The fibroblast and wound repair

Neovascularization of surface demineralized dentin

Uneventful healing of the wound site created by periodontal reconstructive surgery is crucial for the long term survival of the dentition. Wound healing has been shown to be initiated and mediated by matrix components and polypeptide growth factors. Neovascularization (or angiogenesis) is one of the most important events in the healing process of a wound site. Any increase in the degree and/or rate of neovascularization could result in more rapid or complete healing. Previously, we have shown that basic fibroblast growth factor (bFGF) selectively enhances periodontal ligament cell migration and proliferation. In addition, we have shown that FGF stimulates human umbilical vein endothelial cell migration and proliferation. In this study we examined whether human umbilical vein endothelial cells could be influenced to form capillary-like structures in a type I collagen stroma and on dentin surfaces in response to fibroblast growth factor (FGF). We observed tubule-like structures formed from a monolayer of endothelial cells within a type I collagen sponge in response to a gradient of FGF. Furthermore, we observed tubule-like structures formed from self-association of individual endothelial cells on partially demineralized dentin surfaces in response to FGF. Proliferation of human endothelial cells on dentin was dose dependent and maximally stimulated at a concentration of 10 ng/ml FGF. These data indicate that FGF can induce endothelial cell migration, proliferation and tubule formation on dentin.

Effect of platelet-derived transforming growth factor (TGF) type beta 1 on murine inflammatory mononuclear phagocytes: increased fibronectin production

The effect of transforming growth factor type beta 1 (TGF-beta 1) on mononuclear phagocytes (macrophages), cells which play an important role in the inflammatory response resulting from tissue wounding, was investigated. We found that fibronectin production by murine inflammatory macrophages is significantly enhanced by highly purified human TGF-beta 1 in a time- and dose-dependent manner. Specifically, 2 pM TGF-beta 1 was sufficient to cause significant elevation of fibronectin levels, which peaked between 24 and 48 hr of incubation. Both TGF-beta 1-induced and basal levels of fibronectin were completely abolished by cycloheximide, suggesting that protein synthesis was required. Furthermore, fibronectin mRNA levels were significantly enhanced in TGF-beta 1-treated macrophages. The inductive capacity of TGF-beta 1 appeared specific since other agents such as phorbol myristate acetate and endotoxin failed to induce fibronectin production. Since macrophages have been recently shown to secrete an inactive form of TGF-beta 1, the ability of this precursor molecule to induce fibronectin production was tested. It was found that partially purified human platelet latent TGF-beta 1 could not induce fibronectin synthesis, whereas acid treatment of the same preparation which releases mature TGF-beta 1 enhanced fibronectin production. Taken together, results presented here suggest that inflammatory macrophages can directly contribute to the formation of extracellular matrix upon interaction with TGF-beta 1 and that these cells lack the ability to augment fibronectin production in response to a platelet-derived latent form of TGF-beta 1.

Platelet-derived growth factor and transforming growth factor-beta enhance tissue repair activities by unique mechanisms

Platelet-derived growth factor (PDGF) and transforming growth factor-beta (TGF-beta) markedly potentiate tissue repair in vivo. In the present experiments, both in vitro and in vivo responses to PDGF and TGF-beta were tested to identify mechanisms whereby these growth factors might each enhance the wound-healing response. Recombinant human PDGF B-chain homodimers (PDGF-BB) and TGF-beta 1 had identical dose-response curves in chemotactic assays with monocytes and fibroblasts as the natural proteins from platelets. Single applications of PDGF-BB (2 micrograms, 80 pmol) and TGF-beta 1 (20 micrograms, 600 pmol) were next applied to linear incisions in rats and each enhanced the strength required to disrupt the wounds at 5 d up to 212% of paired control wounds. Histological analysis of treated wounds demonstrated an in vivo chemotactic response of macrophages and fibroblasts to both PDGF-BB and to TGF-beta 1 but the response to TGF-beta 1 was significantly less than that observed with PDGF-BB. Marked increases of procollagen type I were observed by immunohistochemical staining in fibroblasts in treated wounds during the first week. The augmented breaking strength of TGF-beta 1 was not observed 2 and 3 wk after wounding. However, the positive influence of PDGF-BB on wound breaking strength persisted through the 7 wk of testing. Furthermore, PDGF-BB-treated wounds had persistently increased numbers of fibroblasts and granulation tissue through day 21, whereas the enhanced cellular influx in TGF-beta 1-treated wounds was not detectable beyond day 7. Wound macrophages and fibroblasts from PDGF-BB-treated wounds contained sharply increased levels of immunohistochemically detectable intracellular TGF-beta. Furthermore, PDGF-BB in vitro induced a marked, time-dependent stimulation of TGF-beta mRNA levels in cultured normal rat kidney fibroblasts. The results suggest that TGF-beta transiently attracts fibroblasts into the wound and may stimulate collagen synthesis directly. In contrast, PDGF is a more potent chemoattractant for wound macrophages and fibroblasts and may stimulate these cells to express endogenous growth factors, including TGF-beta, which, in turn, directly stimulate new collagen synthesis and sustained enhancement of wound healing over a more prolonged period of time.

Collagen synthesis by human fibroblasts. Regulation by transforming growth factor-beta in the presence of other inflammatory mediators

