We thank Dr. Nicolai Konow for providing the data used in this study. Funded by NSF IOS-2016049 and NSF DBI-2021832.

"Avatar"- Optimized Ex Vivo Work Loop Experiment to Emulate In Vivo Muscle Force

<ol>
	<li>Dickinson, M. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+Animals+move:+an+integrative+view.">How Animals move: an integrative view.</a> Science. 288 (5463), 100-106 (2000).</li><li>Sponberg, S., Abbott, E., Sawicki, G. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Perturbing+the+muscle+work+loop+paradigm+to+unravel+the+neuromechanics+of+unsteady+locomotion.">Perturbing the muscle work loop paradigm to unravel the neuromechanics of unsteady locomotion.</a> Journal of Experimental Biology. 226 (7), 243561 (2023).</li><li>Daley, M. A., Biewener, A. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Running+over+rough+terrain+reveals+limb+control+for+intrinsic+stability.">Running over rough terrain reveals limb control for intrinsic stability.</a> Proceedings of the National Academy of Sciences. 103 (42), 15681-15686 (2006).</li><li>Daley, M. A., Usherwood, J. R., Felix, G., Biewener, A. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Running+over+rough+terrain:+guinea+fowl+maintain+dynamic+stability+despite+a+large+unexpected+change+in+substrate+height.">Running over rough terrain: guinea fowl maintain dynamic stability despite a large unexpected change in substrate height.</a> Journal of Experimental Biology. 209 (1), 171-187 (2006).</li><li>Daley, M. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Understanding+the+agility+of+running+birds:+Sensorimotor+and+mechanical+factors+in+avian+bipedal+locomotion.">Understanding the agility of running birds: Sensorimotor and mechanical factors in avian bipedal locomotion.</a> Integrative and Comparative Biology. 58 (5), 884-893 (2018).</li><li>Biewener, A. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Animal locomotion. , (2003).</li><li>Robertson, B. D., Sawicki, G. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Unconstrained+muscle-tendon+workloops+indicate+resonance+tuning+as+a+mechanism+for+elastic+limb+behavior+during+terrestrial+locomotion.">Unconstrained muscle-tendon workloops indicate resonance tuning as a mechanism for elastic limb behavior during terrestrial locomotion.</a> Proceedings of the National Academy of Sciences. 112 (43), E5891-E5898 (2015).</li><li>Josephson, R. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mechanical+power+output+from+striated+muscle+during+cyclic+contraction.">Mechanical power output from striated muscle during cyclic contraction.</a> The Journal of Experimental Biology. 114, 493-512 (1985).</li><li>Ahn, A. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+muscles+function+-+the+work+loop+technique.">How muscles function - the work loop technique.</a> Journal of Experimental Biology. 215 (7), 1051-1052 (2012).</li><li>Sawicki, G. S., Robertson, B. D., Azizi, E., Roberts, T. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Timing+matters:+tuning+the+mechanics+of+a+muscle-tendon+unit+by+adjusting+stimulation+phase+during+cyclic+contractions.">Timing matters: tuning the mechanics of a muscle-tendon unit by adjusting stimulation phase during cyclic contractions.</a> Journal of Experimental Biology. 218 (19), 3150-3159 (2015).</li><li>Libby, T., Chukwueke, C., Sponberg, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=History-dependent+perturbation+response+in+limb+muscle.">History-dependent perturbation response in limb muscle.</a> Journal of Experimental Biology. 223 (1), (2020).</li><li>Askew, G. N., Marsh, R. L., Ellington, C. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+mechanical+power+output+of+the+flight+muscles+of+blue-breasted+quail+(+Coturnix+chinensis+)+during+take-off.">The mechanical power output of the flight muscles of blue-breasted quail ( Coturnix chinensis ) during take-off.</a> Journal of Experimental Biology. 204 (21), 3601-3619 (2001).</li><li>Sponberg, S., Libby, T., Mullens, C. H., Full, R. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Shifts+in+a+single+muscle's+control+potential+of+body+dynamics+are+determined+by+mechanical+feedback.">Shifts in a single muscle's control potential of body dynamics are determined by mechanical feedback.</a> Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences. 366 (1570), 1606-1620 (2011).</li><li>Loeb, G. E., Brown, I. E., Cheng, E. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+hierarchical+foundation+for+models+of+sensorimotor+control.">A hierarchical foundation for models of sensorimotor control.</a> Experimental Brain Research. 126 (1), 1-18 (1999).</li><li>Wakeling, J. M., Tijs, C., Konow, N., Biewener, A. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modeling+muscle+function+using+experimentally+determined+subject-specific+muscle+properties.">Modeling muscle function using experimentally determined subject-specific muscle properties.</a> Journal of Biomechanics. 117, 110242 (2021).</li><li>The Mathworks. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=MATLAB:R2021a.">MATLAB:R2021a.</a> The Mathworks. , (2021).</li><li>Tenan, M. S., Tweedell, A. J., Haynes, C. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+statistical+and+standard+algorithms+for+detecting+muscle+onset+with+surface+electromyography.">Analysis of statistical and standard algorithms for detecting muscle onset with surface electromyography.</a> PLOS ONE. 12 (5), 0177312 (2017).</li><li>Roberts, T. J., Gabald&#243;n, A. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interpreting+muscle+function+from+EMG:+lessons+learned+from+direct+measurements+of+muscle+force.">Interpreting muscle function from EMG: lessons learned from direct measurements of muscle force.</a> Integrative and Comparative Biology. 48 (2), 312-320 (2008).</li><li>Rice, N., Bemis, C. M., Daley, M. A., Nishikawa, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Understanding+muscle+function+during+perturbed+in+vivo+locomotion+using+a+muscle+avatar+approach.">Understanding muscle function during perturbed in vivo locomotion using a muscle avatar approach.