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Jiang Y, Cao Y, Wu J, Bai R, Wan S, Dai L, Su J, Sun H. Au nanozyme-based multifunctional hydrogel for inflammation visible monitoring and treatment. Mater Today Bio 2024; 25:100960. [PMID: 38322658 PMCID: PMC10844747 DOI: 10.1016/j.mtbio.2024.100960] [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: 10/21/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 02/08/2024] Open
Abstract
Chronic inflammation can delay wound healing, eventually leading to tissue necrosis and even cancer. Developing real-time intelligent inflammation monitoring and treatment to achieve effective wound management is important to promote wound healing. In this study, a smart multifunctional hydrogel (Hydrogel@Au NCs&DG) was proposed to monitor and treat the wound inflammation. It was prepared by mixing 3-carboxy-phenylboronic acid modified chitosan (CS-cPBA), β-glycerophosphate (β-GP), albumin-protected gold nanoclusters (BSA-Au NCs), and dipotassium glycyrrhizinate (DG) about 10 s. In this hydrogel, CS-cPBA and β-GP are crosslinked together by boric acid ester bond and hydrogen bond to form the main hydrogel network, endowing the hydrogel with self-healing and injectable properties to adapt irregular wounds. Importantly, the as-prepared hydrogel with good biocompatibility and excellent adhesion property could directly determine the H2O2 to monitor the wound microenvironment by visible fluorescence change of BSA-Au NCs and then guide the frequency of dressing change to eliminate inflammation. The results demonstrated that the as-prepared smart hydrogel could be expected to serve as an intelligent wound dressing to promote inflammation-infected wound healing.
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Affiliation(s)
- Yunjing Jiang
- Collaborative Grant-in-Aid of the HBUT National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Key Laboratory of Fermentation Engineering (Ministry of Education), Key Laboratory of Industrial Microbiology in Hubei, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), School of Bioengineering and Food, Hubei University of Technology, Wuhan, 430068, China
| | - Yuyu Cao
- Collaborative Grant-in-Aid of the HBUT National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Key Laboratory of Fermentation Engineering (Ministry of Education), Key Laboratory of Industrial Microbiology in Hubei, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), School of Bioengineering and Food, Hubei University of Technology, Wuhan, 430068, China
| | - Jie Wu
- Collaborative Grant-in-Aid of the HBUT National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Key Laboratory of Fermentation Engineering (Ministry of Education), Key Laboratory of Industrial Microbiology in Hubei, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), School of Bioengineering and Food, Hubei University of Technology, Wuhan, 430068, China
| | - Rongxian Bai
- Collaborative Grant-in-Aid of the HBUT National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Key Laboratory of Fermentation Engineering (Ministry of Education), Key Laboratory of Industrial Microbiology in Hubei, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), School of Bioengineering and Food, Hubei University of Technology, Wuhan, 430068, China
| | - Shufan Wan
- Collaborative Grant-in-Aid of the HBUT National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Key Laboratory of Fermentation Engineering (Ministry of Education), Key Laboratory of Industrial Microbiology in Hubei, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), School of Bioengineering and Food, Hubei University of Technology, Wuhan, 430068, China
| | - Lei Dai
- Collaborative Grant-in-Aid of the HBUT National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Key Laboratory of Fermentation Engineering (Ministry of Education), Key Laboratory of Industrial Microbiology in Hubei, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), School of Bioengineering and Food, Hubei University of Technology, Wuhan, 430068, China
| | - Jiangtao Su
- Collaborative Grant-in-Aid of the HBUT National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Key Laboratory of Fermentation Engineering (Ministry of Education), Key Laboratory of Industrial Microbiology in Hubei, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), School of Bioengineering and Food, Hubei University of Technology, Wuhan, 430068, China
| | - Hongmei Sun
- Collaborative Grant-in-Aid of the HBUT National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Key Laboratory of Fermentation Engineering (Ministry of Education), Key Laboratory of Industrial Microbiology in Hubei, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), School of Bioengineering and Food, Hubei University of Technology, Wuhan, 430068, China
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2
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Rabbani M, Rahman E, Powner MB, Triantis IF. Making Sense of Electrical Stimulation: A Meta-analysis for Wound Healing. Ann Biomed Eng 2024; 52:153-177. [PMID: 37743460 PMCID: PMC10808217 DOI: 10.1007/s10439-023-03371-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023]
Abstract
Electrical stimulation as a mode of external enhancement factor in wound healing has been explored widely. It has proven to have multidimensional effects in wound healing including antibacterial, galvanotaxis, growth factor secretion, proliferation, transdifferentiation, angiogenesis, etc. Despite such vast exploration, this modality has not yet been established as an accepted method for treatment. This article reviews and analyzes the approaches of using electrical stimulation to modulate wound healing and discusses the incoherence in approaches towards reporting the effect of stimulation on the healing process. The analysis starts by discussing various processes adapted in in vitro, in vivo, and clinical practices. Later it is focused on in vitro approaches directed to various stages of wound healing. Based on the analysis, a protocol is put forward for reporting in vitro works in such a way that the outcomes of the experiment are replicable and scalable in other setups. This work proposes a ground of unification for all the in vitro approaches in a more sensible manner, which can be further explored for translating in vitro approaches to complex tissue stimulation to establish electrical stimulation as a controlled clinical method for modulating wound healing.
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Affiliation(s)
- Mamun Rabbani
- Research Centre for Biomedical Engineering, School of Science and Technology, City University of London, Northampton Square, London, ECIV 0HB, UK
| | - Enayetur Rahman
- Research Centre for Biomedical Engineering, School of Science and Technology, City University of London, Northampton Square, London, ECIV 0HB, UK
| | - Michael B Powner
- Centre for Applied Vision Research, School of Health and Psychological Sciences, City University of London, Northampton Square, London, ECIV 0HB, UK
| | - Iasonas F Triantis
- Research Centre for Biomedical Engineering, School of Science and Technology, City University of London, Northampton Square, London, ECIV 0HB, UK.
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3
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Hunt M, Torres M, Bachar-Wikström E, Wikström JD. Multifaceted roles of mitochondria in wound healing and chronic wound pathogenesis. Front Cell Dev Biol 2023; 11:1252318. [PMID: 37771375 PMCID: PMC10523588 DOI: 10.3389/fcell.2023.1252318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
Mitochondria are intracellular organelles that play a critical role in numerous cellular processes including the regulation of metabolism, cellular stress response, and cell fate. Mitochondria themselves are subject to well-orchestrated regulation in order to maintain organelle and cellular homeostasis. Wound healing is a multifactorial process that involves the stringent regulation of several cell types and cellular processes. In the event of dysregulated wound healing, hard-to-heal chronic wounds form and can place a significant burden on healthcare systems. Importantly, treatment options remain limited owing to the multifactorial nature of chronic wound pathogenesis. One area that has received more attention in recent years is the role of mitochondria in wound healing. With regards to this, current literature has demonstrated an important role for mitochondria in several areas of wound healing and chronic wound pathogenesis including metabolism, apoptosis, and redox signalling. Additionally, the influence of mitochondrial dynamics and mitophagy has also been investigated. However, few studies have utilised patient tissue when studying mitochondria in wound healing, instead using various animal models. In this review we dissect the current knowledge of the role of mitochondria in wound healing and discuss how future research can potentially aid in the progression of wound healing research.
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Affiliation(s)
- Matthew Hunt
- Dermatology and Venerology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
| | - Monica Torres
- Dermatology and Venerology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
- Dermato-Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden
| | - Etty Bachar-Wikström
- Dermatology and Venerology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
| | - Jakob D. Wikström
- Dermatology and Venerology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
- Dermato-Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden
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4
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Wang G, Yang F, Zhou W, Xiao N, Luo M, Tang Z. The initiation of oxidative stress and therapeutic strategies in wound healing. Biomed Pharmacother 2023; 157:114004. [PMID: 36375308 DOI: 10.1016/j.biopha.2022.114004] [Citation(s) in RCA: 64] [Impact Index Per Article: 64.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022] Open
Abstract
When the production of reactive oxygen species (ROS) is overloaded surpassing the capacity of the reductive rheostat, mammalian cells undergo a series of oxidative damage termed oxidative stress (OS). This phenomenon is ubiquitously detected in many human pathological conditions. Wound healing program implicates continuous neovascularization, cell proliferation, and wound remodeling. Increasing evidence indicates that reactive oxygen species (ROS) have profound impacts on the wound healing process through regulating a series of the physiological and pathological program including inflammatory response, cell proliferation, angiogenesis, granulation as well as extracellular matrix formation. In most pathological wound healing processes, excessive ROS exerts a negative role on the wound healing process. Interestingly, the moderate increase of ROS levels is beneficial in killing bacteria at the wound site, which creates a sterile niche for revascularization. In this review, we discussed the physiological rhythms of wound healing and the role of ROS in this progress, aim to explore the potential manipulation of OS as a promising therapeutic avenue.
