Stretching of the back improves gait, mechanical sensitivity and connective tissue inflammation in a rodent model

The role played by nonspecialized connective tissues in chronic non-specific low back pain is not well understood. In a recent ultrasound study, human subjects with chronic low back pain had altered connective tissue structure compared to human subjects without low back pain, suggesting the presence of inflammation and/or fibrosis in the low back pain subjects. Mechanical input in the form of static tissue stretch has been shown in vitro and in vivo to have anti-inflammatory and anti-fibrotic effects. To better understand the pathophysiology of lumbar nonspecialized connective tissue as well as potential mechanisms underlying therapeutic effects of tissue stretch, we developed a carrageenan-induced inflammation model in the low back of a rodent. Induction of inflammation in the lumbar connective tissues resulted in altered gait, increased mechanical sensitivity of the tissues of the low back, and local macrophage infiltration. Mechanical input was then applied to this model as in vivo tissue stretch for 10 minutes twice a day for 12 days. In vivo tissue stretch mitigated the inflammation-induced changes leading to restored stride length and intrastep distance, decreased mechanical sensitivity of the back and reduced macrophage expression in the nonspecialized connective tissues of the low back. This study highlights the need for further investigation into the contribution of connective tissue to low back pain and the need for a better understanding of how interventions involving mechanical stretch could provide maximal therapeutic benefit. This tissue stretch research is relevant to body-based treatments such as yoga or massage, and to some stretch techniques used with physical therapy.     

Design considerations and challenges for mechanical stretch bioreactors in tissue engineering

With the increase in average life expectancy and growing aging population, lack of functional grafts for replacement surgeries has become a severe problem. Engineered tissues are a promising alternative to this problem because they can mimic the physiological function of the native tissues and be cultured on demand. Cyclic stretch is important for developing many engineered tissues such as hearts, heart valves, muscles, and bones. Thus a variety of stretch bioreactors and corresponding scaffolds have been designed and tested to study the underlying mechanism of tissue formation and to optimize the mechanical conditions applied to the engineered tissues. In this review, we look at various designs of stretch bioreactors and common scaffolds and offer insights for future improvements in tissue engineering applications. First, we summarize the requirements and common configuration of stretch bioreactors. Next, we present the features of different actuating and motion transforming systems and their applications. Since most bioreactors must measure detailed distributions of loads and deformations on engineered tissues, techniques with high accuracy, precision, and frequency have been developed. We also cover the key points in designing culture chambers, nutrition exchanging systems, and regimens used for specific tissues. Since scaffolds are essential for providing biophysical microenvironments for residing cells, we discuss materials and technologies used in fabricating scaffolds to mimic anisotropic native tissues, including decellularized tissues, hydrogels, biocompatible polymers, electrospinning, and 3D bioprinting techniques. Finally, we present the potential future directions for improving stretch bioreactors and scaffolds. © 2016 American Institute of Chemical Engineers Biotechnol. Prog., 32:543–553, 2016     

Development of fibroblast-seeded collagen gels under planar biaxial mechanical constraints: a biomechanical study

Prior studies indicated that mechanical loading influences cell turnover and matrix remodeling in tissues, suggesting that mechanical stimuli can play an active role in engineering artificial tissues. While most tissue culture studies focus on influence of uniaxial loading or constraints, effects of multi-axial loading or constraints on tissue development are far from clear. In this study, we examined the biaxial mechanical properties of fibroblast-seeded collagen gels cultured under four different mechanical constraints for 6 days: free-floating, equibiaxial stretching (with three different stretch ratios), strip-biaxial stretching, and uniaxial stretching. Passive mechanical behavior of the cell-seeded gels was also examined after decellularization. A continuum-based two-dimensional Fung model was used to quantify the mechanical behavior of the gel. Based on the model, the value of stored strain energy and the ratio of stiffness in the stretching directions were calculated at prescribed strains for each gel, and statistical comparisons were made among the gels cultured under the various mechanical constraints. Results showed that gels cultured under the free-floating and equibiaxial stretching conditions exhibited a nearly isotropic mechanical behavior, while gels cultured under the strip-biaxial and uniaxial stretching conditions developed a significant degree of mechanical anisotropy. In particular, gels cultured under the equibiaxial stretching condition with a greater stretch ratio appeared to be stiffer than those with a smaller stretch ratio. Also, a decellularized gel was stiffer than its non-decellularized counterpart. Finally, the retained mechanical anisotropy in gels cultured under the strip-biaxial stretching and uniaxial stretching conditions after cell removal reflected an irreversible matrix remodeling.     

