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Gudima A, Hesselbarth D, Li G, Riabov V, Michel J, Liu Q, Schmuttermaier C, Jiao Z, Sticht C, Jawhar A, Obertacke U, Klüter H, Vrana NE, Kzhyshkowska J. Titanium induces proinflammatory and tissue-destructive responses in primary human macrophages. J Leukoc Biol 2024; 116:706-725. [PMID: 38512961 DOI: 10.1093/jleuko/qiae072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/06/2024] [Accepted: 02/21/2024] [Indexed: 03/23/2024] Open
Abstract
Implants and medical devices are efficient and practical therapeutic solutions for a multitude of pathologies. Titanium and titanium alloys are used in orthopedics, dentistry, and cardiology. Despite very good mechanical properties and corrosion resistance, titanium implants can fail due to inflammatory or tissue degradation-related complications. Macrophages are major immune cells that control acceptance of failure of the implant. In this study, for the first time, we have performed a systematic analysis of the response of differentially activated human macrophages, M(Control), M(IFNγ), and M(IL-4), to the polished and porous titanium surfaces in order to identify the detrimental effect of titanium leading to the tissue destruction and chronic inflammation. Transcriptome analysis revealed that the highest number of differences between titanium and control settings are found in M(IL-4) that model healing type of macrophages. Real-time quantitative polymerase chain reaction analysis confirmed that both polished and porous titanium affected expression of cytokines, chitinases/chitinase-like proteins, and matrix metalloproteinases (MMPs). Titanium-induced release and activation of MMP7 by macrophages was enhanced by fibroblasts in both juxtacrine and paracrine cell interaction models. Production of titanium-induced MMPs and cytokines associated with chronic inflammation was independent of the presence of Staphylococcus aureus. MMP7, one of the most pronounced tissue-destroying factors, and chitinase-like protein YKL-40 were expressed in CD68+ macrophages in peri-implant tissues of patients with orthopedic implants. In summary, we demonstrated that titanium induces proinflammatory and tissue-destructing responses mainly in healing macrophages, and the detrimental effects of titanium surfaces on implant-adjacent macrophages are independent on the bacterial contamination.
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Affiliation(s)
- Alexandru Gudima
- Institute for Transfusion Medicine and Immunology, Mannheim Institute for Innate Immunoscience (MI3), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - David Hesselbarth
- Institute for Transfusion Medicine and Immunology, Mannheim Institute for Innate Immunoscience (MI3), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Clinic for Cardiology and Angiology, University Heart Centre Freiburg-Bad Krozingen, Freiburg, Germany
| | - Guanhao Li
- Institute for Transfusion Medicine and Immunology, Mannheim Institute for Innate Immunoscience (MI3), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Vladimir Riabov
- Institute for Transfusion Medicine and Immunology, Mannheim Institute for Innate Immunoscience (MI3), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Laboratory for Translational Cellular and Molecular Biomedicine, Tomsk State University, Tomsk, Russia
| | - Julia Michel
- Institute for Transfusion Medicine and Immunology, Mannheim Institute for Innate Immunoscience (MI3), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany
| | - Quan Liu
- Institute for Transfusion Medicine and Immunology, Mannheim Institute for Innate Immunoscience (MI3), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Christina Schmuttermaier
- Institute for Transfusion Medicine and Immunology, Mannheim Institute for Innate Immunoscience (MI3), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Zhen Jiao
- Institute for Transfusion Medicine and Immunology, Mannheim Institute for Innate Immunoscience (MI3), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Carsten Sticht
- Medical Research Center, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer Ufer 1-3, 68167 Mannheim, Germany
| | - Ahmed Jawhar
- Department of Orthopaedics and Trauma Surgery, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer Ufer 1-3, 68167 Mannheim, Germany
| | - Udo Obertacke
- Department of Orthopaedics and Trauma Surgery, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer Ufer 1-3, 68167 Mannheim, Germany
| | - Harald Klüter
- Institute for Transfusion Medicine and Immunology, Mannheim Institute for Innate Immunoscience (MI3), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany
| | - Nihal Engin Vrana
- SPARTHA Medical, Strasbourg, France
- Department of Biomaterials and Bioengineering, UMR_S1121, Biomaterials and Bioengineering, INSERM and University of Strasburg, Strasbourg, France
| | - Julia Kzhyshkowska
- Institute for Transfusion Medicine and Immunology, Mannheim Institute for Innate Immunoscience (MI3), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany
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Chen CF, Chen CM, Huang WC, Liu SH, Wang LL, Liu PF, Chen PH. The use of customized 3D-printed mandibular prostheses with pressure-reducing device: A clinical trial. Head Neck 2024; 46:1614-1624. [PMID: 38328961 DOI: 10.1002/hed.27660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/08/2024] [Accepted: 01/17/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Segmental bone defects of the mandible result in the complete loss of the affected region. We had incorporated the pressure-reducing device (PRD) designs into the customized mandible prostheses (CMP) and conducted a clinical trial to evaluate this approach. METHODS Seven patients were enrolled in this study. We examined the association among the history of radiotherapy, the number of CMP regions, the number of chin regions involved, and CMP exposure. RESULTS We included five men and two women with an average age of 55 years. We excised tumors with an average weight of 147.8 g and the average weight of the CMP was 68.5 g. No significant difference between the two weights was noted (p = 0.3882). Three patients received temporary dentures and the CMP remained stable in all patients. CONCLUSION The use of PRD in CMP may address the previous challenges associated with CMP, but further research is necessary.
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Affiliation(s)
- Chun-Feng Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Oral and Maxillofacial Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Dental Laboratory Technology, Shu Zen College of Medicine & Management, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Chin Huang
- Laser and Additive Manufacturing Technology Center, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Sung-Ho Liu
- Laser and Additive Manufacturing Technology Center, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Ling-Lin Wang
- KSVGH Originals & Enterprises, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Pei-Feng Liu
- Department of Biomedical Science and Environmental Biology, College of Life Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ping-Ho Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Longobardi Y, D'Alatri L, Brandi VF, Mari G, Marenda ME, Marchese MR, Galli J, Parrilla C. Automatic speaking valve in tracheo-esophageal speech: treatment proposal for a widespread usage. Eur Arch Otorhinolaryngol 2024; 281:3197-3205. [PMID: 38568297 DOI: 10.1007/s00405-024-08605-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/05/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE Aim of this study was to calculate the percentage of the Automatic Speaking Valve (ASV) use in a large cohort of laryngectomized patients with voice prosthesis (VP) and to analyze the main reasons for non-use. Subsequently, a specific rehabilitation training was proposed. METHODS One hundred-ten laryngectomized patients with VP were enrolled in the first phase of the study (census). Among them, 57 patients were included in the second phase (intervention), in which a training based on moving phonatory exercises was proposed. Structured questionnaires were used before and after training in order to investigate ASV use rate (days/week and hours/day; reasons for impeding the ASV use), average adhesive life-time during ASV use; hands-free speech duration; skin irritation. Patients also expressed their degree of on a VAS scale from 0 to 100. RESULTS In the census phase the percentage of use of ASV (everyday, without problems) was equal to 17.27% (19/110 patients). The main causes of disuse concerned excessive fatigue and poor durability of the adhesives. The analysis of the results pre vs. post-training showed a statistically significant increase (p < 0.05) in all the investigated parameters. Patients reported a good level of treatment compliance (average frequency of performing exercises equal to 4.2 ± 2.5 days/week for 1.4 ± 1.01 h/day) and high degrees of satisfaction. After treatment, the percentage of use of AVS increased by 43% reaching a rate of 60% (66/110 patients). CONCLUSION A specific and targeted approach that simulate the phonatory and breathing difficulties of everyday life can increase the ASV usage rate.
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Affiliation(s)
- Ylenia Longobardi
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'InvecchiamentoNeurologicheOrtopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go Agostino Gemelli 8, Roma, Italia
| | - Lucia D'Alatri
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'InvecchiamentoNeurologicheOrtopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go Agostino Gemelli 8, Roma, Italia.
