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Manzaneda Cipriani RM, Adrianzen GA. Ribs with Anterior Protrusion (Winged Ribs) Treated Using Percutaneous Chondroplasty. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e6178. [PMID: 39318445 PMCID: PMC11421723 DOI: 10.1097/gox.0000000000006178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 07/30/2024] [Indexed: 09/26/2024]
Abstract
Background Thoracic features play a significant role in determining various plastic surgery techniques. Particularly, the thorax has potential for excessive anterior projection, commonly referred to as winged ribs. This study aimed to describe a treatment method for addressing winged ribs for aesthetic purposes using percutaneous chondral management. Methods Thirty-two female patients underwent FrontXribs from February to March 2023. Two angular measurements were obtained: (1) the angle formed by lines intersecting tangentially to the shoulder and the lower gluteal border; and (2) the angle formed by a line tangential to the greatest anterior projection, intersected by a vertical line on the standing axis. Length measurements were obtained using a tape measure at the position of the greatest thoracic projection. Pulmonary function studies were conducted. All variables were measured before surgery and 6 months postoperatively. Results On average, patients were 25 years old. The average operative time was 51.1 minutes, and all patients underwent general anesthesia. The average increase for angular measurement 1 was 26.1 degrees, whereas that for angular measurement 2 was 3.43 degrees. The average decrease in anterior chest length during the postoperative period was 9.66 cm (P < 0.001). Spirometric tests showed no significant changes 6 months postoperatively. Conclusions The FrontXribs technique for treating winged ribs effectively reduces anterior costal protrusion, as evidenced by the angular variation of projections and the reduction in thoracic length at this level. No adverse effects on respiratory function were observed 6 months postoperatively.
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Affiliation(s)
- Raúl M. Manzaneda Cipriani
- From Private Practice, Lima, Perú
- Plastic Surgeon, Private Practice, Lima, Perú
- Aesthetic Xpert Scientific Lab, Lima, Perú
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2
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Cormier SA, Kappen C. Identification of a Chondrocyte-Specific Enhancer in the Hoxc8 Gene. J Dev Biol 2024; 12:5. [PMID: 38390956 PMCID: PMC10885077 DOI: 10.3390/jdb12010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
Hox genes encode transcription factors whose roles in patterning animal body plans during embryonic development are well-documented. Multiple studies demonstrate that Hox genes continue to act in adult cells, in normal differentiation, in regenerative processes, and, with abnormal expression, in diverse types of cancers. However, surprisingly little is known about the regulatory mechanisms that govern Hox gene expression in specific cell types, as they differentiate during late embryonic development, and in the adult organism. The murine Hoxc8 gene determines the identity of multiple skeletal elements in the lower thoracic and lumbar region and continues to play a role in the proliferation and differentiation of cells in cartilage as the skeleton matures. This study was undertaken to identify regulatory elements in the Hoxc8 gene that control transcriptional activity, specifically in cartilage-producing chondrocytes. We report that an enhancer comprising two 416 and 224 bps long interacting DNA elements produces reporter gene activity when assayed on a heterologous transcriptional promoter in transgenic mice. This enhancer is distinct in spatial, temporal, and molecular regulation from previously identified regulatory sequences in the Hoxc8 gene that control its expression in early development. The identification of a tissue-specific Hox gene regulatory element now allows mechanistic investigations into Hox transcription factor expression and function in differentiating cell types and adult tissues and to specifically target these cells during repair processes and regeneration.
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Affiliation(s)
- Stephania A. Cormier
- Department of Respiratory Immunology and Toxicology, Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA 70808, USA;
| | - Claudia Kappen
- Department of Developmental Biology, Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA 70808, USA
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Pang Y, Ma Y, Zheng K, Zhu S, Sui H, Ren H, Liu K, Li W, Huang Y, Du D, Gao J, Zhang C. Costal Cartilage Graft Repair Osteochondral Defect in a Mouse Model. Cartilage 2023:19476035231209404. [PMID: 37881954 DOI: 10.1177/19476035231209404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE Osteochondral defects develop into osteoarthritis without intervention. Costal cartilage can be utilized as an alternative source for repairing osteochondral defect. Our previous clinical study has shown the successful osteochondral repair by costal cartilage graft with integration into host bone bed. In this study, we investigate how cartilaginous graft adapt to osteochondral environment and the mechanism of bone-cartilage interface formation. DESIGN Costal cartilage grafting was performed in C57BL/6J mice and full-thickness osteochondral defect was made as control. 3D optical profiles and micro-CT were applied to evaluate the reconstruction of articular cartilage surface and subchondral bone as well as gait analysis to evaluate articular function. Histological staining was performed at 2, 4, and 8 weeks after surgery. Moreover, costal cartilage from transgenic mice with fluorescent markers were transplanted into wild-type mice to observe the in vivo changes of costal chondrocytes. RESULTS At 8 weeks after surgery, 3D optical profiles and micro-CT showed that in the graft group, the articular surface and subchondral bone were well preserved. Gait analysis and International Cartilage Repair Society (ICRS) score evaluation showed a good recovery of joint function and histological repair in the graft group. Safranin O staining showed the gradual integration of graft and host tissue. Costal cartilage from transgenic mice with fluorescent markers showed that donor-derived costal chondrocytes turned into osteocytes in the subchondral area of host femur. CONCLUSION Costal cartilage grafting shows both functional and histological repair of osteochondral defect in mice. Graft-derived costal chondrocytes differentiate into osteocytes and contribute to endochondral ossification.
