The Use of Conductive Biomaterials For Cardiac Tissue Engineering To Treat Post Myocardial Infarction Cardiac Fibrosis
Background: Myocardial infarction (MI) is a common condition that can lead to cardiac fibrosis and heart failure1,2,3,4,5,6. Current treatments have limitations in targeting fibrotic tissue and there are no reliable biomarkers to predict the development or severity of fibrosis1,2,3. The lack of effective treatments for established post-MI cardiac fibrosis further underscores the need for new therapies1,2,3.
Objective: This review aims to summarize recent research on new biomaterials and therapies for cardiac tissue regeneration and restoration of normal heart function following MI.
Search Methods: An online search in the PubMed database was conducted from 2018 to 2023 using the following keywords: “conductive biomaterials”, “cardiac fibrosis”, “conductive hydrogels”.
Results: Several studies have addressed challenges in cardiac tissue regeneration by developing electroconductive scaffolds, cardiopatches, and conductive hydrogels7,8,9,10,11. The electroconductive scaffolds combine biocompatible and conductive polymers and promote cell adhesion, proliferation, and spreading without cytotoxicity7. The resulting biomimetic scaffolds have potential as implantable biomaterials for cardiac tissue regeneration and as 3D tissue models for biomolecule screening7. Cardiopatches were also developed by electrospinning gelatin methacryloyl (GelMA) and conjugating a choline-based bio-ionic liquid (Bio-IL), which exhibited mechanical and conductive properties similar to native myocardium and improved contractile profiles compared to pristine GelMA controls8. Additionally, the conductive hydrogel, PPY-CHI, was investigated to improve electrical propagation in fibrotic cardiac tissue and resynchronize cardiac contraction to preserve cardiac function9. PPY-CHI hydrogel increased conductivity and reduced tissue resistance, leading to improved electrical conduction across the fibrotic scar, enhanced field potential amplitudes, and resynchronized cardiac contraction9. Furthermore, An injectable conductive hydrogel loaded with plasmid DNA and adipose-derived stem cells improved heart function and increased vessel density in rats with myocardial infarction10. Finally, an auxetic conductive cardiac patch for the treatment of myocardial infarction that is cytocompatible with cardiomyocytes, conforms to native heart movements, and in vivo experiments show negligible fibrotic response after two weeks, making it a versatile and robust platform for cardiac biomaterial design and a promising treatment option11.
Conclusions: Cardiac fibrosis is a pathological condition that manifests as the accumulation of extracellular matrix proteins in cardiac tissue, resulting in the formation of scars that disrupt normal tissue architecture1,2. These scars may function as electrical barriers, leading to arrhythmias and heart failure1,2. Conductive biomaterials have shown potential for restoring cardiac function by improving electrical propagation across fibrotic scars3,7,8,9,10,11. However, further research is required to optimize the mechanical and electrical properties of conductive biomaterials in vivo, as well as to investigate strategies to promote vascular regeneration, in order to develop a more viable treatment option for human patients3,7,8,9,10,11.
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