- Sezione di Otorinolaringoiatria, Dipartimento Universitario Testa-collo e organi di senso, Università Cattolica del Sacro Cuore, Roma, Italia.
| | | | - Giorgia Mari
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'InvecchiamentoNeurologicheOrtopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go Agostino Gemelli 8, Roma, Italia
| | - Maria Elisabetta Marenda
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'InvecchiamentoNeurologicheOrtopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go Agostino Gemelli 8, Roma, Italia
| | - Maria Raffaella Marchese
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'InvecchiamentoNeurologicheOrtopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go Agostino Gemelli 8, Roma, Italia
| | - Jacopo Galli
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'InvecchiamentoNeurologicheOrtopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go Agostino Gemelli 8, Roma, Italia
- Sezione di Otorinolaringoiatria, Dipartimento Universitario Testa-collo e organi di senso, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Claudio Parrilla
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'InvecchiamentoNeurologicheOrtopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go Agostino Gemelli 8, Roma, Italia
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Hauschild G, Hardes J, Dudda M, Streitbürger A, Wahrenburg M. Impact of topography and added TiN-coating on adult human dermal fibroblasts after seeding on titanium surface in-vitro. J Biomater Appl 2024; 38:905-914. [PMID: 38358702 PMCID: PMC10893772 DOI: 10.1177/08853282241233194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Complications of transcutaneous osseointegrated prosthetic systems (TOPS) focus on the metal-cutaneous interface at the stoma. Besides pain due to scare tissue as well as undefined neuropathic disorders, there is high evidence that the stoma presents the main risk causing hypergranulation and ascending infection. To restore the cutaneous barrier function in this functional area, soft-tissue on- or in-growth providing a vital and mechanically stable bio-artificial conjunction is considered a promising approach. In this study we assessed viability and proliferation of adult human dermal fibroblasts (HDFa) on modifications of a standard prosthetic titanium surface. Un-coated (TiAl6V4) as well as a titanium-nitrite (TiN) coated additive manufactured porous three-dimensional surface structures (EPORE®) were seeded with HDFa and compared to plain TiAl6V4 and polystyrene surfaces as control. Cell viability and proliferation were assessed at 24 h and 7 days after seeding with a fluorescence-based live-dead assay. Adhesion and cell morphology were analyzed by scanning electron microscopy at the respective measurements. Both EPORE® surface specifications revealed a homogenous cell distribution with flat and spread cell morphology forming filopodia at both measurements. Proliferation and trend to confluence was seen on un-coated EPORE® surfaces with ongoing incubation but appeared substantially lower on the TiN-coated EPORE® specification. While cell viability on both EPORE® specifications was comparable to plain TiAL6V4 and polystyrene controls, cell proliferation and confluence were less pronounced when compared to controls. The EPORE® topography allows for fibroblast adhesion and viability in both standard TiAl6V4 and - to a minor degree - TiN-coated specifications as a proof of principle.
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Affiliation(s)
- G. Hauschild
- Department of Orthopedic Oncology, University Hospital Essen, Essen, Germany
| | - J. Hardes
- Department of Orthopedic Oncology, University Hospital Essen, Essen, Germany
| | - M. Dudda
- Clinic of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, Essen, Germany
| | - A. Streitbürger
- Department of Orthopedic Oncology, University Hospital Essen, Essen, Germany
| | - M. Wahrenburg
- Department of Orthopedic Oncology, University Hospital Essen, Essen, Germany
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Park HS, Lee JS, Kim C, Lee K, Hong I, Jung H, Lee H, Lee YJ, Ajiteru O, Sultan MT, Lee OJ, Kim SH, Park CH. Fluidic integrated 3D bioprinting system to sustain cell viability towards larynx fabrication. Bioeng Transl Med 2023; 8:e10423. [PMID: 36925698 PMCID: PMC10013754 DOI: 10.1002/btm2.10423] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/23/2022] [Accepted: 10/03/2022] [Indexed: 11/10/2022] Open
Abstract
Herein, we report the first study to create a three-dimensional (3D) bioprinted artificial larynx for whole-laryngeal replacement. Our 3D bio-printed larynx was generated using extrusion-based 3D bioprinter with rabbit's chondrocyte-laden gelatin methacryloyl (GelMA)/glycidyl-methacrylated hyaluronic acid (GMHA) hybrid bioink. We used a polycaprolactone (PCL) outer framework incorporated with pores to achieve the structural strength of printed constructs, as well as to provide a suitable microenvironment to support printed cells. Notably, we established a novel fluidics supply (FS) system that simultaneously supplies basal medium together with a 3D bioprinting process, thereby improving cell survival during the printing process. Our results showed that the FS system enhanced post-printing cell viability, which enabled the generation of a large-scale cell-laden artificial laryngeal framework. Additionally, the incorporation of the PCL outer framework with pores and inner hydrogel provides structural stability and sufficient nutrient/oxygen transport. An animal study confirmed that the transplanted 3D bio-larynx successfully maintained the airway. With further development, our new strategy holds great potential for fabricating human-scale larynxes with in vivo-like biological functions for laryngectomy patients.
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Affiliation(s)
- Hae Sang Park
- Department of Otorhinolaryngology–Head and Neck Surgery, Chuncheon Sacred Heart Hospital, College of MedicineHallym UniversityChuncheonRepublic of Korea
- Nano‐Bio Regenerative Medical Institute, School of MedicineHallym UniversityChuncheonRepublic of Korea
- Institute of New Frontier Research TeamHallym University, Hallym Clinical and Translation Science InstituteChuncheonRepublic of Korea
| | - Ji Seung Lee
- Nano‐Bio Regenerative Medical Institute, School of MedicineHallym UniversityChuncheonRepublic of Korea
| | - Chang‐Beom Kim
- Intelligent Robot Research TeamElectronics and Telecommunications Research InstituteDaejeonRepublic of Korea
| | - Kwang‐Ho Lee
- Department of Advanced Materials Science and Engineering, College of EngineeringKangwon National UniversityChuncheonRepublic of Korea
| | - In‐Sun Hong
- Department of Molecular Medicine, School of MedicineGachon UniversityIncheonRepublic of Korea
| | - Harry Jung
- Institute of New Frontier Research TeamHallym University, Hallym Clinical and Translation Science InstituteChuncheonRepublic of Korea
| | - Hanna Lee
- Nano‐Bio Regenerative Medical Institute, School of MedicineHallym UniversityChuncheonRepublic of Korea
| | - Young Jin Lee
- Nano‐Bio Regenerative Medical Institute, School of MedicineHallym UniversityChuncheonRepublic of Korea
| | - Olatunji Ajiteru
- Nano‐Bio Regenerative Medical Institute, School of MedicineHallym UniversityChuncheonRepublic of Korea
| | - Md Tipu Sultan
- Nano‐Bio Regenerative Medical Institute, School of MedicineHallym UniversityChuncheonRepublic of Korea
| | - Ok Joo Lee
- Nano‐Bio Regenerative Medical Institute, School of MedicineHallym UniversityChuncheonRepublic of Korea
| | - Soon Hee Kim
- Nano‐Bio Regenerative Medical Institute, School of MedicineHallym UniversityChuncheonRepublic of Korea
| | - Chan Hum Park
- Department of Otorhinolaryngology–Head and Neck Surgery, Chuncheon Sacred Heart Hospital, College of MedicineHallym UniversityChuncheonRepublic of Korea
- Nano‐Bio Regenerative Medical Institute, School of MedicineHallym UniversityChuncheonRepublic of Korea
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Mialland A, Atallah I, Bonvilain A. Toward a robust swallowing detection for an implantable active artificial larynx: a survey. Med Biol Eng Comput 2023; 61:1299-1327. [PMID: 36792845 DOI: 10.1007/s11517-023-02772-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 01/04/2023] [Indexed: 02/17/2023]
Abstract
Total laryngectomy consists in the removal of the larynx and is intended as a curative treatment for laryngeal cancer, but it leaves the patient with no possibility to breathe, talk, and swallow normally anymore. A tracheostomy is created to restore breathing through the throat, but the aero-digestive tracts are permanently separated and the air no longer passes through the nasal tracts, which allowed filtration, warming, humidification, olfaction, and acceleration of the air for better tissue oxygenation. As for phonation restoration, various techniques allow the patient to talk again. The main one consists of a tracheo-esophageal valve prosthesis that makes the air passes from the esophagus to the pharynx, and makes the air vibrate to allow speech through articulation. Finally, swallowing is possible through the original tract as it is now isolated from the trachea. Yet, many methods exist to detect and assess a swallowing, but none is intended as a definitive restoration technique of the natural airway, which would permanently close the tracheostomy and avoid its adverse effects. In addition, these methods are non-invasive and lack detection accuracy. The feasibility of an effective early detection of swallowing would allow to further develop an implantable active artificial larynx and therefore restore the aero-digestive tracts. A previous attempt has been made on an artificial larynx implanted in 2012, but no active detection was included and the system was completely mechanic. This led to residues in the airway because of the imperfect sealing of the mechanism. An active swallowing detection coupled with indwelling measurements would thus likely add a significant reliability on such a system as it would allow to actively close an artificial larynx. So, after a brief explanation of the swallowing mechanism, this survey intends to first provide a detailed consideration of the anatomical region involved in swallowing, with a detection perspective. Second, the swallowing mechanism following total laryngectomy surgery is detailed. Third, the current non-invasive swallowing detection technique and their limitations are discussed. Finally, the previous points are explored with regard to the inherent requirements for the feasibility of an effective swallowing detection for an artificial larynx. Graphical Abstract.