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Affiliation(s)
- Yidan Pang
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiyang Ma
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kaiwen Zheng
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Siyuan Zhu
- Department of General Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongyu Sui
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
| | - Hao Ren
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
| | - Kang Liu
- Beixcell (Beijing) Biotechnology Ltd, Beijing, China
| | - Wei Li
- Beixcell (Beijing) Biotechnology Ltd, Beijing, China
| | - Yigang Huang
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dajiang Du
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junjie Gao
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Jinjiang Municipal Hospital (Shanghai Sixth People's Hospital Fujian), Jinjiang City, Quanzhou, China
| | - Changqing Zhang
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Wei J, Baptista-Hon DT, Wang Z, Li G, Herrler T, Dai C, Liu K, Yu B, Chen X, Yang M, Han D, Gao Y, Huang RL, Guo L, Zhang K, Li Q. Bioengineered human tissue regeneration and repair using endogenous stem cells. Cell Rep Med 2023; 4:101156. [PMID: 37586324 PMCID: PMC10439273 DOI: 10.1016/j.xcrm.2023.101156] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 04/30/2023] [Accepted: 07/19/2023] [Indexed: 08/18/2023]
Abstract
We describe a general approach to produce bone and cartilaginous structures utilizing the self-regenerative capacity of the intercostal rib space to treat a deformed metacarpophalangeal joint and microtia. Anatomically precise 3D molds were positioned on the perichondro-periosteal or perichondral flap of the intercostal rib without any other exogenous elements. We find anatomically precise metacarpal head and auricle constructs within the implanted molds after 6 months. The regenerated metacarpal head was used successfully to surgically repair the deformed metacarpophalangeal joint. Auricle reconstructive surgery in five unilateral microtia patients yielded good aesthetic and functional results. Long-term follow-up revealed the auricle constructs were safe and stable. Single-cell RNA sequencing analysis reveal early infiltration of a cell population consistent with mesenchymal stem cells, followed by IL-8-stimulated differentiation into chondrocytes. Our results demonstrate the repair and regeneration of tissues using only endogenous factors and a viable treatment strategy for bone and tissue structural defects.
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Affiliation(s)
- Jiao Wei
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Daniel T Baptista-Hon
- University Hospital and Center for Biomedicine and Innovations, Faculty of Medicine, Macau University of Science and Technology, Taipa 999078, Macau, China; Zhuhai International Eye Center, Zhuhai People's Hospital and the First Affiliated Hospital of Faculty of Medicine, Macau University of Technology, Zhuhai, Guangdong, China; Department of Bioinformatics and AI, Guangzhou Laboratory, Guangzhou, China; School of Medicine, University of Dundee, Dundee, UK
| | - Zi Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Gen Li
- Department of Bioinformatics and AI, Guangzhou Laboratory, Guangzhou, China; Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Tanja Herrler
- Department of Hand Surgery, Trauma Center Murnau, 82418 Murnau, Germany
| | - Chuanchang Dai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Kai Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Baofu Yu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Xiaoxue Chen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Mei Yang
- Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Dong Han
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Yuanxu Gao
- University Hospital and Center for Biomedicine and Innovations, Faculty of Medicine, Macau University of Science and Technology, Taipa 999078, Macau, China
| | - Ru-Lin Huang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Lifei Guo
- Division of Plastic Surgery, Lahey Hospital and Medical Center, Burlington, VT 01808, USA.
| | - Kang Zhang
- University Hospital and Center for Biomedicine and Innovations, Faculty of Medicine, Macau University of Science and Technology, Taipa 999078, Macau, China; Zhuhai International Eye Center, Zhuhai People's Hospital and the First Affiliated Hospital of Faculty of Medicine, Macau University of Technology, Zhuhai, Guangdong, China; Department of Bioinformatics and AI, Guangzhou Laboratory, Guangzhou, China.
| | - Qingfeng Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
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Fabian P, Crump JG. Reassessing the embryonic origin and potential of craniofacial ectomesenchyme. Semin Cell Dev Biol 2023; 138:45-53. [PMID: 35331627 PMCID: PMC9489819 DOI: 10.1016/j.semcdb.2022.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 02/28/2022] [Accepted: 03/14/2022] [Indexed: 11/27/2022]
Abstract
Of all the cell types arising from the neural crest, ectomesenchyme is likely the most unusual. In contrast to the neuroglial cells generated by neural crest throughout the embryo, consistent with its ectodermal origin, cranial neural crest-derived cells (CNCCs) generate many connective tissue and skeletal cell types in common with mesoderm. Whether this ectoderm-derived mesenchyme (ectomesenchyme) potential reflects a distinct developmental origin from other CNCC lineages, and/or epigenetic reprogramming of the ectoderm, remains debated. Whereas decades of lineage tracing studies have defined the potential of CNCC ectomesenchyme, these are being revisited by modern genetic techniques. Recent work is also shedding light on the extent to which intrinsic and extrinsic cues determine ectomesenchyme potential, and whether maintenance or reacquisition of CNCC multipotency influences craniofacial repair.
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Affiliation(s)
- Peter Fabian
- Eli and Edythe Broad California Institute for Regenerative Medicine Center for Regenerative Medicine and Stem Cell Research, Department of Stem Cell Biology and Regenerative Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA
| | - J Gage Crump
- Eli and Edythe Broad California Institute for Regenerative Medicine Center for Regenerative Medicine and Stem Cell Research, Department of Stem Cell Biology and Regenerative Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA.
