Polymer hydrogels usable for nervous tissue repair.

The implantation of non-resorbable biocompatible polymer hydrogels into defects in the central nervous system can reduce glial scar formation, bridge the lesion and lead to tissue regeneration within the hydrogel. We implanted hydrogels based on crosslinked poly hydroxyethyl-methacrylate (pHEMA) and poly N-(2-hydroxypropyl)-methacrylamide (pHPMA) into the rat cortex and evaluated the cellular invasion into the hydrogels by means of immunohistochemical methods and tetramethylammonium diffusion measurements. Astrocytes and NF160-positive axons grew similarly into both types of hydrogels. We found no cell types other than astrocytes in the pHEMA hydrogels. In the pHPMA hydrogels, we found a massive ingrowth of connective tissue elements. These changes were accompanied by corresponding changes in the extracellular space volume fraction and tortuosity of the hydrogels.

Spinal cord reconstruction using NeuroGel implants and functional recovery after chronic injury.

There is currently a lack of effective ways to achieve functional tissue repair of the chronically injured spinal cord. We investigated the potential of using NeuroGel, a biocompatible polymer hydrogel, to induce a reconstruction of the rat spinal cord after chronic compression-produced injury. NeuroGel was inserted 3 months after a severe injury into the post-traumatic lesion cavity. Rats were placed in an enriched environment and the functional deficits were measured using the BBB rating scale. A significant improvement in the mean BBB scores was observed. Rats without enriched environment and severely injured rats with an enriched environment alone showed no improvement; however, 7 months after reconstructive surgery using NeuroGel, a reparative neural tissue had formed within the polymer gel that included myelinated axons and dendro-dendritic contacts. NeuroGel implantation into a chronic spinal cord injury therefore resulted in tissue reconstruction and functional improvement, suggesting that such an approach may have therapeutic value in the repair of focal lesions in humans.

Natural and artificial substrates for retinal pigment epithelial monolayer transplantation.

The aim of this study was to culture retinal pigment epithelial (RPE) cells on natural and synthetic substrates for future use in RPE monolayer transplantation in the eye. The extracellular capsules surrounding the human lens and a hydrogel biomaterial were used as substrates for monolayer culture. All materials were seeded with either pig or human retinal pigment epithelial cells and were maintained in tissue culture conditions. Upon confluency, the cell density was calculated and cell viability determined. All monolayers were stained with phalloidin-rhodamine for F-actin and antibodies to tight junction-associated protein, ZO1. The final cell density of human RPE monolayers on the hydrogel and lens capsule was 3,200 +/- 187 and 3,350 +/- 120 cells/mm2 respectively. Pig RPE cells had a final cell density of 3,740 +/- 20 5cells/mm2 on the lens capsule and 3,025+ cells/mm2 on the hydrogel. F-actin staining revealed a circumferential ring of actin filaments in all the cells grown on substrates. ZO1 immunohistochemisty demonstrated staining along the lateral cell borders of all cell types. The successful culture of RPE cells on these substrates may have the potential for transplanting cell monolayers in the eye to improve outcomes for degenerative diseases in the retina.

Homotopic grafts of septal neurons combined to polymeric hydrogels placed into a fimbria-fornix lesion cavity attenuate locomotor hyperactivity but not mnemonic dysfunctions in rats.

