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In Vivo Comparison of Synthetic Macroporous Filamentous and Sponge-like Skin Substitute Matrices Reveals Morphometric Features of the Foreign Body Reaction According to 3D Biomaterial Designs. Cells 2022; 11:cells11182834. [PMID: 36139409 PMCID: PMC9496825 DOI: 10.3390/cells11182834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
Synthetic macroporous biomaterials are widely used in the field of skin tissue engineering to mimic membrane functions of the native dermis. Biomaterial designs can be subclassified with respect to their shape in fibrous designs, namely fibers, meshes or fleeces, respectively, and porous designs, such as sponges and foams. However, synthetic matrices often have limitations regarding unfavorable foreign body responses (FBRs). Severe FBRs can result in unfavorable disintegration and rejection of an implant, whereas mild FBRs can lead to an acceptable integration of a biomaterial. In this context, comparative in vivo studies of different three-dimensional (3D) matrix designs are rare. Especially, the differences regarding FBRs between synthetically derived filamentous fleeces and sponge-like constructs are unknown. In the present study, the FBRs on two 3D matrix designs were explored after 25 days of subcutaneous implantation in a porcine model. Cellular reactions were quantified histopathologically to investigate in which way the FBR is influenced by the biomaterial architecture. Our results show that FBR metrics (polymorph-nucleated cells and fibrotic reactions) were significantly affected according to the matrix designs. Our findings contribute to a better understanding of the 3D matrix tissue interactions and can be useful for future developments of synthetically derived skin substitute biomaterials.
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Pascual G, Benito-Martínez S, Rodríguez M, Pérez-Köhler B, García-Moreno F, Bellón JM. Behaviour at the peritoneal interface of next-generation prosthetic materials for hernia repair. Surg Endosc 2021; 36:579-590. [PMID: 33507384 DOI: 10.1007/s00464-021-08320-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/09/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND When using a prosthetic material in hernia repair, the behaviour of the mesh at the peritoneal interface is especially important for implant success. Biomaterials developed for their intraperitoneal placement are known as composites and are made up of two different-structure materials, one is responsible for good integration within host tissue and the other is responsible to make contact with the viscera. This study examines the behaviour at the peritoneal level of two composites, the fully degradable Phasix-ST® and the partially degradable Symbotex®. A polypropylene mesh (Optilene®) served as control. METHODS Sequential laparoscopy from 3 to 90 days, in a preclinical model in the New Zealand white rabbit, allowed monitoring adhesion formation. Morphological studies were performed to analyse the neoperitoneum formed in the repair process. Total macrophages were identified by immunohistochemical labelling. To identify the different macrophage phenotypes, complementary DNAs were amplified by qRT-PCR using specific primers for M1 (TNF-α/CXCL9) and M2 (MRC1/IL-10) macrophages. RESULTS The percentage of firm and integrated adhesions remained very high in the control group over time. Both composites showed a significant decrease in adhesions at all study times and in qualitative terms were mainly loose. Significant differences were also observed from 7 days onwards between the two composites, increasing the values in Phasix over time. Neoperitoneum thickness for Phasix was significantly greater than those of the other meshes, showing mature and organized neoformed connective tissue. Immunohistochemically, a significantly higher percentage of macrophages was observed in Symbotex. mRNA expression levels for the M2 repair-type macrophages were highest for Phasix but significant differences only emerged for IL-10. CONCLUSIONS Fewer adhesions formed to the Symbotex than Phasix implants. Ninety days after implant, total macrophage counts were significantly higher for Symbotex, yet Phasix showed the greater expression of M2 markers related to the tissue repair process.