</a> Journal of Experimental Biology. 226 (13), 244721 (2023).</li><li>Silva Cornachione, A., Ca&#231;&#227;oOliveiraBenedini-Elias, P., Cristina Polizello , P., C&#233;sar Carvalho, L., Cl&#225;udiaMattiello-Sverzut, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterization+of+Fiber+types+in+different+muscles+of+the+hindlimb+in+female+weanling+and+adult+wistar+rats.">Characterization of Fiber types in different muscles of the hindlimb in female weanling and adult wistar rats.</a> Acta Histochemica Et Cytochemica. 44 (2), 43-50 (2011).</li><li>H&#228;m&#228;l&#228;inen, N., Pette, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+histochemical+profiles+of+fast+fiber+types+IIB,+IID,+and+IIA+in+skeletal+muscles+of+mouse,+rat,+and+rabbit.">The histochemical profiles of fast fiber types IIB, IID, and IIA in skeletal muscles of mouse, rat, and rabbit.</a> Journal of Histochemistry &amp; Cytochemistry. 41 (5), 733-743 (1993).</li><li>Charles, J. P., Cappellari, O., Spence, A. J., Hutchinson, J. R., Wells, D. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Musculoskeletal+geometry,+muscle+architecture+and+functional+specialisations+of+the+mouse+hindlimb.">Musculoskeletal geometry, muscle architecture and functional specialisations of the mouse hindlimb.</a> PLOS ONE. 11 (4), 0147669 (2016).</li><li>Nishikawa, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Titin:+A+Tunable+spring+in+active+muscle.">Titin: A Tunable spring in active muscle.</a> Physiology (Bethesda, Md). 35 (3), 209-217 (2020).</li><li>Dick, T. J. M., Biewener, A. A., Wakeling, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+human+gastrocnemius+forces+predicted+by+Hill-type+muscle+models+and+estimated+from+ultrasound+images).">Comparison of human gastrocnemius forces predicted by Hill-type muscle models and estimated from ultrasound images).</a> The Journal of Experimental Biology. 220, 1643-1653 (2017).</li><li>Daley, M. A., Biewener, A. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Leg+muscles+that+mediate+stability:+mechanics+and+control+of+two+distal+extensor+muscles+during+obstacle+negotiation+in+the+guinea+fowl.">Leg muscles that mediate stability: mechanics and control of two distal extensor muscles during obstacle negotiation in the guinea fowl.</a> Philosophical Transactions of the Royal Society B: Biological Sciences. 366 (1570), 1580-1591 (2011).</li><li>Seth, A., Sherman, M., Reinbolt, J. A., Delp, S. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=OpenSim:+a+musculoskeletal+modeling+and+simulation+framework+for+in+silico+investigations+and+exchange.">OpenSim: a musculoskeletal modeling and simulation framework for in silico investigations and exchange.</a> Procedia IUTAM. 2, 212-232 (2011).</li><li>Sandercock, T. G., Heckman, C. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Doublet+potentiation+during+eccentric+and+concentric+contractions+of+cat+soleus+muscle.">Doublet potentiation during eccentric and concentric contractions of cat soleus muscle.</a> Journal of Applied Physiology. 82 (4), 1219-1228 (1997).</li><li>Marsh, R. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+muscles+deal+with+real-world+loads:+the+influence+of+length+trajectory+on+muscle+performance.">How muscles deal with real-world loads: the influence of length trajectory on muscle performance.</a> The Journal of Experimental Biology. 202, 3377-3385 (1999).</li><li>Hessel, A. L., Monroy, J. A., Nishikawa, K. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Non-cross+bridge+viscoelastic+elements+contribute+to+muscle+force+and+work+during+stretch-shortening+cycles:+evidence+from+whole+muscles+and+permeabilized+fibers.">Non-cross bridge viscoelastic elements contribute to muscle force and work during stretch-shortening cycles: evidence from whole muscles and permeabilized fibers.</a> Frontiers in Physiology. 12, 648019 (2021).</li><li>Lindstedt, S., Nishikawa, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Huxleys'+missing+filament:+form+and+function+of+titin+in+vertebrate+striated+muscle.">Huxleys' missing filament: form and function of titin in vertebrate striated muscle.</a> Annual Review of Physiology. 79, 145-166 (2017).</li><li>Abbate, F., De Ruiter, C. J., Offringa, C., Sargeant, A. J., De Haan, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+situ+rat+fast+skeletal+muscle+is+more+efficient+at+submaximal+than+at+maximal+activation+levels.">In situ rat fast skeletal muscle is more efficient at submaximal than at maximal activation levels.</a> Journal of Applied Physiology. 92 (5), 2089-2096 (2002).</li><li>Eng, C. M., Smallwood, L. H., Rainiero, M. P., Lahey, M., Ward, S. R., Lieber, R. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Scaling+of+muscle+architecture+and+fiber+types+in+the+rat+hindlimb.">Scaling of muscle architecture and fiber types in the rat hindlimb.</a> Journal of Experimental Biology. 211 (14), 2336-2345 (2008).</li><li>Manuel, M., Chardon, M., Tysseling, V., Heckman, C. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Scaling+of+motor+output,+from+mouse+to+humans.">Scaling of motor output, from mouse to humans.</a> Physiology (Bethesda, Md). 34 (1), 5-13 (2019).</li><li>Zajac, F. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Muscle+and+tendon:+properties,+models,+scaling,+and+application+to+biomechanics+and+motor+control.">Muscle and tendon: properties, models, scaling, and application to biomechanics and motor control.</a> Critical Reviews in Biomedical Engineering. 17 (4), 359-411 (1989).</li><li>Rice, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Understanding+muscle+function+during+in+vivo+locomotion+using+a+novel+muscle+avatar+approach.">Understanding muscle function during in vivo locomotion using a novel muscle avatar approach.</a> ProQuest Dissertations and Theses. , (2020).</li></ol>

