The authors acknowledge Dr. Timothy Cashman for previous work on this method. This study was supported by funding from the National Institutes of Health (NIH) (R01-HL132226 and K01 HL133424) and the Leducq Foundation International Networks of Excellence Program (CURE-PLaN).

K.D.C. is a co-founder and Chief Scientific Officer of Novoheart and holds equity ownership in the holding company, Medera Biopharmaceutical. Novoheart did not contribute to the funding, planning, or execution of this study; however, the study outcomes could potentially have a financial impact on Novoheart and Medera. The other authors declare that they have no competing interests.

There are numerous linear engineered cardiac tissue models published in the literature, some of which are described in Table 1. Some models involve the direct measurement of the tissue force, but these typically require transferring the construct to a separate muscle bath38. Most models are designed with the tissues permanently anchored at both ends, most commonly to PDMS posts1,2,3,...

An erratum was issued for:&#160;<a href="https://www.jove.com/t/64368">Designing a Bioreactor to Improve Data Acquisition and Model the Throughput of Engineered Cardiac Tissues</a>. The title was corrected&#160;from:
Designing a Bioreactor to Improve Data Acquisition and Model the Throughput of Engineered Cardiac Tissues
to:
Designing a Bioreactor to Improve Data Acquisition and Model Throughput of Engineered Cardiac Tissues

An erratum was issued for:&#160;<a href="https://www.jove.com/t/64368">Designing a Bioreactor to Improve Data Acquisition and Model the Throughput of Engineered Cardiac Tissues</a>. The title was corrected.

Erratum: Designing a Bioreactor to Improve Data Acquisition and Model Throughput of Engineered Cardiac Tissues