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Affiliation(s)
- Gemma Pascual
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain. .,Networking Biomedical Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain. .,Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain.
| | - Selma Benito-Martínez
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain.,Networking Biomedical Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.,Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Marta Rodríguez
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain.,Networking Biomedical Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.,Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Bárbara Pérez-Köhler
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain.,Networking Biomedical Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.,Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Francisca García-Moreno
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain.,Networking Biomedical Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.,Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Juan M Bellón
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain.,Networking Biomedical Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.,Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
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3
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Papparella A, Noviello C, Ranucci S, Paciello O, Papparella S, De Biase D, Cirillo G, Umano GR. Pneumoperitoneum Modifies Serum and Tissue CCL2-CCL5 Expression in Mice. JSLS 2020; 24:JSLS.2020.00017. [PMID: 32508487 PMCID: PMC7242020 DOI: 10.4293/jsls.2020.00017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background and Objectives: Laparoscopy is the preferred method when operating in the abdomen. In this study, we evaluated systemic and morphological peritoneal cytokine modifications (RANTES/CCL5 and MCP-1/CCL2) due to CO2 pneumoperitoneum in rats. Methods: Twenty-five prepubertal Sprague-Dawley rats were randomized into three groups. Pneumoperitoneum lasting 30 minutes, was induced with a flow of 0.5 L/min, in two groups (S1 and S2, n = 20), at a P/CO2 of 6 and 10 mm Hg, respectively. In the control group (C, n = 5), only anesthesia was carried out. All animals were sacrificed after 24 hours. The serum of the rats was collected for ELISA, and the levels of the cytokines RANTES and MCP-1 were investigated. An immunohistochemical analysis of RANTES and MCP-1 was performed on samples of the peritoneum, and the morphological evaluation was conducted with a blinded evaluation by two independent, experienced pathologists by using a grading system (0, 1+, 2+, 3+: no, faint, moderate, and strong reactivity, respectively). Results: RANTES mean levels were significantly different in the S1, S2, and C groups (70.3 ± 2.26, 58.23 ± 4.32, 29.66 ± 4.03, respectively, P = .0001). The levels of MCP-1 were 32.1 ± 1.63 in the S1 group, 27.0 ± 9.26 in the S2 group, and 16.4 ± 9.55 in the C group (P = .159). Normal control peritoneum showed little reactivity, whereas a moderate to strong cytoplasmic reaction to anti-CCL5/CCL2 antibodies was observed in mesothelial and inflammatory cells in the S1 and S2 groups. Conclusion: CO2 pneumoperitoneum evokes an inflammatory response by modifying plasma RANTES levels and peritoneal CCL5/CCL2 expression.
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Affiliation(s)
- Alfonso Papparella
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli," Naples, Italy
| | | | - Sara Ranucci
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Orlando Paciello
- Faculty of Veterinary Medicine, Department of Pathology and Animal Health, University of Naples Federico II, Naples, Italy
| | - Serenella Papparella
- Faculty of Veterinary Medicine, Department of Pathology and Animal Health, University of Naples Federico II, Naples, Italy
| | - Davide De Biase
- Faculty of Veterinary Medicine, Department of Pathology and Animal Health, University of Naples Federico II, Naples, Italy
| | - Grazia Cirillo
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Giuseppina Rosaria Umano
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli," Naples, Italy
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Friedemann MC, Mehta NA, Jessen SL, Charara FH, Ginn-Hedman AM, Kaulfus CN, Brocklesby BF, Robinson CB, Jokerst S, Glowczwski A, Clubb FJ, Weeks BR. Introduction to Currently Applied Device Pathology. Toxicol Pathol 2019; 47:221-234. [PMID: 30844339 DOI: 10.1177/0192623319826585] [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: 11/15/2022]
Abstract
Pathologic evaluation is crucial to the study of medical devices and integral to the Food and Drug Administration and other regulatory entities' assessment of device safety and efficacy. While pathologic analysis is tailored to the type of device, it generally involves at a minimum gross and microscopic evaluation of the medical device and associated tissues. Due to the complex nature of some implanted devices and specific questions posed by sponsors, pathologic evaluation inherently presents many challenges in accurately assessing medical device safety and efficacy. This laboratory's experience in numerous collaborative projects involving veterinary pathologists, biomedical engineers, physicians, and other scientists has led to a set of interrelated assessments to determine pathologic end points as a means to address these challenges and achieve study outcomes. Thorough device evaluation is often accomplished by utilizing traditional paraffin histology, plastic embedding and microground sections, and advanced imaging modalities. Combining these advanced techniques provides an integrative, comprehensive approach to medical device pathology and enhances medical device safety and efficacy assessment.
