Name: a multi-cue bioreactor to evaluate the inflammatory and regenerative capacity of biomaterials under flow and stretch
Uploaded: 2020-12-10T13:00:00
Description: Watch this Scientific Journal Video about A Multi-Cue Bioreactor to Evaluate the Inflammatory and Regenerative Capacity of Biomaterials under Flow and Stretch at JoVE.com

This study is financially supported by ZonMw as part of the LSH 2Treat program (436001003) and the Dutch Kidney Foundation (14a2d507). N.A.K. acknowledges support from the European Research Council (851960). We gratefully acknowledge the Gravitation Program &#8220;Materials Driven Regeneration&#8221;, funded by the Netherlands Organization for Scientific Research (024.003.013).

In the studies described in this protocol, primary human macrophages isolated from peripheral blood buffy coats and human myofibroblasts isolated from the saphenous vein after coronary by-pass surgery have been used44. The buffy coats were obtained from healthy, anonymized volunteers who&#160;provided written informed consent, which was approved by the Sanquin Research Institutional Medical Ethical Committee. The use of human vena saphena cells (HVSCs) was in accordance to the &#8220;Code Proper S...

The bioreactor described herein allows for the systematic evaluation of the contributions of the individual and combined effects of shear stress and cyclic stretch on inflammation and tissue regeneration in tubular resorbable scaffolds. This approach also enables a large variety of analyses to be performed on vascular constructs, as exemplified in the representative results section. These results show the distinctive impact of the different hemodynamic loading regimes (i.e., different combinations of shear and stretch) o...

Cardiovascular tissue engineering (TE) is being pursued as an alternative treatment option to the currently used permanent cardiovascular prostheses (e.g., vascular grafts, heart valve replacements), which are suboptimal for large cohorts of patients1,2,3,4. Much sought-after applications include tissue-engineered vascular grafts (TEVGs)5,6 and heart valves (TEHVs)7,8. Most often, cardiovascular TE methodologies make use of resorbable biomaterials (either natural or synthetic) that serve as an instructive scaffold for the new tissue to be formed. The formation of new tissue can either be engineered completely in vitro, by seeding the scaffold with cells and culturing in a bioreactor prior to implantation (in vitro TE)9,10,11, or directly in situ, in which the synthetic scaffold is implanted without pre-culturing in order to induce the formation of new tissue directly in the body (in situ TE)12,13,14. For both in vitro and in situ cardiovascular TE approaches, successful functional regeneration is dominantly dependent on both the host immune response to the implanted construct and appropriate biomechanical loading.
The importance of biomechanical loading for cardiovascular TE is well-acknowledged15. In the case of cardiovascular implants, the cells that populate the scaffold are exposed to cyclic stretch and shear stresses that arise as a result of the hemodynamic environment. Numerous studies have reported the stimulatory effect of (cyclic) stretch on the formation of matrix components, such as collagen16,17,18,19, glycosaminoglycans (GAGs)20, and elastin21,22, by various cell types. For example, Huang et al. demonstrated that biaxial stretch elevated the deposition and organization of collagen and elastin in in vitro TEVGs by using a vascular bioreactor23. While the emphasis typically lies on stretch as the dominant load, these studies often make use of flow-driven bioreactors in which the sample is also exposed to shear flow. Although relatively little is known about the isolated influence of shear stresses on tissue formation and inflammation in 3D, some data are available. For example, Hinderer et al. and Eoh et al. demonstrated that shear flow, in addition to a 3D scaffold microstructure, was important for the formation of mature elastin by human vascular smooth muscle cells in an in vitro model system24,25. Altogether, these findings illustrate the relevance of both cyclic stretch and shear stress for cardiovascular TE.
Another important determinant for the success or failure of TE implants is the host&#8217;s immune response to the implanted graft26. This is particularly important for material-driven in situ TE strategies, which actually rely on the acute inflammatory response to the scaffold to kickstart the subsequent processes of cellular influx and endogenous tissue formation and remodeling27. The macrophage is a critical initiator of functional tissue regeneration, which has been shown by multiple studies28,29,30. Analogous to wound healing, the regeneration of tissue is governed by paracrine signaling between macrophages and tissue-producing cells such as fibroblasts and myofibroblasts31,32,33. In addition to coordinating new tissue deposition, macrophages are involved in the active resorption of foreign scaffold material34,35. As such, the in vitro macrophage response to a biomaterial has been identified as a predictive parameter for the in vivo success of implants36,37,38.
