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Gelatin-modified 3D printed PGS elastic hierarchical porous scaffold for cartilage regeneration. 明胶改性3D打印PGS弹性分层多孔软骨再生支架。
IF 6 3区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2023-09-01 DOI: 10.1063/5.0152151
Sinan Wang, Hongying Chen, Jinyi Huang, Sisi Shen, Zhengya Tang, Xiaoyan Tan, Dong Lei, Guangdong Zhou

Regenerative cartilage replacements are increasingly required in clinical settings for various defect repairs, including bronchial cartilage deficiency, articular cartilage injury, and microtia reconstruction. Poly (glycerol sebacate) (PGS) is a widely used bioelastomer that has been developed for various regenerative medicine applications because of its excellent elasticity, biodegradability, and biocompatibility. However, because of inadequate active groups, strong hydrophobicity, and limited ink extrusion accuracy, 3D printed PGS scaffolds may cause insufficient bioactivity, inefficient cell inoculation, and inconsistent cellular composition, which seriously hinders its further cartilage regenerative application. Here, we combined 3D printed PGS frameworks with an encapsulated gelatin hydrogel to fabricate a PGS@Gel composite scaffold. PGS@Gel scaffolds have a controllable porous microstructure, with suitable pore sizes and enhanced hydrophilia, which could significantly promote the cells' penetration and adhesion for efficient chondrocyte inoculation. Furthermore, the outstanding elasticity and fatigue durability of the PGS framework enabled the regenerated cartilage built by the PGS@Gel scaffolds to resist the dynamic in vivo environment and maintain its original morphology. Importantly, PGS@Gel scaffolds increased the rate of cartilage regeneration concurrent with scaffold degradation. The scaffold was gradually degraded and integrated to form uniform, dense, and mature regenerated cartilage tissue with little scaffold residue.

在临床环境中,越来越多地需要再生软骨替代物来修复各种缺陷,包括支气管软骨缺损、关节软骨损伤和小体重建。聚甘油癸二酸酯(PGS)是一种广泛使用的生物弹性体,由于其优异的弹性、生物可降解性和生物相容性,已被开发用于各种再生医学应用。然而,由于活性基团不足,疏水性强,油墨挤出精度有限,3D打印的PGS支架可能导致生物活性不足,细胞接种效率低,细胞组成不一致,严重阻碍了其进一步的软骨再生应用。在这里,我们将3D打印的PGS框架与胶囊明胶水凝胶相结合,制造了PGS@Gel复合支架。PGS@Gel支架具有可控的多孔微观结构,孔径适宜,亲水性增强,可显著促进细胞的渗透和粘附,有效接种软骨细胞。此外,PGS框架出色的弹性和疲劳耐久性使PGS@Gel支架构建的再生软骨能够抵抗体内动态环境并保持其原始形态。重要的是,PGS@Gel支架在支架降解的同时增加了软骨再生的速度。支架逐渐降解、整合,形成均匀、致密、成熟的再生软骨组织,支架残留少。
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引用次数: 1
User-friendly microfluidic system reveals native-like morphological and transcriptomic phenotypes induced by shear stress in proximal tubule epithelium. 用户友好的微流控系统揭示了近端小管上皮剪切应力诱导的原生形态和转录组表型。
IF 6 3区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2023-09-01 DOI: 10.1063/5.0143614
Natalie N Khalil, Andrew P Petersen, Cheng J Song, Yibu Chen, Kaelyn Takamoto, Austin C Kellogg, Elaine Zhelan Chen, Andrew P McMahon, Megan L McCain

