

Crosslinking of collagenous biomaterials currently employs the use of glutaraldehyde. The putative enhancement of glutaraldehyde crosslinking by lysine was investigated in three model systems: bovine pericardium, collagen membranes, and bovine serum albumin. Repetitive sequential treatment of bovine pericardium with glutaraldehyde and lysine and finally with formaldehyde produced a matrix which, by the two criteria used (shrinkage temperature and urea/SDS soluble collagen), was shown to be more highly crosslinked than pericardium fixed in glutaraldehyde alone. Essentially the same results were obtained when membranes prepared from pepsin-soluble pericardial collagen were subjected to sequential glutaraldehyde and lysine treatments, reaching shrinkage temperatures of more than 90 degrees C. Heart valves prepared from lysine-enhanced glutaraldehyde crosslinked bovine pericardium were tested in vitro in an accelerated fatigue tester and have been shown to behave satisfactorily after 300 million cycles. These additional crosslinks proved to be stable in saline at 37 degrees C. Studies on bovine serum albumin attempted to get an insight into the mechanisms of lysine enhancement of glutaraldehyde crosslinking by treating sequentially albumin with glutaraldehyde and lysine and analysis of the products by gel filtration and SDS-PAGE. These studies suggest that free amino groups exposed by proteins are initially reacted with glutaraldehyde and then bridged by the diamino compound (lysine) producing more extensive intermolecular crosslinking than glutaraldehyde alone.

Partial characterization of a low molecular weight proteoglycan isolated from bovine parietal pericardium.

Knowledge of the nature of pericardial connective tissue components is incomplete. To gain a better understanding of the composition of this tissue, bovine parietal pericardium was extracted with 4 M guanidine hydrochloride yielding a proteoglycan-containing protein mixture. This was fractionated by a three-step chromatographic procedure with the resultant purification of a 75-110 Kd proteoglycan. The purified proteoglycan was susceptible to chondroitinase ABC digestion but resistant to chondroitinase AC and nitrous acid degradation suggesting the presence of dermatan sulfate glycosaminoglycan(s). This is the first reported isolation of a proteoglycan from parietal pericardium.

Bovine pericardial proteoglycan: biochemical, immunochemical and ultrastructural studies.

The major proteoglycan in bovine parietal pericardium is a low molecular weight dermatan-sulfate proteoglycan. It possesses structural and immunologic characteristics similar to those of the small proteoglycan found in tendon. We demonstrate that digestion of purified pericardial proteoglycan with low levels of V8 protease results in the liberation of the glycosaminoglycan chain and of a 40 kDa resistant fragment. A similar 40 kDa fragment can be obtained by V8 protease digestion of the proteoglycan deglycosylated by chondroitinase ABC. Although the protein core size of the pericardial proteoglycan is similar to that of tendon PG II, the size of the glycosaminoglycan chain liberated from the former is smaller. The pericardial proteoglycan and its V8 protease products reacted with an anti-PG II antiserum by immunoblotting. The anti-PG-II antibody localized in the pericardial tissue by the immunoperoxidase technique. The presence of intrachain disulfide bonds in the structure of pericardial proteoglycan core protein and V8 resistant fragment was demonstrated by their decreased electrophoretic mobility after disulfide reduction. Digestion of pericardial proteoglycan with Cathepsin C resulted in a rapid liberation of the glycosaminoglycan chain from the core protein, indicating that its attachment site was very close to the amino terminus. Ultrastructural examination of pericardial tissue utilizing Cuprolinic Blue revealed a periodic association of the proteoglycan with the d/e band on the collagen fibrils. Electron microscopic immunohistochemical studies confirmed the perifibrillar association of pericardial proteoglycan. The present data demonstrate that, although the pericardial proteoglycan possesses some unique structural features, it shares structural and immunological characteristics to place it in the category of the small PG II family.