O crescente número de aplicações clínicas envolvendo células mesenquimais estromais multipotentes (CMMs) gera a necessidade da produção em larga escala destas células com adequada qualidade terapêutica. As CMMs são geradas atualmente através de culturas aderentes na presença de soro fetal bovino (SFB). Entretanto, apesar da eficiência na promoção do crescimento celular, o uso de SFB não é isento de desvantagens e riscos. Além do alto custo, sua utilização pode gerar risco de contaminação do produto final com agentes adventícios como vírus e príons. Por outro lado, a sua variabilidade em diferentes lotes e fornecedores dificulta a padronização do meio e reprodutibilidade do cultivo. Uma alternativa promissora para a cultura de células destinadas a terapia celular é a substituição de SFB por soro AB humano obtido a partir de plasma humano. Neste cenário, o objetivo deste trabalho foi produzir soro AB humano e avaliar a sua qualidade e eficácia como substituto do SFB na produção de células mesenquimais destinadas à terapia celular. Para a produção do soro AB humano foram avaliados tanto Plasma comum (PC>24h) (n=3) quanto Plasma isento de crioprecipitado (PCIC) (n=3). Após a produção, foi realizado o controle de qualidade dos lotes produzidos sendo verificado que os mesmos atenderam as exigências necessárias para a utilização na terapia celular. As duas fontes de plasma utilizadas para a produção do soro AB humano apresentaram características semelhantes quanto aos constituintes bioquímicos e demais parâmetros analíticos e foram eficazes na suplementação do cultivo e expansão das CMMs. A suplementação do meio com 10% de soro AB humano foi eficaz tanto no cultivo em culturas estáticas quanto em microcarregadores. Esta característica alinhase com a possibilidade de produção em larga escala, uma vez que, permitiu a expansão das CMMs de maneira similar à condição controle (suplementada com 10% de SFB) e preservou as características imunofenotípicas, funcionais e perfil citogenético pós cultivo. Além disso, o soro AB humano produzido pode ser utilizado por no mínimo doze meses após produção, quando armazenado em temperatura inferior a 20ºC negativos / The growing number of clinical applications involving multipotent mesenchymal stromal cells (MSCs) generates the need for large-scale production of these cells with appropriate treatment quality. The MSCs are now generated through adherent cultures in the presence of fetal bovine serum (FBS). However, despite the efficiency of this method, the use of FBS is not exempt of drawbacks and hazards. Besides the high cost, their use can lead to the risk of final product contamination with adventitious agents such as viruses and prions. In addition, due to its high variability of reproducibility, this methodology requires high level of standardization. A promising alternative would be to replace FBS by human AB serum from human plasma. In this scenario, our objective was to produce human AB serum and evaluate their quality and effectiveness as a FBS substitute on production of mesenchymal cells for therapy. For the production of human AB serum were evaluated both common plasma (CP > 24h; n=3) and plasma cryoprecipitate depleted (PCD; n=3). Quality controls were carried out to stablish minimal requirements of quality to be used in a cell therapy scenario. Both plasma sources of human AB serum presented similar biochemical characteristics and other analytical parameters, being effective in supplementation of the culture and expansion of MSCs. Supplementing the culture medium with 10% human AB serum was effective both in cultivation of static cultures as for microcarriers. This condition might indicate that this method would be useful for large scale production, allowing the expansion of MSCs similarly to the control condition and maintaining immunophenotypic, functional and cytogenetic characteristics. Furthermore, the human AB serum produced can be used for at least twelve months after production when stored at temperature below 20ºC negative

La régénération des défauts osseux de taille critique reste un défi majeur pour la santé. Les limitations des greffes de tissus communes nous ont incités à développer une alternative synthétique basée sur la construction d’un biomatériau, des facteurs ostéoinductifs et des cellules souches. Pour la construction du biomatériau, nous nous sommes concentrés sur les microporteurs polymères poreux, car ils supportent une expansion cellulaire à grande échelle et un assemblage modulaire des tissus, contournant deux goulots d'étranglement importants pour la traduction clinique. Pour assurer l'approvisionnement industriel et l'approbation réglementaire, nous avons conçu une méthode de fabrication sans solvant organique basée sur la cristallisation sphérulitique du poly(L-lactide) (PLLA) dans ses mélanges avec du polyéthylène glycol (PEG). Les sphérulites de PLLA ont été facilement récupérées sous forme de microporteurs en éliminant par rinçage le PEG soluble dans l'eau. Leur taille et leur porosité