PURPOSE: We studied the behavioral effects of an intracavitary implantation of poly[N-(2-hydroxypropyl)-methacrylamidel (PHPMA) hydrogels combined to intraseptal grafts of fetal septal cell suspensions in adult female rats subjected to aspirative fimbria-fornix lesions. The hydrogels were used as substrates for bridging the lesion cavity between the septum and the hippocampus. METHODS: Control groups included sham-operated or lesion-only rats, as well as lesioned rats with only the hydrogel bridge in the lesion cavity, only the graft in the septum, or an intrahippocampal graft of a septal cell suspension as a control for the standardly used ectopic transplantation strategy. Up to 10 months after grafting surgery, all rats were tested for locomotor activity in their home cage, sensorimotor performances using a beam-walking test, and cognitive performances in a radial maze, a water maze and a T-maze (rewarded alternation). RESULTS: The lesions induced hyperlocomotion, sensorimotor disturbances and severe alterations of cognitive functions. We found that neither the grafts or the hydrogels, nor the combination of both, induced any significant enhancement of sensorimotor or cognitive performances. Nevertheless, in rats with both intraseptal (homotopic) grafts and a hydrogel implant, the locomotor activity did no longer differ from that found in sham-operated controls. Histological analysis showed that the hydrogels contained acetylcholinesterase(AChE)-positive fibers and that the hippocampal region in contact with the hydrogel exhibited AChE-positive reaction products over several hundreds of micrometers. CONCLUSIONS: These results are complementary to our previous report on electrophysiological evidence of septo-hippocampal reconnections (Duconseille et al., Rest. Neurol. Neurosci. 15, 1999, 305-317). They further suggest that septal neurons grafted homotopically and/or neurons from the host brain are able to elongate axonal processes through a PHPMA substrate up to the hippocampus. Although they did not affect the cognitive consequences of the lesion, the changes enabled by the homotopic grafts combined to the hydrogel have attenuated the lesion-induced hyperactivity.

The regrowth of axons within tissue defects in the CNS is promoted by implanted hydrogel matrices that contain BDNF and CNTF producing fibroblasts.

In this study we demonstrate the potential for combining biocompatible polymers with genetically engineered cells to elicit axon regrowth across tissue defects in the injured CNS. Eighteen- to 21-day-old rats received implants of poly N-(2-hydroxypropyl)-methacrylamide (HPMA) hydrogels containing RGD peptide sequences that had been infiltrated with control (untransfected) fibroblasts (n = 8), fibroblasts engineered to express brain-derived neurotrophic factor (BDNF) (n = 5), ciliary neurotrophic factor (CNTF) (n = 5), or a mixture of BDNF and CNTF expressing fibroblasts (n = 11). Fibroblasts were prelabeled with Hoechst 33342. Cell/polymer constructs were inserted into cavities made in the left optic tract, between thalamus and superior colliculus. After 4-8 weeks, retinal projections were analyzed by injecting right eyes with cholera toxin (B-subunit). Rats were perfused 24 h later and sections were immunoreacted to visualize retinal axons, other axons (RT97 antibody), host astrocytes and macrophages, donor fibroblasts, and extracellular matrix molecules. The volume fraction (VF) of each gel that was occupied by RT97(+) axons was quantified. RT-PCR confirmed expression of the transgenes prior to, and 5 weeks after, transplantation. Compared to control rats (mean VF = 0.02 +/- 0.01% SEM) there was increased ingrowth of RT97(+) axons into implants in CNTF (mean VF = 0.33 +/- 0.19%) and BDNF (mean VF = 0.62 +/-0.19%) groups. Axon growth into hydrogels in the mixed BDNF/CNTF group (mean VF = 3.58 +/- 0.92%) was significantly greater (P < 0.05) than in the BDNF or CNTF fibroblast groups. Retinal axons exhibited a complex branching pattern within gels containing BDNF or BDNF/CNTF fibroblasts; however, they regrew the greatest distances within implants containing both BDNF and CNTF expressing cells.

Spinal cord repair with PHPMA hydrogel containing RGD peptides (NeuroGel).

A biocompatible hydrogel of poly[N-(2-hydroxypropyl)methacrylamide] (PHPMA) which includes the cell-adhesive region of fibronectin Arg-Gly-Asp was synthesized and its structure, rheological and dielectric properties were characterized. The ability of a PHPMA-RGD hydrogel to promote tissue regeneration and support axonal outgrowth in the injured adult and developing rat spinal cord was evaluated. The structure of the PHPMA-RGD hydrogel displayed an interconnected porous structure, with viscoelastic properties similar to those of the neural tissue, and conductivity properties due to a peptide group. The polymer hydrogel provided a structural, three-dimensional continuity across the defect, facilitating the migration and reorganization of local wound-repair cells, as well as tissue development within the lesion. Angiogenesis and axonal growth also occurred within the microstructure of the tissue network, and supraspinal axons migrated into the reconstructed cord segment. In addition, the hydrogel induced a reduction of necrosis and cavitation in the adjacent white and gray matter. These polymer hydrogel matrices therefore display the potential to repair tissue defects in the central nervous system by enhancing the development of a tissue equivalent as well as axonal growth across the reconstructed lesion.

