U.S. patent application number 16/288831 was filed with the patent office on 2019-07-04 for extracellular matrix-derived gels and related methods.
The applicant listed for this patent is University of Pittsburgh - Of the Commonwealth System of High Education. Invention is credited to Stephen F. Badylak, Donald Freytes.
Application Number | 20190201581 16/288831 |
Document ID | / |
Family ID | 39739031 |
Filed Date | 2019-07-04 |
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United States Patent
Application |
20190201581 |
Kind Code |
A1 |
Badylak; Stephen F. ; et
al. |
July 4, 2019 |
Extracellular Matrix-Derived Gels and Related Methods
Abstract
Provided are methods for preparing gelled, solubilized
extracellular matrix (ECM) compositions useful as cell growth
scaffolds. Also provided are compositions prepared according to the
methods as well as uses for the compositions. In one embodiment a
device, such as a prosthesis, is provided which comprises an
inorganic matrix into which the gelled, solubilized ECM is
dispersed to facilitate in-growth of cells into the ECM and thus
adaptation and/or attachment of the device to a patient.
Inventors: |
Badylak; Stephen F.; (West
Lafayette, IN) ; Freytes; Donald; (Pittsburgh,
PA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
University of Pittsburgh - Of the Commonwealth System of High
Education |
Pittsburgh |
PA |
US |
|
|
Family ID: |
39739031 |
Appl. No.: |
16/288831 |
Filed: |
February 28, 2019 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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15996916 |
Jun 4, 2018 |
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16288831 |
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14182791 |
Feb 18, 2014 |
10004827 |
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15996916 |
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13684830 |
Nov 26, 2012 |
8691276 |
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14182791 |
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12040140 |
Feb 29, 2008 |
8361503 |
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13684830 |
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60892699 |
Mar 2, 2007 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61L 27/34 20130101;
A61L 2400/06 20130101; A61L 27/54 20130101; A61L 2300/64 20130101;
A61L 27/3633 20130101; A61K 35/12 20130101; A61L 27/38 20130101;
A61P 19/00 20180101; A61K 38/00 20130101; A61L 2420/04 20130101;
A61L 27/52 20130101; C12P 21/06 20130101; A61L 27/3687
20130101 |
International
Class: |
A61L 27/36 20060101
A61L027/36; C12P 21/06 20060101 C12P021/06; A61L 27/54 20060101
A61L027/54; A61K 35/12 20060101 A61K035/12; A61L 27/34 20060101
A61L027/34; A61L 27/38 20060101 A61L027/38; A61L 27/52 20060101
A61L027/52 |
Goverment Interests
STATEMENT REGARDING FEDERAL FUNDING
[0002] This invention was made with government support under Grant
No. 5 R01 EB000503-04, awarded by the National Institutes of
Health. The government has certain rights in this invention.
Claims
1-96. (canceled)
97. A composition comprising: an acidic solution comprising an acid
protease and solubilized, intact extracellular matrix from a tissue
selected from the group consisting of heart, pancreas, liver,
ovary, spleen, or urinary bladder removed of submucosa; wherein,
the acidic solution, when neutralized, forms a gel at a temperature
greater than 25.degree. C.
98. The composition of claim 97, wherein the ECM is from heart
tissue.
99. The composition of claim 97, wherein the ECM is from liver
tissue.
100. The composition of claim 97, wherein the acid protease is
pepsin.
101. The composition of claim 97, wherein the solution is
frozen.
102. The composition of claim 97, wherein the solution has a pH of
about 2.
103. A composition comprising: a hydrogel comprising solubilized,
intact extracellular matrix (ECM) and an acid protease, the
hydrogel having a pH in the range of 7.2 to 7.8.
104. The composition of claim 103, wherein the acid protease is
pepsin.
105. The composition of claim 103, wherein the ECM is derived from
a tissue selected from intestine, urinary bladder, liver,
esophagus, pancreas, dermis, heart, ovary, or spleen.
106. The composition of claim 105, wherein the ECM is derived from
heart.
107. The composition of claim 105, wherein the ECM is derived from
liver.
108. The composition of claim 103, wherein the pH is in the range
of 7.2 to 7.4.
109. A method of preparing an extracellular matrix-derived gel
comprising: neutralizing an acidic solution comprising solubilized,
digested, intact extracellular matrix (ECM) and an acid protease to
produce a neutralized solution, wherein the neutralized solution
produces a hydrogel at a temperature greater than 25.degree. C.
110. The method of claim 109, wherein the neutralized solution has
a pH in the range of 7.2 to 7.8.
111. The method of claim 109, wherein the acid protease is
pepsin.
112. The method of claim 109, wherein the hydrogel forms after 40
minutes at 37.degree. C.
113. The method of claim 109, wherein the ECM is derived from a
tissue selected from intestine, urinary bladder, liver, esophagus,
pancreas, dermis, heart, ovary, or spleen.
114. A method of preparing a gelable extracellular matrix
composition comprising: solubilizing intact extracellular matrix
(ECM) in an acidic solution with an acid protease to produce an
acidic solution of solubilized, digested, intact ECM and the acid
protease; wherein, upon neutralizing the acidic solution to produce
a neutralized solution having a pH of between 7.2 to 7.8, the
solution forms a gel at a temperature greater than 25.degree.
C.
115. The method of claim 114, wherein the ECM is from a tissue
selected from the group consisting of intestine, urinary bladder,
liver, esophagus, pancreas, dermis, heart, ovary, or spleen.
116. The method of claim 115, wherein the ECM is from heart
tissue.
117. The method of claim 115, wherein the ECM is from liver
tissue.
118. The method of claim 114, wherein the acid protease is
pepsin.
119. The method of claim 114, wherein the ECM is lyophilized or
dried, and then comminuted prior to solubilizing in the acidic
solution.
120. The method of claim 114, wherein the ECM is solubilized by
stirring in the acidic solution at room temperature.
121. The method of claim 114, wherein the pH of the acidic solution
is about 2.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. patent
application Ser. No. 15/996,916, filed Jun. 4, 2018, which is a
continuation of U.S. patent application Ser. No. 14/182,791, filed
on Feb. 18, 2014 and issued on Jun. 26, 2018, as U.S. Pat. No.
10,004,827, which is a divisional of U.S. patent application Ser.
No. 13/684,830, filed on Nov. 26, 2012 and issued on Apr. 8, 2014
as U.S. Pat. No. 8,691,276, which is a continuation of U.S. patent
application Ser. No. 12/040,140, filed on Feb. 29, 2008 and issued
on Jan. 29, 2013 as U.S. Pat. No. 8,361,503, which claims the
benefit under 35 U.S.C. .sctn. 119(e) to United States Provisional
Patent Application No. 60/892,699, filed on Mar. 2, 2007, each of
which is incorporated herein by reference in its entirety.
BACKGROUND
[0003] Extracellular matrix-derived gels, cell-growth scaffolds and
related methods are described herein.
[0004] The current trend towards minimally invasive,
outpatient-based surgical procedures has prompted the development
of injectable scaffolds, which can be inductive and bioactive or
they can be non-inductive "place holders." Injectable scaffolds can
be used in combination with endoscopic or laparoscopic techniques
to deliver bioactive proteins and/or cells, or bulking agents to
target tissues. Purified collagen, gelatin, autologous fat,
hyaluronic acid, and synthetic materials are clinically used as
injectable scaffolds in regenerative medicine for the treatment of
urinary incontinence, reflux disease, and laryngeal pathologies
[Lightner DJ, et al. Injectable agents: present and future. Curr
Urol Rep. 2002 October; 3(5):408-13; Lehman G A. Injectable and
bulk-forming agents for enhancing the lower esophageal sphincter.
Am J Med. 2003 August 18; 115 Suppl 3A:188S-91S; Duruisseau O, et
al. Endoscopic rehabilitation of vocal cord paralysis with a
silicone elastomer suspension implant. Otolaryngol Head Neck Surg.
2004 September; 131(3):241-7]. In addition, purified collagen gels
have been investigated in pre-clinical studies as a substrate for
the delivery of neonatal cardiomyocytes to infarcted myocardium
[Zhang P, et al. Artificial matrix helps neonatal cardiomyocytes
restore injured myocardium in rats. Artif Organs. 2006
February;30(2):86-93] or as an injectable scaffold for articular
surface repair [Xu J W, et al. Injectable tissue-engineered
cartilage with different chondrocyte sources. Plast Reconstr Surg.
2004 April 15;113(5):1361-71]. However, overly-purified, chemically
modified or synthetic materials can lead to adverse immune
responses by the host and limit cell migration into the matrix.
[0005] Scaffolds composed of naturally occurring extracellular
matrix (ECM) possess many bioactive properties that have been shown
to lead to constructive remodeling of virtually every tissue type
with minimization of scar tissue formation. ECM-derived scaffolds
have been used for the repair of a variety of tissues including
lower urinary tract structures [Dedecker F, et al. [Small
intestinal submucosa (SIS): prospects in urogenital surgery]. Prog
Urol. 2005 June; 15(3):405-10; Wood J D, Simmons-Byrd A, et al. Use
of a particulate extracellular matrix bioscaffold for treatment of
acquired urinary incontinence in dogs. J Am Vet Med Assoc. 2005
April 1; 226(7):1095-7], esophagus [Badylak S, et al. Resorbable
bioscaffold for esophageal repair in a dog model. J Pediatr Surg.
2000 July; 35(7):1097-103; Badylak S F, et al. Esophageal
reconstruction with ECM and muscle tissue in a dog model. J Surg
Res. 2005 September; 128(1):87-97], cardiac tissue [Badylak S, et
al. Extracellular matrix for myocardial repair. Heart Surg Forum.
2003; 6(2):E20-6; Badylak S F, et al. The use of extracellular
matrix as an inductive scaffold for the partial replacement of
functional myocardium. Cell Transplant. 2006; 15 Suppl 1:S29-40;
Robinson K A, et al. Extracellular matrix scaffold for cardiac
repair. Circulation. 2005 August 30; 112(9 Suppl):I135-43], and
musculotendinous structures [Badylak S, et al. Naturally occurring
extracellular matrix as a scaffold for musculoskeletal repair. Clin
Orthop Relat Res. 1999 October (367 Suppl):5333-43; Badylak S F, et
al. The use of xenogeneic small intestinal submucosa as a
biomaterial for Achilles tendon repair in a dog model. J Biomed
Mater Res. 1995 August; 29(8):977-85; Zantop T, et al.
Extracellular matrix scaffolds are repopulated, in part, by bone
marrow-derived cells in a mouse model of achilles tendon
reconstruction. J Orthop Res. 2006 June; 24(6):1299-309] tissues,
often leading to tissue-specific constructive remodeling without
scar formation.
[0006] U.S. Pat. No. 5,275,826 discloses an ECM-derived fluidized,
injectable, non-immunogenic tissue graft that promotes endogenous
tissue growth in the location of the injection of the tissue graft.
The composition is comprised of tunica submucosa, muscularis mucosa
and stratum compactum of the small intestine of a warm-blooded
vertebrate.
[0007] U.S. Pat. No. 5,516,533 discloses a tissue graft composition
comprised of intestinal submucosa delaminated from both the tunica
muscularis (an outer layer of the intestine) and at least the
luminal portion of the tunica mucosa (inner layer of the
intestine).
[0008] U.S. Pat. No. 5,866,414 discloses a cell-growth composition
containing protease-digested submucosal tissue, and added nutrients
to support cell growth. The submucosal tissue and nutrients are
combined in a solution, which is then gelled to form a solid or
semi-solid matrix.