All authors acknowledge there is no conflict of interest.

While organisms move seamlessly across landscapes, the underlying loads and strains that the muscles experience vary drastically1,6,23. During both in vivo locomotion1,24 and in &#34;avatar&#34; experiments, muscles are stimulated submaximally under cyclical, non-steady conditions. The isometric force-length and isotonic force-velocity relationships are not well...

Moving animals achieve impressive athletic feats of endurance, speed, and agility in complex environments. Animal locomotion is particularly impressive in contrast to human-engineered machines-the stability and agility of current-legged robots, prostheses, and exoskeletons remain poor compared to animals. Legged locomotion in natural terrain requires precise control and rapid adjustments to alter the speed and maneuver environmental features that act as unexpected perturbations1,2,3,4. Yet, understanding non-steady locomotion is inherently challenging because the dynamics depend on complex interactions between the physical environment, musculoskeletal mechanics, and sensorimotor control1,2. Legged locomotion requires responding to unexpected perturbations with rapid multi-modal processing of sensory information and coordinated actuation of limbs and joints1,5. Ultimately, movement is made possible by muscles producing force via intrinsic mechanical properties of the musculoskeletal system as well as from neural control1,5,6,7. An outstanding question of neuromechanics is how these factors interact to produce coordinated movement in response to unexpected perturbations. The following technique utilizes muscle&#39;s intrinsic mechanical response to deformation using in vivo strain trajectories during controllable ex vivo experiments with an &#34;avatar&#34; muscle.
The muscle work loop technique has provided an important framework for understanding intrinsic muscle mechanics during cyclical movements8,9,10. The traditional work loop technique drives muscles through predefined, typically sinusoidal, strain trajectories using frequencies and activation patterns measured during in vivo experiments2,8,9,11. Using sinusoidal length trajectories can realistically estimate work and power output during flight12 and swimming2 under conditions where animals do not undergo rapid changes in strain trajectories due to interaction with the environment and musculoskeletal kinematics. However, in vivo muscle strain trajectories during legged locomotion arise dynamically from interactions among neural activation, musculoskeletal kinematics, and loads applied by the environment5,7,13,14. A more realistic work loop technique is needed to emulate loads, strain trajectories, and force production that corresponds to in vivo muscle-tendon dynamics and provides insight into how intrinsic muscle mechanics and neural control interact to produce coordinated movement in the face of perturbations.
Here, we present a novel way to emulate in vivo muscle forces during treadmill locomotion by using an &#34;avatar&#34; muscle from a laboratory rodent during controlled ex vivo experiments with in vivo strain trajectories that represent time-varying in vivo loads. Using the measured in vivo strain trajectories from a target muscle on muscles from a laboratory animal during controlled ex vivo experiments will emulate loads experienced during locomotion. In the experiments described here, the ex vivo mouse extensor digitorum longus (EDL) muscle is used as an &#34;avatar&#34; for the in vivo rat medial gastrocnemius (MG) muscle during walking, trotting, and galloping on a treadmill13. This approach is similar to the work-loop technique, except that in vivo strain trajectories are scaled appropriately and imposed on ex vivo mouse muscles attached to a servo motor. While mouse EDL muscles differ in size, fiber type, and architecture compared to the rat MG, it is possible to control for these differences. The &#34;avatar&#34; technique allows one to: (1) emulate in vivo strain, activation, stride frequency, and work-loop patterns; (2) vary these patterns to match in vivo force responses most accurately; and (3) vary specific features of strain and/or activation in controlled combinations to test mechanistic hypotheses.

