1
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Mahmoudi M, Alizadeh P, Soltani M. Wound healing performance of electrospun PVA/70S30C bioactive glass/Ag nanoparticles mats decorated with curcumin: In vitro and in vivo investigations. BIOMATERIALS ADVANCES 2023; 153:213530. [PMID: 37356283 DOI: 10.1016/j.bioadv.2023.213530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/09/2023] [Accepted: 06/17/2023] [Indexed: 06/27/2023]
Abstract
Biocompatible fibrous scaffold containing polyvinyl alcohol (PVA), 70S30C bioactive glass (BG), silver (Ag) nanoparticles and curcumin (Cur) was fabricated through electrospinning method. Scanning electron microscope (SEM) and Field emission scanning electron microscopy (FESEM) were employed to investigate the morphological characteristics of the scaffolds. In addition, biodegradability, hydrophilicity, and contact angle were studied as criteria for evaluating physical properties of the scaffolds. Tensile strength was reported to be 0.971 ± 0.093 MPa. Also, the viability of fibroblasts after 7 days of cell culture was 93.58 ± 1.36 %. The antibacterial activity against Escherichia coli and Staphylococcus aureus bacteria was illustrated using inhibition zones of 13.12 ± 0.69 and 14.21 ± 1.37 mm, respectively. Histological results revealed that tissue regeneration after 14 days of surgery was much higher for the dressing group compared to the blank group. According to the obtained results, the authors introduce the PVA-BG-Ag-Cur scaffold as a promising candidate for skin tissue engineering applications.
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Affiliation(s)
- Masoud Mahmoudi
- Department of Materials Science and Engineering, Faculty of Engineering & Technology, Tarbiat Modares University, P. O. Box: 14115-143, Tehran, Iran
| | - Parvin Alizadeh
- Department of Materials Science and Engineering, Faculty of Engineering & Technology, Tarbiat Modares University, P. O. Box: 14115-143, Tehran, Iran.
| | - Mohammad Soltani
- Department of Materials Science and Engineering, Faculty of Engineering & Technology, Tarbiat Modares University, P. O. Box: 14115-143, Tehran, Iran
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2
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Fischer NG, Aparicio C. Junctional epithelium and hemidesmosomes: Tape and rivets for solving the "percutaneous device dilemma" in dental and other permanent implants. Bioact Mater 2022; 18:178-198. [PMID: 35387164 PMCID: PMC8961425 DOI: 10.1016/j.bioactmat.2022.03.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/14/2022] [Accepted: 03/12/2022] [Indexed: 02/06/2023] Open
Abstract
The percutaneous device dilemma describes etiological factors, centered around the disrupted epithelial tissue surrounding non-remodelable devices, that contribute to rampant percutaneous device infection. Natural percutaneous organs, in particular their extracellular matrix mediating the "device"/epithelium interface, serve as exquisite examples to inspire longer lasting long-term percutaneous device design. For example, the tooth's imperviousness to infection is mediated by the epithelium directly surrounding it, the junctional epithelium (JE). The hallmark feature of JE is formation of hemidesmosomes, cell/matrix adhesive structures that attach surrounding oral gingiva to the tooth's enamel through a basement membrane. Here, the authors survey the multifaceted functions of the JE, emphasizing the role of the matrix, with a particular focus on hemidesmosomes and their five main components. The authors highlight the known (and unknown) effects dental implant - as a model percutaneous device - placement has on JE regeneration and synthesize this information for application to other percutaneous devices. The authors conclude with a summary of bioengineering strategies aimed at solving the percutaneous device dilemma and invigorating greater collaboration between clinicians, bioengineers, and matrix biologists.
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Affiliation(s)
- Nicholas G. Fischer
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, MN, 55455, USA
| | - Conrado Aparicio
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, MN, 55455, USA
- Division of Basic Research, Faculty of Odontology, UIC Barcelona – Universitat Internacional de Catalunya, C/. Josep Trueta s/n, 08195, Sant Cugat del Valles, Barcelona, Spain
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), C/. Baldiri Reixac 10-12, 08028, Barcelona, Spain
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3
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Kjellin P, Danielsson K, Håkansson J, Agrenius K, Andersson T, Stenlund P. Biomechanical and histomorphometric evaluation of skin integration on titanium and PEEK implants with different surface treatments. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:68. [PMID: 36178551 PMCID: PMC9525375 DOI: 10.1007/s10856-022-06687-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/22/2022] [Indexed: 05/14/2023]
Abstract
Percutaneous implants are frequently affected by bacterial growth at the skin-implant interface. Integration between implant and surrounding skin is important to prevent bacteria from spreading to the underlying tissue. The standard method to evaluate skin-implant integration is by histomorphometry on samples which have been placed in tissue grown in vivo or ex vivo. In this study, a biomechanical method was developed and evaluated. The integration of implants into porcine skin was studied in an ex vivo model, where pig skin samples were cultivated in a nutrient solution. Cylindrical shaped implants, consisting of polyether ether ketone (PEEK) and titanium (Ti) with different surface treatments, were implanted in the skin tissue and the skin was grown in nutrient solution for 2 weeks. The implants were then extracted from the implantation site and the mechanical force during extraction was measured as a quantitative assessment of skin-implant integration. Implants from each group were also processed for histomorphometry and the degree of epidermal downgrowth (ED) and tissue to implant contact (TIC) was measured. A higher mean pullout force was observed for the PEEK implants compared to the Ti implants. Applying nanosized hydroxyapatite (HA) on Ti and PEEK increased the pullout force compared to uncoated controls, 24% for machined and 70% for blasted Ti, and 51% for machined PEEK. Treatment of Ti and PEEK with nanosized zirconium phosphate (ZrP) did not increase the pullout force. The histomorphometry analysis showed correlation between ED and pullout force, where the pullout force was inversely proportional to ED. For TIC, no significant differences were observed between the groups of same material (i.e. Ti, Ti+HA, Ti+ZrP, and PEEK, PEEK + HA, PEEK + ZrP), but it was significantly higher for PEEK compared to Ti. Scanning electron microscopy analysis was done on samples before and after the pullout tests, showing that the ZrP coating was unaffected by the 2 week ex vivo implantation and pullout procedure, no dissolution or detachment of the coating was observed. For the HA coating, a loss of coating was seen on approximately 5% of the total surface area of the implant. Graphical abstract.
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Affiliation(s)
- Per Kjellin
- Promimic AB, AstraZeneca BioventureHub, SE, 43183, Mölndal, Sweden.
| | - Karin Danielsson
- Promimic AB, AstraZeneca BioventureHub, SE, 43183, Mölndal, Sweden
| | - Joakim Håkansson
- Department of Methodology, Textile and Medical Technology, RISE Research Institutes of Sweden, SE, 50115, Borås, Sweden
- Department of Laboratory Medicine, Institute of Biomedicine, Gothenburg University, SE, 40530, Göteborg, Sweden
| | - Karin Agrenius
- Department of Methodology, Textile and Medical Technology, RISE Research Institutes of Sweden, SE, 50115, Borås, Sweden
| | - Therese Andersson
- Department of Methodology, Textile and Medical Technology, RISE Research Institutes of Sweden, SE, 50115, Borås, Sweden
| | - Patrik Stenlund
- Department of Methodology, Textile and Medical Technology, RISE Research Institutes of Sweden, SE, 50115, Borås, Sweden
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4
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Van den Borre CE, Zigterman BGR, Mommaerts MY, Braem A. How surface coatings on titanium implants affect keratinized tissue: A systematic review. J Biomed Mater Res B Appl Biomater 2022; 110:1713-1723. [PMID: 35103386 PMCID: PMC9306745 DOI: 10.1002/jbm.b.35025] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 11/24/2021] [Accepted: 01/19/2022] [Indexed: 02/04/2023]
Abstract
Apart from osseointegration, the stability and long‐term survival of percutaneous titanium implants is also strongly dependent on a qualitative soft‐tissue integration in the transcutaneous region. A firm connective tissue seal is needed to minimize soft‐tissue dehiscence and epithelial downgrowth. It is well‐known that the implant surface plays a key role in controlling the biological response of the surrounding keratinized tissue and several coating systems have been suggested to enhance the soft‐tissue cell interactions. Although some promising results have been obtained in vitro, their clinical significance can be debated. Therefore, the purpose of this systematic review is to gain more insight into the effect of such coatings on the interface formed with keratinized soft‐tissue in vivo. A comprehensive search was undertaken in March 2021. Relevant electronic databases were consulted to identify appropriate studies using a set of search strings. In total, 12 out of 4971 publications were included in this review. The reported coating systems were assigned to several subgroups according to their characteristics: metallic, ceramic and composite. Notwithstanding the differences in study characteristics (animal model, implantation period, reported outcomes), it was noticed that several coatings improve the soft‐tissue integration as compared to pristine titanium. Porous titanium coatings having only limited pore sizes (<250 μm) do not support dermal fibroblast tissue attachment. Yet, larger pores (>700 μm) allow extensive vascularized soft‐tissue infiltration, thereby supporting cell attachment. Nanostructured ceramic coatings are found to reduce the inflammatory response in favor of the formation of cell adhesive structures, that is, hemidesmosomes. Biomolecule coatings seem of particular interest to stimulate the soft‐tissue behavior provided that a durable fixation to the implant surface can be ensured. In this respect, fibroblast growth factor‐2 entrapped in a biomimetic apatite coating instigates a close to natural soft‐tissue attachment with epidermal collagen fibers attaching almost perpendicular to the implant surface. However, several studies had limitations with respect to coating characterization and detailed soft‐tissue analysis, small sample size and short implantation periods. To date, robust and long‐term in vivo studies are still lacking. Further investigation is required before a clear consensus on the optimal coating system allowing enhancing the soft‐tissue seal around percutaneous titanium implants can be reached.
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Affiliation(s)
- Casper E Van den Borre
- Doctoral School of Life Sciences and Medicine, Vrije Universiteit Brussel, Brussels, Belgium.,European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Brandaan G R Zigterman
- European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maurice Y Mommaerts
- European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Annabel Braem
- Department of Materials Engineering, Biomaterials and Tissue Engineering Research Group, KU Leuven, Leuven, Belgium
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5
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Hawthorne B, Simmons JK, Stuart B, Tung R, Zamierowski DS, Mellott AJ. Enhancing wound healing dressing development through interdisciplinary collaboration. J Biomed Mater Res B Appl Biomater 2021; 109:1967-1985. [PMID: 34002476 PMCID: PMC8519107 DOI: 10.1002/jbm.b.34861] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/03/2021] [Accepted: 04/30/2021] [Indexed: 12/31/2022]
Abstract
The process of wound healing includes four phases: Hemostasis, inflammation, proliferation, and remodeling. Many wound dressings and technologies have been developed to enhance the body's ability to close wounds and restore the function of damaged tissues. Several advancements in wound healing technology have resulted from innovative experiments by individual scientists or physicians working independently. The interplay between the medical and scientific research fields is vital to translating new discoveries in the lab to treatments at the bedside. Tracing the history of wound dressing development reveals that there is an opportunity for deeper collaboration between multiple disciplines to accelerate the advancement of novel wound healing technologies. In this review, we explore the different types of wound dressings and biomaterials used to treat wounds, and we investigate the role of multidisciplinary collaboration in the development of various wound management technologies to illustrate the benefit of direct collaboration between physicians and scientists.