Drug-induced nephrotoxicity is a leading cause of drug attrition, partly due to the limited relevance of pre-clinical models of the proximal tubule. Culturing proximal tubule epithelial cells (PTECs) under fluid flow to mimic physiological shear stress has been shown to improve select phenotypes, but existing flow systems are expensive and difficult to implement by non-experts in microfluidics. Here, we designed and fabricated an accessible and modular flow system for culturing PTECs under physiological shear stress, which induced native-like cuboidal morphology, downregulated pathways associated with hypoxia, stress, and injury, and upregulated xenobiotic metabolism pathways. We also compared the expression profiles of shear-dependent genes in our in vitro PTEC tissues to that of ex vivo proximal tubules and observed stronger clustering between ex vivo proximal tubules and PTECs under physiological shear stress relative to PTECs under negligible shear stress. Together, these data illustrate the utility of our user-friendly flow system and highlight the role of shear stress in promoting native-like morphological and transcriptomic phenotypes in PTECs in vitro, which is critical for developing more relevant pre-clinical models of the proximal tubule for drug screening or disease modeling.

药物引起的肾毒性是药物损耗的主要原因,部分原因是近端肾小管临床前模型的相关性有限。在流体流动下培养近端小管上皮细胞(PTECs)以模拟生理剪切应力已被证明可以改善选择的表型,但现有的流动系统昂贵且难以由非微流体专家实施。在这里,我们设计并制造了一个可访问的模块化流动系统,用于在生理剪切应力下培养ptec,诱导原生样立方形态,与缺氧,应激和损伤相关的下调通路,以及上调外源代谢途径。我们还将体外PTEC组织中剪切依赖基因的表达谱与离体近端小管的表达谱进行了比较,发现在生理剪切应力下,离体近端小管与PTEC之间的聚类比在可忽略剪切应力下的PTEC更强。总之,这些数据说明了我们的用户友好型流动系统的实用性,并强调了剪切应力在体外促进ptec中原生样形态和转录组表型中的作用,这对于开发更相关的近端小管临床前模型用于药物筛选或疾病建模至关重要。
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引用次数: 0
A sense of proximity: Cell packing modulates oxygen consumption. 接近感:细胞包装调节氧气消耗。
IF 6 3区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2023-09-01 DOI: 10.1063/5.0160422
Ermes Botte, Piera Mancini, Chiara Magliaro, Arti Ahluwalia

Accurately modeling oxygen transport and consumption is crucial to predict metabolic dynamics in cell cultures and optimize the design of tissue and organ models. We present a methodology to characterize the Michaelis-Menten oxygen consumption parameters in vitro, integrating novel experimental techniques and computational tools. The parameters were derived for hepatic cell cultures with different dimensionality (i.e., 2D and 3D) and with different surface and volumetric densities. To quantify cell packing regardless of the dimensionality of cultures, we devised an image-based metric, referred to as the proximity index. The Michaelis-Menten parameters were related to the proximity index through an uptake coefficient, analogous to a diffusion constant, enabling the quantitative analysis of oxygen dynamics across dimensions. Our results show that Michaelis-Menten parameters are not constant for a given cell type but change with dimensionality and cell density. The maximum consumption rate per cell decreases significantly with cell surface and volumetric density, while the Michaelis-Menten constant tends to increase. In addition, the dependency of the uptake coefficient on the proximity index suggests that the oxygen consumption rate of hepatic cells is superadaptive, as they modulate their oxygen utilization according to its local availability and to the proximity of other cells. We describe, for the first time, how cells consume oxygen as a function of cell proximity, through a quantitative index, which combines cell density and dimensionality. This study enhances our understanding of how cell-cell interaction affects oxygen dynamics and enables better prediction of aerobic metabolism in tissue models, improving their translational value.