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Affiliation(s)
- Gang Wang
- Laboratory for Cardiovascular Pharmacology of Department of Pharmacology, The School of Pharmacy, Southwest Medical University, Luzhou, China; Drug Discovery Research Center, Southwest Medical University, Luzhou, China; Department of Pharmacology, college of Pharmacy, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Drug Metabolism, Key Laboratory for Biochemistry and Molecular Pharmacology of Chongqing, Chongqing, China, Chongqing, China
| | - Feifei Yang
- Department of Pharmacology, college of Pharmacy, Chongqing Medical University, Chongqing, China
| | - Weiying Zhou
- Department of Pharmacology, college of Pharmacy, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Drug Metabolism, Key Laboratory for Biochemistry and Molecular Pharmacology of Chongqing, Chongqing, China, Chongqing, China
| | - Nanyang Xiao
- Department of Microbiology, University of Chicago, Chicago, IL, USA
| | - Mao Luo
- Laboratory for Cardiovascular Pharmacology of Department of Pharmacology, The School of Pharmacy, Southwest Medical University, Luzhou, China; Drug Discovery Research Center, Southwest Medical University, Luzhou, China.
| | - Zonghao Tang
- Laboratory for Cardiovascular Pharmacology of Department of Pharmacology, The School of Pharmacy, Southwest Medical University, Luzhou, China; Drug Discovery Research Center, Southwest Medical University, Luzhou, China; Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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Abdul Ghani N‘I, Razali RA, Chowdhury SR, Fauzi MB, Bin Saim A, Ruszymah BHI, Maarof M. Effect of Different Collection Times of Dermal Fibroblast Conditioned Medium (DFCM) on In Vitro Re-Epithelialisation Process. Biomedicines 2022; 10:biomedicines10123203. [PMID: 36551960 PMCID: PMC9775936 DOI: 10.3390/biomedicines10123203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022] Open
Abstract
A key event in wound healing is re-epithelialisation, which is mainly regulated via paracrine signalling of cytokines, chemokines, and growth factors secreted by fibroblasts. Fibroblast-secreted factors can be collected from the used culture medium, known as dermal fibroblast conditioned medium (DFCM). The goal of this study was to optimise the culture condition to acquire DFCM and evaluate its effect on keratinocyte attachment, proliferation, migration, and differentiation. Confluent fibroblasts were cultured with serum-free keratinocyte-specific (DFCM-KM) and fibroblast-specific (DFCM-FM) medium at different incubation times (Days 1, 2, and 3). DFCM collected after 3 days of incubation (DFCM-KM-3 and DFCM-FM-3) contained a higher protein concentration compared to other days. Supplementation of DFCM-KM-3 enhanced keratinocyte attachment, while DFCM-FM-3 significantly increased the keratinocyte wound-healing rate, with an increment of keratinocyte area and collective cell migration, which was distinctly different from DFCM-KM-3 or control medium. Further analysis confirmed that the presence of calcium at higher concentrations in DFCM-FM facilitated the changes. The confluent dermal fibroblasts after 3 days of incubation with serum-free culture medium produced higher proteins in DFCM, resulting in enhanced in vitro re-epithelialisation. These results suggest that the delivery of DFCM could be a potential treatment strategy for wound healing.
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Affiliation(s)
- Nurul ‘Izzah Abdul Ghani
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Rabiatul Adawiyah Razali
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Shiplu Roy Chowdhury
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Mh Busra Fauzi
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | | | - Binti Haji Idrus Ruszymah
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Manira Maarof
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
- Correspondence: or ; Tel.: +603-91457685; Fax: +603-91457678
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Sklenářová R, Akla N, Latorre MJ, Ulrichová J, Franková J. Collagen as a Biomaterial for Skin and Corneal Wound Healing. J Funct Biomater 2022; 13:jfb13040249. [PMID: 36412890 PMCID: PMC9680244 DOI: 10.3390/jfb13040249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
The cornea and the skin are two organs that form the outer barrier of the human body. When either is injured (e.g., from surgery, physical trauma, or chemical burns), wound healing is initiated to restore integrity. Many cells are activated during wound healing. In particular, fibroblasts that are stimulated often transition into repair fibroblasts or myofibroblasts that synthesize extracellular matrix (ECM) components into the wound area. Control of wound ECM deposition is critical, as a disorganized ECM can block restoration of function. One of the most abundant structural proteins in the mammalian ECM is collagen. Collagen type I is the main component in connective tissues. It can be readily obtained and purified, and short analogs have also been developed for tissue engineering applications, including modulating the wound healing response. This review discusses the effect of several current collagen implants on the stimulation of corneal and skin wound healing. These range from collagen sponges and hydrogels to films and membranes.
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Affiliation(s)
- Renáta Sklenářová
- Department of Medical Chemistry and Biochemistry, Faculty of Medicine and Dentistry, Palacký University in Olomouc, 775 15 Olomouc, Czech Republic
- Maisonneuve-Rosemont Hospital Research Centre, Montréal, QC H1T 2M4, Canada
| | - Naoufal Akla
- Maisonneuve-Rosemont Hospital Research Centre, Montréal, QC H1T 2M4, Canada
- Department of Ophthalmology, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | | | - Jitka Ulrichová
- Department of Medical Chemistry and Biochemistry, Faculty of Medicine and Dentistry, Palacký University in Olomouc, 775 15 Olomouc, Czech Republic
| | - Jana Franková
- Department of Medical Chemistry and Biochemistry, Faculty of Medicine and Dentistry, Palacký University in Olomouc, 775 15 Olomouc, Czech Republic
- Correspondence:
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Mssillou I, Bakour M, Slighoua M, Laaroussi H, Saghrouchni H, Ez-Zahra Amrati F, Lyoussi B, Derwich E. Investigation on wound healing effect of Mediterranean medicinal plants and some related phenolic compounds: A review. JOURNAL OF ETHNOPHARMACOLOGY 2022; 298:115663. [PMID: 36038091 DOI: 10.1016/j.jep.2022.115663] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/07/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The human skin constitutes a biological barrier against external stress and wounds can reduce the role of its physiological structure. In medical sciences, wounds are considered a major problem that requires urgent intervention. For centuries, medicinal plants have been used in the Mediterranean countries for many purposes and against wounds. AIM OF THIS REVIEW Provides an outlook on the Mediterranean medicinal plants used in wound healing. Furthermore, the wound healing effect of polyphenolic compounds and their chemical structures are also summarized. Moreover, we discussed the wound healing process, the structure of the skin, and the current therapies in wound healing. MATERIALS AND METHODS The search was performed in several databases such as ScienceDirect, PubMed, Google Scholar, Scopus, and Web of Science. The following Keywords were used individually and/or in combination: the Mediterranean, wound healing, medicinal plants, phenolic compounds, composition, flavonoid, tannin. RESULTS The wound healing process is distinguished by four phases, which are respectively, hemostasis, inflammation, proliferation, and remodeling. The Mediterranean medicinal plants are widely used in the treatment of wounds. The finding showed that eighty-nine species belonging to forty families were evaluated for their wound-healing effect in this area. The Asteraceae family was the most reported family with 12 species followed by Lamiaceae (11 species). Tunisia, Egypt, Morocco, and Algeria were the countries where these plants are frequently used in wound healing. In addition to medicinal plants, results showed that nineteen phenolic compounds from different classes are used in wound treatment. Tyrosol, hydroxytyrosol, curcumin, luteolin, chrysin, rutin, kaempferol, quercetin, icariin, morin, epigallocatechin gallate, taxifolin, silymarin, hesperidin, naringin, isoliquiritin, puerarin, genistein, and daidzein were the main compounds that showed wound-healing effect. CONCLUSION In conclusion, medicinal plants and polyphenolic compounds provide therapeutic evidence in wound healing and for the development of new drugs in this field.
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Affiliation(s)
- Ibrahim Mssillou
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life (SNAMOPEQ), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez 30000, Morocco.
| | - Meryem Bakour
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life (SNAMOPEQ), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez 30000, Morocco
| | - Meryem Slighoua
- Laboratory of Biotechnology, Health, Agrofood and Environment (LBEAS), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, 30000, Morocco
| | - Hassan Laaroussi
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life (SNAMOPEQ), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez 30000, Morocco
| | - Hamza Saghrouchni
- Department of Biotechnology, Institute of Natural and Applied Sciences, Çukurova University, 01330 Balcalı/Sarıçam, Adana, Turkey
| | - Fatima Ez-Zahra Amrati
- Laboratory of Biotechnology, Health, Agrofood and Environment (LBEAS), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, 30000, Morocco
| | - Badiaa Lyoussi
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life (SNAMOPEQ), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez 30000, Morocco
| | - Elhoussine Derwich
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life (SNAMOPEQ), Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez 30000, Morocco; Unity of GC/MS and GC, City of Innovation, Sidi Mohamed Ben Abdellah University, Fez, 30000, Morocco
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Platelet-rich plasma: a comparative and economical therapy for wound healing and tissue regeneration. Cell Tissue Bank 2022; 24:285-306. [PMID: 36222966 PMCID: PMC9555256 DOI: 10.1007/s10561-022-10039-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 09/10/2022] [Indexed: 11/17/2022]
Abstract
Rise in the incidences of chronic degenerative diseases with aging makes wound care a socio-economic burden and unceasingly necessitates a novel, economical, and efficient wound healing treatment. Platelets have a crucial role in hemostasis and thrombosis by modulating distinct mechanistic phases of wound healing, such as promoting and stabilizing the clot. Platelet-rich plasma (PRP) contains a high concentration of platelets than naïve plasma and has an autologous origin with no immunogenic adverse reactions. As a consequence, PRP has gained significant attention as a therapeutic to augment the healing process. Since the past few decades, a robust volume of research and clinical trials have been performed to exploit extensive role of PRP in wound healing/tissue regeneration. Despite these rigorous studies and their application in diversified medical fields, efficacy of PRP-based therapies is continuously questioned owing to the paucity of large samplesizes, controlled clinical trials, and standard protocols. This review systematically delineates the process of wound healing and involvement of platelets in tissue repair mechanisms. Additionally, emphasis is laid on PRP, its preparation methods, handling, classification,application in wound healing, and PRP as regenerative therapeutics combined with biomaterials and mesenchymal stem cells (MSCs).
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The Role of the Extracellular Matrix (ECM) in Wound Healing: A Review. Biomimetics (Basel) 2022; 7:biomimetics7030087. [PMID: 35892357 PMCID: PMC9326521 DOI: 10.3390/biomimetics7030087] [Citation(s) in RCA: 84] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/23/2022] [Accepted: 06/29/2022] [Indexed: 12/27/2022] Open
Abstract
The extracellular matrix (ECM) is a 3-dimensional structure and an essential component in all human tissues. It is comprised of varying proteins, including collagens, elastin, and smaller quantities of structural proteins. Studies have demonstrated the ECM aids in cellular adherence, tissue anchoring, cellular signaling, and recruitment of cells. During times of integumentary injury or damage, either acute or chronic, the ECM is damaged. Through a series of overlapping events called the wound healing phases—hemostasis, inflammation, proliferation, and remodeling—the ECM is synthesized and ideally returned to its native state. This article synthesizes current and historical literature to demonstrate the involvement of the ECM in the varying phases of the wound healing cascade.