Reconstruction of the transected cat spinal cord following NeuroGel implantation: axonal tracing, immunohistochemical and ultrastructural studies.

This study examined the ability of NeuroGel, a biocompatible porous poly [N-(2-hydroxypropyl) methacrylamide] hydrogel, to establish a permissive environment across a 3 mm gap in the cat spinal cord in order to promote tissue reconstitution and axonal regeneration across the lesion. Animals with NeuroGel implants were compared to transection-only controls and observed for 21 months. The hydrogel formed a stable bridge between the cord segments. Six months after reconstructive surgery, it was densely infiltrated by a reparative tissue composed of glial cells, capillary vessels and axonal fibres. Axonal labelling and double immunostaining for neurofilaments and myelin basic protein, showed that descending supraspinal axons of the ventral funiculus and afferent fibres of the dorsal column regenerated across the reconstructed lesion. Fifteen months after reconstructive surgery, axons had grown, at least, 12 mm into the distal cord tissue, and in the rostral cord there was labelling of neurons of the intermediate gray matter. Electron microscopy showed that after 9 months, most of the regenerating axons were myelinated, principally by Schwann cells. Newly formed neurons presumably from precursor cells of the ependyma and/or migrating neurons were observed within the reparative tissue after 21 months. Results indicate that functional deficit, as assessed by treadmill training, and morphological changes following double transection of the spinal cord can be modified by the implantation of NeuroGel. This technology offers the potential to promote the formation of a neural tissue equivalent via a reparative neohistogenesis process, that facilitates and supports regenerative growth of axons.

Restorative surgery of the central nervous system by means of tissue engineering using NeuroGel implants.

A novel approach aimed at restoring tissue structure and function and enhancing axonal recovery in damaged parts of the central nervous system is described. In contrast to contemporary neurotransplantation technologies which focus on tissue reconstruction of neural parenchyma by cell replacement, this approach is based on repair by tissue engineering. The technique involves the implantation of a 3-dimensional polymer hydrogel into the site of injury. The physical properties of the hydrogel induce the organisation of migrating wound-healing cells and regenerating axons within its 3-dimensional structure. Two complementary approaches are described and illustrated using results obtained in vivo and in vitro: (1) implantation into the brain and spinal cord of the polymer hydrogel NeuroGel, which has a defined macromolecular structure that enhances tissue-building capabilities, and the implantation of advanced hydrogel derivatives carrying biologically active molecules to promote selective cell interactions, and (2) biohybrid hydrogels that contain entrapped developing neural tissue cells, embryonic carcinoma-derived neurons, or genetically modified cells which secrete neurotrophic factors. These techniques create bioartificial tissues with neural tissue specificity. The potential of this biomaterial-based approach to neural tissue engineering for restorative neurosurgery is discussed.

In vivo magnetic resonance imaging and relaxometry study of a porous hydrogel implanted in the trapezius muscle of rabbits.

In vivo magnetic resonance imaging (MRI) and relaxometry were performed to assess noninvasively the tissue reaction and the biological integration of hydrogels made of poly[N-(2-hydroxypropyl) methacrylamide] (PHPMA) after implantation in the trapezius muscle of rabbits. The benefits of incorporating RGD peptide sequences in the polymer backbone were also investigated. The histological status of each implant was probed by the trend of their transversal relaxation times, T(2), while their biocompatibility was evaluated by analyzing the host tissue response through the evolution of the relaxation times of the adjacent muscle tissue. MR results showed the good acceptability of both hydrogels by the host tissue. The transversal relaxation curves of each implant exhibited two distinct phases as a function of implantation time: (1) a monoexponential phase, dominated by the influx of fluids inside the implants; and (2) a biexponential phase related to the infiltration of cells and the granulation tissue formation within the porous structure of each polymer. These MR findings were correlated with the results of conventional histological analyses. The present study demonstrates the effectiveness of MR methods in noninvasively monitoring the biocompatibility and histological status of implanted porous biomaterials.

