Modular tissue engineering is a novel approach to creating scalable, self-assembling three-dimensional tissue constructs with inherent vascularisation. Under initial methods, the subcutaneous implantation of human umbilical vein endothelial cell (HUVEC)-covered collagen modules in immunocompromised mice resulted in significant host inflammation and limited HUVEC survival. Subsequently, a minimally-invasive injection technique was developed to minimize surgery-related inflammation, and cell death was attributed to extensive apoptosis within 72 hours of implantation. In confirmation of in vitro results, coating collagen modules with fibronectin (Fn) was shown in vivo to reduce short-term HUVEC apoptosis by nearly 40%, while increasing long-term HUVEC survival by 30% to 45%. Consequently, a 100% increase in the number of HUVEC-lined vessels was observed with Fn-coated modules, as compared to collagen-only modules, at 7 and 14 days post-implantation. Furthermore, vessels appeared to be perfused with host erythrocytes by day 7, and vessel maturation and stabilization was evident by day 14.

The conventional treatments for craniofacial bone defects currently are unsatisfactory due to several drawbacks. Replacement of lost bone by autografts typically causes donor site morbidity while allografts, xenografts, and demineralized bone matrix all have a chance of disease transmission. Current synthetic implants placed within the defect site generally lack osseointegration and biodegradability. There are several methods of generating a hybrid extracellular matrix (ECM) and synthetic material construct. These include coating the synthetic material scaffold with collagen and calcium phosphate, incorporating acellular biological tissue within the scaffold material, and using cells to generate an ECM coating on the synthetic material scaffold. The research performed for this thesis developed and characterized mesenchymal stem cell (MSC)-generated extracellular matrix poly(ε-caprolactone) constructs (PCL/ECM) for the replacement of bone tissue. The osteogenic potential of the PCL/ECM constructs was explored by culturing i) MSCs and ii) whole marrow cells combined with MSCs onto the construct with or without the osteogenic differentiation supplement, dexamethasone. It was established that the osteogenic differentiation of MSCs seeded onto ECM-containing constructs was maintained even in the absence of dexamethasone and that the co-culture of MSCs and whole bone marrow cells without dexamethasone and ECM enhances the proliferation of a cell population (or populations) present in the whole bone marrow. The osteogenicity of the constructs encouraged the characterization of the protein and mineral composition of the ECM coating on the PCL/ECM constructs. Characterization revealed that at short culture durations the MSCs used to generate the ECM deposited cellular adhesion proteins that are a prerequisite protein network for further bone formation. At the later culture durations, it was determined that the ECM was composed of collagen 1, hydroxyapatite, matrix remodeling proteins, and regulatory proteins. The prior studies on the PCL/ECM constructs persuaded exploration of the effect of various devitalization and demineralization processes on the retention of the ECM components within and the osteogenicity of the PCL/ECM constructs. Analysis demonstrated that the freeze-thaw technique is a milder method of devitalization of cell-generated ECM constructs as compared to other methods, but it reduced the osteogenicity of the constructs. In addition, it was elucidated that void spaces in the surface of the constructs are important for allowing access of MSCs into the interior of the constructs.