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Affiliation(s)
- Adrien Mialland
- Institute of Engineering and Management Univ. Grenoble Alpes, Univ. Grenoble Alpes, CNRS, Grenoble INP, Gipsa-lab, 38000, Grenoble, France.
| | - Ihab Atallah
- Institute of Engineering and Management Univ. Grenoble Alpes, Otorhinolaryngology, CHU Grenoble Alpes, 38700, La Tronche, France
| | - Agnès Bonvilain
- Institute of Engineering and Management Univ. Grenoble Alpes, Univ. Grenoble Alpes, CNRS, Grenoble INP, Gipsa-lab, 38000, Grenoble, France
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7
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Demott CJ, Grunlan MA. Emerging polymeric material strategies for cartilage repair. J Mater Chem B 2022; 10:9578-9589. [PMID: 36373438 DOI: 10.1039/d2tb02005j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cartilage is found throughout the body, serving an array of essential functions. Owing to the limited healing capacity of cartilage, damage or degeneration is often permanent and so requires clinical intervention. Established surgical techniques generally rely on biological grafting. However, recent advances in polymeric materials provide an encouraging alternative to overcome limits of auto- and allografts. For regenerative engineering of cartilage, a polymeric scaffold ideally supports and instructs tissue regeneration while also providing mechanical integrity. Scaffolds direct regeneration via chemical and mechanical cues, as well as delivery and support of exogenous cells and bioactive factors. Advanced polymeric scaffolds aim to direct regeneration locally, replicating the heterogeneities of native tissues. Alternatively, new cartilage-mimetic hydrogels have potential to serve as synthetic cartilage replacements. Prepared as multi-network or composite hydrogels, the most promising candidates have simultaneously realized the hydration, mechanical, and tribological properties of native cartilage. Collectively, the recent rise in polymers for cartilage regeneration and replacement proposes a changing paradigm, with a new generation of materials paving the way for improved clinical outcomes.
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Affiliation(s)
- Connor J Demott
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843-3003, USA
| | - Melissa A Grunlan
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843-3003, USA.,Department of Materials Science & Engineering, Texas A&M University, College Station, TX 77843-3003, USA.,Department of Chemistry, Texas A&M University, College Station, TX 77843-3003, USA.
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8
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Veletić M, Apu EH, Simić M, Bergsland J, Balasingham I, Contag CH, Ashammakhi N. Implants with Sensing Capabilities. Chem Rev 2022; 122:16329-16363. [PMID: 35981266 DOI: 10.1021/acs.chemrev.2c00005] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Because of the aging human population and increased numbers of surgical procedures being performed, there is a growing number of biomedical devices being implanted each year. Although the benefits of implants are significant, there are risks to having foreign materials in the body that may lead to complications that may remain undetectable until a time at which the damage done becomes irreversible. To address this challenge, advances in implantable sensors may enable early detection of even minor changes in the implants or the surrounding tissues and provide early cues for intervention. Therefore, integrating sensors with implants will enable real-time monitoring and lead to improvements in implant function. Sensor integration has been mostly applied to cardiovascular, neural, and orthopedic implants, and advances in combined implant-sensor devices have been significant, yet there are needs still to be addressed. Sensor-integrating implants are still in their infancy; however, some have already made it to the clinic. With an interdisciplinary approach, these sensor-integrating devices will become more efficient, providing clear paths to clinical translation in the future.
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Affiliation(s)
- Mladen Veletić
- Department of Electronic Systems, Norwegian University of Science and Technology, 7491 Trondheim, Norway.,The Intervention Centre, Technology and Innovation Clinic, Oslo University Hospital, 0372 Oslo, Norway
| | - Ehsanul Hoque Apu
- Institute for Quantitative Health Science and Engineering (IQ) and Department of Biomedical Engineering (BME), Michigan State University, East Lansing, Michigan 48824, United States.,Division of Hematology and Oncology, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan 48105, United States
| | - Mitar Simić
- Faculty of Electrical Engineering, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina
| | - Jacob Bergsland
- The Intervention Centre, Technology and Innovation Clinic, Oslo University Hospital, 0372 Oslo, Norway
| | - Ilangko Balasingham
- Department of Electronic Systems, Norwegian University of Science and Technology, 7491 Trondheim, Norway.,The Intervention Centre, Technology and Innovation Clinic, Oslo University Hospital, 0372 Oslo, Norway
| | - Christopher H Contag
- Institute for Quantitative Health Science and Engineering (IQ) and Department of Biomedical Engineering (BME), Michigan State University, East Lansing, Michigan 48824, United States
| | - Nureddin Ashammakhi
- Institute for Quantitative Health Science and Engineering (IQ) and Department of Biomedical Engineering (BME), Michigan State University, East Lansing, Michigan 48824, United States.,Department of Bioengineering, University of California, Los Angeles, California 90095, United States
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9
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Szklanny K, Lachowicz J. Implementing a Statistical Parametric Speech Synthesis System for a Patient with Laryngeal Cancer. SENSORS (BASEL, SWITZERLAND) 2022; 22:3188. [PMID: 35590877 PMCID: PMC9099606 DOI: 10.3390/s22093188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
Total laryngectomy, i.e., the surgical removal of the larynx, has a profound influence on a patient's quality of life. The procedure results in a loss of natural voice, which in effect constitutes a significant socio-psychological problem for the patient. The main aim of the study was to develop a statistical parametric speech synthesis system for a patient with laryngeal cancer, on the basis of the patient's speech samples recorded shortly before the surgery and to check if it was possible to generate speech quality close to that of the original recordings. The recording made use of a representative corpus of the Polish language, consisting of 2150 sentences. The recorded voice proved to indicate dysphonia, which was confirmed by the auditory-perceptual RBH scale (roughness, breathiness, hoarseness) and by acoustical analysis using AVQI (The Acoustic Voice Quality Index). The speech synthesis model was trained using the Merlin repository. Twenty-five experts participated in the MUSHRA listening tests, rating the synthetic voice at 69.4 in terms of the professional voice-over talent recording, on a 0-100 scale, which is a very good result. The authors compared the quality of the synthetic voice to another model of synthetic speech trained with the same corpus, but where a voice-over talent provided the recorded speech samples. The same experts rated the voice at 63.63, which means the patient's synthetic voice with laryngeal cancer obtained a higher score than that of the talent-voice recordings. As such, the method enabled for the creation of a statistical parametric speech synthesizer for patients awaiting total laryngectomy. As a result, the solution would improve the quality of life as well as better mental wellbeing of the patient.
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McNulty J, de Jager K, Lancashire HT, Graveston J, Birchall M, Vanhoestenberghe A. Prediction of larynx function using multichannel surface EMG classification. IEEE TRANSACTIONS ON MEDICAL ROBOTICS AND BIONICS 2021; 3:1032-1039. [PMID: 34901764 PMCID: PMC7612081 DOI: 10.1109/tmrb.2021.3122966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Total laryngectomy (TL) affects critical functions such as swallowing, coughing and speaking. An artificial, bio-engineered larynx (ABL), operated via myoelectric signals, may improve quality of life for TL patients. To evaluate the efficacy of using surface electromyography (sEMG) as a control signal to predict instances of swallowing, coughing and speaking, sEMG was recorded from submental, intercostal and diaphragm muscles. The cohort included TL and control participants. Swallowing, coughing, speaking and movement actions were recorded, and a range of classifiers were investigated for prediction of these actions. Our algorithm achieved F1-scores of 76.0 ± 4.4 % (swallows), 93.8 ± 2.8 % (coughs) and 70.5 ± 5.4 % (speech) for controls, and 67.7 ± 4.4 % (swallows), 71.0 ± 9.1 % (coughs) and 78.0 ± 3.8 % (speech) for TLs, using a random forest (RF) classifier. 75.1 ± 6.9 % of swallows were detected within 500 ms of onset in the controls, and 63.1 ± 6.1 % in TLs. sEMG can be used to predict critical larynx movements, although a viable ABL requires improvements. Results are particularly encouraging as they encompass a TL cohort. An ABL could alleviate many challenges faced by laryngectomees. This study represents a promising step toward realising such a device.