[0009] U.S. Pat. No. 6,893,666 discloses a composition and methods
for using a tissue regenerative matrix to promote the restoration,
remodeling or repair of connective tissue. The composition of the
matrix comprises devitalized mammalian epithelial basement membrane
of the intestine and tunica propria, which can further include
submucosa, tunica muscularis, growth factors, a cell, or a polymer.
The tissue can be obtained from the urinary bladder, skin,
esophagus and small intestine.
[0010] U.S. application Ser. No. 11/182,551 discloses a composition
consisting essentially of an emulsified or injectable extracellular
matrix composition from a mammalian source for regeneration of
absent or defective myocardium. The application also discloses a
composition comprising synthetic or mammalian extracellular matrix
compositions and additional components, such as a cell, peptide,
drug, or nutrient. The application also discloses methods of making
and using the composition. Divisional applications related to
application Ser. No. 11/182,551 include: application Ser. Nos.
11/367,870; 11/448,351; 11/448,355; 11/448,931; and 11/448,968.
These applications disclose a manner of polymerizing the emulsified
composition by altering the pH of the composition. However, none of
the applications discuss the use of temperature to regulate
gelation.
[0011] Many forms of ECM scaffolds have already received regulatory
approval and have been used in more than 500,000 human patients.
However, these current forms of ECM are limited by the material and
geometrical properties inherent to the tissue from which they are
derived (such as sheets or tubes of tissue) and delivery via
injection is limited to powder suspensions.
SUMMARY
[0012] Provided are methods for preparing gelled, solubilized
extracellular matrix (ECM) compositions useful as cell growth
scaffolds. The compositions can be molded prior to implantation or
administered to a patient in an un-gelled form prior to gelation
where the composition gels in situ. Also provided are compositions
prepared according to the methods as well as uses for the
compositions. In one embodiment a device, such as a prosthesis, is
provided which comprises an inorganic matrix into which the gelled,
solubilized ECM is dispersed to facilitate in-growth of cells into
the ECM and thus adaptation and/or attachment of the device to a
patient.
[0013] In one embodiment, injectable ECM-derived gel scaffolds are
provided that facilitate delivery of the scaffold via minimally
invasive methods while retaining bioactivity. In another
embodiment, the gel can be molded into any desired shape for use in
a patient, such as a human patient. The gel scaffold can be used
for regenerative or augmentative purposes, for example to
regenerate organs or tissue in a patient, for example after trauma
or surgery to remove tissue, such as a tumor; or for cosmetic
purposes, such as enhancement of facial features or breast
reconstruction or augmentation. In one embodiment, the gel scaffold
is attached to a biocompatible inorganic matrix, such as, without
limitation, a matrix of metal fibers or beads.
[0014] According to one embodiment, a method of preparing an
extracellular matrix-derived gel is provided. The method
comprising: (i) comminuting an extracellular matrix, (ii)
solubilizing intact, non-dialyzed or non-cross-linked extracellular
matrix by digestion with an acid protease in an acidic solution to
produce a digest solution, (iii) raising the pH of the digest
solution to a pH between 7.2 and 7.8 to produce a neutralized
digest solution, and (iv) gelling the solution at a temperature
greater than approximately 25.degree. C. The ECM typically is
derived from mammalian tissue, such as, without limitation from one
of urinary bladder, spleen, liver, heart, pancreas, ovary, or small
intestine. In certain embodiments, the ECM is derived from a pig,
cow, horse, monkey, or human. In one non-limiting embodiment, the
ECM is lyophilized and comminuted. The ECM is then solubilized with
an acid protease. The acid protease may be, without limitation,
pepsin or trypsin, and in one embodiment is pepsin. The ECM
typically is solubilized at an acid pH suitable or optimal for the
protease, such as greater than about pH 2, or between pH and 4, for
example in a 0.01M HCl solution. The solution typically is
solubilized for 12-48 hours, depending upon the tissue type (e.g.,
see examples below), with mixing (stirring, agitation, admixing,
blending, rotating, tilting, etc.).
[0015] Once the ECM is solubilized (typically substantially
completely) the pH is raised to between 7.2 and 7.8, and according
to one embodiment, to pH 7.4. Bases, such as bases containing
hydroxyl ions, including NaOH, can be used to raise the pH of the
solution. Likewise buffers, such as an isotonic buffer, including,
without limitation, Phosphate Buffered Saline (PBS), can be used to
bring the solution to a target pH, or to aid in maintaining the pH
and ionic strength of the gel to target levels, such as
physiological pH and ionic conditions. The neutralized digest
solution can be gelled at temperatures approaching 37.degree. C.,
typically at any temperature over 25.degree. C., though gelation
proceeds much more rapidly at temperatures over 30.degree. C., and
as the temperature approaches physiological temperature. The method
typically does not include a dialysis step prior to gelation,
yielding a more-complete ECM-like matrix that typically gels at
37.degree. C. more slowly than comparable collagen or dialyzed ECM
preparations.
[0016] As described herein, the composition can be molded into any
shape by any suitable method, including, without limitation,
placing into or onto a mold, electrospinning, electrodeposition,
injection into a cavity or onto a surface in a patient. Further, a
molded gel can be trimmed and otherwise shaped by cutting or other
suitable methods. In one non-limiting embodiment, the gel is
injected into a site on a patient to add additional bulk or to fill
in a void, for example, resulting from trauma or from removal or
degradation of tissue. In one non-limiting embodiment, the acidic
solubilization solution is mixed in a static mixer with a base
and/or buffer during injection into a patient. In further
embodiments, cells, drugs, cytokines and/or growth factors can be
added to the gel prior to, during or after gelation, so long as the
bioactivity of the cells, drugs, cytokines and/or growth factors is
not substantially or practically (for the intended use) affected by
the processing of the gel to its final form.
[0017] Also provided is a novel composition prepared according to
one or more processes described above or herein, namely, by a
method comprising: (i) comminuting an extracellular matrix, (ii)
solubilizing intact, non-dialyzed or non-cross-linked extracellular
matrix by digestion with an acid protease in an acidic solution to
produce a digest solution, (iii) raising the pH of the digest
solution to a pH between 7.2 and 7.8 to produce a neutralized
digest solution, and (iv) gelling the solution at a temperature
greater than 25.degree. C.
[0018] In another embodiment a method of preparing a hybrid
extracellular matrix scaffold is provided along with a matrix
prepared by that method. A scaffold may be any biocompatible
porous, macroporous, microporous, etc. material into which an ECM
gel is dispersed or can be dispersed, and which supports the
desired bioactivity of the device/scaffold, which is typically cell
growth and/or in-growth. The method comprises coating a matrix of a
biocompatible scaffold with a solubilized extracellular matrix and
gelling the matrix. According to one non-limiting embodiment, the
solubilized extracellular matrix can be prepared according to the
process of: (i) comminuting an extracellular matrix, (ii)
solubilizing intact, non-dialyzed or non-cross-linked extracellular
matrix by digestion with an acid protease in an acidic solution to
produce a digest solution, and (iii) raising the pH of the digest
solution to a pH between 7.2 and 7.8 to produce a neutralized
digest solution, and the neutralized digest solution is gelled at a
temperature greater than 25.degree. C., including variations of
this method described above and herein. In one embodiment, after
coating the scaffold, the method further includes ultrasonicating
the scaffold. According to non-limiting embodiments, the scaffold
comprises one or more of a cobalt-chrome alloy, a stainless steel,
titanium, tantalum, and/or a titanium alloy that optionally
comprises non-metallic and metallic components. In one non-limiting
embodiment, the scaffold comprises a commercial pure titanium. In
another, the scaffold comprises a titanium alloy that comprises one
or more of molybdenum, tantalum, niobium, zirconium, iron,
manganese, chromium, cobalt, nickel, aluminum and lanthanum. The
titanium alloy may be an alloy comprising Ti, Al, and V, such as,
for example, an alloy comprising about 90% wt. Ti, about 6% wt. Al
and about 4% wt. V (Ti6Al4V). In one embodiment, the scaffold
comprises filaments. In another, fused beads. The scaffold may
comprise an inorganic, calcium-containing mineral, such as, without
limitation, apatite, hydroxyapatite or a mineral comprising Ca, P
and O. The scaffold also may comprise a polymer (plastic) and/or a
ceramic.
[0019] In another embodiment, a biocompatible device is provided.
The device is coated with a hybrid scaffold comprising gelled
solubilized extracellular matrix embedded into a porous scaffold.
The device may be, without limitation, a prosthesis or an implant.
The prosthesis may be a hand, a forearm, an arm, a foot or a leg
prosthesis. In one non-limiting embodiment, the device is a femoral
implant for use in a hip-replacement procedure. The gelled
solubilized extracellular matrix is, according to one non-limiting
embodiment, prepared by a process comprising: (i) comminuting an
extracellular matrix, (ii) solubilizing intact, non-dialyzed or
non-cross-linked extracellular matrix by digestion with an acid
protease in an acidic solution to produce a digest solution, (iii)
raising the pH of the digest solution to a pH between 7.2 and 7.8
to produce a neutralized digest solution, and (iv) gelling the
solution at a temperature greater than 25.degree. C. in its
variations described above and herein.
[0020] Lastly, a method of attaching a device to tissue and/or
structures of a patient is provided comprising contacting a surface
of a device comprising a hybrid inorganic/extracellular matrix
scaffold comprising a gelled solubilized extracellular matrix
embedded into a porous inorganic scaffold with a patient's cells
for a time period sufficient for in-growth of the patient's cells
into the scaffold. The surface may be contacted with the cells and
the in-growth occurs in vivo and/or ex vivo. Without limitation,
the device may be any device, including a prosthesis, as described
above or herein. In one embodiment, the gelled solubilized
extracellular matrix is prepared by a process comprising: (i)
comminuting an extracellular matrix, (ii) solubilizing intact,
non-dialyzed or non-cross-linked extracellular matrix by digestion
with an acid protease in an acidic solution to produce a digest
solution, (iii) raising the pH of the digest solution to a pH
between 7.2 and 7.8 to produce a neutralized digest solution, and
(iv) gelling the solution at a temperature greater than 25.degree.
C.
BRIEF DESCRIPTION OF THE DRAWINGS
[0021] FIG. 1 shows schematically a cross-sectional view of the
wall of the urinary bladder (not drawn to scale). The following
structures are shown: epithelial cell layer (A), basement membrane
(B), tunica propria (C), muscularis mucosa (D), tunica mucosa (E),
tunica muscularis externa (F), tunica serosa (G), tunica mucosa
(H), and lumen of the bladder (L).
[0022] FIG. 2 shows photographs of the porcine urinary bladder
matrix (UBM) in its different forms: lyophilized UBM sheet (A),
lyophilized UBM powder (B); pepsin-digested solution at a
concentration of 10 mg/ml of UBM (C), and gels at 4 mg/ml of UBM
and at 8 mg/ml of UBM, where a gel of collagen I (Col I) at 4 mg/ml
is shown for comparison (D).
[0023] FIG. 3 shows results from gel-electrophoresis of UBM and Col
I gels.
[0024] FIG. 4 shows scanning electron micrograph (SEM) images of
UBM gels at different concentrations and at different
magnifications: 3 mg/ml UBM gel at 5,000.times. (A) and at 10,000X
(B); and 6 mg/ml UBM gel at 5,000.times. (C) and at 10,000.times.
(D).
[0025] FIG. 5 shows SEM images of a 4 mg/ml Col I gel and of a 4
mg/ml UBM gels at a magnification of 5,000.times..