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Affiliation(s)
- Molly C Friedemann
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Nicole A Mehta
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Staci L Jessen
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Fatima H Charara
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Anne-Marie Ginn-Hedman
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Courtney N Kaulfus
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Breanna F Brocklesby
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Cedric B Robinson
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Steven Jokerst
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Alan Glowczwski
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Fred J Clubb
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
| | - Brad R Weeks
- 1 Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, USA
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Lescan M, Al-Saidi A, Neumann B, Greiner TO, Walker T, Hierlemann H, Brochhausen C, Planck H, Wendel HP, Schlensak C, Lausberg H. Epicardial adhesion prophylaxis in swine model with a bio-absorbable polymer membrane. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:157. [PMID: 30350230 DOI: 10.1007/s10856-018-6173-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 10/12/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Mario Lescan
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany.
| | - Abdulwahab Al-Saidi
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
| | - Bernd Neumann
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
| | - Tim-Oliver Greiner
- Department of General, Visceral and Transplant Surgery, University Medical Center Tübingen, Tübingen, Germany
| | - Tobias Walker
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
| | | | | | | | - Hans-Peter Wendel
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
| | - Christian Schlensak
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
| | - Henning Lausberg
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
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Cai X, Hu S, Yu B, Cai Y, Yang J, Li F, Zheng Y, Shi X. Transglutaminase-catalyzed preparation of crosslinked carboxymethyl chitosan/carboxymethyl cellulose/collagen composite membrane for postsurgical peritoneal adhesion prevention. Carbohydr Polym 2018; 201:201-210. [PMID: 30241812 DOI: 10.1016/j.carbpol.2018.08.065] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/15/2018] [Accepted: 08/16/2018] [Indexed: 02/08/2023]
Abstract
Peritoneal adhesion is a general complication following pelvic and abdominal surgery, which may lead to chronic abdominal pain, bowel obstruction, organ injury, and female infertility. Biodegradable polymer membranes have been suggested as physical barriers to prevent peritoneum adhesion. In this work, a transglutaminase (TGase)-catalyzed crosslinked carboxymethyl chitosan/carboxymethyl cellulose/collagen (CMCS/CMCL/COL) composite anti-adhesion membrane with various proportions of CMCS, CMCL, and COL (40/40/20, 35/35/30, 25/25/50) was developed. After crosslinking by TGase, the composite anti-adhesion membranes shown enhanced mechanical properties and improved biodegradability. Meanwhile, the high cytocompatibility of anti-adhesion membranes was proved by in vitro cell culture study. Moreover, the anti-adhesion membrane with the proportion of 25/25/50 was implanted between the artificially defected cecum and peritoneal wall in rats and following by general observation, histological examination, and inflammatory factors assay. The results indicated that the anti-adhesion membrane can significantly prevent peritoneal adhesion with negligible immunogenicity. Therefore, the composite membrane crosslinked by TGase had satisfactory anti-adhesive effects with high biocompatibility and low antigenicity, which could be used as a preventive barrier for peritoneal adhesion.
