The distribution patterns of COMP and matrilin-3 in septal, alar and triangular cartilages of the human nose

Properties of the Nasal Cartilage, from Development to Adulthood: A Scoping Review

OBJECTIVE

Nasal septum cartilage is a hyaline cartilage that provides structural support to the nasal cavity and midface. Currently, information on its cellular and mechanical properties is widely dispersed and has often been inferred from studies conducted on other cartilage types such as the knee. A detailed understanding of nasal cartilage properties is important for several biological, clinical, and engineering disciplines. The objectives of this scoping review are to (1) consolidate actual existing knowledge on nasal cartilage properties and (2) identify gaps of knowledge and research questions requiring future investigations.

DESIGN

This scoping review incorporated articles identified using PROSPERO, Cochrane Library (CDSR and Central), WOS BIOSIS, WOS Core Collection, and ProQuest Dissertations and Theses Global databases. Following the screening process, 86 articles were considered. Articles were categorized into three groups: growth, extracellular matrix, and mechanical properties.

RESULTS

Most articles investigated growth properties followed by extracellular matrix and mechanical properties. NSC cartilage is not uniform. Nasal cartilage growth varies with age and location. Similarly, extracellular matrix composition and mechanical properties are location-specific within the NSC. Moreover, most articles included in the review investigate these properties in isolation and only very few articles demonstrate the interrelationship between multiple cartilage properties.

CONCLUSIONS

This scoping review presents a first comprehensive description of research on NSC properties with a focus on NSC growth, extracellular matrix and mechanical properties. It additionally identifies the needs (1) to understand how these various cartilage properties intersect and (2) for more granular, standardized assessment protocols to describe NSC.

Zone-Dependent Architecture and Biochemical Composition of Decellularized Porcine Nasal Cartilage Modulate the Activity of Adipose Tissue-Derived Stem Cells in Cartilage Regeneration

Previous anatomical studies have shown different functional zones in human nasal septal cartilage (NC). These zones differ in respect to histological architecture and biochemical composition. The aim of this study was to investigate the influence of these zones on the fate of stem cells from a regenerative perspective. Therefore, decellularized porcine septal cartilage was prepared and subjected to histological assessment to demonstrate its equivalence to human cartilage. Decellularized porcine NC (DPNC) exposed distinct surfaces depending on two different histological zones: the outer surface (OS), which is equivalent to the superficial zone, and the inner surface (IS), which is equivalent to the central zone. Human adipose tissue-derived stem cells (ASCs) were isolated from the abdominal fat tissue of five female patients and were seeded on the IS and OS of DPNC, respectively. Cell seeding efficiency (CSE), vitality, proliferation, migration, the production of sulfated glycosaminoglycans (sGAG) and chondrogenic differentiation capacity were evaluated by histological staining (DAPI, Phalloidin, Live-Dead), biochemical assays (alamarBlue^®, PicoGreen^®, DMMB) and the quantification of gene expression (qPCR). Results show that cell vitality and CSE were not influenced by DPNC zones. ASCs, however, showed a significantly higher proliferation and elevated expression of early chondrogenic differentiation, as well as fibrocartilage markers, on the OS. On the contrary, there was a significantly higher upregulation of hypertrophy marker MMP13 (p < 0.0001) and GAG production (p = 0.0105) on the IS, whereas cell invasion into the three-dimensional DPNC was higher in comparison to the OS. We conclude that the zonal-dependent distinct architecture and composition of NC modulates activities of ASCs seeded on DPNC. These findings might be used for engineering of cartilage substitutes needed in facial reconstructive surgery that yield an equivalent histological and functional structure, such as native NC.

Differences between human septal and alar cartilage with respect to biomechanical features and biochemical composition

Cartilage grafts have become popular in facial plastic surgery to reconstruct defects or to improve aesthetic outcomes in various applications. But there is a considerable rate of graft failure like resorption or deformation. To improve graft survival and function, accurate understanding of the properties of the recipient site is indispensable. Therefore 10 noses of human cadavers were meticulously dissected and specimens of alar and septal cartilage subjected to confined compression and tensile tests. Furthermore, cell number, glycosaminoglycan and hydroxyproline content were measured. RESULTS: showed a significant difference (p < 0.05) of alar and septal cartilage regarding Equilibrium Modulus, cell number and glycosaminoglycan but not hydroxyproline content. Tensile tests showed a significant difference (p < 0.001) between alar and septal cartilage (vertical vector of force) for E-modulus, maximal force and maximal strain but not for horizontal vector of force. There was a significant difference (p < 0.05) within septal cartilage samples depending on vector of force (vertical vs. horizontal). Finally multifactorial linear regression allowed an estimation of Equilibrium Modulus depending on compression, glycosaminoglycan content and cell number with statistical significance (p < 0.05). In conclusion, nasal cartilage differs in function and composition depending on anatomical location and the prevalent forces. Therefore further research will be necessary to evaluate if graft failure depends on a mismatch of functional properties and if grafts can be adapted to the recipient site.