Synergistic effects of dexamethasone on platelet-derived growth factor mitogenesis in vitro

Twenty-five years of recombinant human growth factors rhPDGF-BB and rhBMP-2 in oral hard and soft tissue regeneration

Contemporary oral tissue engineering strategies involve recombinant human growth factor approaches to stimulate diverse cellular processes including cell differentiation, migration, recruitment, and proliferation at grafted areas. Recombinant human growth factor applications in oral hard and soft tissue regeneration have been progressively researched over the last 25 years. Growth factor-mediated surgical approaches aim to accelerate healing, tissue reconstruction, and patient recovery. Thus, regenerative approaches involving growth factors such as recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and recombinant human bone morphogenetic proteins (rhBMPs) have shown certain advantages over invasive traditional surgical approaches in severe hard and soft tissue defects. Several clinical studies assessed the outcomes of rhBMP-2 in diverse clinical applications for implant site development and bone augmentation. Current evidence regarding the clinical benefits of rhBMP-2 compared to conventional therapies is inconclusive. Nevertheless, it seems that rhBMP-2 can promote faster wound healing processes and enhance de novo bone formation, which may be particularly favorable in patients with compromised bone healing capacity or limited donor sites. rhPDGF-BB has been extensively applied for periodontal regenerative procedures and for the treatment of gingival recessions, showing consistent and positive outcomes. Nevertheless, current evidence regarding its benefits at implant and edentulous sites is limited. The present review explores and depicts the current applications, outcomes, and evidence-based clinical recommendations of rhPDGF-BB and rhBMPs for oral tissue regeneration.

Development of Growth Factor Releasing Hyaluronic Acid-Based Hydrogel for Pulp Regeneration: A Preliminary Study

Growth factors play essential roles as signaling molecules in pulp regeneration. We investigated the effect of a hyaluronic acid (HA)-collagen hybrid hydrogel with controlled release of fibroblast growth factor (FGF)-2 and platelet-derived growth factor (PDGF)-BB on human pulp regeneration. The cell interaction and cytotoxicity of the HA-collagen hybrid hydrogel, the release kinetics of each growth factor, and the effects of the released growth factors on pulp cell proliferation were examined. The vitality of pulp cells was maintained. The amounts of FGF-2 and PDGF-BB released over 7 days were 68% and 50%, respectively. Groups with a different concentration of growth factor (FGF-2: 100, 200, 500, and 1000 ng/mL; PDGF-BB: 10, 50, 100, 200, and 500 ng/mL) were experimented on days 1, 3, 5, and 7. Considering FGF-2 concentration, significantly increased pulp cell proliferation was observed on days 1, 3, 5, and 7 in the 100 ng/mL group and on days 3, 5, and 7 in the 200 ng/mL group. In the case of PDGF-BB concentration, significantly increased pulp cell proliferation was observed at all four time points in the 100 ng/mL group and on days 3, 5, and 7 in the 50, 200, and 500 ng/mL groups. This indicates that the optimal concentration of FGF-2 and PDGF-BB for pulp cell proliferation was 100 ng/mL and that the HA-collagen hybrid hydrogel has potential as a controlled release delivery system for FGF-2 and PDGF-BB.

Pericytes of Stria Vascularis Are Targets of Cisplatin-Induced Ototoxicity: New Insights into the Molecular Mechanisms Involved in Blood-Labyrinth Barrier Breakdown

The stria vascularis (SV) contributes to cochlear homeostasis and consists of three layers, one of which contains the blood-labyrinthic barrier (BLB), with a large number of bovine cochlear pericytes (BCPs). Cisplatin is a chemotherapeutic drug that can damage the SV and cause hearing loss. In this study, cell viability, proliferation rate, cytotoxicity and reactive oxygen species production were evaluated. The protein content of phospho-extracellular signal-regulated kinases (ERK) 1/2, total ERK 1/2, phospho-cytosolic phospholipase A₂ (cPLA₂), total cPLA₂ and cyclooxygenase 2 (COX-2) and the release of prostaglandin E2 (PGE2) and vascular endothelial growth factor (VEGF) from BCPs were analyzed. Finally, the protective effect of platelet-derived growth factor (PDGF-BB) on BCPs treated with cisplatin was investigated. Cisplatin reduced viability and proliferation, activated ERK 1/2, cPLA₂ and COX-2 expression and increased PGE2 and VEGF release; these effects were reversed by Dexamethasone. The presence of PDGF-BB during the treatment with cisplatin significantly increased the proliferation rate. No studies on cell regeneration in ear tissue evaluated the effect of the PDGF/Dex combination. The aim of this study was to investigate the effects of cisplatin on cochlear pericytes and propose new otoprotective agents aimed at preventing the reduction of their vitality and thus maintaining the BLB structure.

Effects of Dexamethasone on DNA Synthesis in Lens Epithelial Cells are Dependent on Cell Type and Growth Factor

PURPOSE

To determine the factors that influence the ability of dexamethasone (dex) to inhibit or stimulate the growth of lens epithelial cells.

METHOD

Different growth factors with or without dex (10^-6 M) were added to quiescent cultures of two clones of Nakano mouse lens epithelial cells (NK11) in serum-free medium. DNA synthesis was then measured after 8 to 12 hours by the incorporation of tritiated thymidine.

RESULTS

Dex was found to both stimulate and inhibit mitogen-induced ³H-thymidine incorporation into the DNA of cultured mouse lens epithelial cells. Enhancement or repression by dex was found to depend on the growth factor used to stimulate the quiescent cell. EGF and insulin were consistently inhibited with dex. Basic fibroblast growth factor (bFGF) and retinoblastoma-derived growth factor (RbDGF) were both enhanced and inhibited by dex, depending on the growth factor concentration and the cell clone used for the experiment. Additionally, RbDGF protects against the dex inhibition of insulin stimulation, but not the inhibition of EGF stimulation. Progesterone, an inhibitor of the activation of the glucocorticoid receptor, blocks the dex inhibitory effect on the EGF and insulin stimulation of DNA synthesis.The ability of progesterone to affect the dex inhibition is consistent with the dex receptor modulating DNA synthesis. The dex effect on DNA synthesis, either stimulatory or inhibitory, was still seen if dex was added as late as 10 hours after the growth factor.

CONCLUSIONS

The study demonstrated that dex reduces the overall growth and activity of lens epithelial cells in vitro. This result provides insight into the risk of developing posterior subcapsular cataracts (PSC) in patients on oral glucocorticoid therapy. Understanding the basic mechanisms by which steroids mediate lens cell growth may provide the ability to more accurately predict who will develop PSC. The present studies show the difference in the effect of dex from lens cell to lens cell, but, more importantly, suggest a pattern of dependent variables that might prove useful in such predictions.

In Vivo Evaluation of Decellularized Human Tooth Scaffold for Dental Tissue Regeneration

Conventional root canal treatment may result in loss of tooth vitality, which can lead to unfavorable treatment outcomes. Notably, a ceased tooth development of immature permanent teeth with open apices, regeneration of periodontal ligaments (PDL), and pulp is highly expected healing process. For regeneration, the scaffold is one of the critical components that carry biological benefits. Therefore, this study evaluated a decellularized human tooth as a scaffold for the PDL and pulp tissue regeneration. A tooth scaffold was fabricated using an effective decellularization method as reported in previous studies. PDL stem cells (PDLSCs) and dental pulp stem cells (DPSCs) obtained from human permanent teeth were inoculated onto decellularized scaffolds, then cultured to transplant into immunosuppressed mouse. After 9 weeks, PDLSCs and DPSCs that were inoculated onto decellularized tooth scaffolds and cultured in an in vivo demonstrated successful differentiation. In PDLSCs, a regeneration of the cementum/PDL complex could be expected. In DPSCs, the expression of genes related to revascularization and the hard tissue regeneration showed the possibility of pulp regeneration. This study suggested that the potential possible application of decellularized human tooth could be a scaffold in regeneration PDL and pulp tissue along with PDLSCs and DPSCs, respectively, as a novel treatment method.