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Kurenkova AD, Romanova IA, Kibirskiy PD, Timashev P, Medvedeva EV. Strategies to Convert Cells into Hyaline Cartilage: Magic Spells for Adult Stem Cells. Int J Mol Sci 2022; 23:11169. [PMID: 36232468 PMCID: PMC9570095 DOI: 10.3390/ijms231911169] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/30/2022] Open
Abstract
Damaged hyaline cartilage gradually decreases joint function and growing pain significantly reduces the quality of a patient's life. The clinically approved procedure of autologous chondrocyte implantation (ACI) for treating knee cartilage lesions has several limits, including the absence of healthy articular cartilage tissues for cell isolation and difficulties related to the chondrocyte expansion in vitro. Today, various ACI modifications are being developed using autologous chondrocytes from alternative sources, such as the auricles, nose and ribs. Adult stem cells from different tissues are also of great interest due to their less traumatic material extraction and their innate abilities of active proliferation and chondrogenic differentiation. According to the different adult stem cell types and their origin, various strategies have been proposed for stem cell expansion and initiation of their chondrogenic differentiation. The current review presents the diversity in developing applied techniques based on autologous adult stem cell differentiation to hyaline cartilage tissue and targeted to articular cartilage damage therapy.
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Affiliation(s)
- Anastasiia D. Kurenkova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia or
| | - Irina A. Romanova
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Pavel D. Kibirskiy
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia or
| | - Peter Timashev
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia or
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Ekaterina V. Medvedeva
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia or
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7
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Dynamic transcriptome analysis of NFAT family in guided bone regeneration with occlusive periosteum in swine model. J Orthop Surg Res 2022; 17:364. [PMID: 35883195 PMCID: PMC9327338 DOI: 10.1186/s13018-022-03252-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 07/09/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To investigate the dynamic expression of NFAT family of periosteum in guided bone regeneration process. MATERIAL AND METHODS The swine ribs on one side were used as the trauma group and the contralateral side as the control group. After rib segment was removed, periosteum was sutured to form a closed cavity mimicking guided bone regeneration. The periosteum and regenerated bone tissue were collected at nine time points for gene sequencing and hematoxylin-eosin staining. The expression data of each member were extracted for analysis. Expression correlations among various members were analyzed. RESULTS Staining showed the guided bone regeneration was almost completed 1 month after the operation with later stage for bone remodeling. The expression levels of each member in both groups changed greatly, especially within postoperative 1.5 months. The expression of NFATc1 and NFATC2IP in trauma group was significantly correlated with those of control group. The foldchange of each member also had large fluctuations especially within 1.5 months. In the trauma group, NFATc2 and NFATc4 were significantly upregulated, and there was a significant aggregation correlation of NFAT family expression between the various time points within one month, similar to the "pattern-block" phenomenon. CONCLUSION This study revealed the dynamic expression of NFAT family in guided bone regeneration, and provided a reference for the specific mechanism. The first 1.5 months is a critical period and should be paid attention to. The significant high-expression of NFATc2 and NFATc4 may role importantly in this process, which needs further research to verify it.
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8
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Serowoky MA, Kuwahara ST, Liu S, Vakhshori V, Lieberman JR, Mariani FV. A murine model of large-scale bone regeneration reveals a selective requirement for Sonic Hedgehog. NPJ Regen Med 2022; 7:30. [PMID: 35581202 PMCID: PMC9114339 DOI: 10.1038/s41536-022-00225-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/25/2022] [Indexed: 11/21/2022] Open
Abstract
Building and maintaining skeletal tissue requires the activity of skeletal stem and progenitor cells (SSPCs). Following injury, local pools of these SSPCs become active and coordinate to build new cartilage and bone tissues. While recent studies have identified specific markers for these SSPCs, how they become activated in different injury contexts is not well-understood. Here, using a model of large-scale rib bone regeneration in mice, we demonstrate that the growth factor, Sonic Hedgehog (SHH), is an early and essential driver of large-scale bone healing. Shh expression is broadly upregulated in the first few days following rib bone resection, and conditional knockout of Shh at early but not late post-injury stages severely inhibits cartilage callus formation and later bone regeneration. Whereas Smoothened (Smo), a key transmembrane component of the Hh pathway, is required in Sox9+ lineage cells for rib regeneration, we find that Shh is required in a Prrx1-expressing, Sox9-negative mesenchymal population. Intriguingly, upregulation of Shh expression and requirements for Shh and Smo may be unique to large-scale injuries, as they are dispensable for both complete rib and femur fracture repair. In addition, single-cell RNA sequencing of callus tissue from animals with deficient Hedgehog signaling reveals a depletion of Cxcl12-expressing cells, which may indicate failed recruitment of Cxcl12-expressing SSPCs during the regenerative response. These results reveal a mechanism by which Shh expression in the local injury environment unleashes large-scale regenerative abilities in the murine rib.
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Affiliation(s)
- Maxwell A Serowoky
- Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, 1425 San Pablo Street, Los Angeles, CA, 90089, USA
| | - Stephanie T Kuwahara
- Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, 1425 San Pablo Street, Los Angeles, CA, 90089, USA
| | - Shuwan Liu
- Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, 1425 San Pablo Street, Los Angeles, CA, 90089, USA
| | - Venus Vakhshori
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1520 San Pablo Street, Los Angeles, CA, 90089, USA
| | - Jay R Lieberman
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1520 San Pablo Street, Los Angeles, CA, 90089, USA
| | - Francesca V Mariani
- Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, 1425 San Pablo Street, Los Angeles, CA, 90089, USA.
