This work is financially supported by the Swiss National Foundation, (NRP 64 program, grant no 4064-131232).

1. Preparing the Perfusion System
<ol>
	<li>Set up the perfusion system consisting of a water bath, a perfusion chamber, two columns for oxygenation, two peristaltic pumps, two bubble traps, two flow heaters and one pressure sensor (Figure 1). Connect these components with tubing sections composed of silicone and polyvinyl chloride materials according to the scheme in Figure 2. Finally there are two circuits representing the fetal and maternal circuit, respectively.</li>
	<li>Turn on the water bath, the flow heaters and the heating for the perfusion chamber. The temperature should be 37 &deg;C.</li>
	<li>Warm up the perfusion medium (NCTC-135 tissue culture medium diluted 1:2 with Earle's buffer (6.8 g/L sodium chloride, 0.4 g/L potassium chloride, 0.14 g/L monosodium phosphate, 0.2 g/L magnesium sulfate, 0.2 g/L calcium chloride, 2 g/L glucose) supplemented with glucose (1 g/L), dextran 40 (10 g/L), bovine serum albumin (10 g/L), sodium heparin (2,500 IU/L), amoxicilline (250 mg/L) and sodium bicarbonate (2.2 g/L); pH 7.4) in the water bath.</li>
	<li>Consecutively rinse the arterial systems of the fetal and maternal circuit with a) 200 ml distilled water, b) 50 ml 1% sodium hydroxide, c) 1% phosphoric acid and d) again 200 ml distilled water (flow rate: 15 - 20 ml/min).</li>
	<li>Connect the fetal cannula (&Oslash; 1.2 mm; blunt needle should be attached to a modified winged needle infusion set) to the fetal arterial tubing.</li>
	<li>Rinse the arterial systems of the fetal and maternal circuit with perfusion medium until all tubes contain medium (flow rate: 15-20 ml/min). During this step fill up the bubble traps and remove all bubbles downstream of the trap. Then stop the pumps. It is really important that the afferent arterial tubes are always free of bubbles; otherwise after cannulation especially the fine fetal vessels can rupture.</li>
	<li>Turn on the gas flow. The maternal circuit is oxygenated with 5% carbon dioxide and 95% synthetic air and the fetal circuit with 5% carbon dioxide and 95% nitrogen.</li>
	<li>Start the recording of the pressure sensor.</li>
</ol>
2. Cannulating the Placenta
<ol>
	<li>Obtain intact placentae from uncomplicated term pregnancies after primary cesarean section. Written consent has to be given (was obtained in the case of our studies) by the mothers before delivery and the study has to be approved by the local ethics committee (was the case in our studies). First visual control should be done by midwives to assure a healthy and intact placenta.</li>
	<li>Cannulation of the placenta is a critical step! During perfusion every small disruption in the tissue can lead to a leak between the maternal and fetal circulation. The placenta has to be obtained within 30 min after delivery.</li>
	<li>Select an intact cotyledon at the marginal zone of the placenta without visible disruptions on the maternal side. At the chorionic plate, tie up both associated branches of the umbilical artery and vein upstream to the later cannulation side (towards the umbilical cord) by using surgical suture material. Make always two knots.</li>
	<li>Cannulate the fetal artery first. The fetal placental arteries are always smaller and thinner than the veins.</li>
	<li>Make a suture around the fetal artery, but do not tie it up immediately. Hold the vessel with a forceps, cut the vessel carefully and put the small cannula (&Oslash; 1.2 mm) in the artery. Then tie up the suture (two knots).</li>
	<li>Proceed with the fetal vein in the same manner but use a bigger cannula (&Oslash; 1.5-1.8 mm; blunt needle should be attached to a modified winged needle infusion set).</li>
	<li>Turn on the fetal pump (2 ml/min). If there is no visible leak and blood emanates out of the fetal vein cannula, slowly increase the flow up to 4 ml/min. Observe the pressure in the fetal artery, it should not exceed 70 mmHg. If fluid leaks out at the fetal or maternal cannula fix them with another suture.</li>
	<li>Place the placenta on the tissue holder with the fetal side up and pull the placental membrane and tissue over the spikes. In the end the perfused cotyledon should be in the middle of the hole in the tissue holder.</li>
	<li>Stabilize the part where only the membrane holds the placenta with a silicone membrane (&Oslash; 1 mm) or alternatively two parafilm pieces.</li>
	<li>Assemble the complete tissue holder, tighten the screws and cut the overhanging tissue. Please note that the venous and arterial cannulae are not pinched but instead lay in the small channels of the tissue holder.</li>
	<li>Turn the tissue holder upside down, put it into the perfusion chamber and add the cover. Now, the maternal side should be at the top. Check always if the fetal circuit is still intact and the medium is flowing out of the fetal vein tubing.</li>