PDGFRβ+/c-kit+ pulp cells are odontoblastic progenitors capable of producing dentin-like structure in vitro and in vivo

Background

Successful pulp regeneration depends on identification of pulp stem cells capable of differentiation under odontoblastic lineage and producing pulp-dentinal like structure. Recent studies demonstrate that platelet-derived growth factor (PDGF) plays an important role in damage repair and tissue regeneration. The aim of this study was to identify a subpopulation of dental pulp cells responsive to PDGF and with dentin regeneration potential.

Methods

Pulp tissues were isolated from 12 freshly extracted human impacted third molars. Pulp cells were sorted by their expression of PDGFRβ and stem cell marker genes via flow cytometry. For the selected cells, proliferation was analyzed by a colorimetric cell proliferation assay, differentiation was assessed by real time PCR detection the expression of odontoblast marker genes, and mineralization was evaluated by Alizarin Red S staining. GFP marked PDGFRβ⁺/c-kit⁺ pulp cells were transplanted into emptied root canals of nude rat lower left incisors. Pulp-dentinal regeneration was examined by immunohistochemistry.

Results

PDGFRβ⁺/c-kit⁺ pulp cells proliferated significantly faster than whole pulp cells. In mineralization media, PDGFRβ⁺/c-kit⁺ pulp cells were able to develop under odontoblastic linage as demonstrated by a progressively increased expression of DMP1, DSPP, and osteocalcin. BMP2 seemed to enhance whereas PDGF-BB seemed to inhibit odontoblastic differentiation and mineralization of PDGFRβ⁺/c-kit⁺ pulp cells. In vivo root canal transplantation study revealed globular dentin and pulp-like tissue formation by PDGFRβ⁺/c-kit⁺ cells.

Conclusions

PDGFRβ⁺/c-kit⁺ pulp cells appear to have pulp stem cell potential capable of producing dentinal like structure in vitro and in vivo.

Electronic supplementary material

The online version of this article (doi:10.1186/s12903-016-0307-8) contains supplementary material, which is available to authorized users.

Dentin and dental pulp regeneration by the patient's endogenous cells

The goal of regenerative endodontics is to restore the functions of the dental pulp-dentin complex. Two approaches are being applied toward dental pulp-dentin regeneration: cell transplantation and cell homing. The majority of previous approaches are based on cell transplantation by delivering ex vivo cultivated cells toward dental pulp or dentin regeneration. Many hurdles limit the clinical translation of cell transplantation such as the difficulty of acquiring and isolating viable cells, uncertainty of what cells or what fractions of cells to use, excessive cost of cell manipulation and transportation, and the risk of immune rejection, pathogen transmission, and tumorigenesis in associated with ex vivo cell manipulation. In contrast, cell homing relies on induced chemotaxis of endogenous cells and therefore circumvents many of the difficulties that are associated with cell transplantation. An array of proteins, peptides, and chemical compounds that are yet to be identified may orchestrate endogenous cells to regenerate dental pulp-dentin complex. Both cell transplantation and cell homing are scientifically valid approaches; however, cell homing offers a number of advantages that are compatible with the development of clinical therapies for dental pulp-dentin regeneration.

Effects of growth factors on dental stem/progenitor cells

The primary goal of regenerative endodontics is to restore the vitality and functions of the dentin-pulp complex, as opposed to filing of the root canal with bioinert materials. A myriad of growth factors regulates multiple cellular functions including migration, proliferation, differentiation, and apoptosis of several cell types intimately involved in dentin-pulp regeneration. Recent work showing that growth factor delivery, without cell transplantation, can yield pulp-dentin-like tissues in vivo provides one of the tangible pathways for regenerative endodontics. This review synthesizes knowledge on many growth factors that are known or anticipated to be efficacious in dental pulp-dentin regeneration.

Effects of designed PLLA and 50:50 PLGA scaffold architectures on bone formation in vivo

Biodegradable porous scaffolds have been investigated as an alternative approach to current metal, ceramic, and polymer bone graft substitutes for lost or damaged bone tissues. Although there have been many studies investigating the effects of scaffold architecture on bone formation, many of these scaffolds were fabricated using conventional methods such as salt leaching and phase separation, and were constructed without designed architecture. To study the effects of both designed architecture and material on bone formation, this study designed and fabricated three types of porous scaffold architecture from two biodegradable materials, poly (L-lactic acid) (PLLA) and 50:50 Poly(lactic-co-glycolic acid) (PLGA), using image based design and indirect solid freeform fabrication techniques, seeded them with bone morphogenetic protein-7 transduced human gingival fibroblasts, and implanted them subcutaneously into mice for 4 and 8 weeks. Micro-computed tomography data confirmed that the fabricated porous scaffolds replicated the designed architectures. Histological analysis revealed that the 50:50 PLGA scaffolds degraded but did not maintain their architecture after 4 weeks implantation. However, PLLA scaffolds maintained their architecture at both time points and showed improved bone ingrowth, which followed the internal architecture of the scaffolds. Mechanical properties of both PLLA and 50:50 PLGA scaffolds decreased but PLLA scaffolds maintained greater mechanical properties than 50:50 PLGA after implantation. The increase of mineralized tissue helped support the mechanical properties of bone tissue and scaffold constructs between 4-8 weeks. The results indicate the importance of choice of scaffold materials and computationally designed scaffolds to control tissue formation and mechanical properties for desired bone tissue regeneration.

Growth factors and gene expression of stem cells: bone marrow compared with peripheral blood

PURPOSE

To evaluate and compare the presence of cytokines and growth factors in both bone marrow (BM) and peripheral blood.

MATERIAL

Samples of autogenous BM aspirate and peripheral blood (PB) from 7 patients ranging in age from 49 to 80 years were analyzed with real-time polymerase chain reaction technology to identify and compare selected gene expression for specific cytokines and growth factors. The genes selected for analysis included those involved in osteogenesis, hematogenesis, angiogenesis, extracellular matrix molecules, and cell-adhesion molecules. A maximum of 4 cc';s BM aspirate was taken from the anterior iliac crest and 0.5 mL of venous blood was drawn from each of 7 patients.

RESULTS

The results of the analysis indicate that both circulating blood and BM aspirate contain large quantities of a host of growth factors and cytokines. More platelet-derived growth factor is expressed in patient blood (PB) than in BM. Vascular endothelial growth factor alpha is expressed slightly greater in BM and vascular endothelial growth factor beta is slightly more prominent in PB. Transforming growth factors (TGFs) TGFA, TGFB1, and TGFB3 were equally expressed in BM and PB, and TGFB2 had a greater expression in PB. Bone morphogenetic proteins (BMPs) 1, 3, 7, 8B, R1A, and PR2 were almost equally expressed in BM and PB. BMPs 4 and 6 were expressed greater in PB. BMP2 was expressed more in BM. Extracellular matrix factors were equally expressed in PB and BM. Mesenchymal stem cell lineage markers varied in PB and BMA, and hematopoietic stem cell lineage markers were expressed more in PB than BM. Gene expression for angiogenic factors were equally expressed in PB and BM.

CONCLUSION

In this investigation, specific cytokines and growth factors in BM are compared with those in peripheral blood. Each has similar biologic effects and most expressed equally in BM and PB. However, BMP2 and vascular endothelial growth factor alpha had greater expression in BM.