Grandes defectos óseos constituyen un reto para el campo clínico, ya que no puede ser reparado por el propio organismo, sino que requieren la implantación de injertos de hueso adecuado. Para superar los inconvenientes de los injertos procedentes de fuentes autólogas o allogeneicas, la ingeniería de tejidos óseos pretende sustituir el tejido perdido utilizando el cultivo de células in vitro sobre biomateriales porosos. El cultivo de células en grandes andamios porosos ha demostrado ser difícil, que requiere bioreactores, que se utilizan para el cultivo de tejidos y el estudio del comportamiento de células en 3D de los andamios. De interés especial es el condicionamiento mecánico de los tejidos cultivados por bioreactor de la ingeniería del tejido óseo, que es capaz de aumentar el potencial osteogénico de los injertos sintéticos.En este trabajo, dos sistemas de bioreactores fueron desarrollados para permitir comprender las propiedades bioactivas de andamios de diferentes materiales y la mecanoregulación del comportamiento de células o tejidos. Un sistema de bioreactor de perfusión in vitro fue desarrollado para el sembrado y cultivo de células incorporadas en cilindros de un biomaterial poroso. Varios estudios para la determinación de los parámetros del sembrado de células aplicable se llevaron a cabo, así como experimentos de cultivo de células bajo flujo de fluido constante con una estimulación mecánica adicional por alternancia del flujo.Un sistema de cámara ósea fue desarrollado como un bioreactor in vivo. El sistema produjo un defecto óseo grande en tibias de perros y permitió la implantación repetida de grandes andamios porosos de materiales diferentes. El tejido creciendo en los andamios permite extraer conclusiones sobre las propiedades de osteoconductividad u osteinductividad de los andamios. Además, un dispositivo de compresión se ha desarrollado para aplicar cargas cíclicas en los andamios en vivo para estudiar el efecto de la estimulación mecánica en el desarrollo de los tejidos.Los estudios con el sistema de perfusión desarrollado han demostrado que el sembrado de células en grandes andamios porosos es posible, lo que se considera crucial para el cultivo celular. El largo tiempo de cultivo de células mostró la proliferación de las células madre mesenquimales hasta dos semanas. El patrón de estimulación utilizado en el estudio aumentó la expresión de la osteocalcina, lo que indica una mayor actividad de las células, pero la ausencia de expresión de RunX2 y colágeno I impidió la determinación concluyente de la diferenciación.El sistema desarrollado de la cámara ósea demostró su funcionalidad en el entorno quirúrgico durante los experimentos in vivo. Complicaciones durante los experimentos no permitieron la aplicación de las cargas cíclicas de los andamios implantados. La formación de hueso retrasada debido al defecto óseo creado y material de andamios restantes no permitieron conclusiones definitivas acerca de las propiedades del material del andamio. Sin embargo, el estudio proporciona datos para el desarrollo futuro del dispositivo y protocolo clínico.Los estudios realizados constituyen una novedad en respecto a la creación de bioreactores para el estudio de la andamios porosos sintéticos de grandes dimensiones in vitro e in vivo. Los sistemas desarrollados constituyen la base para otros estudios en mecanobiología de las células óseas y los tejidos. / Large bone defects constitute a challenge for the clinical field, because they cannot be repaired by the body itself, but require the implantation of suitable bone grafts. To overcome the drawbacks of grafts from autologous or allogous sources, modern bone tissue engineering aims to replace lost tissue by cultivating cells in vitro on porous biomaterials. The cell culture on large porous scaffolds has shown to be difficult, requiring bioreactors, which are used for tissue culture and the study of cell behaviour in 3D scaffolds. Of special interest is the mechanical conditioning of the cultured tissue for bioreactor-based bone tissue engineering, which is able to enhance the osteogenic potential of the synthetic grafts.In this work two bioreactor systems were developed to allow insight into bioactive properties of different scaffold materials and the mechanoregulation of cell or tissue behaviour. An in vitro perfusion bioreactor system was developed for the cell seeding and culture on porous biomaterial cylinders. Several studies for the determination of applicable cell seeding parameters were conducted, as well as experiments of cell culture under steady fluid flow with additional mechanical stimulation by alternating fluid flow. A bone chamber system was developed as an in vivo bioreactor. The system produced a large bone defect in dog tibia and allowed the repeated implantation of large porous scaffolds of different material compositions.The ingrowing tissue was observed to allow conclusions about osteoconductive or osteinductive properties of the scaffolds. Additionally a compression device was developed to apply cyclic loading on the scaffolds in vivo to study the effect of mechanical stimulation on tissue development.The studies with the developed in vitro perfusion bioreactor system have shown that it is possible to seed cells throughout large porous scaffolds, which is deemed crucial for the further cell culture. The long time cell culture showed the proliferation of mesenchymal stem cells up to two weeks. The stimulation pattern used in the study enhanced the expression of osteocalcin, indicating an enhanced cell activity, but the absence of RunX2 and collagen I expression rendered the determination of differentiation inconclusive.The developed bone chamber system proved to be functional in the surgical environment during the in vivo experiments. Occurring complications during the experiments did not allow the application of the cyclic loading of implanted scaffolds. Delayed bone formation due to created bone defect and remaining scaffold material did not allow final conclusions about the scaffold material properties. Nevertheless the study provides input for further development of the device and clinical protocol.The conducted studies constitute a novelty regarding the creation of bioreactors for the study of synthetic porous scaffolds of large dimensions in vitro and in vivo. The developed systems form the basis for further studies in mechanobiology of bone cells and tissue.