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Vitale S, Colanero S, Placidi M, Di Emidio G, Tatone C, Amicarelli F, D’Alessandro AM. Phytochemistry and Biological Activity of Medicinal Plants in Wound Healing: An Overview of Current Research. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27113566. [PMID: 35684503 PMCID: PMC9182061 DOI: 10.3390/molecules27113566] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 12/12/2022]
Abstract
Wound healing is a complicated process, and the effective management of wounds is a major challenge. Natural herbal remedies have now become fundamental for the management of skin disorders and the treatment of skin infections due to the side effects of modern medicine and lower price for herbal products. The aim of the present study is to summarize the most recent in vitro, in vivo, and clinical studies on major herbal preparations, their phytochemical constituents, and new formulations for wound management. Research reveals that several herbal medicaments have marked activity in the management of wounds and that this activity is ascribed to flavonoids, alkaloids, saponins, and phenolic compounds. These phytochemicals can act at different stages of the process by means of various mechanisms, including anti-inflammatory, antimicrobial, antioxidant, collagen synthesis stimulating, cell proliferation, and angiogenic effects. The application of natural compounds using nanotechnology systems may provide significant improvement in the efficacy of wound treatments. Increasing the clinical use of these therapies would require safety assessment in clinical trials.
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Affiliation(s)
- Stefania Vitale
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.V.); (M.P.); (G.D.E.); (C.T.); (F.A.)
| | - Sara Colanero
- Department of Biosciences, University of Milan, Via Giovanni Celoria 26, 20133 Milan, Italy;
| | - Martina Placidi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.V.); (M.P.); (G.D.E.); (C.T.); (F.A.)
| | - Giovanna Di Emidio
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.V.); (M.P.); (G.D.E.); (C.T.); (F.A.)
| | - Carla Tatone
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.V.); (M.P.); (G.D.E.); (C.T.); (F.A.)
| | - Fernanda Amicarelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.V.); (M.P.); (G.D.E.); (C.T.); (F.A.)
| | - Anna Maria D’Alessandro
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.V.); (M.P.); (G.D.E.); (C.T.); (F.A.)
- Correspondence:
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A Review on Recent Progress of Stingless Bee Honey and Its Hydrogel-Based Compound for Wound Care Management. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27103080. [PMID: 35630557 PMCID: PMC9145090 DOI: 10.3390/molecules27103080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/08/2021] [Accepted: 12/10/2021] [Indexed: 11/28/2022]
Abstract
Stingless bee honey has a distinctive flavor and sour taste compared to Apis mellifera honey. Currently, interest in farming stingless bees is growing among rural residents to meet the high demand for raw honey and honey-based products. Several studies on stingless bee honey have revealed various therapeutic properties for wound healing applications. These include antioxidant, antibacterial, anti-inflammatory, and moisturizing properties related to wound healing. The development of stingless bee honey for wound healing applications, such as incorporation into hydrogels, has attracted researchers worldwide. As a result, the effectiveness of stingless bee honey against wound infections can be improved in the future to optimize healing rates. This paper reviewed the physicochemical and therapeutic properties of stingless bee honey and its efficacy in treating wound infection, as well as the incorporation of stingless bee honey into hydrogels for optimized wound dressing.
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Holzer-Geissler JCJ, Schwingenschuh S, Zacharias M, Einsiedler J, Kainz S, Reisenegger P, Holecek C, Hofmann E, Wolff-Winiski B, Fahrngruber H, Birngruber T, Kamolz LP, Kotzbeck P. The Impact of Prolonged Inflammation on Wound Healing. Biomedicines 2022; 10:biomedicines10040856. [PMID: 35453606 PMCID: PMC9025535 DOI: 10.3390/biomedicines10040856] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/10/2022] [Accepted: 03/29/2022] [Indexed: 01/27/2023] Open
Abstract
The treatment of chronic wounds still challenges modern medicine because of these wounds’ heterogenic pathophysiology. Processes such as inflammation, ischemia and bacterial infection play major roles in the progression of a chronic wound. In recent years, preclinical wound models have been used to understand the underlying processes of chronic wound formation. However, the wound models used to investigate chronic wounds often lack translatability from preclinical models to patients, and often do not take exaggerated inflammation into consideration. Therefore, we aimed to investigate prolonged inflammation in a porcine wound model by using resiquimod, a TLR7 and TLR8 agonist. Pigs received full thickness excisional wounds, where resiquimod was applied daily for 6 days, and untreated wounds served as controls. Dressing change, visual documentation and wound scoring were performed daily. Biopsies were collected for histological as well as gene expression analysis. Resiquimod application on full thickness wounds induced a visible inflammation of wounds, resulting in delayed wound healing compared to non-treated control wounds. Gene expression analysis revealed high levels of IL6, MMP1 and CD68 expression after resiquimod application, and histological analysis showed increased immune cell infiltration. By using resiquimod, we were able to show that prolonged inflammation delayed wound healing, which is often observed in chronic wounds in patients. The model we used shows the importance of inflammation in wound healing and gives an insight into the progression of chronic wounds.
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Affiliation(s)
- Judith C. J. Holzer-Geissler
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (J.C.J.H.-G.); (E.H.); (L.-P.K.)
- COREMED-Cooperative Centre for Regenerative Medicine, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria;
| | - Simon Schwingenschuh
- HEALTH-Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria; (S.S.); (S.K.); (P.R.); (C.H.); (T.B.)
| | - Martin Zacharias
- Diagnostic and Research Institute of Pathology, Medical University of Graz, 8010 Graz, Austria;
| | - Johanna Einsiedler
- COREMED-Cooperative Centre for Regenerative Medicine, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria;
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Sonja Kainz
- HEALTH-Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria; (S.S.); (S.K.); (P.R.); (C.H.); (T.B.)
| | - Peter Reisenegger
- HEALTH-Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria; (S.S.); (S.K.); (P.R.); (C.H.); (T.B.)
| | - Christian Holecek
- HEALTH-Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria; (S.S.); (S.K.); (P.R.); (C.H.); (T.B.)
| | - Elisabeth Hofmann
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (J.C.J.H.-G.); (E.H.); (L.-P.K.)
- COREMED-Cooperative Centre for Regenerative Medicine, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria;
| | | | | | - Thomas Birngruber
- HEALTH-Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria; (S.S.); (S.K.); (P.R.); (C.H.); (T.B.)
| | - Lars-Peter Kamolz
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (J.C.J.H.-G.); (E.H.); (L.-P.K.)
- COREMED-Cooperative Centre for Regenerative Medicine, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria;
| | - Petra Kotzbeck
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (J.C.J.H.-G.); (E.H.); (L.-P.K.)
- COREMED-Cooperative Centre for Regenerative Medicine, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria;
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
- Correspondence: or ; Tel.: +43-316-876-6000
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Despoudi K, Mantzoros I, Ioannidis O, Loutzidou L, Christidis P, Chatzakis C, Gkasdaris G, Raptis D, Pramateftakis MG, Angelopoulos S, Zaraboukas T, Koliakos G, Tsalis K. Healing of colonic anastomosis in rats under obstructive ileus conditions. Discoveries (Craiova) 2021; 9:e129. [PMID: 34849396 PMCID: PMC8627191 DOI: 10.15190/d.2021.8] [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: 03/23/2021] [Revised: 05/09/2021] [Accepted: 05/10/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The anastomosis leak in colon resections is a crucial post-operative complication with significant morbidity and mortality. Methods: Forty (40) Wistar rats were allocated in two groups. In SHAM group only anastomosis was performed. In ILEUS group anastomosis was performed following one day of ileus. Animals in both groups were subdivided in two groups according to the day they were sacrificed, 4th or 8th post-operative day. A number of variables between the groups were estimated. RESULTS Body weight loss was higher following obstructive ileus on both days. Adhesion score in 4th and 8th post-operative day was higher in ILEUS1, ILEUS2 groups compared to SHAM1, SHAM2 groups respectively (p<0.001 for both). Neovascularization decreased following obstructive ileus compared to control on the 4th day (ILEUS1 vs. SHAM1, p=0.038). Bursting pressure was lower in ILEUS2 group than SHAM2 group (p<0.001). The number of fibroblasts decreased following obstructive ileus compared to control on the 4th and 8th day (ILEUS1 vs. SHAM1, p=0.001, ILEUS2 vs SHAM2, p=0.016). Hydroxyproline concentration was decreased in ILEUS2 group compared to SHAM2 group (p<0.001). CONCLUSIONS The balance of collagenolysis and collagenogenesis plays a decisive role in the healing of anastomoses following bowel obstruction. Under those circumstances, anastomosis' bursting pressure is reduced owning to decreased neovascularization, reduced fibroblast presence and lower hydroxyproline concertation. In our study, local inflammation, neocollagen concentration and collagenase activity were not associated with this adverse effect. However, further research should delineate the mechanisms of healing of colonic anastomoses and identify those factors that can improve our outcomes.
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Affiliation(s)
- Kalliopi Despoudi
- 4th Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Ioannis Mantzoros
- 4th Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Orestis Ioannidis
- 4th Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Lydia Loutzidou
- 4th Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Panagiotis Christidis
- 4th Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Christos Chatzakis
- 4th Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Grigorios Gkasdaris
- 4th Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Dimitrios Raptis
- 4th Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Manousos George Pramateftakis
- 4th Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Stamatios Angelopoulos
- 4th Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Thomas Zaraboukas
- Department of Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - George Koliakos
- Department of Biochemistry, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Konstantinos Tsalis
- 4th Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
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Sharma P, Kumar A, Dey AD, Behl T, Chadha S. Stem cells and growth factors-based delivery approaches for chronic wound repair and regeneration: A promise to heal from within. Life Sci 2021; 268:118932. [PMID: 33400933 DOI: 10.1016/j.lfs.2020.118932] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/03/2020] [Accepted: 12/12/2020] [Indexed: 02/06/2023]
Abstract
The sophisticated chain of cellular and molecular episodes during wound healing includes cell migration, cell proliferation, deposition of extracellular matrix, and remodelling and are onerous to replicate. Encapsulation of growth factors (GFs) and Stem cell-based (SCs) has been proclaimed to accelerate healing by transforming every phase associated with wound healing to enhance skin regeneration. Therapeutic application of mesenchymal stem cells (MSCs), embryonic stem cells (ESCs) and induced pluripotent stem cells (PSCs) provides aid in wound fixing, tissue integrity restoration and function of impaired tissue. Several scientific studies have established the essential role GFs in wound healing and their reduced degree in the chronic wound. The overall limitation includes half-life, unfriendly microhabitat abundant with protease, and inadequate delivery approaches results in decreased delivery of effective amounts in a suitable time-based fashion. Advancements in the area of reformative medicine as well as tissue engineering have offered techniques competent of dispensing SCs and GFs in site-oriented manner. The progress in nanotechnology-based approaches attracts researcher to study and evaluate the potential of this SCs and GFs based therapy in chronic wounds. These techniques embrace the polymeric regime viz., nano-formulations, hydrogels, liposomes, scaffolds, nanofibers, metallic nanoparticles, lipid-based nanoparticles and dendrimers that have established better retort through targeting tissues when GFs and SCs are transported via these humans made devices. Assumed the current problems, improvements in delivery approaches and difficulties offered by chronic wounds, we hope to show that encapsulation of SCs and GFs loaded nanoformulations therapies is the rational next step in improving wound care.