	<li>Turn on the maternal pump (12 ml/min). Introduce the three blunt cannulae (&Oslash; 0.8 mm) at the end of the maternal artery tube into the intervillous space by penetrating the decidual plate. To return the perfusate to the maternal circuit put one tube as venous drain which is also connected with the maternal pump to the lowest position in the upper part of the perfusion chamber.</li>
	<li>Connect the fetal vein cannula to the fetal vein tube.</li>
</ol>
3. Executing the Pre- and Experimental Phase of Perfusion
<ol>
	<li>To allow the tissue to recover from the ischemic period after delivery and to flush out the blood in the intervillous space, an open pre-phase of 20 min is necessary. That means the maternal and fetal vein are not leading back to the arterial reservoir containing the perfusion medium. Collect the fetal and maternal venous outflow in a bottle and discard it after the pre-phase.</li>
	<li>To assess the integrity of the perfusion perform another pre-phase of 20 min but in a closed circuit. Use two separate reservoirs with perfusion medium for the fetal and maternal circuit and close the circuits by leading the fetal venous outflow back in the fetal reservoir and the maternal venous outflow back in the maternal reservoir.</li>
	<li>For the main perfusion experiment prepare two flasks with 120 ml perfusion medium (one for the maternal and one for the fetal reservoir). Add the radiolabeled 14C-antipyrine (4 nCi/ml; serves as positive control; CAUTION: radioactive substance) and the fluorescently labeled xenobiotic or nanoparticles which one wants to analyze to the maternal reservoir. Mix the maternal perfusate well.</li>
	<li>Start the experiment by exchanging the pure perfusion medium with the two prepared flasks (fetal and maternal reservoirs). Close the circuits by leading the fetal venous outflow back in the fetal reservoir and the maternal venous outflow back in the maternal reservoir.</li>
	<li>Continue the perfusion for 6 hr and take samples regularly. Always resuspend the medium in the fetal and maternal reservoir before withdrawal.</li>
	<li>Control the pressure in the fetal artery (should not exceed 70 mmHg), pH in both circuits (should be in a physiological range 7.2-7.4) and the volume of both reservoirs (fetal volume loss should not exceed 4 ml/hr) during perfusion. If necessary adjust the pH values using either hydrochloric acid or sodium hydroxide.</li>
	<li>If the volume loss in the fetal reservoir exceeds 4 ml/hr there is a leak in the tissue and one has to stop the perfusion. The success rate of a perfusion for 6 hr without leak is about 15-20%.</li>
	<li>Stop the perfusion after 6 hr. Turn out the pumps, water bath, flow heaters and gas flow.</li>
	<li>Remove the placenta from the tissue holder, cut the perfused cotyledon (brighter than the unperfused tissue) and weigh it.</li>
	<li>Take samples from unperfused (part of the placenta which was cut in the beginning; could be already taken during the pre-phase) and perfused tissue (each about 1 g) and store them at -20 &deg;C until homogenization or in liquid nitrogen for later analysis. Fix another tissue sample in 4% formalin for histopathological evaluation. The samples should include all layers of the placenta.</li>
	<li>Clean the tubes after perfusion by successively rinsing the arterial systems of the fetal and maternal circuit with a) 200 ml distilled water, b) 50 ml 1% sodium hydroxide, c) 50 ml 1% phosphoric acid and d) again 200 ml distilled water (flow: 15-20 ml/min).</li>
</ol>
The entire working procedure of the placenta perfusion experiment is depicted in Figure 3.
4. Analyzing the Samples
<ol>
	<li>Centrifuge the perfusate samples for 10 min at 800 x g before analysis to remove residual erythrocytes. Take the supernatant for the further analysis. The samples can be left overnight at 4 &deg;C. For the analysis of leptin and hCG production the samples can be stored at -20 &deg;C.</li>
	<li>To evaluate the permeability of the placenta analyze the 14C-antipyrine by liquid scintillation. Mix 300 &mu;l of the fetal and maternal samples with 3 ml scintillation cocktail and measure for 5 min in a beta counter.</li>
	<li>To assess the transfer of the fluorescent nanoparticles or the xenobiotic of interest read the fluorescence at 485 nm excitation and 528 nm emission in a microplate reader (indicated wavelengths are for analysis of the yellow green label which we used for the nanoparticles).</li>
	<li>To determine the viability of the placental tissue during perfusion measure the glucose consumption and lactate production in the fetal and maternal circuit with an automated blood gas system. Additionally, evaluate the production of the placental hormones human choriongonadotropin (hCG) and leptin in the homogenized tissue samples and the perfusates by enzyme-linked immunosorbent assay (ELISA).</li>
</ol>

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The authors declare that they have no competing financial interests.