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Affiliation(s)
- Johnny McNulty
- corresponding author: . H.T. Lancashire is with the Department of Medical Physics and Biomedical Engineering, UCL. J. Graveston was with the UCL Ear Institute, UCL, M. Birchall is with the UCL Ear Institute, Division of Brain Sciences and Royal National Nose and Throat and Eastman Dental Hospitals, UCL
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Lee W, Seong JJ, Ozlu B, Shim BS, Marakhimov A, Lee S. Biosignal Sensors and Deep Learning-Based Speech Recognition: A Review. SENSORS (BASEL, SWITZERLAND) 2021; 21:1399. [PMID: 33671282 PMCID: PMC7922488 DOI: 10.3390/s21041399] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/01/2021] [Accepted: 02/12/2021] [Indexed: 11/16/2022]
Abstract
Voice is one of the essential mechanisms for communicating and expressing one's intentions as a human being. There are several causes of voice inability, including disease, accident, vocal abuse, medical surgery, ageing, and environmental pollution, and the risk of voice loss continues to increase. Novel approaches should have been developed for speech recognition and production because that would seriously undermine the quality of life and sometimes leads to isolation from society. In this review, we survey mouth interface technologies which are mouth-mounted devices for speech recognition, production, and volitional control, and the corresponding research to develop artificial mouth technologies based on various sensors, including electromyography (EMG), electroencephalography (EEG), electropalatography (EPG), electromagnetic articulography (EMA), permanent magnet articulography (PMA), gyros, images and 3-axial magnetic sensors, especially with deep learning techniques. We especially research various deep learning technologies related to voice recognition, including visual speech recognition, silent speech interface, and analyze its flow, and systematize them into a taxonomy. Finally, we discuss methods to solve the communication problems of people with disabilities in speaking and future research with respect to deep learning components.
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Affiliation(s)
- Wookey Lee
- Biomedical Science and Engineering & Dept. of Industrial Security Governance & IE, Inha University, 100 Inharo, Incheon 22212, Korea;
| | - Jessica Jiwon Seong
- Department of Industrial Security Governance, Inha University, 100 Inharo, Incheon 22212, Korea;
| | - Busra Ozlu
- Biomedical Science and Engineering & Department of Chemical Engineering, Inha University, 100 Inharo, Incheon 22212, Korea; (B.O.); (B.S.S.)
| | - Bong Sup Shim
- Biomedical Science and Engineering & Department of Chemical Engineering, Inha University, 100 Inharo, Incheon 22212, Korea; (B.O.); (B.S.S.)
| | | | - Suan Lee
- School of Computer Science, Semyung University, Jecheon 27136, Korea
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Brookes S, Zhang L, Puls TJ, Kincaid J, Voytik-Harbin S, Halum S. Laryngeal Reconstruction Using Tissue-Engineered Implants in Pigs: A Pilot Study. Laryngoscope 2020; 131:2277-2284. [PMID: 33247846 DOI: 10.1002/lary.29282] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/23/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE/HYPOTHESIS There are currently no treatments available that restore dynamic laryngeal function after hemilaryngectomy. We have shown that dynamic function can be restored post hemilaryngectomy in a rat model. Here, we report in a first of its kind, proof of concept study that this previously published technique is scalable to a porcine model. STUDY DESIGN Animal study. METHODS Muscle and fat biopsies were taken from three Yucatan minipigs. Muscle progenitor cells (MPCs) and adipose stem cells (ASCs) were isolated and cultured for 3 weeks. The minipigs underwent a left laterovertical partial laryngectomy sparing the left arytenoid cartilage and transecting the recurrent laryngeal nerve. Each layer was replaced with a tissue-engineered implant: 1) an acellular mucosal layer composed of densified Type I oligomeric collagen, 2) a skeletal muscle layer composed of autologous MPCs and aligned oligomeric collagen differentiated and induced to express motor endplates (MEE), and 3) a cartilage layer composed of autologous ASCs and densified oligomeric collagen differentiated to cartilage. Healing was monitored at 2 and 4 weeks post-op, and at the 8 week study endpoint. RESULTS Animals demonstrated appropriate weight gain, no aspiration events, and audible phonation. Video laryngoscopy showed progressive healing with vascularization and re-epithelialization present at 4 weeks. On histology, there was no immune reaction to the implants and there was complete integration into host tissue with nerve and vascular ingrowth. CONCLUSIONS This pilot study represents a first in which a transmural vertical partial laryngectomy was performed and successfully repaired with a customized, autologous stem cell-derived multi-layered tissue-engineered implant. LEVEL OF EVIDENCE NA Laryngoscope, 131:2277-2284, 2021.
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Affiliation(s)
- Sarah Brookes
- Department of Basic Medical Sciences, Purdue University, West Lafayette, Indiana, U.S.A
| | - Lujuan Zhang
- Department of Speech, Language and Hearing Sciences, Purdue University, West Lafayette, Indiana, U.S.A
| | - Theodore J Puls
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, U.S.A
| | - John Kincaid
- Department of Neurology, Indiana University School of Medicine (IUSM), Indianapolis, Indiana, U.S.A
| | - Sherry Voytik-Harbin
- Department of Basic Medical Sciences, Purdue University, West Lafayette, Indiana, U.S.A.,Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, U.S.A
| | - Stacey Halum
- Department of Otolaryngology-Head and Neck Surgery, Indianapolis, Indiana, U.S.A
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Barthes J, Cazzola M, Muller C, Dollinger C, Debry C, Ferraris S, Spriano S, Vrana NE. Controlling porous titanium/soft tissue interactions with an innovative surface chemical treatment: Responses of macrophages and fibroblasts. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 112:110845. [DOI: 10.1016/j.msec.2020.110845] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 03/05/2020] [Accepted: 03/12/2020] [Indexed: 12/22/2022]
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Leemans M, van Sluis KE, van Son RJJH, van den Brekel MWM. Interaction of functional and participation issues on quality of life after total laryngectomy. Laryngoscope Investig Otolaryngol 2020; 5:453-460. [PMID: 32596487 PMCID: PMC7314459 DOI: 10.1002/lio2.381] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/06/2020] [Accepted: 03/24/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Total laryngectomy (TL) leads to lifelong physical changes which can lead to functional and participation issues. To assess the relationship between self-reported quality of life and functional and participation issues, a large international online questionnaire was used. METHOD A questionnaire was sent out to 8119 recipients of whom 1705 (21%) responded. The questionnaire consisted of 26 questions regarding demographic information, product use of the respondents, experienced overall health and independence, and functional and participation issues. Respondents were grouped based on sex, age, time since TL, educational level, and country of residence. Questions were grouped in one measure of reported quality of life (r-QoL) and seven issue themes ("esthetic issues," "experienced limitations in daily activities," "avoiding social activities," "communication issues," "experienced vulnerability due to environmental factors," "pulmonary issues," and "sleep issues") to assess the underlying relations. RESULTS This study showed that more functional and participation issues and a lower r-QoL are reported in the group of younger respondents (<60 years), women, and respondents who have had the TL procedure less than 2 years ago. The issue themes "experienced limitations in daily activities" and "avoiding social activities" are related to r-QoL. Most participants report "pulmonary issues," and these issues have a strong correlation with most other themes. CONCLUSION The ability to participate in meaningful and social activities is a major factor in r-QoL. Due to the frequency and strong correlations of pulmonary issues with other issue themes, pulmonary issues might be an underlying cause of many other issues. LEVEL OF EVIDENCE 3b.