Engineered cardiac tissue models come in a diverse array of geometries and configurations for recapitulating various aspects of the native cardiac niche that are difficult to attain with traditional two-dimensional cell culture. One of the most common configurations is the linear tissue strip, with flexible anchors at each end to induce tissue self-assembly and providing the tissue with a defined preload and a readout of the resulting twitch forces1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21 
,22,23,24,25,26,27. The force generated can be robustly determined through the optical tracking of the tissue shortening and using elastic beam theory to calculate the force from the measured deflections and the spring constant of the anchors1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20, 
21,22,25,26,28.
However, cardiac tissue engineering is still an evolving field, and some challenges remain. Specialized equipment, such as custom-made bioreactors and functional assessment devices, are required for each model system10,29,30,31. The size and complexity of the microenvironment of these constructs are often limited by low throughput due to labor-intensive protocols, high numbers of cells, and tissue fragility. To address this, some groups have turned to the fabrication of microtissues containing only hundreds or thousands of cells to facilitate high-throughput assays that are useful for drug discovery. However, this reduced scale complicates the accurate assessment of function12, eliminates key aspects of the native cardiac niche (such as nutrient/oxygen diffusion gradients and complex architecture36), and limits the amount of material available for subsequent molecular and structural analysis (often requiring pooling of the tissues). Table 1 summarizes some of the configurations of linear tissue strip models in the literature1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20, 
21,22,23,24,25,26,37,38,39,40.
<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td colspan="2">Group</td>
			<td>Cells per tissue</td>
			<td>Tissues per plate</td>
			<td colspan="2">Plate format</td>
			<td colspan="2">Anchoring feature</td>
			<td colspan="2">Functional data acquisition method</td>
			<td>Shared media bath?</td>
			<td>Functional measure- 
			ment in situ?</td>
		</tr>
		<tr>
			<td colspan="2">Yoshida (ECT)38</td>
			<td>4 million</td>
			<td>6</td>
			<td colspan="2">modified 6-well plate*</td>
			<td colspan="2">force transducer</td>
			<td colspan="2">direct force measurement</td>
			<td>no</td>
			<td>no</td>
		</tr>
		<tr>
			<td colspan="2">Chan (hESC-CM-ECTs)26</td>
			<td>310 k</td>
			<td>6</td>
			<td colspan="2">custom 6-well dish&#160;</td>
			<td colspan="2">PDMS posts</td>
			<td colspan="2">direct force measurement</td>
			<td>yes</td>
			<td>no</td>
		</tr>
		<tr>
			<td colspan="2">Feinberg (dyn-EHT)16</td>
			<td>1.5 million</td>
			<td>6</td>
			<td colspan="2">custom 6-well dish&#160;</td>
			<td colspan="2">PDMS wire</td>
			<td colspan="2">tissue shape</td>
			<td>no</td>
			<td>yes</td>
		</tr>
		<tr>
			<td colspan="2">RADISIC (BioWire)39, 40</td>
			<td>110 k</td>
			<td>8</td>
			<td colspan="2"></td>
			<td colspan="2">polymer wire</td>
			<td colspan="2">wire shape</td>
			<td>yes</td>
			<td>yes</td>
		</tr>
		<tr>
			<td colspan="2">Costa (single hECT)1, 2</td>
			<td>1-2million</td>
			<td>4**</td>
			<td colspan="2">10 cm Petri dish**</td>
			<td colspan="2">PDMS posts</td>
			<td colspan="2">optical deflection (edge/object tracking)</td>
			<td>yes</td>
			<td>yes</td>
		</tr>
		<tr>
			<td colspan="2">Costa (multi-hECT)3&#8211;9</td>
			<td>500 k-1 million</td>
			<td>6</td>
			<td colspan="2">6 cm Petri dish</td>
			<td colspan="2">PDMS posts</td>
			<td colspan="2">optical deflection (edge/object tracking)</td>
			<td>yes</td>
			<td>yes</td>
		</tr>
		<tr>
			<td colspan="2">Costa (multi-hECT W/ SPoT)</td>
			<td>1 million</td>
			<td>6</td>
			<td colspan="2">6 cm Petri dish</td>
			<td colspan="2">PDMS posts with black caps</td>
			<td colspan="2">optical deflection (object tracking)</td>
			<td>yes</td>
			<td>yes</td>
		</tr>
		<tr>
			<td colspan="2">Passier (EHT)17</td>
			<td>245 k</td>
			<td>36</td>
			<td colspan="2">12-well plate</td>
			<td colspan="2">PDMS posts with black caps</td>
			<td colspan="2">optical deflection (object tracking)</td>
			<td>yes</td>
			<td>yes</td>
		</tr>
		<tr>
			<td colspan="2">Vunjak-Novakovic13, 18</td>
			<td>1 million</td>
			<td>12</td>
			<td colspan="2">6 cm Petri dish</td>
			<td colspan="2">PDMS posts with caps</td>
			<td colspan="2">optical deflection (edge detection)</td>
			<td>yes</td>
			<td>yes</td>
		</tr>
		<tr>
			<td colspan="2">Vunjak-Novakovic (MilliPillar)14</td>
			<td>550 k</td>
			<td>6</td>
			<td colspan="2">custom 6-well dish&#160;</td>
			<td colspan="2">PDMS posts with caps</td>
			<td colspan="2">optical deflection (object tracking); calcium imaging</td>
			<td>no</td>
			<td>yes</td>
		</tr>
		<tr>
			<td colspan="2">Eschenhagen (EHT)10, 19&#8211;21</td>
			<td>1 million</td>
			<td>12</td>
			<td colspan="2">12-well plate</td>
			<td colspan="2">PDMS posts with caps</td>
			<td colspan="2">optical deflection (edge detection of post deflection); calcium imaging</td>
			<td>no</td>
			<td>yes</td>
		</tr>
		<tr>
			<td colspan="2">Zandstra (CaMiRi)22</td>
			<td>25-150 k</td>
			<td>96</td>
			<td colspan="2">96-well plate</td>
			<td colspan="2">PDMS posts with hooks</td>
			<td colspan="2">optical deflection (edge detection)</td>
			<td>no</td>
			<td>yes</td>
		</tr>
		<tr>
			<td colspan="2">Murry23, 24</td>
			<td>900 k</td>
			<td>24</td>
			<td colspan="2">24-well plate</td>
			<td colspan="2">PDMS posts with caps, integrated magnet</td>
			<td colspan="2">magnetic sensor</td>
			<td>no</td>
			<td>yes</td>
		</tr>
		<tr>
			<td colspan="2">Reich (&#181;TUG)11, 12, 25</td>
			<td>undefined</td>
			<td>156</td>
			<td colspan="2">156-well dish</td>
			<td colspan="2">PDMS posts with caps, integrated magnet</td>
			<td colspan="2">optical tracking (fluorescent bead)</td>
			<td>yes</td>
			<td>yes</td>
		</tr>
	</tbody>
</table>
Table 1: Characteristics of some linear engineered cardiac tissue models in the literature. Linear engineered cardiac tissue models vary in size, throughput, anchoring feature designs, and the facilitation of shared medium baths, as well as the requirements for a separate muscle bath system for functional characterization. * The researchers used a commercially available engineered tissue system based on the dimensions of a standard 6-well plate.&#160;** A modular system in which single-tissue bioreactors are anchored to any plastic culture dish in the desired number and location.
This paper describes the latest protocol for fabricating our established model of linear human engineered cardiac tissue (hECT)1,2,3,4,5,6,7,8,9,15,27 and methods for assessing hECT contractile function. Each multi-tissue bioreactor accommodates up to six hECTs in a shared medium bath and is composed two &#34;rack&#34; pieces made of the silicone elastomer polydimethylsiloxane (PDMS) mounted on a rigid polysulfone frame. Each PDMS rack contains six&#160;flexible&#160;integrated force-sensing posts that are 0.5 mm in diameter and 3.25 mm long, and together, two racks provide six pairs of posts, each of which holds one hECT. Inversion of the bioreactor helps overcome any hindrance to the visualization of the hECTs from below due to water condensation from the culture medium or distortions from the meniscus of the air-liquid interface. Each contraction of an hECT causes deflection of the integrated end-posts, and the optical measurement of the deflection signal is processed into a force versus time tracing representing the contractile function of the hECT1,2,3,4,5,6,7,8,9,15,27. Compared to the single-tissue bioreactors typically used for tissues of this size, the multi-tissue design improves the experimental throughput and enables the study of paracrine signaling between adjacent tissues of potentially different cellular composition. This system has been validated in published studies describing applications in disease modeling4,8, paracrine signaling6,7, heterocellular culture5,9, and therapeutic screening7,9.