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Affiliation(s)
- Briauna Hawthorne
- Department of Plastic SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - J. Kai Simmons
- Department of Plastic SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Braden Stuart
- Department of Plastic SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Robert Tung
- Department of Plastic SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - David S. Zamierowski
- Department of Plastic SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Adam J. Mellott
- Department of Plastic SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
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6
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Wang X, Lei X, Yu Y, Miao S, Tang J, Fu Y, Ye K, Shen Y, Shi J, Wu H, Zhu Y, Yu L, Pei G, Bi L, Ding J. Biological sealing and integration of a fibrinogen-modified titanium alloy with soft and hard tissues in a rat model. Biomater Sci 2021; 9:5192-5208. [PMID: 34159966 DOI: 10.1039/d1bm00762a] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Percutaneous or transcutaneous devices are important and unique, and the corresponding biological sealing at the skin-implant interface is the key to their long-term success. Herein, we investigated the surface modification to enhance biological sealing, using a metal sheet and screw bonded by biomacromolecule fibrinogen mediated via pre-deposited synthetic macromolecule polydopamine (PDA) as a demonstration. We examined the effects of a Ti-6Al-4V titanium alloy modified with fibrinogen (Ti-Fg), PDA (Ti-PDA) or their combination (Ti-PDA-Fg) on the biological sealing and integration with skin and bone tissues. Human epidermal keratinocytes (HaCaT), human foreskin fibroblasts (HFF) and preosteoblasts (MC3T3-E1), which are closely related to percutaneous implants, exhibited better adhesion and spreading on all the three modified sheets compared with the unmodified alloy. After three-week subcutaneous implantation in Sprague-Dawley (SD) rats, the Ti-PDA-Fg sheets could significantly attenuate the soft tissue response and promote angiogenesis compared with other groups. Furthermore, in the model of percutaneous tibial implantation in SD rats, the Ti-PDA-Fg screws dramatically inhibited epithelial downgrowth and promoted new bone formation. Hence, the covalent immobilization of fibrinogen through the precoating of PDA is promising for enhanced biological sealing and osseointegration of metal implants with soft and hard tissues, which is critical for an orthopedic percutaneous medical device.
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Affiliation(s)
- Xiuli Wang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China.
| | - Xing Lei
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China. and Department of Orthopedic Surgery, Linyi People's Hospital, Linyi 276000, China
| | - Yue Yu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China.
| | - Sheng Miao
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China.
| | - Jingyu Tang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China.
| | - Ye Fu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China.
| | - Kai Ye
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China.
| | - Yang Shen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China.
| | - Jiayue Shi
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China.
| | - Hao Wu
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China.
| | - Yi Zhu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China.
| | - Lin Yu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China.
| | - Guoxian Pei
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China. and Southern University of Science and Technology Hospital, Southern University of Science and Technology, Shenzhen 518055, China
| | - Long Bi
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China.
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China.
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7
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Tissue Engineering 3D Porous Scaffolds Prepared from Electrospun Recombinant Human Collagen (RHC) Polypeptides/Chitosan Nanofibers. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11115096] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Electrospinning, the only method that can continuously produce nanofibers, has been widely used to prepare nanofibers for tissue engineering applications. However, electrospinning is not suitable for preparing clinically relevant three-dimensional (3D) nanofibrous scaffolds with hierarchical pore structures. In this study, recombinant human collagen (RHC)/chitosan nanofibers prepared by electrospinning were combined with porous scaffolds produced by freeze drying to fabricate 3D nanofibrous scaffolds. These scaffolds exhibited high porosity (over 80%) and an interconnected porous structure (ranging from sub-micrometers to 200 μm) covered with nanofibers. As confirmed by the characterization results, these scaffolds showed good swelling ability, stability, and adequate mechanical strength, making it possible to use the 3D nanofibrous scaffolds in various tissue engineering applications. In addition, after seven days of cell culturing, NIH 3T3 was infiltrated into the scaffolds while maintaining its morphology and with superior proliferation and viability. These results indicated that the 3D nanofibrous scaffolds hold great promise for tissue engineering applications.
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8
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Fereydouni N, Movaffagh J, Amiri N, Darroudi S, Gholoobi A, Goodarzi A, Hashemzadeh A, Darroudi M. Synthesis of nano-fibers containing nano-curcumin in zein corn protein and its physicochemical and biological characteristics. Sci Rep 2021; 11:1902. [PMID: 33479286 PMCID: PMC7820604 DOI: 10.1038/s41598-020-73678-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/21/2020] [Indexed: 01/08/2023] Open
Abstract
Curcumin contains many biological activities as a natural bioactive substance, however, its low solubility stands as a huge bioavailability disadvantage. Recently, different methods have been developed for utilizing the tremendous medicinal properties of this material. In this study, an Oil/Water nano-emulsion of curcumin (Nano-CUR) has been woven in zein polymer at three percentages of 5%, 10%, and 15% (v/v). We have investigated the physicochemical properties of nanofibers (NFs) including FESEM, FTIR, tensile strength, encapsulation efficiency, and release profile, as well as biological properties. According to the data, the NFs have been observed to become significantly thinner and more uniformed as the involved percentage of Nano-CUR had been increased from 5 to 15%. It is considerable that the tensile strength can be increased by heightening the existing Nano-CUR from 5% towards 15%. The resultant NFs of zein/Nano-CUR 15% have exhibited higher in vitro release and lower encapsulation efficiency than the other evaluated zein/Nano-CUR NFs. It has been confirmed through the performed viability and antioxidant studies that zein/Nano-CUR 10% NFs are capable of providing the best conditions for cell proliferation. Considering the mentioned facts, this work has suggested that Nano-CUR can be successfully woven in zein NFs and maintain their biological properties.
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Affiliation(s)
- Narges Fereydouni
- Department of Tissue Engineering, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran. .,Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran. .,Department of Medical Biotechnology and Nanotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Jebrail Movaffagh
- Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.,Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nafise Amiri
- Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.,Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Darroudi
- Student Research Committee, International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Aida Gholoobi
- Medical Genetics Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Arash Goodarzi
- Department of Tissue Engineering, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran.,Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Alireza Hashemzadeh
- Department of Medical Biotechnology and Nanotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Darroudi
- Department of Medical Biotechnology and Nanotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. .,Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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9
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Nakhaei K, Ishijima M, Ikeda T, Ghassemi A, Saruta J, Ogawa T. Ultraviolet Light Treatment of Titanium Enhances Attachment, Adhesion, and Retention of Human Oral Epithelial Cells via Decarbonization. MATERIALS (BASEL, SWITZERLAND) 2020; 14:E151. [PMID: 33396339 PMCID: PMC7796045 DOI: 10.3390/ma14010151] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 01/01/2023]
Abstract
Early establishment of soft-tissue adhesion and seal at the transmucosal and transcutaneous surface of implants is crucial to prevent infection and ensure the long-term stability and function of implants. Herein, we tested the hypothesis that treatment of titanium with ultraviolet (UV) light would enhance its interaction with epithelial cells. X-ray spectroscopy showed that UV treatment significantly reduced the atomic percentage of surface carbon on titanium from 46.1% to 28.6%. Peak fitting analysis revealed that, among the known adventitious carbon contaminants, C-C and C=O groups were significantly reduced after UV treatment, while other groups were increased or unchanged in percentage. UV-treated titanium attracted higher numbers of human epithelial cells than untreated titanium and allowed more rapid cell spread. Hemi-desmosome-related molecules, integrin β4 and laminin-5, were upregulated at the gene and protein levels in the cells on UV-treated surfaces. The result of the detachment test revealed twice as many cells remaining adherent on UV-treated than untreated titanium. The enhanced cellular affinity of UV-treated titanium was equivalent to laminin-5 coating of titanium. These data indicated that UV treatment of titanium enhanced the attachment, adhesion, and retention of human epithelial cells associated with disproportional removal of adventitious carbon contamination, providing a new strategy to improve soft-tissue integration with implant devices.
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Affiliation(s)
- Kourosh Nakhaei
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (K.N.); (M.I.); (T.I.); (A.G.); (T.O.)
| | - Manabu Ishijima
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (K.N.); (M.I.); (T.I.); (A.G.); (T.O.)
| | - Takayuki Ikeda
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (K.N.); (M.I.); (T.I.); (A.G.); (T.O.)
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, 1-8-13 Kanda Surugadai, Chiyoda-ku 101-8310, Tokyo, Japan
| | - Amirreza Ghassemi
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (K.N.); (M.I.); (T.I.); (A.G.); (T.O.)
- Section of Periodontics, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, 2800 College Ave, Alton, IL 62002, USA
| | - Juri Saruta
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (K.N.); (M.I.); (T.I.); (A.G.); (T.O.)
- Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, 82 Inaoka, Yokosuka 238-8580, Kanagawa, Japan
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (K.N.); (M.I.); (T.I.); (A.G.); (T.O.)
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10
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Dias-Netipanyj MF, Sopchenski L, Gradowski T, Elifio-Esposito S, Popat KC, Soares P. Crystallinity of TiO 2 nanotubes and its effects on fibroblast viability, adhesion, and proliferation. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2020; 31:94. [PMID: 33128627 DOI: 10.1007/s10856-020-06431-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/24/2020] [Indexed: 06/11/2023]
Abstract
Titanium and titanium alloys are widely used as a biomaterial due to their mechanical strength, corrosion resistance, low elastic modulus, and excellent biocompatibility. TiO2 nanotubes have excellent bioactivity, stimulating the adhesion, proliferation of fibroblasts and adipose-derived stem cells, production of alkaline phosphatase by osteoblasts, platelets activation, growth of neural cells and adhesion, spreading, growth, and differentiation of rat bone marrow mesenchymal stem cells. In this study, we investigated the functionality of fibroblast on titania nanotube layers annealed at different temperatures. The titania nanotube layer was fabricated by potentiostatic anodization of titanium, then annealed at 300, 530, and 630 °C for 5 h. The resulting nanotube layer was characterized using SEM (Scanning Electron Microscopy), TF-XRD (Thin-film X-ray diffraction), and contact angle goniometry. Fibroblasts viability was determined by the CellTiter-Blue method and cytotoxicity by Lactate Dehydrogenase test, and the cell morphology was analyzed by scanning electron microscopy. Also, cell adherence, proliferation, and morphology were analyzed by fluorescence microscopy. The results indicate that the modification in nanotube crystallinity may provide a favorable surface fibroblast growth, especially on substrates annealed at 530 and 630 °C, indicating that these properties provide a favorable template for biomedical implants.
