1851
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Catrina SB, Zheng X. Disturbed hypoxic responses as a pathogenic mechanism of diabetic foot ulcers. Diabetes Metab Res Rev 2016; 32 Suppl 1:179-85. [PMID: 26453314 DOI: 10.1002/dmrr.2742] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 07/15/2015] [Accepted: 09/20/2015] [Indexed: 12/24/2022]
Abstract
Diabetic foot ulceration (DFU) is a chronic complication of diabetes that is characterized by impaired wound healing in the lower extremities. DFU remains a major clinical challenge because of poor understanding of its pathogenic mechanisms. Impaired wound healing in diabetes is characterized by decreased angiogenesis, reduced bone marrow-derived endothelial progenitor cell (EPC) recruitment, and decreased fibroblast and keratinocyte proliferation and migration. Recently, increasing evidence has suggested that increased hypoxic conditions and impaired cellular responses to hypoxia are essential pathogenic factors of delayed wound healing in DFU. Hypoxia-inducible factor-1 (HIF-1, a heterodimer of HIF-1α and HIF-1β) is a master regulator of oxygen homeostasis that mediates the adaptive cellular responses to hypoxia by regulating the expression of genes involved in angiogenesis, metabolic changes, proliferation, migration, and cell survival. However, HIF-1 signalling is inhibited in diabetes as a result of hyperglycaemia-induced HIF-1α destabilization and functional repression. Increasing HIF-1α expression and activity using various approaches promotes angiogenesis, EPC recruitment, and granulation, thereby improving wound healing in experimental diabetes. The mechanisms underlying HIF-1α regulation in diabetes and the therapeutic strategies targeting HIF-1 signalling for the treatment of diabetic wounds are discussed in this review. Further investigations of the pathways involved in HIF-1α regulation in diabetes are required to advance our understanding of the mechanisms underlying impaired wound healing in diabetes and to provide a foundation for developing novel therapeutic approaches to treat DFU.
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Affiliation(s)
- Sergiu-Bogdan Catrina
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Xiaowei Zheng
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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1852
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Clark RM, Coffman B, McGuire PG, Howdieshell TR. Myocutaneous revascularization following graded ischemia in lean and obese mice. Diabetes Metab Syndr Obes 2016; 9:325-336. [PMID: 27757044 PMCID: PMC5053374 DOI: 10.2147/dmso.s117793] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Murine models of diabetes and obesity have provided insight into the pathogenesis of impaired epithelialization of excisional skin wounds. However, knowledge of postischemic myocutaneous revascularization in these models is limited. MATERIALS AND METHODS A myocutaneous flap was created on the dorsum of wild type (C57BL/6), genetically obese and diabetic (ob/ob, db/db), complementary heterozygous (ob+/ob-, db+/db-), and diet-induced obese (DIO) mice (n=48 total; five operative mice per strain and three unoperated mice per strain as controls). Flap perfusion was documented by laser speckle contrast imaging. Local gene expression in control and postoperative flap tissue specimens was determined by quantitative reverse transcription polymerase chain reaction (RT-PCR). Image analysis of immunochemically stained histologic sections confirmed microvascular density and macrophage presence. RESULTS Day 10 planimetric analysis revealed mean flap surface area necrosis values of 10.8%, 12.9%, 9.9%, 0.4%, 1.4%, and 23.0% for wild type, db+/db-, ob+/ob-, db/db, ob/ob, and DIO flaps, respectively. Over 10 days, laser speckle imaging documented increased perfusion at all time points with revascularization to supranormal perfusion in db/db and ob/ob flaps. In contrast, wild type, heterozygous, and DIO flaps displayed expected graded ischemia with failure of perfusion to return to baseline values. RT-PCR demonstrated statistically significant differences in angiogenic gene expression between lean and obese mice at baseline (unoperated) and at day 10. CONCLUSION Unexpected increased baseline skin perfusion and augmented myocutaneous revascularization accompanied by a control proangiogenic transcriptional signature in genetically obese mice compared to DIO and lean mice are reported. In future research, laser speckle imaging has been planned to be utilized in order to correlate spatiotemporal wound reperfusion with changes in cell recruitment and gene expression to better understand the differences in wound microvascular biology in lean and obese states.
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Affiliation(s)
| | | | - Paul G McGuire
- Department of Cell Biology and Vascular Physiology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Thomas R Howdieshell
- Department of Surgery
- Department of Cell Biology and Vascular Physiology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
- Correspondence: Thomas R Howdieshell, Department of Surgery, MSC10-5610, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA, Tel +1 505 272 6441, Fax +1 505 272 0432, Email
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1853
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1854
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BOLKENT Ş, ÖZTAY F, GEZGİNCİ OKTAYOĞLU S, SANCAR BAŞ S, KARATUĞ A. A matter of regeneration and repair: caspases as the key molecules. Turk J Biol 2016. [DOI: 10.3906/biy-1507-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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1855
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Naska S, Yuzwa SA, Johnston APW, Paul S, Smith KM, Paris M, Sefton MV, Datti A, Miller FD, Kaplan DR. Identification of Drugs that Regulate Dermal Stem Cells and Enhance Skin Repair. Stem Cell Reports 2015; 6:74-84. [PMID: 26724904 PMCID: PMC4719140 DOI: 10.1016/j.stemcr.2015.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 12/01/2015] [Accepted: 12/01/2015] [Indexed: 01/24/2023] Open
Abstract
Here, we asked whether we could identify pharmacological agents that enhance endogenous stem cell function to promote skin repair, focusing on skin-derived precursors (SKPs), a dermal precursor cell population. Libraries of compounds already used in humans were screened for their ability to enhance the self-renewal of human and rodent SKPs. We identified and validated five such compounds, and showed that two of them, alprostadil and trimebutine maleate, enhanced the repair of full thickness skin wounds in middle-aged mice. Moreover, SKPs isolated from drug-treated skin displayed long-term increases in self-renewal when cultured in basal growth medium without drugs. Both alprostadil and trimebutine maleate likely mediated increases in SKP self-renewal by moderate hyperactivation of the MEK-ERK pathway. These findings identify candidates for potential clinical use in human skin repair, and provide support for the idea that pharmacological activation of endogenous tissue precursors represents a viable therapeutic strategy. Small-molecule screens identify compounds that enhance SKP self-renewal Alprostadil and trimebutine maleate both increase SKP self-renewal Both compounds likely act by promoting activation of the MEK-ERK pathway Both compounds activated dermal precursors in vivo to enhance wound healing
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Affiliation(s)
- Sibel Naska
- Program in Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Scott A Yuzwa
- Program in Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Adam P W Johnston
- Program in Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Smitha Paul
- Program in Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Kristen M Smith
- Program in Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Maryline Paris
- Program in Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Michael V Sefton
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON M5G 1X5, Canada
| | - Alessandro Datti
- S.M.A.R.T. Laboratory for High-Throughput Screening Programs, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; Department of Agricultural, Food, and Environmental Sciences, University of Perugia, 06121 Perugia, Italy
| | - Freda D Miller
- Program in Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5G 1X5, Canada; Department of Physiology, University of Toronto, Toronto, ON M5G 1X5, Canada.
| | - David R Kaplan
- Program in Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5G 1X5, Canada.
