AFM analysis of collagen fibrils in expanded scalp tissue after anisotropic tissue expansion

Application of extracellular matrix cross-linked by microbial transglutaminase to promote wound healing

One primary focus of skin tissue engineering has been the creation of innovative biomaterials to facilitate rapid wound healing. Extracellular matrix (ECM), an essential biofunctional substance, has recently been discovered to play a crucial role in wound healing. Consequently, we endeavored to decellularize ECM from pig achilles tendon and refine its mechanical and biological properties through modification by utilizing cross-linking agents. Glutaraldehyde (GA), 1-ethyl-(3-dimethylaminopropyl) carbodiimide/N-hydroxysuccinimide (EDC/NHS), double aldol starch (DAS), and microbial transglutaminase (MTG) were utilized to produce crosslinked ECM variants (GA-ECM, EDC/NHS-ECM, DAS-ECM, and MTG-ECM). Comprehensive assessments were conducted to evaluate the physical properties, biocompatibility, and wound healing efficacy of each material. The results indicated that MTG-ECM exhibited superior tensile strength, excellent hydrophilicity, minimal cytotoxicity, and the best pro-healing impact among the four modified scaffolds. Staining analysis of tissue sections further revealed that MTG-ECM impeded the transition from type III collagen to type I collagen in the wound area, potentially reducing the development of wound scar. Therefore, MTG-ECM is expected to be a potential pro-skin repair scaffold material to prevent scar formation.

Correlation between Collagen Type I/III Ratio and Scar Formation in Patients Undergoing Immediate Reconstruction with the Round Block Technique after Breast-Conserving Surgery

The aim of this study was to investigate the relationship between the collagen type I/III ratio and scarring in patients who underwent immediate reconstruction with the round block technique (RBT) after breast conservation surgery. Seventy-eight patients were included, and demographic and clinical characteristics were recorded. The collagen type I/III ratio was measured using immunofluorescence staining and digital imaging, and scarring was assessed using the Vancouver Scar Scale (VSS). The mean VSS scores were 1.92 ± 2.01 and 1.79 ± 1.89, as assessed by two independent plastic surgeons, with good reliability of the scores. A significant positive correlation was found between VSS and the collagen type I/III ratio (r = 0.552, p < 0.01), and a significant negative correlation was found between VSS and the collagen type III content (r = −0.326, p < 0.05). Multiple linear regression analysis showed that the collagen type I/III ratio had a significant positive effect on VSS (β = 0.415, p = 0.028), whereas the collagen type I and collagen type III content had no significant effect on VSS. These findings suggest that the collagen type I/III ratio is associated with scar development in patients undergoing RBT after breast conservation surgery. Further research is needed to develop a patient-specific scar prediction model based on genetic factors affecting the collagen type I/III ratio.

The multiscale characterization and constitutive modeling of healthy and type 2 diabetes mellitus Sprague Dawley rat skin

In type 2 diabetes mellitus (T2DM), elevated glucose level impairs the biochemistry of the skin which may result in alteration of its mechanical and structural properties. The several aspects of structural and mechanical changes in skin due to T2DM remain poorly understood. To fill these research gaps, we developed a non-obese T2DM rat (Sprague Dawley (SD)) model for investigating the effect of T2DM on the in vivo strain stress state, mechanical and structural properties of skin. In vivo strain and mechanical anisotropy of healthy and T2DM skin were measured using the digital imaging correlation (DIC) technique and DIC coupled bulge experiment, respectively. Fluorescence microscopy and histology were used to assess the collagen and elastin fibers microstructure whereas nanoscale structure was captured through atomic force microscopy (AFM). Based on the microstructural observations, skin was modeled as a multilayer membrane where in and out of plane distribution of collagen fibers and planar distribution of elastin fibers were cast in constitutive model. Further, the state of in vivo stresses of healthy and T2DM were measured using model parameters and in vivo strain in the constitutive model. The results showed that T2DM causes significant loss in in vivo stresses (p < 0.01) and increase in anisotropy (p < 0.001) of skin. These changes were found in good correlation with T2DM associated alteration in skin microstructure. Statistical analysis emphasized that increase in blood glucose concentration (HbA1c) was the main cause of impaired biomechanical properties of skin. The presented data in this study can help to understand the skin pathology and to simulate the skin related clinical procedures. STATEMENT OF SIGNIFICANCE: Our study is significant as it presents findings related to the effect of T2DM on the physiologic stress strain, structural and mechanical response of SD rat skin. In this study, we developed a non-obese T2DM SD rat model which mimics the phenotype of Asian type 2 diabetics (non-obese). Several structural and mechanical characterization techniques were explored for multiscale characterization of healthy and T2DM skin. Further, based on microstructural information, we presented the constitutive models that incorporate the real microstructure of skin. The presented results can be helpful to simulate the realistic mechanical response of skin during various clinical trials.