Neural tissue formation within porous hydrogels implanted in brain and spinal cord lesions: ultrastructural, immunohistochemical, and diffusion studies.

A biocompatible heterogeneous hydrogel of poly [N-(2-hydroxypropyl) methacrylamide] (PHPMA), was evaluated for its ability to promote tissue repair and enhance axonal regrowth across lesion cavities in the brain and spinal cord in adult and juvenile (P17 P21) rats. Incorporation of PHPMA hydrogels into surrounding host tissue was examined at the ultrastructural level and using immunohistochemical techniques. In addition, and in parallel to these studies, diffusion parameters (volume fraction and tortuosity of the gel network) of the PHPMA hydrogels were evaluated pre- to postimplantation using an in vivo real-time iontophoretic method. The polymer hydrogels were able to bridge tissue defects created in the brain or spinal cord, and supported cellular ingrowth, angiogenesis, and axonogenesis within the structure of the polymer network. As a result, a reparative tissue grew within the porous structure of the gel, composed of glial cells, blood vessels, axons and dendrites, and extracellular biological matrices, such as laminin and/or collagen. Consistent with matrix deposition and tissue formation within the porous structure of the PHPMA hydrogels, there were measurable changes in the diffusion characteristics of the polymers. Extracellular space volume decreased and tortuosity increased within implanted hydrogels, attaining values similar to that seen in developing neural tissue. PHPMA polymer hydrogel matrices thus show neuroinductive and neuroconductive properties. They have the potential to repair tissue defects in the central nervous system by replacing lost tissue and by promoting the formation of a histotypic tissue matrix that facilitates and supports regenerative axonal growth. () ()

Heterogeneous PHPMA hydrogels for tissue repair and axonal regeneration in the injured spinal cord.

A biocompatible heterogeneous hydrogel of poly[N-(2-hydroxypropyl) methacrylamide] (PHPMA) showing an open porous structure, viscoelastic properties similar to the neural tissue and a large surface area available for cell interaction, was evaluated for its ability to promote tissue repair and axonal regeneration in the transected rat spinal cord. After implantation, the polymer hydrogel could correctly bridge the tissue defect, from a permissive interface with the host tissue to favour cell ingrowth, angiogenesis and axonal growth occurred within the microstructure of the network. Within 3 months the polymer implant was invaded by host derived tissue, glial cells, blood vessels and axons penetrated the hydrogel implant. Such polymer hydrogel matrices which show neuroinductive and neuroconductive properties have the potential to repair tissue defects in the central nervous system by promoting the formation of a tissue matrix and axonal growth by replacing the lost of tissue.

Polymeric hydrogels placed into a fimbria-fornix lesion cavity promote fiber (re)growth: a morphological study in the rat.