In this system, the hECTs are designed to be approximately 6 mm long and 0.5 mm in diameter to facilitate robust optical tracking of force measurements with low noise. Furthermore, aspects of tissue complexity such as diffusion gradients and cellular organization are balanced with a manageable requirement of 1 million cells per tissue. With standard CCD camera technology, forces as weak as 1 &#181;N (representing less than 5 &#181;m post deflection) generate a clear signal, ensuring that even extremely weak contractile function, as observed with some hECT disease models, can be accurately measured. This also facilitates the detailed analysis of the twitch force curve, thus enabling the high-content analysis of up to 16 contractility metrics41, including developed force, rates of contraction (+dF/dt) and relaxation (&#8722;dF/dt), and beat rate variability.
This protocol begins with instructions for fabricating the bioreactor components. Special attention is paid to the steps to maximize the hECT yield, reduce technical variability in the tissue function, and optimize the quality and depth of the tissue assessment. Most cardiac tissue engineering studies do not report rates of tissue loss during fabrication and long-term testing, although it is a well-known challenge in the field and reduces the throughput and efficiency of the studies27. The tissue engineering methods described here have been refined over the years to ensure retention of all hECTs in most of the bioreactors (regardless of how the PDMS racks are fabricated). However, even a 5%-20% loss of tissues can significantly affect the statistical power, particularly in smaller experiments limited by the number of cardiomyocytes available (e.g., due to differentiation challenges with some diseased cell lines4 or due to the high cost of commercially purchased cardiomyocytes), or by the treatment condition (e.g., limited availability or high cost of various treatment compounds).
This protocol describes the fabrication of stable post trackers (SPoTs), a new feature of the PDMS racks, which function as caps at the ends of the force-sensing posts that hold the hECTs27. It is demonstrated how the cap geometry significantly reduces the hECT loss from falling or pulling off the posts, thus opening new opportunities for culturing hECTs with a greater variety of stiffnesses and tensions, which are challenging to culture on uncapped posts. Additionally, the SPoTs provide a high-contrast object to improve the optical tracking of the hECT contraction through a consistent and well-defined shape27. This is followed by a description of culturing human induced pluripotent stem cells (iPSCs) and cardiomyocyte differentiation based on prior published protocols3,42,43 and an explanation of hECT fabrication, culture, and functional measurements.
This article also addresses the need to measure tissue function at physiological temperature. Human myocardium (fetal as well as adult healthy and diseased tissue), as well as heart tissue from a wide range of animal species (including rats, cats, mice, ferrets, and rabbits)44,45, displays a marked increase in the frequency-matched twitch force at temperatures of 28 &#176;C-32 &#176;C compared to physiological temperature-a phenomenon known as hypothermic inotropy45,46. However, the effects of temperature on engineered myocardial tissue function remain understudied. Many recent engineered cardiac tissue models in the literature are designed to be functionally assessed at 37 &#176;C to approximate physiological conditions13,14,37. However, to our knowledge, the temperature-dependent effects on the force generated by engineered cardiac tissues have not been systematically investigated. This protocol describes a pacing electrode design that minimizes heat loss during testing, as well as allowing for the incorporation of an insulated heating element into the setup for functional measurements, which can maintain the hECTs at physiological temperature without compromising sterility27. We then report some of the observed effects of temperature on hECT function, including on the developed force, spontaneous beating frequency, +dF/dt, and &#8722;dF/dt. Altogether, this paper provides the details required to manufacture this multi-tissue force-sensing bioreactor system to fabricate human engineered cardiac tissues and to assess their contractile function, and a set of data is presented that provides a basis for comparison for measurements at room temperature and at 37 &#176;C27.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr >
			<td >0.25 mm diamete 304 Stainless Steel Wire</td>
			<td >McMaster Carr</td>
			<td >6517K61&#160;</td>
			<td ></td>
		</tr>
		<tr >
			<td >0.25% trypsin-EDTA</td>
			<td>Gibco</td>
			<td>25200056</td>
			<td></td>
		</tr>
		<tr >
			<td >1.7 mL Microtubes</td>
			<td>Axygen</td>
			<td>MCT-175-C</td>
			<td></td>
		</tr>
		<tr >
			<td >10 cm dishes (20 mm tall)</td>
			<td>Corning</td>
			<td>353003</td>
			<td></td>
		</tr>
		<tr >
			<td >10 mL Serological Pipette</td>
			<td>Drummond</td>
			<td>6-000-010</td>
			<td></td>
		</tr>
		<tr >
			<td >10 N NaOH</td>
			<td>Fisher Scientific</td>
			<td>SS225-1</td>
			<td>dilute 1:10 in sterile distilled water</td>
		</tr>
		<tr >
			<td >10X Modified Eagle Medium</td>
			<td>Sigma Aldrich</td>
			<td>M0275</td>
			<td></td>
		</tr>
		<tr >
			<td >20 - 200 &#956;L Micropipette</td>
			<td>Eppendorf</td>
			<td>3123000055</td>
			<td></td>
		</tr>
		<tr >
			<td >200 &#956;L MicroPipette Tips</td>
			<td>VWR</td>
			<td>76322-150</td>
			<td></td>
		</tr>
		<tr >
			<td >5 mL Serological Pipette</td>
			<td>Drummond</td>
			<td>6-000-005</td>
			<td></td>
		</tr>
		<tr >
			<td >50 mL Conical Centrifuge Tubes</td>
			<td>Falcon</td>
			<td>352070</td>
			<td></td>
		</tr>
		<tr >
			<td >6 cm Petri Dish</td>
			<td>Corning</td>
			<td>353002</td>
			<td></td>
		</tr>
		<tr >
			<td >6 Watt LED Dual Gooseneck Illuminator</td>
			<td>AmScope</td>
			<td>&#160;LED-6W&#160;</td>
			<td></td>
		</tr>
		<tr >
			<td >6-Well Plates</td>
			<td>Corning</td>
			<td>353046</td>
			<td></td>
		</tr>
		<tr >
			<td >90 degree angle mirror</td>
			<td>Edmund Optics</td>
			<td>45-594</td>
			<td></td>
		</tr>
		<tr >
			<td >Acrylic bonding glue</td>
			<td>SCIGRIP</td>
			<td>#4</td>
			<td></td>
		</tr>
		<tr >
			<td >Adjustable 10 cm x 10 cm jack</td>
			<td>Fisher Scientific</td>
			<td>14-673-50</td>
			<td></td>
		</tr>
		<tr >
			<td >Aluminum 6061</td>
			<td>McMaster Carr</td>
			<td>9008K82</td>
			<td></td>
		</tr>
		<tr >
			<td >A-Plan 10X Objective Lens</td>
			<td>ZEISS</td>
			<td>1020-863</td>
			<td></td>
		</tr>
		<tr >
			<td >Autoclave Bags</td>
			<td>Propper</td>
			<td>21002</td>
			<td></td>
		</tr>
		<tr >