Beneath the dual recirculating perfusion showed here, there are several other experimental configurations possible depending on the question which has to be answered. Particularly open placental perfusions are commonly used to assess the drug clearance at steady-state concentration 3. The recirculating perfusion set-up can be also applied to confirm active transport of endogenous or exogenous substances. For this approach the same concentration of the xenobiotic has to be added to the maternal and the fetal ci...

The placenta is a complex organ which is responsible for the exchange of oxygen, carbon dioxide, nutrients and waste products and at the same time able to keep the two blood circuits of the mother and the growing fetus separated from each other. Additionally, it prevents rejection of the child by the maternal immune system and secretes hormones to maintain pregnancy. The cellular barrier is formed by the cytotrophoblast cells which fuse and form a true syncytium without lateral cell membranes 4,5. The whole placenta is organized in several cotyledons, which contain one fetal villous tree and represent one functional unit of the placenta.
The study of the placental barrier function was intensified with the discovery of the thalidomide induced malformations in the 1960's. For obvious reasons translocation studies with pregnant women cannot be performed. Consequently, various alternative models have been developed 6,7. The most promising and probably most clinical relevant model is the ex vivo human placental perfusion model developed by Panigel and co-workers 2,3.
Many women are exposed to different xenobiotics such as drugs or environmental pollutants during their pregnancy 8. For some drugs which were already administered regularly during pregnancy, in vivo studies can be performed by comparison of the maternal blood concentration with that in umbilical cord blood. However, generally there is only limited information about the pharmacokinetics and -dynamics in the fetus and the teratogenicity of these substances.
For example opiates like heroin easily cross the placental barrier and can lead to intrauterine growth restriction, preterm delivery or spontaneous abortion 9,10. So, in case of missing abstinence during pregnancy a replacement therapy with methadone is recommended. The ex vivo human placental perfusion model revealed that the transfer of methadone into the fetal circulation is negligible 11, which correlates well with the calculated cord blood-to-maternal blood concentration ratio after delivery 12.
Nanotechnology is a growing field especially in medicine. So, beneath the naturally occurring fine (&lt; 2.5 &mu;m in diameter) and ultrafine particles (&lt; 0.1 &mu;m in diameter) in fumes of forest fires, volcano eruptions and in desert dust, exposure to engineered nanomaterials (at least one dimension &lt; 0.1 &mu;m 13) is increasing. This raised questions about the toxicological potential of engineered nanomaterials. Although no human hazard could be proved yet, there are principal experimental studies indicating that engineered nanoparticles can cause adverse biological responses leading to toxicological outcomes 14. Recently, some studies indicated that prenatal exposure to air pollution is linked to a higher respiratory need and airway inflammation in newborns and children 15,16. In addition, small nanoparticles might be used as drug carriers to specifically treat either the fetus or the mother. Therefore, it becomes evident that extensive studies of distinct xenobiotics or nanomaterials and their ability to cross the placental barrier are required. An actual overview on the current studies on placental permeability to engineered nanomaterials is summarized in Menezes et al. 2011 17 and Buerki-Thurnherr et al. 2012 7.
The ex vivo dual recirculating human placental perfusion model provides a controlled and reliable system for studying the placental transport of various endogenous and exogenous compounds 3,11,12,18,19 and a wide range of other functions of the placenta like mechanisms responsible for the development of pathological states like preeclampsia 20-22. In this protocol we focus mainly on the set up, handling and method that allow the study of accumulation, effects and translocation rates of a broad set of xenobiotics or nanoparticles.