pourraient être contrôlées indépendamment en ajustant le rapport PLLA / PEG et la température de cristallisation. La biocompatibilité et l'ostéoconductivité des microporteurs à PLLA ont été confirmées par l'expansion et la différenciation ostéogénique des cellules souches adipeuses humaines (hASC). Comme cette dernière fonction hASC est sensible à différents paramètres de culture, nous avons ensuite utilisé l'approche de conception d'expériences pour leur dépistage rapide. En combinaison avec l'analyse à haut débit, nous avons identifié plusieurs paramètres ayant une influence marquée sur leur différenciation ostéogénique. Enfin, pour la délivrance de facteurs ostéoinducteurs, nous avons élaboré des multicouches de polyélectrolytes (PEM) à base de poly (L-ornithine) et d'acide hyaluronique biocompatibles. Ces PEM ont été caractérisées en termes de croissance, de morphologie, d'aptitude à incorporer des protéines morphogénétiques osseuses (BMP) et à fonctionner en tant que revêtements sur des microporteurs à PLLA. Nos résultats préliminaires ont montré que l’incorporation de BMP dans les PEM avait un effet important sur l’adhérence des hASC. Bien que des études supplémentaires soient nécessaires, les microporteurs à PLLA recouverts de PEM chargés de BMP et ensemencés avec hASC pourraient être un implant synthétique prometteur pour une régénération osseuse améliorée. / The regeneration of critical-sized bone defects remains a major healthcare challenge. The limitations of common tissue grafts prompted us to develop a synthetic alternative based on a biomaterial construct, osteoinductive factors and stem cells. For biomaterial construct, we focused on porous polymeric microcarriers as they support large-scale cell expansion and modular tissue assembly, circumventing two important bottlenecks for clinical translation. To insure industrial supply and regulatory approval, we designed an organic-solvent-free method for their fabrication based on the spherulitic crystallization of poly(L-lactide) (PLLA) in its blends with polyethylene glycol (PEG). The PLLA spherulites were easily recovered as microcarriers by rinsing away the water-soluble PEG. Their size and porosity could be independently controlled by tuning the PLLA/PEG ratio and crystallization temperature. The biocompatibility and osteoconductivity of PLLA microcarriers were confirmed through the expansion and osteogenic differentiation of human adipose stem cells (hASCs). Because the latter hASC function is sensitive to different culture parameters, we then used the Design of Experiments approach for their rapid screening. In combination with high-throughput analysis, we identified several parameters that had a pronounced influence on their osteogenic differentiation. Finally, for the delivery of osteoinductive factors, we elaborated polyelectrolyte multilayers (PEM) based on biocompatible poly(L-ornithine) and hyaluronic acid. These PEMs were characterized in terms of their growth, morphology, the ability to incorporate bone morphogenetic proteins (BMP) and to function as coatings on PLLA microcarriers. Our preliminary results showed that the incorporation of BMPs inside PEMs had a strong effect on hASC adhesion. While further studies are needed, hASC-seeded PLLA microcarriers coated with BMP-loaded PEMs could be a promising synthetic implant for improved bone regeneration.

Les cellules stromales mésenchymateuses (CSM) possèdent de nombreux atouts pour la thérapie cellulaire du cerveau. Nous avons tout d'abord démontré que les CSM ne migraient pas dans le cerveau de rats sains alors qu'elles étaient attirées par une lésion située à grande distance de leur site d'implantation. Nous avons également confirmé que la faible survie et différenciation neuronale des cellules in vivo constituent les obstacles majeurs à la thérapie cellulaire du cerveau. Par conséquent, nous nous sommes ensuite attachés à améliorer le potentiel de différenciation neuronal des CSM avant transplantation, à l'aide d'un pré-traitement en « epidermal growth factor » (EGF) et « basic fibroblast growth factor » (bFGF) in vitro. Finalement, nous avons associé des CSM à des vecteurs polymériques, les microcarriers pharmacologiquement actifs (MPA), afin de favoriser la survie, la différenciation neuronale et les capacités de réparation tissulaire des cellules après transplantation. Ces microsphères de PLGA ont ainsi été enrobées d'une surface biomimétique de laminine, après en avoir démontré les bénéfices sur la différenciation neuronale des CSM in vitro. Des CSM ont ensuite été mises en contact avec des MPA enrobées de laminine et libérant une neurotrophine, avant transplantation dans un modèle animal de la maladie de Parkinson. D'importants effets fonctionnels ont été observés par rapport à la greffe de cellules seules, et cette stratégie est la première à démontrer l'intérêt de cellules souches adultes associées à des vecteurs polymériques bioactifs pour protéger le système nerveux central dans le contexte de la maladie de Parkinson.

