Natural Biomaterials for Cardiac Tissue Engineering: A Highly Biocompatible Solution

Abstract

Cardiovascular diseases (CVD) constitute a major fraction of the current major global diseases and lead to about 30% of the deaths, i.e., 17.9 million deaths per year. CVD include coronary artery disease (CAD), myocardial infarction (MI), arrhythmias, heart failure, heart valve diseases, congenital heart disease, and cardiomyopathy. Cardiac Tissue Engineering (CTE) aims to address these conditions, the overall goal being the efficient regeneration of diseased cardiac tissue using an ideal combination of biomaterials and cells. Various cells have thus far been utilized in pre-clinical studies for CTE. These include adult stem cell populations (mesenchymal stem cells) and pluripotent stem cells (including autologous human induced pluripotent stem cells or allogenic human embryonic stem cells) with the latter undergoing differentiation to form functional cardiac cells. The ideal biomaterial for cardiac tissue engineering needs to have suitable material properties with the ability to support efficient attachment, growth, and differentiation of the cardiac cells, leading to the formation of functional cardiac tissue. In this review, we have focused on the use of biomaterials of natural origin for CTE. Natural biomaterials are generally known to be highly biocompatible and in addition are sustainable in nature. We have focused on those that have been widely explored in CTE and describe the original work and the current state of art. These include fibrinogen (in the context of Engineered Heart Tissue, EHT), collagen, alginate, silk, and Polyhydroxyalkanoates (PHAs). Amongst these, fibrinogen, collagen, alginate, and silk are isolated from natural sources whereas PHAs are produced via bacterial fermentation. Overall, these biomaterials have proven to be highly promising, displaying robust biocompatibility and, when combined with cells, an ability to enhance post-MI cardiac function in pre-clinical models. As such, CTE has great potential for future clinical solutions and hence can lead to a considerable reduction in mortality rates due to CVD.

Current Strategies for the Regeneration of Skeletal Muscle Tissue

“…It is also inexpensive compared to many other biomaterials [ 149 ]. However, alginate-based constructs show a weak cell adhesion, which may cause unfavorable tissue interactions and insufficient regenerative behavior [ 150 ]. The functionalization of alginate with cell adhesion-promoting ligands, such as arginine–glycine–asparagine RGD can support the interaction of the cells with the alginate matrix [ 151 ].…”

Diagnostic and Therapeutic Applications of Extracellular Vesicles in Interstitial Lung Diseases

“…Secondly, owing to their diminutive size, retaining them at a certain site or target tissue is challenging as they are easily flushed by circulation. Therefore, for indications that require the direct application of EVs to localized areas (e.g., ischemic injury), patches of various hydrogels have been developed as scaffolds to provide consistent retention and release [ 104 , 105 ]. More specific EV delivery-enhancement efforts have focused on altering the EV surface for improved tissue retention, including the use of chemically-embedded targeting antibodies or homing peptides [ 106 ].…”

Reconstruction of the Swine Pulmonary Artery Using a Graft Engineered With Syngeneic Cardiac Pericytes

“…Prosthetic or biological materials used for PA reconstruction are not ideal substitutes due to their thrombogenicity, limited durability, and inadequate growth and regeneration potential ( Manavitehrani et al, 2019 ). Tissue engineering aims to create advanced therapy medicinal products (ATMPs) endowed with normal tissue function including capacity for growth and self-repair ( Cheema et al, 2012 ; Durko et al, 2020 ; Majid et al, 2020 ). Cellularized vascular grafts can potentially overcome the shortcomings of currently used materials, and, if successfully passing all the development phases required for a marketing authorization, they might provide a better solution for the pediatric population.…”