This thesis uses a multiscale approach to identify and manipulate physiologic and in vitro developmental milieus towards the functional repair of articular cartilage. The overarching goals of this work are to improve knowledge of cartilage physiology and to enhance functional engineering of biologic cartilage replacements. Towards this end, assessment and modulation of cartilage phenotype were undertaken at multiple levels of complexity: gene transcription, cytoskeletal architecture, ion channels, single cells, extracellular matrix, intact tissue, and the whole joint. The first part of this thesis focused on probing cartilage phenotype at the single cell level. A quantitative single cell gene expression assay was developed and used to quantify cell-to-cell variability and the chondrocyte response to growth factors. Next, the viscoelastic compressive properties of single chondrocytes were measured and compared to cytoskeleton organization before and after growth factor exposure. It was found that growth factors increased matrix gene expression and induced cell stiffening in a time- and cartilage zone-dependent manner. The second part of this thesis investigated the modulation of the chondrocyte microenvironment for enhanced cartilage tissue engineering. Tissue constructs were grown in vitro using a chondrocyte self-assembly process. In one study, it was found that TRPV4 ion channel activation significantly increased cartilage matrix production and improved tensile properties in self-assembled constructs. In a second study, constructs were exposed to static or dynamic application of hypo-osmotic and hyper-osmotic stress. Static application of hyper-osmotic stress was found to improve construct compressive and tensile properties, and their corresponding biochemical mediators, significantly. A third study showed that treatment of constructs with ribose, an agent used for non-enzymatic glycation, produced enhanced tissue mechanics and biochemistry in a time-dependent manner. The third part of this thesis describes efforts to improve the potential clinical translatability of in vitro cartilage repair strategies. A technique was developed to decellularize xenogenic self-assembled constructs. Decellularization resulted in histologic and biochemical cell depletion with maintenance of tissue mechanical properties. Additionally, a comprehensive characterization of the major tissues of the immature knee joint revealed and reinforced important structure-function relationships that will inform future cartilage repair strategies. The total body of work contained in this thesis contributes significantly both to a basic understanding of cartilage physiology as well as to evolving strategies for cartilage repair. This thesis advances the field of cartilage tissue engineering by examining chondrocyte phenotype, the cell and tissue microenvironment, and avenues for clinical translation.

3D ex vivo tumor models are required which better replicate the microenvironment encountered by tumor cells in vivo. In this study, we applied bone tissue engineering culture techniques to develop an ex vivo 3D bone tumor model. Ewing sarcoma cells were cultured on poly(ε-caprolactone) (PCL) microfiber scaffolds, and cellular growth kinetics, morphology, and infiltration were assessed. Cell/scaffold constructs were then exposed to anticancer drugs for up to 16 days and drug response was compared to 2D controls. Ewing sarcoma cells were capable of attachment and proliferation on PCL scaffolds and dense scaffold infiltration up to 200 micrometers. Constructs could be maintained in culture for up to 32 days, and high density 3D cell growth conferred an increased resistance to anticancer drugs over 2D controls. This 3D tumor model shows potential for use in future studies of bone tumor biology, especially as it pertains to the development of new anticancer drugs.

Craniofacial defects resulting from trauma and resection present many challenges to reconstruction due to the complex structure, combinations of tissues, and environment, with exposure to the oral, skin and nasal mucosal pathogens. Tissue engineering seeks to regenerate the tissues lost in these defects; however, the composite nature and proximity to colonizing bacteria remain difficult to overcome. Additionally, many tissue engineering approaches have further hurdles to overcome in the regulatory process to clinical translation. As such these studies investigated a two stage strategy employing an antibiotic-releasing porous polymethylmethacrylate space maintainer fabricated with materials currently part of products approved or cleared by the United States Food and Drug Administration, expediting the translation to the clinic. This porous space maintainer holds the bone defect open allowing soft tissue to heal around the defect. The space maintainer can then be removed and one regenerated in the defect. These studies investigated the individual components of this strategy. The porous space maintainer showed similar soft tissue healing and response to non-porous space maintainers in a rabbit composite tissue defect. In humans, the porous space maintainers were well tolerated and maintained a soft tissue envelope for closure after implantation of a bone regeneration technology. The antibiotic-releasing space maintainers showed release of antibiotics from 1-5 weeks, which could be controlled by loading and fabrication parameters. In vivo, space maintainers releasing a high dose of antibiotics for an extended period of time increased soft tissue healing over burst release space maintainers in an infected composite tissue defect model in a rabbit mandible. Finally, stabilization of bone defects and regeneration could be improved through scaffold structures and delivery of a bone forming growth factor. These studies illustrate the possibility of the two stage strategy for repair of composite tissue defects of the craniofacial complex.