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Affiliation(s)
- Preety Sharma
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Arun Kumar
- Chitkara College of Pharmacy, Chitkara University, Punjab, India.
| | - Asmita Deka Dey
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Swati Chadha
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
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Gradišnik L, Milojević M, Velnar T, Maver U. Isolation, characterisation and phagocytic function of human macrophages from human peripheral blood. Mol Biol Rep 2020; 47:6929-6940. [PMID: 32876844 DOI: 10.1007/s11033-020-05751-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 08/28/2020] [Indexed: 10/23/2022]
Abstract
Macrophages are among the most important cells of the immune system. Among other functions, they take part in almost all defense actions against foreign bodies and bacteria, being particularly important in infections, wound healing, and foreign body reactions. Considering their importance for the health of the human body, as well as their important role in several diseases, the in vitro studies based on these cells, are a crucial research field. Taking all mentioned into account, this study describes a simple isolation method of human macrophages (MFUM-HMP-001 and MFUM-HMP-002 cell lines) from peripheral blood. For this purpose, the morphology, the viability, and the phagocytotic activity of the isolated cells were tested. The Immunostaining of MFUM-HMP-001 and MFUM-HMP-002 cells confirmed the macrophage cell markers CD68, CD80, and CD163/M130. The phagocytotic activity was marked in both MFUM-HMP-001 and MFUM-HMP-002 cells, as was the phagocytosis of the pHrodo green Escherichia coli bioparticles conjugates, which was enhanced with the addition of lipopolysaccharide. The cells were stable and exhibited good growth. According to our results, both cell lines are useful for the development of novel macrophage cell-based in vitro models.
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Affiliation(s)
- Lidija Gradišnik
- Faculty of Medicine, Institute of Biomedical Sciences, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia.,AMEU-ECM Maribor, Slovenska 17, 2000, Maribor, Slovenia
| | - Marko Milojević
- Faculty of Medicine, Institute of Biomedical Sciences, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia
| | - Tomaž Velnar
- Faculty of Medicine, Institute of Biomedical Sciences, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia. .,AMEU-ECM Maribor, Slovenska 17, 2000, Maribor, Slovenia. .,Department of Neurosurgery, University Medical Centre Ljubljana, Zaloska cesta 2, Ljubljana, Slovenia.
| | - Uroš Maver
- Faculty of Medicine, Institute of Biomedical Sciences, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia. .,Faculty of Medicine, Department of Pharmacology, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia.
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Mutlu HS, Erdoğan A, Tapul L. Autologously transplanted dermal fibroblasts improved diabetic wound in rat model. Acta Histochem 2020; 122:151552. [PMID: 32622425 DOI: 10.1016/j.acthis.2020.151552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 01/13/2023]
Abstract
Healing of diabetic wounds are delayed due to late initiation and prolongation of the inflammatory phase, and inadequate growth factor synthesis, which may lead to chronic ulcers that may cause limb amputation, besides making the patients vulnerable to infections. In recent years, it has been extensively discussed whether different cell types transplanted to diabetic wound models accelerate wound healing. In this study, the effect of dermis-derived cells on Streptozotocin (STZ) induced experimental diabetic Sprague-Dawley rats were investigated. Animals were divided into 3 groups. First group was control, second group included diabetic animals with wounds. In the third group, firstly, skin specimens were obtained from animal's back, and then primary explant culture was performed. STZ induced experimental diabetes was applied to these animals and then wound was opened. The cells grown in primary culture were transplanted autologously. In all three groups, the samples taken from the wound areas on the 5th and 15th days of the wound were examined at the level of histochemical and immunohistochemical and electron microscopy. In the study, it was observed that the decreasing α-SMA and KGF (FGF-7) expression in the early period especially in the case of experimental diabetes increased as a result of cell transplantation, and in the sections belonging to the experimental diabetic group, a large number of inflammatory cells in the wound area were removed from the environment. In the cell transplanted group, the collagen fiber bundles as if in the control group. As a result, healthy cells of dermis can act as mesenchymal stem cells under certain conditions and have a positive effect on diabetic wound healing.
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Affiliation(s)
- Hasan Serdar Mutlu
- İstanbul University, İstanbul Medicine Faculty, Histology and Embryology Department, Fatih, İstanbul, Turkey; İstanbul University, Graduate School of Health Sciences, İstanbul, Turkey.
| | - Aslı Erdoğan
- İstanbul University, İstanbul Medicine Faculty, Histology and Embryology Department, Fatih, İstanbul, Turkey; İstanbul University, Graduate School of Health Sciences, İstanbul, Turkey
| | - Leyla Tapul
- İstanbul University, İstanbul Medicine Faculty, Histology and Embryology Department, Fatih, İstanbul, Turkey
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Juncos Bombin AD, Dunne NJ, McCarthy HO. Electrospinning of natural polymers for the production of nanofibres for wound healing applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 114:110994. [PMID: 32993991 DOI: 10.1016/j.msec.2020.110994] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 02/07/2023]
Abstract
Wound healing is a highly regulated process composed of four overlapping phases: (1) coagulation/haemostasis, (2) inflammation, (3) proliferation and (4) remodelling. Comorbidities such as advanced age, diabetes and obesity can impair natural tissue repair, rendering the wound in a pathological state of inflammation. This results in significant discomfort for patients and considerable financial costs for healthcare systems. Due to the complex nature of wound healing, current treatments are ineffective at dealing with delayed healing. With flexible properties that can be tailored, nanomaterials have emerged as alternative therapeutics for many biomedical applications. A nanofibrous network can be made via electrospinning polymers using a high electric field to create a responsive meshwork that can be used as a medical dressing. A nanofibrous device has properties that can overcome the limitations of traditional dressings, such as: (1) adaptability to wound contour; (2) controlled drug delivery of therapeutics; (3) gaseous exchange; (4) exudate absorption and (5) surface functionalisation to further enhance the biological activity of the dressing. This review details emerging trends in nanotechnology to specifically target wound healing applications. Particular focus is given to the most common natural polymers that could address many unmet healthcare needs.
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Affiliation(s)
| | - Nicholas J Dunne
- School of Mechanical and Manufacturing Engineering, Dublin City University, Dublin 9, Ireland; Centre for Medical Engineering Research, School of Mechanical and Manufacturing Engineering, Dublin City University, Dublin 9, Ireland; Department of Mechanical and Manufacturing Engineering, School of Engineering, Trinity College Dublin, Dublin 2, Ireland; Advanced Manufacturing Research Centre (I-Form), School of Mechanical and Manufacturing Engineering, Dublin City University, Glasnevin, Dublin 9, Ireland; Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin, Ireland.; Advanced Processing Technology Research Centre, Dublin City University, Dublin 9, Ireland.; Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland..
| | - Helen O McCarthy
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; School of Chemical Sciences, Dublin City University, Dublin 9, Ireland.
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Blinded, Randomized, Controlled Trial Evaluating the Effects of Light-Emitting Diode Photomodulation on Lower Extremity Wounds Left to Heal by Secondary Intention. Dermatol Surg 2019; 46:605-611. [PMID: 31652220 DOI: 10.1097/dss.0000000000002195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Light-emitting diode (LED) has been used for wound healing because of its stimulatory effects on fibroblast proliferation, matrix synthesis, angiogenesis, and downmodulation of inflammatory reactions. OBJECTIVE The aim of the authors' study was to investigate the effects of red LED (wavelength 633 nm) photomodulation on lower extremity surgical defects left to heal by secondary intention. MATERIALS AND METHODS Fourteen subjects with surgical defects of the lower leg were irradiated with a 633 ± 3-nm light source for 20 minutes (105 mW/cm, 126 J/cm) at 4 weekly sessions. RESULTS The number of days required for wounds to heal was greater in the treatment group (63.2 ± 12.2 days) than in the control group (48.67 ± 11.1 days), although this difference was not statistically significant (p = .07). The percentage of the original wound remaining was not statistically different between treatment and control groups between Weeks 1 and 2 (p = .71) and Weeks 3 and 4 (p = .56). It was significant between Weeks 2 and 3 (p = .01). CONCLUSION This study revealed that red LED photomodulation at a wavelength of 633 nm did not result in clinical improvement in wound healing of surgical defects on the lower extremities.
