Congenital and acquired diseases of the heart are leading causes of morbidity and mortality in developed countries today. Ischemic heart disease represents more than 10% of the world's total mortality. As cardiac cells are completely differentiated shortly after birth, after a massive cell loss due to ischemia, the myocardial tissue lacks intrinsic regeneration capability. Currently available clinical treatments do not directly repair damaged myocardium, therefore patients may experience other debilitating cardiac conditions as time progresses. Therefore, scientists and surgeons are continuously looking for new strategies to regenerate the injured heart. The transplantation of healthy cells by syringe injection directly in the ventricular wall or in the coronary vessels can improve contractile function, however, the efficacy of cell engraftment is very low. Therefore, much effort is now conveyed to the development of tissue engineering strategies using an ideal combination of cells, scaffolds, and signals.
The bioengineering of biomimetic scaffolds can play an important role in advancing the efforts toward myocardial tissue regeneration. Biomimetic scaffolds are structures that mimic nature. They are designed and developed by taking inspiration from the natural scaffold of native tissues, that is the extracellular matrix (ECM). It is well known that the ECM not only provides structural support to tissues, but it also offers a pattern for spatial organization, cellular binding sites and signaling molecules, such as growth factors. A biomimetic scaffold is intended to mimic the ECM under multiple aspects, including chemical composition, structural and mechanical properties, functional capabilities such as mechanical stretch and electrical conduction, bioactivity given by release of growth factors and presence of cell adhesion sites. Therefore, biomimicry can be achieved through the combination of different fabrication and functionalization strategies. By replicating cell-ECM interactions which occur in native cardiac tissue and that are at the basis of tissue development, biomimetic scaffolds promise to make myocardial tissue engineering a clinical therapeutic option for patients suffering from heart disease.
The scope of this article collection is to provide an exhaustive overview of the current state of the art, concerning different strategies to obtain biomimetic scaffolds for myocardial tissue engineering. The call is open for both review and original articles, concerning the following themes referred to myocardial tissue engineering:
• Biomimetic materials design
• Fabrication of biomimetic 3D and injectable scaffolds
• Biomimetic strategies for scaffold functionalization (e.g. immobilization of cell-adhesion sites, controlled release of bioactive agents, design of surface topography to guide tissue organization, composite scaffolds mimicking the physiologic environment in terms of mechanical stiffness and electrical conductivity)
• Electrically conductive biomaterials
• Application of nanotechnology strategies to obtain biomimetic scaffolds
Keywords: biomimetic scaffolds, biomaterials, extracellular matrix, biofabrication, nanotechnology
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