Novel regenerative strategies to enhance periodontal therapy outcome

BACKGROUND

Chronic periodontitis is a widely prevalent inflammatory condition of the supporting tissues of the teeth and is characterized by loss of teeth with an associated risk of systemic complications. Regenerative therapies such as guided tissue and bone regeneration form an important armamentarium in periodontics with a high degree of outcome predictability in certain ideal clinical scenarios.

OBJECTIVE/METHODS

This review elaborates novel tissue regenerative treatment modalities based on sound understanding of developmental biology, tissue engineering, inflammation and wound healing. We focus on the role of biological mediators such as growth factors, gene-based therapy, cell therapy and pro-resolution lipid mediators in the regeneration of lost bone or periodontium.

RESULTS/CONCLUSIONS

These therapies have the potential to regenerate both periodontium and bone, aiding in the treatment of even clinically challenging cases.

Matrices and scaffolds for drug delivery in dental, oral and craniofacial tissue engineering

Current treatments for diseases and trauma of dental, oral and craniofacial (DOC) structures rely on durable materials such as amalgam and synthetic materials, or autologous tissue grafts. A paradigm shift has taken place to utilize tissue engineering and drug delivery approaches towards the regeneration of these structures. Several prototypes of DOC structures have been regenerated such as temporomandibular joint (TMJ) condyle, cranial sutures, tooth structures and periodontium components. However, many challenges remain when taking in consideration the high demand for esthetics of DOC structures, the complex environment and yet minimal scar formation in the oral cavity, and the need for accommodating multiple tissue phenotypes. This review highlights recent advances in the regeneration of DOC structures, including the tooth, periodontium, TMJ, cranial sutures and implant dentistry, with specific emphasis on controlled release of signaling cues for stem cells, biomaterial matrices and scaffolds, and integrated tissue engineering approaches.

Periodontal growth factors and tissue carriers: biocompatibility and mitogenic efficacy in vitro

Clinical research has long been testing techniques of integrating biomaterials with many external factors, such as simple proteins or more complicated devices, in order to achieve the restitutio ad integrum of periodontium. This study assessed the in vitro effectiveness of platelet derivate growth factor-BB (PDGF) and insulin growth factor I (IGF); the biocompatibility of materials like Paroguide, Oclastim membranes, Gingistat sponges, Surgiplaster, and Capset; and their efficacy as carriers for the platelet derivate growth factor-BB (PDGF) and insulin growth factor I (IGF). Fibroblasts from the human periodontal ligament were incubated with growth factors free or vehiculated. Mitogenic effect was evaluated by measuring the growth rate and biocompatibility by observing cell morphology at SEM. PDGF was the most effective in stimulating cell proliferation both in solution (p < 0.001) and vehiculated (p < 0.01). Surgiplaster and Capset were more biocompatible; however, final analysis to assess their efficacy as carriers failed to disclose significant differences between experimental findings and control.

Combined use of designed scaffolds and adenoviral gene therapy for skeletal tissue engineering

While tissue engineering remains the most researched alternative to conventional therapies for repair and regeneration, how to optimally combine two of the most promising techniques, designed solid scaffolds and localized gene therapy, is largely unknown. We have conducted a systematic screening of several variables that may affect generation of bone via adenoviral gene therapy vector delivery, on image-based designed and solid freeform-fabricated scaffolds. These variables included: gene therapy type (ex vivo or in vivo); scaffold base material (sintered hydroxyapatite or a polypropylene fumarate/ tricalcium phosphate (PPF/TCP) composite), secondary carrier used to attach the biofactor to the scaffold (fibrin gel or a poly-lactic acid sponge), and scaffold pores size (300 or 800 microm). The in vivo formation of bone following implantation of these scaffolds was then analyzed. Gene therapy method had the largest effect, with ex vivo gene therapy yielding significant amounts of bone on nearly all the implants and in vivo gene therapy failing to produce any bone on most implants. Secondary carrier was the next most important variable, with fibrin gel consistently producing bone encompassing the implants and producing 2-4 times as much bone as the polymer sponge, which triggered only isolated bone growth. Though both scaffold base materials allowed bone growth, hydoxyapatite scaffolds generated twice as much bone as PPF/TCP scaffolds. The pore sizes tested had no significant effect on tissue generation.

Tissue engineering osteochondral implants for temporomandibular joint repair

Tissue engineering has provided an alternative to traditional strategies to repair and regenerate temporomandibular joints (TMJ). A successful strategy to engineer osteochondral tissue, such as that found in the TMJ, will produce tissue that is both biologically and mechanically functional. Image-based design (IBD) and solid free-form (SFF) fabrication can be used to generate scaffolds that are load bearing and match patient and defect site geometry. The objective of this study was to demonstrate how scaffold design, materials, and biological factors can be used in an integrated approach to regenerate a multi-tissue interface. IBD and SFF were first used to create biomimetic scaffolds with appropriate bulk geometry and microarchitecture. Biphasic composite scaffolds were then manufactured with the same techniques and used to simultaneously generate bone and cartilage in discrete regions and provide for the development of a stable interface between cartilage and subchondral bone. Poly-l-lactic acid/hydroxyapatite composite scaffolds were differentially seeded with fibroblasts transduced with an adenovirus expressing bone morphogenetic protein-7 in the ceramic phase and fully differentiated chondrocytes in the polymeric phase, and were subcutaneously implanted into mice. Following implantation in the ectopic site, the biphasic scaffolds promoted the simultaneous growth of bone, cartilage, and a mineralized interface tissue. Within the ceramic phase, the pockets of tissue generated included blood vessels, marrow stroma, and adipose tissue. This combination of IBD and SFF-fabricated biphasic scaffolds with gene and cell therapy is a promising approach to regenerate osteochondral defects and, ultimately, the TMJ.

Functional bone engineering using ex vivo gene therapy and topology-optimized, biodegradable polymer composite scaffolds

Bone tissue engineering could provide an alternative to conventional treatments for fracture nonunion, spinal fusion, joint replacement, and pathological loss of bone. However, this approach will require a biocompatible matrix to allow progenitor cell delivery and support tissue invasion. The construct must also support physiological loads as it degrades to allow the regenerated tissue to bear an increasing load. To meet these complex requirements, we have employed topology-optimized design and solid free-form fabrication to manufacture biodegradable poly(propylene fumarate)/beta-tricalcium phosphate composites. These scaffolds were seeded with primary human fibroblasts transduced with an adenovirus expressing bone morphogenetic protein-7 and implanted subcutaneously in mice. Specimens were evaluated by microcomputed tomography, compressive testing, and histological staining. New bone was localized on the scaffold surface and closely followed its designed contours. Furthermore, the total stiffness of the constructs was retained for up to 12 weeks after implantation, as scaffold degradation and tissue invasion took place.

Dexamethasone and basic-fibroblast growth factor regulate markers of mineralization in cementoblasts in vitro

BACKGROUND

The aim of this study was to determine the effects of basic-fibroblast growth factor (b-FGF) and/or dexamethasone (Dex) on cementoblasts in vitro.

METHODS

Murine cementoblasts were treated as follows: 1) 5% FBS (fetal bovine serum) + ascorbic acid (AA, 50 microg/ml, control); 2) 5% FBS + Dex (10(7)M) + AA; 3) 5% FBS + b-FGF (50 ng/ml)+AA; or 4) 5% FBS + Dex (10(7) M) + b-FGF (50 ng/ml)+AA and then evaluated by Northern analysis for changes in specific genes and by von Kossa stain for changes in mineral nodule formation.