[0026] FIG. 6 shows turbidimetric gelation kinetics of Col I gels
and UBM gels, which was determined spectrophotometrically by
measuring absorbance during gelation. Results are shown for both
measured absorbance values (A) and normalized absorbance values
(B), which allows for calculating kinetic parameters such as t1/2
(time to reach 50% of maximum turbidity), tlag (lag time of
gelation) and S (speed of gelation).
[0027] FIG. 7 shows turbidimetric gelation kinetics of 1 mg/mL
small intestine submucosa (SIS) gels.
[0028] FIG. 8 shows rheological measurements during the gelation of
UBM gels, where gelation was determined mechanically by monitoring
the oscillatory moduli of the sample at a fixed frequency during
gelation. Results are shown of the elastic modulus (G') and of the
viscosity modulus (G'') for 3 mg/ml UBM gel and for 6 mg/ml UBM
gel.
[0029] FIG. 9 shows rheological measurements during the gelation of
LS (liver stroma) and SIS gels. Gelation kinetics was determined at
5% strain and 1 rad/sec. where results are shown of the elastic
modulus (G') for LS, SIS and UBM gels at 6 mg/mL (A). The storage
modulus (G') as a function of frequency was also determined for LS,
UBM and SIS gels at 6 mg/ml (B).
[0030] FIG. 10 shows the effect of frequency on the dynamic
viscosity of 3 mg/ml Col I gel, 3 mg/ml UBM gel and 6 mg/ml UBM gel
(A).
[0031] FIG. 11 shows the results of an adhesion assay with rat
aortic smooth muscle cells (rSMCs) in culture after 30 minutes,
where rSMCs were cultured on Col I gel, UBM gel (UBM-g) and
lyophilized UBM sheets (UBM-Lyo). Results are shown for adhesion of
rSMCs relative to adhesion of rSMCs on tissue culture plastic
(TCP), where the activity of attached cells was determined by a MTT
assay (n=3).
[0032] FIG. 12 shows the results of a MTT assay to determine the
viability of rSMC cultures after 7 days on either Col I gel or on
UBM gel (UBM-g) (n=4, *p<0.05).
[0033] FIG. 13 shows histological images of rSMC cultures after 7
days. Images are shown for rSMCs (shown by arrows) at 10.times. on
the abluminal (A) and luminal (B) sides of the UBM-Lyo sheets,
where samples were fixed and stained with H & E. Images are
also shown for cultures at 10.times. (C) and at 20.times. (D) on
UBM gels, where samples were fixed and stained with Masson's
trichrome.
[0034] FIG. 14 shows the results of a MTT assay to determine the
viability of rSMC cultures after 3 hours and after 48 hours on
different substrates: tissue culture plate (TCP), Col I (collagen
type I gel), UBM (Urinary bladder matrix gel), LS (porcine liver
stroma gel), spleen (spleen ECM gel), UBM-Lyo (lyophilized UBM
sheet) and UBM-Hy (hydrated UBM sheets). All gels were at 6
mg/ml.
[0035] FIG. 15 shows the results of a chemotaxis assay of human
aortic endothelial cells (HAECs) for different solutions: dilutions
of digest solution of UBM with a solution containing acid and
pepsin (UBM), dilutions of EBM-2 media with a solution containing
acid and pepsin (Buffer), endothelial basal cell medium (EBM-2) and
fetal bovine serum (FBS). Chemotaxis was assessed using
CytoSelect.TM. 96-well Cell Migration Assay, where relative
fluorescence units (RFU) correlated to the number of migratory
cells that achieved chemotaxis.
[0036] FIG. 16 shows the results of a MTT assay to determine the
viability of human microvascular endothelial cells on different
substrates: tissue culture plate (TCP), Collagen (collagen type I
gel), UBM (Urinary bladder matrix gel), LS (porcine liver stroma
gel), and spleen (spleen ECM gel). All gels were at 6 mg/ml and
cells were seeded in triplicates (n=3).
[0037] FIG. 17 shows digital photographs of a porous titanium fiber
penetrated with UBM gel (stained in turquoise), where the fiber was
treated without (A) and with (B) ultrasonication. Scale bars are
2000 .mu.m.
[0038] FIG. 18 shows SEM images of porous metal scaffolds and ESEM
(environmental scanning electron microscopy) images of hybrid
extracellular matrix (ECM)/porous metal scaffolds. SEM images are
shown of a porous metal scaffold containing Ti6Al4V wires in a
fiber mesh (A) or containing sintered commercially pure titanium
(CP Ti) beads (C). ESEM images are shown of the hybrid ECM/porous
metal scaffold, where UBM gel coats both the Ti6A14V wires (B) and
the CP Ti beads (D) after exposure to ultrasonication.
[0039] FIG. 19 shows schematically one embodiment of a femoral
implant described herein.
[0040] FIG. 20 shows schematically one embodiment of a hand
prosthesis described herein.
DETAILED DESCRIPTION
[0041] Methods are described herein of preparing an injectable and
bioactive extracellular matrix (ECM)-derived composition comprising
solubilized extracellular matrix obtained from any of a variety of
tissues. Related compositions, devices and methods of use also are
described. The viscosity of the matrix increases when warmed to
physiological temperatures approaching about 37.degree. C.
According to one non-limiting embodiment, the ECM-derived
composition is an injectable solution at temperatures lower than
37.degree. C., but a gel at a physiological temperature of
37.degree. C. According to certain embodiments, the gel is
bioactive because the entire, intact ECM is solubilized and is not
dialyzed, cross-linked and/or otherwise treated to remove or
otherwise inactivate ECM structural or functional components,
resulting in a highly bioactive gel scaffold that is functionally
superior to earlier-described matrices. A general set of principles
for preparing an ECM-derived gel is provided along with specific
protocols for preparing gels from numerous tissues, including
urinary bladder, spleen, liver, heart, pancreas, ovary and small
intestine.
[0042] The compositions described herein find use as, without
limitation, an injectable graft (e.g., xenogeneic, allogeneic or
autologous) for tissues, for example, bone or soft tissues, in need
of repair or augmentation most typically to correct trauma or
disease-induced tissue defects. The compositions also may be used
as a filler for implant constructs comprising, for example, a
molded construct formed into a desired shape for use in cosmetic or
trauma-treating surgical procedures.
[0043] The compositions may be implanted into a patient, human or
animal, by a number of methods. In one non-limiting embodiment, the
compositions are injected as a liquid into a desired site in the
patient. The composition may be pre-seeded with cells, and then
preferably injected using a larger-bore, e.g. 16 gauge needle, to
prevent shearing of cells. In another non-limiting embodiment, the
composition is gelled within a mold, and the gelled, molded product
is then implanted into the patient at a desired site. The gelled,
molded product may be pre-seeded (laid onto the molded gel or mixed
in during gelation) with cells, such as cells of the patient.
[0044] As used herein, the terms "extracellular matrix" and "ECM"
refer to a natural or artificial scaffolding for cell growth.
Natural ECMs (ECMs found in multicellular organisms, such as
mammals and humans) are complex mixtures of structural and
non-structural biomolecules, including, but not limited to,
collagens, elastins, laminins, glycosaminoglycans, proteoglycans,
antimicrobials, chemoattractants, cytokines, and growth factors. In
mammals, ECM often comprises about 90% collagen, in its various
forms. The composition and structure of ECMs vary depending on the
source of the tissue. For example, small intestine submucosa (SIS),
urinary bladder matrix (UBM) and liver stroma ECM each differ in
their overall structure and composition due to the unique cellular
niche needed for each tissue.
[0045] As used herein, the terms "intact extracellular matrix" and
"intact ECM" refers to an extracellular matrix that retains
activity of its structural and non-structural biomolecules,
including, but not limited to, collagens, elastins, laminins,
glycosaminoglycans, proteoglycans, antimicrobials,
chemoattractants, cytokines, and growth factors, such as, without
limitation comminuted ECM as described herein. The activity of the
biomolecules within the ECM can be removed chemically or
mechanically, for example, by cross-linking and/or by dialyzing the
ECM. Intact ECM essentially has not been cross-linked and/or
dialyzed, meaning that the ECM has not been subjected to a dialysis
and/or a cross-linking process, or conditions other than processes
that occur naturally during storage and handling of ECM prior to
solubilization, as described herein. Thus, ECM that is
substantially cross-linked and/or dialyzed (in anything but a
trivial manner which does not substantially affect the gelation and
functional characteristics of the ECM in its uses described herein)
is not considered to be "intact".
[0046] By "Bio Compatible", it is meant that a device, scaffold
composition, etc. is essentially, practically (for its intended
use) and/or substantially non-toxic, non-injurous or non-inhibiting
or non-inhibitory to cells, tissues, organs, and/or organ systems
that would come into contact with the device, scaffold,
composition, etc.
[0047] In general, the method of preparing an ECM-derived gel
requires the isolation of ECM from an animal of interest and from a
tissue or organ of interest. In certain embodiments, the ECM is
isolated from mammalian tissue. As used herein, the term "mammalian
tissue" refers to tissue derived from a mammal, wherein tissue
comprises any cellular component of an animal. For example and
without limitation, tissue can be derived from aggregates of cells,
an organ, portions of an organ, combinations of organs. In certain
embodiments, the ECM is isolated from a vertebrate animal, for
example and without limitation, human, monkey, pig, cattle, and
sheep. In certain embodiments, the ECM is isolated from any tissue
of an animal, for example and without limitation, urinary bladder,
liver, small intestine, esophagus, pancreas, dermis, and heart. In
one embodiment, the ECM is derived from a urinary bladder. The ECM
may or may not include the basement membrane portion of the ECM. In
certain embodiments, the ECM includes at least a portion of the
basement membrane. The ECM may or may not retain some of the
cellular elements that comprised the original tissue such as
capillary endothelial cells or fibrocytes.
[0048] As used herein, the term "derive" and any other word forms
of cognates thereof, such as, without limitation, "derived" and
"derives", refers to a component or components obtained from any
stated source by any useful method. For example and without
limitation, an ECM-derived gel refers to a gel comprised of
components of ECM obtained from any tissue by any number of methods
known in the art for isolating ECM. In another example, mammalian
tissue-derived ECM refers to ECM comprised of components of
mammalian tissue obtained from a mammal by any useful method.
[0049] The ECM can be sterilized by any number of standard
techniques, including, but not limited to, exposure to peracetic
acid, low dose gamma radiation, gas plasma sterilization, ethylene
oxide treatment or electron beam treatment. More typically,
sterilization of ECM is obtained by soaking in 0.1% (v/v) peracetic
acid, 4% (v/v) ethanol, and 95.9% (v/v) sterile water for two
hours. The peracetic acid residue is removed by washing twice for
15 minutes with PBS (pH=7.4) and twice for 15 minutes with sterile
water.
[0050] Following isolation of the tissue of interest,
decellularization is performed by various methods, for example and
without limitation, exposure to hypertonic saline, peracetic acid,
Triton-X or other detergents. Sterilization and decellularization
can be simultaneous. For example and without limitation,
sterilization with peracetic acid, described above, also can serve
to decellularize the ECM. Decellularized ECM can then be dried,
either lyophilized (freeze-dried) or air dried. Dried ECM can be
comminuted by methods including, but not limited to, tearing,
milling, cutting, grinding, and shearing. The comminuted ECM can
also be further processed into a powdered form by methods, for
example and without limitation, such as grinding or milling in a
frozen or freeze-dried state.
[0051] As used herein, the term "comminute" and any other word
forms or cognates thereof, such as, without limitation,
"comminution" and "comminuting", refers to the process of reducing
larger particles into smaller particles, including, without
limitation, by grinding, blending, shredding, slicing, milling,
cutting, shredding. ECM can be comminuted while in any form,
including, but not limited to, hydrated forms, frozen, air-dried,
lyophilized, powdered, sheet-form.
