Regenerative immunology: the immunological reaction to biomaterials

Cravedi, Paolo; Farouk, Samira S.; Angeletti, Andrea; Edgar, Lauren; Tamburrini, Riccardo; Duisit, Jérôme; Perin, Laura; Orlando, Giuseppe

doi:10.1111/tri.13068

Cited by 54 publications

(33 citation statements)

References 74 publications

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“…Interestingly enough, natural ECM-based scaffolds obtained from human organs that are being used as supporting scaffolding material for bioengineered tissues, have been reported to contain significant amount of TGF-beta [127][128][129][130] and to be able to induce T-cell apoptosis and promote conversion of naïve CD4 + T cells into CD4 + CD25 + Foxp3 + Treg [118,129]. This observation is consistent with the evidence showing that the ECM possesses strong immunomodulatory properties.…”

Section: Regenerative Immunologysupporting

confidence: 79%

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Rethinking Regenerative Medicine From a Transplant Perspective (and Vice Versa)

et al. 2019

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No field in health sciences has more interest than organ transplantation in fostering progress in regenerative medicine (RM) because the future of no other field more than the future of organ transplantation will be forged by progress occurring in RM. In fact, the most urgent needs of modern transplant medicine - namely, more organs to satisfy the skyrocketing demand and immunosuppression-free transplantation -, cannot be met in full with current technologies and are at risk of remaining elusive goals. Instead, in the past few decades, groundbreaking progress in RM is suggesting a different approach to the problem. New, RM-inspired technologies among which decellularization, 3D printing and interspecies blastocyst complementation, promise organoids manufactured from patients' own cells and bear potential to render the use of currently used allografts obsolete. Transplantation, a field that has traditionally been immunology-based, is therefore destined to become a RM-based discipline.However, the contours of RM remain unclear, mainly due to the lack of a universally accepted definition, the lack of clarity of its potential modalities of application and the unjustified and misleading hype that often follows the reports of clinical application of RM technologies. All this generates excessive and unmet expectations and an erroneous perception of what RM really is and can offer.In this manuscript, we will (i) discuss these aspects of RM and transplant medicine, (ii) propose a definition of RM, and (iii) illustrate the state of the art of the most promising RM-based technologies of transplant interest.

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Section: Regenerative Immunologysupporting

confidence: 79%

“…One of the most critical questions to answer is how the immune system could react against a bioengineered cellular construct and if it would be possible to modulate this response [118]. A bioengineered construct consists of two components, the cellular compartment and the cell-supporting system, namely the ECM.…”

Section: Regenerative Immunologymentioning

confidence: 99%

Rethinking Regenerative Medicine From a Transplant Perspective (and Vice Versa)

et al. 2019

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“…The cellular component of a bioengineered graft may also trigger an acute rejection response because it is well known that both allogeneic pluripotent stem cells and autologous adult cells may still elicit an inflammatory response after manipulation in culture, even when harvested directly from the host. It has also been suggested that the ECM component of scaffolds retains the ability to induce T cell apoptosis and CD4‐positive T cell conversion through innate properties of transforming growth factor β 68–70 . The transition of proinflammatory macrophage phenotype M1 to an M2 phenotype occurring 1–2 weeks after implantation may improve remodelling outcomes by using host tissue remodelling and repair mechanisms 7 .…”

Section: State‐of‐the‐art Regenerative Medicine Technologiesmentioning

confidence: 99%

Regenerative medicine, organ bioengineering and transplantation

Edgar

Porter

et al. 2020

British Journal of Surgery

143

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Background Organ transplantation is predicted to increase as life expectancy and the incidence of chronic diseases rises. Regenerative medicine‐inspired technologies challenge the efficacy of the current allograft transplantation model. Methods A literature review was conducted using the PubMed interface of MEDLINE from the National Library of Medicine. Results were examined for relevance to innovations of organ bioengineering to inform analysis of advances in regenerative medicine affecting organ transplantation. Data reports from the Scientific Registry of Transplant Recipient and Organ Procurement Transplantation Network from 2008 to 2019 of kidney, pancreas, liver, heart, lung and intestine transplants performed, and patients currently on waiting lists for respective organs, were reviewed to demonstrate the shortage and need for transplantable organs. Results Regenerative medicine technologies aim to repair and regenerate poorly functioning organs. One goal is to achieve an immunosuppression‐free state to improve quality of life, reduce complications and toxicities, and eliminate the cost of lifelong antirejection therapy. Innovative strategies include decellularization to fabricate acellular scaffolds that will be used as a template for organ manufacturing, three‐dimensional printing and interspecies blastocyst complementation. Induced pluripotent stem cells are an innovation in stem cell technology which mitigate both the ethical concerns associated with embryonic stem cells and the limitation of other progenitor cells, which lack pluripotency. Regenerative medicine technologies hold promise in a wide array of fields and applications, such as promoting regeneration of native cell lines, growth of new tissue or organs, modelling of disease states, and augmenting the viability of existing ex vivo transplanted organs. Conclusion The future of organ bioengineering relies on furthering understanding of organogenesis, in vivo regeneration, regenerative immunology and long‐term monitoring of implanted bioengineered organs.

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“…While blood flows through the dialysis membranes, synthetic materials elicit a foreign body reaction characterized by recruitment of neutrophils and monocytes [34,35], which release pro-inflammatory cytokines, namely interleukin 1 (IL-1), interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α) [36,37]. Therefore, the measurement of activated monocytes provides useful information on dialyzer biocompatibility [38].…”

Section: Cellular Componentsmentioning

confidence: 99%

Immunological Effects of a Single Hemodialysis Treatment

et al. 2020

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Immune disorders, involving both innate and adaptive response, are common in patients with end-stage renal disease under chronic hemodialysis. Endogenous and exogenous factors, such as uremic toxins and the extracorporeal treatment itself, alter the immune balance, leading to chronic inflammation and higher risk of cardiovascular events. Several studies have previously described the immune effects of chronic hemodialysis and the possibility to modulate inflammation through more biocompatible dialyzers and innovative techniques. On the other hand, very limited data are available on the possible immunological effects of a single hemodialysis treatment. In spite of the lacking information about the immunological reactivity related to a single session, there is evidence to indicate that mediators of innate and adaptive response, above all complement cascade and T cells, are implicated in immune system modulation during hemodialysis treatment. Expanding our understanding of these modulations represents a necessary basis to develop pro-tolerogenic strategies in specific conditions, like hemodialysis in septic patients or the last session prior to kidney transplant in candidates for receiving a graft.

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Regenerative immunology: the immunological reaction to biomaterials

Cited by 54 publications

References 74 publications

Rethinking Regenerative Medicine From a Transplant Perspective (and Vice Versa)

Rethinking Regenerative Medicine From a Transplant Perspective (and Vice Versa)

Regenerative medicine, organ bioengineering and transplantation

Immunological Effects of a Single Hemodialysis Treatment

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