The macrophage response to an implanted scaffold is dependent on scaffold design features such as material composition and microstructure35,39,40. In addition to scaffold properties, the macrophage response to a scaffold and their crosstalk with myofibroblasts is also impacted by hemodynamic loads. For example, cyclic stretch was shown to be an important modulator of macrophage phenotype41,42,43,44 and the secretion of cytokines43,44,45,46 in 3D electrospun scaffolds. Using a co-culture system of macrophages and vascular smooth muscle cells, Battiston et al. demonstrated that the presence of macrophages led to increased levels of elastin and GAGs and that moderate levels of cyclic stretch (1.07&#8211;1.10) stimulated the deposition of collagen I and elastin47. In previous works, we have&#160;demonstrated that shear stress is an important determinant for monocyte recruitment into 3D electrospun scaffolds48,49, and that both shear stress and cyclic stretch impact the paracrine signaling between human monocytes and mesenchymal stromal cells50. Fahy et al. demonstrated that shear flow increased the secretion of pro-inflammatory cytokines by human monocytes51.
Taken together, the above evidence shows that an adequate understanding of and control over hemodynamic loads is crucial for cardiovascular TE, and that it is important to consider the inflammatory response to achieve this. Numerous bioreactors have been described previously for the in vitro52,53,54,55,56,57,58 or ex vivo59,60,61 culture of cardiovascular tissues. However, all these systems are designed to mimic the physiological hemodynamic loading conditions as much as possible. While this is highly valuable for the purpose of creating cardiovascular tissues in vitro or maintaining ex vivo cultures, such systems do not allow for systematic studies into the individual effects of individual cues. This is because the application of both cyclic stretch and shear stress in these bioreactors is driven by the same pressurized flow, which intrinsically links them. While microsystems that allow for accurate multi-cue mechanical manipulation have been described for 2D substrates62 or 3D hydrogel setups63,64, such setups do not allow for the incorporation of elastomeric 3D biomaterial scaffolds.
Here, we present the application of a tubular bioreactor system that uniquely enables the decoupling of shear stress and cyclic stretch and helps to mechanistically investigate their individual and combined effects. This system allows for testing of a broad variety of tissue engineered vascular grafts (e.g., synthetic or natural origin, different micro-architecture, various porosities). To effectively decouple the application of shear stress and stretch, the key concepts that the bioreactor uses are (1) separation of the control of shear stress and stretch using distinct pump systems and (2) stimulation of the scaffolds in an &#8216;inside-out&#8217; manner with computationally driven dimensions. Flow is applied on the outside surface of the tubular scaffold through the use of a flow pump, whereas circumferential stretch of the scaffold is induced by expanding a silicone tube on which the scaffold is mounted through the use of a separate strain pump. The dimensions of the silicone tube and the glass tube that contains the construct are carefully chosen and validated using computational fluid dynamics simulations, to ensure that the shear stress on the scaffold (due to flow) and the circumferential stretch (due to tube expansion) do not significantly affect each other. This inside-out design has several practical rationales. If stretch is applied by the luminal fluid pressure (similar to physiological loading), it&#160;inherently requires the sample design to be leak-free. In addition, the pressure required to stretch the sample would be completely determined by the sample stiffness, which may vary between samples and within a sample over time, making it difficult to control the stretch. This bioreactor mounts the tissue engineered graft around a silicone tube and allows for wall shear stress (WSS) application on the outer wall of the graft and pressurizes the graft from the inside. This way, equal loading conditions between samples and within samples over time can be ensured, and moreover, the samples are allowed to be leaky, as is common for porous vascular scaffolds19. This inside-out bioreactor is specifically intended for systematic studies on the effects of shear and/or stretch, rather than the engineering of a native-like blood vessel in vitro, for which traditional vascular bioreactor setups are more suitable. See Figure 1A&#8211;B for the bioreactor design drawings, and its corresponding Table 1 for a functional description and rationale behind the main components of the bioreactor.