[0052] In order to prepare solubilized ECM tissue, comminuted ECM
is digested with an acid protease in an acidic solution to form a
digest solution. As used herein, the term "acid protease" refers to
an enzyme that cleaves peptide bonds, wherein the enzyme has
increased activity of cleaving peptide bonds in an acidic pH. For
example and without limitation, acid proteases can include pepsin
and trypsin.
[0053] The digest solution of ECM typically is kept at a constant
stir for a certain amount of time at room temperature. The ECM
digest can be used immediately or be stored at -20.degree. C. or
frozen at, for example and without limitation, -20.degree. C. or
-80.degree. C. To form a "pre-gel" solution, the pH of the digest
solution is raised to a pH between 7.2 and 7.8. The pH can be
raised by adding one or more of a base or an isotonic buffered
solution, for example and without limitation, NaOH or PBS at pH
7.4. The method typically does not include a dialysis step prior to
gelation, yielding a more-complete ECM-like matrix that typically
gels at 37.degree. C. more slowly than comparable collagen or
dialyzed ECM preparations. The gel is therefore is more amenable to
injection into a patient, and also retains more of the qualities of
native ECM due to retention of many native soluble factors, such
as, without limitation, cytokines. The ability of non-dialyzed
(whole ECM) preparations prepared from a variety of tissues to gel
with kinetics suitable for use in molds or in situ is
unexpected.
[0054] As used herein, the term "isotonic buffered solution" refers
to a solution that is buffered to a pH between 7.2 and 7.8 and that
has a balanced concentration of salts to promote an isotonic
environment. As used herein, the term "base" refers to any compound
or a solution of a compound with a pH greater than 7. For example
and without limitation, the base is an alkaline hydroxide or an
aqueous solution of an alkaline hydroxide. In certain embodiments,
the base is NaOH or NaOH in PBS.
[0055] This "pre-gel" solution can, at that point be incubated at a
suitably warm temperature, for example and without limitation, at
about 37.degree. C. to gel. The pre-gel can be frozen and stored
at, for example and without limitation, -20.degree. C. or
-80.degree. C. As used herein, the term "pre-gel solution" or
"pre-gel" refers to a digest solution wherein the pH is increased.
For example and without limitation, a pre-gel has a pH between 7.2
and 7.8.
[0056] Any type of extracellular matrix tissue can be used in the
methods, compositions and devices as described herein (see
generally, U.S. Pat. Nos. 4,902,508; 4,956,178; 5,281,422;
5,352,463; 5,372,821; 5,554,389; 5,573,784; 5,645,860; 5,771,969;
5,753,267; 5,762,966; 5,866,414; 6,099,567; 6,485,723; 6,576,265;
6,579,538; 6,696,270; 6,783,776; 6,793,939; 6,849,273; 6,852,339;
6,861,074; 6,887,495; 6,890,562; 6,890,563; 6,890,564; and
6,893,666). In certain embodiments, the ECM is isolated from a
vertebrate animal, for example and without limitation, from a warm
blooded mammalian vertebrate animal including, but not limited to,
human, monkey, pig, cow and sheep. The ECM can be derived from any
organ or tissue, including without limitation, urinary bladder,
intestine, liver, esophagus and dermis. In one embodiment, the ECM
is isolated from a urinary bladder. The ECM may or may not include
the basement membrane portion of the ECM. In certain embodiments,
the ECM includes at least a portion of the basement membrane.
[0057] In another embodiment, the ECM is prepared by abrading
porcine bladder tissue to remove the outer layers including both
the tunica serosa and the tunica muscularis (layers G and F in FIG.
1) using a longitudinal wiping motion with a scalpel handle and
moistened gauze. Following eversion of the tissue segment, the
luminal portion of the tunica mucosa (layer H in FIG. 1) is
delaminated from the underlying tissue using the same wiping
motion. Care is taken to prevent perforation of the submucosa
(layer E of FIG. 1). After these tissues are removed, the resulting
ECM consists mainly of the tunica submucosa (layer E of FIG.
1).
[0058] The ECM can be sterilized by any of a number of standard
methods without loss of its ability to induce endogenous tissue
growth. For example, the material can be sterilized by propylene
oxide or ethylene oxide treatment, gamma irradiation treatment
(0.05 to 4 mRad), gas plasma sterilization, peracetic acid
sterilization, or electron beam treatment. The material can also be
sterilized by treatment with glutaraldehyde, which causes cross
linking of the protein material, but this treatment substantially
alters the material such that it is slowly resorbed or not resorbed
at all and incites a different type of host remodeling which more
closely resembles scar tissue formation or encapsulation rather
than constructive remodeling. Cross-linking of the protein material
can also be induced with carbodiimide or dehydrothermal or
photooxidation methods. More typically, ECM is disinfected by
immersion in 0.1% (v/v) peracetic acid (.sigma.), 4% (v/v) ethanol,
and 96% (v/v) sterile water for 2 h. The ECM material is then
washed twice for 15 min with PBS (pH=7.4) and twice for 15 min with
deionized water.
[0059] Commercially available ECM preparations can also be used in
the methods, devices and compositions described herein. In one
embodiment, the ECM is derived from small intestinal submucosa or
SIS. Commercially available preparations include, but are not
limited to, Surgisis.TM., Surgisis-ES.TM., Stratasis.TM., and
Stratasis-ES.TM. (Cook Urological Inc.; Indianapolis, Ind.) and
GraftPatch.TM. (Organogenesis Inc.; Canton Mass.). In another
embodiment, the ECM is derived from dermis. Commercially available
preparations include, but are not limited to Pelvicol.TM. (sold as
Permacol.TM. in Europe; Bard, Covington, Ga.), Repliform.TM.
(Microvasive; Boston, Mass.) and Alloderm.TM. (LifeCell;
Branchburg, N.J.). In another embodiment, the ECM is derived from
urinary bladder. Commercially available preparations include, but
are not limited to UBM (Acell Corporation; Jessup, Md.).
[0060] Tissue for preparation of ECM can be harvested in a large
variety of ways and once harvested, a variety of portions of the
harvested tissue may be used. For example and without limitation,
in one embodiment, the ECM is isolated from harvested porcine
urinary bladder to prepare urinary bladder matrix (UBM). Excess
connective tissue and residual urine are removed from the urinary
bladder. The tunica serosa, tunica muscularis externa, tunica
submucosa and most of the muscularis mucosa (layers G, F, E and
mostly D in FIG. 1) can be removed mechanical abrasion or by a
combination of enzymatic treatment, hydration, and abrasion.
Mechanical removal of these tissues can be accomplished by abrasion
using a longitudinal wiping motion to remove the outer layers
(particularly the abluminal smooth muscle layers) and even the
luminal portions of the tunica mucosa (epithelial layers).
Mechanical removal of these tissues is accomplished by removal of
mesenteric tissues with, for example, Adson-Brown forceps and
Metzenbaum scissors and wiping away the tunica muscularis and
tunica submucosa using a longitudinal wiping motion with a scalpel
handle or other rigid object wrapped in moistened gauze. The
epithelial cells of the tunica mucosa (layer A of FIG. 1) can also
be dissociated by soaking the tissue in a de-epithelializing
solution, for example and without limitation, hypertonic saline.
The resulting UBM comprises basement membrane of the tunica mucosa
and the adjacent tunica propria (layers B and C of FIG. 1), which
is further treated with peracetic acid, lyophilized and powdered.
Additional examples are provided below and are also present in the
related art.
[0061] In another embodiment, the epithelial cells can be
delaminated first by first soaking the tissue in a
de-epithelializing solution such as hypertonic saline, for example
and without limitation, 1.0 N saline, for periods of time ranging
from 10 minutes to 4 hours. Exposure to hypertonic saline solution
effectively removes the epithelial cells from the underlying
basement membrane. The tissue remaining after the initial
delamination procedure includes epithelial basement membrane and
the tissue layers abluminal to the epithelial basement membrane.
This tissue is next subjected to further treatment to remove the
majority of abluminal tissues but not the epithelial basement
membrane. The outer serosal, adventitial, smooth muscle tissues,
tunica submucosa and most of the muscularis mucosa are removed from
the remaining de-epithelialized tissue by mechanical abrasion or by
a combination of enzymatic treatment, hydration, and abrasion.
[0062] In one embodiment, the ECM is prepared by abrading porcine
bladder tissue to remove the outer layers including both the tunica
serosa and the tunica muscularis (layers G and F in FIG. 1) using a
longitudinal wiping motion with a scalpel handle and moistened
gauze. Following eversion of the tissue segment, the luminal
portion of the tunica mucosa (layer H in FIG. 1) is delaminated
from the underlying tissue using the same wiping motion. Care is
taken to prevent perforation of the submucosa (layer E of FIG. 1).
After these tissues are removed, the resulting ECM consists mainly
of the tunica submucosa (layer E of FIG. 1).
[0063] The compositions described herein can be used in a number of
ways or forms. For example and without limitation, according to a
first embodiment, the pre-gel is placed in a suitable mold to model
an organ or a portion thereof. As a non-limiting example, the
composition is molded into a portion of a liver to facilitate
re-growth of liver tissue. In another non-limiting example, the
composition is molded in the shape of nose or ear cartilage, or a
portion thereof, for replacement of damaged or excised
cartilaginous tissue. In yet another non-limiting example, the
composition is molded into the shape of a wound to facilitate
non-scarring healing of that tissue. To prepare the molded gel, the
pre-gel is placed in a biocompatible and preferably sterile mold,
such as a plastic mold, and is incubated at a temperature and for a
time suitable for gelation of the composition, for example and
without limitation at about 37.degree. C. In one embodiment, the
composition and mold is placed in an incubator at 37.degree. C. to
gel. Because CO2 has been found to slow gelation, in one
non-limiting embodiment, CO2 is not injected into the incubator,
though in yet another embodiment, CO2 and/or temperature may be
used to control the gelation process.
[0064] Any useful cytokine, chemoattractant or cells can be mixed
into the composition prior to gelation or diffused, absorbed and/or
adsorbed by the gel after it is gelled. For example and without
limitation, useful components include growth factors, interferons,
interleukins, chemokines, monokines, hormones, angiogenic factors,
drugs and antibiotics. Cells can be mixed into the neutralized
solubilized gel or can be placed atop the molded composition once
it is gelled. In either case, when the gel is seeded with cells,
the cells can be grown and/or adapted to the niche created by the
molded ECM gel by incubation in a suitable medium in a bioreactor
or incubator for a suitable time period to optimally/favorably
prepare the composition for implantation in a patient. The molded
composition can be seeded with cells to facilitate in-growth,
differentiation and/or adaptation of the cells. For example and
without limitation, the cells can be autologous or allogeneic with
respect to the patient to receive the composition/device comprising
the gel. The cells can be stem cells or other progenitor cells, or
differentiated cells. In one example, a layer of dermis obtained
from the patient is seeded on a mold, for use in repairing damaged
skin and/or underlying tissue.
[0065] As used herein, the terms "mold" refers to a cavity or
surface used to form the gel into a three-dimensional shape. For
example and without limitation, the mold can be a well plate, cell
culture dish or a tube or can be shaped into any useful shape. In a
certain embodiment, the mold can be shaped into a certain organ or
part of an organ. The gel can be delivered to the mold in a variety
of methods, including, but not limited to, injection,
deposition.
[0066] As used herein, the terms "drug" and "drugs" refer to any
compositions having a preventative or therapeutic effect, including
and without limitation, antibiotics, peptides, hormones, organic
molecules, vitamins, supplements, factors, proteins and
chemoattractants.