La thérapie cellulaire constitue une stratégie prometteuse dans le traitement de l'infarctus du myocarde. Afin de mieux contrôler la survie, la différenciation et l'intégration des cellules greffées, nous avons tenté une approche d'ingénierie tissulaire en associant les cellules à un microvecteur comportant une surface biomimétique et pouvant libérer un facteur de croissance (FC), les microcarriers pharmacologiquement actifs (MPA). Parmi les cellules utilisées dans une telle approche, les cellules souches adultes dérivées du tissu adipeux (ADSC) ne soulèvent pas de problèmes d'ordre éthique et permettent de réaliser des greffes autologues. Ces cellules sont largement étudiées pour la régénération de nombreux tissus en vertu de leurs propriétés immuno-modulatrices, de leur capacité à sécréter des FC et chémokines, mais également de leur large potentiel de différenciation. Dans une première étape, nous avons étudié l'effet des molécules de la matrice extracellulaire et des MPA sur la différentiation en cardiomyocytes des ADSC en présence d'un cocktail de FC. Nous avons ainsi pu observer que l'apport du cocktail de FC permettait aux cellules de s'engager dans la voie de différentiation cardiaque après 2 semaines. En comparant l'effet de la laminine (LM) et de la fibronectine sur cette différentiation, nous avons pu observer que la LM permettait d'induire une différentiation dans une cellule plus mature et que ceci était potentialisée par un enrichissement du milieu en TGF!1. Finalement, l'apport de MPA recouverts de LM favorisait une différentiation plus rapide des cellules en présence du cocktail. Les MPA peuvent également libérer un facteur de croissance de manière prolongée au cours du temps. Par conséquent, nous avons encapsulé 3 protéines, le VEGF, le HGF et l'IGF-1, et d'étudier leur effet sur les comportement des ADSC. Nous avons ainsi pu observer que des MPA libérant du HGF et de l'IGF-1 induisaient une différenciation de ADSC dans la voie cardiaque et que cette différentiation était également observée lorsque les complexes ADSCMPA étaient intégrés dans un hydrogel thermosensible. Cependant, nous avons aussi observé que la quantité de protéines libérées à partir des MPA était plus faible dans le gel. Nous avons donc cherché dans une dernière partie à améliorer le profile de libération des protéines à partir des MPA en changeant la composition du polymère. Nous avons ainsi utilisé différents copolymères triblock PLGA-PEG-PLGA pour formuler des microsphères et évaluer leur rôle sur la libération de la protéine mais aussi sur la stabilité de celle-ci durant la dégradation du polymère.