			<td >B-27 supplement</td>
			<td>ThermoFisher</td>
			<td>17504044</td>
			<td></td>
		</tr>
		<tr >
			<td >B-27 supplement (without insulin)</td>
			<td>ThermoFisher</td>
			<td>A1895601</td>
			<td></td>
		</tr>
		<tr >
			<td >Benchtop Centrifuge</td>
			<td>Eppendorf</td>
			<td>5810 R</td>
			<td></td>
		</tr>
		<tr >
			<td >Black ABS</td>
			<td>Ultimaker</td>
			<td></td>
			<td>2.85 mm wide</td>
		</tr>
		<tr >
			<td >Bovine Collagen I</td>
			<td>Gibco</td>
			<td>A1064401</td>
			<td></td>
		</tr>
		<tr >
			<td >CHIR99021</td>
			<td>Tocris</td>
			<td>4423</td>
			<td></td>
		</tr>
		<tr >
			<td >Class II Biosafety Cabinet</td>
			<td>Labconco</td>
			<td>3430009</td>
			<td></td>
		</tr>
		<tr >
			<td >Clear Acrylic Sheeting</td>
			<td>estreetplastics</td>
			<td>1002502436</td>
			<td>6.25 mm thick</td>
		</tr>
		<tr >
			<td >CNC Vertical Mill</td>
			<td>Haas</td>
			<td>VF-1</td>
			<td></td>
		</tr>
		<tr >
			<td >Conductive Graphite Bars</td>
			<td>McMaster Carr</td>
			<td>1763T33</td>
			<td></td>
		</tr>
		<tr >
			<td >Dissection microscope</td>
			<td>Olympus</td>
			<td>SZ61</td>
			<td></td>
		</tr>
		<tr >
			<td >Dulbecco&#39;s Modified Eagle Medium/Ham&#39;s F-12 Nutrient Mix</td>
			<td>ThermoFisher</td>
			<td>11330032</td>
			<td></td>
		</tr>
		<tr >
			<td >Ethanol</td>
			<td>Fisher Scientific</td>
			<td>A4094</td>
			<td>Dilute to 70% in water</td>
		</tr>
		<tr >
			<td >EVE Automated Cell counter</td>
			<td>NanoEntek</td>
			<td>E1000</td>
			<td></td>
		</tr>
		<tr >
			<td >EVE Cell Counting Slide</td>
			<td>NanoEntek</td>
			<td>EVS-050</td>
			<td></td>
		</tr>
		<tr >
			<td >Fetal Bovine Serum</td>
			<td>Life Technologies</td>
			<td>10438026</td>
			<td></td>
		</tr>
		<tr >
			<td >Fine Curved Forceps</td>
			<td>Fine Science Tools</td>
			<td>11253-25</td>
			<td></td>
		</tr>
		<tr >
			<td >Forma Series II Water Jacketed CO2 Incubator</td>
			<td>Thermo Electron Corporation</td>
			<td>3110</td>
			<td>AKA &#34;incubator&#34;. With HEPA class 100 filter</td>
		</tr>
		<tr >
			<td >Fusion360 software</td>
			<td>Autodesk</td>
			<td></td>
			<td>AKA &#34;CAD software&#34;</td>
		</tr>
		<tr >
			<td >Glass Hemocytometer</td>
			<td>Reichert</td>
			<td>1475</td>
			<td>0.1 mm deep</td>
		</tr>
		<tr >
			<td >HEPES</td>
			<td>Sigma Aldrich</td>
			<td>H3784</td>
			<td></td>
		</tr>
		<tr >
			<td >hESC qualified matrigel</td>
			<td>Corning</td>
			<td>354277</td>
			<td>AKA &#34;basement membrane matrix&#34;. Store in frozen aliquots</td>
		</tr>
		<tr >
			<td >High Speed CCD Camera</td>
			<td>PixelLINK</td>
			<td>P7410</td>
			<td></td>
		</tr>
		<tr >
			<td >Inverted Microscope</td>
			<td>Carl Zeiss Werk</td>
			<td>Axiovert 40 CFL</td>
			<td>10X phase contrast objective</td>
		</tr>
		<tr >
			<td >IWR-1</td>
			<td>Selleck Chem</td>
			<td>S7086</td>
			<td></td>
		</tr>
		<tr >
			<td >LabView Software</td>
			<td>National Instruments</td>
			<td>2016</td>
			<td></td>
		</tr>
		<tr >
			<td >Laminar flow clean bench</td>
			<td>NuAire</td>
			<td>NU-201-330</td>
			<td>necessary for hECT functional analysis</td>
		</tr>
		<tr >
			<td >Laptop</td>
			<td>AsusTek</td>
			<td>Strix</td>
			<td>Intel Core i&#38; processor ,CPU 2.8GHz, 16GB RAM</td>
		</tr>
		<tr >
			<td >Laser Cutting Machine</td>
			<td>Epilog</td>
			<td>Helix 24</td>
			<td></td>
		</tr>
		<tr >
			<td >Magnification headset</td>
			<td>ExcelBlades</td>
			<td>70020</td>
			<td>Recommended for steps requiring fine manipulations</td>
		</tr>
		<tr >
			<td >Matlab</td>
			<td>Mathworks</td>
			<td>Version 2019b or later</td>
			<td>AKA &#34;data analysis software&#34;</td>
		</tr>
		<tr >
			<td >Micro Vannas Scissors, 3 mm blade</td>
			<td>WPI Instruments</td>
			<td>501839</td>
			<td></td>
		</tr>
		<tr >
			<td >Microscope Boom Stand</td>
			<td>Olympus</td>
			<td>SZ2-STU1</td>
			<td></td>
		</tr>
		<tr >
			<td >Penicillin-Streptomycin stock solution</td>
			<td>ThermoFisher</td>
			<td>15140122</td>
			<td>10,000 IU/ml penicillin; 10,000 &#956;g/ml streptomycin</td>
		</tr>
		<tr >
			<td >Phosphate-buffered saline without divalent cations</td>
			<td>Sigma Aldrich</td>
			<td>P3813</td>
			<td>Diluted in distilled water to 1X and 10X concentrations</td>
		</tr>
		<tr >
			<td >Pipette Controller</td>
			<td>Drummond</td>
			<td>4-000-100</td>
			<td></td>
		</tr>
		<tr >
			<td >PixelLINK Capture OEM</td>
			<td>PixelLINK</td>
			<td>10.2.1.6</td>
			<td>AKA &#34;Camera Software&#34;</td>
		</tr>
		<tr >
			<td >Polysulfone</td>
			<td>McMaster Carr</td>
			<td>86735K73</td>
			<td>translucent amber color</td>
		</tr>
		<tr >
			<td >Polytetrafluoroethylene (PTFE)</td>
			<td>McMaster Carr</td>
			<td>8545K176&#160;</td>
			<td>Black, molded</td>
		</tr>
		<tr >
			<td >ReLeSR</td>
			<td>Stem Cell Technologies</td>
			<td>5872</td>
			<td>AKA &#34;iPSC dissociation media&#34;</td>
		</tr>
		<tr >
			<td >Rosewell Park Memorial Institute 1640 Media</td>
			<td>ThermoFisher</td>
			<td>11875135</td>
			<td></td>
		</tr>
		<tr >
			<td >Silicone Sheeting</td>
			<td >SMI manufacturing</td>
			<td></td>
			<td>glossy, 0.02 in thickness, durometer 40</td>
		</tr>
		<tr >
			<td >Size 10/0 Blue, Green, Red, and Yellow Glass Seed Beads</td>
			<td>Michael&#39;s</td>
			<td></td>
			<td>color should withstand autoclaving</td>
		</tr>
		<tr >
			<td >Spatula</td>
			<td>Fisher Scientific</td>
			<td>14-373</td>
			<td>used for mixing PDMS</td>
		</tr>
		<tr >
			<td >Square Pulse Stimulator&#160;</td>
			<td>Astro-Med / Grass Technologies</td>
			<td>S88X</td>
			<td></td>
		</tr>
		<tr >
			<td >Stainless Steel Razoblades</td>
			<td>GEM</td>
			<td>62-0179-CTN</td>
			<td>preferred over non-stainless steel due to lower hardness</td>
		</tr>
		<tr >
			<td >Stemflex</td>
			<td>ThermoFisher</td>
			<td>A3349401</td>
			<td>AKA &#34;iPSC culture media&#34;</td>
		</tr>
		<tr >
			<td >Sterile distilled water</td>
			<td>ThermoFisher</td>
			<td>5230</td>
			<td></td>
		</tr>
		<tr >
			<td >Sylgard 170 -&#160; Silicone Elastomer Encapsulant Black 0.9 kg Kit</td>
			<td>Dow</td>
			<td>DOWSIL 170 2LB KIT</td>
			<td>AKA black Polydimethylsiloxane (black PDMS)</td>
		</tr>
		<tr >
			<td >Sylgard 184 - Silicone Elastomer Clear 1 lb Kit</td>
			<td>Dow</td>
			<td>DC 184 SYLGARD 0.5KG 1.1LB KIT</td>
			<td>AKA Polydimethylsiloxane (PDMS)</td>
		</tr>
		<tr >
			<td >Temperature-controlled heated stage</td>
			<td>Okolab</td>
			<td>H401-HG-SMU</td>
			<td>Set height to 10 cm</td>
		</tr>
		<tr >
			<td >Thermoplastic 3D printer</td>
			<td>Ultimaker</td>
			<td>Ultimaker 3</td>
			<td></td>
		</tr>
		<tr >
			<td >Thiazovivin</td>
			<td>Selleck Chem</td>
			<td>S1459</td>
			<td></td>
		</tr>
		<tr >
			<td >Trypan Blue</td>
			<td>NanoEntek</td>
			<td>EBT-001</td>
			<td></td>
		</tr>
		<tr >
			<td >Vacuum Chamber</td>
			<td>Bel-Art Parts</td>
			<td>F42027-0000</td>
			<td></td>
		</tr>
		<tr >
			<td >Variable Speed Mini Band Saw</td>
			<td>Micro-Mark</td>
			<td>82203</td>
			<td></td>
		</tr>
		<tr >
			<td >Variable Speed Miniature Drill Press</td>
			<td>Micro-Mark</td>
			<td>82959</td>
			<td></td>
		</tr>
		<tr >
			<td >Vibration Isolation Table</td>
			<td>Labconco</td>
			<td>3618000</td>
			<td></td>
		</tr>
		<tr >
			<td >Weighing Boats</td>
			<td>VWR</td>
			<td>10803-140</td>
			<td></td>
		</tr>
		<tr >
			<td >Talon Cylinder Bench Clamp</td>
			<td>VWR</td>
			<td>97035-528</td>
			<td>AKA screw clamp</td>
		</tr>
	</tbody>
</table>