RESULTS

Mitotic activity: b-FGF stimulated DNA synthesis significantly versus negative control. Gene expression: osteocalcin (OCN): Dex or b-FGF or the combination resulted in a decrease in expression versus control. Bone sialoprotein (BSP): Dex increased expression of BSP mRNA levels, b-FGF decreased transcript for BSP at 6 and 24 hours. Long-term (8 days) Dex, b-FGF, or Dex plus b-FGF caused a decrease in BSP expression versus control; osteopontin (OPN): both Dex and b-FGF increased transcripts for OPN seen by 6 hours, with a greater increase noted with b-FGF versus Dex. No apparent additive effect of Dex with b-FGF was noted; matrix gamma-carboxyglutamic acid protein (MGP): b-FGF induced transcripts for MGP and addition of Dex increased this effect, while Dex alone had no effect on expression. Biomineralization: Dex increased cementoblast- mediated biomineralization, while b-FGF blocked this activity, and addition of Dex to b-FGF did not alter FGF associated inhibition.

CONCLUSION

Dex and FGF alone and in combination alter cementoblast behavior, but additional studies are required to determine whether these factors have beneficial effects at the clinical level.

Engineered osteochondral grafts using biphasic composite solid free-form fabricated scaffolds

Tissue engineering has provided an alternative to traditional strategies to repair cartilage damaged by injury or degenerative disease. A successful strategy to engineer osteochondral tissue will mimic the natural contour of the articulating surface, achieve native mechanical properties and functional load-bearing ability, and lead to integration with host cartilage and underlying subchondral bone. Image-based design (IBD) and solid free-form (SFF) fabrication can be used to generate scaffolds that are load bearing and match articular geometry. The objective of this study was to utilize materials and biological factors in an integrated approach to regenerate a multitissue interface. Biphasic composite scaffolds manufactured by IBD and SFF fabrication were used to simultaneously generate bone and cartilage in discrete regions and provide for the development of a stable interface between cartilage and subchondral bone. Poly-L-lactic acid/hydroxyapatite composite scaffolds were differentially seeded with fibroblasts transduced with an adenovirus expressing bone morphogenetic protein 7 (BMP-7) in the ceramic phase and fully differentiated chondrocytes in the polymeric phase. After subcutaneous implantation into mice, the biphasic scaffolds promoted the simultaneous growth of bone, cartilage, and a mineralized interface tissue. Within the ceramic phase, the pockets of tissue generated included blood vessels, marrow stroma, and adipose tissue. This combination of IBD and SFF-fabricated biphasic scaffolds with gene and cell therapy is a promising approach to regenerate osteochondral defects.

Effects of TGF-beta s on the growth, collagen synthesis and collagen lattice contraction of human dental pulp fibroblasts in vitro

Transforming growth factor-beta (TGF-beta) is important in regulating the repair and regeneration of damaged dental pulp. For further elucidating the roles of different isoforms of TGF-beta in the healing and inflammatory processes of human dental pulp, we found that TGF-beta1, TGF-beta2 and TGF-beta3 inhibited the growth of two human dental pulp cell strains in vitro by 19-29, 18-25 and 23-26%, respectively, at a concentration of 0.5 ng/ml. TGF-beta also differentially stimulated the collagen synthesis of pulp cells. Collagen synthesis increased by 1 ng/ml of TGF-beta1 and TGF-beta2 by 42 and 51%, respectively. TGF-beta3 (0.1-1 ng/ml) lacked of stimulatory effect on collagen synthesis of pulp cells. Pulp cells have the intrinsic capacity to contract collagen lattice, leading to decreasing of lattice diameter. An 8 h exposure to TGF-beta1 and TGF-beta2 enhanced the pulp cell-populated collagen lattice contraction at concentrations ranging from 0.2 to 3 ng/ml. At similar concentrations, TGF-beta3 lacked of this stimulatory effect. When collagen lattice were detached after 24 h of exposure, TGF-beta1 and TGF-beta2 (0.6-3 ng/ml) induced the pulp cells-populated collagen lattice contraction within 4-8h of gel detachment. These results indicate that TGF-beta-induced collagen lattice contraction is a late cellular event. These in vitro results indicate that effects of TGF-beta isoforms on the growth, collagen synthesis and collagen lattice contraction of pulp cells may play crucial roles in the pathobiological processes of dental pulp.

Changes in transforming growth factor-beta1 in gingival crevicular fluid following periodontal surgery

OBJECTIVES

Growth factors play a major part in wound healing, including in the periodontium. However, the presence of growth factors in gingival crevicular fluid (GCF) in humans during periodontal wound healing has not yet been determined. Our hypothesis is that such factors are present in GCF and that changes in their levels might be of value as a prognostic marker of wound-healing activity and therapeutic progress following periodontal surgery. The aim of this study was therefore to measure transforming growth factor-beta1 (TGF-beta1) in GCF collected from sites that have undergone guided tissue regeneration (GTR) and conventional flap (CF) surgery and to compare these with GCF collected from unaffected healthy sites.

MATERIALS AND METHODS

GCF samples were collected, using filter paper strips, at baseline (pre-surgical) and then at intervals up to 26 weeks from 16 patients undergoing GTR and from 11 patients undergoing CF surgery. After elution and acid treatment, TGF-beta1 levels were measured by ELISA.

RESULTS

Treatment of periodontal defect sites significantly reduced the mean probing pocket depth (PPD) and improved the mean lifetime cumulative attachment loss (LCAL). Average GCF volumes also significantly increased at all sites at 2 weeks post-surgery and thereafter declined to baseline levels, except at the GTR test sites that were still elevated at 7 weeks. TGF-beta1 could be detected in almost all GCF samples, and 2 weeks after surgery, the average levels increased two-fold at the surgically treated but not at the control sites, which remained unchanged.

CONCLUSION

TGF-beta1 is readily detectable in GCF and increases transiently following periodontal surgery. This suggests that changes in the levels of this growth factor in GCF might be useful for monitoring the progress of periodontal repair and regeneration.

Bone formation by BMP-7-transduced human gingival keratinocytes

BMPs are a family of pleiotropic signaling molecules involved at various stages in the formation of bones and teeth. In addition, recombinant BMP can induce bone and dentin regeneration when applied directly to adult tissues. We have shown that fibroblasts transduced ex vivo by BMP cDNA delivered by recombinant adenoviruses induce bone formation and convert to osteoblasts upon implantation in vivo. To determine if this osteogenic capacity was limited to fibroblasts, we found that BMP-7-transduced human oral keratinocyte cells (HOKC) also formed ectopic bone. The ossicles formed by the BMP-7-transduced HOKC were smaller and more dense than those formed by BMP-7-transduced human gingival fibroblasts (HGF). Implanted HOKC were localized adjacent to the developing bone by immunocytochemical detection of keratin expression. However, no bone-like tissue formed when HOKC were implanted into diffusion chambers in vivo. We conclude that BMP-transduced HOKC secrete BMP and form bone in vivo but, unlike BMP-transduced HGF, do not transdifferentiate to osteoblasts.

Pharmacotherapy and airway remodelling in asthma?

Over the last few decades attention has largely focused on airway inflammation in asthma, but more recently it has been appreciated that there are important structural airway changes which have been grouped together under the term "airway remodelling". It is only now that questions have been asked about the impact of treatment on these structural changes. This review examines the nature of these structural airway changes, the mechanisms of their generation, their potential consequences, and what is known about the ability of anti-asthma treatments to modulate these changes.

