Non-damaging stretching combined with sodium pyruvate supplement accelerate migration of fibroblasts and myoblasts during gap closure

Diet supplementation with sodium pyruvate increases sleep time and lifespan in Drosophila model

Sodium pyruvate is a natural metabolite commonly used in biological fields, including cell culture. This study investigated the effects of sodium pyruvate on the lifespan and other physiological characters of Drosophila melanogaster, by measuring feeding, fecundity, and spontaneous activity. The results indicated that 0.2 mol/L of sodium pyruvate increased the median lifespan of female flies by 8.33%. Moreover, the group sleep duration of female flies significantly increased by 53.98% when exposed to the sodium pyruvate concentration. However, the intake of sodium pyruvate did not significantly affect the fecundity or food intake of female flies. Our results also show that the effect of extending lifespan and increasing sleep time was dose-dependent and sex-specific. Our data provides the role of sodium pyruvate as an insect culture additive by enhancing survival.

Acceleration of chronic wound healing by bio-inorganic polyphosphate: In vitro studies and first clinical applications

The healing of chronic wounds is impaired by a lack of metabolic energy. In previous studies, we showed that physiological inorganic polyphosphate (polyP) is a generator of metabolic energy by forming ATP as a result of the enzymatic cleavage of the high-energy phosphoanhydride bonds of this polymer. Therefore, in the present study, we investigated whether the administration of polyP can substitute for the energy deficiency in chronic wound healing.

Methods: PolyP was incorporated into collagen mats and applied in vitro and to patients in vivo.

Results: (i) In vitro studies: Keratinocytes grown in vitro onto the polyP/collagen mats formed long microvilli to guide them to a favorable environment. HUVEC cells responded to polyP/collagen mats with an increased adhesion and migration propensity as well as penetration into the mats. (ii) In vivo - human clinical studies: In a “bench to bedside” process these promising in vitro results were translated from the laboratory into the clinic. In the proof-of-concept application, the engineered polyP/collagen mats were applied to chronic wounds in patients. Those mats impressively accelerated the re-epithelialization rate, with a reduction of the wound area to 65% after 3 weeks and to 36.6% and 22.5% after 6 and 9 weeks, respectively. Complete healing was achieved and no further treatment was necessary. Biopsy samples from the regenerating wound area showed predominantly myofibroblasts. The wound healing process was supported by the use of a polyP containing moisturizing solution.

Conclusion: The results strongly recommend polyP as a beneficial component in mats for a substantial healing of chronic wounds.

Higher pyruvate levels after Achilles tendon rupture surgery could be used as a prognostic biomarker of an improved patient outcome

PURPOSE

The primary aim of this study was to assess the relationship between the metabolites lactate and pyruvate in the healing tendon after Achilles tendon rupture (ATR) and patient-reported outcome at 6 and 12 months. A secondary aim was to evaluate which underlying factors regulate lactate and pyruvate concentrations.

METHODS

Lactate and pyruvate concentrations were measured two weeks post-operatively in both the healing- and healthy Achilles tendon in 109 patients (90 men, 19 women; mean age 40 ± 7.9 years). Patient demographics, degree of physical activity, timing of surgery, operation time, patient-reported loading and step counts were investigated in relation to metabolite concentrations. At 6 and 12 months, the Achilles tendon Total Rupture Score (ATRS) questionnaire was used to assess patient outcome.

RESULTS

The mean number of steps taken during the post-operative days 1-10 was the only factor significantly related to the mean concentration of lactate (R² = 0.34, p = 0.038), and pyruvate (R² = 0.46, p = 0.006). Pyruvate was demonstrated as the only factor significantly associated with ATRS at both 6 months (R² = 0.32, p = 0.003) and at 12 months (R² = 0.37, p = 0.004) using multiple linear regression.

CONCLUSION

The mean concentration of pyruvate during early ATR healing may predict patient outcome at 6 and 12 months post-operatively and possibly be used as a biomarker of healing. Early mobilization with an increased number of steps taken is an important clinical strategy to improve the metabolite concentrations during healing.

LEVEL OF EVIDENCE

III.

