EP3359638A1 - Bioréacteur à stress mécanique pour valvules cardiaques - Google Patents
Bioréacteur à stress mécanique pour valvules cardiaquesInfo
- Publication number
- EP3359638A1 EP3359638A1 EP16777936.2A EP16777936A EP3359638A1 EP 3359638 A1 EP3359638 A1 EP 3359638A1 EP 16777936 A EP16777936 A EP 16777936A EP 3359638 A1 EP3359638 A1 EP 3359638A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- construct
- chamber
- reactor chamber
- media
- ventricular
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
- 210000003709 heart valve Anatomy 0.000 title claims abstract description 56
- 238000000338 in vitro Methods 0.000 claims abstract description 31
- 238000000034 method Methods 0.000 claims abstract description 12
- 230000010412 perfusion Effects 0.000 claims description 45
- 238000005086 pumping Methods 0.000 claims description 39
- 230000002861 ventricular Effects 0.000 claims description 28
- 239000012528 membrane Substances 0.000 claims description 27
- 238000011144 upstream manufacturing Methods 0.000 claims description 21
- 239000006285 cell suspension Substances 0.000 claims description 19
- 239000012530 fluid Substances 0.000 claims description 14
- 239000002609 medium Substances 0.000 claims description 14
- 230000000541 pulsatile effect Effects 0.000 claims description 13
- 230000008878 coupling Effects 0.000 claims description 7
- 238000010168 coupling process Methods 0.000 claims description 7
- 238000005859 coupling reaction Methods 0.000 claims description 7
- 238000004519 manufacturing process Methods 0.000 claims description 7
- 238000001727 in vivo Methods 0.000 claims description 5
- 238000004891 communication Methods 0.000 claims description 4
- 239000006143 cell culture medium Substances 0.000 claims description 3
- 230000001143 conditioned effect Effects 0.000 claims description 3
- 230000002452 interceptive effect Effects 0.000 claims 1
- 230000000035 biogenic effect Effects 0.000 abstract description 5
- 238000010276 construction Methods 0.000 abstract description 3
- 210000004027 cell Anatomy 0.000 description 45
- 230000003750 conditioning effect Effects 0.000 description 18
- 239000012071 phase Substances 0.000 description 16
- 210000001519 tissue Anatomy 0.000 description 13
- 230000006870 function Effects 0.000 description 11
- 239000000463 material Substances 0.000 description 8
- 230000035800 maturation Effects 0.000 description 8
- 210000000056 organ Anatomy 0.000 description 7
- 230000003993 interaction Effects 0.000 description 6
- 238000007789 sealing Methods 0.000 description 6
- 230000015572 biosynthetic process Effects 0.000 description 5
- 238000011109 contamination Methods 0.000 description 5
- 239000007789 gas Substances 0.000 description 5
- 230000036513 peripheral conductance Effects 0.000 description 4
- 230000004962 physiological condition Effects 0.000 description 4
- 238000004062 sedimentation Methods 0.000 description 4
- 210000000709 aorta Anatomy 0.000 description 3
- 210000001765 aortic valve Anatomy 0.000 description 3
- 230000000712 assembly Effects 0.000 description 3
- 238000000429 assembly Methods 0.000 description 3
- 210000002889 endothelial cell Anatomy 0.000 description 3
- 230000005484 gravity Effects 0.000 description 3
- 239000007788 liquid Substances 0.000 description 3
- 210000002445 nipple Anatomy 0.000 description 3
- XEEYBQQBJWHFJM-UHFFFAOYSA-N Iron Chemical compound [Fe] XEEYBQQBJWHFJM-UHFFFAOYSA-N 0.000 description 2
- 239000004480 active ingredient Substances 0.000 description 2
- 239000000560 biocompatible material Substances 0.000 description 2
- 238000013461 design Methods 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 229920001971 elastomer Polymers 0.000 description 2
- 239000000806 elastomer Substances 0.000 description 2
- 239000001963 growth medium Substances 0.000 description 2
- 230000002209 hydrophobic effect Effects 0.000 description 2
- 210000004115 mitral valve Anatomy 0.000 description 2
- 238000002360 preparation method Methods 0.000 description 2
- 230000008569 process Effects 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 238000000926 separation method Methods 0.000 description 2
- 210000000329 smooth muscle myocyte Anatomy 0.000 description 2
- 230000001954 sterilising effect Effects 0.000 description 2
- 238000004659 sterilization and disinfection Methods 0.000 description 2
