Title: Subclinical hypothyroidism during pregnancy: the Melbourne public hospitals consensus
Authors: Hamblin, PS
Sheehan, PM
Allan, C
Houlihan, CA
Lu, ZX
Forehan, SP
Topliss, DJ
Gilfillan, C
Krishnamurthy, B
Renouf, D
Sztal-Mazer, S
Varadarajan, S
Issue Year: 2019
Publisher WILEY
Series INTERNAL MEDICINE JOURNAL:
Abstract Tissue flaps are used to cover large/poorly healing wounds, but involve complex surgery and donor site morbidity. In this study a tissue flap is assembled using the mammalian body as a bioreactor to functionally connect an artery and vein to a human capillary network assembled from induced pluripotent stem cell-derived endothelial cells (hiPSC ECs). In vitro: Porous NovoSorb' scaffolds (3 mm x 1.35 mm) were seeded with 200,000 hiPSC ECs 100,000 human vascular smooth muscle cells (hvSMC), and cultured for 1-3 days, with capillaries formed by 24 h which were CD3r, VE-Cadherin', EphB4., VEGFR2' and Ki67, whilst hvSMCs (calponin+) attached abluminally. In vivo: In SCID mice, bi-lateral epigastric vascular pellicles were isolated in a silicone chamber for a 3 week 'delay period' for pedicle capillary sprouting, then reopened, and two hiPSC EC hvSMCs seeded scaffolds transplanted over the pedicle. The chamber was either resealed (Group 1), or removed and surrounding tissue secured around the pedicle + scaffolds (Group 2), for 1 or 2 weeks. Human capillaries survived in vivo and were CD31 +, VE-Cadherin' and VEGFR2'. Human vSMCs remained attached, and host mesenchymal cells also attached abluminally. Systemically injected FITC-dextran present in human capillary lumens indicated inosculation to host capillaries. Human iPSC EC capillary morphometric parameters at one week in vivo were equal to or higher than the same parameters measured in human abdominal skin. This 'proof of concept' study has demonstrated that bio-engineering an autologous human tissue flap based on hiPSC EC could minimize the use of donor flaps and has potential applications for complex wound coverage. Statement of Significance Tissue flaps, used for surgical reconstruction of wounds, require complex surgery, often associated with morbidity. Bio-engineering a simpler alternative, we assembled a human induced pluripotent stem cell derived endothelial cell (hiPSC ECs) capillary network in a porous scaffold in vitro, which when transplanted over a mouse vascular pedicle in vivo formed a functional tissue flap with mouse blood flow in the human capillaries. Therefore it is feasible to form an autologous tissue flap derived from a hiPSC EC capillary network assembled in vitro, and functionally connect to a vascular pedicle in vivo that could be utilized in complex wound repair for chronic or acute wounds. (C) 2019 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
URI: https://publications.svi.edu.au/publications/7757
Other Identifiers 10.1111/imj.14210
Publication type Article