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Stephens CJ, Spector JA, Butcher JT. Biofabrication of thick vascularized neo-pedicle flaps for reconstructive surgery. Transl Res 2019; 211:84-122. [PMID: 31170376 PMCID: PMC6702068 DOI: 10.1016/j.trsl.2019.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 05/06/2019] [Accepted: 05/14/2019] [Indexed: 01/01/2023]
Abstract
Wound chronicity due to intrinsic and extrinsic factors perturbs adequate lesion closure and reestablishment of the protective skin barrier. Immediate and proper care of chronic wounds is necessary for a swift recovery and a reduction of patient vulnerability to infection. Advanced therapies supplemented with standard wound care procedures have been clinically implemented to restore aberrant tissue; however, these treatments are ineffective if local vasculature is too compromised to support minimally-invasive strategies. Autologous "flaps", which are tissues equipped with their own hierarchical vascular supply, can be harvested from one region of the patient and transplanted to the wound where it is reperfused upon microsurgical anastomosis to appropriate recipient vessels. Despite the success of autologous flap transfer, these procedures are extremely invasive, incur obligatory donor-site morbidity, and require sufficient donor-tissue availability, microsurgical expertise, and specialized equipment. 3D-bioprinting modalities, such as extrusion-based bioprinting, can be used to address the clinical constraints of autologous flap transfer, primarily addressing donor-site morbidity and tissue availability. This advancement in regenerative medicine allows the biofabrication of heterogeneous tissue structures with high shape fidelity and spatial resolution to generate biomimetic constructs with the anatomically-precise geometries of native tissue to ensure tissue-specific function. Yet, meaningful progress toward this clinical application has been limited by the lack of vascularization required to meet the nutrient and oxygen demands of clinically relevant tissue volumes. Thus, various criteria for the fabrication of functional tissues with hierarchical, patent vasculature must be considered when implementing 3D-bioprinting technologies for deep, chronic wounds.
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Affiliation(s)
- Chelsea J Stephens
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York
| | - Jason A Spector
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York; Division of Plastic Surgery, Weill Cornell Medical College, New York, New York
| | - Jonathan T Butcher
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York.
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Baptista VIDA, Quintana HT, Lazzarin MC, Benfato ID, De Carvalho FP, Le Sueur-Maluf L, De Oliveira CAM, Baptista JDS, De Oliveira F. Short time insulin treatment post burn improves elastic-collagen rearrangement and reepithelization. Connect Tissue Res 2019; 60:230-239. [PMID: 29929404 DOI: 10.1080/03008207.2018.1484916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Extensive burn may cause acute resistance to insulin, which accentuates hypermetabolism, impairs glucose metabolism, immune dysfunction and risks of sepsis. To minimize these effects, insulin is used as a treatment. The purpose was to analyze the collagen-elastic arrangement effects of insulin on the burned skin. Wistar rats were assigned in groups: control (C); control with insulin (C + I); scald burn injury (SBI); and SBI with insulin (SBI+ I). SBI were submitted to 45% total body surface area burn and the insulin-treated groups received insulin (5 UI/Kg/day) for 4 or 14 days (d). Insulin levels, glucose tolerance test and HOMA index were determined. The skin sections were analyzed for histophatological and morphoquantitative data. Histopathological findings showed increased reepithelization of SBI+ I and formation of a new muscle layer after 14 days. In the collagen-elastic arrangement, insulin for 4 days increased the volume fraction (Vv) of thin collagen and elastic fibers. After 14 days, independently of injury, insulin decreased the elastic fibers. Insulin was able to reverse damages in the collagen-elastic rearrangement and stimulate reepithelization after 4 days. Untreated scald-burned animals showed higher Vv of thick collagen after 4 days, while those treated had a higher Vv of thin collagen. The Vv of elastic fibers was increased in SBI+ I for 4 days. In conclusion, insulin treatment was able to stimulate reepithelization. It also reversed the damages to the collagen-elastic arrangement in the scald-burned group, improving the organization of thin collagen and increasing the Vv of elastic fibers in the injured group treated with insulin for a short time, that is, for 4 days.
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Affiliation(s)
| | | | - Mariana Cruz Lazzarin
- a Department of Biosciences , Federal University of São Paulo, UNIFESP , SP , Brazil
| | - Izabelle Dias Benfato
- a Department of Biosciences , Federal University of São Paulo, UNIFESP , SP , Brazil
| | | | | | | | | | - Flavia De Oliveira
- a Department of Biosciences , Federal University of São Paulo, UNIFESP , SP , Brazil
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Kleineidam B, Nokhbehsaim M, Deschner J, Wahl G. Effect of cold plasma on periodontal wound healing-an in vitro study. Clin Oral Investig 2018; 23:1941-1950. [PMID: 30232626 DOI: 10.1007/s00784-018-2643-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 09/11/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Cold atmospheric plasma (CAP), a room temperate ionized gas, seems to be a possible way to enhance tissue recovery. An in vitro study was conducted to investigate the influence of medical CAP on the regenerative capacity of human periodontal ligament (PDL) cells. MATERIAL AND METHODS Human PDL cells were subjected to CAP at various intensities, distances, and durations. The effects of CAP on a number of specific markers were studied at transcriptional level using real-time PCR. Additionally, an in vitro wound healing assay was applied to PDL cell monolayers either in the presence or absence of CAP by using JuLI™ Br Live Cell Analyzer and software. Finally, cell viability of CAP-treated cells was analyzed by an XTT assay. RESULTS CAP treatment enhanced significantly the expression of the cytokines tumor necrosis factor (TNF)α, cyclooxygenase (COX)2, interleukin (IL)-1β, IL-6, IL-8, collagen (COL)1α, and matrix metalloproteinase (MMP)1, as well as the proliferation markers Ki67 and proliferating cell nuclear antigen (PCNA), but downregulated apoptotic markers Apaf1 and p53. Additionally, the in vitro wound healing rate was significantly enhanced after CAP application. Moreover, CAP treatment resulted in a significantly increased cell viability in the XTT assay. CONCLUSION This in vitro study shows that CAP has regulatable effects on markers of periodontal wound healing thereby underlining the potential use of CAP as a benefit treatment strategy. CLINICAL RELEVANCE Our study demonstrates the application of CAP in the treatment of oral pathologies suggesting a promising future treatment approach.
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Affiliation(s)
- Benedikt Kleineidam
- Department of Oral Surgery, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany.
| | - M Nokhbehsaim
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany
| | - J Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany
| | - G Wahl
- Department of Oral Surgery, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany
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Sekhon UDS, Sen Gupta A. Platelets and Platelet-Inspired Biomaterials Technologies in Wound Healing Applications. ACS Biomater Sci Eng 2017; 4:1176-1192. [DOI: 10.1021/acsbiomaterials.7b00013] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Ujjal Didar Singh Sekhon
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44102, United States
| | - Anirban Sen Gupta
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44102, United States
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Sotomayor S, Pascual G, Blanc-Guillemaud V, Mesa-Ciller C, García-Honduvilla N, Cifuentes A, Buján J. Effects of a novel NADPH oxidase inhibitor (S42909) on wound healing in an experimental ischemic excisional skin model. Exp Dermatol 2016; 26:148-155. [PMID: 27249648 DOI: 10.1111/exd.13099] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2016] [Indexed: 11/28/2022]
Abstract
Chronic wounds are a serious healthcare problem. As non-healing wounds involve continuous pathologic inflammatory stage, research is focused on anti-inflammatory treatments. Our objective was to analyze the effect of S42909, a potent NADPH oxidase inhibitor activity, with vascular anti-inflammatory properties. An ischemic rabbit ear ulcer model (24 New Zealand white rabbits) was used to evaluate the reepithelialization/contraction areas, anti-/pro-inflammatory cytokines mRNA (TGF-β1/IL-10/IFN-γ/VEGF) by qRT-PCR, collagen I/III deposition, and neovascularization (TGF-β1/VEGF) by morphological and immunohistochemical analyses. Three different doses were administered by gavage for 2 weeks: 10 and 30 mg/kg/d in self-microemulsion drug delivery system (SMEDDS) and 100 mg/kg/d in arabic gum. Each vehicle was used as control. No signs of infection or necrosis were found. Reepithelialization was almost complete whatever the groups reaching 95% at the dose of 100 mg/kg. Wound contraction was significantly reduced in all S42909-treated groups. A significant increase in anti-inflammatory cytokines TGF-β1 mRNA and IL-10 mRNA was observed at the dose of 100 and 30 mg/kg/d, respectively. No changes were observed in pro-inflammatory factors INF-γ and VEGF mRNA. Ischemic skin wound areas had scarce expression of collagen I/III and showed rich glycosaminoglycans content. Treatment increased the collagen deposition and TGF-β1 protein expression and decreased glycosaminoglycan content dose dependently; however, no effect in VEGF was appreciated. Therefore, our results indicate that S42909 improved healing process by dampening excessive inflammation and facilitating collagen deposition without wound contraction phenomena. S42909 might be a promising therapy to treat chronic wounds as venous leg ulcers.
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Affiliation(s)
- Sandra Sotomayor
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.,Biomedical Research Networking Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Gemma Pascual
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.,Biomedical Research Networking Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | | | - Claudia Mesa-Ciller
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.,Biomedical Research Networking Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Natalio García-Honduvilla
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.,Biomedical Research Networking Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Alberto Cifuentes
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.,Biomedical Research Networking Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Julia Buján
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.,Biomedical Research Networking Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
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25
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Anti-inflammatory and burn injury wound healing properties of the shell of Haliotis diversicolor. Altern Ther Health Med 2016; 16:487. [PMID: 27894302 PMCID: PMC5126830 DOI: 10.1186/s12906-016-1473-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 11/18/2016] [Indexed: 01/21/2023]
Abstract
Background The shell of Haliotis diversicolor, or shijueming (SJM), is a type of traditional Chinese medicine. The SJM has appeared in historical records as early as the third and fourth centuries. Historical records have revealed that SJM had mainly been used to treat eye diseases. After the Qing Dynasty (1757), records had emerged, detailing the use of SJM for treating skin injuries, particularly for treating poorly managed ulcers or traumatic wounds. Furthermore, in our anti-inflammation-screening system, SJM significantly inhibited the expression of pro-inflammatory proteins. Previous studies have yet to adopt an animal model to verify the phenomenon and described in the historical records regarding the efficacy of SJM in promoting wound healing. Besides, the mechanism of wound healing effect of SJM is also not clear. Methods This study applied in vitro and in vivo models, tissue section analysis, and western blotting to evaluate the effect of SJM on wound healing. The RAW 264.7 cells were used in anti-inflammatory activity assay and phagocytic assay. Male Wistar rats were used to evaluate the effect of SJM on burn injury healing. A copper block (2 × 2 cm, 150 g) preheated to 165 °C in a dry bath was used to contact the skin area for 10 s, thus creating a full-thickness burn injury. The results were analyzed by hematoxylin and eosin staining, picrosirius red staining and Western blotting. Results The results revealed that in the in vitro model, the presence of SJM decreased the inducible nitric oxide synthase (iNOS) expression and enhanced the functions of macrophages. The results of the rat burn injury model revealed that SJM decreased neutrophil infiltration, promoted wound healing, thus increasing the collagen I content and promoting the expression of transforming growth factor-beta 1 (TGF-β1) protein. We speculate that the effect and mechanism of SJM on promoting wound healing is related to macrophage activation. In the inflammation phase, SJM alleviates inflammation by inhibiting iNOS expression and removing neutrophils through phagocytosis. Furthermore, SJM induces the secretion of TGF-β1, converting collagen during the tissue remodeling phase. Conclusions According to our review of relevant literature, this is the first study that applied an evidence-based method to verify that SJM alleviates inflammation, enhances phagocytosis, and triggers wound healing after burn injury. The study findings reveal that SJM provides a promising therapeutic option for treating burn injury.
