This document summarizes research on tissue engineering approaches for treating heart and valve failure. It discusses developing cardiac patches made of biomaterials seeded with cells, testing patches in animal models, and evaluating function. Heart valve engineering using scaffolds seeded with human cells is also reviewed. Whole heart engineering by decellularizing and repopulating rat hearts is presented. Clinical perspectives are discussed, such as enrolling patients for efficacy tests of engineered myocardial tissue and assessing safety issues. The goal is developing tissue engineering therapies for treating unmet clinical needs in heart disease.
Introduction
Anatomy and Physiology of bone
Bone Tissue Engineering
Recent studies related to bone tissue engineering
Commercialized products and ongoing clinical trials
Biomedical start-ups
Concluding remarks
Introduction
Anatomy and Physiology of bone
Bone Tissue Engineering
Recent studies related to bone tissue engineering
Commercialized products and ongoing clinical trials
Biomedical start-ups
Concluding remarks
Introduction
Anatomy and Physiology of bone
Bone Tissue Engineering
Recent studies related to bone tissue engineering
Commercialized products and ongoing clinical trials
Biomedical start-ups
Concluding remarks
A presentation on Tissue Engineering made by Deepak Rajput. It was presented as a seminar requirement at the University of Tennessee Space Institute in Spring 2009.
The term artificial skin is used to describe any material used to replace (permanently or temporarily) or to mimic the dermal and epidermal layers of the skin.
The primary current application of artificial skin is for the treatment of skin loss or damage on burn patients.
Alternatively however, artificial skin is now being used in some places to treat patients with skin diseases, such as diabetic foot ulcers, and severe .
Biomaterials were defined as “any substance, other than a drug, or a combination of substances, synthetic or natural in origin, which can be used for any period of time, as a whole or as a part of a system, which treats, augments or replaces any tissue, organ or function of the body”
Introduction
Artificial skin
Invention
Structure of human skin
Importance of skin
Key development
Biomaterials
Methods to produce artificial skin
Application
Problems
Future development
Conclusions
references
Tissue engineering is the use of a combination of cells, engineering and materials methods, and suitable biochemical and physicochemical factors to improve or replace biological functions.
The term has also been applied to efforts to perform specific biochemical functions using cells within an artificially-created support system (e.g. an artificial pancreas, or a bio artificial liver).
A commonly applied definition of tissue engineering, as stated by Langer and Vacanti is “An interdisciplinary field that applies the principles of engineering and life sciences toward the development of biological substitutes that restore, maintain, or improve [Biological tissue] function or a whole organ”
Using Platelet Rich Plasma for Orthopedic Conditionsregenmedsr
Platelet Rich Plasma is an excellent option, often with far better results than traditional methods, for musculoskeletal problems involving joint, tendons, and ligaments.
Introduction
Anatomy and Physiology of bone
Bone Tissue Engineering
Recent studies related to bone tissue engineering
Commercialized products and ongoing clinical trials
Biomedical start-ups
Concluding remarks
Introduction
Anatomy and Physiology of bone
Bone Tissue Engineering
Recent studies related to bone tissue engineering
Commercialized products and ongoing clinical trials
Biomedical start-ups
Concluding remarks
Introduction
Anatomy and Physiology of bone
Bone Tissue Engineering
Recent studies related to bone tissue engineering
Commercialized products and ongoing clinical trials
Biomedical start-ups
Concluding remarks
A presentation on Tissue Engineering made by Deepak Rajput. It was presented as a seminar requirement at the University of Tennessee Space Institute in Spring 2009.
The term artificial skin is used to describe any material used to replace (permanently or temporarily) or to mimic the dermal and epidermal layers of the skin.
The primary current application of artificial skin is for the treatment of skin loss or damage on burn patients.
Alternatively however, artificial skin is now being used in some places to treat patients with skin diseases, such as diabetic foot ulcers, and severe .
Biomaterials were defined as “any substance, other than a drug, or a combination of substances, synthetic or natural in origin, which can be used for any period of time, as a whole or as a part of a system, which treats, augments or replaces any tissue, organ or function of the body”
Introduction
Artificial skin
Invention
Structure of human skin
Importance of skin
Key development
Biomaterials
Methods to produce artificial skin
Application
Problems
Future development
Conclusions
references
Tissue engineering is the use of a combination of cells, engineering and materials methods, and suitable biochemical and physicochemical factors to improve or replace biological functions.