We have examined the combined effects of transforming growth factor-beta (TGF-beta), serum and gamma-interferon (gamma-IFN) on collagen synthesis by fibroblasts and compared the response of fibroblast subpopulations to TGF-beta. Human diploid fibroblasts were treated with TGF-beta alone and with serum of gamma-IFN. Cells were labelled with radioactive amino acids, and collagen production was measured as collagenase-digestible radioactivity. Collagen mRNA was determined by a solution-hybridization assay using procollagen-alpha 1[I] cDNA clone HF 677. The results showed that either serum or TGF-beta increased incorporation, collagen production and mRNA by fibroblasts approx. 2-fold; however, collagen synthesis relative to total protein synthesis and collagen mRNA relative to total polyadenylated [poly(A)+] RNA were not affected. Only serum activated cell growth. Collagen production increased approx. 4-fold in cells exposed to both TGF-beta and serum, and this increase was equal to that expected for an additive effect by both components. Treatment with gamma-IFN decreased collagen production and collagen mRNA to 44 and 40% respectively, whereas total incorporation and poly(A)+ RNA were affected only marginally. Cells exposed simultaneously to both gamma-IFN and TGF-beta produced less collagen and contained less mRNA than did those treated with TGF-beta alone. The gamma-IFN decreased collagen synthesis in control and TGF-beta-treated cultures to a similar extent, and TGF-beta increased collagen synthesis 2-fold in cells pre-treated with gamma-IFN. Fibroblast strains obtained in medium containing plasma-derived serum synthesized approximately half as much collagen as did cells derived from the same explant in the presence of fresh human serum, and TGF-beta stimulated collagen production and mRNA in both cell strains. We conclude that TGF-beta, serum and gamma-IFN regulate collagen synthesis by independent mechanisms, and that the combined action of these components plays a significant role in regulating collagen synthesis during wound healing and tissue repair.

Healing, regeneration, and repair: prospectus for new dental treatment

Recent advances in our understanding of growth and development have led us to the realization that previously unattainable tissue regeneration and repair are now within the scope of patient care. Concurrent and complementary use of nonbiological substitutes, with complete biological integration and host acceptance, is becoming a leading recognized alternative to the loss of function of biological tissues. This manuscript will examine the implications of the new biotechnology in medical sciences for dental healing, regeneration, and repair. These concepts, when coupled with genetic engineering, could produce enormous changes in the quality of life.

Gastrointestinal cell plasma membrane wounding and resealing in vivo

Previous studies in vitro have shown that various mechanical methods used to wound plasma membranes allow normally impermeant, water-soluble markers, such as fluorescein dextran or horseradish peroxidase, to enter the cytosol. Subsequent membrane resealing traps these nontoxic fluorescent or electron microscopic markers within living, surviving wounded cells. The present report is the first, to our knowledge, to use this strategy to study cell membrane wounding and resealing in the intact animal. We show that gut cells wounded in vivo by mechanical forces are capable of resealing disruptions of their plasma membranes. More importantly, we show that wounding of cell membranes, followed by resealing, occurs not only in mechanically injured gut but also in normal, experimentally undisturbed gut. A variety of cell types were wounded and resealed membrane wounds in the mechanically injured stomach: surface mucous, endothelial, fibroblastic, parietal, and chief cells. Mucous cells successful at resealing membrane wounds apparently became active participants in the motile events of stomach repair. In undisturbed gut, cell membrane wounding and resealing was most frequently observed in the colon, but was also observed in the esophagus, stomach, duodenum, and ileum. Surface epithelial cells in undisturbed gut were retained for greater than 48 h after surviving membrane wounds. Two important roles are suggested for membrane resealing in gut: (a) preservation of motile cells nearest epithelial discontinuities requiring repair after injury, and (b) maintenance of epithelial integrity in normally functioning gut. Our finding of cell wounding in undisturbed gut may explain, in part, why rapid, continual cell turnover is characteristic of gut epithelia. We propose that membrane disruption, or wounding, is a normal and common occurrence in vivo, and that a biologically significant function of the plasma membrane is to reseal such wounds. The occurrence of in vivo cell membrane wounding and resealing suggests an unrecognized route for molecular traffic into and out of cytoplasm.

Taxol, cytochalasin B and colchicine effects on fibroblast migration and contraction: a role in glaucoma filtration surgery?

Migration and contraction are fibroblast activities in scar tissue formation which may contribute towards the failure of trabeculectomies. We attempted to modify the migration and contraction of Tenon's capsule fibroblasts in vitro using the drugs taxol, cytochalasin B and colchicine. Migration assays were conducted in 48-well micro-chemotaxis chambers, using rabbit aqueous humour which has been previously identified as a powerful chemoattractant for Tenon's fibroblasts, and fibronectin as the stimuli for migration. All three drugs inhibited the migration of fibroblasts to both fibronectin and aqueous humour, with maximal activity seen at 10(-6)M (taxol), 10(-5)M (cytochalasin B), and 10(-3) M (colchicine). In a single cell contractile assay in which contraction of whole fibroblasts was initiated with exogenous adenosine triphosphate (ATP), taxol and colchicine showed anticontractile activity, maximal at 10(-5)M and 10(-3)M respectively, but cytochalasin B was ineffective. The significance of the activities of these drugs in relation to their proposed use for improving the success of trabeculectomies is discussed.

Fibroblastic subpopulations in uninjured and wounded rabbit oral mucosa

Fibroblast cultures derived from uninjured and reparative rabbit buccal mucosa were compared in terms of extracellular glycosaminoglycan (GAG) content and cellular response to interleukin-1 (IL-1). Under identical growth conditions, proliferation of both cell lines was the same. Both lines incorporated [3H]-glucosamine into GAG in cellular, pericellular, and medium fractions, with the majority of incorporated label residing in the medium. Dermatan sulfate (DS) was the predominant GAG in the medium fraction of both normal and wound fibroblast cultures; however, the two cell lines differed in the identity of the medium fraction's secondary GAG: chondroitin sulfate (CS) for normal fibroblasts and hyaluronic acid (HA) for wound-derived cells. The GAG content of the pericellular matrix for all cultures was the same regardless of the tissue of origin: heparan sulfate (HS) accompanied by a very small amount of CS. Exposure to IL-1 produced limited but highly specific effects: It was not mitogenic for either cell line but did cause a quantitative change (increase) in overall incorporation into GAG for medium and pericellular fractions for both cell lines. Further, IL-1 induced a qualitative change in GAG composition for normal mucosal fibroblastic medium fractions by causing the synthesis/release of heparan sulfate (HS) and a variant form of DS. These data support the hypothesis that different fibroblastic substrains can populate a given oral site as a function of variables such as injury and/or healing status.