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1856
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Cremers NAJ, Suttorp M, Gerritsen MM, Wong RJ, van Run-van Breda C, van Dam GM, Brouwer KM, Kuijpers-Jagtman AM, Carels CEL, Lundvig DMS, Wagener FADTG. Mechanical Stress Changes the Complex Interplay Between HO-1, Inflammation and Fibrosis, During Excisional Wound Repair. Front Med (Lausanne) 2015; 2:86. [PMID: 26697429 PMCID: PMC4678194 DOI: 10.3389/fmed.2015.00086] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 11/24/2015] [Indexed: 01/11/2023] Open
Abstract
Mechanical stress following surgery or injury can promote pathological wound healing and fibrosis, and lead to functional loss and esthetic problems. Splinted excisional wounds can be used as a model for inducing mechanical stress. The cytoprotective enzyme heme oxygenase-1 (HO-1) is thought to orchestrate the defense against inflammatory and oxidative insults that drive fibrosis. Here, we investigated the activation of the HO-1 system in a splinted and non-splinted full-thickness excisional wound model using HO-1-luc transgenic mice. Effects of splinting on wound closure, HO-1 promoter activity, and markers of inflammation and fibrosis were assessed. After seven days, splinted wounds were more than three times larger than non-splinted wounds, demonstrating a delay in wound closure. HO-1 promoter activity rapidly decreased following removal of the (epi)dermis, but was induced in both splinted and non-splinted wounds during skin repair. Splinting induced more HO-1 gene expression in 7-day wounds; however, HO-1 protein expression remained lower in the epidermis, likely due to lower numbers of keratinocytes in the re-epithelialization tissue. Higher numbers of F4/80-positive macrophages, αSMA-positive myofibroblasts, and increased levels of the inflammatory genes IL-1β, TNF-α, and COX-2 were present in 7-day splinted wounds. Surprisingly, mRNA expression of newly formed collagen (type III) was lower in 7-day wounds after splinting, whereas, VEGF and MMP-9 were increased. In summary, these data demonstrate that splinting delays cutaneous wound closure and HO-1 protein induction. The pro-inflammatory environment following splinting may facilitate higher myofibroblast numbers and increase the risk of fibrosis and scar formation. Therefore, inducing HO-1 activity against mechanical stress-induced inflammation and fibrosis may be an interesting strategy to prevent negative effects of surgery on growth and function in patients with orofacial clefts or in patients with burns.
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Affiliation(s)
- Niels A J Cremers
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences , Nijmegen , Netherlands ; Experimental Rheumatology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences , Nijmegen , Netherlands
| | - Maarten Suttorp
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences , Nijmegen , Netherlands
| | - Marlous M Gerritsen
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences , Nijmegen , Netherlands
| | - Ronald J Wong
- Department of Pediatrics, Stanford University School of Medicine , Stanford, CA , USA
| | - Coby van Run-van Breda
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences , Nijmegen , Netherlands
| | - Gooitzen M van Dam
- Department of Surgery, University Medical Center Groningen , Groningen , Netherlands
| | - Katrien M Brouwer
- Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, MOVE Research Institute Amsterdam , Amsterdam , Netherlands ; Association of Dutch Burn Centers , Beverwijk , Netherlands
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics and Craniofacial Biology, Cleft Palate Craniofacial Center, Radboud University Medical Center , Nijmegen , Netherlands
| | - Carine E L Carels
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences , Nijmegen , Netherlands
| | - Ditte M S Lundvig
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences , Nijmegen , Netherlands
| | - Frank A D T G Wagener
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences , Nijmegen , Netherlands
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1857
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Abstract
Organ and tissue loss through disease and injury motivate the development of therapies that can regenerate tissues and decrease reliance on transplantations. Regenerative medicine, an interdisciplinary field that applies engineering and life science principles to promote regeneration, can potentially restore diseased and injured tissues and whole organs. Since the inception of the field several decades ago, a number of regenerative medicine therapies, including those designed for wound healing and orthopedics applications, have received Food and Drug Administration (FDA) approval and are now commercially available. These therapies and other regenerative medicine approaches currently being studied in preclinical and clinical settings will be covered in this review. Specifically, developments in fabricating sophisticated grafts and tissue mimics and technologies for integrating grafts with host vasculature will be discussed. Enhancing the intrinsic regenerative capacity of the host by altering its environment, whether with cell injections or immune modulation, will be addressed, as well as methods for exploiting recently developed cell sources. Finally, we propose directions for current and future regenerative medicine therapies.
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Affiliation(s)
- Angelo S Mao
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138; Wyss Institute for Biologically Inspired Engineering at Harvard University, Cambridge, MA 02138
| | - David J Mooney
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138; Wyss Institute for Biologically Inspired Engineering at Harvard University, Cambridge, MA 02138
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1858
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Abstract
Complex spatiotemporal interaction of Rho GTPases with microtubules (MTs) and MT-associated proteins drives directed cellular migration. In this issue, Charafeddine et al. describe a role for a novel MT-severing enzyme, fidgetin-like 2 (FL2), in directional migration of keratinocytes and fibroblasts. FL2 normally localizes to the leading edge of the cell cortex where it shears MTs, thus dictating the size and distribution of focal adhesions by regulating cytoskeletal remodeling. Small interfering RNA (siRNA)-directed knockdown of FL2 increases cell migration and focal adhesion area in vitro through possible interaction with Rho GTPases. Efficient FL2 knockdown in murine wounds was achieved using nanoparticles as a siRNA delivery vehicle, and this resulted in enhanced wound closure in vivo. Effective siRNA nanoparticle targeting of MT-severing enzymes offers promise of controlled and targeted delivery that may maximize therapeutic success for patients with burn wounds and chronic wound disorders.
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1859
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Käser SA, Mattiello D, Maurer CA. Distant Metastasis in Colorectal Cancer is a Risk Factor for Anastomotic Leakage. Ann Surg Oncol 2015; 23:888-93. [PMID: 26567149 DOI: 10.1245/s10434-015-4941-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Indexed: 12/17/2022]
Abstract
PURPOSE The aim of this study was to investigate whether metastatic colorectal cancer (Union for International Cancer Control stage IV disease) represents a risk factor for anastomotic leakage after colorectal surgery without major hepatic resection. METHODS This retrospective cohort study was based on an existing prospective colorectal database of all consecutive colorectal resections undertaken at the authors' institution from July 2002 to July 2012 (n = 2104). All patients with colorectal resection and primary anastomosis for colorectal cancer were identified (n = 500). A temporary loop ileostomy was constructed in low rectal anastomosis up to 6 cm from the anal verge (n = 128 cases, 26%). A routine contrast enema was undertaken at the occasion of other prospective studies in 254 patients. UICC stage IV disease was present in 94 patients (19%), while 406 patients (81%) had UICC stage I-III disease. RESULTS The overall anastomotic leak rate was 2.6% (13/500), 2.2% (11/500) for both clinical and radiological leaks, and 0.8% (2/254) for radiological leaks only. Four were managed conservatively and nine (1.8%) required revision laparotomy. In the case of UICC stage IV disease, the anastomotic leak rate was 6.3% (6/94), while in the case of UICC stage I-III disease the leak rate was 1.7% (7/406). UICC stage IV disease [odds ratio (OR) 4.4, 95% confidence interval (CI) 1.3-14.4; p = 0.015] and diabetes (OR 5.7, 95% CI 1.7-18.7; p = 0.004) were independent risk factors for anastomotic leakage after colorectal surgery. CONCLUSIONS Patients with stage IV colorectal cancer have an increased anastomotic leak rate after colorectal surgery. Whether this is due to an impaired immune system remains speculative.