Tissue Rigidity Increased during Carcinogenesis of NTCU-Induced Lung Squamous Cell Carcinoma In Vivo

Increased tissue rigidity is an emerging hallmark of cancer as it plays a critical role in promoting cancer growth. However, the field lacks a defined characterization of tissue rigidity in dual-stage carcinogenesis of lung squamous cell carcinoma (SCC) in vivo. Pre-malignant and malignant lung SCC was developed in BALB/c mice using N-nitroso-tris-chloroethylurea (NTCU). Picro sirius red staining and atomic force microscopy were performed to measure collagen content and collagen (diameter and rigidity), respectively. Then, the expression of tenascin C (TNC) protein was determined using immunohistochemistry staining. Briefly, all tissue rigidity parameters were found to be increased in the Cancer group as compared with the Vehicle group. Importantly, collagen content (33.63 ± 2.39%) and TNC expression (7.97 ± 2.04%) were found to be significantly higher (p < 0.05) in the Malignant Cancer group, as compared with the collagen content (18.08 ± 1.75%) and TNC expression (0.45 ± 0.53%) in the Pre-malignant Cancer group, indicating increased tissue rigidity during carcinogenesis of lung SCC. Overall, tissue rigidity of lung SCC was suggested to be increased during carcinogenesis as indicated by the overexpression of collagen and TNC protein, which may warrant further research as novel therapeutic targets to treat lung SCC effectively.

Effect of collagen fibre orientation on the Poisson's ratio and stress relaxation of skin: an ex vivo and in vivo study

During surgical treatment skin undergoes extensive deformation, hence it must be able to withstand large mechanical stresses without damage. Therefore, understanding the mechanical properties of skin becomes important. A detailed investigation on the relationship between the three-dimensional deformation response of skin and its microstructure is conducted in the current study. This study also discloses the underlying science of skin viscoelasticity. Deformation response of skin is captured using digital image correlation, whereas micro-CT, scanning electron microscopy and atomic force microscopy are used for microstructure analysis. Skin shows a large lateral contraction and expansion (auxeticity) when stretched parallel and perpendicular to the skin tension lines, respectively. Large lateral contraction is a result of fluid exudation from the tissue, while large rotation of the stiff collagen fibres in the loading direction explains the skin auxeticity. During stress relaxation, lateral contraction and fluid effluxion from skin reveal that tissue volume loss is the intrinsic science of skin viscoelasticity. Furthermore, the results obtained from in vivo study on human skin show the relevance of the ex vivo study to physiological conditions and stretching of the skin during its treatments.

D-band strain underestimates fibril strain for twisted collagen fibrils at low strains

Collagen fibrils are the main structural component of load-bearing tissues such as tendons, ligaments, skin, the cornea of the eye, and the heart. The D-band of collagen fibrils is an axial periodic density modulation that can be easily characterized by tissue-level X-ray scattering. During mechanical testing, D-band strain is often used as a proxy for fibril strain. However, this approach ignores the coupling between strain and molecular tilt. We examine the validity of this approximation using an elastomeric collagen fibril model that includes both the D-band and a molecular tilt field. In the low strain regime, we show that the D-band strain substantially underestimates fibril strain for strongly twisted collagen fibrils - such as fibrils from skin or corneal tissue.

Self-swelling tissue expander for soft tissue reconstruction in the craniofacial region: An in vitro and in vivo evaluation

BACKGROUND

Craniofacial soft-tissue defects mostly have an impact on the treatment of various oral diseases. Tissue expander is an important technique for tissue reconstruction, especially for soft tissues in reconstructive surgery.

OBJECTIVE

This research aimed to develop a new self-swelling tissue expander, namely hydrogel, for soft tissue reconstruction in craniofacial region.

METHODS

In vitro, the chemical and physical characteristics of hydrogel were evaluated by SEM, swelling rate, mechanical testing, EDS, and FT-IR. In vivo, the craniofacial implant model of SD rats were divided into group A as control, group B with hydrogels for 1 week expansion, group C for 2 weeks and group D for 4 weeks (n = 5), and the effects were analyzed by HE staining, histological and radiographic evaluation.

RESULTS

The in vitro results suggested that dry hydrogel possessed a uniform surface with micropores, the surface of post-swelling hydrogel formed three-dimensional meshwork. Within 24 hours, hydrogels expanded markedly, then slowed down. The mechanical property of hydrogels with longer expansion was better, whose main elements were carbon and oxygen. FT-IR also verified its molecular structure. In vivo, the wounds of rats recovered well, hydrogels could be removed as one whole piece with original shape and examined by radiographic evaluation, besides, the expanded skin and developed fibrous capsule formed surrounding hydrogels.

CONCLUSION

The new expander was designed successfully with good chemical and physical characteristics, and could be applied in an animal model to help tissue reconstruction.