<table border="1">
	<tbody>
 <tr>
 <td>Name of the Reagent</td>
 <td>Company</td>
 <td>Catalogue Number</td>
 <td>Comments (optional)</td>
 </tr>
 <tr>
 <td>NCTC-135 medium</td>
 <td>ICN Biomedicals, Inc.</td>
 <td>10-911-22C</td>
 <td>could be replaced by Medium 199 from Sigma (M3769)</td>
 </tr>
 <tr>
 <td>Sodium chloride (NaCl)</td>
 <td>Sigma-Aldrich, Fluka</td>
 <td>71381</td>
 <td></td>
 </tr>
 <tr>
 <td>Potassium chloride (KCl)</td>
 <td>Hospital pharmacy</td>
 <td></td>
 <td>also possible: Sigma (P9541)</td>
 </tr>
 <tr>
 <td>Monosodium phosphate (NaH2PO4 &middot; H2O)</td>
 <td>Merck</td>
 <td>106346</td>
 <td></td>
 </tr>
 <tr>
 <td>Magnesium sulfate (MgSO4 &middot; H2O)</td>
 <td>Sigma-Aldrich, Fluka</td>
 <td>63139</td>
 <td></td>
 </tr>
 <tr>
 <td>Calcium chloride (CaCl, anhydrous)</td>
 <td>Merck</td>
 <td>102388</td>
 <td></td>
 </tr>
 <tr>
 <td>D(+) Glucose (anhydrous)</td>
 <td>Sigma-Aldrich, Fluka</td>
 <td>49138</td>
 <td></td>
 </tr>
 <tr>
 <td>Sodium bicarbonate (NaHCO3)</td>
 <td>Merck</td>
 <td>106329</td>
 <td></td>
 </tr>
 <tr>
 <td>Dextran from Leuconostoc spp.</td>
 <td>Sigma-Aldrich</td>
 <td>31389</td>
 <td></td>
 </tr>
 <tr>
 <td>Bovine serum albumin (BSA)</td>
 <td>Applichem</td>
 <td>A1391</td>
 <td></td>
 </tr>
 <tr>
 <td>Amoxicilline (Clamoxyl)</td>
 <td>GlaxoSmithKline AG</td>
 <td>2021101A</td>
 <td></td>
 </tr>
 <tr>
 <td>Sodium heparin</td>
 <td>B. Braun Medical AG</td>
 <td>3511014</td>
 <td></td>
 </tr>
 <tr>
 <td>Sodium hydoxide (NaOH) pellets</td>
 <td>Merck</td>
 <td>106498</td>
 <td>CAUTION: corrosive</td>
 </tr>
 <tr>
 <td>Ortho-phosphoric acid 85% (H3PO4)</td>
 <td>Merck</td>
 <td>100573</td>
 <td>CAUTION: corrosive</td>
 </tr>
 <tr>
 <td>Maternal gas mixture: 95% synthetic air, 5% CO2</td>
 <td>PanGas AG</td>
 <td></td>
 <td></td>
 </tr>
 <tr>
 <td>Fetal gas mixture: 95% N2, 5% CO2</td>
 <td>PanGas AG</td>
 <td></td>
 <td></td>
 </tr>
 <tr>
 <td>Antipyrine (N-methyl-14C)</td>
 <td>American Radiolabeled Chemicals, Inc.</td>
 <td>ARC 0108-50 &mu;Ci</td>
 <td>CAUTION: radioactive material (specific activity: 55mCi/mmol)</td>
 </tr>
 <tr>
 <td>Scintillation cocktail (IrgaSafe Plus)</td>
 <td>Zinsser Analytic GmbH</td>
 <td>1003100</td>
 <td></td>
 </tr>
 <tr>
 <td>Polystyrene particles 80 nm</td>
 <td>Polyscience, Inc.</td>
 <td>17150</td>
 <td></td>
 </tr>
 <tr>
 <td>Polystyrene particles 500 nm</td>
 <td>Polyscience, Inc.</td>
 <td>17152</td>
 <td></td>
 </tr>
 <tr>
 <td></td>
 <td></td>
 <td></td>
 <td>EQUIPMENT</td>
 </tr>
 <tr>
 <td>Water bath</td>
 <td>VWR</td>
 <td>462-7001</td>
 <td></td>
 </tr>
 <tr>
 <td>Thermostat</td>
 <td>IKA-Werke GmbH &amp; Co. KG</td>
 <td>3164000</td>
 <td></td>
 </tr>
 <tr>
 <td>Peristaltic pumps</td>
 <td>Ismatec</td>
 <td>ISM 833</td>
 <td></td>
 </tr>
 <tr>
 <td>Bubble traps (glass)</td>