[0067] As used herein, the terms "cell" and "cells" refer to any
types of cells from any animal, such as, without limitation, rat,
mice, monkey, and human. For example and without limitation, cells
can be progenitor cells, such as stem cells, or differentiated
cells, such as endothelial cells, smooth muscle cells. In certain
embodiments, cells for medical procedures can be obtained from the
patient for autologous procedures or from other donors for
allogeneic procedures.
[0068] One favorable aspect of the use of pre-molded tissue is that
a layered composition can be produced. For example, a core portion
of the composition to be implanted can be prepared with a first ECM
gel, obtained from a first source, and a surrounding layer can be
with a second ECM gel, obtained from a second source different from
the first, or the same source as the first, but containing
different constituents, such as cytokines or cells.
[0069] In another embodiment of the pre-molded composition, the ECM
gel is contained within a laminar sheath of non-comminuted and
non-digested ECM tissue, such as SIS or UBM, to add physical
strength to the gel. In this embodiment, sheets of ECM tissue,
prepared in any manner known in the art, can be placed into the
mold prior to filling the mold with the solubilized ECM tissue for
producing the gel. The sheets of ECM tissue may be used as the
mold, so long as they are formed and sewn or cross-linked into a
desired shape. In this manner, a solid composition can be produced
that has greater physical strength than is the case of a gel,
alone.
[0070] In another non-limiting embodiment, the composition is
injected as a pre-gel into a patient. The composition is injected
at a locus in the patient where the matrix is needed for cell
growth. For example and without limitation, where a patient has had
tissue removed due to trauma, debridement and/or removal of
damaged, diseased or cancerous tissue, the composition can be
injected at the site of tissue removal to facilitate in-growth of
tissue. The viscosity of the pre-gel can be controlled by varying
the amounts of water (e.g., by varying the amounts of water, acid,
base, buffer (such as PBS) or other diluents) used to prepare the
pre-gel. In applications in which a small gauge needle is used,
such as in endoscopy, a less viscous pre-gel would be needed, which
typically results in a less viscous gel, once the pre-gel is
gelled. In applications in which a larger gauge needle is
available, a more viscous gel, with higher strength when gelled,
can be used. Also, use of a larger gauge needle, irrespective of
the viscosity of the pre-gel, favors mixing of live cells with the
pre-gel immediately prior to implantation with less risk of
shearing the cells.
[0071] In one embodiment, a pre-gel is prepared by raising the pH
of the acidic digest solution and the pre-gel is directly injected
into a patient prior to significant gelation proceeds. In one
embodiment, the pre-gel is in a frozen state and is thawed and
warmed prior to injection. In another embodiment, the acidic digest
solution is warmed to physiological temperature and is mixed during
injection in a static mixer with suitable quantities of a base
and/or buffer, such as PBS. Suitable static mixers include, without
limitation, helical or square static mixers, commercially available
from Cammda Corporation of Cobourg, Ontario, Canada or a Mini-Dual
Syringe with Micro Static Mixer commercially available from
Plas-Pak Industries, Inc. of Norwich, Conn.
[0072] In a further embodiment, a commercial kit is provided
comprising a composition described herein. A kit comprises suitable
packaging material and the composition. In one non-limiting
embodiment, the kit comprises a pre-gel in a vessel, which may be
the packaging, or which may be contained within packaging. In this
embodiment, the pre-gel typically is frozen or kept at
near-freezing temperatures, such as, without limitation, below
about 4.degree. C. In another non-limiting embodiment, the kit
comprises a first vessel containing an acidic solution comprising
digest solution of ECM as described herein, and a second vessel
comprising a neutralizing solution comprising a base and/or
buffer(s) to bring the acidic solution of the first vessel to
physiological ionic strength and pH, to form a pre-gel. This kit
also optionally comprises a mixing needle and/or a cold-pack. The
vessel may be a vial, syringe, tube or any other container suitable
for storage and transfer in commercial distribution routes of the
kit.
[0073] In yet another embodiment of the kit, a pre-gel composition
is molded and pre-gelled prior to packaging and distribution. In
one embodiment, the molded gel is packaged in a blister-pack
comprising a plastic container and a paper, plastic and/or foil
sealing portion, as are well-known in the art. The mold and
packaging typically is sterilized prior to or after packaging, for
example and without limitation, by gamma irradiation. The molded
composition may be packaged in any suitable physiological solution,
such as PBS or saline. If the molded gel contains live cells, the
mold can be transported in a suitable cell-culture medium in a
sealed jar or other vessel. Of course, the cell-containing molded
gel would have to be shipped in an expedited manner to preserve the
cells.
[0074] As used herein, the term "hybrid inorganic/ECM scaffold"
refers to a ECM-derived gel that is coated onto a biocompatible
inorganic structure, such as, without limitation, a metal, an
inorganic calcium compound such as calcium hydroxide, calcium
phosphate or calcium carbonate, or a ceramic composition. In one
embodiment, ultrasonication is used to aid in coating of the
inorganic structure with the ECM-derived gel. As used herein, the
term "ultrasonication" refers to the process of exposing ultrasonic
waves with a frequency higher than 15 kHz and lower than 400
kHz.
[0075] As used herein, the term "coat", and related cognates such
as "coated" and "coating," refers to a process comprising of
covering an inorganic structure with ECM-derived gel or hybrid
inorganic/ECM scaffold. For example and without limitation, coating
of an inorganic structure with ECM-derived gel can include methods
such as pouring, embedding, layering, dipping, spraying.
[0076] In another embodiment of the technology described herein,
the composition is coated onto a biocompatible structural material,
such as a metal, an inorganic calcium compound such as calcium
hydroxide, calcium phosphate or calcium carbonate, or a ceramic
composition. Non-limiting examples of suitable metals are
cobalt-chrome alloys, stainless steel alloys, titanium alloys,
tantalum alloys, titanium-tantalum alloys, which can include both
non-metallic and metallic components, such as molybdenum, tantalum,
niobium, zirconium, iron, manganese, chromium, cobalt, nickel
aluminum and lanthanum, including without limitation, CP Ti
(commercially pure titanium) of various grades or Ti 6Al4V (90% wt.
Ti, 6% wt. Al and 4% wt. V), stainless steel 316, Nitinol
(Nickel-titanium alloy), titanium alloys coated with
hydroxyapatite. Metals are useful due to high strength,
flexibility, and biocompatibility. Metals also can be formed into
complex shapes and many can withstand corrosion in the biological
environments, reduce wear, and not cause damage to tissues. In one
non-limiting example, the metal is femoral or acetabular component
used for hip repair. In another example, the metal is a fiber or
other protuberance used in permanent attachment of a prosthesis to
a patient. Other compositions, including ceramics, calcium
compounds, such as, without limitation, aragonite, may be
preferred, for example and without limitation, in repair of or
re-shaping of skeletal or dental structures. Combinations of metal,
ceramics and/or other materials also may prove useful. For
instance, a metal femoral component of a hip replacement may
comprise a ceramic ball and/or may comprise a plastic coating on
the ball surface, as might an acetabular component.
[0077] Metals, as well as other materials, as is appropriate, can
be useful in its different forms, including but not limited to
wires, foils, beads, rods and powders, including nanocrystalline
powder. The composition and surface of metals or other materials
can also be altered to ensure biocompatibility, such as surface
passivation through silane treatments, coating with biocompatible
plastics or ceramics, composite metal/ceramic materials. The
materials and methods for their employment are well-known in the
field of the present invention.
[0078] A difficulty with using metal inserts to repair a patient's
skeletal structure is that the inserts must be anchored/attached to
existing skeletal parts. Traditional methods employed cement and/or
screws. In the case of prostheses, the prostheses are not connected
to a patient's tissue except, typically, by cementing. Therefore,
it is desirable to biologically attach a patient's tissue to a
medical device. This may be accomplished by coating surfaces of the
implant with the ECM gel described herein, which will facilitate
in-growth of tissue and thus attachment of the device. A variety of
porous structures can be attached to the implant to create a
scaffold into which the ECM gel, and later cells or other tissue
(e.g., bone) can infiltrate. Structures include, without
limitation: woven or non-woven mesh, sponge-like porous materials,
fused beads, etc. The porous scaffold will facilitate formation of
a strong bond between living tissue, including bone, and the
device. The "pores" of the porous scaffold may be of any size that
will permit infiltration of an ECM gel, optionally facilitated by
ultrasound or other treatments that would assist in permeation of
the gel, and later cells or other biological materials, such as
bone, cartilage, tendons, ligaments, fascia or other connective
tissue, into the scaffolding. In one embodiment, metal fibers are
attached to the device, and the metal fibers are coated with an ECM
gel described herein, thereby permitting in-growth of tissue within
the fibers. In a second embodiment, a matrix of small beads is
welded or otherwise attached to a surface of the device and an ECM
gel described herein is coated onto the bead matrix, facilitating
in-growth of tissue among the beads. In one example, a device
contains a protuberance of fibers, which can be inserted inside a
bone, permitting fusion of the metal fibers with the bone. In one
embodiment, the ECM gel is seeded and incubated with a suitable
cell population, such as autologous osteoblasts, to facilitate bone
in-growth.
[0079] In another embodiment, the hybrid inorganic/ECM scaffold can
also be used to coat other structural implants, such as, without
limitation, a femoral implant, a prosthesis of the hand. FIG. 19
shows schematically one embodiment of a device 10 inserted into a
femur 15 in a hip replacement procedure. FIG. 19 illustrates device
10, showing an insert portion 20 for insertion into femur 15, and
an extension 25 into which a ball (not shown) is screwed or
otherwise inserted. Device 10 comprises a porous coating 30 of, for
example and without limitation, metal beads welded onto the device
10. Region A in FIG. 19 shows a magnified view of coating 30 of
device 10. Beads 32 are welded to metal surface 34 of device 10.
ECM gel 36 is coated onto and between beads 32. Bone tissue growth
into beads 32 is facilitated by the presence of the ECM gel 36.
[0080] A prosthesis might be anchored into bone in a like manner
using an insert having a porous coating, with the porous coating
extending to the limits of where attachment to a patient's tissue
is desired. As an example, shown in FIG. 20, a hand prosthesis 100
comprises an external portion 115 and an internal portion 120,
which comprises a radius insert portion 122 and an ulnar insert
portion 124. Porous coating 130 extends from insert portions 122
and 124 for attachment to bone, to the beginning of external
portion 115, permitting attachment of dermis and intermediary
tissue between the bones and dermis.
[0081] In use, the device which is coated with a suitable
scaffolding and ECM gel as described herein may be contacted with
cells, e.g. of a patient or allogeneic cells, and the cells are
allowed to infiltrate the matrix. The in-growth or infiltration of
cells can occur in vivo or ex vivo, depending on optimization of
methods. For example and without limitation, in the case of a
femoral implant, the implant can be inserted into the femur and
cells of a patient, and desirable bone tissue, infiltrates the
scaffolding to fuse the device to the bone. In another embodiment,
for example in the case of an artificial tendon or ligament, a
biopsy of a patient's tendons or ligaments is incubated with an
appropriate scaffold in order to create an autologous ligament or
tendon graft.
EXAMPLES
Example 1--Preparation of Porcine Extracellular Matrix (ECM)
(UBM)
[0082] The preparation of UBM has been previously described
[Sarikaya A, et al. Tissue Eng. 2002 February; 8(1):63-71; Ringel R
L, et al. J Speech Lang Hear Res. 2006 February; 49(1):194-208]. In
brief, porcine urinary bladders were harvested from 6-month-old
108-118 kg pigs (Whiteshire-Hamroc, IN) immediately following
euthanasia. Connective tissue and adipose tissue were removed from
the serosal surface and any residual urine was removed by repeated
washes with tap water. The tunica serosa, tunica muscularis
externa, the tunica submucosa, and majority of the tunica
muscularis mucosa were mechanically removed. The urothelial cells
of the tunica mucosa were dissociated from the luminal surface by
soaking the tissue in 1.0 N saline solution yielding a biomaterial
composed of the basement membrane plus the subjacent tunica
propria, which is referred to as urinary bladder matrix (UBM).