The use of the bioreactor is demonstrated on the basis&#160;of a series of recent studies by our group in which we investigated the individual and combined influences of shear stress and cyclic stretch on inflammation and tissue formation in resorbable electrospun scaffolds for in situ cardiovascular tissue19,43,44. To that end, we used human macrophages and myofibroblasts either in mono- or in co-culture to simulate the various phases of the in situ regenerative cascade. We have&#160;demonstrated that cytokine secretion by human macrophages is distinctly impacted by both cyclic stretch and shear stress, affecting the matrix deposition and organization by human myofibroblasts in these scaffolds, both via paracrine signaling and direct contact19,43,44. Notably, these studies revealed that in the case of combined application of shear stress and stretch, the effects on tissue formation and inflammation are either dominated by one of the two loads, or there are synergistic effects of both loads. These findings illustrate the relevance of decoupling both loads to gain a better understanding of the contribution of the mechanical environment on TE processes. This understanding can be applied to systematically optimize scaffold design parameters in relevant hemodynamic loading regimes. In addition, the mechanistic data from such well-controlled environments may serve as input for numerical models that are being developed to predict the course of in situ tissue remodeling, as recently reported for TEVGs65 or TEHVs66, to further improve predictive capacity.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr >
			<td >advanced Dulbecco&#8217;s modified EagleMedium (aDMEM)</td>
			<td >Gibco</td>
			<td >12491-015</td>
			<td >cell culture medium for fibroblasts</td>
		</tr>
		<tr >
			<td >Aqua Stabil</td>
			<td >Julabo</td>
			<td >8940012</td>
			<td >prevent microorganism growth in bioreactor-hydraulic reservoir</td>
		</tr>
		<tr >
			<td >Bovine fibrinogen</td>
			<td >Sigma</td>
			<td >F8630</td>
			<td >to prepare fibrinogen gel to seed the cells on the electrospun scaffold</td>
		</tr>
		<tr >
			<td >Bovine thrombin</td>
			<td >Sigma</td>
			<td >T4648</td>
			<td >to prepare fibrinogen gel to seed the cells on the electrospun scaffold</td>
		</tr>
		<tr >
			<td >Centrifuge</td>
			<td >Eppendorf</td>
			<td >5804</td>
			<td >to spin down cells and conditioned medium</td>
		</tr>
		<tr >
			<td >Clamp scissor - &#34;kelly forceps&#34;</td>
			<td >Almedic</td>
			<td >P-422</td>
			<td >clamp the silicone tubing and apply pre-stretch to the scaffold so the scaffold can be sutured into the engraved groove (autoclave at step 1, step 7)</td>
		</tr>
		<tr >
			<td >CO2 cell culture incubators</td>
			<td >Sanyo</td>
			<td >MCO-170AIC-PE</td>
			<td >for cell culturing</td>
		</tr>
		<tr >
			<td >Compressed air reservoir</td>
			<td >Festo</td>
			<td >CRVZS-5</td>
			<td >smoothing air pressure fluctuations and create time delays for pressure build-up</td>
		</tr>
		<tr >
			<td >Custom Matlab script to calculate the maximum stretches</td>
			<td >Matlab</td>
			<td >R2017. The Mathworks, Natick, MA</td>
			<td >calculate the minimum and maximum outer diameter of the electrospun scaffold</td>
		</tr>
		<tr >
			<td >Data acquisition board</td>
			<td >National Instruments</td>
			<td >BNC-2090</td>
			<td >data processing in between amplifier system and computer</td>
		</tr>
		<tr >
			<td >Ethanol</td>
			<td >VWR</td>
			<td >VWRK4096-9005</td>
			<td >to keep sterile working conditions</td>
		</tr>
		<tr >
			<td >Fetal bovine calf serum (FBS)</td>
			<td >Greiner</td>
			<td >758087</td>
			<td >cell culture medium supplement; serum-supplement</td>
		</tr>
		<tr >
			<td >Flow culture chamber compartments, consisting of a pressure conduit with engraved grooves and small holes to apply pressure on silicone tubing, a screw thread, nose cone, top compartment with flow inlet and bottom compartment flow outlet, adapter bushing</td>