To examine the regeneration capacity of dorsal septohippocampal neurons in the presence of an artificial growth-promoting substrate, biocompatible polymeric hydrogels were implanted between the septum and the hippocampus in a fimbria-fornix lesion cavity. Unmodified (control) or aminosugar-containing (glucosamines or N-acetyl-glucosamines) hydrogels were implanted immediately or ten days after the lesions. Six months later, brain sections were processed for cresyl-violet, acetylcholinesterase, and immunocytochemical (glial fibrillary acidic protein, protein S100, neurofilaments, laminin, fibronectin) staining. All hydrogels were well integrated in the brain, constituting a stable bridge between the septum and the hippocampus. Weak gliosis occasionally surrounded the hydrogel in rats from the immediate-implantation group, whereas a more pronounced gliosis was observed in those from the delayed-implantation group. The hydrogels contained blood vessels and were invaded by host cells including astrocytes. Astrocytes formed a loose tissue network filling the porous structure of the hydrogels. Within the hydrogels, laminin-, fibronectin- or neurofilaments-immunopositive networks were also observed. Moreover, numerous acetylcholinesterase-positive fibers penetrated into the hydrogels from the septal, cortical and striatal areas. Fibre penetration was most important in the N-acetylglucosamines-containing hydrogels. Despite these features, the hippocampus failed to show any increase of acetylcholinesterase-staining as compared to that seen in lesion-only rats. These results confirm the regeneration capacity of severed septohippocampal neurons into polymeric substrates used as a bridge inserted in a fimbria-fornix lesion cavity. As such, biomaterials might be of clinical interest not only in the case of spinal cord sections, but also in cases of brain trauma.

Hydrogels containing peptide or aminosugar sequences implanted into the rat brain: influence on cellular migration and axonal growth.

Biocompatible polymer matrices for implantation into lesion sites in the brain were synthesized by incorporating peptide or aminosugar sequences into N-(2-hydroxypropyl)methacrylamide (HPMA) hydrogels. RGD peptide sequences were chemically linked to the hydrogel backbone via a glycylglycine spacer; aminosugars were glucosamine (NHGlc) or N-acetylglucosamine residues. Unmodified or sequence containing HPMA hydrogels were implanted into the lesioned optic tract or cerebral cortex of juvenile (17- to 19-day-old) or adult rat brains, respectively. After 10-12 months host animals were perfused and the brains were processed for immunohistochemistry using antibodies to neurofilaments (RT97), laminin, glial fibrillary acidic protein (GFAP), carbonic anhydrase II (CAII), S100 protein, macrophages (ED1), and myelin basic protein (MBP). Unmodified (control) HPMA hydrogels contained no cellular infiltration or axonal growth. Peptide (RGD)- and aminosugar-modified hydrogels showed increased adhesion properties with host neural tissue, were vascularized, and were infiltrated by host nonneuronal cells. Astrocytes (GFAP+) and macrophages (ED1(+)) were the major cell types seen within modified HPMA hydrogels, the largest numbers being found in RGD-containing polymers. CAII+ oligodendroglia were not seen within any of the hydrogel matrices. RT97(+)/MBP- axons grew into both the RGD and NHGlc hydrogel matrices for small distances. The number of axons was greatest in hydrogels implanted into cerebral cortex but in both cortex and optic tract implants the highest density of axons was seen in polymers containing RGD. The findings of this study are discussed in the context of CNS tissue replacement and the construction of bioactive scaffolds to promote regenerative axonal growth across areas of injury in the brain and spinal cord.

Cultured rat neuronal and glial cells entrapped within hydrogel polymer matrices: a potential tool for neural tissue replacement.

Cultured Schwann cells, neonatal astrocytes or cells dissociated from embryonic cerebral hemispheres were dispersed within poly-[N-(2-hydroxypropyl)-methacrylamide]-based hydrogel matrices by gel entrapment and maintained in vitro for 1-6 days. Glial cells were pre-labelled with Hoechst 33342. Cell differentiation and viability were studied by immunocytochemistry. Up to 15% of Schwann cells initially entrapped within the polymer matrices were immunopositive for the low affinity nerve growth factor receptor, S100, glial fibrillary acidic protein (GFAP) and laminin; up to 10% of pre-labelled astrocytes were immunopositive for GFAP and laminin. Embryonic neurons displayed immunostaining for neurofilaments. Hydrogels containing entrapped Schwann cells were implanted into the rat neocortex. These polymers supported cellular and axonal ingrowth within parts of the polymer matrix.

Neural tissue engineering: from polymer to biohybrid organs.