Review: pharmacologic control of wound healing in glaucoma filtration surgery

An integrated understanding of the wound healing process, pharmacological agents, and surgical techniques are required for comprehensive treatment of wound healing in glaucoma filtration surgery. More well controlled basic and clinical studies are required to clarify the existing ambiguities in the selection of proper pharmacological agents, dosage, timing, and method of delivery. The most promising treatment modalities may be combination drug therapy and the use of bioerodible compounds for a sustained and localized delivery system.

Collagen deposition during wound repair in rat gingiva

The aim of this study was to examine day-by-day changes at incisional wound edge in rat molar interdental tissue with special reference to early interactions of new and pre-existing collagen fibrils. Twenty rats aged 50 days were divided into experimental groups each comprising two animals. Following incision and post-injury observation periods of 1-10 days, the rats were given an overdose of sodium pentothal and specimens prepared for light and electron microscopy. In 1-3-day post-injury specimens fibrin was replaced by inflammatory cells. Fibroblasts were found along the cut edge in 4-day post-injury specimens. Fibrillogenesis had started at 5 days post-injury. During the period of 5-10 days post-injury increasing amounts of new collagen fibrils were laid down at the wound edge. No granular material was identified at the interface of new and preexisting collagen. In standardized mesiodistal sections, bundles of newly formed fibrils regularly appeared cross-cut in relation to the tangentially cut transseptal fiber system, suggestive of a buccolingual fibril orientation at the wound edge. The ultrastructural observations indicate that during early stages of wound repair, connective tissue continuity is generally established without direct splicing of severed fibers.

Distinctive fibroblastic subpopulations in skin and oral mucosa demonstrated by differences in glycosaminoglycan content

The glycosaminoglycan (GAG) content of rabbit skin, oral mucosa, and cultured [3H]-glucosamine-labeled dermal and submucosal fibroblasts was compared. Skin contained predominantly dermatan sulfate (DS) and a small amount of hyaluronic acid (HA), whereas mucosa contained primarily keratan sulfate (KS) and smaller quantities of HA and DS. Culture medium from dermal and submucosal fibroblasts contained GAGs co-electrophoresing with DS, HA, and chondroitin sulfate (CS), although the relative proportions of these GAG differed. CS isolated from dermal and mucosal fibroblast culture medium co-electrophoresed with chondroitin 4-sulfate (C4-S) on cellulose acetate, whereas dermal medium CS was resistant to digestion by chondroitinase ABC, and mucosal medium CS was chondroitinase ABC-susceptible. The pericellular matrix of dermal fibroblasts contained primarily DS and C4-S/C6-S, as confirmed by chondroitinase ABC digestion; the corresponding fraction of mucosal fibroblasts contained HS and a GAG co-electrophoresing with a C6-S standard, yet resistant to digestion by chondroitinase ABC. Thus the GAG content of dermal and mucosal fibroblasts differed both qualitatively in terms of the type of GAG secreted into the culture medium and pericellular matrix, and quantitatively, in terms of the relative proportions of these GAGs in both fractions. These differences support the concept of distinctive fibroblastic subpopulations in skin and mucosal tissue, inasmuch as the cells were subjected to identical culturing conditions.

Fibroblasts in dermal tissue repair. Electron microscopic and immunohistochemical study

The cellular dynamics of dermal regeneration were studied in nonsutured cutaneous wounds of female pigs and monkeys with electron microscopy and immunohistochemistry to demonstrate the origin and the development of fibroblasts forming granulation tissue. The results indicate that fibroblasts do not originate from histiocytes but from resting fibroblasts in the wound margins. These resting fibroblasts first become undifferentiated mesenchymal cells termed "X" cells. The "X" cells then multiply, migrate, and invade the wound defect in approximately 3 days, transforming into highly active fibroblasts. The active fibroblasts are endowed with the capacity of further transformation to fibroclasts and myofibroblasts. The latter two cell populations then effectively cause remodeling of newly formed tissue and contraction of wound margins.

Transforming growth factor beta stimulates collagen-matrix contraction by fibroblasts: implications for wound healing

An important event during wound healing is the contraction of newly formed connective tissue (granulation tissue) by fibroblasts. The role of polypeptide growth factors in the process of wound contraction was investigated by analyzing the influence of transforming growth factor beta (TGF-beta), platelet-derived growth factor on the ability of fibroblasts to contract a collagen matrix in an in vitro system. TGF-beta, but not the other growth factors tested, markedly enhanced the ability of BHK-21,3T3-L1, and human foreskin fibroblasts to contract collagen gels. These results suggest that TGF-beta released from platelets and inflammatory cells at sites of tissue injury stimulates fibroblasts to contract the provisional wound matrix and that this effect contributes to the ability of TGF-beta to accelerate wound healing.

Exogenous ATP causes the contraction of intact fibroblasts in vitro

The contraction of intact fibroblasts was investigated in vitro. The addition of ATP to the cells lead to a rapid, reversible reduction of cell area, which appeared to be a contraction. The change of cell area was measured using image analysis. ATP (15 mM) elicited the maximal contraction, with a 50% reduction in area achieved within 90 s. Adenosine was a partial agonist for the contraction. The contraction was dependent on control of the environmental calcium; cells in a calcium- and magnesium-free environment underwent spontaneous contraction. Replenishing the calcium and magnesium lead to stability of the cells. Since fibroblast contraction is involved in wound healing at many sites in the body, this system provides a physiological model for the direct investigation of fibroblasts with intact cell membranes, and allows for the testing of drugs which may influence wound healing in vivo.

Interleukin-1-induced changes in extracellular glycosaminoglycan composition of cutaneous scar-derived fibroblasts in culture

Fibroblast cultures established from explants of mature scar and skin tissue were analyzed with regard to extracellular glycosaminoglycan (GAG) composition and response to interleukin-1 (IL-1). Following a serum-free 48 hour label with [3H]glucosamine, pericellular and medium GAGs were isolated by precipitation with cetylpyridinium chloride (CPC) and analyzed by cellulose acetate electrophoresis. In addition, susceptibility of the precipitates to Streptomyces hyaluronidase, chondroitinase ABC and heparitinase was determined. Labeled conditioned medium from the scar-derived cells contained both dermatan sulfate (DS) and hyaluronate (HA), as compared to medium from the control (skin-derived) cells which contained predominantly DS. IL-1 induced the appearance of chondroitin 4-sulfate (C4-S) in the medium of the scar cells with no concurrent effect on either DS or HA, and increased the amount of HA in the medium fraction of normal skin cells. The pericellular fraction of the scar-derived cells contained chondroitin 6-sulfate (C6-S) and DS; addition of IL-1 resulted in a shift from DS to heparan sulfate (HS), and the emergence of a pericellular GAG profile similar to that of normal dermal fibroblasts.