Stretching Micropatterned Cells on a PDMS Membrane

Mechanical forces exerted on cells and/or tissues play a major role in numerous processes. We have developed a device to stretch cells plated on a PolyDiMethylSiloxane (PDMS) membrane, compatible with imaging. This technique is reproducible and versatile. The PDMS membrane can be micropatterned in order to confine cells or tissues to a specific geometry. The first step is to print micropatterns onto the PDMS membrane with a deep UV technique. The PDMS membrane is then mounted on a mechanical stretcher. A chamber is bound on top of the membrane with biocompatible grease to allow gliding during the stretch. The cells are seeded and allowed to spread for several hours on the micropatterns. The sample can be stretched and unstretched multiple times with the use of a micrometric screw. It takes less than a minute to apply the stretch to its full extent (around 30%). The technique presented here does not include a motorized device, which is necessary for applying repeated stretch cycles quickly and/or computer controlled stretching, but this can be implemented. Stretching of cells or tissue can be of interest for questions related to cell forces, cell response to mechanical stress or tissue morphogenesis. This video presentation will show how to avoid typical problems that might arise when doing this type of seemingly simple experiment.     

A comparison of two stretching protocols on hip range of motion: implications for total daily stretch duration

It is theorized that the total stretch time in a day is more important than the actual single stretch duration time. The purpose of this study was to compare 2 stretching protocols, keeping total stretching time equivalent. The 2 protocols were a 10-second duration stretch and a 30-second duration stretch. Although the stretch durations differed, the total stretching time over the course of a day was held constant at 2 minutes for both protocols. Participants were randomly assigned a protocol to each of their legs: subjects stretched 1 leg with the 10-second protocol and the opposite leg with the 30-second protocol. The 10-second stretch was repeated 6 times for a total of 1 minute; the 30-second protocol was repeated 2 times for a total of 1 minute. Stretching was performed twice daily (a total of 2 minutes each day) for 6 weeks. All stretching was performed to the hamstring muscles. Hip flexion measurements were recorded at pretest, 3-weeks, and 6-weeks. Subjects demonstrated significant gains in range of motion for hip flexion over the course of 6 weeks, p = 0.000. No differences existed between the 2 protocols. Range of motion gains were equal between the 2 stretching protocols. The common denominator was total stretch time for a day. Regardless of the duration of a single stretch, the key to improvement was the total daily stretch time. These findings are important as they allow clinicians and individuals to customize stretching protocols to meet individual needs.     

The effects of mechanical stretch on the biological characteristics of human adipose‐derived stem cells

Adipose‐derived stem cells (ADSCs) are a subset of mesenchymal stem cells (MSCs), which have promised a vast therapeutic potential in tissue regeneration. Recent studies have demonstrated that combining stem cells with mechanical stretch may strengthen the efficacy of regenerative therapies. However, the exact influences of mechanical stretch on MSCs still remain inconclusive. In this study, human ADSCs (hADSCs) were applied cyclic stretch stimulation under an in vitro stretching model for designated duration. We found that mechanical stretch significantly promoted the proliferation, adhesion and migration of hADSCs, suppressing cellular apoptosis and increasing the production of pro‐healing cytokines. For differentiation of hADSCs, mechanical stretch inhibited adipogenesis, but enhanced osteogenesis. Long‐term stretch could promote ageing of hADSCs, but did not alter the cell size and typical immunophenotypic characteristics. Furthermore, we revealed that PI3K/AKT and MAPK pathways might participate in the effects of mechanical stretch on the biological characteristics of hADSCs. Taken together, mechanical stretch is an effective strategy for enhancing stem cell behaviour and regulating stem cell fate. The synergy between hADSCs and mechanical stretch would most likely facilitate tissue regeneration and promote the development of stem cell therapy.     