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Affiliation(s)
- Samuel A Käser
- Department of General, Visceral, Vascular, and Thoracic Surgery, Hospital of Baselland, Liestal, Switzerland
| | - Diana Mattiello
- Department of General, Visceral, Vascular, and Thoracic Surgery, Hospital of Baselland, Liestal, Switzerland
| | - Christoph A Maurer
- Department of General, Visceral, Vascular, and Thoracic Surgery, Hospital of Baselland, Liestal, Switzerland. .,Hirslanden Private Clinic Group, Beausite, Schänzlistrasse 11, Bern, Switzerland.
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1860
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Nunan R, Campbell J, Mori R, Pitulescu ME, Jiang WG, Harding KG, Adams RH, Nobes CD, Martin P. Ephrin-Bs Drive Junctional Downregulation and Actin Stress Fiber Disassembly to Enable Wound Re-epithelialization. Cell Rep 2015; 13:1380-1395. [PMID: 26549443 PMCID: PMC4660216 DOI: 10.1016/j.celrep.2015.09.085] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 08/12/2015] [Accepted: 09/30/2015] [Indexed: 12/21/2022] Open
Abstract
For a skin wound to successfully heal, the cut epidermal-edge cells have to migrate forward at the interface between scab and healthy granulation tissue. Much is known about how lead-edge cells migrate, but very little is known about the mechanisms that enable active participation by cells further back. Here we show that ephrin-B1 and its receptor EphB2 are both upregulated in vivo, just for the duration of repair, in the first 70 or so rows of epidermal cells, and this signal leads to downregulation of the molecular components of adherens and tight (but not desmosomal) junctions, leading to loosening between neighbors and enabling shuffle room among epidermal cells. Additionally, this signaling leads to the shutdown of actomyosin stress fibers in these same epidermal cells, which may act to release tension within the wound monolayer. If this signaling axis is perturbed, then disrupted healing is a consequence in mouse and man. Ephrin-B/EphBs are upregulated in the migrating wound epidermis in mouse and man Ephrin-B/EphB signaling drives junction loosening, thus enabling re-epithelialization Ephrin-B/EphB signaling also leads to dissolution of stress fibers and tension release In human chronic wounds ephrin-Bs are misregulated and may be a therapeutic target
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Affiliation(s)
- Robert Nunan
- Schools of Biochemistry and Physiology & Pharmacology, University of Bristol, Bristol BS8 1TD, UK
| | - Jessica Campbell
- Schools of Biochemistry and Physiology & Pharmacology, University of Bristol, Bristol BS8 1TD, UK
| | - Ryoichi Mori
- Schools of Biochemistry and Physiology & Pharmacology, University of Bristol, Bristol BS8 1TD, UK; Department of Pathology, Nagasaki University, Nagasaki 852-8523, Japan
| | - Mara E Pitulescu
- Max Planck Institute for Molecular Biomedicine, 48149 Muenster, Germany; Faculty of Medicine, University of Muenster, 48149 Muenster, Germany
| | - Wen G Jiang
- School of Medicine, Cardiff University, Cardiff CF14 4XN, UK
| | - Keith G Harding
- School of Medicine, Cardiff University, Cardiff CF14 4XN, UK
| | - Ralf H Adams
- Max Planck Institute for Molecular Biomedicine, 48149 Muenster, Germany; Faculty of Medicine, University of Muenster, 48149 Muenster, Germany
| | - Catherine D Nobes
- Schools of Biochemistry and Physiology & Pharmacology, University of Bristol, Bristol BS8 1TD, UK
| | - Paul Martin
- Schools of Biochemistry and Physiology & Pharmacology, University of Bristol, Bristol BS8 1TD, UK; School of Medicine, Cardiff University, Cardiff CF14 4XN, UK.
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1861
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Chen L, Mirza R, Kwon Y, DiPietro LA, Koh TJ. The murine excisional wound model: Contraction revisited. Wound Repair Regen 2015; 23:874-7. [PMID: 26136050 DOI: 10.1111/wrr.12338] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 06/23/2015] [Indexed: 01/09/2023]
Abstract
Rodent models of healing are considered limited because of the perception that rodent wounds heal by contraction while humans heal by reepithelialization The purpose of this report is to present evidence that simple murine excisional wounds provide a valid and reproducible wound model that heals by both contraction and reepithelialization. Previous studies have shown that, although rodent wounds contract by up to 80%, much of this contraction occurs only after epithelial closure. To confirm these previous findings, we measured re-epithelialization and contraction in three separate mouse strains, (BALB/c, db/+, and db/db); reepithelialization and contraction each accounted for ∼40 to 60% of the initial closure of full thickness excisional wounds. After closure, the wound continues to contract and this provides the impression of dominant closure by contraction. In conclusion, the simple excisional rodent wound model produces a well defined and readily identifiable wound bed over which the process of reepithelialization is clearly measurable.
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Affiliation(s)
- Lin Chen
- Department of Periodontics, University of Illinois at Chicago, Chicago, Illinois.,Center for Wound Healing and Tissue Regeneration, University of Illinois at Chicago, Chicago, Illinois
| | - Rita Mirza
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| | - Young Kwon
- Department of Periodontics, University of Illinois at Chicago, Chicago, Illinois.,Center for Wound Healing and Tissue Regeneration, University of Illinois at Chicago, Chicago, Illinois
| | - Luisa A DiPietro
- Department of Periodontics, University of Illinois at Chicago, Chicago, Illinois.,Center for Wound Healing and Tissue Regeneration, University of Illinois at Chicago, Chicago, Illinois
| | - Timothy J Koh
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
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1862
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Ojeh N, Pastar I, Tomic-Canic M, Stojadinovic O. Stem Cells in Skin Regeneration, Wound Healing, and Their Clinical Applications. Int J Mol Sci 2015; 16:25476-501. [PMID: 26512657 PMCID: PMC4632811 DOI: 10.3390/ijms161025476] [Citation(s) in RCA: 178] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 10/15/2015] [Accepted: 10/20/2015] [Indexed: 12/18/2022] Open
Abstract
The skin is the largest organ of the body and has an array of functions. Skin compartments, epidermis, and hair follicles house stem cells that are indispensable for skin homeostasis and regeneration. These stem cells also contribute to wound repair, resulting in restoration of tissue integrity and function of damaged tissue. Unsuccessful wound healing processes often lead to non-healing wounds. Chronic wounds are caused by depletion of stem cells and a variety of other cellular and molecular mechanisms, many of which are still poorly understood. Current chronic wound therapies are limited, so the search to develop better therapeutic strategies is ongoing. Adult stem cells are gaining recognition as potential candidates for numerous skin pathologies. In this review, we will discuss epidermal and other stem cells present in the skin, and highlight some of the therapeutic applications of epidermal stem cells and other adult stem cells as tools for cell/scaffold-based therapies for non-healing wounds and other skin disorders. We will also discuss emerging concepts and offer some perspectives on how skin tissue-engineered products can be optimized to provide efficacious therapy in cutaneous repair and regeneration.