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			<td>Jackson Laboratory</td>
			<td>B6C3Fe a/a Ttn mdm/J</td>
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"avatar", a modified ex vivo work loop experiments using in vivo strain and activation

Movement behaviors are emergent features of dynamic systems that result from muscle force production and work output. The interplay between neural and mechanical systems occurs at all levels of biological organization concurrently, from the tuning of leg muscle properties while running to the dynamics of the limbs interacting with the ground. Understanding the conditions under which animals shift their neural control strategies toward intrinsic muscle mechanics (&#39;preflexes&#39;) in the control hierarchy would allow muscle models to predict in vivo muscle force and work more accurately. To understand in vivo muscle mechanics, ex vivo investigation of muscle force and work under dynamically varying strain and loading conditions similar to in vivo locomotion is required. In vivo strain trajectories typically exhibit abrupt changes (i.e., strain and velocity transients) that arise from interactions among neural activation, musculoskeletal kinematics, and loads applied by the environment. The principal goal of our &#34;avatar&#34; technique is to investigate how muscles function during abrupt changes in strain rate and loading when the contribution of intrinsic mechanical properties to muscle force production may be highest. In the &#34;avatar&#34; technique, the traditional work-loop approach is modified using measured in vivo strain trajectories and electromyographic (EMG) signals from animals during dynamic movements to drive ex vivo muscles through multiple stretch-shortening cycles. This approach is similar to the work-loop technique, except that in vivo strain trajectories are scaled appropriately and imposed on ex vivo mouse muscles attached to a servo motor. This technique allows one to: (1) emulate in vivo strain, activation, stride frequency, and work-loop patterns; (2) vary these patterns to match in vivo force responses most accurately; and (3) vary specific features of strain and/or activation in controlled combinations to test mechanistic hypotheses.

The goal of the &#34;avatar&#34; experiments is to replicate in vivo force production and work output as closely as possible during ex vivo work loop experiments. This study chose to use mouse EDL as an &#34;avatar&#34; for rat MG because mouse EDL and rat MG are both comprised of mostly of fast-twitch muscles20,21. Both muscles are primary movers of the ankle joint (EDL ankle dorsiflexor, MG ankle plantarflexor) with similar pennation angles (m...

Watch this Scientific Journal Video about Bridging the Gap Between In Vivo and Ex Vivo Studies with the "Avatar" Technique to Advance Muscle Mechanics Research at JoVE.com

Author Spotlight: Bridging the Gap Between In Vivo and Ex Vivo Studies with the "Avatar" Technique to Advance Muscle Mechanics Research 

This article details the methodology for emulating in vivo muscle force production during ex vivo work loop experiments using an "avatar" muscle from a laboratory rodent to assess the contributions of strain transients and activation to the muscle force response.

"Avatar", a Modified Ex vivo Work Loop Experiments Using In vivo Strain and Activation

Movement behaviors are emergent features of dynamic systems that result from muscle force production and work output. The interplay between neural and ...

avatar-modified-ex-vivo-work-loop-experiments-using-vivo-strain

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658 visualizações.  Northern Arizona University. This article details the methodology for emulating in vivo muscle force production during ex vivo work loop experiments using an "avatar" muscle from a laboratory rodent to assess the contributions of strain transients and activation to the muscle force response. 

Vídeo: Author Spotlight: Bridging the Gap Between In Vivo and Ex Vivo Studies with the "Avatar" Technique to Advance Muscle Mechanics Research 

Design of a Cyclic Pressure Bioreactor for the Ex Vivo Study of Aortic Heart Valves

The aortic valve, located between the left ventricle and the aorta, allows for unidirectional blood flow, preventing backflow into the ventricle. Aortic valve leaflets are composed of interstitial cells suspended within an extracellular matrix (ECM) and are lined with an endothelial cell monolayer. The valve withstands a harsh, dynamic environment and is constantly exposed to shear, flexion, tension, and compression. Research has shown calcific lesions in diseased valves occur in areas of high mechanical stress as a result of endothelial disruption or interstitial matrix damage1-3. Hence, it is not surprising that epidemiological studies have shown high blood pressure to be a leading risk factor in the onset of aortic valve disease4. 
The only treatment option currently available for valve disease is surgical replacement of the diseased valve with a bioprosthetic or mechanical valve5. Improved understanding of valve biology in response to physical stresses would help elucidate the mechanisms of valve pathogenesis. In turn, this could help in the development of non-invasive therapies such as pharmaceutical intervention or prevention. Several bioreactors have been previously developed to study the mechanobiology of native or engineered heart valves6-9. Pulsatile bioreactors have also been developed to study a range of tissues including cartilage10, bone11 and bladder12. The aim of this work was to develop a cyclic pressure system that could be used to elucidate the biological response of aortic valve leaflets to increased pressure loads. 
The system consisted of an acrylic chamber in which to place samples and produce cyclic pressure, viton diaphragm solenoid valves to control the timing of the pressure cycle, and a computer to control electrical devices. The pressure was monitored using a pressure transducer, and the signal was conditioned using a load cell conditioner. A LabVIEW program regulated the pressure using an analog device to pump compressed air into the system at the appropriate rate. The system mimicked the dynamic transvalvular pressure levels associated with the aortic valve; a saw tooth wave produced a gradual increase in pressure, typical of the transvalvular pressure gradient that is present across the valve during diastole, followed by a sharp pressure drop depicting valve opening in systole. The LabVIEW program allowed users to control the magnitude and frequency of cyclic pressure. The system was able to subject tissue samples to physiological and pathological pressure conditions. This device can be used to increase our understanding of how heart valves respond to changes in the local mechanical environment.