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Affiliation(s)
- Marcela Ferreira Dias-Netipanyj
- Graduate Program in Health Science, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Luciane Sopchenski
- Department of Mechanical Engineering, Polytechnic School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Thatyanne Gradowski
- Graduate Program in Health Science, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Selene Elifio-Esposito
- Graduate Program in Health Science, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Ketul C Popat
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Paulo Soares
- Department of Mechanical Engineering, Polytechnic School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil.
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11
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Bolle ECL, Verderosa AD, Dhouib R, Parker TJ, Fraser JF, Dargaville TR, Totsika M. An in vitro Reconstructed Human Skin Equivalent Model to Study the Role of Skin Integration Around Percutaneous Devices Against Bacterial Infection. Front Microbiol 2020; 11:670. [PMID: 32477277 PMCID: PMC7240036 DOI: 10.3389/fmicb.2020.00670] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 03/24/2020] [Indexed: 01/19/2023] Open
Abstract
Percutaneous devices are a key technology in clinical practice, used to connect internal organs to external medical devices. Examples include prosthesis, catheters and electrical drivelines. Percutaneous devices breach the skin's natural barrier and create an entry point for pathogens, making device infections a widespread problem. Modification of the percutaneous implant surface to increase skin integration with the aim to reduce subsequent infection is attracting a great deal of attention. While novel surfaces have been tested in various in vitro models used to study skin integration around percutaneous devices, no skin model has been reported, for the study of bacterial infection around percutaneous devices. Here, we report the establishment of an in vitro human skin equivalent model for driveline infections caused by Staphylococcus aureus, the most common cause of driveline-related infections. Three types of mock drivelines manufactured using melt electrowriting (smooth or porous un-seeded and porous pre-seeded with human fibroblasts) were implanted in human skin constructs and challenged with S. aureus. Our results show a high and stable load of S. aureus in association with the skin surface and no signs of S. aureus-induced tissue damage. Furthermore, our results demonstrate that bacterial migration along the driveline surface occurs in micro-gaps caused by insufficient skin integration between the driveline and the surrounding skin consistent with clinical reports from explanted patient drivelines. Thus, the human skin-driveline infection model presented here provides a clinically-relevant and versatile experimental platform for testing novel device surfaces and infection therapeutics.
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Affiliation(s)
- Eleonore C. L. Bolle
- Tissue Repair and Translational Physiology Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
- The Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Infection and Immunity Research Program, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Anthony D. Verderosa
- Infection and Immunity Research Program, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rabeb Dhouib
- Infection and Immunity Research Program, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Tony J. Parker
- Tissue Repair and Translational Physiology Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - John F. Fraser
- The Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Tim R. Dargaville
- Tissue Repair and Translational Physiology Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Makrina Totsika
- Infection and Immunity Research Program, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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12
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van Hoof M, Wigren S, Ivarsson Blechert J, Joore MA, Mateijsen DJM, Bom SJH, Stalfors J, Eeg-Olofsson M, Deguine O, van der Rijt AJM, Flynn MC, Algarra JM, Stokroos RJ. Clinical Outcomes of Soft Tissue Preservation Surgery With Hydroxyapatite-Coated Abutments Compared to Traditional Percutaneous Bone Conduction Hearing Implant Surgery-A Pragmatic Multi-Center Randomized Controlled Trial. Front Surg 2020; 7:5. [PMID: 32211417 PMCID: PMC7066494 DOI: 10.3389/fsurg.2020.00005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/30/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Soft tissue preservation using a hydroxyapatite-coated abutment in bone conduction hearing implant surgery may lead to improved clinical outcomes over the short (1 year) and long term (3 years). Methods: In this open multi-center, randomized (1:1), controlled clinical trial, subjects with conductive, mixed hearing loss or single-sided sensorineural deafness were randomly assigned to receive the conventional intervention, a titanium abutment with soft tissue reduction surgery (control), or a new intervention, a hydroxyapatite-coated abutment with soft tissue preservation surgery (test). The primary efficacy outcome was the combined endpoint of numbness, pain, peri-abutment dermatitis, and soft tissue thickening/overgrowth after 1 and 3 years. Results: The Intention-to-treat (ITT) population consisted of 52 control subjects and 51 test subjects. The difference between the groups after 1 year of follow-up as measured by the primary efficacy outcome was not statistically significant (p = 0.12) in the ITT population (n = 103), but did reach statistical significance (p = 0.03) in the per-protocol (PP) population (n = 96). It showed an advantage for the test group, with over twice as many subjects (29%) without these medical events during the first year compared to the control group (13%). After 3 years, the difference between the two groups had declined and did not reach statistical significance (24 vs. 10%, ITT p = 0.45). Secondary outcome measures which showed a statistical significant difference during the first year, such as surgical time (15 vs. 25 minutes, p < 0.0001), numbness (90 vs. 69% of subjects experienced no numbness at 1 year, p < 0.01), neuropathic pain at 3 months (p = 0.0087) and the overall opinion of the esthetic outcome (observer POSAS scale at 3 months, p < 0.01) were favorable for the test group. More soft tissue thickening/overgrowth was observed at 3 weeks for the test group (p = 0.016). Similar results were achieved for the long term follow up. Conclusions: Soft tissue preservation with a hydroxyapatite-coated abutment leads to a reduction in the combined occurrence of complications over the first year which is not statistically significant in the ITT population but is in the PP population. This effect decreased for the long-term study follow up of 3 years and did also not reach statistical significance.
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Affiliation(s)
- M van Hoof
- School for Mental Health and Neuroscience (MHENS), Ear, Nose and Throat (ENT) Department, Maastricht University Medical Center, Maastricht, Netherlands
| | - S Wigren
- Cochlear Bone Anchored Solutions AB, Mölnlycke, Sweden
| | | | - M A Joore
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, Netherlands
| | | | - S J H Bom
- ENT Department, Deventer Hospital, Deventer, Netherlands
| | - J Stalfors
- Department of Otorhinolaryngology, Sahlgrenska University Hospital, and Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Måns Eeg-Olofsson
- Department of Otorhinolaryngology, Sahlgrenska University Hospital, and Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - O Deguine
- ENT Department, Purpan Hospital, Toulouse, France
| | | | - M C Flynn
- Cochlear Bone Anchored Solutions AB, Mölnlycke, Sweden.,University of Newcastle, Callaghan, NSW, Australia
| | - J Marco Algarra
- ENT Department, Clinical University Hospital, Valencia, Spain
| | - R J Stokroos
- Department of Otolaryngology, Head and Neck Surgery, Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, Netherlands
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13
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Twardowski ZJ, Nolph KD, Khanna R, Prowant BF, Ryan LP, Nichols WK. The Need for a “Swan Neck” Permanentl Y Bent, Arcuate Peritoneal Dialysis Catheter. Perit Dial Int 2020. [DOI: 10.1177/089686088500500404] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In 1968 to ensure optimal function of a permanent catheter during periodic peritoneal dialysis, Tenckhoff recommended that a double-cuff catheter be inserted so that a slightly arcuate subcutaneous course would give the external and intraperitoneal segment a caudal direction. During the rapid growth of CAPD over the past five years, nephrologists generally have adapted the Tenckhoff's methods of catheter insertion but have encountered numerous complications. This paper describes a retrospective analysis of the complications associated with 83 peritoneal dialysis catheters functioned for 48,325 catheter days (132 catheter years) in 63 patients on continuous ambulatory peritoneal dialysis (CAPD) at our institution. Pericatheter leaks were seen only with midline insertions. Exit-site infections were significantly more resistant to treatment with singlecuff than with double-cuff catheters as assessed by the proportion of time that the exit-site is infected. If the subcutaneous tunnels were directed downward the infections were more responsive to treatment. Significantly more frequent catheter-tip migrations were observed with subcutaneous tunnel directed left and downward. Thus, our study supports Tenckhoff's observation that we can expect the lowest complication rate with double-cuff catheters with an arcuate tunnel, convex upwards. However, frequently this shape of tunnel is associated with external-cuff extrusions due to resilience of the straight catheter. To reconcile these conflicting requirements we recommend a new catheter permanently bent between the cuffs to eliminate one of the forces responsible for cuff extrusion. Such a catheter, named the swan-neck tunnel peritoneal dialysis catheter, should be inserted surgically through the belly of the rectus muscle.
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Affiliation(s)
- Zbylut J. Twardowski
- From the Department of Medicine, University of Missouri Health Science Center, V.A. Hospital and Dalton Research Center, Columbia, Missouri
| | - Karl D. Nolph
- From the Department of Medicine, University of Missouri Health Science Center, V.A. Hospital and Dalton Research Center, Columbia, Missouri
| | - Ramesh Khanna
- From the Department of Medicine, University of Missouri Health Science Center, V.A. Hospital and Dalton Research Center, Columbia, Missouri
| | - Barbara F. Prowant
- From the Department of Medicine, University of Missouri Health Science Center, V.A. Hospital and Dalton Research Center, Columbia, Missouri
| | - Leonor P. Ryan
- From the Department of Medicine, University of Missouri Health Science Center, V.A. Hospital and Dalton Research Center, Columbia, Missouri
| | - W. Kirt Nichols
- Department of Surgery, University of Missouri Health Science Center, V.A. Hospital and Dalton Research Center, Columbia, Missouri
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14
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Abstract
There is scanty knowledge of the morphology of peritoneal dialysis catheter tunnels in humans, even though such knowledge may impact on peritoneal catheter design, implantation and postimplantation care. Past descriptions of catheter tunnels are based mainly on data from animal experiments. Based on these data, it has been assumed that epidermal spreading is inhibited by collagen fibers ingrown into the cuff. Our preliminary investigation indicated that this may not be the case in humans and led us to study catheter tunnel morphology in more detail. Eighteen catheter tunnels (2 -Smm of tissue around the catheters) were removed in 17 peritoneal dialysis patients. The catheters were inserted 30 to 2013 days prior to removal (median 366 days). The catheters were removed electively or because of infectious or noninfectious complications. Contrary to the observations in animals, in only 1 case did epithelium extend to the cuff with only a minimal amount of granulation tissue present at the end of a 9 mm long sinus tract. In the remaining cases, the leading edge of the epithelium always met granulation tissue 1 −14 mm from the exit, and the cuffs were found 8 33 mm from the exit. In tunnels older than 197 days, dense fibrous tissue was ingrown into the cuffs, and a dense fibrous capsule surrounded the cuff. The uninfected intercuff segment formed a pseudosheath, indistinguishable from a tendon sheath or synovial membrane. Infection in the catheter tunnel propagates through the part of the cuff adjacent to the tubing inside the capsule, suggesting that the cuff per sedoes not constitute a major barrier for spreading infection. This observation, by exclusion, infers that the beneficial role of an external cuff in decreasing exit infections is by providing firm anchorage of the catheter resulting in restriction of its piston like movement and thereby minimizing trauma and inward conveyance of outer sinus tract flora.