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9
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The characterization, cytotoxicity, macrophage response and tissue regeneration of decellularized cartilage in costal cartilage defects. Acta Biomater 2021; 136:147-158. [PMID: 34563726 DOI: 10.1016/j.actbio.2021.09.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 12/22/2022]
Abstract
After harvesting multiple costal cartilages, the local defect disrupts the integrity of the chest wall and may lead to obvious thoracic complications, such as local depression and asymmetry of the bilateral thoracic height. Decellularized materials have been used for tissue reconstruction in clinical surgeries. To apply xenogenic decellularized cartilage in costal cartilage defects, porcine-derived auricular and costal cartilage was tested for characterization, cytotoxicity, macrophage response, and tissue regeneration. Most of the DNA and α-Gal were effectively removed, and the collagen was well preserved after the decellularization process. The glycosaminoglycan (GAG) content decreased significantly compared to that in untreated cartilage. The decellularized auricular cartilage had a larger pore size, more pores, and a higher degradation rate than the decellularized costal cartilage. No apparent nuclei or structural damage was observed in the extracellular matrix. The decellularized auricular cartilage had a higher cell proliferation rate and more prominent immunomodulatory effect than the other groups. Two types of decellularized cartilage, particularly decellularized auricular cartilage, promoted the tissue regeneration in the cartilage defect area, combined with noticeable cartilage morphology and increased chondrogenic gene expression. In our research, the functional components and structure of the extracellular matrix were well preserved after the decellularization process. The decellularized cartilage had better biocompatibility and suitable microenvironment for tissue regeneration in the defect area, suggesting its potential application in cartilage repair during the surgery. STATEMENT OF SIGNIFICANCE: Autologous costal cartilage has been widely used in various surgeries, while the cartilage defects after the harvesting of multiple costal cartilages may cause localized chest wall deformities. Decellularized cartilage is an ideal material that could be produced in the factory and applied in surgeries. In this study, both decellularized costal cartilage and auricular cartilage preserved original structure, functional biocompatibility, immunosuppressive effects, and promoted tissue regeneration in the cartilage defect area.
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10
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Gvaramia D, Kern J, Jakob Y, Zenobi-Wong M, Rotter N. Regenerative Potential of Perichondrium: A Tissue Engineering Perspective. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:531-541. [PMID: 33966486 DOI: 10.1089/ten.teb.2021.0054] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The clinical relevance of perichondrium was recognized more than a century ago. In children and adolescents, perichondrium is essential for the formation and growth of the cartilaginous part of craniofacial features and must be considered during reconstructive surgery in the head and neck area. Also in adults, perichondrium must be preserved during surgical intervention for adequate postoperative healing and cartilage maintenance. Furthermore, the regenerative function of perichondrium in the ribs enables the harvesting of the rib cartilage tissue for reconstruction of craniofacial features. With the advancement of tissue engineering, renewed attention has been focused on the perichondrium, because without this crucial tissue, the function of cartilage engineered for craniofacial reconstruction is incomplete and may not be suitable for long-term reconstructive goals. Furthermore, interest in the perichondrium was revived owing to its possible role as a microenvironment containing stem and progenitor cells. Here we will revisit seminal studies on the perichondrium and review the current literature to provide a holistic perspective on the importance of this tissue in the context of regenerative medicine. We will also highlight the functional significance of perichondrium for cartilage tissue engineering.
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Affiliation(s)
- David Gvaramia
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim Medical Faculty of Heidelberg University, Ruprecht Karl University of Heidelberg, Mannheim, Germany
| | - Johann Kern
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim Medical Faculty of Heidelberg University, Ruprecht Karl University of Heidelberg, Mannheim, Germany
| | - Yvonne Jakob
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim Medical Faculty of Heidelberg University, Ruprecht Karl University of Heidelberg, Mannheim, Germany
| | - Marcy Zenobi-Wong
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Nicole Rotter
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim Medical Faculty of Heidelberg University, Ruprecht Karl University of Heidelberg, Mannheim, Germany
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Recent advances in bioprinting technologies for engineering different cartilage-based tissues. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 123:112005. [PMID: 33812625 DOI: 10.1016/j.msec.2021.112005] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/19/2021] [Accepted: 02/23/2021] [Indexed: 02/07/2023]
Abstract
Inadequate self-repair and regenerative efficiency of the cartilage tissues has motivated the researchers to devise advanced and effective strategies to resolve this issue. Introduction of bioprinting to tissue engineering has paved the way for fabricating complex biomimetic engineered constructs. In this context, the current review gears off with the discussion of standard and advanced 3D/4D printing technologies and their implications for the repair of different cartilage tissues, namely, articular, meniscal, nasoseptal, auricular, costal, and tracheal cartilage. The review is then directed towards highlighting the current stem cell opportunities. On a concluding note, associated critical issues and prospects for future developments, particularly in this sphere of personalized medicines have been discussed.