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Affiliation(s)
- Xianqun Cai
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou, Fujian 350108, China
| | - Shengxue Hu
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou, Fujian 350108, China
| | - Bangrui Yu
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou, Fujian 350108, China
| | - Yilei Cai
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou, Fujian 350108, China
| | - Jianmin Yang
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou, Fujian 350108, China; Fujian Key Lab of Medical Instrument and Pharmaceutical Technology, Fuzhou University, No. 2 Xueyuan Road, Fuzhou, Fujian 350108, China.
| | - Feng Li
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou, Fujian 350108, China; Fujian Key Lab of Medical Instrument and Pharmaceutical Technology, Fuzhou University, No. 2 Xueyuan Road, Fuzhou, Fujian 350108, China
| | - Yunquan Zheng
- Fujian Key Lab of Medical Instrument and Pharmaceutical Technology, Fuzhou University, No. 2 Xueyuan Road, Fuzhou, Fujian 350108, China
| | - Xianai Shi
- College of Biological Science and Engineering, Fuzhou University, No. 2 Xueyuan Road, Fuzhou, Fujian 350108, China; Fujian Key Lab of Medical Instrument and Pharmaceutical Technology, Fuzhou University, No. 2 Xueyuan Road, Fuzhou, Fujian 350108, China.
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Moris D, Chakedis J, Rahnemai-Azar AA, Wilson A, Hennessy MM, Athanasiou A, Beal EW, Argyrou C, Felekouras E, Pawlik TM. Postoperative Abdominal Adhesions: Clinical Significance and Advances in Prevention and Management. J Gastrointest Surg 2017; 21:1713-1722. [PMID: 28685387 DOI: 10.1007/s11605-017-3488-9] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 06/23/2017] [Indexed: 01/31/2023]
Abstract
Postoperative adhesions remain one of the more challenging issues in surgical practice. Although peritoneal adhesions occur after every abdominal operation, the density, time interval to develop symptoms, and clinical presentation are highly variable with no predictable patterns. Numerous studies have investigated the pathophysiology of postoperative adhesions both in vitro and in vivo. Factors such as type and location of adhesions, as well as timing and recurrence of adhesive obstruction remain unpredictable and poorly understood. Although the majority of postoperative adhesions are clinically silent, the consequences of adhesion formation can represent a lifelong problem including chronic abdominal pain, recurrent intestinal obstruction requiring multiple hospitalizations, and infertility. Moreover, adhesive disease can become a chronic medical condition with significant morbidity and no effective therapy. Despite recent advances in surgical techniques, there is no reliable strategy to manage postoperative adhesions. We herein review the pathophysiology and clinical significance of postoperative adhesions while highlighting current techniques of prevention and treatment.
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Affiliation(s)
- Demetrios Moris
- Department of Surgery, Ohio State University, Wexner Medical Center, 395 W. 12th Ave., Suite 670, Columbus, OH, USA
| | - Jeffery Chakedis
- Department of Surgery, Ohio State University, Wexner Medical Center, 395 W. 12th Ave., Suite 670, Columbus, OH, USA
| | - Amir A Rahnemai-Azar
- Department of Surgery, University of Washington Medical Center, Seattle, WA, USA
| | - Ana Wilson
- Department of Surgery, Ohio State University, Wexner Medical Center, 395 W. 12th Ave., Suite 670, Columbus, OH, USA
| | | | - Antonios Athanasiou
- Department of Surgery, Mercy University Hospital, Grenville Pl, Cork, Ireland
| | - Eliza W Beal
- Department of Surgery, Ohio State University, Wexner Medical Center, 395 W. 12th Ave., Suite 670, Columbus, OH, USA
| | - Chrysoula Argyrou
- 1st Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Felekouras
- 1st Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Timothy M Pawlik
- Department of Surgery, Ohio State University, Wexner Medical Center, 395 W. 12th Ave., Suite 670, Columbus, OH, USA.