Design of a Cyclic Pressure Bioreactor for the Ex Vivo Study of Aortic Heart Valves

A cyclic pressure bioreactor capable of subjecting heart valve tissue to physiological and pathological pressure conditions has been designed. A LabVIEW program allows users to control pressure magnitude, amplitude and frequency. This device can be used to study the mechanobiology of heart valve tissue or isolated cells.

Projeto de um biorreator de pressão cíclica para o Ex Vivo Estudo de válvulas cardíacas Aórtica

The aortic valve, located between the left ventricle and the aorta, allows for unidirectional blood flow, preventing backflow into the ventricle. Aortic ...

Bioengenharia

Ex vivo Mimicry of Normal and Abnormal Human Hematopoiesis

Hematopoietic stem cells require a unique microenvironment in order to sustain blood cell formation1; the bone marrow (BM) is a complex three-dimensional (3D) tissue wherein hematopoiesis is regulated by spatially organized cellular microenvironments termed niches2-4. The organization of the BM niches is critical for the function or dysfunction of normal or malignant BM5. Therefore a better understanding of the in vivo microenvironment using an ex vivo mimicry would help us elucidate the molecular, cellular and microenvironmental determinants of leukemogenesis6.
Currently, hematopoietic cells are cultured in vitro in two-dimensional (2D) tissue culture flasks/well-plates7 requiring either co-culture with allogenic or xenogenic stromal cells or addition of exogenous cytokines8. These conditions are artificial and differ from the in vivo microenvironment in that they lack the 3D cellular niches and expose the cells to abnormally high cytokine concentrations which can result in differentiation and loss of pluripotency9,10.
Herein, we present a novel 3D bone marrow culture system that simulates the in vivo 3D growth environment and supports multilineage hematopoiesis in the absence of exogenous growth factors. The highly porous scaffold used in this system made of polyurethane (PU), facilitates high-density cell growth across a higher specific surface area than the conventional monolayer culture in 2D11. Our work has indicated that this model supported the growth of human cord blood (CB) mononuclear cells (MNC)12 and primary leukemic cells in the absence of exogenous cytokines. This novel 3D mimicry provides a viable platform for the development of a human experimental model to study hematopoiesis and to explore novel treatments for leukemia.

Ex vivo Mimicry of Normal and Abnormal Human Hematopoiesis

A 3D culture system for hematopoiesis is described using human cord blood and leukemic bone marrow cells. The method is based on the use of a porous synthetic polyurethane scaffold coated with extracellular matrix proteins. This scaffold is adaptable to accommodate a wide range of cells.

Ex vivo Mimetismo de normal e anormal Hematopoese Humanos

Hematopoietic stem cells require a unique microenvironment in order to sustain blood cell formation1; the bone marrow (BM) is a complex three-dimensional ...

Viral Nanoparticles for In vivo Tumor Imaging

The use of nanomaterials has the potential to revolutionize materials science and medicine. Currently, a number of different nanoparticles are being investigated for applications in imaging and therapy. Viral nanoparticles (VNPs) derived from plants can be regarded as self-assembled bionanomaterials with defined sizes and shapes. Plant viruses under investigation in the Steinmetz lab include icosahedral particles formed by Cowpea mosaic virus (CPMV) and Brome mosaic virus (BMV), both of which are 30 nm in diameter. We are also developing rod-shaped and filamentous structures derived from the following plant viruses: Tobacco mosaic virus (TMV), which forms rigid rods with dimensions of 300 nm by 18 nm, and Potato virus X (PVX), which form filamentous particles 515 nm in length and 13 nm in width (the reader is referred to refs. 1 and 2 for further information on VNPs).
From a materials scientist's point of view, VNPs are attractive building blocks for several reasons: the particles are monodisperse, can be produced with ease on large scale in planta, are exceptionally stable, and biocompatible. Also, VNPs are "programmable" units, which can be specifically engineered using genetic modification or chemical bioconjugation methods 3. The structure of VNPs is known to atomic resolution, and modifications can be carried out with spatial precision at the atomic level4, a level of control that cannot be achieved using synthetic nanomaterials with current state-of-the-art technologies.
In this paper, we describe the propagation of CPMV, PVX, TMV, and BMV in Vigna ungiuculata and Nicotiana benthamiana plants. Extraction and purification protocols for each VNP are given. Methods for characterization of purified and chemically-labeled VNPs are described. In this study, we focus on chemical labeling of VNPs with fluorophores (e.g. Alexa Fluor 647) and polyethylene glycol (PEG). The dyes facilitate tracking and detection of the VNPs 5-10, and PEG reduces immunogenicity of the proteinaceous nanoparticles while enhancing their pharmacokinetics 8,11. We demonstrate tumor homing of PEGylated VNPs using a mouse xenograft tumor model. A combination of fluorescence imaging of tissues ex vivo using Maestro Imaging System, fluorescence quantification in homogenized tissues, and confocal microscopy is used to study biodistribution. VNPs are cleared via the reticuloendothelial system (RES); tumor homing is achieved passively via the enhanced permeability and retention (EPR) effect12. The VNP nanotechnology is a powerful plug-and-play technology to image and treat sites of disease in vivo. We are further developing VNPs to carry drug cargos and clinically-relevant imaging moieties, as well as tissue-specific ligands to target molecular receptors overexpressed in cancer and cardiovascular disease.