Bone morphogenetic protein-transduced human fibroblasts convert to osteoblasts and form bone in vivo

Experimental cell or ex vivo gene therapy for localized bone formation typically uses osteoprogenitor cells propagated from periosteum or bone marrow. Both require bone or marrow biopsies to obtain cells. We have demonstrated that implantation of gingival or dermal fibroblasts transduced with BMP ex vivo, using a recombinant adenovirus (AdCMVBMP) attached to porous biodegradable scaffolds, form bone in vivo. Here we show that BMP-7-transduced fibroblasts suspended in injectable thermoset hydrogels form complete ossicles on subcutaneous injection and repair segmental defects in rat femurs. Bone formation was preceded by an intermediate cartilage stage. To determine the fate of the implanted transduced cells, thermoset hydrogel suspensions of ex vivo BMP-7-transduced or nontransduced fibroblasts were placed in diffusion chambers and implanted to allow development in vivo without direct contact with host cells. Only the BMP-transduced fibroblasts formed bone within the diffusion chambers in vivo, revealing that BMP transduction induces osteoblastic conversion of these cells.

Dexamethasone-mediated androgen metabolism in human gingival and oral periosteal fibroblasts

Dexamethasone modulates the effects of other hormones and mediates cell function; the periodontium is a target tissue for androgens. It was therefore relevant to investigate the modulation of androgen metabolism by dexamethasone in cultured human gingival (HGF) and oral periosteal fibroblasts (HPF). Each cell line was incubated in Eagle minimum essential medium with [(14)C]testosterone/[(14)C]4-androstenedione as substrates and serial concentrations of dexamethasone (0.5-50 microg/ml), for 24h; the medium was solvent-extracted, analyzed and quantified for steroid metabolites. In response to dexamethasone, both HGF (n=6) and HPF (n=4) showed up to two-fold increases in the formation of 5alpha-dihydrotestosterone and 4-androstenedione (P<0.01, one-way ANOVA), and 3.6- to 5-fold increases in the formation of testosterone (P<0.001), from [(14)C]4-androstenedione, with some inhibition at higher concentrations. Dexamethasone stimulated the formation of physiologically active androgen metabolites in a dose-dependent manner. These metabolites might therefore contribute to dichotomous effects in connective tissues of the periodontium, dependent on effective concentrations of dexamethasone.

BMP-7 gene transfer to inflamed ferret dental pulps

In vivo and ex vivo gene transfer are being developed for localized skeletal regeneration. These strategies for tissue regeneration were tested in an adult ferret model of vital pulp therapy. In this model a reversible pulpitis was induced first. Then after 3 d, the pulps were directly infected with recombinant virus or implanted with ex vivo transduced autologous dermal fibroblasts. The genome of the recombinant adenovirus contained a full-length cDNA encoding mouse bone morphogenetic protein (BMP)-7 (AdBMP7) or bacterial beta-galactosidase cDNA (AdlacZ). The BMP-7, but not lacZ, ex vivo transduced dermal fibroblasts induced reparative dentinogenesis with apparent regeneration of the dentin-pulp complex. In vivo infection with AdBMP-7 failed to produce reparative dentin in all cases. E. vivo gene transfer of BMP-7 may be an effective method for inducing dentin regeneration in teeth with reversible pulpitis.

Expression of growth-factor receptors in normal and regenerating human periodontal cells

Growth factors are biologically active mediators that bind to specific receptors on target cells and regulate genes involved in cell growth, wound healing and regeneration. The expression of these receptors is thus of fundamental importance for the response of the cells to the factors. The aim here was to examine, using immunohistochemistry and flow cytometry, the expression of growth factor receptors in normal gingiva, periodontal ligament and in cells derived from these tissues, and also in regenerated tissues following guided tissue regeneration (GTR). By immunocytochemistry platelet-derived growth factor receptor-alpha (PDGF-Ralpha) was not detected in any of the tissues, whereas the PDGF-Rbeta and transforming growth factor-beta receptor types I and II (TGF-beta RI, RII) appeared to be upregulated in regenerated tissues compared with gingival and periodontal ligament tissues. Epidermal growth factor receptor (EGF-R) was also notably elevated in the regenerated tissue and was strongly expressed in the gingival epithelium but not in the periodontal ligament. Neither were fibroblast growth factor receptor-I (FGF-RI) or insulin-like growth factor receptor (IGF-R) detected in the periodontal ligament, nor in the gingiva, but they sometimes stained weakly in the regenerated tissues. Flow cytometry (FCM) showed that all the cells derived from the normal gingiva and the periodontal ligament expressed the PDGF-Rbeta, whereas the TGF-beta RI and RII, FGF-RI and IGF-R were detected in only a proportion of the total cells. In contrast, none of the cells expressed the PDGF-Ralpha or the EGF-R. These observations show that the growth factor receptors are differentially expressed by the periodontal tissues and cells and suggest that the corresponding factors may also be differentially involved in periodontal wound healing and regeneration.

Gene therapy-directed osteogenesis: BMP-7-transduced human fibroblasts form bone in vivo

An ex vivo gene therapy strategy was used to achieve localized skeletal regeneration in vivo. When an adenovirus vector engineered to express bone morphogenetic protein 7 transduced human gingival fibroblasts or rat dermal fibroblasts, these nonosteogenic tissues formed bone and supported the development of hematopoietic tissue when transplanted into immunocompromised mice. Transduced gingival fibroblasts formed marrow-containing ossicles in 100% of transplants after 1-2 weeks in vivo (n = 30). Immunostaining with murine and human-specific antisera raised against osteonectin and in situ hybridization of human-specific Alu genomic sequence demonstrated that the newly formed bone organ was a chimera of both the human donor and the mouse recipient cells. In experiments of greater clinical relevance, AdCMVBMP-7-transduced dermal fibroblasts repaired critical size skeletal defects in rat calvariae (n = 6). The results of this study suggest a bifunctional role of BMP-7-transduced fibroblasts. The transduced, nonosteogenic cells not only secreted biologically active BMP-7 in vitro and in vivo, but also differentiated into bone-forming cells in vivo. This model exploits the use of an easily biopsied, self-regenerating tissue such as gingiva or skin and suggests that local regeneration of tissues by ex vivo gene therapy may not require that autogenous cells be cultured from the tissue that is to be regenerated.

Effect of recombinant human platelet-derived growth factor-BB and bone morphogenetic protein-2 application to demineralized dentin on early periodontal ligament cell response

The purpose of this study is to investigate the early responses of human periodontal ligament cells attached to recombinant human platelet-derived growth factor-BB and bone morphogenetic protein-2 applied EDTA-demineralized dentin. One hundred and seventy-four root-planed flat dentin blocks were prepared from the mid-third of periodontally diseased human tooth roots. After demineralization with 24% EDTA (pH 7.02) 120 dentin blocks were treated with 0.5 and 1 microgram/ml rhPDGF-BB, 1 and 3 micrograms/ml rhBMP-2 and only MEM as control (24/group). Human periodontal ligament cells (HPLC) were seeded on these dentin surfaces and incubated. The alkaline phosphatase (ALP) activity and protein concentration of the attached cell were assessed at d 2, 4 and 7. Fifty-four dentin blocks were seeded with HPLC after application of 1 microgram/ml rhPDGF-BB, 3 micrograms/ml rhBMP-2 and MEM (18/group) and then incubated. At d 2, 4 and 7, the attached cells were stained and counted under light microscope. The results showed a significant increase of protein concentration and cell number in PDGF-BB treated groups than control (p < 0.05, p < 0.01) but not the ALP activity, and a significant increase of ALP activity was observed in BMP-2 treated groups than control (p < 0.05) but protein concentration and cell number remained almost the same over time. Thus, rhPDGF-BB and rhBMP-2 application to EDTA demineralized dentin surfaces promote the early human periodontal ligament cell responses by increasing cell proliferation and differentiation, respectively, which would ultimately enhance periodontal regeneration.