A novel system for dynamic stretching of cell cultures reveals the mechanobiology for delivering better negative pressure wound therapy

Serious wounds, both chronic and acute (e.g., surgical), are among the most common, expensive and difficult-to-treat health problems. Negative pressure wound therapy (NPWT) is considered a mainstream procedure for treating both wound types. Soft tissue deformation stimuli are the crux of NPWT, enhancing cell proliferation and migration from peri-wound tissues which contributes to healing. We developed a dynamic stretching device (DSD) contained in a miniature incubator for applying controlled deformations to fibroblast wound assays. Prior to the stretching experiments, fibroblasts were seeded in 6-well culture plates with elastic substrata and let to reach confluency. Squashing damage was then induced at the culture centers, and the DSD was activated to deliver stretching regimes that represented common clinical NPWT protocols at two peak strain levels, 0.5% and 3%. Analyses of the normalized maximal migration rate (MMR) data for the collective cell movement revealed that for the 3% strain level, the normalized MMR of cultures subjected to a 0.1 Hz stretch frequency regime was ~ 1.4 times and statistically significantly greater (p < 0.05) than that of the cultures subjected to no-stretch (control) or to static stretch (2nd control). Correspondingly, analysis of the time to gap closure data indicated that the closure time of the wound assays subjected to the 0.1 Hz regime was ~ 30% shorter than that of the cultures subjected to the control regimes (p < 0.05). Other simulated NPWT protocols did not emerge as superior to the controls. The present method and system are a powerful platform for further revealing the mechanobiology of NPWT and for improving this technology.

High body mass index is a strong predictor of intraoperative acquired pressure injury in spinal surgery patients when prophylactic film dressings are applied: A retrospective analysis prior to the BOSS Trial

We reported the efficacy of soft silicone multilayered foam dressings in preventing intraoperatively acquired pressure injuries (IAPIs) in the prone position using a Relton-Hall frame (BOSS trial). The aim of this study was to clarify the incidence and extract the risk factors for IAPIs in cases in which polyurethane film dressing was used against IAPIs before the BOSS trial period. This study conducted as a retrospective dual-center cohort study between August 2014 and Jun 2015 using the medical records in the operating room. The incidence of IAPIs that developed within 24 hours after surgery was 7.1% (7/99). The multivariate logistic regression analysis revealed that body mass index (BMI) (P = .0016, odds ratio [OR]: 1.22, 95% confidence interval (CI) 1.08-1.4) and length of surgery (P < .0001, OR 2.47, 95% CI 1.86-3.51) were independently associated with the development of IAPIs. Since high BMI was not extracted in BOSS trial, we conclude that the application of soft silicone multilayer foam dressings is important for preventing the development of IAPIs in patients with high BMI values.

Finite element analysis reveals an important role for cell morphology in response to mechanical compression

Mechanical loading naturally controls cell phenotype, development, motility and various other biological functions; however, prolonged or substantial loading can cause cell damage and eventual death. Loading-induced mechanobiological and mechanostructural responses of different cell types affect their morphology and the internal architecture and the mechanics of the cellular components. Using single, mesenchymal stem cells, we have developed a cell-specific three-dimensional finite-element model; cell models were developed from phase-contrast microscopy images. This allowed us to evaluate the mechanostructural response of the naturally occurring variety of cell morphologies to increase sustained compressive loading. We focus on the morphology of the cytoplasm and the nucleus, as the main mechanically responsive elements, and evaluate formation of tensional strains and area changes in cells undergoing increasing uniaxial compressions. Here, we study mesenchymal stem cells as a model, due to their important role in tissue engineering and regenerative medicine; the method and findings are, however, applicable to any cell type. We observe variability in the cell responses to compression, which correlate directly with the morphology of the cells. Specifically, in cells with or without elongated protrusions (i.e., lamellipodia) tensional strains were, respectively, distributed mostly in the thin extensions or concentrated around the stiff nucleus. Thus, through cell-specific computational modeling of mechanical loading we have identified an underlying cause for stiffening (by actin recruitment) along the length of lamellipodia as well as a role for cell morphology in inducing cell-to-cell variability in mechanostructural response to loading.