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12
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Kagan BJ, Rosello‐Diez A. Integrating levels of bone growth control: From stem cells to body proportions. WILEY INTERDISCIPLINARY REVIEWS-DEVELOPMENTAL BIOLOGY 2020; 10:e384. [DOI: 10.1002/wdev.384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/09/2020] [Accepted: 04/16/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Brett J. Kagan
- Australian Regenerative Medicine Institute Monash University Clayton Australia
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13
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Gao Y, Gao J, Li H, Du D, Jin D, Zheng M, Zhang C. Autologous costal chondral transplantation and costa-derived chondrocyte implantation: emerging surgical techniques. Ther Adv Musculoskelet Dis 2019; 11:1759720X19877131. [PMID: 31579403 PMCID: PMC6759717 DOI: 10.1177/1759720x19877131] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 08/29/2019] [Indexed: 01/08/2023] Open
Abstract
It is a great challenge to cure symptomatic lesions and considerable defects of hyaline cartilage due to its complex structure and poor self-repair capacity. If left untreated, unmatured degeneration will cause significant complications. Surgical intervention to repair cartilage may prevent progressive joint degeneration. A series of surgical techniques, including biological augmentation, microfracture and bone marrow stimulation, autologous chondrocyte implantation (ACI), and allogenic and autogenic chondral/osteochondral transplantation, have been used for various indications. However, the limited repairing capacity and the potential pitfalls of these techniques cannot be ignored. Increasing evidence has shown promising outcomes from ACI and cartilage transplantation. Nevertheless, the morbidity of autologous donor sites and limited resource of allogeneic bone have considerably restricted the wide application of these surgical techniques. Costal cartilage, which preserves permanent chondrocytes and the natural osteochondral junction, is an ideal candidate for the restoration of cartilage defects. Several in vitro and in vivo studies have shown good performance of costal cartilage transplantation. Although costal cartilage is a classic donor in plastic and cosmetic surgery, it is rarely used in skeletal cartilage restoration. In this review, we introduce the fundamental properties of costal cartilage and summarize costa-derived chondrocyte implantation and costal chondral/osteochondral transplantation. We will also discuss the pitfalls and pearls of costal cartilage transplantation. Costal chondral/osteochondral transplantation and costa-based chondrocytotherapy might be up-and-coming surgical techniques for recalcitrant cartilage lesions.
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Affiliation(s)
| | - Junjie Gao
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Centre for Orthopaedic Translational Research, University of Western Australia, Nedlands, WA, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Hengyuan Li
- Department of Orthopaedics, Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
- Centre for Orthopaedic Translational Research, Medical School, University of Western Australia, Nedlands, WA, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Dajiang Du
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Dongxu Jin
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Minghao Zheng
- Centre for Orthopaedic Translational Research, Medical School, University of Western Australia, Nedlands, WA, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Changqing Zhang
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
- Institute of Microsurgery on Extremities, Shanghai 200233, China
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14
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Serowoky MA, Patel DD, Hsieh JW, Mariani FV. The use of commercially available adhesive tapes to preserve cartilage and bone tissue integrity during cryosectioning. Biotechniques 2019; 65:191-196. [PMID: 30284932 DOI: 10.2144/btn-2018-0021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The use of fluorescent tags to monitor protein expression and to lineage-trace cells has become a standard complement to standard histological techniques in the fields of embryology, pathology and regenerative medicine. Unfortunately, traditional paraffin embedding protocols can substantially diminish or abolish the native emission signal of the fluorophore of interest. To preserve the fluorescent signal, an alternative is to use cryosectioning; however, this can often result in undesirable artefacts such as tearing or shattering - particularly for mineralized tissues such as bone and cartilage. Here we present a method of using a commercially available tape to stabilize murine femur tissue, thus allowing for cryosectioning of cartilage and bone tissues carrying fluorescent tags without the need for demineralization.
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Affiliation(s)
- Maxwell A Serowoky
- Department of Stem Cell Biology & Regenerative Medicine, Broad Center for Regenerative Medicine & Stem Cell Research, Keck School of Medicine, University of Southern California, CA, USA
| | - Divya D Patel
- Department of Stem Cell Biology & Regenerative Medicine, Broad Center for Regenerative Medicine & Stem Cell Research, Keck School of Medicine, University of Southern California, CA, USA
| | - Jason W Hsieh
- Department of Stem Cell Biology & Regenerative Medicine, Broad Center for Regenerative Medicine & Stem Cell Research, Keck School of Medicine, University of Southern California, CA, USA
| | - Francesca V Mariani
- Department of Stem Cell Biology & Regenerative Medicine, Broad Center for Regenerative Medicine & Stem Cell Research, Keck School of Medicine, University of Southern California, CA, USA
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15
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Yen CI, Zelken JA, Chang CS, Chen HC, Yang SY, Chang SY, Yang JY, Chuang SS, Hsiao YC. Preventing nasal airway collapse with irradiated homologous costal cartilage versus expanded polytetrafluoroethylene: a novel animal model for nasal airway reconstruction. Sci Rep 2019; 9:6670. [PMID: 31040322 PMCID: PMC6491583 DOI: 10.1038/s41598-019-42947-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 04/12/2019] [Indexed: 11/23/2022] Open
Abstract
Airway collapse can occur when the forces of inhalation overpower the strength of the nasal lining flap. The authors established an animal model of the reconstructed nasal airway, and examined mechanical properties of tissue composites based on various materials. Twenty-three Sprague-Dawley rats were divided into three experimental groups: control (n = 5), irradiated homologous costal cartilage (IHCC, n = 10), and expanded polytetrafluoroethylene (ePTFE, n = 8). Two dorsal skin flaps represented nasal lining and skin envelope. No framework, an IHCC or ePTFE rim graft was used as framework. At three weeks, changes in the cross-sectional area of the lining flap were measured when negative pressure was applied. En-bloc specimens containing the graft and soft tissue were examined for histological change and tissue ingrowth. Reduction of cross-sectional area with simulated inhalation was 87.74% in the control group, 82.76% (IHCC), and 67.29% (ePTFE). Cross-sectional reduction was significantly less in ePTFE group than control group (p = 0.004) and IHCC group (p = 0.001). The difference was not significant in the control and IHCC groups. There was histologic evidence of tissue ingrowth in the ePTFE group. This novel animal model of nasal airway reconstruction supports the use and potential benefit of using ePTFE for prevention of airway collapse.