Viral Nanoparticles for In vivo Tumor Imaging

Plant viral nanoparticles (VNPs) are promising platforms for applications in biomedicine. Here, we describe the procedures for plant VNP propagation, purification, characterization, and bioconjugation. Finally, we show the application of VNPs for tumor homing and imaging using a mouse xenograft model and fluorescence imaging.

Nanopartículas virais para<em&gt; Em vivo</em&gt; Imaging Tumor

The use of nanomaterials has the potential to revolutionize materials science and medicine. Currently, a number of different nanoparticles are being ...

Environmentally-controlled Microtensile Testing of Mechanically-adaptive Polymer Nanocomposites for ex vivo Characterization

Implantable microdevices are gaining significant attention for several biomedical applications1-4. Such devices have been made from a range of materials, each offering its own advantages and shortcomings5,6. Most prominently, due to the microscale device dimensions, a high modulus is required to facilitate implantation into living tissue. Conversely, the stiffness of the device should match the surrounding tissue to minimize induced local strain7-9. Therefore, we recently developed a new class of bio-inspired materials to meet these requirements by responding to environmental stimuli with a change in mechanical properties10-14. Specifically, our poly(vinyl acetate)-based nanocomposite (PVAc-NC) displays a reduction in stiffness when exposed to water and elevated temperatures (e.g. body temperature). Unfortunately, few methods exist to quantify the stiffness of materials in vivo15, and mechanical testing outside of the physiological environment often requires large samples inappropriate for implantation. Further, stimuli-responsive materials may quickly recover their initial stiffness after explantation. Therefore, we have developed a method by which the mechanical properties of implanted microsamples can be measured ex vivo, with simulated physiological conditions maintained using moisture and temperature control13,16,17. 
To this end, a custom microtensile tester was designed to accommodate microscale samples13,17 with widely-varying Young's moduli (range of 10 MPa to 5 GPa). As our interests are in the application of PVAc-NC as a biologically-adaptable neural probe substrate, a tool capable of mechanical characterization of samples at the microscale was necessary. This tool was adapted to provide humidity and temperature control, which minimized sample drying and cooling17. As a result, the mechanical characteristics of the explanted sample closely reflect those of the sample just prior to explantation.
The overall goal of this method is to quantitatively assess the in vivo mechanical properties, specifically the Young's modulus, of stimuli-responsive, mechanically-adaptive polymer-based materials. This is accomplished by first establishing the environmental conditions that will minimize a change in sample mechanical properties after explantation without contributing to a reduction in stiffness independent of that resulting from implantation. Samples are then prepared for implantation, handling, and testing (Figure 1A). Each sample is implanted into the cerebral cortex of rats, which is represented here as an explanted rat brain, for a specified duration (Figure 1B). At this point, the sample is explanted and immediately loaded into the microtensile tester, and then subjected to tensile testing (Figure 1C). Subsequent data analysis provides insight into the mechanical behavior of these innovative materials in the environment of the cerebral cortex.

Environmentally-controlled Microtensile Testing of Mechanically-adaptive Polymer Nanocomposites for ex vivo Characterization

A method is discussed by which the in vivo mechanical behavior of stimuli-responsive materials is monitored as a function of time. Samples are tested ex vivo using a microtensile tester with environmental controls to simulate the physiological environment. This work further promotes understanding the in vivo behavior of our material.

Teste de microtração ambientalmente controlado mecanicamente adaptativas nanocompósitos poliméricos para<em&gt; Ex vivo</em&gt; Caracterização

Implantable microdevices are gaining significant attention for several biomedical applications1-4. Such devices have been made from a range of materials, ...

Imaging Denatured Collagen Strands In vivo and Ex vivo via Photo-triggered Hybridization of Caged Collagen Mimetic Peptides

Collagen is a major structural component of the extracellular matrix that supports tissue formation and maintenance. Although collagen remodeling is an integral part of normal tissue renewal, excessive amount of remodeling activity is involved in tumors, arthritis, and many other pathological conditions. During collagen remodeling, the triple helical structure of collagen molecules is disrupted by proteases in the extracellular environment. In addition, collagens present in many histological tissue samples are partially denatured by the fixation and preservation processes. Therefore, these denatured collagen strands can serve as effective targets for biological imaging. We previously developed a caged collagen mimetic peptide (CMP) that can be photo-triggered to hybridize with denatured collagen strands by forming triple helical structure, which is unique to collagens. The overall goals of this procedure are i)&#160;to image denatured collagen strands resulting from normal remodeling activities in vivo, and ii) to visualize collagens in ex vivo tissue sections using the photo-triggered caged CMPs. To achieve effective hybridization and successful in vivo and ex vivo imaging, fluorescently labeled caged CMPs are either photo-activated immediately before intravenous injection, or are directly activated on tissue sections. Normal skeletal collagen remolding in nude mice and collagens in prefixed mouse cornea tissue sections are imaged in this procedure. The imaging method based on the CMP-collagen hybridization technology presented here could lead to deeper understanding of the tissue remodeling process, as well as allow development of new diagnostics for diseases associated with high collagen remodeling activity.