准确建模氧气运输和消耗是至关重要的预测代谢动力学在细胞培养和优化组织和器官模型的设计。我们提出了一种方法来表征体外Michaelis-Menten耗氧量参数,整合了新的实验技术和计算工具。这些参数是针对不同维度(即二维和三维)、不同表面和体积密度的肝细胞培养而得出的。无论培养物的维度如何,为了量化细胞包装,我们设计了一种基于图像的度量,称为接近指数。Michaelis-Menten参数通过吸收系数(类似于扩散常数)与接近指数相关联,从而可以跨维度定量分析氧动力学。我们的研究结果表明Michaelis-Menten参数对于给定的细胞类型不是恒定的,而是随着细胞密度和维数的变化而变化。每个细胞的最大消耗率随细胞表面积和体积密度的增加而显著降低,Michaelis-Menten常数呈增加趋势。此外,摄取系数对接近指数的依赖性表明,肝细胞的耗氧率是超适应性的,因为它们根据其局部可用性和与其他细胞的接近程度来调节其氧利用。我们首次通过结合细胞密度和维度的定量指数,描述了细胞如何消耗氧气作为细胞接近度的函数。这项研究增强了我们对细胞-细胞相互作用如何影响氧动力学的理解,使我们能够更好地预测组织模型中的有氧代谢,提高它们的翻译价值。
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引用次数: 0
Fluid shear stress enhances natural killer cell's cytotoxicity toward circulating tumor cells through NKG2D-mediated mechanosensing. 流体剪切应力通过nkg2d介导的机械感应增强自然杀伤细胞对循环肿瘤细胞的细胞毒性。
IF 6 3区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2023-09-01 DOI: 10.1063/5.0156628
Bing Hu, Ying Xin, Guanshuo Hu, Keming Li, Youhua Tan

Tumor cells metastasize to distant organs mainly via hematogenous dissemination, in which circulating tumor cells (CTCs) are relatively vulnerable, and eliminating these cells has great potential to prevent metastasis. In vasculature, natural killer (NK) cells are the major effector lymphocytes for efficient killing of CTCs under fluid shear stress (FSS), which is an important mechanical cue in tumor metastasis. However, the influence of FSS on the cytotoxicity of NK cells against CTCs remains elusive. We report that the death rate of CTCs under both NK cells and FSS is much higher than the combined death induced by either NK cells or FSS, suggesting that FSS may enhance NK cell's cytotoxicity. This death increment is elicited by shear-induced NK activation and granzyme B entry into target cells rather than the death ligand TRAIL or secreted cytokines TNF-α and IFN-γ. When NK cells form conjugates with CTCs or adhere to MICA-coated substrates, NK cell activating receptor NKG2D can directly sense FSS to induce NK activation and degranulation. These findings reveal the promotive effect of FSS on NK cell's cytotoxicity toward CTCs, thus providing new insight into immune surveillance of CTCs within circulation.

肿瘤细胞主要通过血液播散向远处器官转移,其中循环肿瘤细胞(循环肿瘤细胞)相对脆弱,消除循环肿瘤细胞具有很大的防止转移的潜力。在血管系统中,自然杀伤细胞(NK)是在流体剪切应力(FSS)作用下有效杀伤CTCs的主要效应淋巴细胞,是肿瘤转移的重要机械提示。然而,FSS对NK细胞抗ctc细胞毒性的影响尚不清楚。我们报道了NK细胞和FSS共同作用下CTCs的死亡率远高于NK细胞或FSS联合作用导致的死亡率,这表明FSS可能增强NK细胞的细胞毒性。这种死亡增加是由剪切诱导的NK活化和颗粒酶B进入靶细胞引起的,而不是死亡配体TRAIL或分泌的细胞因子TNF-α和IFN-γ引起的。当NK细胞与ctc结合或粘附在mica包被的底物上时,NK细胞激活受体NKG2D可直接感知FSS,诱导NK细胞活化和脱颗粒。这些发现揭示了FSS对NK细胞对ctc的细胞毒性的促进作用,从而为循环中ctc的免疫监测提供了新的见解。
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引用次数: 0
A low-profile electromechanical packaging system for soft-to-flexible bioelectronic interfaces. 一种低姿态的机电包装系统,用于软到柔性的生物电子接口。
IF 6 3区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2023-09-01 DOI: 10.1063/5.0152509
Florian Fallegger, Alix Trouillet, Florent-Valéry Coen, Giuseppe Schiavone, Stéphanie P Lacour