Dynamic mechanical stretch of organotypic brain slice cultures induces differential genomic expression: relationship to mechanical parameters

Although the material properties of biological tissues are reasonably well established, recent studies have suggested that the biological response of brain tissue and its constituent cells may also be viscoelastic and sensitive to both the magnitude and rate of a mechanical stimulus. Given the potential involvement of changes in gene expression in the pathogenic sequelae after head trauma, we analyzed the expression of 22 genes related to cell death and survival and found that a number of these genes were differentially regulated after mechanical stretch of an organotypic brain slice culture. Twenty-four hours after stretch, the expression of BDNF, NGF, and TrkA was significantly increased, whereas that of bcl-2, CREB, and GAD65 was significantly decreased (MANOVA followed by ANOVA, p < 0.05). Expression of CREB and GAD65 was negatively correlated with strain, whereas expression of APP695 was negatively correlated with strain rate (all p < 0.05). This study demonstrates that a subset of genes involved in cell death and survival are differentially regulated after dynamic stretch in vitro and that the expression of specific genes is correlated with mechanical parameters of that stretch.     

Cell mechanics studied by a reconstituted model tissue

Tissue models reconstituted from cells and extracellular matrix (ECM) simulate natural tissues. Cytoskeletal and matrix proteins govern the force exerted by a tissue and its stiffness. Cells regulate cytoskeletal structure and remodel ECM to produce mechanical changes during tissue development and wound healing. Characterization and control of mechanical properties of reconstituted tissues are essential for tissue engineering applications. We have quantitatively characterized mechanical properties of connective tissue models, fibroblast-populated matrices (FPMs), via uniaxial stretch measurements. FPMs resemble natural tissues in their exponential dependence of stress on strain and linear dependence of stiffness on force at a given strain. Activating cellular contractile forces by calf serum and disrupting F-actin by cytochalasin D yield "active" and "passive" components, which respectively emphasize cellular and matrix mechanical contributions. The strain-dependent stress and elastic modulus of the active component were independent of cell density above a threshold density. The same quantities for the passive component increased with cell number due to compression and reorganization of the matrix by the cells.     

Deformation responses of a physically cross-linked high molecular weight elastin-like protein polymer

Recombinant protein polymers were synthesized and examined under various loading conditions to assess the mechanical stability and deformation responses of physically cross-linked, hydrated, protein polymer networks designed as triblock copolymers with central elastomeric and flanking plastic-like blocks. Uniaxial stress-strain properties, creep and stress relaxation behavior, as well as the effect of various mechanical preconditioning protocols on these responses were characterized. Significantly, we demonstrate for the first time that ABA triblock protein copolymers when redesigned with substantially larger endblock segments can withstand significantly greater loads. Furthermore, the presence of three distinct phases of deformation behavior was revealed upon subjecting physically cross-linked protein networks to step and cyclic loading protocols in which the magnitude of the imposed stress was incrementally increased over time. We speculate that these phases correspond to the stretch of polypeptide bonds, the conformational changes of polypeptide chains, and the disruption of physical cross-links. The capacity to select a genetically engineered protein polymer that is suitable for its intended application requires an appreciation of its viscoelastic characteristics and the capacity of both molecular structure and conditioning protocols to influence these properties.     