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Schmitt VH, Mamilos A, Schmitt C, Neitzer-Planck CNE, Rajab TK, Hollemann D, Wagner W, Krämer B, Hierlemann H, James Kirkpatrick C, Brochhausen C. Tissue response to five commercially available peritoneal adhesion barriers-A systematic histological evaluation. J Biomed Mater Res B Appl Biomater 2017; 106:598-609. [DOI: 10.1002/jbm.b.33835] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/23/2016] [Accepted: 12/05/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Volker H. Schmitt
- Cardiology I, Centre for Cardiology; University Medical Centre, Johannes Gutenberg University of Mainz; Mainz Germany
| | - Andreas Mamilos
- REPAIR-lab, European Institute of Excellence on Tissue Engineering and Regenerative Medicine; Institute of Pathology, University of Regensburg; Regensburg Germany
| | - Christine Schmitt
- Department of Internal Medicine; St. Vincenz and Elisabeth Hospital of Mainz (KKM); Mainz Germany
| | - Constanze N. E. Neitzer-Planck
- Department of Gynaecology and Obstetrics; University of Tuebingen; Tuebingen Germany
- German Centre of Biomaterials and Artificial Organs e.V. Denkendorf; Germany
| | | | - David Hollemann
- Department of Internal Medicine; St. Vincenz and Elisabeth Hospital of Mainz (KKM); Mainz Germany
| | - Willi Wagner
- Diagnostic and Interventional Radiology; University Medical Center Heidelberg; Heidelberg Germany
| | - Bernhard Krämer
- Department of Gynaecology and Obstetrics; University of Tuebingen; Tuebingen Germany
| | - Helmut Hierlemann
- German Centre of Biomaterials and Artificial Organs e.V. Denkendorf; Germany
- Institute of Textile Technology and Process Engineering; Denkendorf Germany
| | - C. James Kirkpatrick
- Department of Biomaterials; Sahlgrenska Academy, University of Gothenburg; Gothenburg Sweden
| | - Christoph Brochhausen
- Department of Internal Medicine; St. Vincenz and Elisabeth Hospital of Mainz (KKM); Mainz Germany
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Rapid reperitonealization and wound healing in a preclinical model of abdominal trauma repair with a composite mesh. Int J Surg 2015; 22:86-91. [PMID: 26166739 DOI: 10.1016/j.ijsu.2015.06.071] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 06/18/2015] [Indexed: 11/23/2022]
Abstract
PURPOSE Peritoneal tissue healing is characterized by the simultaneous repopulation of mesothelial cells and the formation of neoperitoneum. Despite the common use of mesh products for abdominal wall repair, there are few investigations of how these materials may impact the peritoneal healing process. Here, we utilized an animal model of abdominal trauma to specifically investigate the peritoneal healing process in conjunction with a composite (poliglecaprone 25-coated polypropylene) mesh. METHODS Abdominal wall injury was simulated in New Zealand White rabbits and peritoneal tissue was covered with composite mesh and fixed with peripheral sutures. Animals were sacrificed at regular intervals (up to 28 days) for macroscopic and microscopic evaluation. RESULTS Mesothelial cells were consistently identified on the surface of the central areas of the implanted mesh as early as 3-5 days after implantation. From day 7 onward, the entire mesh surface was covered by neoperitoneum which matured over the remaining study intervals. Fibroblast ingrowth of the mesh was apparent by day 5 and increased over time, concurrent with fragmentation of the film on the composite mesh. CONCLUSIONS These results suggest that composite mesh products used for abdominal wall repair do not significantly delay mesothelial repopulation. Study results also support the hypothesis that mesothelial cells involved in healing are derived, at least in part in this model, from free-floating precursor cells located within the peritoneal cavity.
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10
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Mutsaers SE, Birnie K, Lansley S, Herrick SE, Lim CB, Prêle CM. Mesothelial cells in tissue repair and fibrosis. Front Pharmacol 2015; 6:113. [PMID: 26106328 PMCID: PMC4460327 DOI: 10.3389/fphar.2015.00113] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 05/12/2015] [Indexed: 12/21/2022] Open
Abstract
Mesothelial cells are fundamental to the maintenance of serosal integrity and homeostasis and play a critical role in normal serosal repair following injury. However, when normal repair mechanisms breakdown, mesothelial cells take on a profibrotic role, secreting inflammatory, and profibrotic mediators, differentiating and migrating into the injured tissues where they contribute to fibrogenesis. The development of new molecular and cell tracking techniques has made it possible to examine the origin of fibrotic cells within damaged tissues and to elucidate the roles they play in inflammation and fibrosis. In addition to secreting proinflammatory mediators and contributing to both coagulation and fibrinolysis, mesothelial cells undergo mesothelial-to-mesenchymal transition, a process analogous to epithelial-to-mesenchymal transition, and become fibrogenic cells. Fibrogenic mesothelial cells have now been identified in tissues where they have not previously been thought to occur, such as within the parenchyma of the fibrotic lung. These findings show a direct role for mesothelial cells in fibrogenesis and open therapeutic strategies to prevent or reverse the fibrotic process.