Interfacing the human body with the next generation of electronics requires technological advancement in designing and producing bioelectronic circuits. These circuits must integrate electrical functionality while simultaneously addressing limitations in mechanical compliance and dynamics, biocompatibility, and consistent, scalable manufacturing. The combination of mechanically disparate materials ranging from elastomers to inorganic crystalline semiconductors calls for modular designs with reliable and scalable electromechanical connectors. Here, we report on a novel interconnection solution for soft-to-flexible bioelectronic interfaces using a patterned and machined flexible printed circuit board, which we term FlexComb, interfaced with soft transducing systems. Using a simple assembly process, arrays of protruding "fingers" bearing individual electrical terminals are laser-machined on a standard flexible printed circuit board to create a comb-like structure, namely, the FlexComb. A matching pattern is also machined in the soft system to host and interlock electromechanically the FlexComb connections via a soft electrically conducting composite. We examine the electrical and electromechanical properties of the interconnection and demonstrate the versatility and scalability of the method through various customized submillimetric designs. In a pilot in vivo study, we validate the stability and compatibility of the FlexComb technology in a subdural electrocorticography system implanted for 6 months on the auditory cortex of a minipig. The FlexComb provides a reliable and simple technique to bond and connect soft transducing systems with flexible or rigid electronic boards, which should find many implementations in soft robotics and wearable and implantable bioelectronics.

将人体与下一代电子产品相连接需要在设计和生产生物电子电路方面取得技术进步。这些电路必须集成电气功能,同时解决机械顺应性和动力学、生物相容性以及一致、可扩展制造方面的限制。从弹性体到无机晶体半导体等机械不同材料的组合需要具有可靠和可扩展的机电连接器的模块化设计。在这里,我们报告了一种用于软到柔性生物电子接口的新型互连解决方案,该解决方案使用图像化和机加工的柔性印刷电路板,我们称之为FlexComb,与软传感系统接口。使用一个简单的组装过程,在一个标准的柔性印刷电路板上用激光加工出带有单个电气端子的突出“手指”阵列,以创建一个梳状结构,即FlexComb。在软系统中也加工了匹配的图案,通过软导电复合材料来承载和连锁FlexComb连接。我们研究了互连的电气和机电特性,并通过各种定制的亚毫米设计展示了该方法的多功能性和可扩展性。在一项试点体内研究中,我们将FlexComb技术植入迷你猪的听觉皮层6个月的硬脑膜下皮质电成像系统,验证其稳定性和兼容性。FlexComb提供了一种可靠而简单的技术,可以将软换能器系统与柔性或刚性电子板结合和连接,这在软机器人和可穿戴和植入式生物电子学中应该有很多应用。
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引用次数: 1
GelMA-glycol chitosan hydrogels for cartilage regeneration: The role of uniaxial mechanical stimulation in enhancing mechanical, adhesive, and biochemical properties. 用于软骨再生的凝胶-乙二醇壳聚糖水凝胶:单轴机械刺激在增强机械、粘合和生化性能方面的作用。
IF 6 3区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2023-09-01 DOI: 10.1063/5.0160472
Sattwikesh Paul, Karsten Schrobback, Phong Anh Tran, Christoph Meinert, Jordan William Davern, Angus Weekes, Udhaya Nedunchezhiyan, Travis Jacob Klein

Untreated osteochondral defects are a leading cause of osteoarthritis, a condition that places a heavy burden on both patients and orthopedic surgeons. Although tissue engineering has shown promise for creating mechanically similar cartilage-like constructs, their integration with cartilage remains elusive. Therefore, a formulation of biodegradable, biocompatible biomaterial with sufficient mechanical and adhesive properties for cartilage repair is required. To accomplish this, we prepared biocompatible, photo-curable, mechanically robust, and highly adhesive GelMA-glycol chitosan (GelMA-GC) hydrogels. GelMA-GC hydrogels had a modulus of 283 kPa and provided a biocompatible environment (>70% viability of embedded chondrocytes) in long-term culture within a bovine cartilage ring. The adhesive strength of bovine chondrocyte-laden GelMA-GC hydrogel to bovine cartilage increased from 38 to 52 kPa over four weeks of culture. Moreover, intermittent uniaxial mechanical stimulation enhanced the adhesive strength to ∼60 kPa, indicating that the cartilage-hydrogel integration could remain secure and functional under dynamic loading conditions. Furthermore, gene expression data and immunofluorescence staining revealed the capacity of chondrocytes in GelMA-GC hydrogel to synthesize chondrogenic markers (COL2A1 and ACAN), suggesting the potential for tissue regeneration. The promising in vitro results of this work motivate further exploration of the potential of photo-curable GelMA-GC bioadhesive hydrogels for cartilage repair and regeneration.