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Affiliation(s)
- Cheng-I Yen
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan
| | | | - Chun-Shin Chang
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Hung-Chang Chen
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Shih-Yi Yang
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Shu-Yin Chang
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Jui-Yung Yang
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Shiow-Shuh Chuang
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Yen-Chang Hsiao
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan.
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16
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Kuwahara ST, Serowoky MA, Vakhshori V, Tripuraneni N, Hegde NV, Lieberman JR, Crump JG, Mariani FV. Sox9+ messenger cells orchestrate large-scale skeletal regeneration in the mammalian rib. eLife 2019; 8:40715. [PMID: 30983567 PMCID: PMC6464605 DOI: 10.7554/elife.40715] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 03/22/2019] [Indexed: 11/13/2022] Open
Abstract
Most bones in mammals display a limited capacity for natural large-scale repair. The ribs are a notable exception, yet the source of their remarkable regenerative ability remains unknown. Here, we identify a Sox9-expressing periosteal subpopulation that orchestrates large-scale regeneration of murine rib bones. Deletion of the obligate Hedgehog co-receptor, Smoothened, in Sox9-expressing cells prior to injury results in a near-complete loss of callus formation and rib bone regeneration. In contrast to its role in development, Hedgehog signaling is dispensable for the proliferative expansion of callus cells in response to injury. Instead, Sox9-positive lineage cells require Hh signaling to stimulate neighboring cells to differentiate via an unknown signal into a skeletal cell type with dual chondrocyte/osteoblast properties. This type of callus cell may be critical for bridging large bone injuries. Thus despite contributing to only a subset of callus cells, Sox9-positive progenitors play a major role in orchestrating large-scale bone regeneration. Editorial note This article has been through an editorial process in which the authors decide how to respond to the issues raised during peer review. The Reviewing Editor's assessment is that all the issues have been addressed (see decision letter).
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Affiliation(s)
- Stephanie T Kuwahara
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Keck School of Medicine, Los Angeles, United States
| | - Maxwell A Serowoky
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Keck School of Medicine, Los Angeles, United States
| | - Venus Vakhshori
- Department of Orthopaedic Surgery, University of Southern California, Keck School of Medicine, Los Angeles, United States
| | - Nikita Tripuraneni
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Keck School of Medicine, Los Angeles, United States
| | - Neel V Hegde
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Keck School of Medicine, Los Angeles, United States
| | - Jay R Lieberman
- Department of Orthopaedic Surgery, University of Southern California, Keck School of Medicine, Los Angeles, United States
| | - J Gage Crump
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Keck School of Medicine, Los Angeles, United States
| | - Francesca V Mariani
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Keck School of Medicine, Los Angeles, United States
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17
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The Regenerated Tissue at the Donor Site After Costal Cartilage Harvest for Auricular Reconstruction. J Craniofac Surg 2019; 30:e490-e494. [PMID: 30921060 DOI: 10.1097/scs.0000000000005370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To observe and summarize the nature of the regenerative tissue at the donor site after harvesting costal cartilage for auricular reconstruction and to explore the contribution of the perichondrium to the regeneration of costal cartilage in the clinic. METHODS From January 2016 to June 2017, 23 patients with microtia who were performed chest computed tomography (CT) after costal cartilage harvest for ear reconstruction were reviewed. And they had the surgery for at least 6 months. Of 23 patients, 17 patients were males and 6 were females; these patients were aged 7 to 43 years (mean age, 15.2 years). The authors divided the patients into 2 groups according to whether the perichondrium was retained or not. Group 1 was patients with intact perichondrium, total 20. Group 2 was patients with damaged perichondrium, total 3. Every patients' regenerative tissue CT value at the donor-site region of costal cartilage was measured and recorded. In addition, 2 regenerated tissue samples for examined histologic evaluation by hematoxylin and eosin stain were collected. RESULTS Of 23 patients, regenerated tissue with high CT value (above 100 Hounsfield unit [Hu]) was observed in 19 (82.61%) patients from group 1. And the direction of the regenerated tissue is roughly similar to that of the resected cartilage in the early surgery. Of 4 patients (1 from group and 3 from group 2), nothing on the donor site was found. From histologic evaluation, fibrocalcific tissue was seen, and cartilage cells were not seen in 2 patients with high CT value. CONCLUSION Clinical observation presented that regenerative tissue at the donor site after harvesting costal cartilage, leaving the subjacent perichondrium completely intact, was mostly fibrocalcific tissue rather than cartilage tissue. The authors suspect that the perichondrium itself may not have regenerative power, but as an envelope for regeneration, perichondrium has a role.