[0083] The UBM sheets were disinfected for two hours on a shaker in
a solution containing 0.1% (v/v) peracetic acid, 4% (v/v) ethanol,
and 95.9% (v/v) sterile water. The peracetic acid residue was
removed by washing with sterile phosphate-buffered saline (pH=7.4)
twice for 15 minutes each and twice for 15 minutes each with
sterile water. The UBM sheets (as in FIG. 2A) were then lyophilized
(FIG. 2B) using a FTS Systems Bulk Freeze Dryer Model 8-54 and
powdered using a Wiley Mini Mill.
[0084] One gram of lyophilized UBM powder (FIG. 2B) and 100 mg of
pepsin were both mixed in 100 ml of 0.01 M HCl. The solution was
kept at a constant stir for .about.48 hrs at room temperature
(25.degree. C.). After pepsin digestion, the digest solution (FIG.
1C) was aliquoted and stored at -20.degree. C. until use. After
completion, the solution is referred to as digest solution or ECM
digest or ECM stock solution.
Example 2--Preparation of Porcine Spleen ECM
[0085] Fresh spleen tissue was obtained. Outer layers of the spleen
membrane were removed by slicing, where remaining tissue was cut
into uniform pieces. Remnants of outer membrane were trimmed, then
rinsed three times in water. Water was strained by using a sieve.
Splenocytes were lysed by massaging. Spleen slices were incubated
in a solution of 0.02% trypsin/0.05% EDTA at 37.degree. C. for 1
hour in a water bath. If necessary, splenocytes were further lysed
by massaging. After rinsing, slices were soaked in 3% Triton X-100
solution and put on a shaker for 1 hour. If necessary, splenocytes
were further lysed by massaging. Slices were then soaked in 4%
deoxycholic acid solution and put on a shaker for 1 hour. After
thoroughly rinsing, the purified spleen ECM was stored for further
processing. This tissue was next disinfected with peracetic acid
treatment and dried.
[0086] One gram of dry porcine spleen ECM and 100 mg of pepsin were
both mixed in 100 ml of 0.01 M HCl. The solution was kept at a
constant stir for .about.72 hrs at room temperature (25.degree.
C.). If there are no visible pieces of the ECM floating in the
solution, aliquot the sample and freeze (-20.degree. C.) or use
immediately.
Example 3--Preparation of Porcine Liver Stroma ECM
[0087] Fresh liver tissue was obtained. Excess fat and tissue were
trimmed. Outer layers of the liver membrane were removed by
slicing, where remaining tissue was cut into uniform pieces.
Remnants of outer membrane were trimmed using a scalpel or razor
blade, then rinsed three times in water. Water was strained by
using a sieve. Cells were lysed by massaging. Liver slices were
incubated in a solution of 0.02% trypsin/0.05% EDTA at 37.degree.
C. for 1 hour in a water bath. If necessary, cells were further
lysed by massaging. After rinsing, slices were soaked in 3% Triton
X-100 solution and put on a shaker for 1 hour. If necessary, cells
were further lysed by massaging. Slices were then soaked in 4%
deoxycholic acid solution and put on a shaker for 1 hour. After
thoroughly rinsing, the purified liver stroma was stored in
deionized water for further processing. This tissue was next
disinfected with peracetic acid treatment and dried.
[0088] One gram of dry porcine liver stroma ECM and 100 mg of
pepsin were both mixed in 100 ml of 0.01 M HCl. The solution was
kept at a constant stir for .about.24-48 hrs at room temperature
(25.degree. C.). If there are no visible pieces of the ECM floating
in the solution, aliquot the sample and freeze (-20.degree. C.) or
use immediately.
Example 4--Preparation of Human Liver Stroma ECM
[0089] Fresh liver tissue was obtained. Excess fat and tissue were
trimmed. Outer layers of the liver membrane were removed by
slicing, where remaining tissue was cut into uniform pieces.
Remnants of outer membrane were trimmed using a scalpel or razor
blade, then rinsed three times in water. Water was strained by
using a sieve. Cells were lysed by massaging. Liver slices were
incubated in a solution of 0.02% trypsin/0.05% EDTA at 37.degree.
C. for 1 hour in a water bath. If necessary, cells were further
lysed by massaging. After rinsing, slices were soaked in 3% Triton
X-100 solution and put on a shaker for 1 hour. If necessary, cells
were further lysed by massaging. Slices were then soaked in 4%
deoxycholic acid solution and put on a shaker for 1 hour. After
thoroughly rinsing, the purified liver stroma was stored in
deionized water for further processing. This tissue was next
disinfected with peracetic acid treatment and dried.
[0090] One gram of dry human liver stroma ECM and 200 mg of pepsin
were both mixed in 50 ml of 0.01 M HCl. The solution was kept at a
constant stir for .about.3-5 days at room temperature (25.degree.
C.). The solution will need to be monitored every day. If there are
no visible pieces of the ECM floating in the solution, aliquot the
sample and freeze (-20.degree. C.) or use immediately.
Example 5--Preparation of Porcine Cardiac ECM
[0091] One gram of dry porcine cardiac ECM with 100 mg of pepsin
were both mixed in 50 mL of 0.01 M HCl. The solution was kept at a
constant stir for .about.48 hours at room temperature (25.degree.
C.).
Example 6--Preparation of Porcine Pancreatic ECM
[0092] One gram of dry de-fatted porcine pancreatic ECM with 100 mg
of pepsin were both mixed in 50 mL of 0.01 M HC1. The solution was
kept at a constant stir for .about.48 hours at room temperature
(25.degree. C.).
Example 7--Preparation of Porcine Ovarian ECM
[0093] Fresh ovarian tissue is obtained within 6 hours of harvest.
Ovaries were removed and stored in physiological saline tissue
until ready for dissection and residual uterine tissue was removed.
Longitudinal incisions were made through the hilum of the ovary and
the follicles were disrupted. Once all the follicles have been
disrupted, the ECM has been harvested from the ovaries. Rinse three
times in filtered water and strain the water using a sieve. Cells
were lysed by gentle massaging. ECM was incubated in a solution of
0.02% trypsin/0.05% EDTA at 37.degree. C. for 1 hour in a water
bath and then rinsed. If necessary, cells were further lysed by
massaging. ECM was soaked in 3% Triton X-100 solution and put on a
shaker for 1 hour. After rinsing, cells were further lysed by
massaging if necessary. Slices were then soaked in 4% deoxycholic
acid solution and put on a shaker for 1 hour. After thoroughly
rinsing to remove residual surfactant, the ECM was stored in
sterile/filtered water until further use. This tissue was next
disinfected with peracetic acid treatment and dried.
[0094] One gram of lyophilized ovarian ECM powder and 100 mg of
pepsin were both mixed in 100 ml of 0.01 M HCl. The solution was
kept at a constant stir for .about.48 hrs at room temperature
(25.degree. C.). After pepsin digestion, the digest solution was
aliquoted and stored at -20.degree. C. until use.
Example 8--General Method of Preparation of Gels from ECM
[0095] UBM gel was formed into a gel by mixing 0.1 N NaOH ( 1/10 of
the volume of digest solution) and 10.times. PBS pH 7.4 ( 1/9 of
the volume of digest solution) in appropriate amounts at 4.degree.
C. The solution was brought to the desired volume and concentration
using cold (4.degree. C.) 1.times. PBS pH 7.4 and placed in a
37.degree. C. incubator for gelation to occur (FIG. 2D).
[0096] The ECM was able to form a matrix after 40 minutes in
solution as shown in FIG. 2. The ECM-derived gel was liquid at
temperatures below 20.degree. C. but turn into a gel when the
temperature is raised to 37.degree. C.
[0097] In preparing gels from ECM, all of the following solutions
should be kept on ice and the following variables must be
determined: [0098] C.sub.f=concentration of the final gel in mg/ml
[0099] C.sub.s=concentration of the ECM digest solution in mg/ml
[0100] V.sub.f=volume of the final gel solution needed for the
experiments [0101] V.sub.d=volume needed from the ECM digest
solution in ml [0102] V.sub.10X=volume of 10.times. PBS needed in
ml [0103] V.sub.1X=volume of 1.times. PBS needed in ml [0104]
V.sub.NaOH=volume of 0.1 N NaOH needed in ml
[0105] First, determine the final concentration (Cf) and volume
(Vf) of ECM gel required. Then, calculate the mass of ECM needed by
multiplying Cf (mg/ml)*Vf (ml). This value will give you the volume
needed from the ECM digest solution (Vd), where Vd=[Cf (mg/ml)*Vf
(ml)]/Cs. Calculate the volume of 10.times. PBS needed by dividing
the calculated volume Vd by 9 (V10.times.=Vd/9). Calculate the
volume of 0.1 N NaOH needed by dividing the calculated volume Vd by
10 (VNaOH=Vd/10). Calculate the amount of 1.times. PBS needed to
bring the solution to the appropriate concentration/volume as
follow: V1X=Vf-Vd -V10X-VNaOH. Add all the reagents
(V1X+Vd+V10X+VNaOH) to an appropriate container (usually 15 or 50
ml centrifuge tubes) without the ECM digest (Vd). Place solutions
on ice and keep on ice at all times.
[0106] Add the appropriate volume from the ECM digest solution (Vd)
to the PBS/NaOH mixture prepared above and mix well with a 1 ml
micropipette while being careful and avoiding the creation of air
bubbles in the solution. Depending on the viscosity of the ECM
digest solution, there might be some significant volume loss during
the transfer. Monitor the total volume and add appropriate amounts
until the final volume is achieved. Measure the pH of the pre-gel
solution, where pH should be around 7.4.
[0107] Add the pre-gel solution to a mold or to appropriate wells.
Place the mold or wells in 37.degree. C. incubator for a minimum of
40 minutes. Avoid using an incubator with CO2 control. If water
evaporation is a concern, place the mold inside a plastic zip-lock
bag before placing in the incubator. After gelation, the gel can be
removed from the mold and placed on 1.times. PBS. If the gels were
made in tissue culture plates, 1.times. PBS can be placed on top of
the gels until use to maintain the gels hydrated.
[0108] Sample calculation: Make 6 ml of gel with a final
concentration of 6 mg/ml from the 10 mg/ml stock solution.
TABLE-US-00001 GIVEN: C.sub.s = 10 mg/ml; C.sub.f = 6 mg/ml;
V.sub.f = 6 ml V.sub.d =[6 mg/ml * 6 ml]/10 mg/ml =3.600 ml
V.sub.10x =3.6/9 =0.400 ml V.sub.NaOH =3.6/10 =0.360 ml V.sub.1x =6
ml - 3.6 ml - 0.400 ml - 0.360 =1.640 ml
Example 9--Composition and Morphology of Porcine UBM
[0109] UBM and rat-tail collagen type I (BD, Biosciences) solutions
were electrophoresed on 4-20% polyacrylamide gels under reducing
conditions (5% 2-Mercaptoethanol). The proteins were visualized
with Gel-Code Blue (Bio-Rad), and documented by a Kodak imaging
station.
[0110] Collagen and sulfated glycosaminoglycan (S-GAG) content were
determined using the hydroxyproline assay [Reddy G K, Enwemeka C S.