Nutrient restriction and migration of turkey satellite cells

Post hatch muscle growth and the repair or regeneration of muscle after myofiber injury is mediated by satellite cells. Satellite cells proliferate, migrate, differentiate, and fuse with growing or regenerating myofibers. The proliferation and differentiation of satellite cells are affected by nutrition, but it is unknown how nutrition impacts satellite cell migration. The objective of the study was to determine the effect of a nutrient restriction on satellite cell migration. Satellite cells from the pectoralis major muscle of 1 and 49-day-old Randombred Control Line 2 turkeys were grown in culture, and migration was measured using a wound healing assay. Nutrient restrictions of 0, 5, 10, and 20% of the standard culture medium were applied starting immediately after scratch or 24 h prior to scratch. Nutrient restrictions of 5 and 20% increased 1 D satellite cell migration at 6 h post scratch compared to 1 D satellite cells with standard culture medium but had no effect after 12 h post scratch. Nutrient restrictions started 24 h prior to scratch increased 1 D satellite cell migration at 6 and 12 h post scratch compared to nutrient restrictions started immediately after scratch. The migration of 49 D satellite cells was not affected by the percentage or timing of the nutrient restriction. These data suggest that nutrition has only a minor effect on the migration of turkey pectoralis major muscle satellite cells. Therefore, the influence of nutrition on satellite cell migration is likely not an important factor for evaluating poultry diet formulations to optimize muscle growth and structure for improved meat protein and fat content as well as meat texture.

Sodium pyruvate pre-treatment prevents cell death due to localised, damaging mechanical strains in the context of pressure ulcers

We demonstrate sodium pyruvate (NaPy) pre-treatment as a successful approach for pressure ulcer (PU) prevention by averting their aetiological origin-cell-level damage and death by large, sustained mechanical loads. We evaluated the NaPy pre-treatment effect on permeability changes in the cell's plasma membrane (PM) following application of in vitro damaging-level strains. Fibroblasts or myoblasts, respectively, models for superficial or deep-tissue damage were grown in 0 or 1 mM NaPy, emulating typical physiological or cell culture conditions. Cells were pre-treated for 4 hours with 0 to 5 mM NaPy prior to 3-hour sustained, damaging-level loads (12% strain). PM permeability was quantified by the cell uptake of small (4 kDa), fluorescent dextran compared with unstrained control using fluorescence-activated cell sorting (FACS). Pre-treatment with 1 mM, and especially 5 mM, NaPy significantly reduces damage to PM integrity. Long-term NaPy pre-exposure can improve protective treatment, affecting fibroblasts and myoblasts differently. Pre-treating with NaPy, a natural cell metabolite, allows cells under damaging-level mechanical loads to maintain their PM integrity, that is, to avoid loss of homeostasis and inevitable, eventual cell death, by preventing initial, microscale stages of PU formation. This pre-treatment may be applied prior to planned periods of immobility, for example, planned surgery or transport, to prolong safe time in a position by preventing initial cell damage that can cascade and lead to PU formation.

Release of sodium pyruvate from sacral prophylactic dressings: A computational model

The use of sacral dressings for pressure ulcer prevention is growing rapidly. In addition to their passive biomechanical role in pressure and shear reduction, in the near future, prophylactic dressings may also provide active tissue protection by releasing preventive agents or drugs into skin and deeper tissues. We investigated delivery of sodium pyruvate (NaPy) from an active dressing to potentially protect the sacral skin and underlying tissues in addition. We used four finite element model variants describing different skin roughness levels to determine time profiles of NaPy diffusion from the dressing into the skin layers. The NaPy concentrations for the different modelled cases stabilised after 1 to 6.5 hours from the time of application of the dressings, at 1% to 3% of the NaPy concentration in the dressing reservoir, which is considered potent. We conclude that prophylactic sacral dressings have the potential to deliver NaPy into skin and subdermally, to potentially increase soft tissue tolerance to sustained bodyweight-caused cell and tissue deformations. The time durations to achieve the steady-state potent NaPy dermal concentrations are clinically feasible, for example, for preparation of patients for surgery or for use in intensive care units.