Breathing new life into tissue engineering: exploring cutting-edge vascularization strategies for skin substitutes

IF 9.2 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

Angiogenesis Pub Date : 2024-06-06 DOI:10.1007/s10456-024-09928-6

M. Zohaib Iqbal, Mahrukh Riaz, Thomas Biedermann, Agnes S. Klar

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Abstract

Tissue-engineered skin substitutes (TESS) emerged as a new therapeutic option to improve skin transplantation. However, establishing an adequate and rapid vascularization in TESS is a critical factor for their clinical application and successful engraftment in patients. Therefore, several methods have been applied to improve the vascularization of skin substitutes including (i) modifying the structural and physicochemical properties of dermal scaffolds; (ii) activating biological scaffolds with growth factor-releasing systems or gene vectors; and (iii) developing prevascularized skin substitutes by loading scaffolds with capillary-forming cells. This review provides a detailed overview of the most recent and important developments in the vascularization strategies for skin substitutes. On the one hand, we present cell-based approaches using stem cells, microvascular fragments, adipose tissue derived stromal vascular fraction, endothelial cells derived from blood and skin as well as other pro-angiogenic stimulation methods. On the other hand, we discuss how distinct 3D bioprinting techniques and microfluidics, miRNA manipulation, cell sheet engineering and photosynthetic scaffolds like GelMA, can enhance skin vascularization for clinical applications. Finally, we summarize and discuss the challenges and prospects of the currently available vascularization techniques that may serve as a steppingstone to a mainstream application of skin tissue engineering.

Graphical abstract

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为组织工程注入新活力：探索皮肤替代品的尖端血管化策略。

组织工程皮肤替代物（TESS）是改善皮肤移植的一种新疗法。然而，在 TESS 中建立充分、快速的血管化是其临床应用和在患者体内成功移植的关键因素。因此，人们采用了多种方法来改善皮肤替代物的血管化，包括：（i）改变真皮支架的结构和理化特性；（ii）用释放生长因子的系统或基因载体激活生物支架；以及（iii）通过在支架中加入毛细血管形成细胞来开发预血管化皮肤替代物。本综述详细概述了皮肤替代品血管化策略的最新重要进展。一方面，我们介绍了使用干细胞、微血管片段、脂肪组织衍生的基质血管部分、血液和皮肤衍生的内皮细胞以及其他促血管生成刺激方法的基于细胞的方法。另一方面，我们还讨论了独特的三维生物打印技术和微流控技术、miRNA 操作、细胞片工程和光合作用支架（如 GelMA）如何在临床应用中增强皮肤血管生成。最后，我们总结并讨论了目前可用的血管化技术所面临的挑战和前景，这些技术可作为皮肤组织工程主流应用的垫脚石。

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来源期刊

Angiogenesis PERIPHERAL VASCULAR DISEASE-

CiteScore

21.90

自引率

8.20%

发文量

审稿时长

6-12 weeks

期刊介绍： Angiogenesis, a renowned international journal, seeks to publish high-quality original articles and reviews on the cellular and molecular mechanisms governing angiogenesis in both normal and pathological conditions. By serving as a primary platform for swift communication within the field of angiogenesis research, this multidisciplinary journal showcases pioneering experimental studies utilizing molecular techniques, in vitro methods, animal models, and clinical investigations into angiogenic diseases. Furthermore, Angiogenesis sheds light on cutting-edge therapeutic strategies for promoting or inhibiting angiogenesis, while also highlighting fresh markers and techniques for disease diagnosis and prognosis.