The term has also been applied to efforts to perform specific biochemical functions using cells within an artificially-created support system (e.g. an artificial pancreas, or a bio artificial liver).
A commonly applied definition of tissue engineering, as stated by Langer and Vacanti is “An interdisciplinary field that applies the principles of engineering and life sciences toward the development of biological substitutes that restore, maintain, or improve [Biological tissue] function or a whole organ”
Using Platelet Rich Plasma for Orthopedic Conditionsregenmedsr
Platelet Rich Plasma is an excellent option, often with far better results than traditional methods, for musculoskeletal problems involving joint, tendons, and ligaments.
Tissue engineering and regenerative medicine Suman Nandy
Tissue engineering is the use of a combination of cells, engineering and materials methods, and suitable biochemical and physicochemical factors to improve or replace biological tissues. Tissue engineering involves the use of a scaffold for the formation of new viable tissue for a medical purpose.
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Abstract
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Rotator cuff repair using a stem cell approachZakary Bondy
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Biomaterials & Tissue engineering - London - AgendaTony Couch
Designed for experts in academia and industry working in this exciting field, this conference will examine cutting-edge
research in several key areas across four dedicated tracks. Talks will look to cover the development of scaffold
technology for both soft and hard tissues, and the novel biomaterials used in their construction, new platforms for
Biofabrication, tissue culture techniques, advances in hydrogels in regenerative medicine, and recent developments in
stem cell research. There will also be a track dedicated to the exciting developing field of organ fabrication, reviewing
recent advances and challenges to be overcome.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
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India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
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One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Artificial Intelligence to Optimize Cardiovascular Therapy
Tissue engineering in heart and valve failure management.
1. Tissue engineering in heart and
valve failure management
Dr. Alexander Lyon
Senior Lecturer and Consultant Cardiologist
Royal Brompton Hospital and Imperial College, London
3. Overview
• Concepts for cardiovascular tissue engineering
• Making a cardiac patch
• Testing a cardiac patch in vivo
• Heart valve engineering
• Whole heart engineering
• Clinical perspective
4.
5. Fukushima, S. et al. Circulation 2007;115:2254-2261
Why do we need a patch in cell and tissue therapy
Retention and Survival of grafted cells
Bone marrow cells - intramyocardial
Bone marrow cells - intracoronary
6. • In vitro culturing of cells on a biomaterial
• Direct intramyocardial injection of cells with biomaterial scaffold
• Direct intramyocardial injection of biomaterial alone
• Direct intramyocardial injection of other agents such as proteins or gene therapy
Christman et al. (2006) J. Am. Coll. Cardiol
Delivery Options
a) a polymer mesh
8. Materials to enhance cell attachment or survival
Material Advantages Disadvantages
Naturally occurring materials
•Collagen
•Alginate
•Hyaluronic acid
•Fibrin
•Gelatin
•Chitosan
•Matrigel
•Peritoneal membranes
Biocompatibility
Porous
Biodegradable
Bioresorbable
Poor processibility
Poor mechanical properties
Possible immunogenic
problems
Biodegradable synthetic
polymers
•Poly(lactic acid)
•Poly(ethylene terephthalate) = PED
•Poly(glycerol sebacate) = PGS
•Poly(lactic-co-glycolic acid)
•Polypropylene fumarate
•Poly(orthoesters)
•Poly(anhydrides)
Good biocompatibility
Off-the-shelf availability
Good processibility
Bioresorbable
Biodegradable (wide range
of rates)
Added value from material
tailoring
• Controlled porosity
• Mechanical support
•Electrical conductivity
•Controlled release of factors
Inflammation or
nanotoxicity from
degradation products
Loss of mechanical
properties after
degradation
Non-degradable synthetic
polymers
Off-the-shelf availability
No foreign-body reactions
Tailored mechanical
properties
Effect of long term
presence in the body
9. Biodegradable synthetic polymers
Passive Stress-Strain Curves
Chen et al Biomaterials
2008 and 2010
(31)
(34)
(30)
(33)
(33)
(32)
E = 0.056 MPa
E = 0.22 MPa
PED/TiO2
PGS@120C
PGS@110C
PED
11. Mechanical and electrical stimulation improve
Engineered Heart Tissue maturation
Neonatal rat cardiomyocytes in collagen
human embryonic stem cell-derived cardiomyocytes
T Eschenhagen, WH Zimmermann
12. 1) Application of spin negative
photo-resist polymers.