			<td >Custom made, Department of Biomedical Engineering, Eindhoven University of Technology</td>
			<td >n.a.</td>
			<td >flow culture chamber compartments (autoclave at step 1, step 7)</td>
		</tr>
		<tr >
			<td >Glass Pasteur pipet</td>
			<td >Assistant</td>
			<td >HE40567002</td>
			<td >apply vacuum on electrospun scaffold (autoclave at step 1)</td>
		</tr>
		<tr >
			<td >Glass tubes of the flow culture chamber</td>
			<td >Custon made, Equipment &#38; Prototype Center, Eindhoven University of Technology</td>
			<td >n.a.</td>
			<td >part of the flow culture chamber (clean and store in 70% ethanol, at step 1 and 7)</td>
		</tr>
		<tr >
			<td >GlutaMax</td>
			<td >Gibco</td>
			<td >35050061</td>
			<td >cell culture medium amino acid supplement, minimizes ammonia build-up</td>
		</tr>
		<tr >
			<td >High speed camera</td>
			<td >MotionScope</td>
			<td >M-5</td>
			<td >to monitor the stretch during culture; time-lapse photographs of the scaffolds are captured at a frequency of 30 Hz for 6 sec (i.e. 3 stretch cycles)</td>
		</tr>
		<tr >
			<td >High speed camera lens - Micro-NIKKOR 55mm f/2.8 - lens</td>
			<td >Nikon</td>
			<td >JAA616AB</td>
			<td >to monitor the stretch during culture; time-lapse photographs of the scaffolds are captured at a frequency of 30 Hz for 6 sec (i.e. 3 stretch cycles)</td>
		</tr>
		<tr >
			<td >Hose clip</td>
			<td >ibidi GmbH</td>
			<td >10821</td>
			<td >block medium flow (autoclave at step 1, step 7)</td>
		</tr>
		<tr >
			<td >Hydraulic reservoir with 8 screw threads for 8 flow culture chambers</td>
			<td >Custom made, Department of Biomedical Engineering, Eindhoven University of Technology</td>
			<td >n.a.</td>
			<td >to apply pressure to the silicone mounted constructs (clean outside with a paper tissue with 70% ethanol, rinse reservoir with 70% ethanol followed by demi water, at step 1 and 7)</td>
		</tr>
		<tr >
			<td >Ibidi pump system (8x) including ibidi pump, PumpControl software, fluidic unit, perfusion set (medium tubing), air pressure tubing, drying bottles with orange silica beads</td>
			<td >ibidi GmbH</td>
			<td >10902</td>
			<td >set up used to control the flow in the flow culture chambers. Note 1: the ibidi pumps were modified by the manufacturer to enable 200 mbar capacity. Note 2: can be replaced by pump system of other manufacturer, as long as same flow regimes can be applied.</td>
		</tr>
		<tr >
			<td >Knives (no.10 sterile blades, individual foil pack) and scalpel handle (stainless steel, individually wrapped)</td>
			<td >Swann Morton</td>
			<td >0301; 0933</td>
			<td >to cut the silicone tubing in the correct size for the scaffold and to cut the suture material</td>
		</tr>
		<tr >
			<td >LabVIEW Software</td>
			<td >National Instruments</td>
			<td >version 2018</td>
			<td >to control the stretch applied to the scaffolds</td>
		</tr>
		<tr >
			<td >Laminar flow biosafety cabinet with UV light</td>
			<td >Labconco</td>
			<td >302310001</td>
			<td >to ensure sterile working conditions. The UV is used to decontaminate everything that cannot be autoclaved, or touched after autoclaving</td>
		</tr>
		<tr >
			<td >Large and small petri dishes</td>
			<td >Greiner</td>
			<td >664-160</td>
			<td >for sterile working conditions</td>
		</tr>
		<tr >
			<td >L-ascorbic acid 2-phosphate (vitamin C)</td>
			<td >Sigma</td>
			<td >A8960</td>
			<td >cell culture medium supplement, important for collagen production</td>
		</tr>
		<tr >
			<td >LED light cold source KL2500</td>
			<td >Zeiss</td>
			<td >Schott AG</td>
			<td >to aid in visualization for the time lapse of the scaffolds during monitoring of the stretch</td>
		</tr>
		<tr >
			<td >Luer (female and male) locks and connectors, white luer caps</td>
			<td >ibidi GmbH</td>
			<td >various, see (https://ibidi.com/26-flow-accessories)</td>
			<td >to close or connect parts of the bioreactor and the ibidi pump (autoclave at step 1, step 7)</td>
		</tr>
		<tr >
			<td >Measuring amplifier (PICAS)</td>