designing a bioreactor to improve data acquisition and model throughput of engineered cardiac tissues

Heart failure remains the leading cause of death worldwide, creating a pressing need for better preclinical models of the human heart. Tissue engineering is crucial for basic science cardiac research; in vitro human cell culture eliminates the interspecies differences of animal models, while a more tissue-like 3D environment (e.g., with extracellular matrix and heterocellular coupling) simulates in vivo conditions to a greater extent than traditional two-dimensional culture on plastic Petri dishes. However, each model system requires specialized equipment, for example, custom-designed bioreactors and functional assessment devices. Additionally, these protocols are often complicated, labor-intensive, and plagued by the failure of the small, delicate tissues.
This paper describes a process for generating a robust human engineered cardiac tissue (hECT) model system using induced pluripotent stem-cell-derived cardiomyocytes for the longitudinal measurement of tissue function. Six hECTs with linear strip geometry are cultured in parallel, with each hECT&#160;suspended from a pair of force-sensing polydimethylsiloxane (PDMS) posts attached to PDMS racks. Each post is capped with a black PDMS stable post tracker (SPoT), a new feature that improves the ease of use, throughput, tissue retention, and data quality. The shape allows for the reliable optical tracking of post deflections, yielding improved twitch force tracings with absolute active and passive tension. The cap geometry eliminates tissue failure due to hECTs slipping off the posts, and as they involve a second step after PDMS rack fabrication, the SPoTs can be added to existing PDMS post-based designs without major changes to the bioreactor fabrication process.
The system is used to demonstrate the importance of measuring hECT function at physiological temperatures and shows stable tissue function during data acquisition. In summary, we describe a state-of-the-art model system that reproduces key physiological conditions to advance the biofidelity, efficiency, and rigor of engineered cardiac tissues for in vitro applications.