 <td>UNI-GLAS Laborbedarf</td>
 <td></td>
 <td></td>
 </tr>
 <tr>
 <td>Flow heater</td>
 <td>UNI-GLAS Laborbedarf</td>
 <td></td>
 <td></td>
 </tr>
 <tr>
 <td>Pressure sensor + Software for analyses</td>
 <td>MSR Electronics GmbH</td>
 <td>145B5</td>
 <td></td>
 </tr>
 <tr>
 <td>Notebook</td>
 <td>Hewlett Packard</td>
 <td></td>
 <td></td>
 </tr>
 <tr>
 <td>Miniature gas exchange oxygenator</td>
 <td>Living Systems Instrumentation</td>
 <td>LSI-OXR</td>
 <td></td>
 </tr>
 <tr>
 <td>Tygon Tube (ID: 1.6 mm; OD: 4.8 mm)</td>
 <td>Ismatec</td>
 <td>MF0028</td>
 <td></td>
 </tr>
 <tr>
 <td>Tubes for pumps (PharMed BPT; ID: 1.52 mm)</td>
 <td>Ismatec</td>
 <td>SC0744</td>
 <td></td>
 </tr>
 <tr>
 <td>Blunt cannulae (&Oslash; 0.8 mm)</td>
 <td>Polymed Medical Center</td>
 <td>03.592.81</td>
 <td></td>
 </tr>
 <tr>
 <td>Blunt cannulae (&Oslash; 1.2 mm)</td>
 <td>Polymed Medical Center</td>
 <td>03.592.90</td>
 <td></td>
 </tr>
 <tr>
 <td>Blunt cannulae (&Oslash; 1.5 mm)</td>
 <td>Polymed Medical Center</td>
 <td>03.592.94</td>
 <td></td>
 </tr>
 <tr>
 <td>Blunt cannulae (&Oslash; 1.8 mm)</td>
 <td>Polymed Medical Center</td>
 <td>03.952.82</td>
 <td></td>
 </tr>
 <tr>
 <td>Parafilm</td>
 <td>VWR</td>
 <td>291-1212</td>
 <td></td>
 </tr>
 <tr>
 <td>Perfusion chamber with tissue holder (plexiglass)</td>
 <td>Internal technical department</td>
 <td></td>
 <td>Similar equipment is available from Hemotek Limited, UK</td>
 </tr>
 <tr>
 <td>Surgical suture material (PremiCron)</td>
 <td>B. Braun Medical AG</td>
 <td>C0026005</td>
 <td></td>
 </tr>
 <tr>
 <td>Winged Needle Infusion Set (21G Butterfly)</td>
 <td>Hospira, Inc.</td>
 <td>ASN 2102</td>
 <td></td>
 </tr>
 <tr>
 <td>Multidirectional stopcock (Discofix C-3)</td>
 <td>B. Braun Medical AG</td>
 <td>16494C</td>
 <td></td>
 </tr>
 <tr>
 <td>Surgical scissors</td>
 <td>B. Braun Medical AG</td>
 <td>BC304R</td>
 <td></td>
 </tr>
 <tr>
 <td>Dissecting scissors</td>
 <td>B. Braun Medical AG</td>
 <td>BC162R</td>
 <td></td>
 </tr>
 <tr>
 <td>Needle holder</td>
 <td>B. Braun Medical AG</td>
 <td>BM200R</td>
 <td></td>
 </tr>
 <tr>
 <td>Dissecting forceps</td>
 <td>B. Braun Medical AG </td>
 <td>BD215R</td>
 <td></td>
 </tr>
 <tr>
 <td>Automated blood gas system </td>
 <td>Radiometer Medical ApS</td>
 <td>ABL800 FLEX</td>
 <td></td>
 </tr>
 <tr>
 <td>Multi-mode microplate reader</td>
 <td>BioTek</td>
 <td>Synergy HT</td>
 <td></td>
 </tr>
 <tr>
 <td>Liquid scintillation analyzer</td>
 <td>GMI, Inc.</td>
 <td>Packard Tri-Carb 2200</td>
 <td></td>
 </tr>
 <tr>
 <td>Scintillation tubes 5.5 ml</td>
 <td>Zinsser Analytic GmbH</td>
 <td>3020001</td>
 <td></td>
 </tr>
 <tr>
 <td>Tissue Homogenizer</td>
 <td>OMNI, Inc.</td>
 <td>TH-220</td>
 <td></td>
 </tr>
 <tr>
 <td>pH meter + electrode</td>
 <td>VWR</td>
 <td>662-2779 </td>
 <td></td>
 </tr>
	 </tbody>
 </table>