- 239000000725 suspension Substances 0.000 description 2
- 230000002123 temporal effect Effects 0.000 description 2
- 238000012360 testing method Methods 0.000 description 2
- 238000012546 transfer Methods 0.000 description 2
- 238000013022 venting Methods 0.000 description 2
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 2
- VGGSQFUCUMXWEO-UHFFFAOYSA-N Ethene Chemical compound C=C VGGSQFUCUMXWEO-UHFFFAOYSA-N 0.000 description 1
- 241001465754 Metazoa Species 0.000 description 1
- 239000003570 air Substances 0.000 description 1
- 230000000735 allogeneic effect Effects 0.000 description 1
- 230000004075 alteration Effects 0.000 description 1
- 210000002565 arteriole Anatomy 0.000 description 1
- 210000001367 artery Anatomy 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 230000000747 cardiac effect Effects 0.000 description 1
- 238000004113 cell culture Methods 0.000 description 1
- 230000030833 cell death Effects 0.000 description 1
- 230000006727 cell loss Effects 0.000 description 1
- 230000001413 cellular effect Effects 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 238000004140 cleaning Methods 0.000 description 1
- 230000000295 complement effect Effects 0.000 description 1
- 239000002131 composite material Substances 0.000 description 1
- 210000001608 connective tissue cell Anatomy 0.000 description 1
- 239000012531 culture fluid Substances 0.000 description 1
- 238000012258 culturing Methods 0.000 description 1
- 239000013536 elastomeric material Substances 0.000 description 1
- 210000003038 endothelium Anatomy 0.000 description 1
- 239000000835 fiber Substances 0.000 description 1
- 210000002950 fibroblast Anatomy 0.000 description 1
- 239000011261 inert gas Substances 0.000 description 1
- 230000036512 infertility Effects 0.000 description 1
- 230000016507 interphase Effects 0.000 description 1
- 229910052742 iron Inorganic materials 0.000 description 1
- 238000002955 isolation Methods 0.000 description 1
- 239000004816 latex Substances 0.000 description 1
- 229920000126 latex Polymers 0.000 description 1
- 239000007791 liquid phase Substances 0.000 description 1
- 229920001684 low density polyethylene Polymers 0.000 description 1
- 239000004702 low-density polyethylene Substances 0.000 description 1
- 239000011159 matrix material Substances 0.000 description 1
- 238000011169 microbiological contamination Methods 0.000 description 1
- 230000005012 migration Effects 0.000 description 1
- 238000013508 migration Methods 0.000 description 1
- 238000010943 off-gassing Methods 0.000 description 1
- 230000002093 peripheral effect Effects 0.000 description 1
- 230000002572 peristaltic effect Effects 0.000 description 1
- 230000035699 permeability Effects 0.000 description 1
- 239000004814 polyurethane Substances 0.000 description 1
- 239000013354 porous framework Substances 0.000 description 1
- 239000002244 precipitate Substances 0.000 description 1
- 230000001902 propagating effect Effects 0.000 description 1
- 210000003102 pulmonary valve Anatomy 0.000 description 1
- 238000010992 reflux Methods 0.000 description 1
- 230000002940 repellent Effects 0.000 description 1
- 239000005871 repellent Substances 0.000 description 1
- 230000000284 resting effect Effects 0.000 description 1
- 229920002631 room-temperature vulcanizate silicone Polymers 0.000 description 1
- 239000013049 sediment Substances 0.000 description 1
- 229920002379 silicone rubber Polymers 0.000 description 1
- 239000004945 silicone rubber Substances 0.000 description 1
- 238000004088 simulation Methods 0.000 description 1
- 125000006850 spacer group Chemical group 0.000 description 1
- 230000003068 static effect Effects 0.000 description 1
- 238000003860 storage Methods 0.000 description 1
- 238000013517 stratification Methods 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 230000001360 synchronised effect Effects 0.000 description 1
- 239000012780 transparent material Substances 0.000 description 1
- 210000000591 tricuspid valve Anatomy 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
- 238000009423 ventilation Methods 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
- 238000005406 washing Methods 0.000 description 1
- 238000009736 wetting Methods 0.000 description 1
- 238000004804 winding Methods 0.000 description 1
Classifications
-