3) Cast PDMS mould added.
2) Exposure to ultraviolet
(UV) light through
transparency mask –
photolithography.
Silicon Wafer
Scale bar 20 µm Myosin Heavy Chain DAPI
10µm 4) PDMS mould with
microgrooves.
10µm
4µm deep
5) Coat microgrooves with
fibronectin.
Physical patterning to enhance cardiomyocyte maturity
iPSC-CM onto fibronectin coated microgrooved polydimethylsiloxane (PDMS) scaffolds
fabricated using photolithography
Rao et al Biomaterials. 2013 Mar;34(10):2399-411
13. Rao et al Biomaterials. 2013 Mar;34(10):2399-411
Physical patterning to enhance cardiomyocyte maturity
14. Physical patterning to enhance cardiomyocyte maturity
Rao et al Biomaterials. 2013 Mar;34(10):2399-411
15. In vivo testing in preclinical models
1 cm diameter patch, 0.5mm thick, sutured onto left ventricle, 2 weeks
(N=6-8 per column)
Control SO ST Qizhi
0
50
100
Max Pressure
ns
ns
ns
mmHg
Untreated PED PED/TiO2 PGS
0
2500
5000
7500
10000
12500
dp/dt max
ns
ns
ns
mmHg/sec
Untreated PED PED/TiO2 PGS
0.0
2.5
5.0
7.5
10.0
12.5
ns
ns
ns
LVEDP
mmHg
Untreated PED PED/TiO2 PGS
0
25
50
75
100
ns
ns
ns
LVEF
mmHg
Untreated PED PED/TiO2 PGS
Hikaru Ishii
No obvious
impact of sutured
patch on normal
cardiac function
16. Ex vivo MRI of cardiac scaffolds
PED biopolymer PED + TiO2
Dan Stuckey
17. Hearts imaged in vivo at 1 and 6 weeks
PGS scaffold degraded
In vivo myocardial scaffold degradation
Stuckey et al Tissue Engineering 2010
18. Scaffolds attached infarcted rat heart epicardium (n = 12)
Hearts imaged in vivo at 1 week at 11.7T
In vivo detection of scaffold motion
PED + TiO2 PGS
Stuckey et al Tissue Engineering 2010
19. Tissue engineered trileaflet valve made of
B PGA/P4HB seeded with human cells
C PCL scaffold seeded with human cells
Poly e-caprolactone (PCL):
biocompatible and biodegradable
strong mechanical properties
slow degradation rate
Brugmans, M.M., et al., Journal of tissue
engineering and regenerative medicine,
2013.
Collagen deposition (in red)
Heart Valve Engineering
20. easy to setup and handle
high productivity
average fibre diameter: 300 – 1100 nm
fibre diameter span: 100-700 nm to 100-2000 nm
Heart Valve Engineering at Imperial College
Jet spraying to make Polymer nanofibres
21. Cells follow fibre orientation
Sohier J, Carubelli I, et al Biomaterials. 2014 Feb;35(6):1833-44
22. Mechanical properties show the fibres are anisotropic
but still not as strong as native tissue
Sohier J, Carubelli I, et al Biomaterials. 2014 Feb;35(6):1833-44
23. 3D Printing – Tissue Engineering
Murphy and Atala Nature Biotechnol. 2014 Aug;32(8):773-85.
24. Murphy and Atala Nature Biotechnol. 2014 Aug;32(8):773-85.
3D Printing – Tissue Engineering
Scaffold biosynthesis
25. Can we build a whole heart?
Decellularised rat heart repopulated with neonatal cardiomyocytes
26. Clinical Perspective
Myocardial tissue engineering
• Clinical unmet need
• Efficacy
– Who to enrol first?
• LVAD patients
• CABG + LV aneurysmectomy
• Large Anterior MI
• How to measure efficacy?
– Physical
• Durability
• New myocardium
• Electrically coupled
– Functional impact
• Regional
• Global
– Clinical
• Symptoms
• Exercise tolerance
• Hard endpoints
28. Acknowledgements
• Professor Sian Harding
• Professor Cesare Terracciano
• Dr. Dan Stuckey (CMR)
• Dr. Hikaru Ishii (in vivo studies)
• Dr. Ivan Carubelli
(Valve studies)
• Dr. Adrain Chester
(Valve studies)
