Le cartilage est un tissu clé des articulations synoviales. Suite à un problème mécanique, traumatique ou inflammatoire, le cartilage est dégradé entrainant des douleurs articulaires et une perte de mobilité. Le cartilage étant un tissu non innervé et non vascularisé, son auto-réparation est très faible. De plus en plus de techniques sont développées pour la réparation des défauts cartilagineux mais aucune n’a encore permis d’obtenir un nouveau cartilage pleinement fonctionnel. En particulier, l’ingénierie tissulaire (IT) est une technique très prometteuse qui consiste à obtenir un greffon de cartilage dont les propriétés mécaniques et structurales soient satisfaisantes une fois implantée dans l’articulation. L’IT est basée sur l’association de cellules, d’un biomatériau et de facteurs de croissance. Le but de cette thèse est d’étudier l’effet de l’âge du donneur des cellules sur la synthèse du greffon par l’IT in vitro et sur la qualité du cartilage obtenu lors de l’implantation dans un modèle de rat NUDE. Puis dans une dernière partie, l’impact de l’environnement chimique et mécanique est étudié sur la qualité du greffon. Nos études montrent ainsi que l’âge du donneur aussi bien dans un contexte in vitro ou in vivo impacte la qualité du greffon et la réparation une fois implanté dans l’animal. En effet, les greffons issus des donneurs âgés ont des propriétés mécaniques légèrement plus élevées et une synthèse des protéines de la matrice extracellulaire (MEC) du cartilage significativement plus élevée que les greffons issus de donneurs jeunes. De plus, la réponse inflammatoire des greffons implantés dans un défaut cartilagineux chez le rat NUDE est plus faible pour les donneurs âgés. Enfin, nous montrons que le microenvironnement mécanique (compression ou pression hydrostatique) et chimique (liquide synovial (LS) ou TGF-β pur) joue un rôle important sur la réponse cellulaire. Par ailleurs, en fonction de l’âge, l’association de ces différents facteurs donnent des résultats différents. Par exemple, pour une sollicitation de type compression, c’est le LS qui est à favoriser pour obtenir les greffons de meilleure qualité dans le cas des donneurs âgés. Au contraire, pour la même sollicitation de type compression, c’est la présence de TGF-β1 qui conduit au greffon de meilleure qualité pour les donneurs jeunes. Ces études mettent en évidence l’importance de l’âge du donneur et montrent de plus qu’un protocole IT patient spécifique est la meilleure solution. / Cartilage is an important tissue of synovial joints. Following a mechanical problem, traumatic or inflammatory, the cartilage is degraded causing joint pain and loss of mobility. Because cartilage is a non-innervated and non-vascularized tissue, its self-repair is very weak. More and more techniques are being developed for the cartilage but none has resulted in a new fully functional cartilage. In particular, tissue engineering (TE) is a very promising technique that consists in obtaining a cartilage graft whose mechanical and structural properties are satisfactory once implanted in the joint. TE is based on the association of cells, biomaterial and growth factors. The aim of this thesis is to study the effect of cell donor’s age on graft synthesis by TE in vitro and on the quality of the cartilage obtained during implantation in a NUDE rat model. Then in a last part, the impact of the chemical and mechanical environment is studied on the quality of the graft. Our studies show that the age of the donor both in vitro and in vivo has an impact on graft quality and repair once implanted in the animal. In fact, grafts from older donors have slightly higher mechanical properties and significantly higher synthesis of extracellular matrix proteins (ECM) than grafts from younger donors. In addition, the inflammatory response of grafts implanted in a cartilage defect in the NUDE rat is lower for older donors. Finally, we show that the mechanical microenvironment (compression or hydrostatic pressure) and chemical microenvironment (synovial fluid (SF) or TGF-β) play an important role in the cellular response. Moreover, depending on age, the combination of these different factors gives different results. For example, for a compression solicitation, it is the SF that is to be favored to obtain better quality grafts in the case of elderly donors. On the contrary, for the same compression stress, it is the presence of TGF-β1 that leads to the best quality graft for young donors. These studies highlight the importance of donor age and further show that a specific patient protocol of TE is the best solution.