Equibiaxial cyclic stretch stimulates fibroblasts to rapidly remodel fibrin

Understanding the effects of the mechanical environment on wound healing is critical for developing more effective treatments to reduce scar formation and contracture. The aim of this study was to investigate the effects of dynamic mechanical stretch on cell-mediated early wound remodeling independent of matrix alignment which obscures more subtle remodeling mechanisms. Cyclic equibiaxial stretch (16% stretch at 0.2 Hz) was applied to fibroblast-populated fibrin gel in vitro wound models for eight days. Compaction, density, tensile strength, and collagen content were quantified as functional measures of remodeling. Stretched samples were approximately ten times stronger, eight-fold more dense, and eight times thinner than statically cultured samples. These changes were accompanied by a 15% increase in net collagen but no significant differences in cell number or viability. When collagen crosslinking was inhibited in stretched samples, the extensibility increased and the strength decreased. The apparent weakening was due to a reduction in compaction rather than a decrease in ability of the tissue to withstand tensile forces. Interestingly, inhibiting collagen crosslinking had no measurable effects on the statically cultured samples. These results indicate that amplified cell-mediated compaction and even a slight addition in collagen content play substantial roles in mechanically induced wound strengthening. These findings increase our understanding of how mechanical forces guide the healing response in skin, and the methods employed in this study may also prove valuable tools for investigating stretch-induced remodeling of other planar connective tissues and for creating mechanically robust engineered tissues.     

Design and validation of a biomechanical bioreactor for cartilage tissue culture

Specific tissues, such as cartilage, undergo mechanical solicitation under their normal performance in human body. In this sense, it seems necessary that proper tissue engineering strategies of these tissues should incorporate mechanical solicitations during cell culture, in order to properly evaluate the influence of the mechanical stimulus. This work reports on a user-friendly bioreactor suitable for applying controlled mechanical stimulation—amplitude and frequency—to three-dimensional scaffolds. Its design and main components are described, as well as its operation characteristics. The modular design allows easy cleaning and operating under laminar hood. Different protocols for the sterilization of the hermetic enclosure are tested and ensure lack of observable contaminations, complying with the requirements to be used for cell culture. The cell viability study was performed with KUM5 cells.     

周期性单轴拉伸力学刺激对哺乳动物细胞有丝分裂方向影响的研究

哺乳动物细胞的有丝分裂过程与细胞的增殖、分化以及生物体发育、组织器官形成、损伤组织的修复和疾病的发生有关．广泛存在的力学刺激能否对细胞有丝分裂方向产生影响,以及其影响有丝分裂定向的途径尚未完全阐明．采用小鼠成纤维细胞作为模型,研究周期性单轴拉伸力学刺激对细胞应力纤维排布和有丝分裂方向的影响．结果表明,周期性单轴拉伸诱导细胞有丝分裂与应力纤维垂直于拉伸方向排布．而阻断应力纤维的两种基本组成成分(微丝和肌球蛋白Ⅱ),会造成在周期性单轴拉伸条件下的应力纤维和有丝分裂方向重排．特别是,Y27632 (10 μmol/L) 和低浓度的ML7 (50 μmol/L)、Blebbistatin (50 μmol/L)可以诱导细胞有丝分裂与应力纤维平行于拉伸方向排布．统计结果表明,在不同实验条件下,应力纤维排布和有丝分裂方向均具有高度相关性．Western blot实验表明,肌球蛋白轻链磷酸化水平与周期性单轴拉伸刺激下的应力纤维排 布和有丝分裂方向密切相关．上述结果提示：周期性单轴拉伸力学刺激通过诱导应力纤维的排布,决定了细胞的有丝分裂方向．     

Live en face imaging of aortic valve leaflets under mechanical stress

Soft tissues, such as tendons, skin, arteries, or lung, are constantly subject to mechanical stresses in vivo. None more so than the aortic heart valve that experiences an array of forces including shear stress, cyclic pressure, strain, and flexion. Anisotropic biaxial cyclic stretch maintains valve homeostasis; however, abnormal forces are implicated in disease progression. The response of the valve endothelium to deviations from physiological levels has not been fully characterized. Here, we show the design and validation of a novel stretch apparatus capable of applying biaxial stretch to viable heart valve tissue, while simultaneously allowing for live en face endothelial cell imaging via confocal laser scanning microscopy (CLSM). Real-time imaging of tissue is possible while undergoing highly characterized mechanical conditions and maintaining the native extracellular matrix. Thus, it provides significant advantages over traditional cell culture or in vivo animal models. Planar biaxial tissue stretching with simultaneous live cell imaging could prove useful in studying the mechanobiology of any soft tissue.     