Synthetic integrin-binding peptides promote adhesion and proliferation of human periodontal ligament cells in vitro

Periodontal ligament (PDL) cells have been shown to express several integrins (alphav, alpha5, beta1, beta3) that use RGD (arginine-glycine-aspartic Acid)-dependent mechanisms for the recognition and binding of their ligands. The objective of this study was to evaluate the effects of certain integrin-binding cyclic and linear synthetic RGD-containing peptides on PDL cells' adhesion, proliferation, and de novo protein synthesis in vitro. Fifth passages of normal human PDL cells established from teeth extracted from patients (ages 12 to 14) for orthodontic reasons were used for all experiments. Synthetic peptides containing the EPRGDNYR sequence in two different spatial conformations (linear and cyclic) were covalently attached to bovine serum albumin (BSA). Type I collagen, EPRGDNYR-BSA conjugates, 1:1 mixtures of type I collagen and conjugates, as well as BSA (a negative control) were coated on bacteriological plastic and evaluated for their attachment-promoting activities. In addition, the effects of these substrates on cell proliferation were evaluated by [3H]thymidine incorporation by the PDL cells. For attachment and spreading, the cyclic forms of EPRGDNYR-BSA conjugate and type I collagen were most potent, followed by linear EPRGDNYR-BSA conjugate. The effects of all collagen/conjugate mixtures were equivalent to that of type I collagen except for the collagen/linear EPRGDNYR-BSA mixture, which was less potent. The cyclic EPRGDNYR-BSA conjugate was the most effective substrate to stimulate cell proliferation, and it was followed in potency by the linear peptide-BSA conjugate. Collagen alone did not stimulate [3H]thymidine incorporation above the control level. Mixtures of collagen with all of the conjugates showed stimulatory effects similar to that of the cyclic peptide-BSA conjugate. No significant differences in de novo protein synthesis were detected. These results suggest that the synthetic RGD-containing peptides attached to a carrier are potent ligands for the human PDL cells, and that they could provide a basis for the development of new strategies aimed at the regeneration of the periodontium.

Role of synthetic extracellular matrix in development of engineered dental pulp

In cases of damaged oral tissues, traditional therapies, such as a root canal, replace the injured tissue with a synthetic material. However, while the materials currently used can offer structural replacement of the lost tissue, they are incapable of completely replacing the function of the original tissue, and often fail over time. This report describes a tissue engineering approach to dental pulp tissue replacement utilizing cultured cells seeded upon synthetic extracellular matrices. Human pulp fibroblasts were obtained and multiplied in culture. These cells were then seeded onto three different synthetic matrices: scaffolds fabricated from polyglycolic acid (PGA) fibers, a type I collagen hydrogel, and alginate in an effort to examine which matrix is most suitable for dental pulp tissue formation. In addition, methods previously developed for seeding and culturing pulp cells on PGA were optimized. Culturing cells on PGA resulted in a very high cell density tissue with significant collagen deposition. No cell proliferation was observed on alginate, and the growth of cells in collagen gels after 45 days was only moderate. These studies indicate dental pulp-like tissues can be engineered, and this may provide the first step to engineering a complete tooth.

Dexamethasone activates expression of the PDGF-alpha receptor and induces lung fibroblast proliferation

Corticosteroids (CSs) are commonly used for anti-inflammatory therapy in asthma and in interstitial lung diseases. In attempting to understand the mechanisms through which CSs control cell proliferation, we have carried out experiments to test the effects of dexamethasone (Dex) on the growth of lung fibroblasts. Using mouse 3T3 fibroblasts as well as early-passage rat lung fibroblasts (RLFs), we show that the quiescent cells in 1% serum or in serum-free media proliferate significantly in response to the addition of 10(-7) to 10(-9) M Dex. Increases as high as fourfold in cell numbers were recorded for the RLFs after 48 h in culture. A polyclonal antibody to the AB isoform of human platelet-derived growth factor (PDGF) blocked the proliferative response. As expected, the fibroblasts produced primarily PDGF-A chain, and the RLFs exhibited few PDGF-alpha receptors (PDGF-R alpha), the receptor type necessary for binding the AA isoform. Accordingly, we determined that Dex upregulated PDGF-R alpha mRNA and protein. Therefore, we can postulate that Dex-induced fibroblast proliferation is mediated, at least in part, by PDGF-AA, which binds to the PDGF-R alpha.

Porphyromonas gingivalis reduces mitogenic and chemotactic responses of human periodontal ligament cells to platelet-derived growth factor in vitro

The effects of a sonicated Porphyromonas gingivalis ATCC 33277 protein extract on the mitogenic and chemotactic responses of human periodontal ligament (PDL) cells to the recombinant human platelet-derived growth factor-BB homodimer (PDGF-BB) were examined in vitro. Proliferation of PDL cells was inhibited by P. gingivalis extract at concentrations higher than 10 micrograms/mL protein. At 100 micrograms/mL of P. gingivalis extract, cells did not proliferate. DNA synthesis in PDL cells, as revealed by [3H]-thymidine incorporation, was also inhibited by approximately 50% in the presence of 50 micrograms/mL P. gingivalis extract for 24 hours. In contrast, PDGF-BB at 1 ng/mL enhanced DNA synthesis in PDL cells, followed by maximum enhancement at concentrations higher than 10 ng/mL PDGF-BB. However, this mitogenic response to PDGF-BB was markedly reduced in the presence of 20 micrograms/mL of P. gingivalis extract and did not reach the maximum level even if PDGF-BB concentrations were increased to 250 ng/mL. PDL cells exhibited a chemotactic response to PDGF-BB at 1 ng/mL, which was also inhibited by pretreatment of the cells with P. gingivalis extract at 10 to 50 micrograms/mL. Scatchard analysis of a [125I]-PDGF binding assay demonstrated that PDL cells have both high and low PDGF binding affinity sites. Treatment of the cells with P. gingivalis extract decreased the number of PDGF-binding sites to approximately 35% of the control level, while it caused only a slight change in the affinities of both types of binding site. These results indicated that the P. gingivalis extract reduced mitogenic and chemotactic responses of human PDL cells, possibly through mechanisms involving a decrease in PDGF-binding capacity of these cells. Due to this inhibitory effect of P. gingivalis, the normal levels of PDGF in periodontal lesions may not be sufficient to promote periodontal regeneration through activation of PDL cell proliferation and migration. Therefore, the therapeutic use of PDGF-BB, as a supplement to pre-existing PDGF and as an adjunct, while also eliminating P. gingivalis from periodontal lesions, would help periodontal tissue regeneration.

The effects of platelet-derived growth factor-BB and insulin-like growth factor-1 on epithelial dysplasia

Growth factors are multi-functional and multi-targeted proteins which play a significant role in wound healing. Platelet-derived growth factor B-chain homodimer (PDGF-BB) and insulin-like growth factor-1 (IGF-1) have demonstrated efficacy for periodontal regeneration in animal models. Although primarily associated with wound healing, PDGF-BB and IGF-1 also facilitate growth of a number of malignant neoplasms. Of particular concern to periodontists is epithelial dysplasia, a necessary precursor to squamous cell carcinoma, the most common oral malignancy. Certain risk factors for oral cancer, such as tobacco, age, and alcohol, are also associated with an increased incidence of periodontal disease. The effects of the combination of PDGF-BB and IGF-1 on epithelial dysplasia have not previously been reported. The purpose of this study was to examine the effects of the combination of PDGF-BB and IGF-1 on epithelial dysplasia induced in the buccal cheek pouch of the Syrian golden hamster. A total of 66 hamsters received 18 applications of 0.5% dimethylbenzanthracene (DMBA), a topical carcinogen, over a 6-week period for the induction of dysplasia. The hamsters were subsequently divided into a baseline and 3 experimental groups (growth factors, saline vehicle, untreated control). Following the final DMBA application (day 0), the baseline group (N = 6) was sacrificed, the growth factor group (N = 21) received a single injection in the cheek pouch containing 4 micrograms of PDGF-BB and 4 micrograms of IGF-1 in saline, the saline group (N = 19) received an injection in the cheek pouch containing the saline vehicle only, and the untreated control group (N = 20) received no injection. Animals in experimental groups were sacrificed on days 3, 6, and 10. The cheek pouches were harvested for histologic and histochemical evaluation. Dysplasia was histologically graded from 0 to 4. Statistical analysis of the histologic data revealed no significant differences either by sacrifice date or by group. Histochemical evaluation, via staining for gamma-glutamyl transpeptidase (GGT), a marker for dysplastic cell colonies, revealed that the density of GGT-positive cells in experimental groups differed significantly from baseline levels. No significant differences were detected between experimental groups. There was poor correlation between the density of GGT-positive cells and the histologic grading of dysplasia. It is concluded that exposure to PDGF-BB and IGF-1 had no demonstrable effect on epithelial dysplasia in this hamster model.