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Affiliation(s)
- Nkemcho Ojeh
- Faculty of Medical Sciences, the University of the West Indies, Cave Hill Campus, P.O. Box 64, Bridgetown BB 11000, St. Michael, Barbados; E-Mail:
| | - Irena Pastar
- Wound Healing and Regenerative Medicine Research Program, Department of Dermatology and Cutaneous Surgery, University of Miami Miller Medical School, 1600 NW 10th Avenue, RMSB, Room 2023-A, Miami, FL 33136, USA; E-Mails: (I.P.); (M.T.-C.)
| | - Marjana Tomic-Canic
- Wound Healing and Regenerative Medicine Research Program, Department of Dermatology and Cutaneous Surgery, University of Miami Miller Medical School, 1600 NW 10th Avenue, RMSB, Room 2023-A, Miami, FL 33136, USA; E-Mails: (I.P.); (M.T.-C.)
| | - Olivera Stojadinovic
- Wound Healing and Regenerative Medicine Research Program, Department of Dermatology and Cutaneous Surgery, University of Miami Miller Medical School, 1600 NW 10th Avenue, RMSB, Room 2023-A, Miami, FL 33136, USA; E-Mails: (I.P.); (M.T.-C.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-305-243-7295; Fax: +1-305-243-6191
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1863
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Järvinen TAH, May U, Prince S. Systemically Administered, Target Organ-Specific Therapies for Regenerative Medicine. Int J Mol Sci 2015; 16:23556-71. [PMID: 26437400 PMCID: PMC4632713 DOI: 10.3390/ijms161023556] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 09/17/2015] [Accepted: 09/22/2015] [Indexed: 12/12/2022] Open
Abstract
Growth factors and other agents that could potentially enhance tissue regeneration have been identified, but their therapeutic value in clinical medicine has been limited for reasons such as difficulty to maintain bioactivity of locally applied therapeutics in the protease-rich environment of regenerating tissues. Although human diseases are treated with systemically administered drugs in general, all current efforts aimed at enhancing tissue repair with biological drugs have been based on their local application. The systemic administration of growth factors has been ruled out due to concerns about their safety. These concerns are warranted. In addition, only a small proportion of systemically administered drugs reach their intended target. Selective delivery of the drug to the target tissue and use of functional protein domains capable of penetrating cells and tissues could alleviate these problems in certain circumstances. We will present in this review a novel approach utilizing unique molecular fingerprints (“Zip/postal codes”) in the vasculature of regenerating tissues that allows target organ-specific delivery of systemically administered therapeutic molecules by affinity-based physical targeting (using peptides or antibodies as an “address tag”) to injured tissues undergoing repair. The desired outcome of targeted therapies is increased local accumulation and lower systemic concentration of the therapeutic payload. We believe that the physical targeting of systemically administered therapeutic molecules could be rapidly adapted in the field of regenerative medicine.
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Affiliation(s)
- Tero A H Järvinen
- School of Medicine, University of Tampere, 33520 Tampere, Finland.
- Department of Orthopedics & Traumatology, Tampere University Hospital, 33520 Tampere, Finland.
| | - Ulrike May
- School of Medicine, University of Tampere, 33520 Tampere, Finland.
| | - Stuart Prince
- School of Medicine, University of Tampere, 33520 Tampere, Finland.
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1864
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In situ gel-forming AP-57 peptide delivery system for cutaneous wound healing. Int J Pharm 2015; 495:560-571. [PMID: 26363112 DOI: 10.1016/j.ijpharm.2015.09.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/07/2015] [Accepted: 09/07/2015] [Indexed: 02/05/2023]
Abstract
In situ gel-forming system as local drug delivery system in dermal traumas has generated a great interest. Accumulating evidence shows that antimicrobial peptides play pivotal roles in the process of wound healing. Here in this study, to explore the potential application of antimicrobial peptide in wound healing, biodegradable poly(L-lactic acid)-Pluronic L35-poly(L-lactic acid) (PLLA-L35-PLLA) was developed at first. Then based on this polymer, an injectable in situ gel-forming system composed of human antimicrobial peptides 57 (AP-57) loaded nanoparticles and thermosensitive hydrogel was prepared and applied for cutaneous wound healing. AP-57 peptides were enclosed with biocompatible nanoparticles (AP-57-NPs) with high drug loading and encapsulation efficiency. AP-57-NPs were further encapsulated in a thermosensitive hydrogel (AP-57-NPs-H) to facilitate its application in cutaneous wound repair. As a result, AP-57-NPs-H released AP-57 in an extended period and exhibited quite low cytotoxicity and high anti-oxidant activity in vitro. Moreover, AP-57-NPs-H was free-flowing liquid at room temperature, and can form non-flowing gel without any crosslink agent upon applied on the wounds. In vivo wound healing assay using full-thickness dermal defect model of SD rats indicated that AP-57-NPs-H could significantly promote wound healing. At day 14 after operation, AP-57-NPs-H treated group showed nearly complete wound closure of 96.78 ± 3.12%, whereas NS, NPs-H and AP-57-NPs group recovered by about 68.78 ± 4.93%, 81.96 ± 3.26% and 87.80 ± 4.62%, respectively. Histopathological examination suggested that AP-57-NPs-H could promote cutaneous wound healing through enhancing granulation tissue formation, increasing collagen deposition and promoting angiogenesis in the wound tissue. Therefore, AP-57-NPs-H might have potential application in wound healing.
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1865
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Ermolaeva MA, Dakhovnik A, Schumacher B. Quality control mechanisms in cellular and systemic DNA damage responses. Ageing Res Rev 2015; 23:3-11. [PMID: 25560147 DOI: 10.1016/j.arr.2014.12.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 12/21/2014] [Accepted: 12/23/2014] [Indexed: 11/30/2022]
Abstract
The maintenance of the genome is of pivotal importance for the functional integrity of cells and tissues. The gradual accumulation of DNA damage is thought to contribute to the functional decline of tissues and organs with ageing. Defects in multiple genome maintenance systems cause human disorders characterized by cancer susceptibility, developmental failure, and premature ageing. The complex pathological consequences of genome instability are insufficiently explained by cell-autonomous DNA damage responses (DDR) alone. Quality control pathways play an important role in DNA repair and cellular DDR pathways. Recent years have revealed non-cell autonomous effects of DNA damage that impact the physiological adaptations during ageing. We will discuss the role of quality assurance pathways in cell-autonomous and systemic responses to genome instability.