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15
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Pawar DRL, Jeyapalina S, Bachus KN. Evaluation of soft-tissue response around laser microgrooved titanium percutaneous devices. J Biomed Mater Res B Appl Biomater 2020; 108:2031-2040. [PMID: 31889421 DOI: 10.1002/jbm.b.34543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/25/2019] [Accepted: 12/08/2019] [Indexed: 01/27/2023]
Abstract
Percutaneous devices are prone to epidermal downgrowth and sinus tract formation, which can serve as a nidus for bacterial colonization and increase the risk of peri-prosthetic infection. A laser microgrooved topography has been shown to limit gingival epidermal downgrowth around dental implants. However, the efficacy of this laser microgrooved topography to limit epidermal downgrowth around nongingival percutaneous devices is yet to be investigated. In this study, devices with a porous-coated subdermal component and a percutaneous post were designed and manufactured. The proximal 2 mm section of the percutaneous post were left smooth, or were textured with either a porous coating, or with the laser microgrooved topography. The smooth and porous topographies served as controls. The devices were tested in a hairless guinea pig back model, where 18 animals were randomly assigned into three groups, with each group receiving one implant type (n = 6/group). Four weeks postimplantation, the devices with surrounding soft-tissues were harvested and processed for histological analyses. Results indicated that the laser microgrooved topography failed to prevent epidermal downgrowth (23 ± 4%) around percutaneous posts in this model. Furthermore, no significant differences (p = 0.70) in epidermal downgrowth were present between the three topographies, with all the groups exhibiting similar measures of downgrowth. Overall, these findings suggest that the laser microgrooved topography may not halt downgrowth around percutaneous devices for dermal applications.
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Affiliation(s)
- Divya R L Pawar
- Orthopaedic Research Laboratories, George E. Wahlen, Department of Veterans Affairs Medical Center & University of Utah Orthopaedic Center, Salt Lake City, Utah.,Department of Bioengineering, University of Utah, Salt Lake City, Utah
| | - Sujee Jeyapalina
- Orthopaedic Research Laboratories, George E. Wahlen, Department of Veterans Affairs Medical Center & University of Utah Orthopaedic Center, Salt Lake City, Utah.,Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Kent N Bachus
- Orthopaedic Research Laboratories, George E. Wahlen, Department of Veterans Affairs Medical Center & University of Utah Orthopaedic Center, Salt Lake City, Utah.,Department of Bioengineering, University of Utah, Salt Lake City, Utah
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16
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D’Ovidio TJ, Friederich ARW, de Herrera N, Davis-Hall D, Mann EE, Magin CM. Micropattern-mediated apical guidance accelerates epithelial cell migration to improve healing around percutaneous gastrostomy tubes. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/ab50d5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Abstract
Hypergranulation, bacterial infection, and device dislodgment are common complications associated with percutaneous gastronomy (PG) tube placement for enteral feeding largely attributable to delayed stoma tract maturation around the device. Stoma tract maturation is a wound-healing process that requires collective and complete migration of an advancing epithelial layer. While it is widely accepted that micropatterned surfaces enhance cell migration when cells are cultured directly on the substrate, few studies have investigated the influence of apical contact guidance from micropatterned surfaces on cell migration, as occurs during stoma tract formation. Here, we developed 2D and 3D in vitro epithelial cell migration assays to test the effect of various Sharklet micropatterns on apically-guided cell migration. The 2D modified scratch wound assay identified a Sharklet micropattern (+10SK50×50) that enhanced apical cell migration by 4-fold (p = 0.0105) compared to smooth controls over the course of seven days. The best-performing micropattern was then applied to cylindrical prototypes with the same outer diameter as a pediatric PG tube. These prototypes were evaluated in the novel 3D migration assay where magnetic levitation aggregated cells around prototypes to create an artificial stoma. Results indicated a 50% increase (p < 0.0001) in cell migration after seven days along Sharklet-micropatterned prototypes compared to smooth controls. The Sharklet micropattern enhanced apically-guided epithelial cell migration in both 2D and 3D in vitro assays. These data suggest that the incorporation of a Sharklet micropattern onto the surface of a PG tube may accelerate cell migration via apical contact, improve stoma tract maturation, and reduce skin-associated complications.
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17
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Ayukawa Y, Oshiro W, Atsuta I, Furuhashi A, Kondo R, Jinno Y, Koyano K. Long Term Retention of Gingival Sealing around Titanium Implants with CaCl 2 Hydrothermal Treatment: A Rodent Study. J Clin Med 2019; 8:jcm8101560. [PMID: 31569492 PMCID: PMC6832415 DOI: 10.3390/jcm8101560] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/16/2019] [Accepted: 09/23/2019] [Indexed: 02/02/2023] Open
Abstract
We previously reported that CaCl2 hydrothermal-treated (Ca-HT) titanium (Ti) implants induced a tight sealing at the interface between the implant and peri-implant epithelium (PIE) after implantation. However, it is not clear how long this improved epithelium sealing can be maintained. We subsequently investigated whether the positive effect of Ca-HT to promote sealing between the PIE and implant was sustained longer term. Maxillary molars were extracted from rats and replaced with either Ca-HT implants (Ca-HT group), distilled water-HT implants (DW-HT group) or non-treated implants (control group). After 16 weeks, the majority of implants in the Ca-HT group remained at the maxillary with no apical extension of the PIE. Conversely, half the number of control implants was lost following down-growth of the PIE. The effect of Ca-HT on migration and proliferation of rat oral epithelial cells (OECs) was also investigated. In OECs cultured on Ca-HT Ti plates, protein expression in relation to cell migration decreased, and proliferation was higher than other groups. Surface analysis indicated HT enhanced the formation of surface TiO2 layer without altering surface topography. Consequently, Ca-HT of Ti reduced PIE down-growth via tight epithelial attachment to the surface, which may enhance implant capability for a longer time post-implantation.
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Affiliation(s)
- Yasunori Ayukawa
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8282, Japan.
| | - Wakana Oshiro
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8282, Japan.
| | - Ikiru Atsuta
- Division of Advanced Dental Devices and Therapeutics, Faculty of Dental Science, Kyushu University, Fukuoka 812-8282, Japan.
| | - Akihiro Furuhashi
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8282, Japan.
| | - Ryosuke Kondo
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8282, Japan.
| | - Yohei Jinno
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö S-20506, Sweden.
| | - Kiyoshi Koyano
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8282, Japan.
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18
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Abstract
The ability to generate new microvessels in desired numbers and at desired locations has been a long-sought goal in vascular medicine, engineering, and biology. Historically, the need to revascularize ischemic tissues nonsurgically (so-called therapeutic vascularization) served as the main driving force for the development of new methods of vascular growth. More recently, vascularization of engineered tissues and the generation of vascularized microphysiological systems have provided additional targets for these methods, and have required adaptation of therapeutic vascularization to biomaterial scaffolds and to microscale devices. Three complementary strategies have been investigated to engineer microvasculature: angiogenesis (the sprouting of existing vessels), vasculogenesis (the coalescence of adult or progenitor cells into vessels), and microfluidics (the vascularization of scaffolds that possess the open geometry of microvascular networks). Over the past several decades, vascularization techniques have grown tremendously in sophistication, from the crude implantation of arteries into myocardial tunnels by Vineberg in the 1940s, to the current use of micropatterning techniques to control the exact shape and placement of vessels within a scaffold. This review provides a broad historical view of methods to engineer the microvasculature, and offers a common framework for organizing and analyzing the numerous studies in this area of tissue engineering and regenerative medicine. © 2019 American Physiological Society. Compr Physiol 9:1155-1212, 2019.
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Affiliation(s)
- Joe Tien
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
- Division of Materials Science and Engineering, Boston University, Brookline, Massachusetts, USA
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19
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Bolle ECL, Bartnikowski N, Haridas P, Parker TJ, Fraser JF, Gregory SD, Dargaville TR. Improving skin integration around long-term percutaneous devices using fibrous scaffolds in a reconstructed human skin equivalent model. J Biomed Mater Res B Appl Biomater 2019; 108:738-749. [PMID: 31169980 DOI: 10.1002/jbm.b.34428] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/03/2019] [Accepted: 05/21/2019] [Indexed: 01/02/2023]
Abstract
The interface between synthetic percutaneous devices and skin is a common area for bacterial infection, which may ultimately result in failure of the device. Better integration of percutaneous devices with skin may help reduce infection rates due to the creation of a dermal seal. However, the mismatch in material and chemical properties of devices and skin presents a challenge for closing the dermal gap at the skin-device interface. Here, we have used a tissue engineering approach to tissue integration by creating a highly fibrous poly(ε-caprolactone) scaffold using melt electrowriting and seeding this with dermal fibroblasts, followed by maturation and insertion into a full-thickness defect made in an ex vivo skin model. The integration of seeded scaffolds was compared with controls including a non-seeded scaffold and a polymer tube with a smooth surface. Dermal fibroblast inclusion in the scaffold and epidermal upgrowth versus downgrowth/marsupialization around the device were used as measures of integration. Based on these measures, almost all pre-seeded scaffolds performed better than both the non-seeded scaffolds and smooth tubes. The hypothesis is that the fibroblasts act as a barrier to epithelial downward migration, and provide healthy tissue for nascent epidermal development.