Expression of genes for bone morphogenetic proteins and receptors in human dental pulp

Bone morphogenetic proteins (BMP) have been shown to induce reparative dentine formation experimentally but the cells responsible, which respond to BMPs, have not been identified. The BMP signal is probably mediated by interaction of type I and II BMP receptors (R). Here, the RNA of human adult dental pulp and pulp cells in culture was examined by reverse transcription (RT) polymerase chain reaction (PCR) for evidence of mRNA for BMPs. mRNAs for BMP-2, -4, osteogenic protein-1, ActR-1 (activin-like kinase receptor), BMPR-IA, -IB and -II were detected by RT-PCR. The 698-bp PCR fragment for BMPR-IB was used to probe pulp cells for expression of that receptor. Cell expression of BMPR-IB was detected by the hybridization probe. The findings suggest that resident pulp cells may be able to respond to BMPs to initiate tissue formation.

Periodontal tissue engineering by growth factors

Polypeptide growth factors (GFs) have been shown to modulate the wound healing response in both hard and soft tissues. During the past decade, many investigators have demonstrated the anabolic effects of these wound healing molecules on the promotion of periodontal attachment structures, namely alveolar bone, periodontal ligament and tooth root cementum. The molecular cloning and large scale purification of GFs has allowed expanded in vivo studies on periodontal tissue regeneration. This review will outline specific effects of these factors at both the in vitro and in vivo level on the promotion of periodontal and peri-implant bone wound healing. This paper will conclude with a future perspective of ongoing studies in the human clinical trial arena using growth and osteoinductive factors to promote periodontal tissue regeneration and alveolar bone repair in the oral cavity.

Proliferative and matrix synthesis response of canine anterior cruciate ligament fibroblasts submitted to combined growth factors

We investigated the effects of growth factors on the proliferation and matrix synthesis of anterior cruciate ligament fibroblasts. Fibroblasts from the anterior cruciate ligaments of dogs were transferred at the second passage in a defined medium. Epidermal growth factor, platelet-derived growth factor-AB, transforming growth factor-beta 1, insulin-like growth factor-1, and insulin, combined two by two following a 5 x 5 logarithmic concentration matrix, were added. Tridimensional curves showing cell proliferation at 24 hours against the concentration of two effectors were obtained for each combination. Collagen and proteoglycan productions were quantified using [14C]glycine and Na2[35S]O4. Ratios of type I:III collagen and hydrodynamic size distributions of proteoglycans were assayed, respectively, by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and gel filtration chromatography. Epidermal growth factor had an effect nearly equivalent to that of platelet-derived growth factor-AB on cell proliferation. Both had a greater effect than insulin-like effect of transforming growth factor-beta 1. Neither platelet-derived growth factor-AB nor insulin has a significant effect by itself on collagen production. Epidermal growth factor slightly decreases collagen production as well as the type I:III collagen ratio; both transforming growth factor-beta 1 and insulin-like growth factor-1 increase the same parameters. Epidermal growth factor inhibits the stimulation induced by transforming growth factor-beta 1. Similarly, insulin decreases the response to insulin-like growth factor-1. Proteoglycan production was significantly increased by all growth factors in this study, with transforming growth factor-beta 1 having the strongest effect. Small hydrodynamic size of proteoglycan was correlated to a high level of proteoglycan. biosynthesis. The results may be readily applied to tissue engineering or provide a basis for in vivo investigations.

Cytokines and cell signalling in the periodontium

A large number of potential regulatory mechanisms have been described which may be involved in the control of cell function in the periodontium. In this review, soluble effector molecules which may regulate normal cell turnover and which may control the maintenance of the periodontal space are considered. There is evidence for the involvement of growth factors including EGF, PDGF, FGFs, IGF I & II and TGF-beta in these processes. The role of bone morphogenetic proteins (BMPs) in periodontal turnover is of considerable interest as they appear to be able to regulate all stages of this process from specifying cell commitment to regulating differentiated cell function. Empirical evidence suggests the importance of mechanical stimulation in controlling the maintenance of the periodontal ligament space. The wide range of effects of mechanical stimulation are briefly reviewed and the central role of prostaglandins is considered. Recent evidence suggests the involvement of nitric oxide (NO) in the regulation of mineralised tissue function, and the potential role of NO in maintenance of the ligament space is considered. Further studies are required which address the interactions between all of these mechanisms in order to determine the key factors which may control periodontal cell function. For the future an understanding of these interactions has the potential to lead to important clinical developments in periodontal and orthodontic therapy.

Platelet-derived growth factor-modulated guided tissue regenerative therapy

The goal of this study was to develop an effective regenerative therapy capable of achieving periodontal regeneration of Class III furcation defects. We attempted to achieve this goal by combining three therapeutic approaches. First, the lesion was protected by an expanded polytetrafluoroethylene barrier membrane that prevents migration of gingival fibroblasts as well as osteogenic cells from the mucoperiosteal flaps. Second, platelet-derived growth factor-BB (PDGF-BB), which has potent chemotactic and mitogenic effects on periodontal ligament fibroblasts (PDL), was used to promote migration of fibroblasts and their proliferation on the root surface. Third, the root surface, demineralized by citric acid conditioning, was chosen as the primary site for PDGF-BB application. The demineralized root surface appeared to have the capability of providing a sustained release of the applied growth factor. This seemed to facilitate rapid repopulation of PDL fibroblasts on the root surface and new PDL formation in the early stages of repair, which contributed to complete periodontal regeneration without root resorption and ankylosis in later stages. Combining these approaches, we developed a therapy referred to as "PDGF-modulated guided tissue regenerative therapy." Unlike guided tissue regenerative therapy alone (without PDGF-BB), this therapy effectively promoted periodontal regeneration of Class III furcation defects in the beagle dog without significant ankylosis or root resorption.

Dexamethasone enhances the effects of parathyroid hormone on human periodontal ligament cells in vitro

Periodontal ligament cells (PDL) are thought to play a major role in promoting periodontal regeneration. Recent studies, focused on characterizing PDL cells, have been directed at establishing their osteoblast-like properties and determining biological mediators and/or factors that induce osteoblastic cell populations in the PDL. The glucocorticoid, dexamethasone (Dex), has been shown to selectively stimulate osteoprogenitor cell proliferation and to induce osteoblastic cell differentiation in many cell systems. In the present study the ability of Dex to modulate parathyroid hormone (PTH)-stimulated cAMP synthesis in cultured human PDL cells was examined. PDL cells, obtained from premolar teeth extracted for orthodontic reasons, were cultured with Dex (0-1000 nM) for 7 days prior to PTH (1-34) stimulation. The exposure of PDL cells to Dex resulted in a dose-dependent increase in cAMP production in response to PTH stimulation. This response was seen in cells obtained from three different patients. The first significant Dex effect was seen on day 7 when compared to day 1 for 100 nM Dex. PTH (1-34) stimulation caused a dose-dependent increase in cAMP synthesis after Dex (1000 nM) treatment for 7 days. Conversely, stimulation of the cells with PTH (7-34) (0-1000 nM) did not increase cAMP production in PDL cells after Dex treatment. Forskolin- (1 microM) and isoproterenol- (1 microM) stimulated cAMP synthesis was not augmented by Dex treatment. Dex treatment did not alter calcitonin-(1 microM) stimulated cAMP production in PDL cells. Glucocorticoid enhancement of PTH-stimulated cAMP synthesis in these cells supports the presence of an osteoblast-like population in the PDL, in vitro.