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Affiliation(s)
- Maria A Ermolaeva
- Institute for Genome Stability in Ageing and Disease, Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 26, 50931 Cologne, Germany; Cologne Excellence Cluster for Cellular Stress Responses in Ageing-Associated Diseases (CECAD) and Systems Biology of Ageing Cologne, University of Cologne, Joseph-Stelzmann-Str. 26, 50931 Cologne, Germany.
| | - Alexander Dakhovnik
- Institute for Genome Stability in Ageing and Disease, Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 26, 50931 Cologne, Germany; Cologne Excellence Cluster for Cellular Stress Responses in Ageing-Associated Diseases (CECAD) and Systems Biology of Ageing Cologne, University of Cologne, Joseph-Stelzmann-Str. 26, 50931 Cologne, Germany
| | - Björn Schumacher
- Institute for Genome Stability in Ageing and Disease, Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 26, 50931 Cologne, Germany; Cologne Excellence Cluster for Cellular Stress Responses in Ageing-Associated Diseases (CECAD) and Systems Biology of Ageing Cologne, University of Cologne, Joseph-Stelzmann-Str. 26, 50931 Cologne, Germany.
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1866
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Wound repair: role of immune-epithelial interactions. Mucosal Immunol 2015; 8:959-68. [PMID: 26174765 PMCID: PMC4916915 DOI: 10.1038/mi.2015.63] [Citation(s) in RCA: 190] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 05/28/2015] [Indexed: 02/07/2023]
Abstract
The epithelium serves as a highly selective barrier at mucosal surfaces. Upon injury, epithelial wound closure is orchestrated by a series of events that emanate from the epithelium itself as well as by the temporal recruitment of immune cells into the wound bed. Epithelial cells adjoining the wound flatten out, migrate, and proliferate to rapidly cover denuded surfaces and re-establish mucosal homeostasis. This process is highly regulated by proteins and lipids, proresolving mediators such as Annexin A1 protein and resolvins released into the epithelial milieu by the epithelium itself and infiltrating innate immune cells including neutrophils and macrophages. Failure to achieve these finely tuned processes is observed in chronic inflammatory diseases that are associated with non-healing wounds. An improved understanding of mechanisms that mediate repair is important in the development of therapeutics aimed to promote mucosal wound repair.
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1867
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Frykberg RG, Banks J. Challenges in the Treatment of Chronic Wounds. Adv Wound Care (New Rochelle) 2015; 4:560-582. [PMID: 26339534 PMCID: PMC4528992 DOI: 10.1089/wound.2015.0635] [Citation(s) in RCA: 1220] [Impact Index Per Article: 135.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 05/04/2015] [Indexed: 02/06/2023] Open
Abstract
Significance: Chronic wounds include, but are not limited, to diabetic foot ulcers, venous leg ulcers, and pressure ulcers. They are a challenge to wound care professionals and consume a great deal of healthcare resources around the globe. This review discusses the pathophysiology of complex chronic wounds and the means and modalities currently available to achieve healing in such patients. Recent Advances: Although often difficult to treat, an understanding of the underlying pathophysiology and specific attention toward managing these perturbations can often lead to successful healing. Critical Issues: Overcoming the factors that contribute to delayed healing are key components of a comprehensive approach to wound care and present the primary challenges to the treatment of chronic wounds. When wounds fail to achieve sufficient healing after 4 weeks of standard care, reassessment of underlying pathology and consideration of the need for advanced therapeutic agents should be undertaken. However, selection of an appropriate therapy is often not evidence based. Future Directions: Basic tenets of care need to be routinely followed, and a systematic evaluation of patients and their wounds will also facilitate appropriate care. Underlying pathologies, which result in the failure of these wounds to heal, differ among various types of chronic wounds. A better understanding of the differences between various types of chronic wounds at the molecular and cellular levels should improve our treatment approaches, leading to better healing rates, and facilitate the development of new more effective therapies. More evidence for the efficacy of current and future advanced wound therapies is required for their appropriate use.
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1868
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Gibbons GW. Grafix ®, a Cryopreserved Placental Membrane, for the Treatment of Chronic/Stalled Wounds. Adv Wound Care (New Rochelle) 2015; 4:534-544. [PMID: 26339532 PMCID: PMC4529022 DOI: 10.1089/wound.2015.0647] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 05/09/2015] [Indexed: 12/17/2022] Open
Abstract
Objective: To discuss the use of Grafix®, a commercially available, cryopreserved placental membrane, for the treatment of chronic/stalled wounds of different etiologies. Approach: To describe the unique composition of Grafix, to provide an overview of the existing clinical evidence supporting the benefits of Grafix for wound treatment, and to share the experience of the South Shore Hospital Center for Wound Healing (Weymouth, MA) with Grafix for the treatment of nonhealing wounds. Results: Clinical evidence supports the safety and efficacy of Grafix for the treatment of chronic/stalled wounds, including those that have failed other advanced treatment modalities. Innovation: Grafix is a cryopreserved placental membrane manufactured utilizing a novel technology that enables the preservation of all placental membrane components in their native state. Placental membranes have a unique composition of extracellular matrix, growth factors, and cells (including mesenchymal stem cells), which makes this tissue unique among other advanced biological wound treatment modalities. Conclusion: Clinical evidences support the benefits of Grafix for head-to-toe wound treatment.
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Affiliation(s)
- Gary W Gibbons
- South Shore Hospital Center for Wound Healing , Weymouth, Massachusetts
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1869
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Ramirez HA, Liang L, Pastar I, Rosa AM, Stojadinovic O, Zwick TG, Kirsner RS, Maione AG, Garlick JA, Tomic-Canic M. Comparative Genomic, MicroRNA, and Tissue Analyses Reveal Subtle Differences between Non-Diabetic and Diabetic Foot Skin. PLoS One 2015; 10:e0137133. [PMID: 26318001 PMCID: PMC4552836 DOI: 10.1371/journal.pone.0137133] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 08/12/2015] [Indexed: 12/24/2022] Open
Abstract
Diabetes Mellitus (DM) is a chronic, severe disease rapidly increasing in incidence and prevalence and is associated with numerous complications. Patients with DM are at high risk of developing diabetic foot ulcers (DFU) that often lead to lower limb amputations, long term disability, and a shortened lifespan. Despite this, the effects of DM on human foot skin biology are largely unknown. Thus, the focus of this study was to determine whether DM changes foot skin biology predisposing it for healing impairment and development of DFU. Foot skin samples were collected from 20 patients receiving corrective foot surgery and, using a combination of multiple molecular and cellular approaches, we performed comparative analyses of non-ulcerated non-neuropathic diabetic foot skin (DFS) and healthy non-diabetic foot skin (NFS). MicroRNA (miR) profiling of laser captured epidermis and primary dermal fibroblasts from both DFS and NFS samples identified 5 miRs de-regulated in the epidermis of DFS though none reached statistical significance. MiR-31-5p and miR-31-3p were most profoundly induced. Although none were significantly regulated in diabetic fibroblasts, miR-29c-3p showed a trend of up-regulation, which was confirmed by qPCR in a prospective set of 20 skin samples. Gene expression profiling of full thickness biopsies identified 36 de-regulated genes in DFS (>2 fold-change, unadjusted p-value ≤ 0.05). Of this group, three out of seven tested genes were confirmed by qPCR: SERPINB3 was up-regulated whereas OR2A4 and LGR5 were down-regulated in DFS. However no morphological differences in histology, collagen deposition, and number of blood vessels or lymphocytes were found. No difference in proliferative capacity was observed by quantification of Ki67 positive cells in epidermis. These findings suggest DM causes only subtle changes to foot skin. Since morphology, mRNA and miR levels were not affected in a major way, additional factors, such as neuropathy, vascular complications, or duration of DM, may further compromise tissue's healing ability leading to development of DFUs.
