Editors' ChoiceTissue Engineering

Construction–Deconstruction–Reconstruction

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Science Translational Medicine  25 May 2011:
Vol. 3, Issue 84, pp. 84ec79
DOI: 10.1126/scitranslmed.3002660

To build something only to deconstruct it and then rebuild it again seems to be a Sisyphean task to solve a Promethean problem. However, this is exactly the approach taken by Quint et al. with their successful integration of tissue engineering, endothelial progenitor cell therapy, and surgery to create functional allogeneic blood vessels that can be used as arterial conduits in bypass operations to treat cardiovascular disease.

The authors started with a biomimetic perfusion system to culture pig aortic smooth muscle cells on a scaffold composed of polyglycolic acid. Layers of smooth muscle cells became interposed with collagenous extracellular matrix and a few residual scaffold fibers. Next, the authors performed a decellularization step that removed the smooth muscle cells, leaving behind an extracellular matrix skeleton on which new blood vessels could be built. The researchers then constructed new blood vessels by seeding the extracellular matrix skeleton with endothelial progenitor cells from pigs that were destined to be grafted with the tissue-engineered blood vessels. The tissue-engineered blood vessels were maintained in a bioreactor under appropriate hemodynamic and physiological conditions, and their functional and mechanical properties were tested. They were then implanted as arterial conduits into the carotid artery of pigs to mimic a cardiac bypass operation. The endothelial cell–seeded tissue-engineered blood vessels out-performed control blood vessel grafts, showing greater patency and a lower rate of intimal hyperplasia. This study demonstrates that tissue-engineered blood vessels with the correct mechanical properties can be produced relatively quickly, providing a much-needed alternative for the many patients with heart disease who need a bypass operation but do not have a suitable vein that can be used for grafting. Sometimes construction–deconstruction–reconstruction is the triad that works best.

C. Quint et al., Decellularized tissue-engineered blood vessel as an arterial conduit. Proc. Natl. Acad. Sci. U.S.A. 12 May 2011 (10.1073/pnas.1019506108). [Abstract]

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