Imaging Denatured Collagen Strands In vivo and Ex vivo via Photo-triggered Hybridization of Caged Collagen Mimetic Peptides

This procedure demonstrates in vivo near IR fluorescence imaging of collagen remodeling activities in mice as well as ex vivo staining of collagens in tissue sections using caged collagen mimetic peptides that can be photo-triggered to hybridize with denatured collagen strands.

Imagiologia desnaturadas colágeno Vertentes<em&gt; In vivo</em&gt; E<em&gt; Ex vivo</em&gt; Via foto desencadeada Hibridização do Caged Colágeno mimético Peptídeos

Collagen is a major structural component of the extracellular matrix that supports tissue formation and maintenance. Although collagen remodeling is an ...

Fabrication and Implantation of Miniature Dual-element Strain Gages for Measuring In Vivo Gastrointestinal Contractions in Rodents.

Gastrointestinal dysfunction remains a major cause of morbidity and mortality. Indeed, gastrointestinal (GI) motility in health and disease remains an area of productive research with over 1,400 published animal studies in just the last 5 years. Numerous techniques have been developed for quantifying smooth muscle activity of the stomach, small intestine, and colon. In vitro and ex vivo techniques offer powerful tools for mechanistic studies of GI function, but outside the context of the integrated systems inherent to an intact organism. Typically, measuring in vivo smooth muscle contractions of the stomach has involved an anesthetized preparation coupled with the introduction of a surgically placed pressure sensor, a static pressure load such as a mildly inflated balloon or by distending the stomach with fluid under barostatically-controlled feedback. Yet many of these approaches present unique disadvantages regarding both the interpretation of results as well as applicability for in vivo use in conscious experimental animal models. The use of dual element strain gages that have been affixed to the serosal surface of the GI tract has offered numerous experimental advantages, which may continue to outweigh the disadvantages. Since these gages are not commercially available, this video presentation provides a detailed, step-by-step guide to the fabrication of the current design of these gages. The strain gage described in this protocol is a design for recording gastric motility in rats. This design has been modified for recording smooth muscle activity along the entire GI tract and requires only subtle variation in the overall fabrication. Representative data from the entire GI tract are included as well as discussion of analysis methods, data interpretation and presentation.

Fabrication and Implantation of Miniature Dual-element Strain Gages for Measuring In Vivo Gastrointestinal Contractions in Rodents.

The in vivo measurement of smooth muscle contractions along the gastrointestinal tract of laboratory animals remains a powerful, though underutilized, technique. Flexible, dual element strain gages are not commercially available and require fabrication. This protocol describes the construction of reliable, inexpensive strain gages for acute or chronic implantation in rodents.

Fabricação e Implantação de miniatura de elemento duplo Medidores de tensão para medição<em&gt; In Vivo</em&gt; Gastrointestinal Contrações em roedores.

Gastrointestinal dysfunction remains a major cause of morbidity and mortality. Indeed, gastrointestinal (GI) motility in health and disease remains an ...

The Use of the Ex Vivo Chandler Loop Apparatus to Assess the Biocompatibility of Modified Polymeric Blood Conduits

The foreign body reaction occurs when a synthetic surface is introduced to the body. It is characterized by adsorption of blood proteins and the subsequent attachment and activation of platelets, monocyte/macrophage adhesion, and inflammatory cell signaling events, leading to post-procedural complications. The Chandler Loop Apparatus is an experimental system that allows researchers to study the molecular and cellular interactions that occur when large volumes of blood are perfused over polymeric conduits. To that end, this apparatus has been used as an ex vivo model allowing the assessment of the anti-inflammatory properties of various polymer surface modifications. Our laboratory has shown that blood conduits, covalently modified via photoactivation chemistry with recombinant CD47, can confer biocompatibility to polymeric surfaces. Appending CD47 to polymeric surfaces could be an effective means to promote the efficacy of polymeric blood conduits. Herein is the methodology detailing the photoactivation chemistry used to append recombinant CD47 to clinically relevant polymeric blood conduits and the use of the Chandler Loop as an ex vivo experimental model to examine blood interactions with the CD47 modified and control conduits.

The Use of the Ex Vivo Chandler Loop Apparatus to Assess the Biocompatibility of Modified Polymeric Blood Conduits

Blood exposure to polymeric blood conduits initiates the foreign body reaction that has been implicated in clinical complications. Here, the Chandler Loop Apparatus, an experimental tool mimicking blood perfusion through these conduits, is described. Appendage of recombinant CD47 results in decreased evidence of the foreign body reaction on these conduits.

O uso do<em&gt; Ex Vivo</em&gt; Chandler Circuito Aparelho para avaliar a biocompatibilidade de Modificados Condutas sangue Poliméricos

The foreign body reaction occurs when a synthetic surface is introduced to the body. It is characterized by adsorption of blood proteins and the ...