Tissue engineering is a multidisciplinary subject aimed at producing the immunologically tolerant artificial tissues/organs to repair or replace damaged ones. In this field, tissue scaffold plays a key role to support cell growth and new tissue regeneration. For fabrication of tissue scaffolds with individual external geometry and predefined inner structure, rapid prototyping (RP) systems based on fluid dispensing techniques have proved to be very promising. The present research conducted a comprehensive study on the dispensing-based fabrication process. <p>First of all, the scaffold materials are characterized in terms of their biocompatibility and flow behaviour. The biocompatibility of biomaterials of PLLA, PCL, collagen, chitosan, and gelatine is evaluated in terms of supporting neuron cells adhesion and outgrowth. Chitosan solution (2% w/v) in acetic acid is shown to be the most promising among the examined biomaterials for the fabrication of nerve tissue scaffolds. Its non-Newtonian flow behaviour is identified by using a commercial rheometer. <p>In the fabrication process, the flow rate of biomaterials dispensed, the profile of strand cross-sections, and the scaffold porosity are very important and must be precisely controlled. A model is developed to represent the flow rate of biomaterials dispensed under the assumptions that the flow is incompressible, steady, laminar, and axisymmetric. Also, the profile and size of line strands at different layers and portions are modeled based on the Young-Laplace equation. Thus the dispensing-based fabrication process can be predicted in terms of the flow rate and the scaffold porosity. <p>The effects of operation conditions on the fabrication result are identified theoretically and experimentally. Simulation result shows that a higher driving pressure, a higher temperature, and a larger needle diameter will result in a larger size of the strand cross-sections and lower scaffold porosity. The change pattern, however, is nonlinear, which is affected by the fluid surface tension and non-Newtonian flow behaviour of scaffold biomaterials. <p>To verify the effectiveness of the developed models, experiments were carried out on a commercial dispensing system (C-720, Asymtek, USA). To avoid the possible error derived from the temperature difference between the dispensing system and the rheometer, a new method is presented to characterize the fluid properties used for model predictions. Experimental results illustrate that the developed models, combined with the new identification method, are very promising to predict the dispensing-based fabrication process.

Drug development research on wound repair is challenging and inefficient due to the complex nature of wound healing and scarring processes and the limitations of available in vitro or in vivo models used for preclinical drug testing. Many patients who undergo elective back surgery develop post-surgical complications resulting from excess peridural scarring in and around the site of operation. We tested the effects of two anti-inflammatory compounds, quercetin and L-2-oxothiazolidine-4-carboxylate (OTC), in ameliorating peridural scar formation following spinal laminectomy surgery in laboratory rats. Western blot and immunocytochemical analyses indicated that the peridural scar tissue contained MyoD-positive myoblast cells and expressed prolyl-4-hydroxylase (P4H), a fibroblast marker. Treatment with 1 mM OTC reduced activation of ERK1/2 and p38 mitogen-activated protein kinases (MAPK) at 21 days post-surgery suggesting potential anti-scarring mechanism. However, large animal to animal variation in the expression levels of collagen biosynthesis markers made it difficult to demonstrate any efficacy of quercetin or OTC in reducing peridural scar formation. The shortcomings of this live animal approach led us to develop a novel three-dimensional (3-D) <i>in vitro</i> wound repair model for evaluating quercetin and OTC effects. High-density micromass co-cultures seeded at a 1:3 ratio of FR 3T3 fibroblast cells and L8 myoblast cells formed 3-D microtissues <i>in vitro</i> that expressed MyoD, P4H, and á-smooth muscle actin. The micromass tissue layer remained adherent to the culture plate when inflicted with a single laceration injury, which allowed monitoring of cell migration into the wound site. Wounded cultures were treated with quercetin, OTC and other agents (TGF- â1, mitomycin, p38 inhibitor SB202190, ERK inhibitor PD184352) to determine their effects on collagen accumulation, wound closure rates, MAPK activation, and gene transcript expression. Both OTC and quercetin treatments reduced collagen biosynthesis in dose-dependent manner. In addition, 1.5 mM OTC accelerated wound closure and significantly reduced p38 MAPK activation without affecting ERK1/2. In contrast, 40 µM quercetin delayed wound closure in micromass co-cultures and reduced ERK1/2 activation. Our in vitro findings suggest that OTC might have potential as an anti-scarring agent. Importantly, our novel micromass co-culture system shows promise as an improved 3-D scaffold-free in vitro model for use in preclinical drug development research.