			<td >PEEKEL instruments B.V.</td>
			<td >n.a.</td>
			<td >to amplify the signal from the pressure sensor and feedback to LabView</td>
		</tr>
		<tr >
			<td >Medium reservoir (large syringes 60 mL) and reservoir holders</td>
			<td >ibidi GmbH</td>
			<td >10974</td>
			<td >medium reservoir (autoclave at step 1, step 7)</td>
		</tr>
		<tr >
			<td >Medium tubing with 4.25 mm outer diameter and 1 mm inner diameter</td>
			<td >Rubber BV</td>
			<td >1805</td>
			<td >to allow for a larger flow rate, the ibidi medium tubing with larger diameter is used. Note: the part of medium tubing guided through the fluidic unit valves are the same as the default ibidi medium tubing</td>
		</tr>
		<tr >
			<td >Motion Studio Software</td>
			<td >Idtvision</td>
			<td >2.15.00</td>
			<td >to make the high speed time lapse images for stretch monitoring</td>
		</tr>
		<tr >
			<td >Needle (19G)</td>
			<td >BD Microlance</td>
			<td >301700</td>
			<td >together with thin flexible tubing used to fill the hydraulic reservoir with ultrapure water without adding air bubbles</td>
		</tr>
		<tr >
			<td >Needle driver</td>
			<td >Adson</td>
			<td >2429218</td>
			<td >to handle the needle of the nylon suture through the silicone tube (autoclave at step 1, step 7)</td>
		</tr>
		<tr >
			<td >Paper tissues</td>
			<td >Kleenex</td>
			<td >38044001</td>
			<td >for cleaning of the equipment with 70% ethanol</td>
		</tr>
		<tr >
			<td >Parafilm</td>
			<td >Sigma</td>
			<td >P7793-1EA</td>
			<td >quick fix if leakage occurs</td>
		</tr>
		<tr >
			<td >Penicillin/streptomycin (P/S)</td>
			<td >Lonza</td>
			<td >DE17-602E</td>
			<td >cell culture medium supplement; prevent bacterial contamination</td>
		</tr>
		<tr >
			<td >Phosphate Buffered Saline (PBS)</td>
			<td >Sigma</td>
			<td >P4417-100TAB</td>
			<td >for storage and washing steps (autoclave at step 1)</td>
		</tr>
		<tr >
			<td >Plastic containers (60 mL) with red screw caps</td>
			<td >Greiner</td>
			<td >206202</td>
			<td >to prepare the fibrinogen solution</td>
		</tr>
		<tr >
			<td >Pneumatic cylinder</td>
			<td >Festo</td>
			<td >AEVC-20-10-I-P</td>
			<td >to actuate the Teflon bellow (clean with a paper tissue with 70% ethanol at step 1 and 7)</td>
		</tr>
		<tr >
			<td >Polycaprolactone bisurea (PCL-BU) tubular scaffolds (3 mm inner diameter, 200 &#181;m wall thickness, 20 mm length)</td>
			<td >SyMO-Chem, Eindhoven, The Netherlands</td>
			<td >n.a.</td>
			<td >produced using electrospinning from 15% (w/w) chloroform (Sigma; 372978) polymer solutions. See Van Haaften et al Tissue Engineering Part C (2018) for more details</td>
		</tr>
		<tr >
			<td >Pressure conduit without holes (for static control)</td>
			<td >Custom made, Department of Biomedical Engineering, Eindhoven University of Technology</td>
			<td >n.a.</td>
			<td >to mount electrospun tubes on silicon tubing (autoclave at step 1, step 7)</td>
		</tr>
		<tr >
			<td >Pressure sensor and transducer</td>
			<td >BD</td>
			<td >TC-XX and P 10 EZ</td>
			<td >the air pressure going to the pneumatic actuated pump is raised until it reaches the set pressure</td>
		</tr>
		<tr >
			<td >Proportional air pressure control valve and pressure sensor</td>
			<td >Festo</td>
			<td >MPPES-3-1/8-2-010, 159596</td>
			<td >provides compressed air to the pneumatic actuated pump</td>
		</tr>
		<tr >
			<td >Roswell Park Memorial Institute 1640 (RPMI-1640)</td>
			<td >Gibco</td>
			<td >A1049101</td>
			<td >cell culture medium for monocyte/macrophage</td>
		</tr>
		<tr >
			<td >Safe lock Eppendorf tubes (1.5 mL)</td>
			<td >Eppendorf</td>
			<td >30120086</td>
			<td >multiple applications (autoclave at step 1)</td>
		</tr>
		<tr >
			<td >Sodium dodecyl sulfate solution 20%</td>
			<td >Sigma</td>
			<td >5030</td>
			<td >Used to clean materials, at a concentration of 0.1%.&#160;&#160;</td>
		</tr>
		<tr >
			<td >Silicone O-rings</td>
			<td >Technirub</td>
			<td >1250S</td>
			<td >to prevent leakage (autoclave at step 1, step 7)</td>