determination of the transport rate of xenobiotics and nanomaterials across the placenta using the ex vivo human placental perfusion model

Decades ago the human placenta was thought to be an impenetrable barrier between mother and unborn child. However, the discovery of thalidomide-induced birth defects and many later studies afterwards proved the opposite. Today several harmful xenobiotics like nicotine, heroin, methadone or drugs as well as environmental pollutants were described to overcome this barrier. With the growing use of nanotechnology, the placenta is likely to come into contact with novel nanoparticles either accidentally through exposure or intentionally in the case of potential nanomedical applications. Data from animal experiments cannot be extrapolated to humans because the placenta is the most species-specific mammalian organ 1. Therefore, the ex vivo dual recirculating human placental perfusion, developed by Panigel et al. in 1967 2 and continuously modified by Schneider et al. in 1972 3, can serve as an excellent model to study the transfer of xenobiotics or particles.
Here, we focus on the ex vivo dual recirculating human placental perfusion protocol and its further development to acquire reproducible results.
The placentae were obtained after informed consent of the mothers from uncomplicated term pregnancies undergoing caesarean delivery. The fetal and maternal vessels of an intact cotyledon were cannulated and perfused at least for five hours. As a model particle fluorescently labelled polystyrene particles with sizes of 80 and 500 nm in diameter were added to the maternal circuit. The 80 nm particles were able to cross the placental barrier and provide a perfect example for a substance which is transferred across the placenta to the fetus while the 500 nm particles were retained in the placental tissue or maternal circuit. The ex vivo human placental perfusion model is one of few models providing reliable information about the transport behavior of xenobiotics at an important tissue barrier which delivers predictive and clinical relevant data.

Figure 4A shows the perfusion profiles of small polystyrene particles (80 nm) which were transported across the placenta compared to bigger polystyrene particles (500 nm) which were not transferred to the fetal compartment. Each data point represents the mean particle concentration to the given time point of at least 3 independent experiments. For polystyrene nanoparticles the placental transfer is size-dependent 19. After 3 hr of placenta perfusion already 20-30% of the initially added 80 nm ...

Watch this Scientific Journal Video about Determination of the Transport Rate of Xenobiotics and Nanomaterials Across the Placenta using the ex vivo Human Placental Perfusion Model at JoVE.com

Determination of the Transport Rate of Xenobiotics and Nanomaterials Across the Placenta using the ex vivo Human Placental Perfusion Model

The ex vivo dual recirculating human placental perfusion model can be used to investigate the transfer of xenobiotics and nanoparticles across the human placenta. In this video protocol we describe the equipment and techniques required for a successful execution of a placenta perfusion.

Determination of the Transport Rate of Xenobiotics and Nanomaterials Across the Placenta using the ex vivo Human Placental Perfusion Model

Decades ago the human placenta was thought to be an impenetrable barrier between mother and unborn child. However, the discovery of thalidomide-induced ...

determination-transport-rate-xenobiotics-nanomaterials-across

Research

JoVE Journal

Bioengineering

17.2K Views.  University Hospital Zurich. The ex vivo dual recirculating human placental perfusion model can be used to investigate the transfer of xenobiotics and nanoparticles across the human placenta. In this video protocol we describe the equipment and techniques required for a successful execution of a placenta perfusion.

Video: Determination of the Transport Rate of Xenobiotics and Nanomaterials Across the Placenta using the ex vivo Human Placental Perfusion Model

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.

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

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.

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

Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens

A detailed understanding of the complexity and relative variability within the human cardiac venous system is crucial for the development of cardiac devices that require access to these vessels. For example, cardiac venous anatomy is known to be one of the key limitations for the proper delivery of cardiac resynchronization therapy (CRT)1 Therefore, the development of a database of anatomical parameters for human cardiac venous systems can aid in the design of CRT delivery devices to overcome such a limitation. In this research project, the anatomical parameters were obtained from 3D reconstructions of the venous system using contrast-computed tomography (CT) imaging and modeling software (Materialise, Leuven, Belgium). The following parameters were assessed for each vein: arc length, tortuousity, branching angle, distance to the coronary sinus ostium, and vessel diameter.
	CRT is a potential treatment for patients with electromechanical dyssynchrony. Approximately 10-20% of heart failure patients may benefit from CRT2. Electromechanical dyssynchrony implies that parts of the myocardium activate and contract earlier or later than the normal conduction pathway of the heart. In CRT, dyssynchronous areas of the myocardium are treated with electrical stimulation. CRT pacing typically involves pacing leads that stimulate the right atrium (RA), right ventricle (RV), and left ventricle (LV) to produce more resynchronized rhythms. The LV lead is typically implanted within a cardiac vein, with the aim to overlay it within the site of latest myocardial activation. 
	We believe that the models obtained and the analyses thereof will promote the anatomical education for patients, students, clinicians, and medical device designers. The methodologies employed here can also be utilized to study other anatomical features of our human heart specimens, such as the coronary arteries. To further encourage the educational value of this research, we have shared the venous models on our free access website: <a href="http://www.vhlab.umn.edu/atlas" target="_blank">www.vhlab.umn.edu/atlas</a>.