未经治疗的骨软骨缺损是骨关节炎的主要原因,这种情况给患者和骨科医生带来了沉重的负担。尽管组织工程已经显示出创造机械上类似软骨的结构的希望,但它们与软骨的整合仍然难以捉摸。因此,需要一种可生物降解的、具有足够机械和粘附性能的生物材料来修复软骨。为了实现这一目标,我们制备了生物相容性,光固化,机械坚固,高度粘合的gelma -乙二醇壳聚糖(GelMA-GC)水凝胶。GelMA-GC水凝胶的模量为283 kPa,在牛软骨环内长期培养提供了生物相容性环境(>70%的包埋软骨细胞存活率)。在4周的培养过程中,载牛软骨细胞的GelMA-GC水凝胶与牛软骨的粘附强度从38 kPa增加到52 kPa。此外,间歇性单轴机械刺激将黏附强度提高到~ 60 kPa,这表明在动态加载条件下,软骨-水凝胶结合可以保持安全和功能。此外,基因表达数据和免疫荧光染色显示GelMA-GC水凝胶中的软骨细胞能够合成软骨生成标志物(COL2A1和ACAN),表明其具有组织再生的潜力。这项工作的体外结果鼓舞了进一步探索光固化GelMA-GC生物粘合剂水凝胶用于软骨修复和再生的潜力。
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引用次数: 0
Deep focus light-field camera for handheld 3D intraoral scanning using crosstalk-free solid immersion microlens arrays. 使用无串扰固体浸没微透镜阵列进行手持式3D口腔内扫描的深焦光场相机。
IF 6 3区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2023-08-28 eCollection Date: 2023-09-01 DOI: 10.1063/5.0155862
Jae-Myeong Kwon, Sang-In Bae, Taehan Kim, Jeong Kun Kim, Ki-Hun Jeong

3D in vivo imaging techniques facilitate disease tracking and treatment, but bulky configurations and motion artifacts limit practical clinical applications. Compact light-field cameras with microlens arrays offer a feasible option for rapid volumetric imaging, yet their utilization in clinical practice necessitates an increased depth-of-field for handheld operation. Here, we report deep focus light-field camera (DF-LFC) with crosstalk-free solid immersion microlens arrays (siMLAs), allowing large depth-of-field and high-resolution imaging for handheld 3D intraoral scanning. The siMLAs consist of thin PDMS-coated microlens arrays and a metal-insulator-metal absorber to extend the focal length with low optical crosstalk and specular reflection. The experimental results show that the immersion of MLAs in PDMS increases the focal length by a factor of 2.7 and the transmittance by 5.6%-27%. Unlike conventional MLAs, the siMLAs exhibit exceptionally high f-numbers up to f/6, resulting in a large depth-of-field for light-field imaging. The siMLAs were fully integrated into an intraoral scanner to reconstruct a 3D dental phantom with a distance measurement error of 82 ± 41 μm during handheld operation. The DF-LFC offers a new direction not only for digital dental impressions with high accuracy, simplified workflow, reduced waste, and digital compatibility but also for assorted clinical endoscopy and microscopy.