		</tr>
		<tr >
			<td >Silicone tubing (2.8 mm outer diameter, 400 um wall thickness)</td>
			<td >Rubber BV</td>
			<td >1805</td>
			<td >to mount the electrospun tubes on the pressure conduits (autoclave at step 1)</td>
		</tr>
		<tr >
			<td >Sterile tube (15 mL)</td>
			<td >Falcon</td>
			<td >352095</td>
			<td >multiple applications</td>
		</tr>
		<tr >
			<td >Suture, 5-0 prolene with pre-attached taper point needle</td>
			<td >Ethicon, Johnson&#38;Johnson</td>
			<td >EH7404H</td>
			<td >Prolene suture wire 5-0 (75cm length, TF taper point needle, 1/2 circle, 13 mm needle length)</td>
		</tr>
		<tr >
			<td >Syringe (24 mL)</td>
			<td >B. Braun Melsungen AG</td>
			<td >2057932</td>
			<td >to add the ultrapure water or medium to the hydraulic reservoir or flow culture chamber</td>
		</tr>
		<tr >
			<td >Syringe filter (0.2 &#181;m)</td>
			<td >Satorius</td>
			<td >17597-K</td>
			<td >to filter the fibrinogen solution</td>
		</tr>
		<tr >
			<td >T150 cell culture flask with filter cap</td>
			<td >Nunc</td>
			<td >178983</td>
			<td >to degas culture medium</td>
		</tr>
		<tr >
			<td >T75 Cell culture flask with filter cap</td>
			<td >Nunc</td>
			<td >156499</td>
			<td >to culture static control samples</td>
		</tr>
		<tr >
			<td >Teflon bellow</td>
			<td >Custom made, Department of Biomedical Engineering, Eindhoven University of Technology</td>
			<td >n.a.</td>
			<td >to load the hydraulic reservoir (clean outside with a paper tissue with 70% ethanol at step 1 and 7)</td>
		</tr>
		<tr >
			<td >Tray (stainless steel)</td>
			<td >PolarWare</td>
			<td >15-248</td>
			<td >for easy transport of the fluidic culture chambers and the bioreactor from incubator to laminar flow cabinet and back (clean with a paper tissue with 70% ethanol before and after use)</td>
		</tr>
		<tr >
			<td >Tweezers</td>
			<td >Wironit</td>
			<td >4910</td>
			<td >sterile handling of individual parts (autoclave at step 1 and 7)</td>
		</tr>
		<tr >
			<td >Ultrapure water</td>
			<td >Stakpure</td>
			<td >Omniapure UV 18200002</td>
			<td >to correct for medium evaporation, mixed with aqua stabil mixed and used as hydraulic fluid. (autoclave ultrapure water at step 1)</td>
		</tr>
		<tr >
			<td >UV light</td>
			<td >Philips</td>
			<td >TUV 30W/G30 T8</td>
			<td >for decontamination of grafts and bioreactor parts before seeding</td>
		</tr>
	</tbody>
</table>

a multi-cue bioreactor to evaluate the inflammatory and regenerative capacity of biomaterials under flow and stretch

The use of resorbable biomaterials to induce regeneration directly in the body is an attractive strategy from a translational perspective. Such materials induce an inflammatory response upon implantation, which is the driver of subsequent resorption of the material and the regeneration of new tissue. This strategy, also known as in situ tissue engineering, is pursued to obtain cardiovascular replacements such as tissue-engineered vascular grafts. Both the inflammatory and the regenerative processes are determined by the local biomechanical cues on the scaffold (i.e., stretch and shear stress). Here, we describe in detail the use of a custom-developed bioreactor that uniquely enables the decoupling of stretch and shear stress on a tubular scaffold. This allows for the systematic and standardized evaluation of the inflammatory and regenerative capacity of tubular scaffolds under the influence of well-controlled mechanical loads, which we demonstrate on the basis of a dynamic co-culture experiment using human macrophages and myofibroblasts. The key practical steps in this approach&#8212;the construction and setting up of the bioreactor, preparation of the scaffolds and cell seeding, application and maintenance of stretch and shear flow, and sample harvesting for analysis&#8212;are discussed in detail.

