Efird WM, Fletcher AG, Draeger RW, Spang JT, Dahners LE, Weinhold PS. Deferoxamine-Soaked Suture Improves Angiogenesis and Repair Potential After Acute Injury of the Chicken Achilles Tendon.
Orthop J Sports Med 2018;
6:2325967118802792. [PMID:
30370309 PMCID:
PMC6201186 DOI:
10.1177/2325967118802792]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background:
A major obstacle to the treatment of soft tissue injuries is the hypovascular
nature of the tissues. Deferoxamine (DFO) has been shown to stimulate
angiogenesis by limiting the degradation of intracellular hypoxia-inducible
factor 1–alpha.
Hypothesis:
DFO-saturated suture would induce angiogenesis and improve the markers of
early healing in an Achilles tendon repair model.
Study Design:
Controlled laboratory study.
Methods:
Broiler hens were randomly assigned to the control (CTL) group or DFO group
(n = 9 per group). The right Achilles tendon was partially transected at its
middle third. The defect was surgically repaired using 3-0 Vicryl suture
soaked in either sterile water (CTL group) or 324 mM DFO solution (DFO
group). All animals were euthanized 2 weeks after the injury, and the tendon
was harvested. Half of the tendon was used to evaluate angiogenesis via
hemoglobin content and tissue repair via DNA content and proteoglycan (PG)
content. The other half of the tendon was sectioned and stained with
hematoxylin and eosin, safranin O, and lectin to evaluate vessel
density.
Results:
Hemoglobin content (percentage of wet tissue weight) was significantly
increased in the DFO group compared with the CTL group (0.081 ± 0.012 vs
0.063 ± 0.016, respectively; P = .046). DNA content
(percentage of wet tissue weight) was also significantly increased in the
DFO group compared with the CTL group (0.31 ± 0.05 vs 0.23 ± 0.03,
respectively; P = .024). PG content (percentage of wet
tissue weight) was significantly decreased in the DFO group compared with
the CTL group (0.26 ± 0.02 vs 0.33 ± 0.08, respectively; P
= .035). Total chondroid area (number of vessels per mm2 of
tissue area evaluated) was significantly decreased in the DFO group compared
with the CTL group (17.2 ± 6.6 vs 24.6 ± 5.1, respectively;
P = .038). Articular zone vessel density
(vessels/mm2) was significantly increased in the DFO group
compared with the CTL group (7.1 ± 2.5 vs 2.1 ± 0.9, respectively;
P = .026).
Conclusion:
The significant increase in hemoglobin content as well as articular zone
vessel density in the DFO group compared with the CTL group is evidence of
increased angiogenesis in the fibrocartilaginous region of the tendon
exposed to DFO. The DFO group also displayed a significantly greater level
of DNA and significantly lower level of PG, suggesting enhanced early
healing by fibrous tissue formation.
Clinical Relevance:
Stimulating angiogenesis by DFO-saturated suture may be clinically useful to
improve healing of poorly vascularized tissues.
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