The objective of this research is to recreate and then access the anatomy of the human cardiac venous system using 3D reconstructions generated from contrast-computed tomography scans.

A detailed  understanding of the complexity and relative variability within the human  cardiac venous system is crucial for the development of cardiac ...

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.

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

Determination of Zeta Potential via Nanoparticle Translocation Velocities through a Tunable Nanopore: Using DNA-modified Particles as an Example

Nanopore technologies, known collectively as Resistive Pulse Sensors (RPS), are being used to detect, quantify and characterize proteins, molecules and nanoparticles. Tunable resistive pulse sensing (TRPS) is a relatively recent adaptation to RPS that incorporates a tunable pore that can be altered in real time. Here, we use TRPS to monitor the translocation times of DNA-modified nanoparticles as they traverse the tunable pore membrane as a function of DNA concentration and structure (i.e., single-stranded to double-stranded DNA).
TRPS is based on two Ag/AgCl electrodes, separated by an elastomeric pore membrane that establishes a stable ionic current upon an applied electric field. Unlike various optical-based particle characterization technologies, TRPS can characterize individual particles amongst a sample population, allowing for multimodal samples to be analyzed with ease. Here, we demonstrate zeta potential measurements via particle translocation velocities of known standards and apply these to sample analyte translocation times, thus resulting in measuring the zeta potential of those analytes.
As well as acquiring mean zeta potential values, the samples are all measured using a particle-by-particle perspective exhibiting more information on a given sample through sample population distributions, for example. Of such, this method demonstrates potential within sensing applications for both medical and environmental fields.

Here we use a polyurethane tunable nanopore integrated into a resistive pulse sensing technique to characterize nanoparticles surface chemistry via the measurement of particle translocation velocities, which can be used to determine the zeta potential of individual nanoparticles.

Nanopore technologies, known collectively as Resistive Pulse Sensors (RPS), are being used to detect, quantify and characterize proteins, molecules and ...

An Experimental and Finite Element Protocol to Investigate the Transport of Neutral and Charged Solutes across Articular Cartilage

Osteoarthritis (OA) is a debilitating disease that is associated with degeneration of articular cartilage and subchondral bone. Degeneration of articular cartilage impairs its load-bearing function substantially as it experiences tremendous chemical degradation, i.e. proteoglycan loss and collagen fibril disruption. One promising way to investigate chemical damage mechanisms during OA is to expose the cartilage specimens to an external solute and monitor the diffusion of the molecules. The degree of cartilage damage (i.e. concentration and configuration of essential macromolecules) is associated with collisional energy loss of external solutes while moving across articular cartilage creates different diffusion characteristics compared to healthy cartilage. In this study, we introduce a protocol, which consists of several steps and is based on previously developed experimental micro-Computed Tomography (micro-CT) and finite element modeling. The transport of charged and uncharged iodinated molecules is first recorded using micro-CT, which is followed by applying biphasic-solute and multiphasic finite element models to obtain diffusion coefficients and fixed charge densities across cartilage zones.

We propose a protocol to investigate the transport of charged and uncharged molecules across articular cartilage with the aid of recently developed experimental and numerical methods.

Osteoarthritis (OA) is a debilitating disease that is associated with degeneration of articular cartilage and subchondral bone. Degeneration of articular ...

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.