Sustained Administration of &#946;-cell Mitogens to Intact Mouse Islets Ex Vivo Using Biodegradable Poly(lactic-co-glycolic acid) Microspheres

The development of biomaterials has significantly increased the potential for targeted drug delivery to a variety of cell and tissue types, including the pancreatic &#946;-cells. In addition, biomaterial particles, hydrogels, and scaffolds also provide a unique opportunity to administer sustained, controllable drug delivery to &#946;-cells in culture and in transplanted tissue models. These technologies allow the study of candidate &#946;-cell proliferation factors using intact islets and a translationally relevant system. Moreover, determining the effectiveness and feasibility of candidate factors for stimulating &#946;-cell proliferation in a culture system is critical before moving forward to in vivo models. Herein, we describe a method to co-culture intact mouse islets with biodegradable compound of interest (COI)-loaded poly(lactic-co-glycolic acid) (PLGA) microspheres for the purpose of assessing the effects of sustained in situ release of mitogenic factors on &#946;-cell proliferation. This technique describes in detail how to generate PLGA microspheres containing a desired cargo using commercially available reagents. While the described technique uses recombinant human Connective tissue growth factor (rhCTGF) as an example, a wide variety of COI could readily be used. Additionally, this method utilizes 96-well plates to minimize the amount of reagents necessary to assess &#946;-cell proliferation. This protocol can be readily adapted to use alternative biomaterials and other endocrine cell characteristics such as cell survival and differentiation status.

Here, we present methodology to generate and administer compound of interest-loaded poly(lactic-co-glycolic acid) (PLGA) microspheres to intact mouse islets in culture with subsequent immunofluorescence analysis of &#946;-cell proliferation. This method is suitable for determining the efficacy of candidate &#946;-cell mitogens.

Administração sustentada dos mitógenos de células β para intactas mouse Ilhotas<em&gt; Ex Vivo</em&gt; Usando biodegradável poli (ácido láctico-co-glicólico) Microesferas

The development of biomaterials has significantly increased the potential for targeted drug delivery to a variety of cell and tissue types, including the ...

Nanosensors to Detect Protease Activity In Vivo for Noninvasive Diagnostics

Proteases are multi-functional enzymes that specialize in the hydrolysis of peptide-bonds and control broad biological processes including homeostasis and allostasis. Moreover, dysregulated protease activity drives pathogenesis and is a functional biomarker of diseases such as cancer; therefore, the ability to detect protease activity in vivo may provide clinically relevant information for biomedical diagnostics. The goal of this protocol is to create nanosensors that probe for protease activity in vivo by producing a quantifiable signal in urine. These protease nanosensors consist of two components: a nanoparticle and substrate. The nanoparticle functions to increase circulation half-life and substrate delivery to target disease sites. The substrate is a short peptide sequence (6-8 AA), which is designed to be specific to a target protease or group of proteases. The substrate is conjugated to the surface of the nanoparticle and is terminated by a reporter, such as a fluorescent marker, for detection. As dysregulated proteases cleave the peptide substrate, the reporter is filtered into urine for quantification as a biomarker of protease activity. Herein we describe construction of a nanosensor for matrix metalloproteinase 9 (MMP9), which is associated with tumor progression and metastasis, for detection of colorectal cancer in a mouse model.

Nanosensors to Detect Protease Activity In Vivo for Noninvasive Diagnostics

Proteases are tightly regulated enzymes involved in fundamental biological processes, and dysregulated protease activity drives progression of complex diseases such as cancer. This method&#39;s goal is to create nanosensors that measure protease activity in vivo by producing a cleavage signal that is detectable from host urine and discriminates disease.

Nanosensors para detectar Protease atividade In Vivo para diagnóstico não-invasivo

Proteases are multi-functional enzymes that specialize in the hydrolysis of peptide-bonds and control broad biological processes including homeostasis and ...

A New Ex Vivo Model for the Evaluation of Endoscopic Submucosal Injection Material Performance

Increasing the performance of submucosal injection materials (SIMs) is important for endoscopic therapy of early gastrointestinal cancer. It is essential to establish an ex vivo model that can evaluate SIM performance accurately, for developing high-performance SIMs. In our previous study, we developed a new ex vivo model that can be used to evaluate the performance of various SIMs in detail by applying constant tension to the specimen&#39;s ends. We also confirmed that the proposed new ex vivo model allows accurate submucosal elevation height (SEH) measurement under uniform conditions and detailed comparisons of the performances of various types of SIMs. Here, we describe the new ex vivo model and explain the detailed setup methodology of this model. Since all parts of the new model were easy to obtain, the setup of the new model could be completed quickly. SEH of various SIMs could be measured more accurately by using the new model. The critical factor that determines SIM performance can be identified using the new model. SIM development speed will drastically increase after the factor has been identified.

A New Ex Vivo Model for the Evaluation of Endoscopic Submucosal Injection Material Performance

We developed a new ex vivo model that applies constant tension to the porcine gastric specimen. This development made it possible to evaluate the performance (the height and duration of the submucosal elevation) of various SIMs accurately.&#160; The detailed setup methodology of this new model is explained.

Um novo modelo Ex Vivo para a avaliação de desempenho de Material de injeção submucosa endoscópica

Increasing the performance of submucosal injection materials (SIMs) is important for endoscopic therapy of early gastrointestinal cancer. It is essential ...