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Affiliation(s)
- Maartje Leemans
- Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute-Antoni van Leeuwenhoek Amsterdam The Netherlands
| | - Klaske E van Sluis
- Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute-Antoni van Leeuwenhoek Amsterdam The Netherlands
- Amsterdam Center for Language and Communication University of Amsterdam Amsterdam The Netherlands
| | - Rob J J H van Son
- Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute-Antoni van Leeuwenhoek Amsterdam The Netherlands
- Amsterdam Center for Language and Communication University of Amsterdam Amsterdam The Netherlands
| | - Michiel W M van den Brekel
- Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute-Antoni van Leeuwenhoek Amsterdam The Netherlands
- Amsterdam Center for Language and Communication University of Amsterdam Amsterdam The Netherlands
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Varghese BT. Function restoration after laryngectomy - Present and future. Oral Oncol 2019; 98:161. [PMID: 31548128 DOI: 10.1016/j.oraloncology.2019.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 09/17/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Bipin T Varghese
- Head and Neck Surgery Unit, Surgical Services, Regional Cancer Centre, Trivandrum, Kerala 695011, India
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16
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A review of the approaches to predict the ease of swallowing and post-swallow residues. Trends Food Sci Technol 2019. [DOI: 10.1016/j.tifs.2019.02.045] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Alcaraz JP, Cinquin P, Martin DK. Tackling the Concept of Symbiotic Implantable Medical Devices with Nanobiotechnologies. Biotechnol J 2018; 13:e1800102. [PMID: 30367543 DOI: 10.1002/biot.201800102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 09/17/2018] [Indexed: 12/21/2022]
Abstract
This review takes an approach to implanted medical devices that considers whether the intention of the implanted device is to have any communication of energy or materials with the body. The first part describes some specific examples of three different classes of implants, analyzed with regards to the type of signal sent to cells. Through several examples, the authors describe that a one way signaling to the body leads to encapsulation or degradation. In most cases, those phenomena do not lead to major problems. However, encapsulation or degradation are critical for new kinds of medical devices capable of duplex communication, which are defined in this review as symbiotic devices. The concept the authors propose is that implanted medical devices that need to be symbiotic with the body also need to be designed with an intended duplex communication of energy and materials with the body. This extends the definition of a biocompatible system to one that requires stable exchange of materials between the implanted device and the body. Having this novel concept in mind will guide research in a new field between medical implant and regenerative medicine to create actual symbiotic devices.
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Affiliation(s)
- Jean-Pierre Alcaraz
- Univverity Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, F-38000 Grenoble, France.,SyNaBi, Pavillon Taillefer, Domaine de la Merci, La Tronche 38706, Grenoble, France
| | - Philippe Cinquin
- Univverity Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, F-38000 Grenoble, France.,SyNaBi, Pavillon Taillefer, Domaine de la Merci, La Tronche 38706, Grenoble, France
| | - Donald K Martin
- Univverity Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, F-38000 Grenoble, France.,SyNaBi, Pavillon Taillefer, Domaine de la Merci, La Tronche 38706, Grenoble, France
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Banus MS, Birchall MA, Graveston JA. Developing control algorithms of a voluntary cough for an artificial bioengineered larynx using surface electromyography of chest muscles: A prospective cohort study. Clin Otolaryngol 2018; 43:562-566. [PMID: 29069534 DOI: 10.1111/coa.13022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This prospective cohort study investigates the prediction of a voluntary cough using surface electromyography (EMG) of intercostal and diaphragm muscles, to develop control algorithms for an EMG-controlled artificial larynx. SETTING The Ear Institute, London. MAIN OUTCOME MEASURES Electromyography onset compared to voluntary cough exhalation onset and to 100 ms (to give the artificial larynx the time to close the bioengineered vocal cords) before voluntary cough exhalation onset, in twelve healthy participants. RESULTS In the 189 EMG of intercostal muscle-detected voluntary coughs, 172 coughs (91% CI 70-112) were detected before onset of cough exhalation and 128 coughs (67.6% CI 33.7-101.7) 100 ms before onset of cough exhalation. In the 158 EMG of diaphragm muscle-detected voluntary coughs, 149 coughs (94.3% CI 76.3-112.3) were detected before onset of cough exhalation and 102 coughs (64.6% CI 26.6-102.6) 100 ms before onset of cough exhalation. More coughs were detected before onset of cough exhalation when combining EMG activity of intercostal and diaphragm muscles and comparing this to intercostal muscle activity alone (183 coughs [96.8% CI 83.8-109.8] vs 172 coughs, P = .0294). When comparing the mentioned combination to diaphragm muscle activity alone, the higher percentage of detected coughs before cough exhalation onset was not found to be significant (183 coughs vs 149 coughs, P = .295). In addition, more coughs were detected 100 ms before onset of cough exhalation with the mentioned combination of EMG activity and comparing this to intercostal muscles alone (149 coughs [78.8% CI 48.8-108.8] vs 128 coughs, P = .0198) and to diaphragm muscles alone (149 coughs vs 102 coughs, P = .0038). CONCLUSIONS Most voluntary coughs can be predicted based on combined EMG signals of intercostal and diaphragm muscles, and therefore, these two muscle groups will be useful in controlling the bioengineered vocal cords within the artificial larynx during a voluntary cough.
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Affiliation(s)
- M S Banus
- Department of Otolaryngology, Head and Neck surgery, The Ear Institute, University College of London, London, UK
| | - M A Birchall
- Department of Otolaryngology, Head and Neck surgery, The Ear Institute, University College of London, London, UK
| | - J A Graveston
- Department of Otolaryngology, Head and Neck surgery, The Ear Institute, University College of London, London, UK
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Etienne H, Fabre D, Gomez Caro A, Kolb F, Mussot S, Mercier O, Mitilian D, Stephan F, Fadel E, Dartevelle P. Tracheal replacement. Eur Respir J 2018; 51:51/2/1702211. [DOI: 10.1183/13993003.02211-2017] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 11/29/2017] [Indexed: 11/05/2022]
Abstract
Tracheal reconstruction is one of the greatest challenges in thoracic surgery when direct end-to-end anastomosis is impossible or after this procedure has failed. The main indications for tracheal reconstruction include malignant tumours (squamous cell carcinoma, adenoid cystic carcinoma), tracheoesophageal fistula, trauma, unsuccessful surgical results for benign diseases and congenital stenosis. Tracheal substitutes can be classified into five types: 1) synthetic prosthesis; 2) allografts; 3) tracheal transplantation; 4) tissue engineering; and 5) autologous tissue composite. The ideal tracheal substitute is still unclear, but some techniques have shown promising clinical results. This article reviews the advantages and limitations of each technique used over the past few decades in clinical practice. The main limitation seems to be the capacity for tracheal tissue regeneration. The physiopathology behind this has yet to be fully understood. Research on stem cells sparked much interest and was thought to be a revolutionary technique; however, the poor long-term results of this approach highlight that there is a long way to go in this research field. Currently, an autologous tissue composite, with or without a tracheal allograft, is the only long-term working solution for every aetiology, despite its technical complexity and setbacks.
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EGFR Immunoexpression in Laryngeal Squamous Cell Carcinoma. CURRENT HEALTH SCIENCES JOURNAL 2017; 43:340-344. [PMID: 30595900 PMCID: PMC6286452 DOI: 10.12865/chsj.43.04.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 12/16/2017] [Indexed: 12/22/2022]
Abstract
ABSTRACT: Epidermal growth factor receptor (EGFR) is a tyrosine kinase molecule associated to the initial stages of neoplastic transformation. High expression of EGFR is connected to aggressive tumor behavior and high risk of metastasis and treatment failure. The aim of our study was to analyze the immunohistochemical expression of EGFR in 38 cases of laryngeal squamous cell carcinomas depending on clinicopathological parameters related to prognosis. The EGFR immunoreactions have statistical significant higher values in high grade carcinomas. Although the EGFR values were superior in advanced stages lesions, the aspect was not significant EGFR may be useful in identifying the aggressive laryngeal squamous carcinomas.