3D体内成像技术有助于疾病跟踪和治疗,但庞大的配置和运动伪影限制了实际的临床应用。带有微透镜阵列的紧凑型光场相机为快速体积成像提供了一种可行的选择,但在临床实践中使用它们需要增加手持操作的景深。在这里,我们报道了具有无串扰固体浸没微透镜阵列(siMLA)的深聚焦光场相机(DF-LFC),允许用于手持式3D口腔内扫描的大景深和高分辨率成像。siMLA由薄PDMS涂覆的微透镜阵列和金属绝缘体-金属吸收体组成,以在低光学串扰和镜面反射的情况下延长焦距。实验结果表明,MLAs在PDMS中的浸泡使焦距增加了2.7倍,透射率增加了5.6%-27%。与传统MLAs不同,siMLAs表现出高达f/6的极高f数,从而使光场成像具有较大的景深。将siMLA完全集成到口内扫描仪中,以重建距离测量误差为82的3D牙体模 ± 41 μm。DF-LFC不仅为具有高精度、简化工作流程、减少浪费和数字兼容性的数字牙印模提供了一个新的方向,还为各种临床内窥镜检查和显微镜检查提供了新的方向。
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引用次数: 0
Direct differentiation of human pluripotent stem cells into vascular network along with supporting mural cells. 将人类多能干细胞与支持壁细胞一起直接分化成血管网络。
IF 6 3区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2023-08-08 eCollection Date: 2023-09-01 DOI: 10.1063/5.0155207
Taylor Bertucci, Shravani Kakarla, Max A Winkelman, Keith Lane, Katherine Stevens, Steven Lotz, Alexander Grath, Daylon James, Sally Temple, Guohao Dai

During embryonic development, endothelial cells (ECs) undergo vasculogenesis to form a primitive plexus and assemble into networks comprised of mural cell-stabilized vessels with molecularly distinct artery and vein signatures. This organized vasculature is established prior to the initiation of blood flow and depends on a sequence of complex signaling events elucidated primarily in animal models, but less studied and understood in humans. Here, we have developed a simple vascular differentiation protocol for human pluripotent stem cells that generates ECs, pericytes, and smooth muscle cells simultaneously. When this protocol is applied in a 3D hydrogel, we demonstrate that it recapitulates the dynamic processes of early human vessel formation, including acquisition of distinct arterial and venous fates, resulting in a vasculogenesis angiogenesis model plexus (VAMP). The VAMP captures the major stages of vasculogenesis, angiogenesis, and vascular network formation and is a simple, rapid, scalable model system for studying early human vascular development in vitro.

在胚胎发育过程中,内皮细胞(EC)经历了血管生成过程,形成原始的血管丛,并组装成由壁细胞稳定的血管组成的网络,这些血管具有分子上不同的动脉和静脉特征。这种有组织的血管是在血流开始之前建立的,取决于一连串复杂的信号事件,这些事件主要在动物模型中得到阐明,但对人类的研究和了解较少。在这里,我们为人类多能干细胞开发了一种简单的血管分化方案,可同时生成血管细胞、周细胞和平滑肌细胞。在三维水凝胶中应用该方案时,我们证明它再现了人类早期血管形成的动态过程,包括获得不同的动脉和静脉命运,形成了血管生成血管生成模型丛(VAMP)。VAMP 抓住了血管生成、血管生成和血管网络形成的主要阶段,是研究体外人类早期血管发育的一个简单、快速、可扩展的模型系统。
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引用次数: 0
Fluid flow to mimic organ function in 3D in vitro models. 在三维体外模型中模拟器官功能的流体流动。
IF 6.6 3区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2023-08-04 eCollection Date: 2023-09-01 DOI: 10.1063/5.0146000
Yago Juste-Lanas, Silvia Hervas-Raluy, José Manuel García-Aznar, Alejandra González-Loyola

Many different strategies can be found in the literature to model organ physiology, tissue functionality, and disease in vitro; however, most of these models lack the physiological fluid dynamics present in vivo. Here, we highlight the importance of fluid flow for tissue homeostasis, specifically in vessels, other lumen structures, and interstitium, to point out the need of perfusion in current 3D in vitro models. Importantly, the advantages and limitations of the different current experimental fluid-flow setups are discussed. Finally, we shed light on current challenges and future focus of fluid flow models applied to the newest bioengineering state-of-the-art platforms, such as organoids and organ-on-a-chip, as the most sophisticated and physiological preclinical platforms.

