Key result
By 30 days, calcium accumulated most intensively in glutaraldehyde-crosslinked bovine pericardium, whereas diepoxide-crosslinked bovine pericardium did not calcify at all.
Why the study?
The causes of heart valve bioprosthetic calcification remain unclear.
Diepoxide crosslinking of bovine pericardium completely prevented calcification up to 30 days in a rat subcutaneous model, unlike standard glutaraldehyde crosslinking.
DE crosslinking may prevent pericardial calcification; leaves open translation to human bioprostheses.
The causes of heart valve bioprosthetic calcification are still not clear. In this paper, we compared the calcification in the porcine aorta (Ao) and the bovine jugular vein (Ve) walls, as well as the bovine pericardium (Pe). Biomaterials were crosslinked with glutaraldehyde (GA) and diepoxide (DE), after which they were implanted subcutaneously in young rats for 10, 20, and 30 days. Collagen, elastin, and fibrillin were visualized in non-implanted samples. Atomic absorption spectroscopy, histological methods, scanning electron microscopy, and Fourier-transform infrared spectroscopy were used to study the dynamics of calcification. By the 30th day, calcium accumulated most intensively in the collagen fibers of the GA-Pe. In elastin-rich materials, calcium deposits were associated with elastin fibers and localized differences in the walls of Ao and Ve. The DE-Pe did not calcify at all for 30 days. Alkaline phosphatase does not affect calcification since it was not found in the implant tissue. Fibrillin surrounds elastin fibers in the Ao and Ve, but its involvement in calcification is questionable. In the subcutaneous space of young rats, which are used to model the implants' calcification, the content of phosphorus was five times higher than in aging animals. We hypothesize that the centers of calcium phosphate nucleation are the positively charged nitrogen of the pyridinium rings, which is the main one in fresh elastin and appears in collagen as a result of GA preservation. Nucleation can be significantly accelerated at high concentrations of phosphorus in biological fluids. The hypothesis needs further experimental confirmation.
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Zhuravleva et al. (2023) studied Heart valve bioprosthetic calcification. Bioprosthetic materials crosslinked with glutaraldehyde and diepoxide was evaluated on Calcification dynamics. By 30 days, calcium accumulated most intensively in glutaraldehyde-crosslinked bovine pericardium, whereas diepoxide-crosslinked bovine pericardium did not calcify at all.
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