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

Comprehensive Evaluation of the Effectiveness and Safety of Placenta-Targeted Drug Delivery Using Three Complementary Methods

No effective treatments currently exist for placenta-associated pregnancy complications, and developing strategies for the targeted delivery of drugs to the placenta while minimizing fetal and maternal side effects remains challenging. Targeted nanoparticle carriers provide new opportunities to treat placental disorders. We recently demonstrated that a synthetic placental chondroitin sulfate A binding peptide (plCSA-BP) could be used to guide nanoparticles to deliver drugs to the placenta. In this protocol, we describe in detail a system for assessing the efficiency of drug delivery to the placenta by plCSA-BP that employs three separate methods used in combination: in vivo imaging, high-frequency ultrasound (HFUS), and high-performance liquid chromatography (HPLC). Using in vivo imaging, plCSA-BP-guided nanoparticles were visualized in the placentas of live animals, while HFUS and HPLC demonstrated that plCSA-BP-conjugated nanoparticles efficiently and specifically delivered methotrexate to the placenta. Thus, a combination of these methods can be used as an effective tool for the targeted delivery of drugs to the placenta and development of new treatment strategies for several pregnancy complications.

We describe a system that utilizes three methods to evaluate the safety and effectiveness of placenta-targeted drug delivery: in vivo imaging to monitor nanoparticle accumulation, high-frequency ultrasound to monitor placental and fetal development, and HPLC to quantify drug delivery to tissue.

No effective treatments currently exist for placenta-associated pregnancy complications, and developing strategies for the targeted delivery of drugs to ...

Bioparticle Microarrays for Chemotactic and Molecular Analysis of Human Neutrophil Swarming in vitro

Neutrophil swarming is a cooperative process by which neutrophils seal off a site of infection and promote tissue reorganization. Swarming has classically been studied in vivo in animal models showing characteristic patterns of cell migration. However, in vivo models have several limitations, including intercellular mediators that are difficult to access and analyze, as well as the inability to directly analyze human neutrophils. Because of these limitations, there is a need for an in vitro platform that studies swarming with human neutrophils and provides easy access to the molecular signals generated during swarming. Here, a multistep microstamping process is used to generate a bioparticle microarray that stimulates swarming by mimicking an in vivo infection. The bioparticle microarray induces neutrophils to swarm in a controlled and stable manner. On the microarray, neutrophils increase in speed and form stable swarms around bioparticle clusters. Additionally, supernatant generated by the neutrophils was analyzed and 16 proteins were discovered to have been differentially expressed over the course of swarming. This in vitro swarming platform facilitates direct analysis of neutrophil migration and protein release in a reproducible, spatially controlled manner.

This protocol generates bioparticle microarrays that provide spatially controlled neutrophil swarming. It provides easy access to the mediators that neutrophils release during migration and allows for quantitative imaging analysis.

Neutrophil swarming is a cooperative process by which neutrophils seal off a site of infection and promote tissue reorganization. Swarming has classically ...

Biofunctionalization of Magnetic Nanomaterials

Magnetic nanomaterials have received great attention in different biomedical applications. Biofunctionalizing these nanomaterials with specific targeting agents is a crucial aspect to enhance their efficacy in diagnostics and treatments while minimizing the side effects. The benefit of magnetic nanomaterials compared to non-magnetic ones is their ability to respond to magnetic fields in a contact-free manner and over large distances. This allows to guide or accumulate them, while they can also be monitored. Recently, magnetic nanowires (NWs) with unique features were developed for biomedical applications. The large magnetic moment of these NWs enables a more efficient remote control of their movement by a magnetic field. This has been utilized with great success in cancer treatment, drug delivery, cell tracing, stem cell differentiation or magnetic resonance imaging. In addition, the NW fabrication by template-assisted electrochemical deposition provides a versatile method with tight control over the NW properties. Especially iron NWs and iron-iron oxide (core-shell) NWs are suitable for biomedical applications, due to their high magnetization and low toxicity.
In this work, we provide a method to biofunctionalize iron/iron oxide NWs with specific antibodies directed against a specific cell surface marker that is overexpressed in a large number of cancer cells. Since the method utilizes the properties of the iron oxide surface, it is also applicable to superparamagnetic iron oxide nanoparticles. The NWs are first coated with 3-aminopropyl-tri-ethoxy-silane (APTES) acting as a linker, which the antibodies are covalently attached to. The APTES coating and the antibody biofunctionalization are proven by electron energy loss spectroscopy (EELS) and zeta potential measurements. In addition, the antigenicity of the antibodies on the NWs is tested by using immunoprecipitation and western blot. The specific targeting of the biofunctionalized NWs and their biocompatibility are studied by confocal microscopy and a cell viability assay.

In this work, we provide a protocol to biofunctionalize magnetic nanomaterials with antibodies for specific cell targeting. As examples, we utilize iron nanowires to target cancer cells.

Magnetic nanomaterials have received great attention in different biomedical applications. Biofunctionalizing these nanomaterials with specific targeting ...