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Affiliation(s)
- Steven E Mutsaers
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine and Pharmacology, University of Western Australia and Harry Perkins Institute of Medical Research , Nedlands, WA, Australia ; Institute for Respiratory Health, Centre for Asthma, Allergy and Respiratory Research, School of Medicine and Pharmacology, University of Western Australia , Nedlands, WA, Australia
| | - Kimberly Birnie
- Institute for Respiratory Health, Centre for Asthma, Allergy and Respiratory Research, School of Medicine and Pharmacology, University of Western Australia , Nedlands, WA, Australia
| | - Sally Lansley
- Institute for Respiratory Health, Centre for Asthma, Allergy and Respiratory Research, School of Medicine and Pharmacology, University of Western Australia , Nedlands, WA, Australia
| | - Sarah E Herrick
- Institute of Inflammation and Repair, Faculty of Medical and Human Sciences and Manchester Academic Health Science Centre, University of Manchester , Manchester, UK
| | - Chuan-Bian Lim
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine and Pharmacology, University of Western Australia and Harry Perkins Institute of Medical Research , Nedlands, WA, Australia ; Institute for Respiratory Health, Centre for Asthma, Allergy and Respiratory Research, School of Medicine and Pharmacology, University of Western Australia , Nedlands, WA, Australia
| | - Cecilia M Prêle
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine and Pharmacology, University of Western Australia and Harry Perkins Institute of Medical Research , Nedlands, WA, Australia ; Institute for Respiratory Health, Centre for Asthma, Allergy and Respiratory Research, School of Medicine and Pharmacology, University of Western Australia , Nedlands, WA, Australia
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11
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Cassidy MR, Sherburne AC, Heydrick SJ, Stucchi AF. Combined intraoperative administration of a histone deacetylase inhibitor and a neurokinin-1 receptor antagonist synergistically reduces intra-abdominal adhesion formation in a rat model. Surgery 2015; 157:581-9. [PMID: 25726317 DOI: 10.1016/j.surg.2014.09.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 09/08/2014] [Accepted: 09/16/2014] [Indexed: 01/25/2023]
Abstract
BACKGROUND Intra-abdominal adhesions are the most frequent postoperative complication after abdominopelvic surgery. Our laboratory has previously shown that an intraoperative peritoneal lavage containing either the histone deacetylase inhibitor valproic acid (VPA) or a neurokinin-1 receptor antagonist (NK-1RA) reduced adhesions by approximately 50% in a rat model. The objective of this study was to determine whether the combination of these 2 drugs was more effective in reducing adhesions than either alone. METHODS Rats underwent laparotomy with creation of peritoneal ischemic buttons to induce adhesions. A single dose of VPA (25 mg/kg), NK-1RA (50 mg/kg), a combination of both, or 0.9% saline was lavaged intraperitoneally just before wound closure. On postoperative day 7, adhesions were quantified. To investigate early mechanisms of adhesiogenesis, adhesions were created as described and adhesive button tissue was harvested at 30 minutes and 3 hours postoperatively and fibrinogen and vascular endothelial growth factor (VEGF) protein levels, both indices of peritoneal extravasations, were determined by Western blot analysis. Peritoneal fluid was collected in similar experiments at 30 minutes, and 3 and 6 hours to measure fibrinolytic activity, an index of the ability of the peritoneum to degrade fibrinous adhesions. RESULTS The coadministration of VPA plus NK-1RA reduces adhesions by 72.6% relative to saline (P < .001); this reduction was greater than either compound alone (P < .001). Peritoneal fibrinolytic activity was significantly increased at 3 and 6 hours postoperatively in animals administered the combination therapy versus saline (P = .01). VPA plus NK-1RA significantly decreased fibrinogen and VEGF protein levels at 3 and 6 hours compared with saline controls. CONCLUSION These results suggest that a combined pharmacologic approach targeting multiple adhesiogenic pathways provides optimal adhesion prevention.