Induction of transforming growth factor-alpha in activated human alveolar macrophages

The early monocyte infiltration observed in normal wound repair and in a number of pathologic processes precedes the epithelial and connective tissue proliferative responses, suggesting that the monocyte/macrophage may be an important source of growth factors for these tissues. In culture, activated macrophages secrete growth factors active on fibroblasts, smooth muscle, endothelium, and epithelium. This report demonstrates that activated human alveolar macrophages express the gene for transforming growth factor-alpha (TGF-alpha) in an inducible manner and secrete a factor into the culture medium that is functionally and immunologically identical to TGF-alpha. Two different molecular species of TGF-alpha activity (approximately 8,500-12,000 and 28,500 daltons) are identified in macrophage-conditioned medium. These observations establish the macrophage as a diploid human cell capable of synthesizing and secreting TGF-alpha. The activated macrophage therefore represents a cellular source of a mitogenic factor that is potentially important in epithelial proliferation and repair.

In vivo incisional wound healing augmented by platelet-derived growth factor and recombinant c-sis gene homodimeric proteins

Human platelet-derived growth factor (hPDGF) is likely to be important in stimulating tissue repair, based upon its in vivo chemotactic and stimulatory activities for inflammatory cells and fibroblasts and upon the presence of PDGF and related proteins in platelets, macrophages, and activated fibroblasts, cell types that make up the milieu of the healing wound. Recombinant human c-sis (rPDGF-B), homodimers of the B chain of PDGF, were compared with hPDGF in vitro. rPDGF-B was immunologically similar to hPDGF and, at identical concentrations, similar to hPDGF in stimulating fibroblast mitogenesis and chemotaxis of polymorphonuclear leukocytes, monocytes, and fibroblasts. Purified hPDGF and rPDGF-B were also tested in vivo for potency in a model of tissue repair using a linear incision wound through rat dermis. A single application of hPDGF or rPDGF-B (2-20 micrograms/wound) in a slow release vehicle at the time of wounding resulted in a dose-dependent, statistically highly significant increase of breaking strength of treated wounds. Wound healing in animals treated with rPDGF-B was 170% stronger and accelerated by 2 d during the first week over control wounds and by 4-6 d over the next 2 wk. Histologic evaluation of growth factor-treated wounds correlated the in vitro chemotactic activity and the accelerated healing of wounds with a striking inflammatory cell infiltrate early after wounding, markedly increased formation of granulation tissue by 4-d, and increased fibrosis by 14 d in comparison to control wounds. The results thus demonstrate that rPDGF-B is fully active in in vitro tests of mitogenesis and chemotaxis and, for the first time, demonstrate directly that PDGF significantly advances wound healing in incisional wounds of experimental animals.

Tumor necrosis factor stimulates proliferation of human osteosarcoma cells and accumulation of c-myc messenger RNA

The objective of this study was to establish whether human recombinant tumor necrosis factor (TNF) can significantly stimulate the proliferation of some tumor cells. Treatment with TNF had little or no effect on the growth of human tumor cells and murine NIH/3T3 cells cultured in medium with high serum concentration. Two tumor lines, SK-MEL-109 melanoma and HOS osteosarcoma cells, were adapted to grow in medium supplemented with 0.5% serum. The growth of these SK-MEL-109 cells was inhibited by TNF, but that of the HOS cells was greatly stimulated by TNF in a dose-dependent way. Treatment with 10 ng/ml of TNF resulted in a two-fold increase in the rate of cell division. This effect of TNF was also shown by measuring DNA and protein synthesis. The continuous presence of TNF was not required for its mitogenic activity on HOS cells cultured with 0.5% serum, since treatment for only one day with TNF resulted in prolonged growth stimulation. The failure of TNF to promote division of cells cultured in medium with 10% serum may possibly be explained by the presence of saturating amounts of growth factors in serum. Interferons abolished the mitogenic activity of TNF on HOS cells. Furthermore, TNF did not show synergism with insulin or epidermal growth factor in stimulating growth of these cells. The level of c-myc mRNA was increased five-fold after 30 minutes of treatment with TNF. This shows that TNF is a growth factor for HOS cells and that it induces accumulation of c-myc mRNA.

Effect of cephalosporins on fascial healing after celiotomy

A 7 day course of either cefonicid or cefazolin significantly reduced mean wound breaking weight after midline celiotomy in Sprague-Dawley rats compared with control animals. This detrimental effect was not seen when each drug was administered as a single preoperative dose. Even a 3 day course of cefonicid was associated with a significant reduction in the weight required to disrupt a healing abdominal closure. An increased incidence of incisional hernias was also noted among animals treated for 7 days with cefonicid or cefazolin. Shorter antibiotic regimens were not associated with an increased frequency of incisional herniation.

Phorbol ester stimulates macrophage invasion of fibrin matrices

Macrophages migrate through a fibrin-rich extracellular matrix in chronic inflammation, wound healing, and other pathophysiological processes. To investigate the factors that might influence the ability of mononuclear phagocytes to invade fibrin matrices, we cultured macrophage-like P388D1 cells as well as resident and thioglycollate-elicited mouse peritoneal macrophages on three-dimensional fibrin gels, and we examined the effect of agents known to stimulate a variety of macrophage functions, including the production of fibrinolytic enzymes. Cells grown on fibrin gels under control conditions, as well as cells treated with either bacterial lipopolysaccharide or concanavalin A, remained confined to the gel surface. In contrast, the tumor promoter 4 beta-phorbol 12-myristate 13-acetate (PMA) induced both P388D1 cells and peritoneal macrophages to invade the underlying fibrin matrix. The invasive behavior of PMA-treated P388D1 cells was not affected by protease inhibitors of various specificities. These results demonstrate that certain exogenous signals can profoundly modify the ability of macrophages to migrate through fibrin matrices.