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Affiliation(s)
- Horacio A. Ramirez
- Human Genetics and Genomics Graduate Program in Biomedical Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America
- Wound Healing and Regenerative Medicine Research Program, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School Of Medicine, Miami, FL, United States of America
| | - Liang Liang
- Wound Healing and Regenerative Medicine Research Program, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School Of Medicine, Miami, FL, United States of America
| | - Irena Pastar
- Wound Healing and Regenerative Medicine Research Program, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School Of Medicine, Miami, FL, United States of America
| | - Ashley M. Rosa
- Wound Healing and Regenerative Medicine Research Program, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School Of Medicine, Miami, FL, United States of America
| | - Olivera Stojadinovic
- Wound Healing and Regenerative Medicine Research Program, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School Of Medicine, Miami, FL, United States of America
| | - Thomas G. Zwick
- University of Miami Hospital, UM Health System, Miami, FL, United States of America
| | - Robert S. Kirsner
- Wound Healing and Regenerative Medicine Research Program, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School Of Medicine, Miami, FL, United States of America
- University of Miami Hospital, UM Health System, Miami, FL, United States of America
| | - Anna G. Maione
- Cell, Molecular, Developmental Biology, Tufts University, Sackler School of Graduate Biomedical Sciences, Boston, MA, United States of America
- Department of Oral and Maxillofacial Pathology, Oral Medicine and Craniofacial Pain School of Dental Medicine, Tufts University, Boston, MA, United States of America
| | - Jonathan A. Garlick
- Cell, Molecular, Developmental Biology, Tufts University, Sackler School of Graduate Biomedical Sciences, Boston, MA, United States of America
- Department of Oral and Maxillofacial Pathology, Oral Medicine and Craniofacial Pain School of Dental Medicine, Tufts University, Boston, MA, United States of America
| | - Marjana Tomic-Canic
- Human Genetics and Genomics Graduate Program in Biomedical Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America
- Wound Healing and Regenerative Medicine Research Program, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School Of Medicine, Miami, FL, United States of America
- * E-mail:
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1870
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Basilico N, Magnetto C, D'Alessandro S, Panariti A, Rivolta I, Genova T, Khadjavi A, Gulino GR, Argenziano M, Soster M, Cavalli R, Giribaldi G, Guiot C, Prato M. Dextran-shelled oxygen-loaded nanodroplets reestablish a normoxia-like pro-angiogenic phenotype and behavior in hypoxic human dermal microvascular endothelium. Toxicol Appl Pharmacol 2015; 288:330-8. [PMID: 26276311 DOI: 10.1016/j.taap.2015.08.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 08/06/2015] [Accepted: 08/10/2015] [Indexed: 11/19/2022]
Abstract
In chronic wounds, hypoxia seriously undermines tissue repair processes by altering the balances between pro-angiogenic proteolytic enzymes (matrix metalloproteinases, MMPs) and their inhibitors (tissue inhibitors of metalloproteinases, TIMPs) released from surrounding cells. Recently, we have shown that in human monocytes hypoxia reduces MMP-9 and increases TIMP-1 without affecting TIMP-2 secretion, whereas in human keratinocytes it reduces MMP-2, MMP-9, and TIMP-2, without affecting TIMP-1 release. Provided that the phenotype of the cellular environment is better understood, chronic wounds might be targeted by new oxygenating compounds such as chitosan- or dextran-shelled and 2H,3H-decafluoropentane-cored oxygen-loaded nanodroplets (OLNs). Here, we investigated the effects of hypoxia and dextran-shelled OLNs on the pro-angiogenic phenotype and behavior of human dermal microvascular endothelium (HMEC-1 cell line), another cell population playing key roles during wound healing. Normoxic HMEC-1 constitutively released MMP-2, TIMP-1 and TIMP-2 proteins, but not MMP-9. Hypoxia enhanced MMP-2 and reduced TIMP-1 secretion, without affecting TIMP-2 levels, and compromised cell ability to migrate and invade the extracellular matrix. When taken up by HMEC-1, nontoxic OLNs abrogated the effects of hypoxia, restoring normoxic MMP/TIMP levels and promoting cell migration, matrix invasion, and formation of microvessels. These effects were specifically dependent on time-sustained oxygen diffusion from OLN core, since they were not achieved by oxygen-free nanodroplets or oxygen-saturated solution. Collectively, these data provide new information on the effects of hypoxia on dermal endothelium and support the hypothesis that OLNs might be used as effective adjuvant tools to promote chronic wound healing processes.
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Affiliation(s)
- Nicoletta Basilico
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università di Milano, via Pascal 36, 20133 Milano, Italy.
| | - Chiara Magnetto
- Istituto Nazionale di Ricerca Metrologica (INRIM), Strada delle Cacce, 91, 10135 Torino, Italy.
| | - Sarah D'Alessandro
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, via Pascal 36, 20133 Milano, Italy.
| | - Alice Panariti
- Dipartimento di Scienze della Salute, Università di Milano Bicocca, Via Cadore 48, 20900 Monza, Italy.
| | - Ilaria Rivolta
- Dipartimento di Scienze della Salute, Università di Milano Bicocca, Via Cadore 48, 20900 Monza, Italy.
| | - Tullio Genova
- Dipartimento di Scienze della Vita e Biologia dei Sistemi, Via Accademia Albertina 13, 10123 Torino, Italy.
| | - Amina Khadjavi
- Dipartimento di Neuroscienze, Università di Torino, Corso Raffaello 30, 10125 Torino, Italy.
| | - Giulia Rossana Gulino
- Dipartimento di Oncologia, Università di Torino, Via Santena 5 bis, 10126 Torino, Italy.
| | - Monica Argenziano
- Dipartimento di Scienza e Tecnologia del Farmaco, Università di Torino, Via Giuria, 9, 10125 Torino, Italy.
| | - Marco Soster
- Dipartimento di Scienza e Tecnologia del Farmaco, Università di Torino, Via Giuria, 9, 10125 Torino, Italy.
| | - Roberta Cavalli
- Dipartimento di Scienza e Tecnologia del Farmaco, Università di Torino, Via Giuria, 9, 10125 Torino, Italy.
| | - Giuliana Giribaldi
- Dipartimento di Oncologia, Università di Torino, Via Santena 5 bis, 10126 Torino, Italy.
| | - Caterina Guiot
- Dipartimento di Neuroscienze, Università di Torino, Corso Raffaello 30, 10125 Torino, Italy.
| | - Mauro Prato
- Dipartimento di Neuroscienze, Università di Torino, Corso Raffaello 30, 10125 Torino, Italy.