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Affiliation(s)
- Eleonore C L Bolle
- Tissue Repair and Translational Physiology Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Chemistry, Physics and Mechanical Engineering, Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia.,Innovative Cardiovascular Engineering and Technology Laboratory (ICETLAB), Critical Care Research Group, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Nicole Bartnikowski
- School of Chemistry, Physics and Mechanical Engineering, Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia.,Innovative Cardiovascular Engineering and Technology Laboratory (ICETLAB), Critical Care Research Group, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Parvathi Haridas
- Tissue Repair and Translational Physiology Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Tony J Parker
- Tissue Repair and Translational Physiology Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - John F Fraser
- Innovative Cardiovascular Engineering and Technology Laboratory (ICETLAB), Critical Care Research Group, The Prince Charles Hospital, Chermside, Queensland, Australia.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Shaun D Gregory
- Innovative Cardiovascular Engineering and Technology Laboratory (ICETLAB), Critical Care Research Group, The Prince Charles Hospital, Chermside, Queensland, Australia.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Victoria, Australia.,Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Tim R Dargaville
- Tissue Repair and Translational Physiology Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Chemistry, Physics and Mechanical Engineering, Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia
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20
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Pawar DRL, Mitchell SJ, Jeyapalina S, Hawkes JE, Florell SR, Bachus KN. Peri-prosthetic tissue reaction to discontinuation of negative pressure wound therapy around porous titanium percutaneous devices. J Biomed Mater Res B Appl Biomater 2018; 107:564-572. [PMID: 29732684 DOI: 10.1002/jbm.b.34148] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 03/09/2018] [Accepted: 04/11/2018] [Indexed: 02/06/2023]
Abstract
Negative pressure wound therapy (NPWT) has been reported to limit epithelial downgrowth, one of the failure mechanisms of percutaneous devices. In a previous study, when NPWT was applied for 4 weeks (NPWT Group) to porous coated titanium percutaneous devices, downgrowth (5 ± 4%; mean ± one SD) was significantly reduced compared to untreated controls (Untreated Group) (16 ± 6%; p ≤ 0.01). However, it was unclear whether this beneficial effect was sustained when NPWT was discontinued. In order to test this, porous coated titanium percutaneous devices were implanted into 6 hairless guinea pigs. Post-surgery, animals received 4 weeks of NPWT treatment followed by 4 weeks of no treatment (Discontinued Group). At necropsy, the devices and surrounding tissues were harvested and processed. Quantitative downgrowth measurements and qualitative analyses of tissue characteristics were performed, and compared to historical controls (NPWT and Untreated Groups). The Discontinued Group, at 8 weeks, had significantly more downgrowth than the NPWT Group at 4 weeks (23 ± 3% vs. 5 ± 4%; p ≤ 0.01). At 8 weeks, the Discontinued Group qualitatively appeared to exhibit reduced numbers of blood vessels and increased degree of fibrosis compared to the NPWT Group at 4 weeks. This study suggests that NPWT will only be an effective treatment for limiting downgrowth if used continuously. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 564-572, 2019.
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Affiliation(s)
- Divya R L Pawar
- Orthopaedic Research Laboratories, George E. Wahlen, Department of Veterans Affairs Medical Center, University of Utah Orthopaedic Center, Salt Lake City, Utah, 84148.,Department of Bioengineering, University of Utah, Salt Lake City, Utah, 84112
| | - Saranne J Mitchell
- Department of Bioengineering, University of Utah, Salt Lake City, Utah, 84112
| | - Sujee Jeyapalina
- Orthopaedic Research Laboratories, George E. Wahlen, Department of Veterans Affairs Medical Center, University of Utah Orthopaedic Center, Salt Lake City, Utah, 84148.,Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, 84132
| | - Jason E Hawkes
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah, 84132
| | - Scott R Florell
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah, 84132
| | - Kent N Bachus
- Orthopaedic Research Laboratories, George E. Wahlen, Department of Veterans Affairs Medical Center, University of Utah Orthopaedic Center, Salt Lake City, Utah, 84148.,Department of Bioengineering, University of Utah, Salt Lake City, Utah, 84112
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21
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Abstract
Artificial eardrums made from biodegradable poly(D, L-lactic acid), poly(glycolic acid) and poly(ß-benzyl-L-aspartate-co-L-leucine) 50/50, and made from the microporous poly(tetrafluoroethylene) and bisphenol-A poly(carbonate) membranes were implanted into the ear and as a reference subcutaneously in rats. The implants were histologically examined for periods up to one year. From the biodegradable polymers studied the poly(ß-benzyl-L-aspartate-co-L-leucine) 50/50 evoked the least tissue reaction and the newly formed tympanic membranes are the best in terms of thickness and overall integrity. The microporous poly(tetrafluoroethylene) membrane can be considered as a valuable support for the formation of a reinforced tympanic membrane.
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Affiliation(s)
- L. Feenstra
- Ear-, Nose- and Throat Department, Free University, Amsterdam, The Netherlands
| | | | - F.E. Kohn
- Department of Chemical Engineering, Twente University of Technology, Enschede, The Netherlands
| | - J. Feijen
- Department of Chemical Engineering, Twente University of Technology, Enschede, The Netherlands
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22
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Affiliation(s)
- F.E. Kohn
- Present address: Firet BV, P.O. Box 45, 3900 AA Veenendaal, The Netherlands
| | - J. Feijen
- Department of Chemical Engineering, Twente University of Technology, P.O. Box 217 7500 AE, Enschede, The Netherlands
| | - L. Feenstra
- Ear-, Nose- and Throat Department, Free University, Amsterdam, The Netherlands
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23
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Pal P, Dadhich P, Srivas PK, Das B, Maulik D, Dhara S. Bilayered nanofibrous 3D hierarchy as skin rudiment by emulsion electrospinning for burn wound management. Biomater Sci 2018. [PMID: 28650050 DOI: 10.1039/c7bm00174f] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Mimicking skin extracellular matrix hierarchy, the present work aims to develop a bilayer skin graft comprising a porous cotton-wool-like 3D layer with membranous structure of PCL-chitosan nanofibers. Emulsion electrospinning with differential stirring periods of PCL-chitosan emulsion results in development of a bilayer 3D structure with varied morphology. The electrospun membrane has fiber diameter ∼274 nm and pore size ∼1.16 μm while fluffy 3D layer has fiber diameter ∼1.62 μm and pore size ∼62 μm. The 3D layer was further coated with collagen I isolated from Cirrhinus cirrhosus fish scales to improve biofunctionality. Surface coating with collagen I resulted in bundling the fibers together, thereby increasing their average diameter to 2.80 μm and decreasing pore size to ∼45 μm. The architecture and composition of the scaffold promotes efficient cellular activity where interconnected porosity with ECM resembling collagen I coating assists cellular adhesion, infiltration, and proliferation from initial days of fibroblast seeding, while keratinocytes migrate on the surface only without infiltrating in the membranous nanofiber layer. Anatomy of the scaffold arising due to variation in pore size distribution at different layers thereby facilitates compartmentalization and prevents initial cellular transmigration. The scaffold also assists in extracellular matrix protein synthesis and keratinocyte stratification in vitro. Further, the scaffold effectively integrates and attaches with third-degree burn wound margins created in rat models and accelerates healing in comparison to standard Tegaderm dressing™. The bilayer scaffold is thus a promising, readily available, cost-effective, off-the-shelf matrix as a skin substitute.
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Affiliation(s)
- Pallabi Pal
- Biomaterials & Tissue Engineering Laboratory, School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, Kharagpur 721302, India.
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Pal P, Srivas PK, Dadhich P, Das B, Maulik D, Dhara S. Nano-/Microfibrous Cotton-Wool-Like 3D Scaffold with Core–Shell Architecture by Emulsion Electrospinning for Skin Tissue Regeneration. ACS Biomater Sci Eng 2017; 3:3563-3575. [DOI: 10.1021/acsbiomaterials.7b00681] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Pallabi Pal
- Biomaterials
and Tissue Engineering Laboratory, School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, Kharagpur 721302, India
| | - Pavan Kumar Srivas
- Biomaterials
and Tissue Engineering Laboratory, School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, Kharagpur 721302, India
| | - Prabhash Dadhich
- Biomaterials
and Tissue Engineering Laboratory, School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, Kharagpur 721302, India
| | - Bodhisatwa Das
- Biomaterials
and Tissue Engineering Laboratory, School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, Kharagpur 721302, India
| | - Dhrubajyoti Maulik
- Department
of Surgery, Bankura Sammilani Medical College, Bankura, India
| | - Santanu Dhara
- Biomaterials
and Tissue Engineering Laboratory, School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, Kharagpur 721302, India
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Abdallah MN, Badran Z, Ciobanu O, Hamdan N, Tamimi F. Strategies for Optimizing the Soft Tissue Seal around Osseointegrated Implants. Adv Healthc Mater 2017; 6. [PMID: 28960892 DOI: 10.1002/adhm.201700549] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/12/2017] [Indexed: 12/20/2022]
Abstract
Percutaneous and permucosal devices such as catheters, infusion pumps, orthopedic, and dental implants are commonly used in medical treatments. However, these useful devices breach the soft tissue barrier that protects the body from the outer environment, and thus increase bacterial infections resulting in morbidity and mortality. Such associated infections can be prevented if these devices are effectively integrated with the surrounding soft tissue, and thus creating a strong seal from the surrounding environment. However, so far, there are no percutaneous/permucosal medical devices able to prevent infection by achieving strong integration at the soft tissue-device interface. This review gives an insight into the current status of research into soft tissue-implant interface and the challenges associated with these interfaces. Biological soft/hard tissue interfaces may provide insights toward engineering better soft tissue interfaces around percutaneous devices. In this review, focus is put on the history and current findings as well as recent progress of the strategies aiming to develop a strong soft tissue seal around osseointegrated implants, such as orthopedic and dental implants.
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Affiliation(s)
- Mohamed-Nur Abdallah
- Division of Biomedical Sciences; Faculty of Dentistry; McGill University; Montreal H3A 1G1 QC Canada
- Division of Orthodontics; Faculty of Dentistry; Toronto University; Toronto M5G 1G6 ON Canada
| | - Zahi Badran
- Division of Biomedical Sciences; Faculty of Dentistry; McGill University; Montreal H3A 1G1 QC Canada
- Department of Periodontology (CHU/Rmes Inserm U1229/UIC11); Faculty of Dental Surgery; University of Nantes; Nantes 44042 France
| | - Ovidiu Ciobanu
- Division of Biomedical Sciences; Faculty of Dentistry; McGill University; Montreal H3A 1G1 QC Canada
| | - Nader Hamdan
- Department of Dental Clinical Sciences; Faculty of Dentistry; Dalhousie University; Halifax B3H 4R2 NS Canada
| | - Faleh Tamimi
- Division of Biomedical Sciences; Faculty of Dentistry; McGill University; Montreal H3A 1G1 QC Canada
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Mohamed MS, Torabi A, Paulose M, Kumar DS, Varghese OK. Anodically Grown Titania Nanotube Induced Cytotoxicity has Genotoxic Origins. Sci Rep 2017; 7:41844. [PMID: 28165491 PMCID: PMC5292953 DOI: 10.1038/srep41844] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/30/2016] [Indexed: 01/17/2023] Open
Abstract
Nanoarchitectures of titania (TiO2) have been widely investigated for a number of medical applications including implants and drug delivery. Although titania is extensively used in the food, drug and cosmetic industries, biocompatibility of nanoscale titania is still under careful scrutiny due to the conflicting reports on its interaction with cellular matter. For an accurate insight, we performed in vitro studies on the response of human dermal fibroblast cells toward pristine titania nanotubes fabricated by anodic oxidation. The nanotubes at low concentrations were seen to induce toxicity to the cells, whereas at higher concentrations the cell vitality remained on par with controls. Further investigations revealed an increase in the G0 phase cell population depicting that majority of cells were in the resting rather than active phase. Though the mitochondrial set-up did not exhibit any signs of stress, significantly enhanced reactive oxygen species production in the nuclear compartment was noted. The TiO2 nanotubes were believed to have gained access to the nuclear machinery and caused increased stress leading to genotoxicity. This interesting property of the nanotubes could be utilized to kill cancer cells, especially if the nanotubes are functionalized for a specific target, thus eliminating the need for any chemotherapeutic agents.