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Affiliation(s)
- Michael R Cassidy
- Department of Surgery, Boston University School of Medicine, Boston, MA
| | - Alan C Sherburne
- Department of Surgery, Boston University School of Medicine, Boston, MA
| | | | - Arthur F Stucchi
- Department of Surgery, Boston University School of Medicine, Boston, MA.
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Trehalose solution protects mesothelium and reduces bowel adhesions. J Surg Res 2014; 191:224-30. [DOI: 10.1016/j.jss.2014.03.077] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 03/24/2014] [Accepted: 03/25/2014] [Indexed: 11/17/2022]
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Cassidy MR, Sheldon HK, Gainsbury ML, Gillespie E, Kosaka H, Heydrick S, Stucchi AF. The neurokinin 1 receptor regulates peritoneal fibrinolytic activity and postoperative adhesion formation. J Surg Res 2014; 191:12-8. [PMID: 24836694 DOI: 10.1016/j.jss.2014.04.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 04/01/2014] [Accepted: 04/15/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Intra-abdominal adhesions are a common source of postoperative morbidity. Previous studies in our laboratory have shown that a neurokinin 1 receptor antagonist (NK-1RA) reduces abdominal adhesion formation and increases peritoneal fibrinolytic activity. However, the cellular pathway by which the antagonist exerts its effects is unclear, as cultured peritoneal mesothelial cells exposed to the NK-1RA show increases in fibrinolytic activity despite having very low expression of neurokinin 1 receptor (NK-1R) messenger RNA and protein. Our aim was to determine whether the NK-1R plays an essential role in the adhesion-reducing effects of the NK-1RA, or if the NK-1RA is acting independently of the receptor. METHODS Homozygous NK-1R knockout mice and age matched wild-type mice underwent laparotomy with cecal cautery to induce adhesions. At the time of surgery, mice received a single intraperitoneal dose of either NK-1RA (25 mg/kg) or saline alone. Adhesion severity at the site of cecal cautery was assessed on postoperative day 7. In a separate experiment, peritoneal fluid was collected from wild type and NK-1R knockout mice 24 h after laparotomy with cecal cautery and administration of either NK-1RA or saline. Tissue plasminogen activator levels, representative of total fibrinolytic activity, were then measured in peritoneal fluid. RESULTS In wild-type mice, NK-1RA administration significantly decreased adhesion formation compared with saline controls. Among the NK-1R knockout mice, there was no significant reduction in adhesion formation by the NK-1RA. Fibrinolytic activity increased 244% in wild-type mice administered NK-1RA compared with saline controls; however, the NK-1RA did not raise fibrinolytic activity above saline controls in NK-1R knockout mice. CONCLUSIONS These data indicate that the NK-1R mediates the adhesion-reducing effects of the NK-1RA, in part, by the upregulation of peritoneal fibrinolysis, and suggest that the NK-1R is a promising therapeutic target for adhesion prevention.
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Affiliation(s)
- Michael R Cassidy
- Department of Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Holly K Sheldon
- Department of Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Melanie L Gainsbury
- Department of Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Earl Gillespie
- Department of Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Hisashi Kosaka
- Department of Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Stanley Heydrick
- Department of Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Arthur F Stucchi
- Department of Surgery, Boston University School of Medicine, Boston, Massachusetts.
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