Myofibroblasts in healing laser wounds of rat tongue mucosa

The distribution of myofibroblasts was studied in healing laser incisions compared with scalpel-incision and excision wounds in dorsal tongue mucosa and excision wounds in back skin. Myofibroblasts (m-f-b) were visualized by staining with NBD-phallacidin, a fluorescent probe specific for F-actin, and by electron microscopy. Few, randomly-orientated m-f-b were found in laser wounds over 28 days. Neither m-f-b nor contraction were seen in the scalpel-incisions. No contraction was observed in the laser wounds whereas an organized network of m-f-b with substantial contraction occurred in excision wounds. It is suggested that lack of contraction in laser wounds is partially due to the fewness of m-f-b. The residual connective tissue matrix resisting the laser treatment also seems to play a role in preventing the wound contraction.

Modulation of fibroblast growth and glycosaminoglycan synthesis by interleukin-1

Cellular response to inflammatory mediators is central to the regulation of new scar tissue formation. Fibroblasts derived from normal dermis and from 14-day old skin wound granulation tissue were compared with regard to production of non-collagenous extracellular matrix and response to interleukin-1 (IL-1). Following a serum-free 48 hour labeling with [3H]-glucosamine, the cellular, pericellular and medium fractions from the two cell types were collected, precipitated with cetylpyridinium chloride (CPC), and analyzed by cellulose acetate electrophoresis. In addition, susceptibility of precipitates to the polysaccharidases Streptomyces hyaluronidase and chondroitinase ABC was determined. Labeled conditioned medium from both cell types contained dermatan sulfate (DS) and hyaluronate (HA), although the relative amounts of these glycosaminoglycans (GAGs) were different. Medium from normal dermal fibroblasts contained more DS than HA, while 14-day granulation tissue culture medium contained a proportionately larger amount of HA. The amount of HA in the medium fraction of normal dermal fibroblasts was increased approximately 10-fold in the presence of 5 U/ml IL-1, while HA in the medium of wound-derived fibroblasts was quantitatively unaffected by addition of the mediator. Pericellular GAG consisted of heparan sulfate (HS) and chondroitin sulfate (CS), with no observable differences between the two cell types and no effect of IL-1 on this profile for either cell type. Conditioned medium from both cell types contained IL-1 activity (measured by thymocyte proliferation assay), with medium from 14-day granulation tissue fibroblasts containing 10-fold higher activity than normal dermal fibroblast medium.

Accelerated healing of incisional wounds in rats induced by transforming growth factor-beta

The role of polypeptide growth factors in the processes of inflammation and repair was investigated by analyzing the influence of transforming growth factor-beta (TGF-beta), applied directly to linear incisions made through rat dorsal skin. A dose-dependent, direct stimulatory effect of a single application of TGF-beta on the breaking strength of healing incisional wounds was demonstrated. An increase in maximum wound strength of 220 percent of control was observed at 5 days; the healing rate was accelerated by approximately 3 days for at least 14 days after production of the wound and application of TGF-beta. These increases in wound strength were accompanied by an increased influx of mononuclear cells and fibroblasts and by marked increases in collagen deposition at the site of application of TGF-beta. TGF-beta is thus a potent pharmacologic agent that can accelerate wound healing in rats.

Expression and secretion of type beta transforming growth factor by activated human macrophages

Alveolar macrophages activated with concanavalin A and peripheral blood monocytes activated with lipopolysaccharide secrete type beta transforming growth factor (TGF-beta). There is minimal TGF-beta secretion in unactivated monocytes, even though TGF-beta mRNA is expressed in these cells at a level similar to that in activated, lipopolysaccharide-treated cultures. U937 lymphoma cells, which have monocytic characteristics, also express mRNA for TGF-beta. Freshly isolated monocytes, both control and lipopolysaccharide-treated, secrete an acid-labile binding protein that inhibits TGF-beta action. We conclude the following: (i) that expression of TGF-beta mRNA is unrelated to monocyte activation, (ii) that secretion of TGF-beta is induced by monocyte activation, and (iii) that cosecretion of TGF-beta and its monocyte/macrophage-derived binding protein may modulate growth factor action. In contrast, monocytic expression of other growth factor genes, such as the B chain of platelet-derived growth factor, is not constitutive and requires activation.

Phorbol ester induces cultured endothelial cells to invade a fibrin matrix in the presence of fibrinolytic inhibitors

We have previously shown that the tumor promoter 4 beta-phorbol 12-myristate 13-acetate (PMA) induces capillary endothelial cells grown to confluency on the surface of three-dimensional collagen gels to invade the underlying matrix and to form capillary-like tubular structures, a phenomenon mimicking angiogenic processes that occur in vivo (Montesano and Orci: Cell, 42:469-477, 1985). Since angiogenesis frequently occurs within a fibrin-rich extracellular matrix, we have examined the ability of PMA-treated endothelial cells to invade fibrin gels. Control endothelial cells grown on fibrin gels formed a confluent monolayer on the gel surface and did not invade the underlying matrix. Treatment of the cultures with PMA resulted in a progressive lysis of the substrate without invasion of the fibrin matrix. However, if the cells were treated with PMA either in the presence of fibrinolytic inhibitors (Trasylol, epsilon-aminocaproic acid) or in the absence of detectable plasminogen, dissolution of the substrate was prevented, and the endothelial cells invaded the fibrin gel, forming vessel-like tubular structures similar to those previously observed with collagen gels. These results demonstrate that the invasive and morphogenetic events induced by PMA do not necessarily require an interaction between endothelial cells and collagen fibrils but can also occur with other biologically relevant substrata. They also suggest (1) that invasion may occur via a plasmin-independent mechanism and (2) that in vivo, neutralization of excess proteolytic activity may play an important permissive role in angiogenesis and other invasive processes by preventing uncontrolled matrix degradation.

