Leading OpinionThe extracellular matrix as a biologic scaffold material☆
Section snippets
The extracellular matrix as a biologic scaffold material
The extracellular matrix (ECM) is by definition nature's ideal biologic scaffold material. The ECM is custom designed and manufactured by the resident cells of each tissue and organ and is in a state of dynamic equilibrium with its surrounding microenvironment [1]. The structural and functional molecules of the ECM provide the means by which adjacent cells communicate with each other and with the external environment [2], [3], [4]. The ECM is obviously biocompatible since host cells produce
The bioinductive properties of ECM bioscaffolds
The mechanisms by which scaffolds composed of naturally occurring ECM facilitate the constructive remodeling of tissues are not completely understood. It is clear, however, that the bioinductive properties of these scaffolds play a very important role in tissue remodeling. The viscoelastic behavior, biomechanical properties, and ability to support host cell attachment through collagen, fibronectin and laminin ligands are insufficient alone to explain the constructive remodeling events that are
Biomechanical properties of ECM
The mechanical properties of the ECM are largely a consequence of its collagen fiber architecture and kinematics. With the exception of ECM derived from the small intestine (SIS) and urinary bladder, there has been almost no systematic examination of the biomechanical properties of ECM scaffold materials, especially with respect to the effect of processing methods (e.g., sterilization) upon such properties.
SIS has been shown to have a global preferred fiber alignment along the longitudinal axis
Host tissue response to xenogeneic SIS–ECM
The use of xenogeneic ECM as a biologic scaffold should logically raise questions regarding the host (recipient) immune response. Many ECM scaffolds are of porcine origin including SIS. However, bovine tissue (e.g., TissueMend®) and allogeneic human tissue (e.g., AlloDerm) are well represented among the group of ECM biomaterials. Non-autologous biologic materials have been used for many years in humans without evidence of adverse immunologic outcomes. For example, porcine heart valves for valve
Degradation of SIS–ECM
Perhaps the most important characteristic of SIS–ECM is its ability to be rapidly and completely degraded [20], [82], [83]. Quantitative studies of 14C-labeled SIS used in both augmentation cytoplasty procedures and Achilles tendon reconstruction show that greater than 50% of the ECM scaffold is degraded and removed from the implantation site by 28 days and virtually all of the SIS is replaced by 60 days. The fate of 95% of the SIS degradation products is urinary excretion and it appears that
Summary
Biologic scaffolds composed of naturally occurring ECM such as SIS have received significant attention for their potential therapeutic applications. The full potential of the ability of ECM scaffolds to promote constructive remodeling will not be realized, however, until an understanding of the biology and the external influences that affect biology, are better achieved. The factors that appear important for the constructive remodeling of SIS are its ability to be rapidly and completely
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Editor's Note: Leading Opinions: This paper is one of a newly instituted series of scientific articles that provide evidence-based scientific opinions on topical and important issues in biomaterials science. They have some features of an invited editorial but are based on scientific facts, and some features of a review paper, without attempting to be comprehensive. These papers have been commissioned by the Editor-in-Chief and reviewed for factual, scientific content by referees.