L'essor des thérapies régénératives au cours des 10 dernières années a entraîné un effort de recherche important, mais l'obtention des cellules souches humaines en quantité suffisante reste cependant encore problématique, notamment concernant les cellules souches mésenchymateuses (CSM). Ces travaux ont donc mis en œuvre une approche à la croisée de la biologie et du génie des procédés afin d'identifier les verrous limitant la croissance des CSM. L'étude des méthodes d'intensification de culture a été entreprise grâce à l'utilisation de microporteurs et d'une plateforme de minibioréacteurs de 200~mL. Puis le développement d'un milieu de culture sans sérum a été testé dans le but de maximiser la croissance cellulaire dans des conditions biochimiques contrôlées. Les CSM humaines en tant que modèle type en thérapie cellulaire ont été démontrées comme extrêmement sensibles aux phases de congélation/décongélation, aux variations de température, à un vieillissement prématuré et nécessitant un milieu de culture complexe riche en facteurs de croissance et d'adhérence. Suite à cette étude, plusieurs écueils pourront être évités lors de la montée en échelle d'un procédé de culture de CSM afin d'intégrer leurs paramètres biologiques intrinsèques aux paramètres d'ingénierie des bioréacteurs (transfert de chaleur, contraintes hydrodynamiques, surface d'adhérence) / Progress in regenerative medicines over the past ten years have led to an important research mobilisation, but obtaining a sufficient amount of human stem cells remains nonetheless problematic, especially for mesenchymal stem cells (MSC). Hence, this work developed an approach coupling biology and process engineering to identify barriers limiting MSC growth. The study of scaled-up amplification methods was performed using microcarriers and a 200~mL minibioreactors platform. In order to maximise MSC growth in a biochemically controlled environment, a serum free medium development was tested as well. Human MSC as model cell type for cellular therapies have thus been demonstrated as extremely sensitive to freeze/thaw cycles, temperature variations, subject to premature aging and needing a complex medium enriched in multiple growth and adherence factors. Following this study, several pitfalls might be avoided during MSC process scale-up by integrating the cells biology into the bioreactors' process engineering parameters (heat transfer, hydrodamic stress, adhesion surface)

O crescente número de aplicações clínicas envolvendo células mesenquimais estromais multipotentes (CMMs) gera a necessidade da produção em larga escala destas células com adequada qualidade terapêutica. As CMMs são geradas atualmente através de culturas aderentes na presença de soro fetal bovino (SFB). Entretanto, apesar da eficiência na promoção do crescimento celular, o uso de SFB não é isento de desvantagens e riscos. Além do alto custo, sua utilização pode gerar risco de contaminação do produto final com agentes adventícios como vírus e príons. Por outro lado, a sua variabilidade em diferentes lotes e fornecedores dificulta a padronização do meio e reprodutibilidade do cultivo. Uma alternativa promissora para a cultura de células destinadas a terapia celular é a substituição de SFB por soro AB humano obtido a partir de plasma humano. Neste cenário, o objetivo deste trabalho foi produzir soro AB humano e avaliar a sua qualidade e eficácia como substituto do SFB na produção de células mesenquimais destinadas à terapia celular. Para a produção do soro AB humano foram avaliados tanto Plasma comum (PC>24h) (n=3) quanto Plasma isento de crioprecipitado (PCIC) (n=3). Após a produção, foi realizado o controle de qualidade dos lotes produzidos sendo verificado que os mesmos atenderam as exigências necessárias para a utilização na terapia celular. As duas fontes de plasma utilizadas para a produção do soro AB humano apresentaram características semelhantes quanto aos constituintes bioquímicos e demais parâmetros analíticos e foram eficazes na suplementação do cultivo e expansão das CMMs. A suplementação do meio com 10% de soro AB humano foi eficaz tanto no cultivo em culturas estáticas quanto em microcarregadores. Esta característica alinhase com a possibilidade de produção em larga escala, uma vez que, permitiu a expansão das CMMs de maneira similar à condição controle (suplementada com 10% de SFB) e preservou as características imunofenotípicas, funcionais e perfil citogenético pós cultivo. Além disso, o soro AB humano produzido pode ser utilizado por no mínimo doze meses após produção, quando armazenado em temperatura inferior a 20ºC negativos / The growing number of clinical applications involving multipotent mesenchymal stromal cells (MSCs) generates the need for large-scale production of these cells with appropriate treatment quality. The MSCs are now generated through adherent