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18
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Simkin J, Seifert AW. Concise Review: Translating Regenerative Biology into Clinically Relevant Therapies: Are We on the Right Path? Stem Cells Transl Med 2017; 7:220-231. [PMID: 29271610 PMCID: PMC5788874 DOI: 10.1002/sctm.17-0213] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/29/2017] [Indexed: 02/06/2023] Open
Abstract
Despite approaches in regenerative medicine using stem cells, bio‐engineered scaffolds, and targeted drug delivery to enhance human tissue repair, clinicians remain unable to regenerate large‐scale, multi‐tissue defects in situ. The study of regenerative biology using mammalian models of complex tissue regeneration offers an opportunity to discover key factors that stimulate a regenerative rather than fibrotic response to injury. For example, although primates and rodents can regenerate their distal digit tips, they heal more proximal amputations with scar tissue. Rabbits and African spiny mice re‐grow tissue to fill large musculoskeletal defects through their ear pinna, while other mammals fail to regenerate identical defects and instead heal ear holes through fibrotic repair. This Review explores the utility of these comparative healing models using the spiny mouse ear pinna and the mouse digit tip to consider how mechanistic insight into reparative regeneration might serve to advance regenerative medicine. Specifically, we consider how inflammation and immunity, extracellular matrix composition, and controlled cell proliferation intersect to establish a pro‐regenerative microenvironment in response to injuries. Understanding how some mammals naturally regenerate complex tissue can provide a blueprint for how we might manipulate the injury microenvironment to enhance regenerative abilities in humans. Stem Cells Translational Medicine2018;7:220–231
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Affiliation(s)
- Jennifer Simkin
- Department of Biology, University of Kentucky, Lexington, Kentucky, USA
| | - Ashley W Seifert
- Department of Biology, University of Kentucky, Lexington, Kentucky, USA
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19
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Uchimura T, Hollander JM, Nakamura DS, Liu Z, Rosen CJ, Georgakoudi I, Zeng L. An essential role for IGF2 in cartilage development and glucose metabolism during postnatal long bone growth. Development 2017; 144:3533-3546. [PMID: 28974642 DOI: 10.1242/dev.155598] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 08/15/2017] [Indexed: 12/18/2022]
Abstract
Postnatal bone growth involves a dramatic increase in length and girth. Intriguingly, this period of growth is independent of growth hormone and the underlying mechanism is poorly understood. Recently, an IGF2 mutation was identified in humans with early postnatal growth restriction. Here, we show that IGF2 is essential for longitudinal and appositional murine postnatal bone development, which involves proper timing of chondrocyte maturation and perichondrial cell differentiation and survival. Importantly, the Igf2 null mouse model does not represent a simple delay of growth but instead uncoordinated growth plate development. Furthermore, biochemical and two-photon imaging analyses identified elevated and imbalanced glucose metabolism in the Igf2 null mouse. Attenuation of glycolysis rescued the mutant phenotype of premature cartilage maturation, thereby indicating that IGF2 controls bone growth by regulating glucose metabolism in chondrocytes. This work links glucose metabolism with cartilage development and provides insight into the fundamental understanding of human growth abnormalities.
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Affiliation(s)
- Tomoya Uchimura
- Program in Cell, Molecular and Developmental Biology, Sackler School of Graduate Biomedical Sciences, Tufts University, 136 Harrison Avenue, Boston, MA 02111, USA.,Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
| | - Judith M Hollander
- Program in Cell, Molecular and Developmental Biology, Sackler School of Graduate Biomedical Sciences, Tufts University, 136 Harrison Avenue, Boston, MA 02111, USA.,Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
| | - Daisy S Nakamura
- Program in Cell, Molecular and Developmental Biology, Sackler School of Graduate Biomedical Sciences, Tufts University, 136 Harrison Avenue, Boston, MA 02111, USA.,Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
| | - Zhiyi Liu
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA 02155, USA
| | - Clifford J Rosen
- Center for Clinical & Translational Research, Maine Medical Center Research Institute, 81 Research Drive, Scarborough, ME 04074, USA
| | - Irene Georgakoudi
- Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA 02155, USA
| | - Li Zeng
- Program in Cell, Molecular and Developmental Biology, Sackler School of Graduate Biomedical Sciences, Tufts University, 136 Harrison Avenue, Boston, MA 02111, USA .,Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA.,Department of Orthopedics, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA
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20
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Shaalan AM, Kasb I, Elwakeel EE, Elkamali YA. Outcome of surgical repair of Pectus Excavatum in adults. J Cardiothorac Surg 2017; 12:72. [PMID: 28851442 PMCID: PMC5576375 DOI: 10.1186/s13019-017-0635-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/24/2017] [Indexed: 11/16/2022] Open
Abstract
Background Pectus Excavatum (PEx) is the most common congenital chest wall deformity, accounting for over 90% of all chest wall deformities. Surgical correction is recommended because severe PEx can affect the physical and psychological development of patients. The aim of our study was to assess the impact of surgical repair of Pectus Excavatum in adults during hospital course and results after 1 year. Methods Prospective study was carried out on 86 adult patients aged ≥ 15 years, 52 males and 34 females (mean age was 26 ± 1.5 years). All cases were divided into two groups, group I: (15–25 years old) and group II: (> 25 years old). Preoperative, operative, and postoperative data were reviewed. Statistical analysis was performed. Results Statistical analyses revealed significant improvement postoperatively of cosmetic satisfaction (P-value < 0.0001), pain (P-value =0.0003), exertional dyspnea (p-value <0.05) and exercise tolerance. The degree of chest compression was significantly improved after surgical correction within 12 months and the estimated measurement postoperatively of Haller Index showed significant reduction (p-value <0.001). Patient satisfaction postoperatively was excellent in 77.9% of all cases. Conclusion Surgical correction of Pectus Excavatum using open technique in adults had excellent post-operative outcome in the short term follow up that encourage performing the procedure for all cases. Long term results need longer period for follow up. Etiology and predisposing factors still need further research.