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1871
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Schneider D, Wickström SA. Force generation and transmission in keloid fibroblasts: dissecting the role of mechanosensitive molecules in cell function. Exp Dermatol 2015; 24:574-5. [DOI: 10.1111/exd.12753] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 01/13/2023]
Affiliation(s)
- David Schneider
- Paul Gerson Unna Group ‘Skin Homeostasis and Ageing’; Max Planck Institute for Biology of Ageing; Cologne Germany
| | - Sara A. Wickström
- Paul Gerson Unna Group ‘Skin Homeostasis and Ageing’; Max Planck Institute for Biology of Ageing; Cologne Germany
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1872
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Khalil H, Cullen M, Chambers H, Carroll M, Walker J. Elements affecting wound healing time: An evidence based analysis. Wound Repair Regen 2015; 23:550-6. [PMID: 25907979 DOI: 10.1111/wrr.12307] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/02/2015] [Accepted: 04/16/2015] [Indexed: 12/20/2022]
Abstract
The purpose of this study was to identify the predominant client factors and comorbidities that affected the time taken for wounds to heal. A prospective study design used the Mobile Wound Care (MWC) database to capture and collate detailed medical histories, comorbidities, healing times and consumable costs for clients with wounds in Gippsland, Victoria. There were 3,726 wounds documented from 2,350 clients, so an average of 1.6 wounds per client. Half (49.6%) of all clients were females, indicating that there were no gender differences in terms of wound prevalence. The clients were primarily older people, with an average age of 64.3 years (ranging between 0.7 and 102.9 years). The majority of the wounds (56%) were acute and described as surgical, crush and trauma. The MWC database categorized the elements that influenced wound healing into 3 groups--factors affecting healing (FAH), comorbidities, and medications known to affect wound healing. While there were a multitude of significant associations, multiple linear regression identified the following key elements: age over 65 years, obesity, nonadherence to treatment plan, peripheral vascular disease, specific wounds associated with pressure/friction/shear, confirmed infection, and cerebrovascular accident (stroke). Wound healing is a complex process that requires a thorough understanding of influencing elements to improve healing times.© 2015 by the Wound Healing Society.
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Affiliation(s)
- Hanan Khalil
- Monash University, Faculty of Medicine, Nursing and Health Sciences, School of Rural Health, Victoria, Australia
| | - Marianne Cullen
- Latrobe Community Health Centre, Morwell, Victoria, Australia
| | - Helen Chambers
- Monash University, Faculty of Medicine, Nursing and Health Sciences, School of Rural Health, Victoria, Australia
| | - Matthew Carroll
- Monash University, Faculty of Medicine, Nursing and Health Sciences, School of Rural Health, Victoria, Australia
| | - Judi Walker
- Monash University, Faculty of Medicine, Nursing and Health Sciences, School of Rural Health, Victoria, Australia
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1873
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Alkhalil A, Tejiram S, Travis T, Prindeze N, Carney B, Moffatt L, Johnson L, Ramella-Roman J, Shupp J. A Translational Animal Model for Scar Compression Therapy Using an Automated Pressure Delivery System. EPLASTY 2015; 15:e29. [PMID: 26171101 PMCID: PMC4492193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pressure therapy has been used to prevent and treat hypertrophic scars following cutaneous injury despite the limited understanding of its mechanism of action and lack of established animal model to optimize its usage. OBJECTIVES The aim of this work was to test and characterize a novel automated pressure delivery system designed to deliver steady and controllable pressure in a red Duroc swine hypertrophic scar model. METHODS Excisional wounds were created by dermatome on 6 red Duroc pigs and allowed to scar while assessed weekly via gross visual inspection, laser Doppler imaging, and biopsy. A portable novel automated pressure delivery system was mounted on developing scars (n = 6) for 2 weeks. RESULTS The device maintained a pressure range of 30 ± 4 mm Hg for more than 90% of the 2-week treatment period. Pressure readings outside this designated range were attributed to normal animal behavior and responses to healing progression. Gross scar examination by the Vancouver Scar Scale showed significant and sustained (>4 weeks) improvement in pressure-treated scars (P < .05). Histological examination of pressure-treated scars showed a significant decrease in dermal thickness compared with other groups (P < .05). Pressure-treated scars also showed increased perfusion by laser Doppler imaging during the treatment period compared with sham-treated and untreated scars (P < .05). Cellular quantification showed differential changes among treatment groups. CONCLUSION These results illustrate the applications of this technology in hypertrophic scar Duroc swine model and the evaluation and optimization of pressure therapy in wound-healing and hypertrophic scar management.
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Affiliation(s)
- A. Alkhalil
- aFirefighters’ Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC
| | - S. Tejiram
- aFirefighters’ Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC,bThe Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC
| | - T. E. Travis
- aFirefighters’ Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC,bThe Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC
| | - N. J. Prindeze
- aFirefighters’ Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC
| | - B. C. Carney
- aFirefighters’ Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC
| | - L. T. Moffatt
- aFirefighters’ Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC
| | - L. S. Johnson
- aFirefighters’ Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC,bThe Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC
| | - J. Ramella-Roman
- bThe Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC
| | - J. W. Shupp
- aFirefighters’ Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC,bThe Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC,Correspondence:
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1874
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Neofytou E, O'Brien CG, Couture LA, Wu JC. Hurdles to clinical translation of human induced pluripotent stem cells. J Clin Invest 2015; 125:2551-7. [PMID: 26132109 DOI: 10.1172/jci80575] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Human pluripotent stem cells are known to have the capacity to renew indefinitely, being intrinsically able to differentiate into many different cell types. These characteristics have generated tremendous enthusiasm about the potential applications of these cells in regenerative medicine. However, major challenges remain with the development and testing of novel experimental stem cell therapeutics in the field. In this Review, we focus on the nature of the preclinical challenges and discuss potential solutions that could help overcome them. Furthermore, we discuss the use of allogeneic versus autologous stem cell products, including a review of their respective advantages and disadvantages, major clinical requirements, quality standards, time lines, and costs of clinical grade development.