L'articulation temporo-mandibulaire (ATM) est une articulation formée entre l'os temporal et le condyle mandibulaire, et est fréquemment atteinte. Ces affections sont souvent si douloureuses lors d'activités orales fondamentales que les patients ont une qualité de vie diminuée. Les limites de la thérapeutique pour les atteintes des ATM, ont conduit à accroître l'intérêt pour les stratégies régénératives combinant les cellules souches, les "scaffolds" implantables et les molécules bioactives. Réussir dans la régénération fonctionnelle et structurelle de l'ATM constitue un véritable défi. Des stratégies innovantes et des biomatériaux sont absolument essentiels car l'ATM peut être considérée comme l'un des ensembles tissulaires les plus difficiles à régénérer, au vu de sa capacité de guérison limitée, de ses propriétés histologiques et structurelles uniques et de la nécessité de prévenir à long terme ses adhérences ossifiées ou fibreuses. Une première étude in vitro a été menée pour développer un implant nanostructuré pro-régénératif du cartilage portant des cellules souches mésenchymateuses humaines. Les nanoréservoirs de TGFβ3 au sein d’une matrice de collagène de type II de méduse ont montrés leur capacité chondrogénique. Ils ont permis une colonisation, puis une différenciation et une maturation matricielle favorable à la régénération cartilagineuse. Ces résultats sont encourageants vu la difficulté de mise en culture des chondrocytes et la nécessité d'une restauration rapide de la couche cartilagineuse des surfaces articulaires. Une deuxième étude in vivo a été menée pour développer un implant nanostructuré pro-régénératif anti-inflammatoire osseux. Des matrices biomimétiques nanofibreuses et microporeuses de polycaprolactone (PCL) ont été fonctionnalisées par des nanoréservoirs de BMP-2 et d’ibuprofène. Elles ont été implantées sur des modèles murins de lésions osseuses maxillaires. L’accélération de la régénération induite par ces implants nanofonctionnalisés a été mise en évidence sur des souris sauvages et sur des souris mutantes Tabby. Le bénéfice ainsi établi de fonctionnalisation des implants par la BMP-2 et l'ibuprofène revêt un intérêt particulier face aux fréquentes pathologies inflammatoires chroniques de l'ATM. Ces résultats prometteurs devront faire suite à des approches d'orchestration tridimensionnelle des différents tissus de l'ATM. / The temporomandibular joint (TMJ) is an articulation formed between the temporal bone and the mandibular condyle which is commonly affected. These affections are often so painful during fundamental oral activities that patients have lower quality of life. Limitations of therapeutics for severe TMJ diseases have led to increased interest in regenerative strategies combining stem cells, implantable scaffolds and well-targeting bioactive molecules. To succeed in functional and structural regeneration of TMJ is very challenging. Innovative strategies and biomaterials are absolutely crucial because TMJ can be considered as one of the most difficult tissues to regenerate due to its limited healing capacity, its unique histological and structural properties and the necessity for long-term prevention of its ossified or fibrous adhesions. A first in vitro study was conducted to develop a pro-regenerative nanostructured cartilage implant bearing human mesenchymal stem cells. The nanoreservoirs of TGFβ3 within a jellyfish type II collagen matrix showed their chondrogenic capacity. They allowed colonization, then differentiation and matrix maturation favorable to cartilaginous regeneration. These results are encouraging given the difficulty of culturing chondrocytes and the need for rapid restoration of the cartilaginous layer of articular surfaces. A second in vivo study was conducted to develop a nanostructured pro-regenerative anti-inflammatory bone implant. Nanofibrous and microporous biomimetic matrices of polycaprolactone (PCL) were functionalized by nanoreservoirs of BMP-2 and ibuprofen. They have been implanted in mouse models of maxillary bone lesions. The acceleration of regeneration induced by these nanofunctionalized implants has been demonstrated in wild-type mice and Tabby mutant mice. The benefit thus established of functionalization of implants by BMP-2 and ibuprofen is of particular interest in the frequent chronic inflammatory pathologies of TMJ. These promising results follow three-dimensional orchestration approaches for different TMJ tissues.