Exaggerated spontaneous release of platelet-derived growth factor by alveolar macrophages from patients with idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis is a fibrotic lung disease characterized by an increased number of mesenchymal cells in the alveolar walls. Alveolar macrophages constitutively express low levels of c-sis, the protooncogene coding for the B chain of platelet-derived growth factor, a protein with chemotactic and mitogenic activity toward mesenchymal cells. We therefore hypothesized that alveolar macrophages in patients with idiopathic pulmonary fibrosis may release increased amounts of platelet-derived growth factor, which might help to explain the accumulation of mesenchymal cells and the fibrosis of the lower respiratory tract in the disease. Evaluation of alveolar macrophages recovered from the lungs of patients with idiopathic pulmonary fibrosis demonstrated that these cells spontaneously released four times more platelet-derived growth factor than did alveolar macrophages recovered from normal persons (P less than 0.01). That the platelet-derived growth factor molecules were potentially active was shown by their chemotactic activity for smooth-muscle cells and their ability to act as a "competence" factor for fibroblast growth. These observations suggest the possibility that the accumulation of mesenchymal cells within the alveolar walls in patients with idiopathic pulmonary fibrosis may result partly from the exaggerated release of the potent mitogen platelet-derived growth factor by mononuclear phagocytes in the lower respiratory tract.

Mechanism of fibroblast attachment to bone extracellular matrix: role of a 44 kilodalton bone phosphoprotein

While the exact mechanisms regulating bone homeostasis are unknown, it is generally accepted that factors with the capacity to regulate cell attachment and spreading play a role in osteogenesis. A 44 kDa bone phosphoprotein (44K BPP), isolated from rat bone and synthesized by osteoblasts, was evaluated for its role in attachment and spreading of fibroblasts. In uncoated plates, enhanced cell attachment and spreading were observed when fibroblasts were exposed to the 44K BPP. The attachment properties of the bone phosphoprotein are different from those of fibronectin, in that the 44K BPP did not promote cell attachment in type I collagen wells, as was seen with fibronectin. Also, 44K BPP continued to enhance cell attachment up to 24 h, whereas cell attachment declined in time with cells exposed to fibronectin. Cycloheximide did not alter 44K BPP promotion of cell attachment, indicating that de novo protein synthesis was not required. These studies suggest that the 44K BPP is important in the regulation of cell attachment and spreading at sites of mineralization.

Antibacterial immunity and its modeling in experimental tumor tetanus and wound tetanus of the mouse

The experimental and theoretical analysis of the tumor-tetanus phenomenon has provided us with new insights into the pathogenesis of tetanus infection. Our theoretical model of clostridial propagation in the proliferating tissue is based upon the principle of mitosis-controlled rod division (hit and cloning model). It has lent itself to the description of early growth stages of the clostridial rod population in our experiments of tumor tetanus and of wound tetanus of the mouse. However, the later course of the tetanus lethality curves under antitoxin protection, about a week following injection of the tumor cell-spore or CaCl2-spore suspensions, reveals a pronounced delay in clostridial propagation. Based on our model we can explain this process by a humoral immune reaction directed against the clostridial rods taking into account the variability of elimination of the heterologous tetanus antitoxin applied. The experimental results are in good agreement with those obtained by computer simulation. The theoretical knowledge resulting from these studies can be used for the interpretation of the serodiagnostic tumor test with apathogenic clostridia as well as for the quantitative assessment of the malignancy of neoplastic growth.

Platelet-derived growth factor stimulates phagocytosis and blocks agonist-induced activation of the neutrophil oxidative burst: a possible cellular mechanism to protect against oxygen radical damage

The effect of platelet-derived growth factor (PDGF) on agonist-induced activation of the superoxide-generating oxidative burst in human neutrophils was tested. PDGF had no effect on the resting level of superoxide generation but inhibited both the rate and the extent of fMet-Leu-Phe-stimulated superoxide production in a dose-dependent manner. The concentration required to inhibit the response by 50% was 95 +/- 26 pM (n = 10). PDGF also blocked activation by other receptor-mediated agonists such as the complement protein C5a and opsonized zymosan, but not by phorbol myristate acetate or arachidonate, both of which may act at postreceptor sites. The growth factor, however, had no effect on the binding of fMet-Leu-Phe to its receptor. PDGF in concentrations that blocked the oxidative burst stimulated phagocytosis of opsonized latex particles. Thus, PDGF functions as a heterologous "down-regulator" of receptor-mediated activation of the neutrophil oxidative burst and an activator of phagocytosis. A model for a feedback regulatory loop between platelets and neutrophils is proposed.

Identification of a protein in sera of normal humans that inhibits fibroblast chemotactic and random migration in vitro

Normal human serum contains a 230,000 Mr protein that inhibits fibroblast chemotactic and random migration. This serum inhibitor of fibroblast migration (SIFM) is a heat-stable, trypsin-sensitive protein with a pI of 4.8 that reversibly inhibits the random and chemotactic migration of fibroblasts in vitro. Although SIFM effectively inhibits the chemotaxis of fibroblasts to interstitial collagens, fibronectin, lymphocyte-derived chemotactic factor for fibroblasts, and serum-derived chemotactic factor, it does not alter the chemotactic migration of human peripheral blood neutrophils or monocytes, and does not act as a cytotoxin to human dermal fibroblasts. The SIFM appears to act through a cell-directed mechanism to alter the fibroblast's ability to migrate. Serum inhibitor of fibroblast migration may function in vivo to modulate fibroblast migration under physiologic and pathologic conditions.

Theoretical and experimental prerequisites of fibrous activated carbon AUVM "Dnepr"MN applications in healing of wounds and burns

Physico-chemical and biological properties of fibrous activated carbons AUVM "Dnepr" MN are examined. These properties turn them into a promising application material for wounds and burns. The experiments in rabbits with a model musculocutaneous hip wound have shown that an early AUVM application prevents the development of traumatic edema, contributes to rapid and uncomplicated wound healing, while in the control group the complications occur in 80% of the animals with a 30% lethality. The therapeutic AUVM effect is associated with the ability of these materials to rapidly sorb and eliminate inflammation-inducing mediators as well as the protective properties of the AUVM against secondary wound infections.