Periodontal regeneration in class III furcation defects of beagle dogs using guided tissue regenerative therapy with platelet-derived growth factor

We developed an effective regenerative therapy, referred to as platelet-derived growth factor-BB (PDGF-BB)-modulated guided tissue regenerative (GTR) therapy (P-GTR), capable of achieving periodontal regeneration of horizontal (Class III) furcation defects in the beagle dog. To determine its efficacy, repair and regeneration of horizontal furcation defects by P-GTR therapy and GTR therapy were compared. Chronically inflamed horizontal furcation defects were created around the second (P2) and fourth mandibular premolars (P4). After demineralization of the root surfaces with citric acid, the surfaces of left P2 and P4 were treated with PDGF-BB (P-GTR therapy) and those of contralateral teeth were treated with vehicle only (GTR therapy). Periodontal membranes were placed and retained 0.5 mm above the cemento-enamel junction for both groups. The mucoperiosteal flap was sutured in a coronal position and plaque control was achieved by daily irrigation with 2% chlorhexidine gluconate. At 5, 8, and 11 weeks, two animals each were sacrificed by perfusion with 2.5% glutaraldehyde through the carotid arteries, and the lesions were sliced mesio-distally, demineralized, dehydrated, and embedded. Periodontal healing and regeneration after GTR and P-GTR therapy were compared by histomorphometric as well as morphological analysis. Morphometric analysis for each time period was performed on the pooled samples of P2 and P4. Five weeks after both therapies, the lesions were filled primarily by tissue-free area, epithelium, inflamed tissue, and a small amount of newly formed fibrous connective tissue. At 8 and 11 weeks after P-GTR therapy, there was a statistically greater amount of bone and periodontal ligament formed in the lesions. The newly formed bone filled 80% of the lesion at 8 weeks and 87% at 11 weeks with P-GTR therapy, compared to 14% of the lesion at 8 weeks and 60% at 11 weeks with GTR therapy. Also, with P-GTR therapy there was less epithelium and tissue-free area, less inflamed tissue, and less connective tissue. Morphological analysis indicated that the defects around P2 revealed faster periodontal repair and regeneration than those around P4. While the lesions around P2 were effectively regenerated by 11 weeks even after GTR therapy, those around P4 failed to regenerate. On the other hand, P-GTR therapy further promoted periodontal repair and regeneration so that at 8 weeks the lesions around P2 and P4 demonstrated complete and nearly complete regeneration, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)

Receptor binding of PDGF-AA and PDGF-BB, and the modulation of PDGF receptors by TGF-beta, in human periodontal ligament cells

The growth factors PDGF-AA and PDGF-BB have previously been shown to be potent mitogens for human periodontal ligament (hPDL) cells in vitro. Additionally, the mitogenic response to PDGF-AA has been shown to be specifically inhibited by TGF-beta. The purpose of the present investigation was to examine the binding of PDGF-AA and PDGF-BB, and the modulation of PDGF binding by TGF-beta, in hPDL cells. Scatchard analysis identified an average of 32,000 PDGF-AA high-affinity binding sites per cell with a dissociation constant (Kd) of 0.66 nM and an average of 36,000 PDGF-BB binding sites per cell with a dissociation constant (kd) of 0.44 nM. After treatment with TGF-beta, the receptor number for PDGF-AA was found to specifically decrease by approximately 50%, with no change in binding affinity. This reduced number of binding sites was shown to correlate with both a decrease in levels of receptor tyrosine phosphorylation and a decreased number of alpha receptor subunits. Northern blot analysis identified the TGF-beta-mediated decrease in PDGF alpha receptor subunit mRNA levels. PDGF-BB showed little change in the number of binding sites or in the binding affinity with TGF-beta treatment, and the data were consistent with an increase in the number of beta receptor subunits. These results demonstrate nearly equivalent numbers of receptors for both PDGF-AA and PDGF-BB in hPDL cells. Also, modulation of PDGF binding, by TGF-beta, was shown to result in a reduced number of alpha receptor subunits with an increase in the number of beta receptor subunits.

Platelet-derived growth factor and dexamethasone combined with a collagen matrix induce regeneration of the periodontium in monkeys

Platelet-derived growth factor (PDGF) and the glucocorticoid dexamethasone combined with a collagen carrier matrix (CM) induced regeneration of the periodontium in monkeys. Regeneration was stringently defined as: (1) new cementum, (2) new supra-crestal bone extending coronally from the residual alveolar interdental septum and (3) functionally-oriented periodontal ligament fibers attaching new cementum to new bone. A single application of PDGF/dexamethasone/CM or CM was placed in debrided lesions of experimental periodontitis displaying 3-5 mm of attachment loss associated with horizontal and angular bony defects. Regeneration, judged histologically by these criteria and quantified by computer assisted histomorphometry after 4 weeks, was present only in PDGF/dexamethasone/CM treated lesions and not in those treated with CM or debridement alone. PDGF/dexamethasone/CM induced 5-fold more new cementum and ligament, and 7-fold more supra-crestal bone than control treatments. The presence of substantial amounts of regenerated periodontium including increased height of the alveolar bone; fill of vertically resorbed interdental alveolar septa in PDGF/dexamethasone/CM treated lesions suggests that this combination may provide a new therapeutic agent for the regeneration of lesions of periodontitis associated with horizontal as well as angular bony defects.

Mitogenic effects of growth factors on human periodontal ligament cells in vitro

Periodontal regeneration is thought to require the migration and proliferation of periodontal ligament cells. Evidence suggests that the polypeptide growth factors PDGF, IL-1, and TGF-beta are mediators of these cellular events in wound healing. The purpose of this study was to determine the effects of these growth factors on human periodontal ligament (PDL) cell mitogenesis, and to identify the regulatory influences of TGF-beta on the response to PDGF and IL-1. Confluent, quiescent human PDL cells were cultured in vitro and treated with the polypeptide growth factors PDGF-AA and -BB, IL-1 beta, and TGF-beta in both a dose and time-dependent manner. Mitogenic activity, as a measure of proliferative potential, was determined by the quantitation of 3H-thymidine incorporation during DNA synthesis. The results of this study demonstrated that both PDGF-AA and -BB enhance mitogenic activity in a dose-dependent manner over a concentration range of 1.0 to 50.0 ng/ml. IL-1 beta (0.01 to 1.0 pM) resulted in no mitogenic enhancement, and at high concentrations (10.0 to 100.0 pM) demonstrated an inhibitory effect. TGF-beta produced a significant increase (P < 0.01) in mitogenic activity (although relatively much less than PDGF) in a delayed, bimodal, dose-dependent manner over a concentration range of 0.01 to 20.0 ng/ml, with a maximal response at a concentration of 1.0 ng/ml. Additionally, incubation with TGF-beta at 1.0 ng/ml prior to the addition of PDGF significantly enhanced (P < 0.01) the mitogenic response to both PDGF-AA and PDGF-BB.(ABSTRACT TRUNCATED AT 250 WORDS)