Gluteraldehyde stabilized bovine pericardium is used for clinical application since 1970s because of its desirable features such as less immunogenicity and acceptable durability. However, a propensity for calcification and long term implant failure is reported because of gluteraldehyde treatment. There is also failure of implant to integrate into host tissue because of its resistance to tissue remodeling. Decellularized bovine pericardium, a potential alternative allows tissue remodeling but it has problems such as immunogenicity and chronic inflammatory response. In this study, decellularized bovine pericardium was subjected to short duration, low concentration gluteraldehyde cross-linking at two levels and its biological response (both in vitro and in vivo) was compared with un-crosslinked decellularized bovine pericardium and fully crosslinked normal bovine pericardium. It was observed that both un-crosslinked and partially crosslinked decellularized bovine pericardium to be non-cytotoxic and it caused significantly less inflammatory cytokine release such as TNF alpha and IL1beta from activated macrophages. Among all groups, short duration 0.2% Gluteraldehyde treated decellularized bovine pericardium showed significantly less antibody response and inflammatory response compared to un-crosslinked decellularized pericardium, short duration 0.6% gluteraldehyde treated decellularized bovine pericardium or completely cross linked bovine pericardium in juvenile rat subcutaneous implantation model. Moreover, short duration 0.2% gluteraldehyde crosslinked decellularized bovine pericardium showed minimum calcification, better host fibroblast incorporation, new collagen deposition and angiogenesis within the implant. These attributes may finally lead to better implant remodeling and sustained implant function during clinical use.

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Decellularised tissue produces a variety of host responses ranging from constructive remodeling to scarring on account of its differences in the source of tissue, processing or sterilization methods. In this study, in vivo regeneration induced by decellularised bovine pericardium with or without mild glutaraldehyde crosslinking was studied in relation to its immune and inflammatory response using rat abdominal regeneration model. Mild glutaraldehyde crosslinking was done to subdue inflammatory and immune response without compromising host cell incorporation and graft remodeling. Evaluations were done at both 21 and 90 days. Un-crosslinked decellularised bovine pericardium showed more intense macrophage response predominantly of M2 phenotype at 90 days indicating chronic inflammatory response compared to mildly crosslinked group. This group also showed significant increase in plasma cell and lymphocyte count indicating immune stimulation. Lymphocyte transformation test detected presence of bovine pericardial antigen sensitized lymphocytes at both periods in un-crosslinked group. Lymphocytes from mildly crosslinked group failed to respond in this test at both periods. Significantly higher antibody response was also noted at both periods in un-crosslinked group. However, abdominal wall regeneration was observed only in animals implanted with un-crosslinked decellularised bovine pericardium at 90 days. From the above findings, it is inferred that un-crosslinked decellularised bovine pericardium produced significant chronic inflammatory response at 90 days and stimulated both humoral and cell mediated immune response in comparison to mildly crosslinked decellularised bovine pericardium. Yet this group produced skeletal muscle formation within graft at 90 days.