Cette thèse a pour objectif de développer une méthode de bioimpression 3D de tissus vivants. Ce nouveau champ disciplinaire a pour but la fabrication de tissus grâce à une bioimprimante en s’appuyant sur les principes fondamentaux de l’ingénierie tissulaire. Pour mener à bien ces travaux, une bio-encre spécifique a été formulée à l’aide de biomatériaux naturels afin de répondre aux critères de biocompatibilité, de maintien de la viabilité cellulaire et de support pour la formation d’un réseau cellulaire en trois dimensions. Plusieurs caractérisations ont ainsi pu être réalisées afin de démontrer l’innocuité du procédé de bioimpression 3D sur les cellules utilisées.L’évolution technologique de la bioimprimante utilisée est ensuite présentée en partant d’une technologie open-source pour arriver à l’utilisation d’un bras robotique 6 axes. L’exigence du cahier des charges de cette bioimprimante a évolué au fil des différents prototypes utilisés.La dernière partie de ce travail de thèse présente les résultats de bioimpression de tissus obtenus grâce à de multiples collaborations. Plusieurs tissus seront étudiés et caractérisés : le derme et sa maturation vers une peau totale, le cartilage et la bioimpression de cellules souches mésenchymateuses, un tissu microvascularisé grâce à l’incorporation de cellules endothéliales et pour finir un tissu perfusable en utilisant une approche de culture dynamique en bioréacteur / This thesis focus on the development of a 3D bioprinting process for living tissue. This new field of research, 3D bioprinting, aims to fabricate tissues using a bioprinter based on the tissue engineering fundamentals.To carry out this work, a specific bioink was formulated using natural biomaterials to meet the requirement of biocompatibility, cell viability and support of a three-dimensional cellular network. Several characterizations have been used to demonstrate the cells viability during the 3D bioprinting process.The bioprinter technological evolution is then presented, starting from an open-source technology and ending with the use of a 6-axis robotic arm. The specifications of this bioprinter evolved through different prototypes.The last part of this thesis concerns tissue bioprinting results obtained through multiple collaborations. Several tissues will be studied and characterized: the dermis and its maturation towards a total skin, the cartilage and the mesenchymal stem cells bioprinting, a microvascularized tissue thanks to the incorporation of endothelial cells and finally a perfusable tissue by using a dynamic culture approach in bioreactor

Disease and degeneration of articular cartilage and fibrocartilage tissues severely compromise the quality of life for millions of people. Although current surgical repair techniques can address symptoms in the short term, they do not adequately treat degenerative joint diseases such as osteoarthritis. Thus, novel tissue engineering strategies may be necessary to combat disease progression and repair or replace damaged tissue. Both articular cartilage and the meniscal fibrocartilage in the knee joint are subjected to a complex mechanical environment consisting of compressive, shear, and tensile forces. Therefore, engineered replacement tissues must be both mechanically and biologically competent to function after implantation. The goal of this work was to investigate the effects of oscillatory tensile loading on three dimensional engineered cartilaginous tissues in an effort to elucidate important aspects of chondrocyte and fibrochondrocyte mechanobiology. To investigate the metabolic responses of articular chondrocytes and meniscal fibrochondrocytes to oscillatory tensile loading, various protocols were used to identify stimulatory parameters. Several days of continuously applied tensile loading inhibited extracellular matrix metabolism, whereas short durations and intermittently applied loading could stimulate matrix production. Subpopulations of chondrocytes, separated based on their zonal origin within the tissue, differentially responded to tensile loading. Proteoglycan synthesis was enhanced in superficial zone cells, but the molecular structure of these molecules was not affected. In contrast, neither total proteoglycan nor protein synthesis levels of middle and deep zone chondrocytes were substantially affected by tensile loading; however, the sizes of these new matrix molecules were altered. Up to 14 days of intermittently applied oscillatory tensile loading induced modest increases in construct mechanical properties, but longer durations adversely affected these mechanical properties and increased degradative enzyme activity. These results provide insights into cartilage and fibrocartilage mechanobiology by elucidating cellular responses to tensile mechanical stimulation, which previously had not been widely explored for these tissues. Understanding the role that mechanical stimuli such as tension can play in the generation of engineered cartilaginous tissues will further the goal of developing successful treatment strategies for degenerative joint diseases.