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Affiliation(s)
- Ayman M Shaalan
- Cardiothoracic Surgery Department, Benha University, Benha, Egypt. .,Dallah Hospital, Cardiac Center, Riyadh, Saudi Arabia.
| | - Ibrahim Kasb
- Cardiothoracic Surgery Department, Benha University, Benha, Egypt
| | - Eman E Elwakeel
- Anatomy and Embryology Department, Benha University, Benha, Egypt
| | - Yusra A Elkamali
- Statistics Department, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
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21
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Enhanced cartilage repair in 'healer' mice-New leads in the search for better clinical options for cartilage repair. Semin Cell Dev Biol 2016; 62:78-85. [PMID: 27130635 DOI: 10.1016/j.semcdb.2016.04.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 04/25/2016] [Indexed: 12/13/2022]
Abstract
Adult articular cartilage has a poor capacity to undergo intrinsic repair. Current strategies for the repair of large cartilage defects are generally unsatisfactory because the restored cartilage does not have the same resistance to biomechanical loading as authentic articular cartilage and degrades over time. Recently, an exciting new research direction, focused on intrinsic cartilage regeneration rather than fibrous repair by external means, has emerged. This review explores the new findings in this rapidly moving field as they relate to the clinical goal of restoration of structurally robust, stable and non-fibrous articular cartilage following injury.
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22
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Jamshidi P, Chouhan G, Williams RL, Cox SC, Grover LM. Modification of gellan gum with nanocrystalline hydroxyapatite facilitates cell expansion and spontaneous osteogenesis. Biotechnol Bioeng 2016; 113:1568-76. [DOI: 10.1002/bit.25915] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 12/21/2015] [Accepted: 12/22/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Parastoo Jamshidi
- School of Metallurgy and Materials; University of Birmingham; Edgbaston B15 2TT United Kingdom
| | - Gurpreet Chouhan
- School of Chemical Engineering; University of Birmingham; Edgbaston B15 2TT United Kingdom
| | - Richard L. Williams
- School of Chemical Engineering; University of Birmingham; Edgbaston B15 2TT United Kingdom
| | - Sophie C. Cox
- School of Chemical Engineering; University of Birmingham; Edgbaston B15 2TT United Kingdom
| | - Liam M. Grover
- School of Chemical Engineering; University of Birmingham; Edgbaston B15 2TT United Kingdom
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23
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Abstract
The regulation of organ size is essential to human health and has fascinated biologists for centuries. Key to the growth process is the ability of most organs to integrate organ-extrinsic cues (eg, nutritional status, inflammatory processes) with organ-intrinsic information (eg, genetic programs, local signals) into a growth response that adapts to changing environmental conditions and ensures that the size of an organ is coordinated with the rest of the body. Paired organs such as the vertebrate limbs and the long bones within them are excellent models for studying this type of regulation because it is possible to manipulate one member of the pair and leave the other as an internal control. During development, growth plates at the end of each long bone produce a transient cartilage model that is progressively replaced by bone. Here, we review how proliferation and differentiation of cells within each growth plate are tightly controlled mainly by growth plate-intrinsic mechanisms that are additionally modulated by extrinsic signals. We also discuss the involvement of several signaling hubs in the integration and modulation of growth-related signals and how they could confer remarkable plasticity to the growth plate. Indeed, long bones have a significant ability for "catch-up growth" to attain normal size after a transient growth delay. We propose that the characterization of catch-up growth, in light of recent advances in physiology and cell biology, will provide long sought clues into the molecular mechanisms that underlie organ growth regulation. Importantly, catch-up growth early in life is commonly associated with metabolic disorders in adulthood, and this association is not completely understood. Further elucidation of the molecules and cellular interactions that influence organ size coordination should allow development of novel therapies for human growth disorders that are noninvasive and have minimal side effects.
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Affiliation(s)
- Alberto Roselló-Díez
- Developmental Biology Program, Sloan Kettering Institute, New York, New York 10065
| | - Alexandra L Joyner
- Developmental Biology Program, Sloan Kettering Institute, New York, New York 10065
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24
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Duran I, Csukasi F, Taylor S, Krakow D, Becerra J, Bombarely A, Marí-Beffa M. Collagen duplicate genes of bone and cartilage participate during regeneration of zebrafish fin skeleton. Gene Expr Patterns 2015; 19:60-9. [DOI: 10.1016/j.gep.2015.07.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 07/14/2015] [Accepted: 07/31/2015] [Indexed: 11/17/2022]
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25
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Tripuraneni N, Srour MK, Funnell JW, Thein TZT, Mariani FV. A surgical procedure for resecting the mouse rib: a model for large-scale long bone repair. J Vis Exp 2015:52375. [PMID: 25651082 DOI: 10.3791/52375] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
This protocol introduces researchers to a new model for large-scale bone repair utilizing the mouse rib. The procedure details the following: preparation of the animal for surgery, opening the thoracic body wall, exposing the desired rib from the surrounding intercostal muscles, excising the desired section of rib without inducing a pneumothorax, and closing the incisions. Compared to the bones of the appendicular skeleton, the ribs are highly accessible. In addition, no internal or external fixator is necessary since the adjacent ribs provide a natural fixation. The surgery uses commercially available supplies, is straightforward to learn, and well-tolerated by the animal. The procedure can be carried out with or without removing the surrounding periosteum, and therefore the contribution of the periosteum to repair can be assessed. Results indicate that if the periosteum is retained, robust repair occurs in 1 - 2 months. We expect that use of this protocol will stimulate research into rib repair and that the findings will facilitate the development of new ways to stimulate bone repair in other locations around the body.
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Affiliation(s)
- Nikita Tripuraneni
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California
| | - Marissa K Srour
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California
| | - John W Funnell
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California
| | - Thu Zan Tun Thein
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California
| | - Francesca V Mariani
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California;
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