This investigation reports on the immobilization of neuronal and glial cells (Schwann cells and astrocytes) within N-(2-hydroxypropyl) methacrylamide (HPMA) polymer hydrogels for the production of cell-based polymer hybrid devices. Cells were included within HPMA polymer networks by gel-entrapment, and these biogels were maintained in vitro for up to 6 days. Cell viability and differentiation were studied using immunocytochemical methods and image analysis techniques. The polymer structure and its relationships with cells were examined by scanning electron microscopy. A proportion of the cell population was viable, expressing its own antigenic profile throughout the period of gel incubation, as cells do in conventional culture conditions, and some cells exhibited behaviour such as spreading or process outgrowth and secretion of laminin. The result of the present study allows us to envisage tissue replacement in the central nervous system by means of such cell-based polymer constructs.

Intracerebral implantation of hydrogel-coupled adhesion peptides: tissue reaction.

Arg-Gly-Asp peptides (RGD) were synthesized and chemically coupled to the bulk of N-(2-hydroxypropyl) methacrylamide-based polymer hydrogels. Fourier Transform Infrared Spectroscopy (FTIR) and amino acid analysis confirmed the peptide coupling to the polymer. Activated and control (unmodified) polymer matrices were stereotaxically implanted in the striata of rat brains, and two months later the brains were processed for immunohistochemistry using antibodies for glial acidic fibrillary protein (GFAP), laminin and neurofilaments. RGD-containing polymer matrices promoted stronger adhesion to the host tissue than the unmodified polymer matrices. In addition, the RGD-grafted polymer implants promoted and supported the growth and spread of GFAP-positive glial tissue onto and into the hydrogels. Neurofilament-positive fibers were also seen running along the surface of the polymer and, in some instances, penetrating the matrix. These findings are discussed in the context of using bioactive polymers as a new approach for promoting tissue repair and axonal regeneration of damaged structures of the central nervous system.

Hydrogels for neural tissue reconstruction and transplantation.

Since the first use of hydrogels as biomaterials, interest in synthetic hydrogels in medicine has increased considerably and the range of biomedical applications has expanded. This paper discusses a novel application of the use of synthetic hydrogels that are processed to serve as artificial matrices for neural tissue reconstruction, the delivery of cells and the promotion of axonal regeneration required for successful neurotransplantation. The possibility to create hydrogels with bioactive characteristics for neural cell adhesion and growth is also presented.

Evaluation of two cross-linked collagen gels implanted in the transected spinal cord.

In previous experiments, we have shown that spinal axons grow into a collagen matrix implanted between the stumps of a transected spinal cord. However, the matrix became denatured after 2 to 3 months. To improve the stability and the durability of the collagen gel implants, collagen was coprecipitated with chondroitin-6-sulfate (C-6-S) or chemically cross-linked with carbodiimide (CD). The spinal cords were taken out after 3 days, 1, 3, or 6 months and analyzed using different histological and tracing techniques. The cross-linked collagen matrices underwent major structural changes. Cross-linking treatments improved the stability of collagen implants which withstood at least 6 months. Axons revealed with DiI or silver staining crossed the proximal interface and grew into the bioimplants. Some axons were also followed across the distal bioimplant-spinal interface in DiI treated tissues. This study suggests that cross-linking the collagen hydrogel has improved the mechanical properties of the matrix, modified the normal scarring process, and favored axonal regeneration.

Synthetic polymer derivatives as substrata for neuronal adhesion and growth.

The adhesion and viability of dissociated neurons of rat cerebral hemispheres onto methacrylate and methacrylamide hydrogels, either unmodified or containing collagen, basement membrane proteins, and glucosamine, were measured in vitro. The degree of cell adhesion was affected by properties of the polymers such as hydrophilicity, hydrophobicity, presence of reactive chemical groups, and incorporation of biological molecules. Adhesion was promoted by attachment of glucosamine to the polymer backbone. Viability was enhanced by the presence of basement membrane proteins within the polymer network. Morphological studies of cells seeded, both onto and within the polymeric matrices, demonstrated the capacity of such substrates to support neuritic outgrowth. The potential of these in vitro assays in the design of polymeric matrices as neural tissue repair promoter substrate is discussed.