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Affiliation(s)
- M Sheikh Mohamed
- Bio Nano Electronics Research Centre, Graduate School of Interdisciplinary New Science, Toyo University, Kawagoe, 350-8585 Japan
| | - Aida Torabi
- Nanomaterials and Devices Laboratory, Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - Maggie Paulose
- Nanomaterials and Devices Laboratory, Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - D Sakthi Kumar
- Bio Nano Electronics Research Centre, Graduate School of Interdisciplinary New Science, Toyo University, Kawagoe, 350-8585 Japan
| | - Oomman K Varghese
- Nanomaterials and Devices Laboratory, Department of Physics, University of Houston, Houston, Texas 77204, USA
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Abstract
Macrophages are the initial biologic responders to biomaterials. These highly plastic immune sentinels control and modulate responses to materials, foreign or natural. The responses may vary from immune stimulatory to immune suppressive. Several parameters have been identified that influence macrophage response to biomaterials, specifically size, geometry, surface topography, hydrophobicity, surface chemistry, material mechanics, and protein adsorption. In this review, the influence of these parameters is supported with examples of both synthetic and naturally derived materials and illustrates that a combination of these parameters ultimately influences macrophage responses to the biomaterial. Having an understanding of these properties may lead to highly efficient design of biomaterials with desirable biologic response properties.
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Accelerating full thickness wound healing using collagen sponge of mrigal fish (Cirrhinus cirrhosus) scale origin. Int J Biol Macromol 2016; 93:1507-1518. [DOI: 10.1016/j.ijbiomac.2016.04.032] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/28/2016] [Accepted: 04/12/2016] [Indexed: 01/06/2023]
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van Hoof M, Wigren S, Duimel H, Savelkoul PHM, Flynn M, Stokroos RJ. Can the Hydroxyapatite-Coated Skin-Penetrating Abutment for Bone Conduction Hearing Implants Integrate with the Surrounding Skin? Front Surg 2015; 2:45. [PMID: 26442276 PMCID: PMC4568398 DOI: 10.3389/fsurg.2015.00045] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 08/21/2015] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Percutaneous implants, such as bone conduction hearing implants, suffer from complications that include inflammation of the surrounding skin. A sealed skin-abutment interface can prevent the ingress of bacteria, which should reduce the occurrence of peri-abutment dermatitis. It was hypothesized that a hydroxyapatite (HA)-coated abutment in conjunction with soft tissue preservation surgery should enable integration with the adjacent skin. Previous research has confirmed that integration is never achieved with as-machined titanium abutments. Here, we investigate, in vivo, if skin integration is achievable in patients using a HA-coated abutment. MATERIALS AND METHODS One titanium abutment (control) and one HA-coated abutment (case) together with the surrounding skin were surgically retrieved from two patients who had a medical indication for this procedure. Histological sections of the skin were investigated using light microscopy. The abutment was qualitatively analyzed using scanning electron microscopy. RESULTS The titanium abutment only had a partial and thin layer of attached amorphous biological material. The HA-coated abutment was almost fully covered by a pronounced thick layer of organized skin, composed of different interconnected structural layers. CONCLUSION Proof-of-principle evidence that the HA-coated abutment can achieve integration with the surrounding skin was presented for the first time.
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Affiliation(s)
- Marc van Hoof
- Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center , Maastricht , Netherlands
| | - Stina Wigren
- Cochlear Bone Anchored Solutions AB , Mölnlycke , Sweden
| | - Hans Duimel
- Institute of Nanoscopy, Maastricht University Medical Center , Maastricht , Netherlands
| | - Paul H M Savelkoul
- Department of Medical Microbiology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center , Maastricht , Netherlands ; Department of Medical Microbiology and Infection Control, VU University Medical Center , Amsterdam , Netherlands
| | - Mark Flynn
- Cochlear Bone Anchored Solutions AB , Mölnlycke , Sweden
| | - Robert Jan Stokroos
- Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center , Maastricht , Netherlands
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Miguel SP, Ribeiro MP, Brancal H, Coutinho P, Correia IJ. Thermoresponsive chitosan–agarose hydrogel for skin regeneration. Carbohydr Polym 2014; 111:366-73. [DOI: 10.1016/j.carbpol.2014.04.093] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 04/24/2014] [Accepted: 04/27/2014] [Indexed: 12/17/2022]
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Wang Z, Wu G, Bai S, Feng Z, Dong Y, Zhou J, Qin H, Zhao Y. MAPs/bFGF-PLGA microsphere composite-coated titanium surfaces promote increased adhesion and proliferation of fibroblasts. Biomed Mater 2014; 9:035006. [PMID: 24739496 DOI: 10.1088/1748-6041/9/3/035006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Infection and epithelial downgrowth are two major problems with maxillofacial transcutaneous implants, and both are mainly due to lack of stable closure of soft tissues at transcutaneous sites. Fibroblasts have been shown to play a key role in the formation of biological seals. In this work, titanium (Ti) model surfaces were coated with mussel adhesive proteins (MAPs) utilizing its unique adhesion ability on diverse inorganic and organic surfaces in wet environments. Prepared basic fibroblast growth factor (bFGF)-poly(lactic-co-glycolic acid) (PLGA) microspheres can be easily synthesized and combined onto MAPs-coated Ti surfaces, due to the negative surface charges of microspheres in aqueous solution, which is in contrast to the positive charges of MAPs. Titanium model surfaces were divided into three groups. Group A: MAPs/bFGF-PLGA microspheres composite-coated Ti surfaces. Group B: MAPs-coated Ti surfaces. Group C: uncoated Ti surfaces. The effects of coated Ti surfaces on adhesion of fibroblasts, cytoskeletal organization, proliferation, and extracellular matrix (ECM)-related gene expressions were examined. The results revealed increased adhesion (P < 0.05), enhanced actin cytoskeletal organization, and up-regulated ECM-related gene expressions in groups A and B compared with group C. Increased proliferation of fibroblasts during five days of incubation was observed in group A compared with groups B and C (P < 0.05). Collectively, the results from this in vitro study demonstrated that MAPs/bFGF-PLGA microspheres composite-coated Ti surfaces had the ability to increase fibroblast functionality. In addition, MAPs/bFGF-PLGA microsphere composite-coated Ti surfaces should be studied further as a method of promoting formation of stable biological seals around transcutaneous sites.
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Affiliation(s)
- Zhongshan Wang
- Department of Prosthetics, School of Stomatology, The Fourth Military Medical University, Xi'an, People's Republic of China
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Cook SJ, Nichols FR, Brunker LB, Bachus KN. A novel vacuum assisted closure therapy model for use with percutaneous devices. Med Eng Phys 2014; 36:768-73. [PMID: 24685323 DOI: 10.1016/j.medengphy.2014.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 12/16/2013] [Accepted: 01/27/2014] [Indexed: 11/17/2022]
Abstract
Long-term maintenance of a dermal barrier around a percutaneous prosthetic device remains a common clinical problem. A technique known as Negative Pressure Wound Therapy (NPWT) uses negative pressure to facilitate healing of impaired and complex soft tissue wounds. However, the combination of using negative pressure with percutaneous prosthetic devices has not been investigated. The goal of this study was to develop a methodology to apply negative pressure to the tissues surrounding a percutaneous device in an animal model; no tissue healing outcomes are presented. Specifically, four hairless rats received percutaneous porous coated titanium devices implanted on the dorsum and were bandaged with a semi occlusive film dressing. Two of these animals received NPWT; two animals received no NPWT and served as baseline controls. Over a 28-day period, both the number of dressing changes required between the two groups as well as the pressures were monitored. Negative pressures were successfully applied to the periprosthetic tissues in a clinically relevant range with a manageable number of dressing changes. This study provides a method for establishing, maintaining, and quantifying controlled negative pressures to the tissues surrounding percutaneous devices using a small animal model.
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Affiliation(s)
- Saranne J Cook
- Orthopaedic Research Laboratory, University of Utah Orthopaedic Center, Salt Lake City, UT 84108, USA; Bone and Joint Research Laboratory, Department of Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Francesca R Nichols
- Orthopaedic Research Laboratory, University of Utah Orthopaedic Center, Salt Lake City, UT 84108, USA; Bone and Joint Research Laboratory, Department of Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Lucille B Brunker
- Bone and Joint Research Laboratory, Department of Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Kent N Bachus
- Orthopaedic Research Laboratory, University of Utah Orthopaedic Center, Salt Lake City, UT 84108, USA; Bone and Joint Research Laboratory, Department of Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA; Department of Bioengineering, University of Utah, Salt Lake City, UT 84112, USA.
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Atsuta I, Ayukawa Y, Yamaza T, Furuhashi A, Koyano K. The role of phosphoinositide 3-kinase in adhesion of oral epithelial cells to titanium. Arch Oral Biol 2013; 58:1696-708. [PMID: 24112737 DOI: 10.1016/j.archoralbio.2013.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 07/23/2013] [Accepted: 07/28/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND Oral epithelial cells (OECs) adhesion to titanium may improve the success rate of implant restoration. PURPOSE We investigated the mechanism by which OECs adhere to titanium dental implants. MATERIALS AND METHODS (1) After culturing rat OECs on titanium plates (Ti) or culture dishes in the presence or absence of a phosphoinositide 3-kinase (PI3K) activator or inhibitors and/or growth factors, and OEC morphology under these conditions were analyzed. (2) Right maxillary first molars were extracted and replaced with experimental implants. The rats were treated with or without growth factors. RESULTS (1) Cell adherence was lower of OECs on Ti than in those on culture dishes, as were the levels of integrin β4 and the continuity of F-actin structures. After PI3K inhibition, markedly reducing adherence to both substrates. In contrast, PI3K activation with activator or insulin-like growth factor restored the OEC adherence and the expression of adhesion molecules on Ti to the levels seen in OECs cultured on dishes. Cell migration was inhibited by PI3K activation. (2) High expression of integrin β4 was observed in the peri-implant epithelia of PI3K-activated rats. CONCLUSION These findings suggest that PI3K plays an important role in the adhesion of OECs to Ti.
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Affiliation(s)
- Ikiru Atsuta
- Section of Implant and Rehabilitative Dentistry, Devision of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Center for Craniofacial Molecular Biology, University of Southern California School of Dentistry, Los Angeles, CA 90033, USA.
