Alginate Formulations: Current Developments in the Race for Hydrogel-Based Cardiac Regeneration

Abstract

Cardiovascular diseases, including myocardial infarction (MI), represent the main worldwide cause of mortality and morbidity. In this scenario, to contrast the irreversible damages following MI, cardiac regeneration has emerged as a novel and promising solution for in situ cellular regeneration, preserving cell behavior and tissue cytoarchitecture. Among the huge variety of natural, synthetic, and hybrid compounds used for tissue regeneration, alginate emerged as a good candidate for cellular preservation and delivery, becoming one of the first biomaterial tested in pre-clinical research and clinical trials concerning cardiovascular diseases. Although promising results have been obtained, recellularization and revascularization of the infarcted area present still major limitations. Therefore, the demand is rising for alginate functionalization and its combination with molecules, factors, and drugs capable to boost the regenerative potential of the cardiac tissue. The focus of this review is to elucidate the promising properties of alginate and to highlight its benefits in clinical trials in relation to cardiac regeneration. The definition of hydrogels, the alginate characteristics, and recent biomedical applications are herewith described. Afterward, the review examines in depth the ongoing developments to refine the material relevance in cardiac recovery and regeneration after MI and presents current clinical trials based on alginate.

Keywords: alginate; biomaterials; cardiac regeneration; clinical trials; heart failure; hydrogels.

FIGURE 1

Alginate-based devices development in cardiac treatment. Alginate displays some physico-chemical and biological advantageous characteristics that, combined together, render this biomaterial suitable for further modification. Possible modifications and implementations are: the inclusion of different cell types, bioactive molecules, functional oligomers, and conductive materials to provide further functionalities to the pristine material addressing the main issues in cardiac regeneration field. Thanks to its functionalization, alginate can be implied either as a delivery system or as a support material in cardiac regeneration choosing the most efficient way of administration, in situ or not.