A simplified method for the analysis of hydroxyproline in
biological tissues. Clin Biochem. 1996 June; 29(3):225-9] and the
Blyscan.TM. assay kit (Biocolor, Northern Ireland) respectively
(three samples were tested). The Blyscan.TM. assay was performed
according to the manufacturer's instruction. The hydroxyproline
content was determined by hydrolyzing the samples with 2 M NaOH
(100 .mu.l total volume) in an autoclave at 120.degree. C. for 20
minutes. The samples were neutralized with 50 .mu.l of 4 M HCl and
reacted with 300 .mu.l of 0.056 M chloramine-T (Spectrum), mixed
gently, and allowed to oxidize for 25 minutes at room temperature.
The samples were then mixed with 300 .mu.l of 1 M Ehrlich's
aldehyde (Spectrum) and incubated at 65.degree. C. for 20 minutes.
A standard curve was generated using rat-tail collagen type I (BD
Biosciences) and used to calculate the total amount of collagen
present in the digested UBM solutions. The colorimetric change was
determined by the absorbance at 550 nm using a SpectraMax
spectrophotometer.
[0111] The composition of the gel has been determined. The collagen
concentration for pepsin digested UBM was found to be 0.8.+-.0.2 mg
per mg of dry lyophilized UBM powder (mean.+-.SD). The total S-GAG
content was found to be 5.1.+-.0.9 .mu.g per mg of dry lyophilized
UBM powder (mean.+-.SD). The electrophoresed proteins show the
typical bands for collagen type I present on the UBM lane with
extra bands as shown in FIG. 3. The difference may be in part due
to the additional components, that is, to small peptides and
glycosaminoglycans) present in the UBM gels.
[0112] The surface morphology of the UBM gels was examined using a
scanning electron microscope (SEM). The specimens were fixed in
cold 2.5% glutaraldehyde and rinsed in PBS, followed by a
dehydration process through a graded series of ethanol (30% to
100%), and finally critically point dried in an Emscope CPD 750
critical point dryer. The samples were attached to aluminum SEM
specimen mounting stubs (Electron Microscopy Sciences, Hatfield,
Pa.) and sputter coated with a gold palladium alloy using a Sputter
Coater 108 Auto (Cressington Scientific Instruments, Valencia,
Pa.). Finally, samples were examined using a scanning electron
microscope (JEOL 6330F). Images were taken at a 5,000 and
10,000.times. magnification. The scanning electron microscopy
pictures show the fibrillar appearance of the UBM gels at
concentrations of 3 mg/ml and 6 mg/ml (FIG. 4A-4D) as well as at 4
mg/ml (FIG. 5B).
Example 10--Rheological Properties and Gelation Kinetics of Porcine
UBM, SIS and LS Gels
[0113] The rheological properties of the UBM derived gel was
characterized during gelation. The UBM gel consists of a viscous
solution at temperature below 25.degree. C. and a gel at
physiological temperatures (37.degree. C.). Rheological properties
of other gels can be measured using similar methods described
herein. Rheological properties of liver stroma (LS) and small
intestine submucosa (SIS) were also measured.
[0114] Turbidimetric gelation kinetics was determined
spectrophotometrically as previously described [Gelman R A, et al.
Collagen fibril formation. Evidence for a multistep process. J Biol
Chem. 1979 January 10; 254(1):180-6]. Final pre-gel solutions at
the appropriate concentration were kept at 4.degree. C. and
transferred to a cold 96 well plate by placing 100 .mu.l per well
in triplicates. The SpectraMax spectrophotometer (Molecular
Devices) was pre-heated to 37.degree. C., the plate was placed in
the spectrophotometer, and the turbidity of each well was measured
at 405 nm every 2 minutes for 1.5 hours (FIG. 6A). Turbidity can
also be measured at 530 nm (FIG. 7). The absorbance values were
recorded and normalized as shown in FIG. 6B. The time needed to
reach 50% of the maximum turbidity measurement (e.g. maximum
absorbance value) was defined as t1/2 and the lag phase (tlag) was
calculated by extrapolating the linear growth of the curve. The
speed (S) of the gelation based on turbidimetric measurements was
determined by calculating the slope of the growth portion of the
curve as shown in FIG. 6B.
[0115] Dynamic oscillatory measurements are commonly used in
fundamental studies of gelation and in characterizing the
viscoelastic properties of gels. The sample was subjected to an
oscillatory strain of:
.gamma.(t)=.gamma..sub.0 cos(2.pi.ft) (1)
where .gamma..sub.0 was the amplitude of the sinusoidal strain, t
was the time, and f was the frequency. The sample developed a
sinusoidal stress described as follow:
.sigma.(t)=|G*|.gamma.(t) (2)
where G* was the frequency dependent complex modulus of the sample.
The real part of G*, denoted G', was in phase with the applied
strain and was called the storage modulus since it corresponded to
storage of mechanical energy in the elastic deformation of the
sample. The imaginary portion of G*, denoted G'', was 90.degree.
out of phase with the applied strain and was called the loss
modulus since it corresponded to the loss of energy by viscous
dissipation within the sample. Since the sample was expected to
develop solid-like characteristics as gelation proceeds, G' was
expected to increase significantly.
[0116] A final property of interest was the magnitude of the
complex viscosity defined as follows:
.eta. * = G * 2 .pi. f = G '2 + G ''2 2 .pi. f ( 3 )
##EQU00001##
where |n*| was the frequency dependent complex viscosity, G* was
the frequency dependent complex modulus, and f was the frequency.
It is common to fit complex viscosity versus frequency data to a
power-law of the form:
|n*|=kf.sup.n (4)
where k and n are both constants.
[0117] Rheological experiments were performed with a TA Instruments
AR2000 stress-controlled rheometer using a 40mm-diameter parallel
plate geometry and a Peltier cell to maintain the sample
temperature. The samples were prepared as discussed earlier and
loaded into the rheometer with the Peltier cell maintaining a
temperature of 15.degree. C. The sample edge was protected from
evaporation by applying mineral oil. The viscosity of the sample
was first measured by applying a constant stress of 1 Pa on the
sample for one minute at 15.degree. C. The temperature was then set
to 37.degree. C. to induce gelation; the Peltier cell typically
reached a temperature of 30.degree. C. within 10 seconds and
37.degree. C. within 50 seconds. During this increase in
temperature and the subsequent gelation, the oscillatory moduli of
the sample were monitored continuously at a fixed frequency of
0.159 Hz (1 rad/s) and a strain of 5%. When there was no further
change in the elastic modulus (G') with time, gelation was deemed
to be complete. The final linear viscoelastic properties of the gel
were measured by performing a frequency sweep between 15.9 Hz and
0.08 Hz at 37.degree. C. and 5% strain and fitted to equation
4.
[0118] The turbidimetric gelation kinetics and the calculated
parameters are shown in FIG. 6 and the results presented in Table
1. The turbidimetric gelation kinetics for UBM and collagen type I
gels followed a sigmoidal shape (FIG. 6A). Collagen type I gels at
a concentration of 3 mg/ml became more turbid following gelation
than UBM-gel at a concentration of 3 mg/ml and 6 mg/ml (FIG. 6A).
The lag phase (tlag) and the time required to reach half the final
turbidity (t1/2) were greater in the UBM gel (at 3 and 6 mg/ml)
than collagen type I (3 mg/ml). In addition, the speed of the
turbidimetric gelation kinetics (S) was lower for UBM when compared
to collagen type I. There was no change in tlag, t1/2, and S in UBM
gels with a change in concentration but there was a change in the
maximum turbidity reached.
[0119] Turbidimetric kinetics of 1 mg/mL SIS gel also followed a
sigmoidal shape (FIG. 7). Whereas UBM measurements were obtained at
405 nm, SIS measurements were obtained at 530 nm. SIS measurements
also displayed a decrease in turbidity before maximum turbidity was
reached.
[0120] Both the storage modulus (G') and the loss modulus (G'') of
UBM gels changed over time with a sigmoidal shape after the
temperature of the sample was raised from 15.degree. C. to
37.degree. C. (FIG. 8). G' and G'' reached a steady state after
approximately 8 minutes, suggesting that gelation had occurred. The
kinetics of G' and G'' were faster than the turbidimetric kinetics.
The viscosities of both UBM and collagen type I are shown in FIG.
10 over a frequency range of .about.0.08-15 Hz and the results are
summarized in Table 1.
[0121] The storage modulus (G') of LS and SIS gels also changed
over time with a sigmoidal shape after the temperature of the
sample was raised to 37.degree. C. (FIG. 9A). Kinetics of G' for
both LS and SIS gels were faster than kinetics of G' for UBM gels.
The storage modulus (G') of LS, SIS and UBM gels were also measured
as a function of angular frequency (FIG. 9B).
TABLE-US-00002 TABLE 1 Results from the turbidimetric analysis of
the UBM gelation kinetics. Data represents mean .+-. SD. Three
samples were tested (n = 3). Material k t.sub.1/2 t.sub.lag
Collagen type I 3 mg/ml 0.20 (0.01)* 12.2 (1.1)* 9.7 (0.8)* UBM 3
mg/ml 0.07 (0.01) 24.4 (2.4) 15.8 (2.0) UBM 6 mg/ml 0.09 (0.04)
22.4 (4.9) 14.1 (3.7) *p < 0.05
[0122] In an effort to explore the feasibility of using UBM as an
injectable material, multiple trials were performed to test them in
an injection setting. ECM powder suspended in saline and UBM gels
were tested side by side to see if they could successfully pass
through injection needles frequently used in medical procedures
such as vocal cord augmentation. These needles had 1 cm long, 25
gauge caliber tips that are attached to 25 cm long, 16 gauge needle
shafts. UBM gels easily and consistently passed through these
needles. The UBM powder suspension had an upper limit concentration
of l0mg/ml above which the needle would be frequently occluded,
making it difficult to determine the actual amount of ECM
delivered. This trial showed the feasibility of using the UMB gel
as an injectable material (Table 2).
TABLE-US-00003 TABLE 2 Comparison of the viscosity of UBM gels with
injectable materials commercially available. Frequency Material k n
r.sup.2 Range [Hz] REF Urinary 2.35 -1.0617 0.988 0.01-15 --
Bladder Matrix 3 mg/ml Urinary 5.69 -0.9547 0.999 0.01-15 --
Bladder Matrix 6 mg/ml Gelatin 149.39 -0.9030 0.997 0.01-15 Chan et
al. .sup.a (Gelfoam) Zyplast .TM. 99.851 -0.9145 0.998 0.01-15 Chan
et al. .sup.a Zyderm .TM. 66.395 -0.9154 0.998 0.01-15 Chan et al.
.sup.a Zyderm .TM. 12 -0.860 0.977 0.01-100 Klemuk et al. .sup.b
Cymetra .RTM. 19.9 -0.778 0.972 0.01-100 Klemuk et al. .sup.b
Hyaluronic 3.19 -0.744 0.974 0.01-100 Klemuk et al. .sup.b
Acid-DTPH Human 23.576 -0.9508 0.994 0.01-15 Chan et al. .sup.a
abdominal subcutaneous fat Polytetra- 1151.9 -1.0267 0.997 0.01-15
Chan et al. .sup.a fluoroethylene (PTFE) .sup.a Chan RW, et al.
Viscosities of implantable biomaterials in vocal fold augmentation
surgery. Laryngoscope. 1998 May; 108(5): 725-31. .sup.b Klemuk SA,
et al. Viscoelastic properties of three vocal-fold injectable
biomaterials at low audio frequencies. Laryngoscope. 2004
September; 114(9): 1597-603.