Following the above protocol, cardiomyocytes were generated from a healthy iPSC line used previously by our group9,15 and fabricated into hECTs after 8-61 days in culture. Figure 9A shows representative images of hECTs as viewed from the bottom, which were created without (top) and with (bottom) SPoTs. Functional measurements were taken at room temperature (23 &#176;C) and at physiological temperature (36 &#176;C) between 37 days and...

Watch this Scientific Journal Video about Designing a Bioreactor to Improve Data Acquisition and Model Throughput of Engineered Cardiac Tissues at JoVE.com

Designing a Bioreactor to Improve Data Acquisition and Model Throughput of Engineered Cardiac Tissues

Three-dimensional cardiac tissues bioengineered using stem-cell-derived cardiomyocytes have emerged as promising models for studying healthy and diseased human myocardium in vitro while recapitulating key aspects of the native cardiac niche. This manuscript describes a protocol for fabricating and analyzing high-content engineered cardiac tissues generated from human induced pluripotent stem-cell-derived cardiomyocytes.

Heart failure remains the leading cause of death worldwide, creating a pressing need for better preclinical models of the human heart. Tissue engineering ...

designing-bioreactor-to-improve-data-acquisition-model-throughput

Research

JoVE Journal

Bioengineering

705 Views.  Icahn School of Medicine at Mount Sinai. Three-dimensional cardiac tissues bioengineered using stem-cell-derived cardiomyocytes have emerged as promising models for studying healthy and diseased human myocardium in vitro while recapitulating key aspects of the native cardiac niche. This manuscript describes a protocol for fabricating and analyzing high-content engineered cardiac tissues generated from human induced pluripotent stem-cell-derived cardiomyocytes.

Video: Designing a Bioreactor to Improve Data Acquisition and Model Throughput of Engineered Cardiac Tissues

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 ...

Operation of a Benchtop Bioreactor

Fermentation systems are used to provide an optimal growth environment for many different types of cell cultures. The ability afforded by fermentors to carefully control temperature, pH, and dissolved oxygen concentrations in particular makes them essential to efficient large scale growth and expression of fermentation products. This video will briefly describe the advantages of the fermentor over the shake flask. It will also identify key components of a typical benchtop fermentation system and give basic instruction on setup of the vessel and calibration of its probes. The viewer will be familiarized with the sterilization process and shown how to inoculate the growth medium in the vessel with culture. Basic concepts of operation, sampling, and harvesting will also be demonstrated. Simple data analysis and system cleanup will also be discussed.

Fermentors are used to increase culture yield and productivity of bioengineered cells. After screening multiple microbial or animal cell culture candidates in shake flasks, the next logical step is to increase the selected culture&#x2019;s biomass with the fermentor. This video demonstrates the setup and operation of a typical benchtop bioreactor system.

Fermentation systems are used to provide an optimal growth environment for many different types of cell cultures. The ability afforded by fermentors to ...

Generation and Grafting of Tissue-engineered Vessels in a Mouse Model

The construction of vascular conduits is a fundamental strategy for surgical repair of damaged and injured vessels resulting from cardiovascular diseases. The current protocol presents an efficient and reproducible strategy in which functional tissue engineered vessel grafts can be generated using partially induced pluripotent stem cell (PiPSC) from human fibroblasts. We designed a decellularized vessel scaffold bioreactor, which closely mimics the matrix protein structure and blood flow that exists within a native vessel, for seeding of PiPSC-endothelial cells or smooth muscle cells prior to grafting into mice. This approach was demonstrated to be advantageous because immune-deficient mice engrafted with the PiPSC-derived grafts presented with markedly increased survival rate 3 weeks after surgery. This protocol represents a valuable tool for regenerative medicine, tissue engineering and potentially patient-specific cell-therapy in the near future.

Here, we present a protocol to generate tissue engineered vessel grafts that are functional for grafting into mice by double seeding partially induced pluripotent stem cell (PiPSC) - derived smooth muscle cells and PiPSC - derived endothelial cells on a decellularized vessel scaffold bioreactor.

The construction of vascular conduits is a fundamental strategy for surgical repair of damaged and injured vessels resulting from cardiovascular diseases. ...

Production, Characterization and Potential Uses of a 3D Tissue-engineered Human Esophageal Mucosal Model

The incidence of both esophageal adenocarcinoma and its precursor, Barrett&#8217;s Metaplasia, are rising rapidly in the western world. Furthermore esophageal adenocarcinoma generally has a poor prognosis, with little improvement in survival rates in recent years. These are difficult conditions to study and there has been a lack of suitable experimental platforms to investigate disorders of the esophageal mucosa.
A model of the human esophageal mucosa has been developed in the MacNeil laboratory which, unlike conventional 2D cell culture systems, recapitulates the cell-cell and cell-matrix interactions present in vivo and produces a mature, stratified epithelium similar to that of the normal human esophagus. Briefly, the model utilizes non-transformed normal primary human esophageal fibroblasts and epithelial cells grown within a porcine-derived acellular esophageal scaffold. Immunohistochemical characterization of this model by CK4, CK14, Ki67 and involucrin staining demonstrates appropriate recapitulation of the histology of the normal human esophageal mucosa.
This model provides a robust, biologically relevant experimental model of the human esophageal mucosa. It can easily be manipulated to investigate a number of research questions including the effectiveness of pharmacological agents and the impact of exposure to environmental factors such as alcohol, toxins, high temperature or gastro-esophageal refluxate components. The model also facilitates extended culture periods not achievable with conventional 2D cell culture, enabling, inter alia, the study of the impact of repeated exposure of a mature epithelium to the agent of interest for up to 20 days. Furthermore, a variety of cell lines, such as those derived from esophageal tumors or Barrett&#8217;s Metaplasia, can be incorporated into the model to investigate processes such as tumor invasion and drug responsiveness in a more biologically relevant environment.