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Swain D, Gupta A. Mechanics of cutaneous wound rupture. J Biomech 2016; 49:3722-3730. [PMID: 27765266 DOI: 10.1016/j.jbiomech.2016.09.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 09/25/2016] [Accepted: 09/30/2016] [Indexed: 11/30/2022]
Abstract
A cutaneous wound may rupture during healing as a result of stretching in the skin and incompatibility at the wound-skin interface, among other factors. By treating both wound and skin as hyperelastic membranes, and using a biomechanical framework of interfacial growth, we study rupturing as a problem of cavitation in nonlinear elastic materials. We obtain analytical solutions for deformation and residual stress field in the skin-wound configuration while emphasizing the coupling between wound rupture and wrinkling in the skin. The solutions are analyzed in detail for variations in stretching environment, healing condition, and membrane stiffness.
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Affiliation(s)
- Digendranath Swain
- Department of Mechanical Engineering, Indian Institute of Technology, Kanpur 208016, India
| | - Anurag Gupta
- Department of Mechanical Engineering, Indian Institute of Technology, Kanpur 208016, India.
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Das S, Baker AB. Biomaterials and Nanotherapeutics for Enhancing Skin Wound Healing. Front Bioeng Biotechnol 2016; 4:82. [PMID: 27843895 PMCID: PMC5087310 DOI: 10.3389/fbioe.2016.00082] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 10/11/2016] [Indexed: 02/06/2023] Open
Abstract
Wound healing is an intricate process that requires complex coordination between many cell types and an appropriate extracellular microenvironment. Chronic wounds often suffer from high protease activity, persistent infection, excess inflammation, and hypoxia. While there has been intense investigation to find new methods to improve cutaneous wound care, the management of chronic wounds, burns, and skin wound infection remain challenging clinical problems. Ideally, advanced wound dressings can provide enhanced healing and bridge the gaps in the healing processes that prevent chronic wounds from healing. These technologies have great potential for improving outcomes in patients with poorly healing wounds but face significant barriers in addressing the heterogeneity and clinical complexity of chronic or severe wounds. Active wound dressings aim to enhance the natural healing process and work to counter many aspects that plague poorly healing wounds, including excessive inflammation, ischemia, scarring, and wound infection. This review paper discusses recent advances in the development of biomaterials and nanoparticle therapeutics to enhance wound healing. In particular, this review focuses on the novel cutaneous wound treatments that have undergone significant preclinical development or are currently used in clinical practice.
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Affiliation(s)
- Subhamoy Das
- Department of Biomedical Engineering, University of Texas at Austin , Austin, TX , USA
| | - Aaron B Baker
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX, USA; Institute for Biomaterials, Drug Delivery and Regenerative Medicine, University of Texas at Austin, Austin, TX, USA; Institute for Cellular and Molecular Biology, University of Texas at Austin, Austin, TX, USA; Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX, USA
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28
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Velnar T, Bunc G, Klobucar R, Gradisnik L. Biomaterials and host versus graft response: a short review. Bosn J Basic Med Sci 2016; 16:82-90. [PMID: 26894284 PMCID: PMC4853000 DOI: 10.17305/bjbms.2016.525] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 02/18/2016] [Accepted: 07/16/2015] [Indexed: 01/27/2023] Open
Abstract
Biomaterials and biotechnology are increasing becoming an important area in modern medicine. The main aim in this area is the development of materials, which are biocompatible to normal tissue. Tissue-implant interactions with molecular, biological and cellular characteristics at the implant-tissue interface are important for the use and development of implants. Implantation may cause an inflammatory and immune response in tissue, foreign body reaction, systemic toxicity and imminent infection. Tissue-implant interactions determine the implant life-period. The aims of the study are to consider the biological response to implants. Biomaterials and host reactions to implants and their mechanisms are also briefly discussed.
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Affiliation(s)
- Tomaz Velnar
- University Medical Centre Maribor, Department of Neurosurgery.
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29
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Warsinske HC, Ashley SL, Linderman JJ, Moore BB, Kirschner DE. Identifying Mechanisms of Homeostatic Signaling in Fibroblast Differentiation. Bull Math Biol 2015; 77:1556-82. [PMID: 26384829 DOI: 10.1007/s11538-015-0096-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 08/21/2015] [Indexed: 10/23/2022]
Abstract
Fibroblasts play an important role in the wound-healing process by generating extracellular matrix (ECM) and undergoing differentiation into myofibroblasts, but these cells can also be involved in pathologic remodeling of tissue. Nascent ECM provides a substrate for re-epithelialization to occur, restoring damaged tissue to a functional state. Dysregulation of this process can result in fibrosis--stiffening and scarring of the tissue. Current treatments cannot halt or reverse this process. The molecular mechanisms underlying fibrotic dysregulation are poorly understood, providing an untapped pool of potential therapeutic targets. Transforming growth factor-β (TGF-β) and adhesion signaling are involved in inducing fibroblast differentiation into α-smooth muscle actin (αSMA) expressing myofibroblasts, while prostaglandin E₂ (PGE₂) has been shown to antagonize TGF-β signaling; however, the temporal and mechanistic details of this relationship have not yet been fully characterized. We measured αSMA, a marker of fibroblast to myofibroblast differentiation, as a function of: TGF-β1 receptor-ligand complex internalization, PGE₂ binding, and adhesion signaling and developed a mathematical model capturing the molecular mechanisms of fibroblast differentiation. Using our model, we predict the following: Periodic dosing with PGE₂ temporarily renders fibroblasts incapable of differentiation and refractory to additional TGF-β1 stimulation; conversely, periodic dosing with TGF-β1 in the presence of PGE₂ induces a reduced signal response that can be further inhibited by the addition of more PGE₂. Controlled fibroblast differentiation is necessary for effective wound healing; however, excessive accumulation of αSMA-expressing myofibroblasts can result in fibrosis. Homeostasis of αSMA in our model requires a balance of positive and negative regulatory signals. Sensitivity analysis predicts that PGE₂ availability, TGF-β1 availability, and the rate of TGF-β1 receptor recycling each highly influence the rates of αSMA production. With this model, we are able to demonstrate that regulation of both TGF-β1 and PGE₂ signaling levels is essential for preventing fibroblast dysregulation.
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Affiliation(s)
- Hayley C Warsinske
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Shanna L Ashley
- Immunology Graduate Program, University of Michigan, Ann Arbor, MI, USA
| | | | - Bethany B Moore
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Denise E Kirschner
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, USA.
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31
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Ferroni L, Bellin G, Emer V, Rizzuto R, Isola M, Gardin C, Zavan B. Treatment by Therapeutic Magnetic Resonance (TMR™) increases fibroblastic activity and keratinocyte differentiation in anin vitromodel of 3D artificial skin. J Tissue Eng Regen Med 2015; 11:1332-1342. [DOI: 10.1002/term.2031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 03/03/2015] [Accepted: 04/21/2015] [Indexed: 01/11/2023]
Affiliation(s)
- Letizia Ferroni
- Department of Biomedical Sciences; University of Padova; Italy
| | - Gloria Bellin
- Department of Biomedical Sciences; University of Padova; Italy
| | - Valeria Emer
- Department of Biomedical Sciences; University of Padova; Italy
| | - Rosario Rizzuto
- Department of Biomedical Sciences; University of Padova; Italy
| | - Maurizio Isola
- Dipartimenti di Medicina Animale, Produzioni e Salute (MAPS); University of Padova; Italy
| | - Chiara Gardin
- Department of Biomedical Sciences; University of Padova; Italy
| | - Barbara Zavan
- Department of Biomedical Sciences; University of Padova; Italy
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Maguire G, Friedman P. Systems biology approach to developing S 2RM-based “systems therapeutics” and naturally induced pluripotent stem cells. World J Stem Cells 2015; 7:745-756. [PMID: 26029345 PMCID: PMC4444614 DOI: 10.4252/wjsc.v7.i4.745] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 11/25/2014] [Accepted: 03/18/2015] [Indexed: 02/06/2023] Open
Abstract
The degree to, and the mechanisms through, which stem cells are able to build, maintain, and heal the body have only recently begun to be understood. Much of the stem cell’s power resides in the release of a multitude of molecules, called stem cell released molecules (SRM). A fundamentally new type of therapeutic, namely “systems therapeutic”, can be realized by reverse engineering the mechanisms of the SRM processes. Recent data demonstrates that the composition of the SRM is different for each type of stem cell, as well as for different states of each cell type. Although systems biology has been successfully used to analyze multiple pathways, the approach is often used to develop a small molecule interacting at only one pathway in the system. A new model is emerging in biology where systems biology is used to develop a new technology acting at multiple pathways called “systems therapeutics”. A natural set of healing pathways in the human that uses SRM is instructive and of practical use in developing systems therapeutics. Endogenous SRM processes in the human body use a combination of SRM from two or more stem cell types, designated as S2RM, doing so under various state dependent conditions for each cell type. Here we describe our approach in using state-dependent SRM from two or more stem cell types, S2RM technology, to develop a new class of therapeutics called “systems therapeutics.” Given the ubiquitous and powerful nature of innate S2RM-based healing in the human body, this “systems therapeutic” approach using S2RM technology will be important for the development of anti-cancer therapeutics, antimicrobials, wound care products and procedures, and a number of other therapeutics for many indications.