Tissue-engineering (TE) is one of the most innovative approaches for tackling many diseases and body parts that need to be replaced, by developing artificial tissues and organs. For this, tissue scaffolds play an important role in various TE applications. A tissue scaffold is a 3D (3D) structure with interconnected pore networks and used to facilitate cell growth and transport of nutrients and wastes while degrading gradually itself. Many fabrication techniques have been developed recently for incorporating living cells into the scaffold fabrication process and among them; dispensing-based rapid prototyping techniques have been drawn considerable attention due to its fast and efficient material processing. This research is aimed at conducting a preliminary study on the dispensing-based biofabrication of 3D cell-encapsulated alginate hydrogel scaffolds. Dispensing-based polymer deposition system was used to fabricate 3D porous hydrogel scaffolds. Sodium alginate was chosen and used as a scaffolding biomaterial. The influences of fabrication process parameters were studied. With knowledge and information gained from this study, 3D hydrogel scaffolds were successfully fabricated. Calcium chloride was employed as crosslinker in order to form hydrogels from alginate solution. The mechanical properties of formed hydrogels were characterized and examined by means of compressive tests. The influences of reagent concentrations, gelation time, and gelation type were studied. A post-fabrication treatment was used and characterized in terms of strengthening the hydrogels formed. In addition, the influence of calcium ions used as crosslinker on cell viability and proliferation during and after the dispensing fabrication process was examined and so was the influence of concentration of calcium solutions and exposing time in both media and alginate hydrogel. The study also showed that the density of encapsulated cells could affect the viscosity of alginate solution. In summary, this thesis presents a preliminary study on the dispensing-based biofabrication of 3D cell-encapsulated alginate hydrogel scaffolds. The results obtained regarding the influence of various factors on the cell viability and scaffold fabrication would form the basis and rational to continue research on fabricating 3D cell-encapsulated scaffolds for specific applications.

<p>Continuous nanostructures, such as electrospun nanofibers, embedded with proteins may synergistically present the topographical and biochemical signals to cells for tissue engineering applications. In this dissertation, co-axial electrospinning is introduced as a mean to efficiently encapsulate and release protein and live entities while producing a tissue engineering scaffold with uniaxial topography. In the first specific aim, aligned poly (caprolactone) nanofibers encapsulated with BSA and growth factors were produced to demonstrate controlled release and bioactivity retention properties. Control over release kinetics is achieved by incorporation of poly(ethylene glycol) as a porogen in the shell of the fibers. PEG leaches out in a concentration and molecular weight dependent fashion, leading to BSA release half-lives that range from 1 -20 days. The second specific aim introduces the fabrication of virus and bacterial cell encapsulated electrospun fibers to achieve unique biological functionalization. Adenovirus encoding the gene for green fluorescent protein was efficiently encapsulated into the core of poly(caprolactone) fibers through co-axial electrospinning and subsequently released via the porogen-mediated process. Encapsulated bacterial cells were confined to fibers of varying core sizes, which provided an aqueous core environment for free mobility and allowed the bacterias to proliferate within the fibers. </p><p>In the third specific aim, the differentiation of skeletal myoblasts on aligned electrospun polyurethane fibers and in the presence of electromechanical stimulation were systematically studied. Skeletal myoblasts cultured on aligned polyurethane (PU) fibers showed more pronounced elongation, better alignment, upregulation of contractile proteins and higher percentage of striated myotubes compared to those cultured on random PU fibers and film. In the last specific aim, the controlled release aspect of co-axial electrospun fibers were combined with skeletal tissue engineering to serve as a therapeutic implant for the treatment of hemophilia. A non-viral, tissue engineering approach were taken to stimulate local lymphatic or vascular system in order to enhance transport near the FVIII-producing implants to provide effective and sustained treatment for hemophilia A. Stable FVIII-producing clones were engineered from isolated myoblasts and cultured on aligned, protein-releasing electrospun fibers to form skeletal myotubes. The implanted construct rapidly integrated with host tissue and selectively induced angiogenesis or lymphangiogenesis as a result of the encapsulated growth factors. Constructs inducing angiogenesis significantly enhanced the transport of produced FVIII and achieved hemophilia phenotypic correction over two months. The use of co-axial electrospun fibers to serve as controlled delivery and tissue engineering construct furthers the continued pursue of a more sophisticated and medically relevant implant scaffold design.</p> / Dissertation