This manuscript describes the production, characterization and potential uses of a tissue engineered 3D esophageal construct prepared from normal primary human esophageal fibroblast and squamous epithelial cells seeded within a de-cellularized porcine scaffold. The results demonstrate the formation of a mature stratified epithelium similar to the normal human esophagus.

The incidence of both esophageal adenocarcinoma and its precursor, Barrett&#8217;s Metaplasia, are rising rapidly in the western world. Furthermore ...

Athymic Rat Model for Evaluation of Engineered Anterior Cruciate Ligament Grafts

Anterior cruciate ligament (ACL) rupture is a common ligamentous injury that often requires surgery because the ACL does not heal well without intervention. Current treatment strategies include ligament reconstruction with either autograft or allograft, which each have their associated limitations. Thus, there is interest in designing a tissue-engineered graft for use in ACL reconstruction. We describe the fabrication of an electrospun polymer graft for use in ACL tissue engineering. This polycaprolactone graft is biocompatible, biodegradable, porous, and is comprised of aligned fibers. Because an animal model is necessary to evaluate such a graft, this paper describes an intra-articular athymic rat model of ACL reconstruction that can be used to evaluate engineered grafts, including those seeded with xenogeneic cells. Representative histology and biomechanical testing results at 16 weeks postoperatively are presented, with grafts tested immediately post-implantation and contralateral native ACLs serving as controls. The present study provides a reproducible animal model with which to evaluate tissue engineered ACL grafts, and demonstrates the potential of a regenerative medicine approach to treatment of ACL rupture.

Animal models are important tools for the evaluation of tissue-engineered grafts. This paper presents the protocol for preparing an electrospun biodegradable polymer graft for use in anterior cruciate ligament tissue engineering, as well as a surgical protocol for implantation in a rat model.

Anterior cruciate ligament (ACL) rupture is a common ligamentous injury that often requires surgery because the ACL does not heal well without ...

Construction of Defined Human Engineered Cardiac Tissues to Study Mechanisms of Cardiac Cell Therapy

Human cardiac tissue engineering can fundamentally impact therapeutic discovery through the development of new species-specific screening systems that replicate the biofidelity of three-dimensional native human myocardium, while also enabling a controlled level of biological complexity, and allowing non-destructive longitudinal monitoring of tissue contractile function. Initially, human engineered cardiac tissues (hECT) were created using the entire cell population obtained from directed differentiation of human pluripotent stem cells, which typically yielded less than 50% cardiomyocytes. However, to create reliable predictive models of human myocardium, and to elucidate mechanisms of heterocellular interaction, it is essential to accurately control the biological composition in engineered tissues. 
To address this limitation, we utilize live cell sorting for the cardiac surface marker SIRP&#945; and the fibroblast marker CD90 to create tissues containing a 3:1 ratio of these cell types, respectively, that are then mixed together and added to a collagen-based matrix solution. Resulting hECTs are, thus, completely defined in both their cellular and extracellular matrix composition.
Here we describe the construction of defined hECTs as a model system to understand mechanisms of cell-cell interactions in cell therapies, using an example of human bone marrow-derived mesenchymal stem cells (hMSC) that are currently being used in human clinical trials. The defined tissue composition is imperative to understand how the hMSCs may be interacting with the endogenous cardiac cell types to enhance tissue function. A bioreactor system is also described that simultaneously cultures six hECTs in parallel, permitting more efficient use of the cells after sorting.

This manuscript describes the creation of defined engineered cardiac tissues using surface marker expression and cell sorting. The defined tissues can then be used in a multi-tissue bioreactor to investigate mechanisms of cardiac cell therapy in order to provide a functional, yet controlled, model system of the human heart.

Human cardiac tissue engineering can fundamentally impact therapeutic discovery through the development of new species-specific screening systems that ...

Automated Contraction Analysis of Human Engineered Heart Tissue for Cardiac Drug Safety Screening

Cardiac tissue engineering describes techniques to constitute three dimensional force-generating engineered tissues. For the implementation of these procedures in basic research and preclinical drug development, it is important to develop protocols for automated generation and analysis under standardized conditions. Here, we present a technique to generate engineered heart tissue (EHT) from cardiomyocytes of different species (rat, mouse, human). The technique relies on the assembly of a fibrin-gel containing dissociated cardiomyocytes between elastic polydimethylsiloxane (PDMS) posts in a 24-well format. Three-dimensional, force-generating EHTs constitute within two weeks after casting. This procedure allows for the generation of several hundred EHTs per week and is technically limited only by the availability of cardiomyocytes (0.4-1.0 x 106/EHT). Evaluation of auxotonic muscle contractions is performed in a modified incubation chamber with a mechanical interlock for 24-well plates and a camera placed on top of this chamber. A software controls a camera moved on an XYZ axis system to each EHT. EHT contractions are detected by an automated figure recognition algorithm, and force is calculated based on shortening of the EHT and the elastic propensity and geometry of the PDMS posts. This procedure allows for automated analysis of high numbers of EHT under standardized and sterile conditions. The reliable detection of drug effects on cardiomyocyte contraction is crucial for cardiac drug development and safety pharmacology. We demonstrate, with the example of the hERG channel inhibitor E-4031, that the human EHT system replicates drug responses on contraction kinetics of the human heart, indicating it to be a promising tool for cardiac drug safety screening.

