The effect of chronic kidney disease on tissue formation of in situ tissue-engineered vascular grafts
Vascular in situ tissue engineering encompasses a single-step approach with a wide adaptive potential and true off-the-shelf availability for vascular grafts. However, a synchronized balance between breakdown of the scaffold material and neo-tissue formation is essential. Chronic kidney disease (CKD...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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AIP Publishing LLC
2023-06-01
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| Series: | APL Bioengineering |
| Online Access: | http://dx.doi.org/10.1063/5.0138808 |
| _version_ | 1827892559928623104 |
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| author | Paul J. Besseling Merle M. Krebber Joost O. Fledderus Martin Teraa Krista den Ouden Melanie van de Kaa Petra M. de Bree Aurelie Serrero Carlijn V. C. Bouten Patricia Y. W. Dankers Martijn A. J. Cox Marianne C. Verhaar |
| author_facet | Paul J. Besseling Merle M. Krebber Joost O. Fledderus Martin Teraa Krista den Ouden Melanie van de Kaa Petra M. de Bree Aurelie Serrero Carlijn V. C. Bouten Patricia Y. W. Dankers Martijn A. J. Cox Marianne C. Verhaar |
| author_sort | Paul J. Besseling |
| collection | DOAJ |
| description | Vascular in situ tissue engineering encompasses a single-step approach with a wide adaptive potential and true off-the-shelf availability for vascular grafts. However, a synchronized balance between breakdown of the scaffold material and neo-tissue formation is essential. Chronic kidney disease (CKD) may influence this balance, lowering the usability of these grafts for vascular access in end-stage CKD patients on dialysis. We aimed to investigate the effects of CKD on in vivo scaffold breakdown and tissue formation in grafts made of electrospun, modular, supramolecular polycarbonate with ureido-pyrimidinone moieties (PC-UPy). We implanted PC-UPy aortic interposition grafts (n = 40) in a rat 5/6th nephrectomy model that mimics systemic conditions in human CKD patients. We studied patency, mechanical stability, extracellular matrix (ECM) components, total cellularity, vascular tissue formation, and vascular calcification in CKD and healthy rats at 2, 4, 8, and 12 weeks post-implantation. Our study shows successful in vivo application of a slow-degrading small-diameter vascular graft that supports adequate in situ vascular tissue formation. Despite systemic inflammation associated with CKD, no influence of CKD on patency (Sham: 95% vs CKD: 100%), mechanical stability, ECM formation (Sirius red+, Sham 16.5% vs CKD 25.0%–p:0.83), tissue composition, and immune cell infiltration was found. We did find a limited increase in vascular calcification at 12 weeks (Sham 0.08% vs CKD 0.80%—p:0.02) in grafts implanted in CKD animals. However, this was not associated with increased stiffness in the explants. Our findings suggest that disease-specific graft design may not be necessary for use in CKD patients on dialysis. |
| first_indexed | 2024-03-12T21:42:19Z |
| format | Article |
| id | doaj.art-576e9e71f08d4945ac29a81368da757c |
| institution | Directory Open Access Journal |
| issn | 2473-2877 |
| language | English |
| last_indexed | 2024-03-12T21:42:19Z |
| publishDate | 2023-06-01 |
| publisher | AIP Publishing LLC |
| record_format | Article |
| series | APL Bioengineering |
| spelling | doaj.art-576e9e71f08d4945ac29a81368da757c2023-07-26T15:56:53ZengAIP Publishing LLCAPL Bioengineering2473-28772023-06-0172026107026107-1210.1063/5.0138808The effect of chronic kidney disease on tissue formation of in situ tissue-engineered vascular graftsPaul J. Besseling0Merle M. Krebber1Joost O. Fledderus2Martin Teraa3Krista den Ouden4Melanie van de Kaa5Petra M. de Bree6Aurelie Serrero7Carlijn V. C. Bouten8Patricia Y. W. Dankers9Martijn A. J. Cox10Marianne C. Verhaar11 Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands Xeltis BV, Eindhoven, The Netherlands Department of Biomedical Engineering and Institute for Complex Molecular Systems, TU/e, Eindhoven, The Netherlands Department of Biomedical Engineering and Institute for Complex Molecular Systems, TU/e, Eindhoven, The Netherlands Xeltis BV, Eindhoven, The Netherlands Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The NetherlandsVascular in situ tissue engineering encompasses a single-step approach with a wide adaptive potential and true off-the-shelf availability for vascular grafts. However, a synchronized balance between breakdown of the scaffold material and neo-tissue formation is essential. Chronic kidney disease (CKD) may influence this balance, lowering the usability of these grafts for vascular access in end-stage CKD patients on dialysis. We aimed to investigate the effects of CKD on in vivo scaffold breakdown and tissue formation in grafts made of electrospun, modular, supramolecular polycarbonate with ureido-pyrimidinone moieties (PC-UPy). We implanted PC-UPy aortic interposition grafts (n = 40) in a rat 5/6th nephrectomy model that mimics systemic conditions in human CKD patients. We studied patency, mechanical stability, extracellular matrix (ECM) components, total cellularity, vascular tissue formation, and vascular calcification in CKD and healthy rats at 2, 4, 8, and 12 weeks post-implantation. Our study shows successful in vivo application of a slow-degrading small-diameter vascular graft that supports adequate in situ vascular tissue formation. Despite systemic inflammation associated with CKD, no influence of CKD on patency (Sham: 95% vs CKD: 100%), mechanical stability, ECM formation (Sirius red+, Sham 16.5% vs CKD 25.0%–p:0.83), tissue composition, and immune cell infiltration was found. We did find a limited increase in vascular calcification at 12 weeks (Sham 0.08% vs CKD 0.80%—p:0.02) in grafts implanted in CKD animals. However, this was not associated with increased stiffness in the explants. Our findings suggest that disease-specific graft design may not be necessary for use in CKD patients on dialysis.http://dx.doi.org/10.1063/5.0138808 |
| spellingShingle | Paul J. Besseling Merle M. Krebber Joost O. Fledderus Martin Teraa Krista den Ouden Melanie van de Kaa Petra M. de Bree Aurelie Serrero Carlijn V. C. Bouten Patricia Y. W. Dankers Martijn A. J. Cox Marianne C. Verhaar The effect of chronic kidney disease on tissue formation of in situ tissue-engineered vascular grafts APL Bioengineering |
| title | The effect of chronic kidney disease on tissue formation of in situ tissue-engineered vascular grafts |
| title_full | The effect of chronic kidney disease on tissue formation of in situ tissue-engineered vascular grafts |
| title_fullStr | The effect of chronic kidney disease on tissue formation of in situ tissue-engineered vascular grafts |
| title_full_unstemmed | The effect of chronic kidney disease on tissue formation of in situ tissue-engineered vascular grafts |
| title_short | The effect of chronic kidney disease on tissue formation of in situ tissue-engineered vascular grafts |
| title_sort | effect of chronic kidney disease on tissue formation of in situ tissue engineered vascular grafts |
| url | http://dx.doi.org/10.1063/5.0138808 |
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