cultures in the presence of fetal bovine serum (FBS). However, despite the efficiency of this method, the use of FBS is not exempt of drawbacks and hazards. Besides the high cost, their use can lead to the risk of final product contamination with adventitious agents such as viruses and prions. In addition, due to its high variability of reproducibility, this methodology requires high level of standardization. A promising alternative would be to replace FBS by human AB serum from human plasma. In this scenario, our objective was to produce human AB serum and evaluate their quality and effectiveness as a FBS substitute on production of mesenchymal cells for therapy. For the production of human AB serum were evaluated both common plasma (CP > 24h; n=3) and plasma cryoprecipitate depleted (PCD; n=3). Quality controls were carried out to stablish minimal requirements of quality to be used in a cell therapy scenario. Both plasma sources of human AB serum presented similar biochemical characteristics and other analytical parameters, being effective in supplementation of the culture and expansion of MSCs. Supplementing the culture medium with 10% human AB serum was effective both in cultivation of static cultures as for microcarriers. This condition might indicate that this method would be useful for large scale production, allowing the expansion of MSCs similarly to the control condition and maintaining immunophenotypic, functional and cytogenetic characteristics. Furthermore, the human AB serum produced can be used for at least twelve months after production when stored at temperature below 20ºC negative

The field of biomedical sciences has been expanded through the introduction of a novel cohort of soft and intelligent microrobots that can be remotely operated and controlled through the use of external stimuli, such as ultrasound, magnetic fields, or electric fields, or internal stimuli, such as chemotaxis. The distinguishing factor of these microrobots lies in their propulsion system, which may encompass chemical, physical, or biohybrid mechanisms. Particularly, microrobots propelled by motile cells or microorganisms have found extensive usage because they combine the control/steerability and image-enhancement capabilities of the synthetic microstructures with the taxis and cell-interaction capabilities of the biological components. Spermatozoa (sperms), among other types of motile microorganisms and cells, are promising biological materials for building biohybrid microrobots because they are inherently designed to swim through complex fluids and organs, like those in the reproductive system, without triggering negative immune responses. Sperms are suitable for a variety of gynecological healthcare applications due to their drug encapsulating capability and high drug-carrying stability, in addition to their natural role of fertilization. One objective of this project is to help sperms reach the site of fertilization in vivo where the sperm count is low (20 million sperm per mL), a condition known as oligospermia. In order to reach this goal, we are developing alternative strategies for transporting a significant number of sperms, as well as improving the functionality of sperm-hybrid microcarriers. Here, we use a thermoresponsive hydrogel made of poly(N-isopropylacrylamide) (PNIPAM) and a non-stimuli-responsive polymer (IPS photoresist) to create four dimensional (4D)-printed sperm-hybrid microcarriers via two-photon polymerization (TPP). We present a multifunctional microcarrier that can: i) transport and deliver multiple motile sperms to increase the likelihood of fertilization, ii) capacitate/hyperactivate the sperms in situ through the local release of heparin, and iii) assist the degradation of the hyaluronic acid (HA), present in extracellular matrix (ECM) of oocyte-cumulus surrounded the Egg. HA degradation occurs through the local action of hyaluronidase-loaded polymersomes (HYAL-Psomes) that have been immobilized on the microcarrier's surface. Dual ultrasonic (US)/photoacoustic (PA) imaging technology can also be used to visualize a swarm of microcarriers, making them ideal candidates for upcoming in vivo applications. In addition, as a second objective, we demonstrate that similar sperm-hybrid microcarriers can be utilized to deliver targeted enzymes and medication for the treatment of gynecological cancer. As proof of concept, we show that combined therapy using enzymes and anti-cancer drugs is an appealing strategy for disrupting the tumor tissue microenvironment and inducing cell apoptosis, thereby offering a more effective cancer therapy. To achieve this, we functionalize the microcarriers with polymersomes loaded with enzymes (such as hyaluronidase and collagenase) and anti-cancer drugs (such as curcumin), respectively, and demonstrate their cargo-release capability, enzyme function, and