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33
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Gnyawali SC, Barki KG, Mathew-Steiner SS, Dixith S, Vanzant D, Kim J, Dickerson JL, Datta S, Powell H, Roy S, Bergdall V, Sen CK. High-resolution harmonics ultrasound imaging for non-invasive characterization of wound healing in a pre-clinical swine model. PLoS One 2015; 10:e0122327. [PMID: 25799513 PMCID: PMC4370665 DOI: 10.1371/journal.pone.0122327] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 02/10/2015] [Indexed: 11/18/2022] Open
Abstract
This work represents the first study employing non-invasive high-resolution harmonic ultrasound imaging to longitudinally characterize skin wound healing. Burn wounds (day 0-42), on the dorsum of a domestic Yorkshire white pig were studied non-invasively using tandem digital planimetry, laser speckle imaging and dual mode (B and Doppler) ultrasound imaging. Wound depth, as measured by B-mode imaging, progressively increased until day 21 and decreased thereafter. Initially, blood flow at the wound edge increased up to day 14 and subsequently regressed to baseline levels by day 21, when the wound was more than 90% closed. Coinciding with regression of blood flow at the wound edge, there was an increase in blood flow in the wound bed. This was observed to regress by day 42. Such changes in wound angiogenesis were corroborated histologically. Gated Doppler imaging quantitated the pulse pressure of the primary feeder artery supplying the wound site. This pulse pressure markedly increased with a bimodal pattern following wounding connecting it to the induction of wound angiogenesis. Finally, ultrasound elastography measured tissue stiffness and visualized growth of new tissue over time. These studies have elegantly captured the physiological sequence of events during the process of wound healing, much of which is anticipated based on certain dynamics in play, to provide the framework for future studies on molecular mechanisms driving these processes. We conclude that the tandem use of non-invasive imaging technologies has the power to provide unprecedented insight into the dynamics of the healing skin tissue.
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Affiliation(s)
- Surya C. Gnyawali
- Comprehensive Wound Center, Davis Heart and Lung Research Institute, Centers for Regenerative Medicine and Cell Based Therapies, The Ohio State University, Columbus, Ohio, United States of America
| | - Kasturi G. Barki
- Comprehensive Wound Center, Davis Heart and Lung Research Institute, Centers for Regenerative Medicine and Cell Based Therapies, The Ohio State University, Columbus, Ohio, United States of America
| | - Shomita S. Mathew-Steiner
- Comprehensive Wound Center, Davis Heart and Lung Research Institute, Centers for Regenerative Medicine and Cell Based Therapies, The Ohio State University, Columbus, Ohio, United States of America
| | - Sriteja Dixith
- Comprehensive Wound Center, Davis Heart and Lung Research Institute, Centers for Regenerative Medicine and Cell Based Therapies, The Ohio State University, Columbus, Ohio, United States of America
| | - Daniel Vanzant
- Comprehensive Wound Center, Davis Heart and Lung Research Institute, Centers for Regenerative Medicine and Cell Based Therapies, The Ohio State University, Columbus, Ohio, United States of America
| | - Jayne Kim
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, United States of America
| | - Jennifer L. Dickerson
- Comprehensive Wound Center, Davis Heart and Lung Research Institute, Centers for Regenerative Medicine and Cell Based Therapies, The Ohio State University, Columbus, Ohio, United States of America
| | - Soma Datta
- Comprehensive Wound Center, Davis Heart and Lung Research Institute, Centers for Regenerative Medicine and Cell Based Therapies, The Ohio State University, Columbus, Ohio, United States of America
| | - Heather Powell
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, United States of America
- Department of Materials Science and Engineering, The Ohio State University, Columbus, Ohio, United States of America
| | - Sashwati Roy
- Comprehensive Wound Center, Davis Heart and Lung Research Institute, Centers for Regenerative Medicine and Cell Based Therapies, The Ohio State University, Columbus, Ohio, United States of America
| | - Valerie Bergdall
- Veterinary Preventive Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Chandan K. Sen
- Comprehensive Wound Center, Davis Heart and Lung Research Institute, Centers for Regenerative Medicine and Cell Based Therapies, The Ohio State University, Columbus, Ohio, United States of America
- * E-mail:
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Helary C, Abed A, Mosser G, Louedec L, Letourneur D, Coradin T, Giraud-Guille MM, Meddahi-Pellé A. Evaluation of dense collagen matrices as medicated wound dressing for the treatment of cutaneous chronic wounds. Biomater Sci 2014. [PMID: 26218128 DOI: 10.1039/c4bm00370e] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Cutaneous chronic wounds are characterized by an impaired wound healing which may lead to infection and amputation. When current treatments are not effective enough, the application of wound dressings is required. To date, no ideal biomaterial is available. In this study, highly dense collagen matrices have been evaluated as novel medicated wound dressings for the treatment of chronic wounds. For this purpose, the structure, mechanical properties, swelling ability and in vivo stability of matrices concentrated from 5 to 40 mg mL(-1) were tested. The matrix stiffness increased with the collagen concentration and was associated with the fibril density and thickness. Increased collagen concentration also enhanced the material resistance against accelerated digestion by collagenase. After subcutaneous implantation in rats, dense collagen matrices exhibited high stability without any degradation after 15 days. The absence of macrophages and neutrophils evidenced their biocompatibility. Subsequently, dense matrices at 40 mg mL(-1) were evaluated as drug delivery system for ampicillin release. More concentrated matrices exhibited the best swelling abilities and could absorb 20 times their dry weight in water, allowing for an efficient antibiotic loading from their dried form. They released efficient doses of antibiotics that inhibited the bacterial growth of Staphylococcus Aureus over 3 days. In parallel, they show no cytotoxicity towards human fibroblasts. These results show that dense collagen matrices are promising materials to develop medicated wound dressings for the treatment of chronic wounds.
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Affiliation(s)
- Christophe Helary
- University Pierre and Marie Curie, Ecole Pratique des Hautes Etudes, CNRS - UMR 7574, Condensed Matter Chemistry Laboratory, Batiment F, 4 place Jussieu, 75005 Paris, France.
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Uysal CA, Tobita M, Hyakusoku H, Mizuno H. The Effect of Bone-Marrow-Derived Stem Cells and Adipose-Derived Stem Cells on Wound Contraction and Epithelization. Adv Wound Care (New Rochelle) 2014; 3:405-413. [PMID: 24940554 DOI: 10.1089/wound.2014.0539] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 03/26/2014] [Indexed: 01/08/2023] Open
Abstract
Objective: The relationship between the wound contraction and levels of α-smooth muscle actin (α-SMA) has been revealed in different studies. We aimed to investigate the effects of mesenchymal stem cells (MSCs), mainly bone-marrow-derived stem cells (BSCs) and adipose-derived stem cells (ASCs), and find out the α-SMA, fibroblast growth factor (FGF), transforming growth factor beta, and vascular endothelial growth factor (VEGF) levels on an in vivo acute wound healing model after the application of MSCs. Approach: Four circular skin defects were formed on the dorsum of Fisher rats (n=20). The defects were applied phosphate-buffered saline (PBS), ASCs, BSCs, and patchy skin graft, respectively. The healing time and scar area were noted. Results: There was a statistical decrease in the healing time in ASC, BSC, and skin graft groups (p<0.05). However, the scar was smaller in the PBS group (p<0.05). The α-SMA levels were statistically lower in ASC, BSC, and graft groups (p<0.05). The FGF levels were statistically higher in ASC and BSC groups (p<0.05). The differentiation of the injected MSCs to endothelial cells and keratinocytes was observed. Innovation and Conclusion: MSCs decrease the healing time and contraction of the wound while increasing the epithelization rate by increasing angiogenesis.
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Affiliation(s)
- Cagri A. Uysal
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Morikuni Tobita
- Department of Plastic and Reconstructive Surgery, Juntendo University, Tokyo, Japan
| | - Hiko Hyakusoku
- Department of Plastic and Reconstructive Surgery, Nippon Medical School, Tokyo, Japan
| | - Hiroshi Mizuno
- Department of Plastic and Reconstructive Surgery, Juntendo University, Tokyo, Japan
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Alkafafy M, Montaser M, El-Shazly SA, Bazid S, Ahmed MM. Ethanolic extract of sharah, Plectranthus aegyptiacus, enhances healing of skin wound in rats. Acta Histochem 2014; 116:627-38. [PMID: 24382517 DOI: 10.1016/j.acthis.2013.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 11/21/2013] [Accepted: 11/25/2013] [Indexed: 11/16/2022]
Abstract
Sharah, Plectranthus aegyptiacus (Forssk.) C. Chr. is a common native plant in the Taif region of Saudi Arabia. An ethanolic extract of freeze dried sharah leaves was added as 10% (w/w) to an ointment base of beeswax and sesame oil. The resultant ointment was examined as a potential enhancer of wound healing. Excision wounds in the nape region of the skin were induced in sixty albino Wistar rats. Animals were allocated in 4 groups (n=15) and kept individually in clean cages. The first group served as negative untreated controls without medication; the second group was treated with ointment base (vehicle); the third group represented the positive control and was treated with a reference ointment and the fourth one served as the experimental group and received the test plant extract (as ointment). Animal groups received the respective medications for 14 successive days. Wounds were measured and photographed every 3 days till the end of the experiment (day 21) in order to determine the wound closure rate (WCR). Specimens from wounds and surrounding skin were collected from sacrificed animals for histological and molecular studies. Both morphometric (based on WCR) and histological findings showed that the healing in animals treated with the sharah plant extract was better than those in control group or vehicle-treated group and was similar to that in the group that received the reference ointment. Moreover, the molecular findings concerning the expression levels of hepatocyte growth factor (HGF) and its receptor (c-Met) displayed a reasonable healing enhancing effect of the plant extract with the expression levels of both being higher in the extract-treated group than in the control group.