Example 11--Adhesion and Proliferation Assays with Rat Smooth
Muscle Cells (rSMCs)
[0123] The preparation of UBM has been previously described
[Freytes, D O et al, Biomaterials, 2004. 25(12): 2353-61]. Briefly,
porcine urinary bladders were harvested and the tunica serosa,
tunica muscularis externa, tunica submucosa, and most of the tunica
muscularis mucosa were mechanically removed. The resulting
biomaterial was composed of the basement membrane plus the
subjacent tunica propria. T his bi-laminate structure was referred
to as urinary bladder matrix or UBM. UBM sheets were disinfected
for two hours in a 0.1% (v/v) peracetic acid solution. UBM sheets
were either lyophilized or lyophilized and powdered after
processing.
[0124] One gram of lyophilized UBM powder and 100 mg of pepsin were
mixed in 100 mL of 0.01 M HCl and kept at a constant stir for
.about.48 hrs at room temperature (25.degree. C.). UBM and rat tail
collagen type I gels were made by bringing the pH and the ionic
strength to physiological range using 1.times. PBS in a 37.degree.
C. incubator. Gel formation kinetics was determined by measuring
the absorbance (570 nm) every 2 minutes for .about.1.5 hrs. Gels
were properly fixed and imaged using scanning electron microscopy
(SEM). Equal amounts of each solution were electrophoresed on a
gradient 4-20% polyacrylamide gel under reducing conditions (5%
2-Mercaptoethanol). The proteins were visualized with Gel-Code Blue
(Bio-Rad), and documented by a Kodak imaging station. Collagen and
sulfated glycosaminoglycan (S-GAG) content were determined using
the hydroxyproline assay and the Blyscan.TM. assay kit (Biocolor,
Northern Ireland).
[0125] Rat smooth muscle cells (rSMCs) were harvested as previously
described [Ray J L, Leach R, Herbert J M, Benson M. Isolation of
vascular smooth muscle cells from a single murine aorta. Methods
Cell Sci. 2001; 23(4):185-8] and expanded in DMEM with low
bicarbonate and supplemented with 10% fetal bovine serum (FBS) and
100 U/ml Penicillin/100 .mu.m/ml Streptomycin. The adhesion and
proliferation of rSMCs was measured by seeding the surface of 6 mm
disks of collagen type I and UBM gels in triplicates. The disks
were prepared by adding 100 .mu.l of the appropriate gel (3 mg/ml)
onto wells of 96 well plates.
[0126] Adhesion experiments were performed with rSMCs suspended in
serum free DMEM and seeded at a concentration of 4.times.10.sup.4
per well for 30 minutes. Non-adherent cells were removed and the
activity of the attached cells was quantified using the MTT assay.
The MTT assay is a colorimetric test that measures cell viability
by activity of mitochondria within the cells, where increased
absorbance at 570 nm relates to increased activity of enzymes
within the mitochondria. rSMCs showed similar adhesion on collagen
type I (Col I), UBM gels, and lyophilized UBM sheets (FIG. 11).
[0127] Proliferation experiments were performed with rSMCs at three
different concentrations (1, 2 and 4.times.10.sup.4 cells per
well), and the activity of the cells was determined using the MTT
assay by following the manufacturer's instructions. rSMCs
successfully adhered to UBM gels and were able to grow for 48 hours
with a slight increase in cell activity when compared to cells
grown on collagen type I (Table 3). rSMCs cultured for one week
also showed an increase in mitochondrial activity on UBM gels when
compared to the activity on collagen type I gels (see FIG. 12).
TABLE-US-00004 TABLE 3 Results form the proliferation and adhesion
assays using primary rat aortic endothelial cells. Data represents
mean .+-. SD. Three samples were tested (n = 3). Initial Cell % of
Cellular Activity when Assay Number Compared to Collagen Type I 48
hrs 1 .times. 10.sup.4 124 (12) proliferation 2 .times. 10.sup.4
111 (13) 4 .times. 10.sup.4 119 (7) 30 min adhesion 4 .times.
10.sup.4 73 (29)
[0128] Growth of rSMCs on collagen type I gels, UBM gels, and UBM
lyophilized sheets was also examined histologically. Disks of UBM
gel were made using a stainless steel ring (1.5 cm in diameter) as
a mold. rSMCs were seeded on the top surface of the gel at a
density of 0.5.times.10.sup.6 cells/cm.sup.2. Media was changed
every other day and the cells were allowed to grow for 10 days. The
samples where then fixed with 10% buffered formalin and stained
using H&E or Masson's Trichrome stain. rSMCs formed a confluent
multilayer after the 7-10 day incubation period on both UBM gels
and UBM lyophilized sheets (FIG. 13). Contraction of the UBM and
collagen type I gels was observed which could suggest a change of
the rSMCs from a proliferative state to a contractile state when
seeded on the gels, which shows that cell-matrix interactions and
traction forces were formed during in vitro culture
[0129] Cell viability was also measured over a period of 48 hours
on different types of ECM-derived gels. rSMCs were seeded at
0.125.times.10.sup.6 cells/cm.sup.2 in triplicates on the surface
of different substrates and the MTT assay used to determine cell
viability at 3 and 48 hours following seeding (FIG. 14). TCP=Tissue
Culture Plate; Col I=Purified Collagen Type I Gel, UBM=Urinary
Bladder Matrix Gel; LS=Porcine Liver Stroma Gel; Spleen=Spleen ECM
Gel; UBM-Lyo=Lyophilized UBM sheet; and UBM-Hy=Hydrated UBM sheets.
All gels were at a 6 mg/ml concentration.
[0130] Preliminary implantation of 6 mg/ml UBM gels on a
subcutaneous pocket of a rat showed complete degradation of the
scaffold after 14 days with no signs of inflammation (unpublished
results). Together, these data show the potential cytocompatibility
of the UBM gels but further in vivo testing is required.
Example 12--Chemotaxis Assay with Human Aortic Endothelial
Cells
[0131] The solubilized UBM also retains its bioactivity such as
chemoattractant properties, where human aortic endothelial cells
(HAECs) migrated towards a UBM digest solution more than towards a
solution containing pepsin alone (FIG. 15, comparing data from
"Buffer 1:10" to "UBM 1:10").
[0132] Chemotaxis assay was assessed using CytoSelect.TM. 96-well
Cell Migration Assay following the manufacturer's instructions.
Briefly, a membrane with a small pore size discriminates between
migratory and non-migratory cells. Migratory cells extend
protrusions towards the chemoattractants on the other side of the
membrane and pass through the pores. These migratory cells are
dissociated from the membrane and detected by fluorescence with
CyQuant.RTM. GR Dye (Invitrogen), which binds to cellular nucleic
acid. Therefore, increased relative fluorescence units (RFU)
correlated to a higher number of migratory cells that achieved
chemotaxis through the membrane.
Example 13--Adhesion and Proliferation Assay with Human Aortic
Endothelial Cells
[0133] Human microvascular endothelial cells (at the mentioned
Initial Cell Number per well) were seeded in triplicates on the
surface of different substrates and the MTT assay used to determine
cell viability (FIG. 16). TCP=Tissue Culture Plate;
Collagen=Purified Collagen Type I, UBM=Urinary Bladder Matrix Gel;
LS=Porcine Liver Stroma Gel; Spleen=Spleen ECM Gel. All gels were
at a 6 mg/ml concentration.
Example 14--Hybrid Inorganic/ECM Scaffold
[0134] Restoration of joint kinematics after limb amputation and
replacement with a prosthesis is limited due to the inability to
attach existing musculature to the prosthesis via boney insertion
of tendons [Higuera, C. A., et al.: J Orthop Res. 1091-9 (23)
2005]. Although a variety of porous titanium and tantalum alloys
have been successful at promoting bone ingrowth, there are no
alternatives to promote the ingrowth of fibrocartilaginous tissue
that restores a ligament or tendon insertion site. Recently, porous
tantalum scaffolds have been investigated for their ability to
promote ingrowth of a vascularized fibrous tissue with promising
mechanical strength [Hacking, S. A., et al.: J Biomed Mater Res,
631-8 (52) 2000]. Naturally derived extracellular matrix (ECM)
scaffolds from the porcine small intestine and urinary bladder
(UBM) have also been shown to form well organized tendon, ligament,
cartilage, and bone, as well as strong boney insertion sites with
good mechanical strength [Badylak, S. F.: Transpl Immunol. 367-77
(12) 2004; Dejardin, L. M., et al.: AJSM. 175-84 (29) 2001]. It is
reasonable to expect that a porous tantalum or titanium scaffold
with an ECM embedded within the pores may improve the ingrowth of
soft tissue into the metal surface and promote the formation of
fibrocartilaginous tissue. The goal of the current study was to
determine the feasibility of coating a porous titanium scaffold
with an ECM gel for the eventual application of ligament or tendon
insertion repair.
[0135] UBM powder was produced as described previously [Freytes, D
O et al, Biomaterials, 2004. 25(12): 2353-61]. A UBM gel digest was
prepared by mixing one gram of lyophilized UBM powder with 100 mg
of pepsin in 100 mL of 0.01 M HCl under constant stirring for
.about.48 hrs at room temperature. UBM gel polymerization was
initiated by bringing the pH and the ionic strength to
physiological range using PBS at 37.degree. C. Complete
polymerization of the gel occurred within 30 min. The porous metal
scaffolds were cleaned with acetone, methanol, and water, and
passivated with 20-45% nitric acid.
[0136] The contact angles between the UBM gel digest (before [10
mg/ml] and after physiologic activation [6 mg/ml]) and sheets of CP
Ti or Ti 6Al4V were measured. One ml of the digest was added to
each surface and a digital photograph was taken for subsequent
angle determination.
[0137] Two methods tested for ability to promote penetration of the
polymerized UBM gel into either CP titanium fiber mesh or CP
titanium sintered beads. The entire surface of each porous metal
scaffold was covered with activated UBM gel for 5 minutes. For half
of the scaffolds, the gel was permitted to penetrate under static
conditions, while in the other half of the samples penetration took
place using ultrasonication. Dye was added to visualize the
gel.
[0138] To verify the presence of UBM gel within the porous titanium
scaffolds and to better understand the interaction between the UBM
gel and the metal, specimens were prepared for environmental
scanning electron microscopy (ESEM). Since the samples were able to
be visualized with ESEM while still in the hydrated condition, the
interactions between the titanium scaffold and the UBM gel were
able to be determined without disruption of the ECM by
dehydration.
[0139] Both the UBM gel digest and the activated UBM gel wet the
surface of the CP Ti and Ti 6Al 4V well (Table 4). Therefore, the
porous metal should not exclude the ECM. Based on these results,
subsequent experiments focused on the activated gel. The UBM gel
was able to penetrate half way through the thickness of each porous
metal scaffold in the static condition. With the addition of
ultrasonication, pores were infiltrated through the entire
thickness of the scaffold (FIG. 17). Examination of the hybrid
scaffolds with ESEM showed excellent penetration within and
coverage of the porous titanium (FIG. 18).
[0140] It is possible to create a hybrid ECM/porous metal scaffold
using UBM gel and a porous titanium scaffold. Future studies will
evaluate whether these scaffolds can support cell growth in vitro
and promote connective tissue ingrowth in vivo. The eventual goal
of this effort is to develop a scaffold that will promote ingrowth
of soft tissue into the metal to serve as an insertion site for
ligaments and tendons.
TABLE-US-00005 TABLE 4 Contact angle for UBM material on titanium
alloys (Mean .+-. SD) Type of Metal UBM digest UBM gel CP Ti 46.8
.+-. 1.3 27.0 .+-. 4.0 Ti6A14V 38.2 .+-. 4.8 41.3 .+-. 1.6
* * * * *