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Farrell BJ, Prilutsky BI, Ritter JM, Kelley S, Popat K, Pitkin M. Effects of pore size, implantation time, and nano-surface properties on rat skin ingrowth into percutaneous porous titanium implants. J Biomed Mater Res A 2013; 102:1305-15. [PMID: 23703928 DOI: 10.1002/jbm.a.34807] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 05/13/2013] [Accepted: 05/15/2013] [Indexed: 11/10/2022]
Abstract
The main problem of percutaneous osseointegrated implants is poor skin-implant integration, which may cause infection. This study investigated the effects of pore size (Small, 40-100 μm and Large, 100-160 μm), nanotubular surface treatment (Nano), and duration of implantation (3 and 6 weeks) on skin ingrowth into porous titanium. Each implant type was percutaneously inserted in the back of 35 rats randomly assigned to seven groups. Implant extrusion rate was measured weekly and skin ingrowth into implants was determined histologically after harvesting implants. It was found that all three types of implants demonstrated skin tissue ingrowth of over 30% (at week 3) and 50% (at weeks 4-6) of total implant porous area under the skin; longer implantation resulted in greater skin ingrowth (p < 0.05). Only one case of infection was observed (infection rate 2.9%). Small and Nano groups showed the same implant extrusion rate which was lower than the Large group rate (0.06 ± 0.01 vs. 0.16 ± 0.02 cm/week; p < 0.05). Ingrowth area was comparable in the Small, Large, and Nano implants. However, qualitatively, the Nano implants showed greatest cellular inhabitation within first 3 weeks. We concluded that percutaneous porous titanium implants allow for skin integration with the potential for a safe seal.
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Affiliation(s)
- Brad J Farrell
- School of Applied Physiology, Center for Human Movement Studies, Georgia Institute of Technology, Atlanta, Georgia
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Koschwanez HE, Reichert WM. Textured and Porous Materials. Biomater Sci 2013. [DOI: 10.1016/b978-0-08-087780-8.00030-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Holt BM, Bachus KN, Beck JP, Bloebaum RD, Jeyapalina S. Immediate post‐implantation skin immobilization decreases skin regression around percutaneous osseointegrated prosthetic implant systems. J Biomed Mater Res A 2012; 101:2075-82. [DOI: 10.1002/jbm.a.34510] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 10/18/2012] [Accepted: 10/29/2012] [Indexed: 01/16/2023]
Affiliation(s)
- Brian Mueller Holt
- Bone and Joint Research Laboratory, DVA SLC HCS, Salt Lake City, Utah 84148
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah 84108
| | - Kent N. Bachus
- Bone and Joint Research Laboratory, DVA SLC HCS, Salt Lake City, Utah 84148
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah 84108
- Orthopaedic Research Laboratory, University of Utah Orthopaedic Center, Salt Lake City, Utah 84108
| | - James Peter Beck
- Bone and Joint Research Laboratory, DVA SLC HCS, Salt Lake City, Utah 84148
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah 84108
| | - Roy Drake Bloebaum
- Bone and Joint Research Laboratory, DVA SLC HCS, Salt Lake City, Utah 84148
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah 84108
| | - Sujee Jeyapalina
- Bone and Joint Research Laboratory, DVA SLC HCS, Salt Lake City, Utah 84148
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah 84108
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Scantlebury T, Ambruster J. The Development of Guided Regeneration: Making the Impossible Possible and the Unpredictable Predictable. J Evid Based Dent Pract 2012; 12:101-17. [DOI: 10.1016/s1532-3382(12)70022-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Isackson D, Cook KJ, McGill LD, Bachus KN. Mesenchymal stem cells increase collagen infiltration and improve wound healing response to porous titanium percutaneous implants. Med Eng Phys 2012; 35:743-53. [PMID: 22940446 DOI: 10.1016/j.medengphy.2012.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Revised: 07/31/2012] [Accepted: 08/07/2012] [Indexed: 01/09/2023]
Abstract
Epidermal downgrowth, commonly associated with long-term percutaneous implants, weakens the skin-implant seal and greatly increases the vulnerability of the site to infection. To improve the skin attachment and early tissue integration with porous metal percutaneous implants, we evaluated the effect of bone marrow-derived mesenchymal stem cells (BMMSCs) to provide wound healing cues and vascularization to the dermal and epidermal tissues in establishing a barrier with the implant. Two porous metal percutaneous implants, one treated with BMMSCs and one untreated, were placed subdermally on the dorsum of Lewis rats. Implants were evaluated at 0, 3, 7, 28, and 56 days after implantation. Histological analyses evaluated cellular infiltrates, vascularization, quantity and quality of tissue ingrowth, epidermal downgrowth, and fibrous encapsulation. The amount of collagen infiltrating the porous coating was significantly greater for the BMMSC-treated implants at 3 and 28 days post implantation compared to untreated implants. There was an early influx and resolution of cellular inflammatory infiltrates in the treated implants compared to the untreated, though not statistically significant. Vascularization increased over time in both treated and untreated implants, with no statistical significance. Epidermal downgrowth was minimally observed in all implants with or without the BMMSC treatment. Our results suggest that BMMSCs can influence an early and rapid resolution of acute and chronic inflammation in wound healing, and can stimulate early collagen deposition and granulation tissue associated with later stages of wound repair. These findings provide evidence that BMMSCs can stimulate a more rapid and improved barrier between the skin and porous metal percutaneous implant.
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Affiliation(s)
- Dorthyann Isackson
- Orthopaedic Research Laboratory, University of Utah Orthopaedic Center, Salt Lake City, UT 84108, USA
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Fleckman P, Usui M, Zhao G, Underwood R, Maginness M, Marshall A, Glaister C, Ratner B, Olerud J. Cutaneous and inflammatory response to long-term percutaneous implants of sphere-templated porous/solid poly(HEMA) and silicone in mice. J Biomed Mater Res A 2012; 100:1256-68. [PMID: 22359383 DOI: 10.1002/jbm.a.34012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 10/17/2011] [Accepted: 10/24/2011] [Indexed: 11/10/2022]
Abstract
This study investigates mouse cutaneous responses to long-term percutaneously implanted rods surrounded by sphere-templated porous biomaterials engineered to mimic medical devices surrounded by a porous cuff. We hypothesized that keratinocytes would migrate through the pores and stop, permigrate, or marsupialize along the porous/solid interface. Porous/solid-core poly(2-hydroxyethyl methacrylate) [poly(HEMA)] and silicone rods were implanted in mice for 14 days, and for 1, 3, and 6 months. Implants with surrounding tissue were analyzed (immuno)histochemically by light microscopy. Poly(HEMA)/skin implants yielded better morphologic data than silicone implants. Keratinocytes at the poly(HEMA) interface migrated in two different directions. "Ventral" keratinocytes contiguous with the dermal-epidermal junction migrated into the outermost pores, forming an integrated collar surrounding the rods. "Dorsal" keratinocytes appearing to emanate from the differentiated epithelial layer, extended upward along and into the exterior portion of the rod, forming an integrated sheath. Leukocytes persisted in poly(HEMA) and silicone pores for the duration of the study. Vascular and collagen networks within the poly(HEMA) pores matured as a function of time up to 3-months implantation. Nerves were not observed within the pores. Poly(HEMA) underwent morphological changes by 6 months of implantation. Marsupialization, foreign body encapsulation, and infection were not observed in any implants.
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Affiliation(s)
- Philip Fleckman
- Department of Medicine (Dermatology), University of Washington, Seattle, Washington, USA.
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Fabrication of biocompatible, vibrational magnetoelastic materials for controlling cellular adhesion. BIOSENSORS-BASEL 2012; 2:57-69. [PMID: 25585632 PMCID: PMC4263540 DOI: 10.3390/bios2010057] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 02/08/2012] [Accepted: 02/10/2012] [Indexed: 02/06/2023]
Abstract
This paper describes the functionalization of magnetoelastic (ME) materials with Parylene-C coating to improve the surface reactivity to cellular response. Previous study has demonstrated that vibrating ME materials were capable of modulating cellular adhesion when activated by an externally applied AC magnetic field. However, since ME materials are not inherently biocompatible, surface modifications are needed for their implementation in biological settings. Here, the long-term stability of the ME material in an aqueous and biological environment is achieved by chemical-vapor deposition of a conformal Parylene-C layer, and further functionalized by methods of oxygen plasma etching and protein adsorption. In vitro cytotoxicity measurement and characterization of the vibrational behavior of the ME materials showed that Parylene-C coatings of 10 µm or greater could prevent hydrolytic degradation without sacrificing the vibrational behavior of the ME material. This work allows for long-term durability and functionality of ME materials in an aqueous and biological environment and makes the potential use of this technology in monitoring and modulating cellular behavior at the surface of implantable devices feasible.
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Underwood RA, Usui ML, Zhao G, Hauch KD, Takeno MM, Ratner BD, Marshall AJ, Shi X, Olerud JE, Fleckman P. Quantifying the effect of pore size and surface treatment on epidermal incorporation into percutaneously implanted sphere-templated porous biomaterials in mice. J Biomed Mater Res A 2011; 98:499-508. [PMID: 21681942 DOI: 10.1002/jbm.a.33125] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 03/05/2011] [Accepted: 03/18/2011] [Indexed: 11/08/2022]
Abstract
The sinus between skin and a percutaneous medical device is often a portal for infection. Epidermal integration into an optimized porous biomaterial could seal this sinus. In this study, we measured epithelial ingrowth into rods of sphere-templated porous poly(2-hydroxyethyl methacrylate) implanted percutaneously in mice. The rods contained spherical 20-, 40-, or 60-μm pores with and without surface modification. Epithelial migration was measured 3, 7, and 14 days post-implantation utilizing immunohistochemistry for pankeratins and image analysis. Our global results showed average keratinocyte migration distances of 81 ± 16.85 μm (SD). Migration was shorter through 20-μm pores (69.32 ± 21.73) compared with 40 and 60 μm (87.04 ± 13.38 μm and 86.63 ± 8.31 μm, respectively). Migration was unaffected by 1,1' carbonyldiimidazole surface modification without considering factors of pore size and healing duration. Epithelial integration occurred quickly showing an average migration distance of 74.13 ± 12.54 μm after 3 days without significant progression over time. These data show that the epidermis closes the sinus within 3 days, migrates into the biomaterial (an average of 11% of total rod diameter), and stops. This process forms an integrated epithelial collar without evidence of marsupialization or permigration.
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Affiliation(s)
- Robert A Underwood
- Department of Medicine/Division of Dermatology, University of Washington, Seattle, Washington, USA.