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Affiliation(s)
- Mohamed Alkafafy
- Department of Biotechnology, College of Science, Taif University, Taif, Saudi Arabia; Department of Cytology and Histology, College of Veterinary Medicine, University of Sadat City, Egypt
| | - Metwally Montaser
- Department of Biotechnology, College of Science, Taif University, Taif, Saudi Arabia; Department of Zoology, College of Science, Al-Azhar University, Cairo, Egypt
| | - Samir A El-Shazly
- Department of Biotechnology, College of Science, Taif University, Taif, Saudi Arabia; Department of Biochemistry, College of Veterinary Medicine, Kafrelsheikh University, Egypt
| | - Saleh Bazid
- Department of Biology, College of Science, Taif University, Taif, Saudi Arabia
| | - Mohamed M Ahmed
- Department of Biotechnology, College of Science, Taif University, Taif, Saudi Arabia; Department of Biochemistry, College of Veterinary Medicine, University of Sadat City, Egypt.
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Pakyari M, Farrokhi A, Maharlooei MK, Ghahary A. Critical Role of Transforming Growth Factor Beta in Different Phases of Wound Healing. Adv Wound Care (New Rochelle) 2013; 2:215-224. [PMID: 24527344 DOI: 10.1089/wound.2012.0406] [Citation(s) in RCA: 367] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Indexed: 12/11/2022] Open
Abstract
SIGNIFICANCE This review highlights the critical role of transforming growth factor beta (TGF-β)1-3 within different phases of wound healing, in particular, late-stage wound healing. It is also very important to identify the TGF-β1-controlling factors involved in slowing down the healing process upon wound epithelialization. RECENT ADVANCES TGF-β1, as a growth factor, is a known proponent of dermal fibrosis. Several strategies to modulate or regulate TGF's actions have been thoroughly investigated in an effort to create successful therapies. This study reviews current discourse regarding the many roles of TGF-β1 in wound healing by modulating infiltrated immune cells and the extracellular matrix. CRITICAL ISSUES It is well established that TGF-β1 functions as a wound-healing promoting factor, and thereby if in excess it may lead to overhealing outcomes, such as hypertrophic scarring and keloid. Thus, the regulation of TGF-β1 in the later stages of the healing process remains as critical issue of which to better understand. FUTURE DIRECTIONS One hypothesis is that cell communication is the key to regulate later stages of wound healing. To elucidate the role of keratinocyte/fibroblast cross talk in controlling the later stages of wound healing we need to: (1) identify those keratinocyte-released factors which would function as wound-healing stop signals, (2) evaluate the functionality of these factors in controlling the outcome of the healing process, and (3) formulate topical vehicles for these antifibrogenic factors to improve or even prevent the development of hypertrophic scarring and keloids as a result of deep trauma, burn injuries, and any type of surgical incision.
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Affiliation(s)
| | - Ali Farrokhi
- Department of Surgery, University of British Columbia , Vancouver, Canada . ; Professional Fire Fighters' Burn & Wound Healing Research Laboratory, University of British Columbia , Vancouver, Canada
| | - Mohsen Khosravi Maharlooei
- Department of Surgery, University of British Columbia , Vancouver, Canada . ; Professional Fire Fighters' Burn & Wound Healing Research Laboratory, University of British Columbia , Vancouver, Canada
| | - Aziz Ghahary
- Department of Surgery, University of British Columbia , Vancouver, Canada . ; Professional Fire Fighters' Burn & Wound Healing Research Laboratory, University of British Columbia , Vancouver, Canada
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Common healthcare challenges. PLASMA MEDICINE 2012. [DOI: 10.1017/cbo9780511902598.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Maxson S, Lopez EA, Yoo D, Danilkovitch-Miagkova A, LeRoux MA. Concise review: role of mesenchymal stem cells in wound repair. Stem Cells Transl Med 2012; 1:142-9. [PMID: 23197761 PMCID: PMC3659685 DOI: 10.5966/sctm.2011-0018] [Citation(s) in RCA: 531] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 01/04/2012] [Indexed: 12/13/2022] Open
Abstract
Wound healing requires a coordinated interplay among cells, growth factors, and extracellular matrix proteins. Central to this process is the endogenous mesenchymal stem cell (MSC), which coordinates the repair response by recruiting other host cells and secreting growth factors and matrix proteins. MSCs are self-renewing multipotent stem cells that can differentiate into various lineages of mesenchymal origin such as bone, cartilage, tendon, and fat. In addition to multilineage differentiation capacity, MSCs regulate immune response and inflammation and possess powerful tissue protective and reparative mechanisms, making these cells attractive for treatment of different diseases. The beneficial effect of exogenous MSCs on wound healing was observed in a variety of animal models and in reported clinical cases. Specifically, they have been successfully used to treat chronic wounds and stimulate stalled healing processes. Recent studies revealed that human placental membranes are a rich source of MSCs for tissue regeneration and repair. This review provides a concise summary of current knowledge of biological properties of MSCs and describes the use of MSCs for wound healing. In particular, the scope of this review focuses on the role MSCs have in each phase of the wound-healing process. In addition, characterization of MSCs containing skin substitutes is described, demonstrating the presence of key growth factors and cytokines uniquely suited to aid in wound repair.
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Affiliation(s)
- Scott Maxson
- Osiris Therapeutics, Inc., Columbia, Maryland, USA
| | | | - Dana Yoo
- Osiris Therapeutics, Inc., Columbia, Maryland, USA
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The clinical evidence for dressings with TLC technology. J Wound Care 2011. [DOI: 10.12968/jowc.2011.20.sup1.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Dressings with TLC-Ag technology. J Wound Care 2011. [DOI: 10.12968/jowc.2011.20.sup1.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Affiliation(s)
- Richard White
- Tissue Viability, Institute of Health and Society, University of Worcester
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Dressings with TLC-NOSF Technology. J Wound Care 2011. [DOI: 10.12968/jowc.2011.20.sup1.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Pre-clinical evidence. J Wound Care 2011. [DOI: 10.12968/jowc.2011.20.sup1.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Velnar T, Bailey T, Smrkolj V. The wound healing process: an overview of the cellular and molecular mechanisms. J Int Med Res 2010; 37:1528-42. [PMID: 19930861 DOI: 10.1177/147323000903700531] [Citation(s) in RCA: 1255] [Impact Index Per Article: 89.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Wound healing remains a challenging clinical problem and correct, efficient wound management is essential. Much effort has been focused on wound care with an emphasis on new therapeutic approaches and the development of technologies for acute and chronic wound management. Wound healing involves multiple cell populations, the extracellular matrix and the action of soluble mediators such as growth factors and cytokines. Although the process of healing is continuous, it may be arbitrarily divided into four phases: (i) coagulation and haemostasis; (ii) inflammation; (iii) proliferation; and (iv) wound remodelling with scar tissue formation. The correct approach to wound management may effectively influence the clinical outcome. This review discusses wound classification, the physiology of the wound healing process and the methods used in wound management.
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Affiliation(s)
- Tomaz Velnar
- Department of Neurosurgery, University Medical Centre Maribor, Maribor, Slovenia.
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Myers WT, Leong M, Phillips LG. Optimizing the patient for surgical treatment of the wound. Clin Plast Surg 2007; 34:607-20. [PMID: 17967617 DOI: 10.1016/j.cps.2007.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Plastic surgeons are consulted often to close wounds that fail or are difficult to heal. Optimizing the patient's medical condition before surgical closure of a wound can mean the difference between a successful outcome and an undesirable one. It is imperative that plastic surgeons have an extensive knowledge of the modifiable risk factors affecting the wound-healing process and their subsequent complications. This knowledge allows the surgeon to tailor the treatment options and intervene when appropriate to optimize outcomes for successful surgical closure of a wound. Whether the impairments to wound healing and closure are local or systemic, they must be addressed appropriately.
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Affiliation(s)
- Wesley T Myers
- Division of Plastic Surgery, Department of Surgery, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA
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Abstract
Wound healing is a complex interchange, orchestrated between cellular components that play their respective parts signaled by and mediated by different cellular instruments of healing. When healing is performed well, the final product is a thing of beauty. When healing is delayed, interrupted, or excessive, then unsightly scars of chronic painful wounds that are frustrating to the patient and physician occur.
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Affiliation(s)
- Margaret K Strecker-McGraw
- Department of Emergency Medicine, Scott and White Hospital, Texas A&M University College of Medicine, 2401 S. 31st Street, Temple, TX 76504, USA.
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Cobb MJ, Chen Y, Underwood RA, Usui ML, Olerud J, Li X. Noninvasive assessment of cutaneous wound healing using ultrahigh-resolution optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2006; 11:064002. [PMID: 17212525 DOI: 10.1117/1.2388152] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Ultrahigh-resolution optical coherence tomography (OCT) was used for noninvasive in vivo evaluation of the wound healing process. Cutaneous wounds were induced by 2.5-mm diameter full-thickness punch biopsies on the dorsal surface of seven mice. OCT imaging was performed to assess the structural characteristics associated with the healing process. The OCT results were compared to corresponding histology. Two automated quantitative analysis routines were implemented to identify the dermal-epidermal junction and segment the OCT images. Hallmarks of cutaneous wound healing such as wound size, epidermal migration, dermal-epidermal junction formation, and differences in wound composition were readily identified on the OCT images. Blister formation was also observed. Preliminary findings suggest OCT is a viable tool to noninvasively monitor wound healing in vivo.
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Affiliation(s)
- Michael J Cobb
- Department of Bioengineering, University of Washington, Seattle, Washington 98195, USA
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Abstract
Optimum healing of a cutaneous wound requires a well-orchestrated integration of the complex biological and molecular events of cell migration and proliferation, and of extracellular matrix deposition and remodelling. Cellular responses to inflammatory mediators, growth factors, and cytokines, and to mechanical forces, must be appropriate and precise. However, this orderly progression of the healing process is impaired in chronic wounds, including those due to diabetes. Several pathogenic abnormalities, ranging from disease-specific intrinsic flaws in blood supply, angiogenesis, and matrix turnover to extrinsic factors due to infection and continued trauma, contribute to failure to heal. Yet, despite these obstacles, there is increasing cause for optimism in the treatment of diabetic and other chronic wounds. Enhanced understanding and correction of pathogenic factors, combined with stricter adherence to standards of care and with technological breakthroughs in biological agents, is giving new hope to the problem of impaired healing.
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Affiliation(s)
- Vincent Falanga
- Department of Dermatology, Boston University, Boston, MA, USA.
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