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1875
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Grützner V, Unger RE, Baier G, Choritz L, Freese C, Böse T, Landfester K, Kirkpatrick CJ. Enzyme-responsive nanocomposites for wound infection prophylaxis in burn management: in vitro evaluation of their compatibility with healing processes. Int J Nanomedicine 2015; 10:4111-24. [PMID: 26150717 PMCID: PMC4484651 DOI: 10.2147/ijn.s81263] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Responsive, theranostic nanosystems, capable of both signaling and treating wound infections, is a sophisticated approach to reduce the most common and potentially traumatizing side effects of burn wound treatment: slowed wound healing due to prophylactic anti-infective drug exposure as well as frequent painful dressing changes. Antimicrobials as well as dye molecules have been incorporated into biodegradable nanosystems that release their content only in the presence of pathogens. Following nanocarrier degradation by bacterial enzymes, any infection will thus emit a visible signal and be effectively treated at its source. In this study, we investigated the effect of fluorescent-labeled hyaluronan nanocapsules containing polyhexanide biguanide and poly-L-lactic acid nanoparticles loaded with octenidine on primary human dermal microvascular endothelial cells, which play a major role in cutaneous wound healing. Microscopic and flow cytometric analysis indicated a time-dependent uptake of both the nanocapsules and the nanoparticles. However, enzyme immunoassays showed no significant influence on the expression of pro-inflammatory cell adhesion molecules and cytokines by the endothelial cells. Under angiogenic-stimulating conditions, the potential to form capillary-like structures in co-culture with dermal fibroblasts was not inhibited. Furthermore, cytotoxicity studies (the MTS and crystal violet assay) after short- and long-term exposure to the materials demonstrated that both systems exhibited less toxicity than solutions of the antiseptic agents alone in comparable concentrations. The results indicate that responsive antimicrobial nanocomposites could be used as an advanced drug delivery system and a promising addition to current best practice wound infection prophylaxis with few side effects.
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Affiliation(s)
- Verena Grützner
- REPAIR-Lab, Institute of Pathology, University Medical Center, Mainz, Germany
| | - Ronald E Unger
- REPAIR-Lab, Institute of Pathology, University Medical Center, Mainz, Germany
| | - Grit Baier
- Max Planck Institute for Polymer Research, Mainz, Germany
| | - Lars Choritz
- Department of Ophthalmology, University Clinic, Magdeburg, Germany
| | - Christian Freese
- REPAIR-Lab, Institute of Pathology, University Medical Center, Mainz, Germany
| | - Thomas Böse
- REPAIR-Lab, Institute of Pathology, University Medical Center, Mainz, Germany
| | | | - C James Kirkpatrick
- REPAIR-Lab, Institute of Pathology, University Medical Center, Mainz, Germany
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1876
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Kamber M, Papalazarou V, Rouni G, Papageorgopoulou E, Papalois A, Kostourou V. Angiotensin II inhibitor facilitates epidermal wound regeneration in diabetic mice. Front Physiol 2015; 6:170. [PMID: 26106332 PMCID: PMC4460301 DOI: 10.3389/fphys.2015.00170] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 05/20/2015] [Indexed: 11/14/2022] Open
Abstract
Tissue regeneration and wound healing are severely impaired in diabetes and are associated with poor circulation and dysfunctional blood vessels. Angiotensin II inhibitors are anti-hypertensive drugs used in clinical practice to regulate blood pressure and could affect tissue remodeling. We hypothesize that blocking angiotensin II, using Losartan, could facilitate tissue regeneration in diabetic mice. To this end, we established an experimental model of wound healing in streptozotocin-induced diabetic mice. Our data demonstrated that Losartan accelerates wound repair and normalizes wound stromal responses, having a beneficial role in wounds of diabetic individuals. Our findings highlight a potential therapeutic use of Losartan in improving wound repair in diabetic conditions.
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Affiliation(s)
- Maria Kamber
- Biomedical Sciences Research Centre "Alexander Fleming," Athens, Greece
| | | | - Georgia Rouni
- Biomedical Sciences Research Centre "Alexander Fleming," Athens, Greece
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1877
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1878
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Lindeman JHN. The pathophysiologic basis of abdominal aortic aneurysm progression: a critical appraisal. Expert Rev Cardiovasc Ther 2015; 13:839-51. [PMID: 26028299 DOI: 10.1586/14779072.2015.1052408] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
An aneurysm of the abdominal aorta is a common pathology and a major cause of sudden death in the elderly. Currently, abdominal aortic aneurysms (AAAs) can only be treated by surgery and an effective medical therapy is urgently missing. The pathophysiology of AAAs is complex and is believed to be best described as a comprehensive inflammatory response with an accompanying proteolytic imbalance; the latter being held responsible for the progressive weakening of the aortic wall. Remarkably, while interference in inflammatory and/or proteolytic cascades proves highly effective in preclinical studies, emerging clinical studies consistently fail to show a benefit. In fact, some anti-inflammatory interventions appear to adversely influence the disease process. Altogether, recent clinical observations not only challenge the prevailing concepts of AAA progression, but also raise doubt on the translatability of findings from rodent models for growing AAA.
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Affiliation(s)
- Jan H N Lindeman
- Department Vascular and Transplant Surgery, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
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1879
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Xiao E, Graves DT. Impact of Diabetes on the Protective Role of FOXO1 in Wound Healing. J Dent Res 2015; 94:1025-6. [PMID: 25978971 DOI: 10.1177/0022034515586353] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- E Xiao
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - D T Graves
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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1880
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Oxygen-Loaded Nanodroplets Effectively Abrogate Hypoxia Dysregulating Effects on Secretion of MMP-9 and TIMP-1 by Human Monocytes. Mediators Inflamm 2015; 2015:964838. [PMID: 25878404 PMCID: PMC4386605 DOI: 10.1155/2015/964838] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/09/2015] [Indexed: 11/28/2022] Open
Abstract
Monocytes play a key role in the inflammatory stage of the healing process. To allow monocyte migration to injured tissues, the balances between secreted matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) must be finely modulated. However, a reduction of blood supply and local oxygen tension can modify the phenotype of immune cells. Intriguingly, hypoxia might be targeted by new effective oxygenating devices such as 2H,3H-decafluoropentane- (DFP-) based oxygen-loaded nanodroplets (OLNs). Here, hypoxia effects on gelatinase/TIMP release from human peripheral monocytes were investigated, and the therapeutic potential of dextran-shelled OLNs was evaluated. Normoxic monocytes constitutively released ~500 ng/mL MMP-9, ~1.3 ng/mL TIMP-1, and ~0.6 ng/mL TIMP-2 proteins. MMP-2 was not detected. After 24 hours, hypoxia significantly altered MMP-9/TIMP-1 balance by reducing MMP-9 and increasing TIMP-1, without affecting TIMP-2 secretion. Interestingly OLNs, not displaying toxicity to human monocytes after cell internalization, effectively counteracted hypoxia, restoring a normoxia-like MMP-9/TIMP-1 ratio. The action of OLNs was specifically dependent on time-sustained oxygen diffusion up to 24 h from their DFP-based core. Therefore, OLNs appear as innovative, nonconventional, cost-effective, and nontoxic therapeutic tools, to be potentially employed to restore the physiological invasive phenotype of immune cells in hypoxia-associated inflammation.
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1881
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Relative Expression of Proinflammatory and Antiinflammatory Genes Reveals Differences between Healing and Nonhealing Human Chronic Diabetic Foot Ulcers. J Invest Dermatol 2015; 135:1700-1703. [PMID: 25647438 DOI: 10.1038/jid.2015.30] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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