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Smith BS, Yoriya S, Johnson T, Popat KC. Dermal fibroblast and epidermal keratinocyte functionality on titania nanotube arrays. Acta Biomater 2011; 7:2686-96. [PMID: 21414425 DOI: 10.1016/j.actbio.2011.03.014] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 03/04/2011] [Accepted: 03/10/2011] [Indexed: 11/28/2022]
Abstract
Transcutaneous implants that penetrate through the depth of the skin are used in numerous clinical applications, including prosthetics and dental implants. Favorable interactions between the implant surface and the respective skin layers are critical for the long-term success of transcutaneous implantable devices, hence, it is essential to understand the physiologic response elicited by skin-biomaterial interactions. Recent studies have shown that material surfaces that provide topographic cues at the nanoscale level may provide one possible solution to enhanced biomaterial integration, thus preventing biomaterial rejection. In this study titania nanotube arrays were fabricated using a simple anodization technique as potential interfaces for transcutaneous implantable devices. The in vitro functionality of human dermal fibroblasts and epidermal keratinocytes were evaluated on these nanotube arrays (diameter 70-90 nm, length 1-1.5 μm). Cellular functionality in terms of adhesion, proliferation, orientation, viability, cytoskeletal organization, differentiation and morphology were investigated for up to 4 days in culture using fluorescence microscope imaging, a cell viability assay, indirect immunofluorescence and scanning electron microscopy. The results reported in this study indicate increased dermal fibroblast and decreased epidermal keratinocyte adhesion, proliferation and differentiation on titania nanotube arrays.
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Affiliation(s)
- Barbara S Smith
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO 80523, USA
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43
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Atsuta I, Ayukawa Y, Ogino Y, Moriyama Y, Jinno Y, Koyano K. Evaluations of epithelial sealing and peri-implant epithelial down-growth around "step-type" implants. Clin Oral Implants Res 2011; 23:459-66. [PMID: 21457351 DOI: 10.1111/j.1600-0501.2011.02163.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Implant designs that can stimulate and integrate with an epithelial wound-healing process may significantly enhance the efficacy of dental implants. Here, we evaluated the potential of "step-type" implant systems to improve the sealing between the peri-implant epithelium (PIE) and the implant surface, and investigated the effect of implant structure on PIE down-growth. MATERIALS AND METHODS Right maxillary first molars were extirpated from rats and implanted with either a straight-type or a step-type implant varying in step height and/or width (N(s): 0.8 mm height, 0.1 mm width; W(s): 0.8 mm height, 0.2 mm width; H(s): 0.4 mm height, 0.1 mm width). Maxillae were harvested at various time points over 16 weeks to evaluate laminin-5 distribution as an indicator of wound healing and PIE formation, horse-radish peroxidase (HRP) penetration as a measurement of epithelial sealing, and PIE down-growth formation. RESULTS In all implant models, the PIE formed from the oral sulcular epithelium and spread apically along the implant surface. In the W(s) group, HRP penetration was detected only in the coronal region of the PIE at 4 weeks, whereas in the straight-type, it was observed in the apical region and the connective tissue. At 16 weeks, the W(s) implants exhibited markedly less PIE down-growth than the Con, N(s) or H(s) implants, and were equivalent to that observed in natural teeth. CONCLUSION The step-type implant system may have the potential for improving epithelial sealing at the tissue-implant interface, as well as reducing apical PIE down-growth, thus enhancing dental implant efficacy.
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Affiliation(s)
- Ikiru Atsuta
- Section of Removable Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Higashi-ku, Fukuoka, Japan.
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Isackson D, McGill LD, Bachus KN. Percutaneous implants with porous titanium dermal barriers: an in vivo evaluation of infection risk. Med Eng Phys 2010; 33:418-26. [PMID: 21145778 DOI: 10.1016/j.medengphy.2010.11.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Revised: 11/04/2010] [Accepted: 11/07/2010] [Indexed: 11/28/2022]
Abstract
Osseointegrated percutaneous implants are a promising prosthetic alternative for a subset of amputees. However, as with all percutaneous implants, they have an increased risk of infection since they breach the skin barrier. Theoretically, host tissues could attach to the metal implant creating a barrier to infection. When compared with smooth surfaces, it is hypothesized that porous surfaces improve the attachment of the host tissues to the implant, and decrease the infection risk. In this study, four titanium implants, manufactured with a percutaneous post and a subcutaneous disk, were placed subcutaneously on the dorsum of eight New Zealand White rabbits. Beginning at four weeks post-op, the implants were inoculated weekly with 10(8) CFU Staphylococcus aureus until signs of clinical infection presented. While we were unable to detect a difference in the incidence of infection of the porous metal implants, smooth surface (no porous coating) percutaneous and subcutaneous components had a 7-fold increased risk of infection compared to the implants with a porous coating on one or both components. The porous coated implants displayed excellent tissue ingrowth into the porous structures; whereas, the smooth implants were surrounded with a thick, organized fibrotic capsule that was separated from the implant surface. This study suggests that porous coated metal percutaneous implants are at a significantly lower risk of infection when compared to smooth metal implants. The smooth surface percutaneous implants were inadequate in allowing a long-term seal to develop with the soft tissue, thus increasing vulnerability to the migration of infecting microorganisms.
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Affiliation(s)
- Dorthyann Isackson
- Orthopaedic Research Laboratory, University of Utah Orthopaedic Center, Salt Lake City, UT 84108, USA
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Meretoja VV, Rossi S, Peltola T, Pelliniemi LJ, Närhi TO. Adhesion and proliferation of human fibroblasts on sol-gel coated titania. J Biomed Mater Res A 2010; 95:269-75. [PMID: 20607871 DOI: 10.1002/jbm.a.32829] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The objective of this study was to evaluate growth and attachment of human gingival fibroblasts on nonresorbable sol-gel-derived nanoporous titania (TiO2) coated discs and noncoated commercially pure titania (cpTi) discs in vitro. The strength of attachment was evaluated using serial trypsinization. The number of cells detached from TiO2-substrates was 30% +/- 3%, whereas those detached from the cpTi was 58% +/- 4% indicating a stronger cell attachment on the coated surfaces. In scanning electron microscopy (SEM) images fewer cells, with more rounded shape, were seen with cpTi than with TiO2 after the detachment assay. Fibroblasts grew more efficiently on TiO2 than on cpTi substrates, showing significantly higher cell activities at all times. In transmission electron microscopy (TEM), a continuous layer of two to three cells thick covered the coated and noncoated discs after 7 days of culture. The plasma membrane of cells in contact with the coating was in close opposition and the cytoplasm was ultrastructurally similar to the cells grown on noncoated discs with well-preserved organelles. In conclusion, we demonstrated that the sol-gel-derived TiO2 coatings can facilitate cell growth and attachment of human gingival fibroblasts on titanium in vitro. This in vitro study is in line with our previous in vivo observations of improved soft tissue attachment of TiO2 coatings in comparison with cpTi.
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Affiliation(s)
- V V Meretoja
- Department of Prosthetic Dentistry and Biomaterials Science, Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, FI-20520 Turku, Finland
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Fukano Y, Usui ML, Underwood RA, Isenhath S, Marshall AJ, Hauch KD, Ratner BD, Olerud JE, Fleckman P. Epidermal and dermal integration into sphere-templated porous poly(2-hydroxyethyl methacrylate) implants in mice. J Biomed Mater Res A 2010; 94:1172-86. [PMID: 20694984 DOI: 10.1002/jbm.a.32798] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Percutaneous medical devices remain susceptible to infection and failure. We hypothesize that healing of the skin into the percutaneous device will provide a seal, preventing bacterial attachment, biofilm formation, and subsequent device failure. Porous poly(2-hydroxyethyl methacrylate) [poly(HEMA)] with sphere-templated pores (40 microm) and interconnecting throats (16 microm) were implanted in normal C57BL/6 mice for 7, 14, and 28 days. Poly(HEMA) was either untreated, keeping the surface nonadhesive for cells and proteins, or modified with carbonyldiimidazole (CDI) or CDI reacted with laminin 332 to enhance adhesion. No clinical signs of infection were observed. Epidermal and dermal response within the poly(HEMA) pores was evaluated using light and transmission electron microscopy. Cells (keratinocytes, fibroblasts, endothelial cells, inflammatory cells) and basement membrane proteins (laminin 332, beta4 integrin, type VII collagen) could be demonstrated within the poly(HEMA) pores of all implants. Blood vessels and dermal collagen bundles were evident in all of the 14- and 28-day implants. Fibrous capsule formation and permigration were not observed. Sphere-templated polymers with 40 microm pores demonstrate an ability to recapitulate key elements of both the dermal and the epidermal layers of skin. Our morphological findings indicate that the implant model can be used to study the effects of biomaterial pore size, pore interconnect (throat) size, and surface treatments on cutaneous biointegration. Further, this model may be used for bacterial challenge studies.
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Affiliation(s)
- Y Fukano
- Department of Medicine (Dermatology), University of Washington, Seattle, Washington, USA
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Peramo A, Marcelo CL. Bioengineering the Skin–Implant Interface: The Use of Regenerative Therapies in Implanted Devices. Ann Biomed Eng 2010; 38:2013-31. [DOI: 10.1007/s10439-010-9937-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Accepted: 01/17/2010] [Indexed: 11/25/2022]
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Peramo A, Marcelo CL, Goldstein SA, Martin DC. Continuous Delivery of Biomaterials to the Skin-Percutaneous Device Interface Using a Fluid Pump. Artif Organs 2010; 34:E27-33. [DOI: 10.1111/j.1525-1594.2009.00931.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Improved Preservation of the Tissue Surrounding Percutaneous Devices by Hyaluronic Acid and Dermatan Sulfate in a Human Skin Explant Model. Ann Biomed Eng 2009; 38:1098-110. [DOI: 10.1007/s10439-009-9872-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 12/08/2009] [Indexed: 01/13/2023]
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Peramo A, Bahng JH, Marcelo CL, Kotov N, Martin DC. In vitro integration of human skin dermis with porous cationic hydrogels. Acta Biomater 2009; 5:3337-45. [PMID: 19481182 DOI: 10.1016/j.actbio.2009.05.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Revised: 04/06/2009] [Accepted: 05/14/2009] [Indexed: 11/29/2022]
Abstract
Porous poly(DMAA-co-AMTAC) hydrogels, fabricated using the inverted colloid crystal method, were used to observe their integration with human skin. Full thickness human breast skin explants discarded from surgeries were cultured for up to 10days at the air-liquid interface using a Transwell culture system. Cylindrical, disk- or other shaped hydrogels were placed inside the skin explants fitting punctures produced by punch biopsies or scalpels and full section histological analysis of the skin explants with the inserted hydrogel was then performed. In addition, separated hydrogels were cultured up to 7days with human fibroblasts. The results indicate that poly(DMAA-co-AMTAC) hydrogels induce substantial extracellular matrix material deposition, maintain dermal integrity in the contact areas with the skin and permit dermal fibers to integrate into the hydrogel pores. Different types of cells remaining in the explants migrated into the hydrogels pores, including red blood cells. Fibroblasts adhered to and colonized separately cultured hydrogels. We plan to use this type of soft material as an interface to permit skin integration with percutaneous devices in contact with skin.
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Affiliation(s)
- Antonio Peramo
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI 48109, USA
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