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Barthes J, Ciftci S, Ponzio F, Knopf-Marques H, Pelyhe L, Gudima A, Kientzl I, Bognár E, Weszl M, Kzhyshkowska J, Vrana NE. Review: the potential impact of surface crystalline states of titanium for biomedical applications. Crit Rev Biotechnol 2017; 38:423-437. [PMID: 28882077 DOI: 10.1080/07388551.2017.1363707] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In many biomedical applications, titanium forms an interface with tissues, which is crucial to ensure its long-term stability and safety. In order to exert control over this process, titanium implants have been treated with various methods that induce physicochemical changes at nano and microscales. In the past 20 years, most of the studies have been conducted to see the effect of topographical and physicochemical changes of titanium surface after surface treatments on cells behavior and bacteria adhesion. In this review, we will first briefly present some of these surface treatments either chemical or physical and we explain the biological responses to titanium with a specific focus on adverse immune reactions. More recently, a new trend has emerged in titanium surface science with a focus on the crystalline phase of titanium dioxide and the associated biological responses. In these recent studies, rutile and anatase are the major two polymorphs used for biomedical applications. In the second part of this review, we consider this emerging topic of the control of the crystalline phase of titanium and discuss its potential biological impacts. More in-depth analysis of treatment-related surface crystalline changes can significantly improve the control over titanium/host tissue interface and can result in considerable decreases in implant-related complications, which is currently a big burden on the healthcare system.
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Affiliation(s)
- Julien Barthes
- a Fundamental Research Unit , Protip Medical , Strasbourg , France.,b INSERM, UMR-S 1121 , , "Biomatériaux et Bioingénierie" , Strasbourg Cedex , France
| | - Sait Ciftci
- b INSERM, UMR-S 1121 , , "Biomatériaux et Bioingénierie" , Strasbourg Cedex , France.,c Service ORL , Hopitaux Universitaires de Strasbourg , Strasbourg , France
| | - Florian Ponzio
- b INSERM, UMR-S 1121 , , "Biomatériaux et Bioingénierie" , Strasbourg Cedex , France.,d Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg , Fédération des Matériaux et Nanoscience d'Alsace (FMNA), Faculté de Chirurgie Dentaire , Strasbourg , France
| | - Helena Knopf-Marques
- b INSERM, UMR-S 1121 , , "Biomatériaux et Bioingénierie" , Strasbourg Cedex , France.,d Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg , Fédération des Matériaux et Nanoscience d'Alsace (FMNA), Faculté de Chirurgie Dentaire , Strasbourg , France
| | - Liza Pelyhe
- e Department of Materials Science and Engineering, Faculty of Mechanical Engineering , Budapest University of Technology and Economics , Budapest , Hungary
| | - Alexandru Gudima
- f Medical Faculty Mannheim , Institute of Transfusion Medicine and Immunology, University of Heidelberg , Mannheim , Germany
| | - Imre Kientzl
- e Department of Materials Science and Engineering, Faculty of Mechanical Engineering , Budapest University of Technology and Economics , Budapest , Hungary
| | - Eszter Bognár
- e Department of Materials Science and Engineering, Faculty of Mechanical Engineering , Budapest University of Technology and Economics , Budapest , Hungary.,g MTA-BME Research Group for Composite Science and Technology , Budapest , Hungary
| | - Miklós Weszl
- h Department of Biophysics and Radiation Biology , Semmelweis University , Budapest , Hungary
| | - Julia Kzhyshkowska
- f Medical Faculty Mannheim , Institute of Transfusion Medicine and Immunology, University of Heidelberg , Mannheim , Germany.,i German Red Cross Blood Service Baden-Württemberg-Hessen , Mannheim , Germany
| | - Nihal Engin Vrana
- a Fundamental Research Unit , Protip Medical , Strasbourg , France.,b INSERM, UMR-S 1121 , , "Biomatériaux et Bioingénierie" , Strasbourg Cedex , France
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Leemans M, van Alphen MJA, van den Brekel MWM, Hekman EEG. Analysis of tracheostoma morphology. Acta Otolaryngol 2017; 137:997-1001. [PMID: 28391734 DOI: 10.1080/00016489.2017.1306880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Existing fixation methods of automatic speaking valves (ASVs) suffer from shortcomings which partly are the result of insufficient conformity of the intratracheal fixation method's shape to the tracheostoma anatomy. However, quantitative data are lacking and will be helpful to analyse solutions for airtight fixation. This article provides such data. PATIENTS AND METHODS The tracheostoma morphology was measured in computerized tomography scans of 20 laryngectomized patients. Measured were transverse and sagittal diameters, transition angle between skin level and tracheostoma lumen and between the tracheostoma lumen to the trachea, TE valve placement and stoma depth. RESULTS The mean transverse and sagittal diameters of the stoma at the peristomal lip are 19.2 mm [standard deviation (SD 5.2 mm)] and 17.6 mm (SD 5.3 mm), respectively. The mean transition angles are 84.5° (SD 15.6°) at skin level and 153.6° (SD 11.7°) into the trachea. The mean distance between TE valve and peristomal lip is 13.5 mm (SD 7.0 mm). The mean stoma depth is 14.0 mm (SD 6.4 mm). CONCLUSIONS Due to the large variation, no 'average tracheostoma morphology', suitable for shaping a generic intratracheal fixation device, can be defined. Therefore, providing an airtight fixation in each patient would require a large range of different sizes, customization or a new approach.
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Affiliation(s)
- Maartje Leemans
- Department of Biomedical Engineering, University of Twente, Enschede, The Netherlands
| | - Maarten J. A. van Alphen
- Department of Head and Neck Oncology and Surgery, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Michiel W. M. van den Brekel
- Department of Head and Neck Oncology and Surgery, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Edsko E. G. Hekman
- Department of Biomedical Engineering, University of Twente, Enschede, The Netherlands
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Lorenz KJ. Rehabilitation after Total Laryngectomy-A Tribute to the Pioneers of Voice Restoration in the Last Two Centuries. Front Med (Lausanne) 2017; 4:81. [PMID: 28695120 PMCID: PMC5483444 DOI: 10.3389/fmed.2017.00081] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 05/31/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The most severe consequence of laryngectomy for patients is the loss of their voice. For this reason, voice rehabilitation has been an integral aspect of treatment after total laryngectomy from the very beginning. A wide variety of different technical and surgical approaches are available and reflect the problems associated with the rehabilitation of communication and swallowing after the removal of the larynx. METHODS We used Internet search engines and libraries to conduct a search of the current medical literature and historical sources of medical information in order to identify and summarize landmark work on this subject. DISCUSSION Four types of methods have been used to restore the voices of patients, i.e., external devices, esophageal speech, internal voice prostheses, and surgically created tracheo-esophageal fistulas that do not involve the use of a prosthetic device.
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Affiliation(s)
- Kai J. Lorenz
- Department of Otolaryngology/Head and Neck Surgery, German Armed Forces Hospital, Ulm, Germany
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Debry C, Vrana NE, Dupret-Bories A. More on Implantation of an Artificial Larynx after Total Laryngectomy. N Engl J Med 2017; 376:e29. [PMID: 28379791 DOI: 10.1056/nejmc1701193] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Hamilton NJI, Birchall MA. Tissue-Engineered Larynx: Future Applications in Laryngeal Cancer. CURRENT OTORHINOLARYNGOLOGY REPORTS 2017; 5:42-48. [PMID: 28367360 PMCID: PMC5357481 DOI: 10.1007/s40136-017-0144-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Purpose of Review This article reviews the latest developments in tissue engineering for the larynx with a specific focus on the treatment of laryngeal cancer. Recent Findings Challenges in tissue engineering a total larynx can be divided into scaffold design, methods of re-mucosalization, and how to restore laryngeal function. The literature described a range of methods to deliver a laryngeal scaffold including examples of synthetic, biomimetic, and biological scaffolds. Methods to regenerate laryngeal mucosa can be divided into examples that use a biological dressing and those that engineer a new mucosal layer de novo. Studies aiming to restore laryngeal function have been reported, but to date, the optimum method for achieving this as part of a total laryngeal transplant is yet to be determined. Summary There is great potential for tissue engineering to improve the treatments available for laryngeal cancer within the next 10 years. A number of challenges exist however and advances in restoring function must keep pace with developments in scaffold design.