therapeutic effect for targeting cervical cancer cells in vitro.:Abstract iv 1 Introduction 1 1.1 Motivation 1 1.2 Objectives 3 1.3 Structure of this dissertation 4 2 Background 5 2.1 Introduction on additive manufacturing technology 5 2.2 Direct laser writing (DLW) based on two-photon polymerization 6 2.2.1 Writing principles of two-photon lithography 8 2.2.2 Available materials for two-photon lithography 9 2.2.3 Engineering (Preprogrammed designs) 12 2.3 4D Lithography 13 2.3.1 Biodegradable microrobot 13 2.3.2 Stimuli-responsive micromotors 15 2.3.3 Other 4D-printing approaches 17 2.4 Motion at the microscale (Micromotility) 21 2.4.1 Physical propelled micromotors 23 2.4.2 Chemical propelled micromotors 32 2.4.3 Biohybrid micromotors 34 2.5 Other two-photon polymerized microrobots and their biomedical applications 35 2.5.1 Functionalized carriers 36 2.5.2 Multiple-cell carrying scaffolds 38 2.5.3 Single particle and cell transporters 39 2.6 Comparison of 3D and 4D-lithography with other fabrication methods 42 3 Materials and methods 44 3.1 Synthesis and fabrication 44 3.1.1 Synthesis of PNIPAM 44 3.1.2 Fabrication of microcarrier 44 3.1.3 Preparation of sperm medium and sperm solution 45 3.1.4 Preparation and composition of different body fluids 45 3.1.5 Fluidics channels 46 3.1.6 In situ preparation of microcarriers and sperms 46 3.1.7 Loading of microcarriers with heparin 46 3.1.8 Synthesis of block copolymers (BCPs) 47 3.1.9 Fabrication of Empty-Psomes A and D 48 3.1.10 Preparation of Curcumin complex CU(βCD)2 and calibration curve 49 3.1.11 Fabrication of cargo-loaded Psomes with enzymes and antitumoral drug 50 3.2 Characterization 51 3.2.1 MTS-Assay 51 3.2.2 Toluidine blue assay 52 3.2.3 Characterization of Empty-Psomes A and D: pH cycles and pH titration by dynamic light scattering (DLS) 53 3.2.4 Characterization of cargo-loaded Psomes with enzymes and antitumoral drug 54 3.2.5 Loading efficiency of HYAL-Psomes 55 3.2.6 Loading efficiency of MMPsomes 56 3.2.7 Loading efficiency, stability and release study of CU(βCD)2-Psomes 57 3.2.8 Size and polydispersity analysis of cargo-loaded Psomes in different simulated body fluids by DLS 58 3.2.9 Conformation and stability study of cargo-loaded Psomes in different simulated body fluids by asymmetric flow field flow fractionation (AF4) 59 3.2.10 Immobilization of the cargo-loaded Psomes on the surfaces 61 3.2.11 Enzymatic assay of HYAL for enzyme activity measurement 62 3.2.12 Enzymes assay in different simulated body fluids 64 3.2.13 Stability study of RhB-HYAL-Psomes in different pH 65 3.2.14 Calculation of the magnetic field flux of an external hand-held magnet 66 3.3 Temperature actuation and imaging 67 3.3.1 Temperature actuation test of PNIPAM and video recording 67 3.3.2 Hybrid ultrasound (US) and photoacoustic (PA) Imaging 67 3.4 Other useful information 68 3.4.1 pH and temperature through the female reproductive tract 68 3.4.2 Calculation of the light-to-heat conversion during imaging process 69 4 Multifunctional 4D-printed sperm-hybrid microcarriers for assisted reproduction 72 4.1 Background 72 4.2 Concept and fabrication of the 4D-printed microcarriers 74 4.3 Sperm coupling and geometrical optimization of microcarrier 77 4.4 Characterization of the 4D-printed streamlined microcarriers 78 4.5 Microcarrier loaded with heparin for in situ sperm capacitation 82 4.6 Microcarriers decorated with HYAL-Psomes for in situ degradation of the HA-cumulus complex 86 4.6.1 Immobilization of HYAL-Psomes on the microcarrier’s surface 89 4.6.2 Qualitative study of cumulus cell removal 90 4.7 Sperm-microcarrier motion performance in oviduct-mimicking fluids 91 4.7.1 Capture, transport, and release of sperms 92 4.7.2 Sperm-microcarrier motion performance on ex vivo oviduct tissue 93 4.8 Tracking of a swarm of microcarriers with a dual ultrasound (US) and photoacoustic (PA) imaging system 95 4.9 Summary 96 5 Polymersomes-decorated micromotors with multiple cargos for gynecological cancer therapy 98 5.1 Background 98 5.2 Characterization and size quantification of Psomes before and after loading of cargoes by DLS, and Cryo-TEM 103 5.3 Characterization and size quantification of cargo-loaded Psomes by DLS, and Cryo-TEM in different simulated bodily fluids 104 5.4 Immobilization and characterization of cargo-loaded Psomes on the microcarrier’s surface 106 5.5 Immobilization and characterization of dual cargo-loaded Psomes on the microcarrier’s surface 108 5.6 Investigation of ECM degradation and antitumoral effect of cargo-loaded Psomes 110 5.7 Magnetic and bio-hybrid guidance of microcarriers toward targeted cargo delivery 115 5.8 Summary 117 6 Conclusion and Outlook 119 6.1 Achievements 119 6.2 Outlook 121 Bibliography I List of Figures and Tables XXI Acknowledgements and funding XXIV Scientific publications and contributions XXVI Curriculum Vitae XXVII