- C—CHEMISTRY; METALLURGY
- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
- C12M—APPARATUS FOR ENZYMOLOGY OR MICROBIOLOGY; APPARATUS FOR CULTURING MICROORGANISMS FOR PRODUCING BIOMASS, FOR GROWING CELLS OR FOR OBTAINING FERMENTATION OR METABOLIC PRODUCTS, i.e. BIOREACTORS OR FERMENTERS
- C12M35/00—Means for application of stress for stimulating the growth of microorganisms or the generation of fermentation or metabolic products; Means for electroporation or cell fusion
- C12M35/04—Mechanical means, e.g. sonic waves, stretching forces, pressure or shear stimuli
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2412—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
- A61F2/2415—Manufacturing methods
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L27/507—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials for artificial blood vessels
-
- C—CHEMISTRY; METALLURGY
- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
- C12M—APPARATUS FOR ENZYMOLOGY OR MICROBIOLOGY; APPARATUS FOR CULTURING MICROORGANISMS FOR PRODUCING BIOMASS, FOR GROWING CELLS OR FOR OBTAINING FERMENTATION OR METABOLIC PRODUCTS, i.e. BIOREACTORS OR FERMENTERS
- C12M21/00—Bioreactors or fermenters specially adapted for specific uses
- C12M21/08—Bioreactors or fermenters specially adapted for specific uses for producing artificial tissue or for ex-vivo cultivation of tissue
-
- C—CHEMISTRY; METALLURGY
- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
- C12M—APPARATUS FOR ENZYMOLOGY OR MICROBIOLOGY; APPARATUS FOR CULTURING MICROORGANISMS FOR PRODUCING BIOMASS, FOR GROWING CELLS OR FOR OBTAINING FERMENTATION OR METABOLIC PRODUCTS, i.e. BIOREACTORS OR FERMENTERS
- C12M29/00—Means for introduction, extraction or recirculation of materials, e.g. pumps
- C12M29/12—Pulsatile flow
Definitions
- the technical problem underlying the present invention was to provide a bioreactor system for the improved control or adjustability of a desired modeled physiological condition for the conditioning of an in vitro heart valve construct with simultaneously low media requirements and in particular easy sterilization or interchangeability of the parts.
- the bioreactor system should allow for flexible universal pulsatile perfusion of the in vitro construct with a dynamically adjustable or adjustable pressure curve across the heart valve over a wide range.
- the invention solves the aforementioned technical problems and satisfies the requirements for an efficient automatic production of biogenic heart valve preparations by a novel integral bioreactor system for colonization, cultivation and, in particular, directed, pressure-controlled perfusion of an in vitro heart valve construct.
- this contains at least the components listed and characterized below or, in a preferred embodiment, consists exclusively of:
- the individual temporal pressure profiles in both pumping arrangements work together to simulate the desired physiological pressure course for conditioning and maturation of the construct.
- a third function of both pumping arrangements according to the invention arises in interaction with the adjacent reactor chamber and will be described in more detail below.
- the membrane is preferably a flat disc made of elastomeric material, which is stretched in the housing of the pump assembly, especially clamped between housing halves, wherein the elastomeric membrane can then additionally serve as a seal between the housing elements.
- Preferred membrane material is a particularly easily sterilizable biocompatible elastomer or surface-functionalized elastomer, preferably selected from: silicone rubber, especially RTV silicone, PU, LDPE and latex.
- material composites or bellows constructions can alternatively be used as movable membranes.
- these three components are joined together to form an integral housing block, preferably the housings of the components are fixed to one another or they are formed together in a one-piece (one-part or multi-part) fluid block.
- the block of the bioreactor system preferably consists exclusively of these three components.
- the luminal compartment of the construct for the duration of this pressurization can be completed and specifically separated in each case from the residual volume of the two media chambers of the pumping arrangements and the rest of the perfusion system.