This bioreactor was developed to study the individual and combined effects of shear stress and cyclic stretch on vascular tissue growth and remodeling in 3D biomaterial scaffolds. The design of the bioreactor allows for culturing up to eight vascular constructs under various loading conditions (Figure 1A). The vascular constructs are positioned in a flow culture chamber (Figure 1B) in which both the circumferential stretch and WSS can be independently controlled...

Watch this Scientific Journal Video about A Multi-Cue Bioreactor to Evaluate the Inflammatory and Regenerative Capacity of Biomaterials under Flow and Stretch at JoVE.com

A Multi-Cue Bioreactor to Evaluate the Inflammatory and Regenerative Capacity of Biomaterials under Flow and Stretch

The goal of this protocol is to execute a dynamic co-culture of human macrophages and myofibroblasts in tubular electrospun scaffolds to investigate material-driven tissue regeneration, using a bioreactor which enables the decoupling of shear stress and cyclic stretch.

The use of resorbable biomaterials to induce regeneration directly in the body is an attractive strategy from a translational perspective. Such materials ...

So far, it has been really difficult to identify the cause and effect relationships between hemodynamics and vascular tissue regeneration. And this has because it's challenging to control the individual mechanical loads. This bioreactor enables us to mechanistically investigate the individual and combined effects of sheer stress and cyclic stretch on the regenerative potential of a broad variety of tissue engineered vascular grafts.Demonstrating this procedure will be Suzanne Koch, a PhD candidate in our group. And Dr.Tamar Wissing who is a postdoctoral researcher from our laboratory. To mount the electro spun scaffold onto the silicone tubing, thread a 4-0 prolene suture into one end of a piece of silicone tubing and out of the other.Make a small knot on both sides of the tube leaving approximately 10 centimeters of wire on both knots and make a third knot on top of the two. After removing a suture needle, trim the edges of the silicone tubing into a triangular shape and make a final knot at the end of the two 10 centimeter wires. Dip the electro spun scaffold in 30%ethanol and place the scaffold over one end of free suture wire.Next, gently stretch both sides of the silicone tubing and the 10 centimeter suture knot while second researcher uses tweezers with a smooth inner tip to gently slide the electro spun scaffold over the tubing. Slowly release the stretch on the silicone tubing while simultaneously smoothing the electro spun scaffold with the tweezers. And dip the scaffold and silicone tubing in ultra pure water two times.Construct the bottom compartment and make sure that the O-ring is properly placed. Place an adaptor bushing in the upper part of the bottom compartment and place the pressure conduit with holes through the bottom compartment. Lace the silicone O-ring around the lower end of the pressure conduit to prevent leakage.And screw the lower part of the bottom compartment to the upper part of the bottom compartment to secure the pressure conduit. Make sure that the lower engraved groove of the pressure conduit is approximately three to five millimeters above the edge of the adapter bushing of the bottom compartment. Pull the silicone tube with the electro spun scaffold over the pressure conduit and make a nod and the suture wire at the lower end of the electro spun scaffold, at the location of the engraved groove on the pressure conduit.Make a second nod at the opposite side to tightly secure the silicone tubing with the electro spun graft. And placing a scissor clamp equipped with a rule at the upper end of the silicone tubing, pull the scissor clamp upwards in a consistent manner and gently pull on the electric spawn scaffold to remove any wrinkles. Use a suture wire to make two knots at both ends of the scaffold at the upper engraved groove of the pressure conduit.When both knots have been made, release the scissor clamp and use a knife to remove any excess silicone tubing. Screw the nose cones on the screw thread of the pressure