Wound healing properties of cimetidine in vitro

Cimetidine was one of a variety of drugs frequently given to surgical patients perioperatively tested for their effect on gap closure of wounded monolayers of human fascia cells in vitro. Cimetidine-treated cultures closed faster and had greater cell proliferation than controls. Closure of cimetidine-treated cultures occurred at six hours compared to ten hours in controls. Cimetidine concentrations of 1000 micrograms/ml resulted in 13.5 +/- 0.67 (SEM) X 10(4) cells/cm2 at six hours compared to 7.9 +/- 0.48 X 10(4) cells/cm2 in controls (p less than 0.05); the area covered by cells was 6.5 +/- 0.02 mm2 in treated cultures compared to 3.0 +/- 0.01 mm2 in controls (p less than 0.05). It is concluded that cimetidine stimulates fibroblast proliferation in vitro.

Basic mechanisms in the healing cutaneous wound

The process of wound healing can be divided into substrate, proliferative, and remodeling phases. The basic biologic and physiologic events which transpire during these stages are examined in detail. Particular emphasis is placed on the interactions between platelets, macrophages, and other inflammatory cells, and fibroblasts in the healing wound. Recent advances in the roles played by interleukins, fibronectin, and epidermal growth factor are discussed.

Transforming growth factor-beta: biological function and chemical structure

Transforming growth factor-beta (TGF-beta) is a multifunctional peptide that controls proliferation, differentiation, and other functions in many cell types. Many cells synthesize TGF-beta and essentially all of them have specific receptors for this peptide. TGF-beta regulates the actions of many other peptide growth factors and determines a positive or negative direction of their effects. Its marked ability to enhance formation of connective tissue in vivo suggests several therapeutic applications.

Cytodifferentiation and tissue phenotype change during transformation of embryonic lens epithelium to mesenchyme-like cells in vitro

A number of adult and embryonic epithelia, when suspended within native type I collagen gels, give rise to elongate bipolar cells that migrate freely within the three-dimensional matrix. The morphology of these newly formed mesenchyme-like cells is indistinguishable from "true" mesenchymal cells at the light and ultrastructural level. In this report, we extend previous observations on the transformation of embryonic avian lens epithelium to mesenchyme-like cells. Lens epithelia, dissected from 12-day chick embryos, were cultured either within a collagen matrix or on a two-dimensional surface. Cells derived from explants on the surface of type I collagen express the epithelial phenotype. The cells form new basal lamina, continue to express delta-crystallin protein and secrete both type IV collagen and laminin. In contrast, epithelia suspended within collagen gels lose epithelial morphology, phenotype, and cytodifferentiation. The newly formed mesenchyme-like cells lack the ability to synthesize lens-specific delta-crystallin protein, type IV collagen, and laminin. They do, however, express type I collagen de novo, a characteristic of mesenchymal cells. The changes in cytodifferentiation and tissue phenotype which occur during the transformation are stable under the conditions studied here. When mesenchyme-like cells are removed from the gel and replated onto two-dimensional surfaces, they remain bipolar, will invade collagen matrices, and are unable to synthesize delta-crystallin protein.

Production of transforming growth factor beta by human T lymphocytes and its potential role in the regulation of T cell growth

This study examines the potential role of transforming growth factor beta (TGF-beta) in the regulation of human T lymphocyte proliferation, and proposes that TGF-beta is an important autoregulatory lymphokine that limits T lymphocyte clonal expansion, and that TGF-beta production by T lymphocytes is important in T cell interactions with other cell types. TGF-beta was shown to inhibit IL-2-dependent T cell proliferation. The addition of picograms amounts of TGF-beta to cultures of IL-2-stimulated human T lymphocytes suppressed DNA synthesis by 60-80%. A potential mechanism of this inhibition was found. TGF-beta inhibited IL-2-induced upregulation of the IL-2 and transferrin receptors. Specific high-affinity receptors for TGF-beta were found both on resting and activated T cells. Cellular activation was shown to result in a five- to sixfold increase in the number of TGF-beta receptors on a per cell basis, without a change in the affinity of the receptor. Finally, the observations that activated T cells produce TGF-beta mRNA and that TGF-beta biologic activity is present in supernatants conditioned by activated T cells is strong evidence that T cells themselves are a source of TGF-beta. Resting T cells were found to have low to undetectable levels of TGF-beta mRNA, while PHA activation resulted in a rapid increase in TGF-beta mRNA levels (within 2 h). Both T4 and T8 lymphocytes were found to make mRNA for TGF-beta upon activation. Using both a soft agar assay and a competitive binding assay, TGF-beta biologic activity was found in supernatants conditioned by T cells; T cell activation resulted in a 10-50-fold increase in TGF-beta production. Thus, TGF-beta may be an important antigen-nonspecific regulator of human T cell proliferation, and important in T cell interaction with other cell types whose cellular functions are modulated by TGF-beta.

Comparative evaluation of the effects of ultrasonic and ultraviolet irradiation on tissue regeneration

Twenty rabbits were divided into two matching groups. Holes of 1 cm2 area were bored through the full thickness of the pinna of both ears in each rabbit. In group I, the right ears were irradiated with pulsed ultrasound three times/week for 18 weeks. In group II, the right ears were irradiated with ultraviolet rays using a hot quartz lamp, three times/week for 18 weeks. The left ears in all rabbits were not irradiated and acted as controls. The rate of wound healing was calculated in terms of decrease in surface area of the wounds measured with a planimeter from enlarged photographs taken from the wound edges at the end of third, fifth and seventh weeks. The results revealed that ultrasound has a better effect on promotion of tissue regeneration than ultraviolet irradiation, as evidenced by both reduction in the surface area of wounds and by histopathological examination.