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Krishnan G, Du C, Fishman JM, Foreman A, Lott DG, Farwell G, Belafsky P, Krishnan S, Birchall MA. The current status of human laryngeal transplantation in 2017: A state of the field review. Laryngoscope 2017; 127:1861-1868. [PMID: 28224630 DOI: 10.1002/lary.26503] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Human laryngeal allotransplantation has long been contemplated as a surgical option following laryngectomy, but there is a paucity of information regarding the indications, surgical procedure, and patient outcomes. Our objectives were to identify all human laryngeal allotransplants that have been undertaken and reported in the English literature and to evaluate the success of the procedure. DATA SOURCES MEDLINE, Embase, Current Index to Nursing and Allied Health Literature, Web of Science and Scopus, and the Gray literature. REVIEW METHODS A comprehensive search strategy was undertaken across multiple databases. Inclusion criteria were case reports of patients who had undergone human laryngeal allotransplantation. Information regarding indications, operative techniques, complications, graft viability, and functional outcomes were extracted. RESULTS A total of 5,961 articles, following removal of duplicates, matched the search criteria and were screened, with five case reports relating to two patients, ultimately fulfilling the entry criteria. CONCLUSIONS Two laryngeal transplants have been reported in the medical literature. Although both patients report improved quality of life relating to their ability to communicate with voice, further research is necessary to shape our understanding of this complicated operation, its indications, and its functional outcomes. Laryngoscope, 127:1861-1868, 2017.
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Affiliation(s)
- Giri Krishnan
- Department of Otolaryngology-Head and Neck Surgery, The Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Charles Du
- Department of Otolaryngology-Head and Neck Surgery, The Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Jonathan M Fishman
- Department of Otolaryngology-Head and Neck Surgery, UCL Ear Institute, University College London, London, United Kingdom
| | - Andrew Foreman
- Department of Otolaryngology-Head and Neck Surgery, The Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - David G Lott
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, U.S.A
| | - Gregory Farwell
- Department of Otolaryngology, Division of Head and Neck Surgery, University of California Davis, Sacramento, California, U.S.A
| | - Peter Belafsky
- Department of Otolaryngology, Division of Head and Neck Surgery, University of California Davis, Sacramento, California, U.S.A
| | - Suren Krishnan
- Department of Otolaryngology-Head and Neck Surgery, The Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Martin A Birchall
- Department of Otolaryngology-Head and Neck Surgery, UCL Ear Institute, University College London, London, United Kingdom
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Abstract
Research has been fighting against organ failure and shortage of donations by supplying artificial organs for many years. With the raise of new technologies, tissue engineering and regenerative medicine, many organs can benefit of an artificial equivalent: thanks to retinal implants some blind people can visualize stimuli, an artificial heart can be proposed in case of cardiac failure while awaiting for a heart transplant, artificial larynx enables laryngectomy patients to an almost normal life, while the diabetic can get a glycemic self-regulation controlled by smartphones with an artificial device. Dialysis devices become portable, as well as the oxygenation systems for terminal respiratory failure. Bright prospects are being explored or might emerge in a near future. However, the retrospective assessment of putative side effects is not yet sufficient. Finally, the cost of these new devices is significant even if the advent of three dimensional printers may reduce it.
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Affiliation(s)
- Thibaut Raguin
- Service ORL et chirurgie cervico-faciale, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg Cedex, France
| | - Agnès Dupret-Bories
- Service d'otorhinolaryngologie et chirurgie cervico-faciale, Institut Universitaire du Cancer, avenue Hubert Curien, 31100 Toulouse, France
| | - Christian Debry
- Service ORL et chirurgie cervico-faciale, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg Cedex, France
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Koenig G, Ozcelik H, Haesler L, Cihova M, Ciftci S, Dupret-Bories A, Debry C, Stelzle M, Lavalle P, Vrana NE. Cell-laden hydrogel/titanium microhybrids: Site-specific cell delivery to metallic implants for improved integration. Acta Biomater 2016; 33:301-10. [PMID: 26802440 DOI: 10.1016/j.actbio.2016.01.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 12/17/2015] [Accepted: 01/19/2016] [Indexed: 11/30/2022]
Abstract
Porous titanium implants are widely used in dental, orthopaedic and otorhinolaryngology fields to improve implant integration to host tissue. A possible step further to improve the integration with the host is the incorporation of autologous cells in porous titanium structures via cell-laden hydrogels. Fast gelling hydrogels have advantageous properties for in situ applications such as localisation of specific cells and growth factors at a target area without dispersion. The ability to control the cell types in different regions of an implant is important in applications where the target tissue (i) has structural heterogeneity (multiple cell types with a defined spatial configuration with respect to each other); (ii) has physical property gradients essential for its function (such as in the case of osteochondral tissue transition). Due to their near immediate gelation, such gels can also be used for site-specific modification of porous titanium structures, particularly for implants which would face different tissues at different locations. Herein, we describe a step by step design of a model system: the model cell-laden gel-containing porous titanium implants in the form of titanium microbead/hydrogel (maleimide-dextran or maleimide-PVA based) microhybrids. These systems enable the determination of the effect of titanium presence on gel properties and encapsulated cell behaviour as a miniaturized version of full-scale implants, providing a system compatible with conventional analysis methods. We used a fibroblast/vascular endothelial cell co-cultures as our model system and by utilising single microbeads we have quantified the effect of gel microenvironment (degradability, presence of RGD peptides within gel formulation) on cell behaviour and the effect of the titanium presence on cell behaviour and gel formation. Titanium presence slightly changed gel properties without hindering gel formation or affecting cell viability. Cells showed a preference to move towards the titanium beads and fibroblast proliferation was significantly higher in hybrids compared to gel only controls. The MMP (Matrix Metalloproteinase)-sensitive hydrogels induced sprouting by cells in co-culture configuration which was quantified by fluorescence microscopy, confocal microscopy and qRT-PCR (Quantitative Reverse transcription polymerase chain reaction). When the microhybrid up-scaled to 3D thick structures, cellular localisation in specific areas of the 3D titanium structures was achieved, without decreasing overall cell proliferation compared to titanium only scaffolds. Microhybrids of titanium and hydrogels are useful models for deciding the necessary modifications of metallic implants and they can be used as a modelling system for the study of tissue/titanium implant interactions. STATEMENT OF SIGNIFICANCE This article demonstrates a method to apply cell-laden hydrogels to porous titanium implants and a model of titanium/hydrogel interaction at micro-level using titanium microbeads. The feasibility of site-specific modification of titanium implants with cell-laden microgels has been demonstrated. Use of titanium microbeads in combination with hydrogels with conventional analysis techniques as described in the article can facilitate the characterisation of surface modification of titanium in a relevant model system.
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Affiliation(s)
- Geraldine Koenig
- Institut National de la Santé et de la Recherche Médicale, INSERM Unité 1121, 11 Rue Humann, 67000 Strasbourg, France; Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Sainte Elisabeth, 67000 Strasbourg, France
| | - Hayriye Ozcelik
- Institut National de la Santé et de la Recherche Médicale, INSERM Unité 1121, 11 Rue Humann, 67000 Strasbourg, France; Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Sainte Elisabeth, 67000 Strasbourg, France
| | - Lisa Haesler
- NMI Natural and Medical Sciences Institute at the University of Tübingen, BioMEMS Group, Markwiesenstraße 55, D-72770 Reutlingen, Germany
| | - Martina Cihova
- NMI Natural and Medical Sciences Institute at the University of Tübingen, BioMEMS Group, Markwiesenstraße 55, D-72770 Reutlingen, Germany
| | - Sait Ciftci
- Institut National de la Santé et de la Recherche Médicale, INSERM Unité 1121, 11 Rue Humann, 67000 Strasbourg, France; Hôpitaux Universitaires de Strasbourg, Service Oto-Rhino-Laryngologie, 67098 Strasbourg, France
| | - Agnes Dupret-Bories
- Institut National de la Santé et de la Recherche Médicale, INSERM Unité 1121, 11 Rue Humann, 67000 Strasbourg, France; Hôpitaux Universitaires de Strasbourg, Service Oto-Rhino-Laryngologie, 67098 Strasbourg, France; Institut Universitaire du Cancer de Toulouse, 1 avenue Irène Joliot Curie, 31059 Toulouse, France
| | - Christian Debry
- Institut National de la Santé et de la Recherche Médicale, INSERM Unité 1121, 11 Rue Humann, 67000 Strasbourg, France; Hôpitaux Universitaires de Strasbourg, Service Oto-Rhino-Laryngologie, 67098 Strasbourg, France
| | - Martin Stelzle
- NMI Natural and Medical Sciences Institute at the University of Tübingen, BioMEMS Group, Markwiesenstraße 55, D-72770 Reutlingen, Germany
| | - Philippe Lavalle
- Institut National de la Santé et de la Recherche Médicale, INSERM Unité 1121, 11 Rue Humann, 67000 Strasbourg, France; Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Sainte Elisabeth, 67000 Strasbourg, France
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Özçelik H, Vrana NE, Gudima A, Riabov V, Gratchev A, Haikel Y, Metz-Boutigue MH, Carradò A, Faerber J, Roland T, Klüter H, Kzhyshkowska J, Schaaf P, Lavalle P. Harnessing the multifunctionality in nature: a bioactive agent release system with self-antimicrobial and immunomodulatory properties. Adv Healthc Mater 2015; 4:2026-36. [PMID: 26379222 DOI: 10.1002/adhm.201500546] [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: 07/12/2015] [Indexed: 12/14/2022]
Abstract
Major problems with biomedical devices in particular implants located in nonsterile environments concern: (i) excessive immune response to the implant, (ii) development of bacterial biofilms, and (iii) yeast and fungi infections. An original multifunctional coating that addresses all these issues concomitantly is developed. A new exponentially growing polyelectrolyte multilayer film based on polyarginine (PAR) and hyaluronic acid (HA) is designed. The films have a strong inhibitory effect on the production of inflammatory cytokines released by human primary macrophage subpopulations. This could reduce potential chronic inflammatory reaction following implantation. Next, it is shown that PAR, due to its positive charges, has an antimicrobial activity in film format against Staphylococcus aureus for 24 h. In order to have a long-term antimicrobial activity, a precursor nanoscale silver coating is deposited on the surface before adding the PAR/HA films. Moreover, the PAR/HA films can be easily further functionalized by embedding antimicrobial peptides, like catestatin (CAT), a natural host defense peptide. This PAR/HA+CAT film proves to be effective as an antimicrobial coating against yeast and fungi and its cytocompatibility is also assessed. Finally, this all-in-one system constitutes an original strategy to limit inflammation and prevents bacteria, yeast, and fungi infections.