Cyclic stress at mHz frequencies aligns fibroblasts in direction of zero strain

Recognition of external mechanical signals is vital for mammalian cells. Cyclic stretch, e.g. around blood vessels, is one such signal that induces cell reorientation from parallel to almost perpendicular to the direction of stretch. Here, we present quantitative analyses of both, cell and cytoskeletal reorientation of umbilical cord fibroblasts. Cyclic strain of preset amplitudes was applied at mHz frequencies. Elastomeric chambers were specifically designed and characterized to distinguish between zero strain and minimal stress directions and to allow accurate theoretical modeling. Reorientation was only induced when the applied stretch exceeded a specific amplitude, suggesting a non-linear response. However, on very soft substrates no mechanoresponse occurs even for high strain. For all stretch amplitudes, the angular distributions of reoriented cells are in very good agreement with a theory modeling stretched cells as active force dipoles. Cyclic stretch increases the number of stress fibers and the coupling to adhesions. We show that changes in cell shape follow cytoskeletal reorientation with a significant temporal delay. Our data identify the importance of environmental stiffness for cell reorientation, here in direction of zero strain. These in vitro experiments on cultured cells argue for the necessity of rather stiff environmental conditions to induce cellular reorientation in mammalian tissues.     

Differential Orientation of 10T1/2 Mesenchymal Cells on Non-Uniform Stretch Environments

Non-uniform stress and strain fields are prevalent in many tissues in vivo, and often exacerbated by disease or injury. These mechanical gradients potentially play a role in contributing to pathological conditions, presenting a need for experimental tools to allow investigation of cell behavior within non-uniformly stimulated environments. Herein, we employ two in vitro cell-stretching devices (one previously published; one newly presented) capable of subjecting cells to cyclic, non-uniform stretches upon the surface of either a circular elastomeric membrane or a cylindrical PDMS tube. After 24 hours of cyclic stretch, 10T1/2 cells on both devices showed marked changes in long-axis orientation, with tendencies to align parallel to the direction of minimal deformation. The degree of this response varied depending on location within the stretch gradients. These results demonstrated the feasibility of conducting cell mechanobiology investigations with the two novel devices, while also highlighting the experimental capabilities of non-uniform mechanical environments for these types of studies. Such capabilities include robust data collection for developing mechanobiological dose-response curves, signal threshold identification, and potential spatial targeting for drug delivery.     

Effect of streptomycin on the active force of bioengineered heart muscle in response to controlled stretch

In this study, we describe a bioreactor system to deliver controlled stretch protocols to bioengineered heart muscle (BEHMs) and test the system when streptomycin (an aminoglycoside antibiotic, which blocks stretch-activated channels) is either added to or excluded from the culture medium. Streptomycin is a very commonly used component of cell culture antibiotic-antimycotic media additives, so its effects on muscle development and functional response to mechanical signals in vitro is worthy of investigation. Our hypothesis is that BEHMs will not adapt to the applied mechanical stretch protocol when streptomycin is present in the culture medium, but will do so when streptomycin is excluded. Bioengineered heart muscles were formed by culturing primary neonatal cardiac myocytes in a fibrin gel using a method previously developed in our laboratory. A custom bioreactor system was designed using SolidWorks and structural components manufactured using fusion deposition modeling. We utilized a stretch protocol of 1 Hz, 10% strain for 7 d. BEHMs were stretched in the presence and absence of streptomycin. As controls, BEHMs were maintained in a cell culture incubator with and without streptomycin. The contractile properties of all BEHMs were evaluated to determine the active force. We were able to demonstrate compatibility of the bioreactor system with BEHMs and were able to stretch 58 constructs with zero incidence of failure. When the BEHMs were stretched in the absence of streptomycin, the active force increased from a mean value of 51.7 +/- 5.6 (N = 10) to 102.4 +/- 16.3 muN (N = 10), with p < 0.05. However, BEHMs that were stretched in the presence of streptomycin did not show any significant increase in active force generation. The average active force of BEHMs increased from a mean value of 57.6 +/- 10.2 (N = 10) to 91.4 +/- 19.8 muN (N = 10) when stretched in the presence of streptomycin. In this study, we demonstrate compatibility of the a bioreactor system with BEHMs, stability of the BEHMs in response to stretch protocols, and significant functional improvement in response to controlled stretch only when streptomycin is excluded from the culture medium, supporting our hypothesis.     