体外器官生理学、组织功能和疾病模型的文献中有许多不同的策略;然而,这些模型大多缺乏体内的生理流体动力学。在此,我们强调流体流动对组织稳态的重要性,特别是在血管、其他管腔结构和间质中,并指出目前的三维体外模型需要灌注。重要的是,我们讨论了当前不同实验流体流动设置的优势和局限性。最后,我们阐明了将流体流动模型应用于最新生物工程平台(如有机体和芯片器官)的当前挑战和未来重点,这些平台是最复杂和最生理学的临床前平台。
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引用次数: 0
Computational pulmonary edema: A microvascular model of alveolar capillary and interstitial flow. 计算肺水肿:肺泡毛细血管和间质血流的微血管模型。
IF 6 3区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2023-07-05 eCollection Date: 2023-09-01 DOI: 10.1063/5.0158324
James B Grotberg, Francesco Romanò

We present a microvascular model of fluid transport in the alveolar septa related to pulmonary edema. It consists of a two-dimensional capillary sheet coursing by several alveoli. The alveolar epithelial membrane runs parallel to the capillary endothelial membrane with an interstitial layer in between, making one long septal tract. A coupled system of equations uses lubrication theory for the capillary blood, Darcy flow for the porous media of the interstitium, a passive alveolus, and the Starling equation at both membranes. Case examples include normal physiology, cardiogenic pulmonary edema, acute respiratory distress syndrome (ARDS), hypoalbuminemia, and effects of PEEP. COVID-19 has dramatically increased ARDS in the world population, raising the urgency for such a model to create an analytical framework. Under normal conditions fluid exits the alveolus, crosses the interstitium, and enters the capillary. For edema, this crossflow is reversed with fluid leaving the capillary and entering the alveolus. Because both the interstitial and capillary pressures decrease downstream, the reversal can occur within a single septal tract, with edema upstream and clearance downstream. Clinically useful solution forms are provided allowing calculation of interstitial fluid pressure, crossflows, and critical capillary pressures. Overall, the interstitial pressures are found to be significantly more positive than values used in the traditional physiological literature. That creates steep gradients near the upstream and downstream end outlets, driving significant flows toward the distant lymphatics. This new physiological flow provides an explanation to the puzzle, noted since 1896, of how pulmonary lymphatics can function so far from the alveoli: the interstitium is self-clearing.

我们提出了肺泡间隔流体运输的微血管模型与肺水肿有关。它由几个肺泡形成的二维毛细血管片组成。肺泡上皮膜与毛细血管内皮膜平行,中间有间质层,形成一条长间隔束。一个耦合系统的方程使用润滑理论的毛细血管血,达西流的多孔介质间质,被动肺泡,和斯塔林方程在两个膜。病例包括生理正常、心源性肺水肿、急性呼吸窘迫综合征(ARDS)、低白蛋白血症和PEEP的影响。COVID-19大大增加了世界人口中的ARDS,因此迫切需要这样一个模型来创建一个分析框架。在正常情况下,液体流出肺泡,穿过间质,进入毛细血管。对于水肿,这种横流是相反的,液体离开毛细血管进入肺泡。由于下游间质压力和毛细血管压力均下降,逆转可发生在单个间隔束内,上游为水肿,下游为清除。提供了临床有用的溶液形式,允许计算间质流体压力,横流和临界毛细管压力。总的来说,发现间质压力比传统生理文献中使用的值明显更积极。这在上游和下游末端出口附近形成了陡峭的坡度,驱使大量水流流向远处的淋巴管。这种新的生理流动为自1896年以来人们所注意到的谜题提供了一个解释,即肺淋巴如何在远离肺泡的地方发挥作用:间质是自我清除的。
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引用次数: 1
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