conduits for the samples that will be dynamically loaded. Dip the pressure conduit, tubing, and scaffold one time in 30%ethanol and two times in ultrapure water to pre-wet the setup.Place the glass tube over the pressure conduit and push gently on the bottom compartment to secure the glass tube in place. Then place the flow straightener, a silicone O-ring, and adapter bushing in the top compartment. And secure the compartment over the open end of the glass tube.Remove the male lure plug from the flow outlet, work in a sterile laminar flow cabinet. Open the white lure cap and place an ethanol soak tissue in front of the flow outlet. Deconstruct the flow culture chamber by taking off the glass tube with the top compartment.Place a vacuum pasture pipe add onto the electro spun scaffold to remove as much medium as possible. And add fibrinogen solution at a one-to-one ratio with the thrombin supplemented cell suspension. Pipette the solution up and down one time and immediately drip the solution over the full length of the scaffold.When all of the cells have been delivered, slowly move the scaffold from left to right and up and down to achieve an even distribution of the cells. When both sides of the scaffold have been seeded, carefully reconstruct the flow culture chamber by putting the glass tube and top compartment back. And place the flow culture chamber into the incubator to let the fiber solidify.To couple the bioreactor to the pump system, place the flow culture chamber on one of the eight screw threads on the bioreactor base. And place a host clip on the medium tubing. Remove the white lure cap, covering the flow inlet of the top compartment of the flow culture chamber and remove the female lure coupler of the medium tubing.Connect the medium tubing with one side of the flow inlet on the top compartment. And the other side with the flow outlet at the bottom compartment. Transfer the complete setup from the laminar flow cabinet to the incubator.And connect a fluidic units and the bioreactor base to the air pressure tubing and electric cable. Start the software and initialize the pumps. Start the medium flow for the samples one by one.Then change the strain pump parameters to the desired settings and start the strain. Monitor the stretch applied to the scaffold every other day. The monitoring of stretch and wall shear stress over longterm culture periods shows that these values can be maintained at relatively constant levels over a period of up to 20 days.After three days of hemodynamic loading, immunofluorescent staining reveals a homogenous distribution of monocyte derived macrophages and myofibroblasts throughout the scaffold. After 20 days of co-culture, cyclic stretch results in the deposition of more numerous and thicker collagen type 1 fibers. While in the combined hemodynamic load group, the cyclic stretch effect is overruled by sheer stress resulting in a less pronounced collagen type 1 deposition.After eight days of macrophage monoculture, fiber erosion and fiber cleavage are observed in all of the hemodynamic loading regimes with the most pronounced resorption observed in the static group, and the least pronounced resorption observed in the sheer stress group. Both cyclic stretch and a sheer stress impact the cytokine secretion profile of the co-culture setup. Interestingly, the combined effects of both loads show either dominance of one of the two loads or synergistic effects of both loads.Co-culture experiments also show that the mechanical environment and resulting loading dependent inflammatory environments modulate the phenotype of the myofibroblasts. Furthermore, the gene expression patterns of contractile marker alpha smooth muscle actin correlate with protein synthesis. The most important thing when performing this protocol is that's what the application of stretch, it's essential that your setup is leak-free.

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JoVE Journal

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