Attenuation of pulmonary fibrosis in mice by aminophylline

Cyclic nucleotides have been shown in vitro to regulate fibroblast proliferation and/or collagen production. We have reported previously that propranolol, which decreases the cAMP/cGMP ratio, potentiates the amount of fibrosis produced in a damaged lung. The purpose of this study was to determine if elevations in the cAMP/cGMP ratio may attenuate collagen production by fibroblasts following lung damage. Lung injury was induced in mice by either butylated hydroxytoluene (BHT) (350 or 400 mg/kg intraperitoneally) or bleomycin (4 units/kg intratracheally). The mice were treated with a phosphodiesterase inhibitor, aminophylline (20 mg/kg twice daily), prior to induction of lung injury and for the duration of the study. Cyclic nucleotide changes in the lung were also determined during lung injury, with and without aminophylline. The administration of aminophylline, which increased the cAMP/cGMP ratio, resulted in attenuation of the increase in total lung collagen normally seen after injury, while having no effect on collagen levels in the undamaged lung. The results are compatible with the hypothesis that elevation of whole lung cAMP/cGMP ratio early in the damage and repair process correlates with decreased hydroxyproline deposition.

Modulation of fibroblast-induced clot retraction by calcium channel blocking drugs and the monoclonal antibody ALB6

Suspensions of living human fibroblast induce fibrin clot retractile activity (FCR). The efficiency is dependent on the growth phase; it is maximal during active growth and reduced in post-confluent cultures. In contrast human osteosarcoma cells constantly exhibit very low FCR efficiency. Two different calcium channel-blocking drugs Diltiazem and Verapamil inhibit, depending on the concentrations employed, FCR, and spreading within the clots of the normal cells. Intermediate FCR levels are associated with intermediate degrees of spreading. A similar dose dependent inhibition is also obtained by treating the normal cells with the calmodulin inhibitor trifluoperazine (TFP). On the other hand, treatment of the normal cells with the monoclonal antibody ALB6 which is directed at the human leukocyte differentiation antigen CD9 (p24) causes a significant increase in the FCR efficiency in post-confluent normal cells, but it has no effect on the Te85 osteosarcoma cells. Moreover ALB6 IgG reverses the FCR inhibitory effect of the calcium-channel blocking drugs but not that of TFP. This means that the ALB6 IgG target on the cellular membrane is probably the same as that of the two drugs and that ALB6 IgG is active in the regulation of the calcium flux which controls fibrin clot retractile activity of normal human fibroblasts.

Collagen fiber formation in repair tissue: development of strength and toughness

Dermal repair tissue shows a progressive increase in collagen content which may be related to the wound tensile strength. Wound strength and extensibility are lower than those found in normal skin. In animals, wounds closed by metal clips are chosen as a model to study the proliferative and remodeling phases of healing from a mechanical and morphological point of view. During the proliferative phase the low wound strength is associated with formation of collagen fibers of small diameter, later, (days 28-45) an acute change appears corresponding to the remodeling phase, with increased collagen fiber diameters observed by scanning electron microscopy and light microscopy, and increased tensile strength and toughness. By 180 days, wound strength and collagen fiber morphology were close to that observed in the normal skin. These observations show a direct relationship between collagen fiber diameter and tensile strength. In addition, packing density of collagen fibrils (determined by the birefringence retardation per unit thickness under polarized light) was unchanged until day 90, although collagen fiber diameters increased during this time.

A significant part of macrophage-derived growth factor consists of at least two forms of PDGF

The macrophage has been suggested to be responsible for the connective tissue cell proliferation that accompanies most chronic inflammatory responses. One of the secretory products of activated macrophages is MDGF, a growth factor (or factors) for fibroblasts, 3T3 cells, smooth muscle, and vascular endothelium. This report demonstrates that a significant portion of the mitogenic activity for 3T3 cells secreted by cultured human alveolar and peritoneal macrophages is due to a molecule (or molecules) similar to platelet-derived growth factor (PDGF). Two size classes (approximately 37,000-39,000 and 12,000-17,000 daltons) of mitogenically active PDGF-like molecules are detected by two criteria--antigenic similarity with PDGF and ability to compete with 125I-PDGF for high-affinity binding to the PDGF receptor. The presence of mRNA for the B chain of PDGF is demonstrated by Northern analysis, and de novo synthesis of these molecules by activated macrophages is shown by immunoprecipitation of 35S-labeled proteins with anti-PDGF IgG.

Natural history of fibrocellular epiretinal membranes: a quantitative, autoradiographic, and immunohistochemical study

Quantitative, autoradiographic, or immunohistochemical light microscopy was conducted on 85 surgically excised epiretinal membranes to investigate the activities of component cells and the natural history of the extraretinal scars. Membranes of less than four months' clinical duration ('early' membranes) contained significantly more cells than 'late' membranes, while collagen was more abundant in the older specimens. No correlation was established between membrane opacification and either the cellularity or the collagen content of the membranes. Epiretinal membranes had some features in common with healing skin wounds, but the activities of cells in the epiretinal membranes were relatively protracted and disordered. Fibronectin was found to be a significant component of epiretinal membranes and therefore represents a target at which pharmacological intervention could be aimed.

Nerve growth factor accelerates the early cellular events associated with wound healing

The effects of injecting nerve growth factor (NGF) into subdermal air sacs on the backs of mice was studied. Sequential infiltration of cells into the lining of the sacs was observed. The initial cell type to infiltrate was the polymorphonuclear leukocyte, followed by highly vacuolated mononuclear cells, and then by fibroblast-like cells. This resembles the classical pattern of cellular responses during the normal process of wound healing. The kinetics for the peak accumulation of each cell type were dependent upon the concentration of NGF injected, and significant acceleration of infiltration of each cell type was observed with as little as 1 nM NGF. A similar acceleration of cellular infiltration was observed when mice were injected with the synthetic chemotactic peptide n-formyl-methionyl-leucyl-phenylalanine. This finding suggests that application of any chemotactic factor to wound sites may lead to accelerated tissue repair and an enhanced rate of wound contraction. The observation that NGF can act as a chemotactic factor in vivo may explain its ability to accelerate the healing of experimentally induced wounds in mice.