Mechanical force mobilizes zyxin from focal adhesions to actin filaments and regulates cytoskeletal reinforcement

Organs and tissues adapt to acute or chronic mechanical stress by remodeling their actin cytoskeletons. Cells that are stimulated by cyclic stretch or shear stress in vitro undergo bimodal cytoskeletal responses that include rapid reinforcement and gradual reorientation of actin stress fibers; however, the mechanism by which cells respond to mechanical cues has been obscure. We report that the application of either unidirectional cyclic stretch or shear stress to cells results in robust mobilization of zyxin from focal adhesions to actin filaments, whereas many other focal adhesion proteins and zyxin family members remain at focal adhesions. Mechanical stress also induces the rapid zyxin-dependent mobilization of vasodilator-stimulated phosphoprotein from focal adhesions to actin filaments. Thickening of actin stress fibers reflects a cellular adaptation to mechanical stress; this cytoskeletal reinforcement coincides with zyxin mobilization and is abrogated in zyxin-null cells. Our findings identify zyxin as a mechanosensitive protein and provide mechanistic insight into how cells respond to mechanical cues.     

Improved prediction of the collagen fiber architecture in the aortic heart valve

Living tissues show an adaptive response to mechanical loading by changing their internal structure and morphology. Understanding this response is essential for successful tissue engineering of load-bearing structures, such as the aortic valve. In this study, mechanically induced remodeling of the collagen architecture in the aortic valve was investigated. It was hypothesized that, in uniaxially loaded regions, the fibers aligned with the tensile principal stretch direction. For biaxial loading conditions, on the other hand, it was assumed that the collagen fibers aligned with directions situated between the principal stretch directions. This hypothesis has already been applied successfully to study collagen remodeling in arteries. The predicted fiber architecture represented a branching network and resembled the macroscopically visible collagen bundles in the native leaflet. In addition, the complex biaxial mechanical behavior of the native valve could be simulated qualitatively with the predicted fiber directions. The results of the present model might be used to gain further insight into the response of tissue engineered constructs during mechanical conditioning.     

周期性张应力对面颌肌细胞Na~＋/K~＋-ATPase的影响

目的：研究周期性张应力对Na＋/K＋-ATPase功能活性及其表达的影响,明确Na＋/K＋-ATPase在功能矫形中面颌肌肉适应性改建的生物和分子机制。方法：构建面颌肌细胞体外培养-力学刺激模型;应用多通道细胞牵张应力加载系统,对面颌肌细胞施加不同时段的张应力刺激,测定Na＋/K＋-ATPase的功能活性;运用实时荧光定量PCR研究周期性张应力刺激对Na＋/K＋-ATPase功能亚基α亚单位mRNA的影响。结果：Na＋/K＋-ATPaseα1,α2亚单位随着加力时间延长,表达增强,同对照组比较,呈一致性上调（P〈0.001）;细胞加力1小时,α1的mRNA表达不受影响;加力2小时后,α1和α2的mRNA表达呈现逐渐增强趋势,48 h时达到最大值。张应力刺激对α2亚单位的mRNA表达似乎更为敏感,加力1 h时α2亚单位的mRNA表达水平即增加,增加量约为对照组的37.74%,具有显著的统计学意义。结论：周期性的机械牵张作用于培养的骨骼肌细胞,可诱导α1和α2亚单位mRNA的表达量增加;α1和α2亚单位对周期性张应力刺激的作用时间反应不同,α2亚单位的反应可能更为敏感。周期性张力刺激的增加所产生的压力可能是转录调节的主要因素;周期性张应力对骨骼肌细胞Na＋/K＋-ATPase水解亚的调节作用不同,可能在面颌肌肉对功能矫形力的适应性改建中具有重要作用。