Zusammenfassung
Die Züchtung von künstlichem Herzmuskelersatzgewebe wird zukünftig ein an Bedeutung zunehmender therapeutischer Ansatz werden. Allerdings stellt bei der Erzeugung von Geweben, die eine größere Stärke als 100 µm erreichen sollen, die Versorgung der Graftzellen mit Sauerstoff und Nährstoffen sowie der Abtransport der Stoffwechselprodukte über Diffusionswege ein kritisches Moment dar. Die Viabilität der besiedelten Zellen des myokardialen Ersatzgewebes bedingt aber unmittelbar dessen Funktion, sodass eine möglichst frühzeitige und suffiziente Vaskularisierung erforderlich ist. Über die Auswahl des Substrats, die Strukturierung der Matrizes, spezifische zelluläre Besiedelung und Wachstumsfaktoren wird versucht, die Vaskularisierung zu optimieren.
Diese Übersichtsarbeit stellt den Stand der Forschung zur myokardialen Gewebezüchtung unter Verwendung natürlicher solider Substrate (Harnblase, Gallenblase, Dünndarm, Magen, Peritoneum, Omentum, Uterus, Skelettmuskel, Zwerchfell und Herzmuskel) dar und beleuchtet besonders die in den jeweiligen Ansätzen erzielten Erfolge bei der Vaskularisierung des bioartifiziellen Gewebes.
Abstract
Tissue engineering of bioartificial myocardial tissue will become an increasingly important therapeutic approach in the near future but supply of oxygen and nutrients as well as evacuation of metabolic products represent a critical obstacle in tissues with a thickness of 100 µm and above. Viability of seeded cells in the myocardial patch is positively correlated with its function and thus early sufficient vascularization is mandatory. The choice of substrate, structure of matrices, specific cellular seeding and addition of growth factors contribute to this necessary vascularization process.
This review article gives an overview of the current state of research on recent myocardial tissue engineering utilizing natural and solid substrates (urinary bladder, gall bladder, small intestine, stomach, peritoneum, omentum, uterus, skeletal muscle, diaphragm and cardiac muscle) with a special focus on the results of vascularization of bioartificial tissue for each approach.
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Danksagung
Wir danken der Deutschen Forschungsgemeinschaft (DFG) für die Förderung eigener Untersuchungen zur Entwicklung vaskularisierten Myokardersatzgewebes im Rahmen des SFB599.
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Schilling, T., Cebotari, S., Tudorache, I. et al. Tissue Engineering von vaskularisiertem Myokardersatzgewebe. Chirurg 82, 319–324 (2011). https://doi.org/10.1007/s00104-010-2032-1
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DOI: https://doi.org/10.1007/s00104-010-2032-1