Thèse de doctorat : Bioingénierie. Ingénierie Cellulaire et Tissulaire : Nancy 1 : 2007. / Titre provenant de l'écran-titre.

Cartilage regeneration is one of the most widely studied areas in tissue-engineering. Despite significant progress, most efforts to date have only focused on generating homogenous tissues whose bulk properties are similar to articular cartilage. However, anatomically and functionally, articular cartilage consists of four spatially distinct regions: the superficial, transitional, deep, and calcified zones. Each zone is characterized by unique extra-cellular matrix (ECM) compositions, mechanical properties, and cellular organization. The ECM is primarily composed of type II collagen and glycosaminoglycans (GAGs), whose relative concentrations vary between zones and therefore lead to distinctive mechanical properties. One of the major unsolved challenges in engineering cartilage has been the inability to regenerate tissue that mimics the zonal architecture of articular cartilage. Recent studies have attempted to imitate this spatial organization using zone-specific chondrocytes isolated from donor animal cartilage. Directed differentiation of a single stem population into zonally organized native-like articular cartilage has not yet been reported. This dissertation reports that hydrogels, incorporating both synthetic and natural polymers as well as cell-induced degradability, are suitable for generating zone-specific chondrogenic phenotypes from a single MSC population. Specifically, cues provided from the unique combinations of chondroitin sulfate (CS), hyaluronic acid (HA), and MMP-sensitive peptide (MMP-pep) within a PEG-based hydrogel, direct the chondrogenic differentiation of MSCs. The findings of this dissertation demonstrate the capability of creating native-like and mechanically relevant articular cartilage consisting of zone specific layers. This ability provides a new direction in cartilage tissue engineering and could be invaluable for cartilage repair if incorporated with current minimally invasive surgical techniques. / text

Abstract: Objective: To compare the long-term viability of percutaneously injected crushed auricular cartilage to surgically implanted cartilage in the rabbit. Methods: Auricular cartilage was harvested bilaterally in 10 New Zealand white rabbits. A 1 cm2 cartilage graft was harvested and implanted surgically on the upper nasal dorsum. The remaining cartilage was crushed and percutaneously injected on the lower nasal dorsum. Volume and mass of each graft were compared between pre-implantation and after 3 months of observation. A histological study was conducted to evaluate chondrocyte viability and degree of fibrosis on the grafts. Results: Mass and volume remained similar for surgically implanted cartilage grafts. Mass and volume diminished by an average of 47% and 40% respectively after 3 months for the injected crushed cartilage grafts. Chondrocyte viability was an average of 25% lower in the injected grafts. Conclusion: Cartilage injection is a promising technique that must be refined to increase long term chondrocyte viability. Developing an appropriate injection apparatus would improve this technique. / Résumé : Objectif: Comparer la viabilité à long-terme de cartilage auriculaire broyé injecté de façon percutanée au cartilage implanté chirurgicalement chez le lapin Méthodes: Prélèvement de cartilage auriculaire bilatéralement chez 10 lapins blancs « New Zealand ». Pour chaque lapin, une greffe de cartilage de 1 cm2 fut prélevée et implantée chirurgicalement au niveau du dorsum nasal supérieur. Le reste du cartilage fut broyé puis injecté de manière percutanée sur le dorsum nasal inférieur. La masse et le volume de chaque greffon furent mesurés lors de la chirurgie initiale et 3 mois plus tard. Une étude histologique a été entreprise afin de comparer la viabilité des greffons et le degré de fibrose. Résultats: La masse et le volume des greffons de cartilage entier sont demeurés semblables suite à l’implantation. La masse et le volume des greffons de cartilage injecté ont diminué en moyenne de 47% et 40% respectivement suite à l’implantation. L’analyse histologique a démontré une diminution moyenne de 25% de la viabilité chondrocytaire pour les greffons de cartilage injecté. Conclusion: L’injection de cartilage est une technique prometteuse devant être raffinée pour augmenter la viabilité chondrocytaire à long-terme. Le développement d’un instrument d’injection approprié faciliterait la technique.