Here, we show the generation of human engineered heart tissue from induced pluripotent stem cells (hiPSC)-derived cardiomyocytes. We present a method to analyze contraction force and exemplary alteration of contraction pattern by the hERG channel inhibitor E-4031. This method shows high level of robustness and suitability for cardiac drug screening.

Cardiac tissue engineering describes techniques to constitute three dimensional force-generating engineered tissues. For the implementation of these ...

Seeding and Implantation of a Biosynthetic Tissue-engineered Tracheal Graft in a Mouse Model

Treatment options for congenital or secondary long segment tracheal defects have historically been limited due to an inability to replace functional tissue. Tissue engineering holds great promise as a potential solution with its ability to integrate cells and signaling molecules into a 3-dimensional scaffold. Recent work with tissue engineered tracheal grafts (TETGs) has seen some success but their translation has been limited by graft stenosis, graft collapse, and delayed epithelialization. In order to investigate the mechanisms driving these issues, we have developed a mouse model for tissue engineered tracheal graft implantation. TETGs were constructed using electrospun polymers polyethylene terephthalate (PET) and polyurethane (PU) in a mixture of PET and PU (20:80 percent weight). Scaffolds were then seeded using bone marrow mononuclear cells isolated from 6-8 week-old C57BL/6 mice by gradient centrifugation. Ten million cells per graft were seeded onto the lumen of the scaffold and allowed to incubate overnight before implantation between the third and seventh tracheal rings. These grafts were able to recapitulate the findings of stenosis and delayed epithelialization as demonstrated by histological analysis and lack of Keratin 5 and Keratin 14 basal epithelial cells on immunofluorescence. This model will serve as a tool for investigating cellular and molecular mechanisms involved in host remodeling.

Graft stenosis poses a critical obstacle in tissue engineered airway replacement. To investigate cellular mechanisms underlying stenosis, we utilize a murine model of tissue engineered tracheal replacement with seeded bone marrow mononuclear cells (BM-MNC). Here, we detail our protocol, including scaffold manufacturing, BM-MNC isolation, graft seeding, and implantation.

Treatment options for congenital or secondary long segment tracheal defects have historically been limited due to an inability to replace functional ...

Preparation of Mesh-Shaped Engineered Cardiac Tissues Derived from Human iPS Cells for In Vivo Myocardial Repair

The current protocol describes methods to generate scalable, mesh-shaped engineered cardiac tissues (ECTs) composed of cardiovascular cells derived from human induced pluripotent stem cells (hiPSCs), which are developed towards the goal of clinical use. HiPSC-derived cardiomyocytes, endothelial cells, and vascular mural cells are mixed with gel matrix and then poured into a polydimethylsiloxane (PDMS) tissue mold with rectangular internal staggered posts. By culture day 14 ECTs mature into a 1.5 cm x 1.5 cm mesh structure with 0.5 mm diameter myofiber bundles. Cardiomyocytes align to the long-axis of each bundle and spontaneously beat synchronously. This approach can be scaled up to a larger (3.0 cm x 3.0 cm) mesh ECT while preserving construct maturation and function. Thus, mesh-shaped ECTs generated from hiPSC-derived cardiac cells may be feasible for cardiac regeneration paradigms.

The present protocol generates mesh-shaped engineered cardiac tissues containing cardiovascular cells derived from human induced pluripotent stem cells to allow the investigation of cell implantation therapy for heart diseases.

The current protocol describes methods to generate scalable, mesh-shaped engineered cardiac tissues (ECTs) composed of cardiovascular cells derived from ...

Cardiac Spheroids as in vitro Bioengineered Heart Tissues to Study Human Heart Pathophysiology

Despite several advances in cardiac tissue engineering, one of the major challenges to overcome remains the generation of a fully functional vascular network comprising several levels of complexity to provide oxygen and nutrients within bioengineered heart tissues. Our laboratory has developed a three-dimensional in vitro model of the human heart, known as the "cardiac spheroid" or "CS". This presents biochemical, physiological, and pharmacological features typical of the human heart and is generated by co-culturing its three major cell types, such as cardiac myocytes, endothelial cells, and fibroblasts. Human induced pluripotent stem cells-derived cardiomyocytes (hiPSC-CMs or iCMs) are co-cultured at ratios approximating the ones found in vivo with human cardiac fibroblasts (HCFs) and human coronary artery endothelial cells (HCAECs) in hanging drop culture plates for three to four days. The confocal analysis of CSs stained with antibodies against cardiac Troponin T, CD31 and vimentin (markers for cardiac myocytes, endothelial cells and fibroblasts, respectively) shows that CSs present a complex endothelial cell network, resembling the native one found in the human heart. This is confirmed by the 3D rendering analysis of these confocal images. CSs also present extracellular matrix (ECM) proteins typical of the human heart, such as collagen type IV, laminin and fibronectin. Finally, CSs present a contractile activity measured as syncytial contractility closer to the one typical of the human heart compared to CSs that contain iCMs only. When treated with a cardiotoxic anti-cancer agent, such as doxorubicin (DOX, used to treat leukemia, lymphoma and breast cancer), the viability of DOX-treated CSs is significantly reduced at 10 &#181;M genetic and chemical inhibition of endothelial nitric oxide synthase, a downstream target of DOX in HCFs and HCAECs, reduced its toxicity in CSs. Given these unique features, CSs are currently used as in vitro models to study heart biochemistry, pathophysiology, and pharmacology.

This protocol aims to fabricate 3D cardiac spheroids (CSs) by co-culturing cells in hanging drops.&#160;Collagen-embedded CSs are treated with doxorubicin (DOX, a cardiotoxic agent) at physiological concentrations to model heart failure. In vitro testing using DOX-treated CSs may be used to identify novel therapies for heart failure patients.

Despite several advances in cardiac tissue engineering, one of the major challenges to overcome remains the generation of a fully functional vascular ...