Role of Biomaterials in Cardiac Repair and Regeneration: Therapeutic Intervention for Myocardial Infarction

Abstract

Heart failure or myocardial infarction (MI) is one of the world's leading causes of death. Post MI, the heart can develop pathological conditions such as ischemia, inflammation, fibrosis, and left ventricular dysfunction. However, current surgical approaches are sufficient for enhancing myocardial perfusion but are unable to reverse the pathological changes. Tissue engineering and regenerative medicine approaches have shown promising effects in the repair and replacement of injured cardiomyocytes. Additionally, biomaterial scaffolds with or without stem cells are established to provide an effective environment for cardiac regeneration. Excipients loaded with growth factors, cytokines, oligonucleotides, and exosomes are found to help in such cardiac eventualities by promoting angiogenesis, cardiomyocyte proliferation, and reducing fibrosis, inflammation, and apoptosis. Injectable hydrogels, nanocarriers, cardiac patches, and vascular grafts are some excipients that can help the self-renewal in the damaged heart but are not understood well yet, in the context of used biomaterials. This review focuses on the use of various biomaterial-based approaches for the regeneration and repair of cardiac tissue postoccurrence of MI. It also discusses the outlines of cardiac remodeling and current therapeutic approaches after myocardial infarction, which are translationally important with respect to used biomaterials. It provides comprehensive details of the biomaterial-based regenerative approaches, which are currently the focus of the research for cardiac repair and regeneration and can provide a broad outline for further improvements.

Control of the post-infarct immune microenvironment through biotherapeutic and biomaterial-based approaches

“…While therapeutics alone are clearly efficacious tools for reorientation of the post ischemic inflammatory milieu, their use can be hindered by factors such as suboptimal pharmacokinetics (i.e., rapid blood clearance, non-specific cell and tissue biodistribution) and resulting off-target effects such as systemic toxicity and increased risk of infection [ 263 ]. Functional biomaterials have been widely used to address these challenges in cardiac repair [ 264 , 265 ], which may be composed of either natural or synthetic components (Table 3 ). Here, we outline biomaterial-based strategies, including systemically or locally administered therapeutic vehicles that have demonstrated utility in modulating the immune response to mitigate impacts toward IHF.…”

A Novel Conductive Polypyrrole‐Chitosan Hydrogel Containing Human Endometrial Mesenchymal Stem Cell‐Derived Exosomes Facilitated Sustained Release for Cardiac Repair

“…[ 9 ] Therefore, to improve their therapeutic efficacy and increase retention time at the targeted region, a suitable scaffold system is required to contain these exosomes. [ 10 ] Injectable hydrogels have been documented to be able to retain exosomes and facilitate their release over a long period of time, and have been demonstrated to be effective in treating MI. [ 11 ] Furthermore, we have previously demonstrated that human endometrial mesenchymal stem cells (hEMSCs) have significant effects on improving cardiac function, by stimulating angiogenesis and preserving viable cardiomyocytes.…”

Annexin A1-Loaded Alginate Hydrogel Promotes Cardiac Repair via Modulation of Macrophage Phenotypes after Myocardial Infarction

“…Biomaterials possess customizable carrier properties that enable a continuous and local release of factors, as well as provide mechanical support to the injured area and bioactive cues for cell adhesion, survival, and differentiation. − Alginate (Alg) is a natural anion polysaccharide extracted from brown algae, which can be cross-linked with divalent cations to form hydrogel with a certain viscosity and mechanical strength . This polymer offers modifiable properties and is a nonthrombogenic biomaterial, making it a suitable candidate for cardiac applications .…”