- the movable membrane is preferably provided, at least on the side facing the media ports of the reactor chamber, with an elastically sealing and / or hydrophobic stratification or consists of such a material.
- the in vitro heart valve construct can advantageously be colonized with cells introduced there in the form of a cell suspension and then switched seamlessly into the (pulsatile) perfusion mode. Complicated handling and opening of the reactor cycle is not required, which simplifies and automates operations while avoiding contamination.
- bioreactor system In the context of the invention, however, an integral embodiment of the bioreactor system is preferred, wherein the pulsatile pressure-controlled perfusion takes place exclusively by the two pumping arrangements in conjunction with the return channel with check valve and throttle valve described herein and the colonization operation by interaction of the same two pumping arrangements in conjunction with the immediate interposed reactor chamber takes place.
- the bioreactor according to the invention contains a holding device (flap holder) which is particularly suitable for colonization as well as for perfusion of the in vitro heart valve construct.
- the holding device is advantageously physically separated from the reactor chamber and in particular for the purpose of clamping the scaffold at the beginning of production as well as the recovery of the mature heart valve from the reactor chamber removed.
- the holding device is designed and dimensioned such that in the functional state of the reactor it sealingly engages the interior of the reactor chamber so that a luminal compartment and an extraluminal compartment are formed in the reactor chamber in connection with the fixed construct. These are preferably accessible from the outside by suitable entrances (ports) which are formed on the reactor chamber, preferably separately from one another.
- entrances ports
- cell suspensions can be separated from the luminal side or the extraluminal ones by these accesses Side of the construct to be colonized separately with cells.
- a specific variant of the holding device contains on both sides of circular frame parts which are spaced apart by individual longitudinal struts.
- the individual longitudinal struts do not form a continuous cylinder wall. This advantageously allows the cells which have fallen onto the reactor chamber wall to be resuspended by turbulence on the longitudinal struts during rotation and preferably additionally guided specifically to the outer surface of the populated construct, like a paddle wheel or a washing drum.
- the external drive unit is a particularly static electromagnet or coil arrangement (stator), which forms a brushless internal rotor or a stepping motor with discreetly controllable angular positions together with the holding device as a permanent magnetic armature (rotor).
- magnetic flux-conducting soft iron segments are provided in the holding device instead of the permanent magnets, which in electromagnetic interaction with correspondingly segmented stator windings in the external drive unit allow a preferably stepwise rotation with discretely controllable angular positions.
- an annular disc is provided in the holding device in place of the permanent magnets, which allow in electromagnetic interaction with corresponding field coils in the external drive unit, a continuous rotation by eddy current effects in the annular disc.
- drive unit and their electrical control conceivable, which can be used on known basic principles such as synchronous drive, asynchronous, reluctance and similar in conjunction with appropriately clocked power supply including variable frequency or electronic commutation.
- step d) the active pressurization of the working chamber of the ventricle-side pumping arrangement over time follows a predetermined in vivo ventricular pressure curve and the active pressurization of the working chamber of the aortic pumping device follows a predetermined in vivo aortic pressure profile over time.
- sealing means (47) are provided on the frame parts (44) for sealing the media ports (21, 22).
- magnetic coupling means (49) in the frame part (44) are present, which allow a torque from the external drive unit (70) with corresponding magnetic coupling means (71).
- a (schematically illustrated) check valve (61) and a (schematically illustrated) adjustable throttle valve (64) are integrated.
- the main part of the reactor is a tubular, horizontally arranged and filled with culture medium vessel in the middle of which is located in a holder, the heart valve.
- At each end of the tube there is an air chamber which is separated from the liquid phase by a flexible membrane.
- the distal ends of the air chambers as well as the membranes are made of transparent material to allow visual observation of the function of the tissue.
- the displaced during filling of the bioreactor air can escape as well as forming during operation gas bubbles. This is done via special ports in the pumping chambers, which have a lid with a hydrophobic sterile filter membrane (as used, for example, in cell culture bottles).
- the diameter of the ports is at least so large that water in them can flow down by gravity alone. If the diameter is too small - as in the case of Luer Lock-based syringe filters - water once held in is held in the access by the surface tension and thus blocks the gas permeability of the membrane.