Articular cartilage on weight-bearing joints experiences three main forces: fluid-induced shear across the surface, perfusion through the cartilage from the surrounding fluid, and compression during motion of the joint. A new bioreactor that employs two of these forces was developed in this lab to study their effect on tissue-engineered cartilage development. The focus of this research and overall hypothesis is that bioreactors that employ both perfusion and shear will improve chondrogenesis and preservation to produce functionally relevant cartilage by modulating shear stress and introducing exogenous preservation factors. Applying both a low shear stress across the surface of cell-seeded scaffolds and perfusion through them in a perfusion concentric cylinder (PCC) bioreactor may stimulate chondrocytes to undergo chondrogenesis. Experimental data showed that the PCC bioreactor stimulated cartilage growth over the course of four weeks, supported by the appearance of glycosaminoglycan (GAG) and collagen type II, which are markers for articular cartilage. Computational fluid dynamics modeling showed that shear stress across the face of the construct was heterogeneous, and that only the center experienced a relatively uniform shear stress of 0.4 dynes/cm^2 when the outer cup of the bioreactor rotated at 38 rpm. When compared to a concentric cylinder (CC) bioreactor that employed only shear stress, the PCC bioreactor caused a significant increase in cellular proliferation, which resulted in a 12-fold increase in cell number per construct compared to 7-fold increase within the CC bioreactor. However, the PCC bioreactor had a less pronounced effect on glycosaminoglycan and collagen content with 1.3 mg of GAG and 1.8 mg of collagen per construct within the CC bioreactor and 0.7 mg of GAG and 0.8 mg of collagen per construct within the PCC bioreactor after 28 days in culture (p < 0.05). Our results led to an important observation that the PCC bioreactor affected cellular proliferation significantly but not extracellular matrix synthesis. The next objective of this study focused on the PCC bioreactor to evaluate the direct role of perfusion and shear on chondrogenesis in vitro and in vivo.

[Truncated abstract] Hyaline articular cartilage is a highly specialised tissue consisting of chondrocytes embedded in a matrix of proteoglycan and collagens. Hyaline articular cartilage withstands high levels of mechanical stress and continuously renews its extracellular matrix. Despite this durability, mature articular cartilage is vulnerable to injury and disease processes that cause irreparable tissue damage. Native hyaline articular cartilage has poor regenerative capacity following injury, largely due to the tissue's lack of blood and lymphatic supply, as well as the inability of native chondrocytes to migrate through the dense extracellular matrix into the defect site. Articular cartilage injuries that fail to penetrate the subchondral bone plate evoke only a short-lived metabolic and enzymatic response, which fails to provide sufficient new cells or matrix to repair even minimal damage. Clinically, it has previously been accepted that treatment of such defects does not result in the restoration of normal hyaline articular cartilage, which is able to withstand the mechanical demands that are placed on the joint during every day activities of daily living. ... Historically, rehabilitation following ACI has not kept pace with the advances in cell culture and surgical technique. Subsequently, there exists a significant gap in knowledge regarding `best practice' in post operative rehabilitation following ACI. The importance of structured rehabilitation in ACI should not be underestimated when evaluating the clinical success of this chondral treatment. Patients should not be left to their own devices following ACI surgery, as the risk of damage to their implant (via delamination) is high if immediate postoperative movement is not controlled. Furthermore, the biological longevity and clinical success of the graft is dependent on a controlled and graduated return to ambulation and physical activity, and the biomechanical stimulation of the implanted chondrocytes.

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 5 uppsatser.