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Affiliation(s)
- Hayriye Özçelik
- Institut National de la Santé et de la Recherche Médicale; INSERM Unité 1121, 11 rue Humann 67085 Strasbourg France
- Faculté de Chirurgie Dentaire; Université de Strasbourg; 1 Place de l'Hôpital 67000 Strasbourg France
| | - Nihal Engin Vrana
- Institut National de la Santé et de la Recherche Médicale; INSERM Unité 1121, 11 rue Humann 67085 Strasbourg France
- Protip SAS; 8 Place de l'Hôpital 67000 Strasbourg France
| | - Alexandru Gudima
- Institute of Transfusion Medicine and Immunology; Medical Faculty Mannheim; University of Heidelberg; Theodor-Kutzer Uber 1-3 68167 Mannheim Germany
| | - Vladimir Riabov
- Institute of Transfusion Medicine and Immunology; Medical Faculty Mannheim; University of Heidelberg; Theodor-Kutzer Uber 1-3 68167 Mannheim Germany
| | - Alexei Gratchev
- Institute of Transfusion Medicine and Immunology; Medical Faculty Mannheim; University of Heidelberg; Theodor-Kutzer Uber 1-3 68167 Mannheim Germany
- Laboratory for Translational Cellular and Molecular Biomedicine; Tomsk State University; 36 Lenin Prospekt, Tomsk 634050 Russia
| | - Youssef Haikel
- Institut National de la Santé et de la Recherche Médicale; INSERM Unité 1121, 11 rue Humann 67085 Strasbourg France
- Faculté de Chirurgie Dentaire; Université de Strasbourg; 1 Place de l'Hôpital 67000 Strasbourg France
| | - Marie-Hélène Metz-Boutigue
- Institut National de la Santé et de la Recherche Médicale; INSERM Unité 1121, 11 rue Humann 67085 Strasbourg France
- Faculté de Chirurgie Dentaire; Université de Strasbourg; 1 Place de l'Hôpital 67000 Strasbourg France
| | - Adele Carradò
- Institut de Physique et Chimie des Matériaux de Strasbourg; UMR 7054 CNRS; 23 rue du Loess Strasbourg Cedex 2 Strasbourg 67034 France
| | - Jacques Faerber
- Institut de Physique et Chimie des Matériaux de Strasbourg; UMR 7054 CNRS; 23 rue du Loess Strasbourg Cedex 2 Strasbourg 67034 France
| | - Thierry Roland
- Institut Charles Sadron; CNRS UPR 22; Strasbourg 67034 France
| | - Harald Klüter
- Institute of Transfusion Medicine and Immunology; Medical Faculty Mannheim; University of Heidelberg; Theodor-Kutzer Uber 1-3 68167 Mannheim Germany
- Red Cross Blood Service Baden-Württemberg - Hessen; Friedrich-Ebert Str. 107 D-68167 Mannheim Germany
| | - Julia Kzhyshkowska
- Institute of Transfusion Medicine and Immunology; Medical Faculty Mannheim; University of Heidelberg; Theodor-Kutzer Uber 1-3 68167 Mannheim Germany
- Laboratory for Translational Cellular and Molecular Biomedicine; Tomsk State University; 36 Lenin Prospekt, Tomsk 634050 Russia
- Red Cross Blood Service Baden-Württemberg - Hessen; Friedrich-Ebert Str. 107 D-68167 Mannheim Germany
| | - Pierre Schaaf
- Institut National de la Santé et de la Recherche Médicale; INSERM Unité 1121, 11 rue Humann 67085 Strasbourg France
- Institut Charles Sadron; CNRS UPR 22; 23 rue du Lœss 67034 Strasbourg France
| | - Philippe Lavalle
- Institut National de la Santé et de la Recherche Médicale; INSERM Unité 1121, 11 rue Humann 67085 Strasbourg France
- Faculté de Chirurgie Dentaire; Université de Strasbourg; 1 Place de l'Hôpital 67000 Strasbourg France
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Rieger E, Dupret-Bories A, Salou L, Metz-Boutigue MH, Layrolle P, Debry C, Lavalle P, Vrana NE. Controlled implant/soft tissue interaction by nanoscale surface modifications of 3D porous titanium implants. NANOSCALE 2015; 7:9908-9918. [PMID: 25967094 DOI: 10.1039/c5nr01237f] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Porous titanium implants are widely employed in the orthopaedics field to ensure good bone fixation. Recently, the use of porous titanium implants has also been investigated in artificial larynx development in a clinical setting. Such uses necessitate a better understanding of the interaction of soft tissues with porous titanium structures. Moreover, surface treatments of titanium have been generally evaluated in planar structures, while the porous titanium implants have complex 3 dimensional (3D) architectures. In this study, the determining factors for soft tissue integration of 3D porous titanium implants were investigated as a function of surface treatments via quantification of the interaction of serum proteins and cells with single titanium microbeads (300-500 μm in diameter). Samples were either acid etched or nanostructured by anodization. When the samples are used in 3D configuration (porous titanium discs of 2 mm thickness) in vivo (in subcutis of rats for 2 weeks), a better integration was observed for both anodized and acid etched samples compared to the non-treated implants. If the implants were also pre-treated with rat serum before implantation, the integration was further facilitated. In order to understand the underlying reasons for this effect, human fibroblast cell culture tests under several conditions (directly on beads, beads in suspension, beads encapsulated in gelatin hydrogels) were conducted to mimic the different interactions of cells with Ti implants in vivo. Physical characterization showed that surface treatments increased hydrophilicity, protein adsorption and roughness. Surface treatments also resulted in improved adsorption of serum albumin which in turn facilitated the adsorption of other proteins such as apolipoprotein as quantified by protein sequencing. The cellular response to the beads showed considerable difference with respect to the cell culture configuration. When the titanium microbeads were entrapped in cell-laden gelatin hydrogels, significantly more cells migrated towards the acid etched beads. In conclusion, the nanoscale surface treatment of 3D porous titanium structures can modulate in vivo integration by the accumulative effect of the surface treatment on several physical factors such as protein adsorption, surface hydrophilicity and surface roughness. The improved protein adsorption capacity of the treated implants can be further exploited by a pre-treatment with autologous serum to render the implant surface more bioactive. Titanium microbeads are a good model system to observe these effects in a 3D microenvironment and provide a better representation of cellular responses in 3D.
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Affiliation(s)
- Elisabeth Rieger
- Institut National de la Santé et de la Recherche Médicale, INSERM Unité 1121, 11 Rue Humann, 67000 Strasbourg, France
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Voice Prostheses, Microbial Colonization and Biofilm Formation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 830:123-36. [DOI: 10.1007/978-3-319-11038-7_8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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