Engineered Extracellular Vesicle-Based Therapies for Valvular Heart Disease.

IF 2.3 4区 医学 Q3 BIOPHYSICS Cellular and molecular bioengineering Pub Date : 2023-09-26 eCollection Date: 2023-08-01 DOI:10.1007/s12195-023-00783-x
Ana I Salazar-Puerta, Mia Kordowski, Tatiana Z Cuellar-Gaviria, Maria A Rincon-Benavides, Jad Hussein, Dorma Flemister, Gabriel Mayoral-Andrade, Grant Barringer, Elizabeth Guilfoyle, Britani N Blackstone, Binbin Deng, Diana Zepeda-Orozco, David W McComb, Heather Powell, Lakshmi P Dasi, Daniel Gallego-Perez, Natalia Higuita-Castro
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Abstract

Introduction: Valvular heart disease represents a significant burden to the healthcare system, with approximately 5 million cases diagnosed annually in the US. Among these cases, calcific aortic stenosis (CAS) stands out as the most prevalent form of valvular heart disease in the aging population.  CAS is characterized by the progressive calcification of the aortic valve leaflets, leading to valve stiffening. While aortic valve replacement is the standard of care for CAS patients, the long-term durability of prosthetic devices is poor, calling for innovative strategies to halt  or reverse disease progression. Here, we explor the potential use of novel extracellular vesicle (EV)-based nanocarriers for delivering molecular payloads to the affected valve tissue. This approach aims to reduce inflammation and potentially promote resorption of the calcified tissue.

Methods: Engineered EVs loaded with the reprogramming myeloid transcription factors, CEBPA and Spi1, known to mediate the transdifferentiation of committed endothelial cells into macrophages. We evaluated the ability of these engineered EVs to deliver DNA and transcripts encoding CEBPA and Spil into calcified aortic valve tissue obtained from patients undergoing valve replacement due to aortic stenosis. We also investigated whether these EVs could induce the transdifferentiation of endothelial cells into macrophage-like cells.

Results: Engineered EVs loaded with CEBPA + Spi1 were successfully derived from human dermal fibroblasts. Peak EV loading was found to be at 4 h after nanotransfection of donor cells.  These CEBPA + Spi1 loaded EVs effectively transfected aortic valve cells, resulting in the successful induction of transdifferentiation, both in vitro with  endothelial cells and ex vivo with valvular endothelial cells, leading to the development of anti-inflammatory macrophage-like cells.

Conclusions: Our findings highlight the potential of engineered EVs as a next generation nanocarrier to target aberrant calcifications on diseased heart valves. This development holds promise as a novel therapy for high-risk patients who may not be suitable candidates for valve replacement surgery.

Supplementary information: The online version contains supplementary material available at 10.1007/s12195-023-00783-x.

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工程细胞外囊泡治疗瓣膜性心脏病。
简介:瓣膜性心脏病是医疗系统的一大负担,美国每年约有500万例确诊病例。在这些病例中,钙化性主动脉瓣狭窄(CAS)是老年人口中最常见的瓣膜性心脏疾病。CAS的特征是主动脉瓣叶进行性钙化,导致瓣膜硬化。虽然主动脉瓣置换术是CAS患者的标准护理,但人工装置的长期耐用性较差,需要创新策略来阻止或逆转疾病进展。在这里,我们探索了新型基于细胞外囊泡(EV)的纳米载体在向受影响的瓣膜组织递送分子有效载荷方面的潜在用途。这种方法旨在减少炎症,并可能促进钙化组织的吸收。方法:负载重编程骨髓转录因子CEBPA和Spi1的工程EVs,已知可介导定向内皮细胞转分化为巨噬细胞。我们评估了这些工程EVs将编码CEBPA和Spil的DNA和转录物递送到钙化主动脉瓣组织中的能力,这些钙化主动脉瓣是从因主动脉狭窄而进行瓣膜置换的患者获得的。我们还研究了这些EVs是否可以诱导内皮细胞转分化为巨噬细胞样细胞。结果:装有CEBPA的工程电动汽车 + Spi1成功地来源于人真皮成纤维细胞。发现EV负载峰值在供体细胞纳米转染后4小时。这些CEBPA + Spi1负载的EVs有效地转染了主动脉瓣细胞,导致在体外用内皮细胞和离体用瓣膜内皮细胞成功诱导转分化,从而形成抗炎巨噬细胞样细胞。结论:我们的发现突出了工程EVs作为下一代纳米载体靶向病变心脏瓣膜异常钙化的潜力。这一进展有望成为一种新的治疗方法,用于可能不适合瓣膜置换手术的高危患者。补充信息:在线版本包含补充材料,请访问10.1007/s12195-023-00783-x。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.60
自引率
3.60%
发文量
30
审稿时长
>12 weeks
期刊介绍: The field of cellular and molecular bioengineering seeks to understand, so that we may ultimately control, the mechanical, chemical, and electrical processes of the cell. A key challenge in improving human health is to understand how cellular behavior arises from molecular-level interactions. CMBE, an official journal of the Biomedical Engineering Society, publishes original research and review papers in the following seven general areas: Molecular: DNA-protein/RNA-protein interactions, protein folding and function, protein-protein and receptor-ligand interactions, lipids, polysaccharides, molecular motors, and the biophysics of macromolecules that function as therapeutics or engineered matrices, for example. Cellular: Studies of how cells sense physicochemical events surrounding and within cells, and how cells transduce these events into biological responses. Specific cell processes of interest include cell growth, differentiation, migration, signal transduction, protein secretion and transport, gene expression and regulation, and cell-matrix interactions. Mechanobiology: The mechanical properties of cells and biomolecules, cellular/molecular force generation and adhesion, the response of cells to their mechanical microenvironment, and mechanotransduction in response to various physical forces such as fluid shear stress. Nanomedicine: The engineering of nanoparticles for advanced drug delivery and molecular imaging applications, with particular focus on the interaction of such particles with living cells. Also, the application of nanostructured materials to control the behavior of cells and biomolecules.
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