- the device is such that a heart valve model can be sewn on, adhered or clamped.
- the valve model is tubular, while the valve pockets / sails are approximately located centrally inside the tube.
- the flap holder contains two connectors (connector) to which the heart valve can optionally be attached and clamped, sewn, glued, etc. can be. Spacers between the two connectors span the flap between the connectors.
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Chemical & Material Sciences (AREA)
- Wood Science & Technology (AREA)
- Organic Chemistry (AREA)
- Zoology (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Biomedical Technology (AREA)
- General Health & Medical Sciences (AREA)
- Genetics & Genomics (AREA)
- Biotechnology (AREA)
- Microbiology (AREA)
- Sustainable Development (AREA)
- Biochemistry (AREA)
- General Engineering & Computer Science (AREA)
- Animal Behavior & Ethology (AREA)
- Public Health (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Veterinary Medicine (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Medicinal Chemistry (AREA)
- Epidemiology (AREA)
- Cell Biology (AREA)
- Mechanical Engineering (AREA)
- Dermatology (AREA)
- Manufacturing & Machinery (AREA)
- Molecular Biology (AREA)
- Heart & Thoracic Surgery (AREA)
- Prostheses (AREA)
Abstract
La présente invention concerne un nouveau système de bioréacteur pour la production de tissus par génie génétique, spécialement conçu pour la formation in vitro d'une valvule cardiaque en vue d'obtenir une prothèse de valvule cardiaque biogène, ainsi que des procédés et des applications dudit système de bioréacteur.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE102015219313.6A DE102015219313B3 (de) | 2015-10-06 | 2015-10-06 | Herzklappenmechanobioreaktor |
| PCT/EP2016/072368 WO2017060081A1 (fr) | 2015-10-06 | 2016-09-21 | Bioréacteur à stress mécanique pour valvules cardiaques |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| EP3359638A1 true EP3359638A1 (fr) | 2018-08-15 |
Family
ID=56889898
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| EP16777936.2A Withdrawn EP3359638A1 (fr) | 2015-10-06 | 2016-09-21 | Bioréacteur à stress mécanique pour valvules cardiaques |
Country Status (3)
| Country | Link |
|---|---|
| EP (1) | EP3359638A1 (fr) |
| DE (1) | DE102015219313B3 (fr) |
| WO (1) | WO2017060081A1 (fr) |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110037831B (zh) * | 2019-05-02 | 2020-10-09 | 武汉唯柯医疗科技有限公司 | 一种猪心包瓣叶处理装置 |
| CN111925939B (zh) * | 2020-09-08 | 2023-07-04 | 华中科技大学同济医学院附属协和医院 | 一种动态加压组织工程瓣膜细胞接种器的使用方法 |
Family Cites Families (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7348175B2 (en) * | 2002-03-15 | 2008-03-25 | St3 Development Corporation | Bioreactor with plurality of chambers for conditioning intravascular tissue engineered medical products |
| DE10322024A1 (de) * | 2003-05-16 | 2004-12-02 | Symetis Ag | Bioreaktor zum Herstellen einer Gewebeprothese, insbesondere Herzklappe |
| EP1693025A1 (fr) * | 2005-02-17 | 2006-08-23 | Universität Zürich | Procédé pour la production d'une prothèse par génie tissulaire |
| EP2085054A1 (fr) * | 2008-02-01 | 2009-08-05 | Technische Universiteit Eindhoven | Procédé de fabrication de construction créée par tissu |
| EP2399986A1 (fr) * | 2010-06-22 | 2011-12-28 | Ludwig-Maximilians-Universität München | Bioréacteur et procédé de création et/ou de conditionnement de tissus biologiques |
-
2015
- 2015-10-06 DE DE102015219313.6A patent/DE102015219313B3/de not_active Expired - Fee Related
-
2016
- 2016-09-21 WO PCT/EP2016/072368 patent/WO2017060081A1/fr not_active Ceased
- 2016-09-21 EP EP16777936.2A patent/EP3359638A1/fr not_active Withdrawn
Also Published As
| Publication number | Publication date |
|---|---|
| DE102015219313B3 (de) | 2016-09-29 |
| WO2017060081A1 (fr) | 2017-04-13 |
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