Defective chicken skin collagen molecules, hydrolyzed by actinidain protease, assemble to form loosely packed fibrils that promote cell spheroid formation

Cells recognize collagen fibrils as the first step in the process of adherence. Fibrils of chicken skin actinidain-hydrolyzed collagen (low adhesive scaffold collagen, LASCol), in which the telopeptide domains are almost completely removed, cause adhering cells to form spheroids instead of adopting a monolayer morphology. Our goal was to elucidate the ultrastructure of the LASCol fibrils compared with pepsin-hydrolyzed collagen (PepCol) fibrils. At low concentration of 0.2 mg/mL, the time to reach the maximum increasing rate of turbidity for LASCol was all slower than that for PepCol. Differential scanning calorimetry showed that the thermal stability of collagen self-assembly changed significantly between pH 5.5 and pH 6.6 with and without a small number of telopeptides. However, the calorimetric enthalpy change did not vary much in that pH range. The melting temperature of LASCol fibrils at pH 7.3 was 55.1 °C, whereas PepCol fibrils exhibited a peak around 56.9 °C. The D-periodicity of each fibril was the same at 67 nm. Nevertheless, the looseness of molecular packing in LASCol fibrils was demonstrated by circular dichroism measurements and immuno-scanning electron microscopy with a polyclonal antibody against type I collagen. As there is a close relationship between function and structure, loosely packed collagen fibrils would be one factor that promotes cell spheroid formation.

Inflammatory Responses in Oro-Maxillofacial Region Expanded Using Anisotropic Hydrogel Tissue Expander

OBJECTIVE

Reconstruction of oral and facial defects often necessitate replacement of missing soft tissue. The purpose of tissue expanders is to grow healthy supplementary tissue under a controlled force. This study investigates the inflammatory responses associated with the force generated from the use of anisotropic hydrogel tissue expanders.

METHODS

Sprague Dawley rats (n = 7, body weight = 300 g ± 50 g) were grouped randomly into two groups-control (n = 3) and expanded (n = 4). Anisotropic hydrogel tissue expanders were inserted into the frontal maxillofacial region of the rats in the expanded group. The rats were sacrificed, and skin samples were harvested, fixed in formalin, and embedded in paraffin wax for histological investigation. Hematoxylin and eosin staining was performed to detect histological changes between the two groups and to investigate the inflammatory response in the expanded samples. Three inflammatory markers, namely interleukin (IL)-1α, IL-6, and tumor necrosis factor-α (TNF-α), were analyzed by immunohistochemistry.

RESULT

IL-1-α expression was only observed in the expanded tissue samples compared to the controls. In contrast, there was no significant difference in IL-6, and TNF-α production. Histological analysis showed the absence of inflammatory response in expanded tissues, and a negative non-significant correlation (Spearman's correlation coefficient) between IL-1-α immune-positive cells and the inflammatory cells (r = -0.500). In conclusion, tissues that are expanded and stabilized using an anisotropic self-inflating hydrogel tissue expander might be useful for tissue replacement and engraftment as the expanded tissue does not show any sign of inflammatory responses. Detection of IL-1-α in the expanded tissues warrants further investigation for its involvement without any visible inflammatory response.

Frequency dependent inelastic response of collagen architecture of pig dermis under cyclic tensile loading: An experimental study

The evaluation of collagen architecture of the dermis in response to mechanical stimulation is important as it affects the macroscopic mechanical properties of the dermis. A detailed understanding of the processes involved in the alteration of the collagen structure is required to correlate the mechanical stimulation with tissue remodeling. This study investigated the effect of cyclic frequencies i.e. low (0.1 Hz), medium (2.0 Hz), and high (5.0 Hz) (physiological range) in the alteration of pig dermis collagen structure and its correlation with the macroscopic mechanical response of the dermis. The assessment of the collagen structure of virgin and mechanical tested specimens at tropocollagen, collagen fibril, and fiber level was performed using Fourier-transform infrared-attenuated total reflection (FTIR-ATR), atomic force microscopy (AFM), and scanning electron microscopy (SEM) respectively. After 10³ cycles, a significantly higher alteration in collagen structure with discrete plastic-type damage was found for low frequency. This frequency dependent alteration of the collagen structure was found in correlation with the dermis macroscopic response. The value of inelastic strain, stress softening, damage parameter (reduction in elastic modulus), and reduction in energy dissipation were observed significantly large for slow frequency. A power-law based empirical relations, as a function of frequency and number of cycles, were proposed to predict the value of inelastic strain and damage parameter. This study also suggests that hierarchical structural response against the mechanical stimulation is time-dependent rather than cycle-dependent, may affect the tissue remodeling.

Label-Free Infrared Spectral Histology of Skin Tissue Part I: Impact of Lumican on Extracellular Matrix Integrity

Proteoglycans (PG) play an important role in maintaining the extracellular matrix (ECM) integrity. Lumican, a small leucine rich PG, is one such actor capable of regulating such properties. In this study, the integrity of the dermis of lumican-deleted Lum^–/– vs. wild-type mice was investigated by conventional histology and by infrared spectral histology (IRSH). Infrared spectroscopy is a non-invasive, rapid, label-free and sensitive technique that allows to probe molecular vibrations of biomolecules present in a tissue. Our IRSH results obtained on control (WT, n = 3) and Lum^–/– (n = 3) mice showed that different histological structures were identified by using K-means clustering and validated by hematoxylin eosin saffron (HES) staining. Furthermore, an important increase of the dermis thickness was observed in Lum^–/– compared to WT mice. In terms of structural information, analysis of the spectral images also revealed an intra-group homogeneity and inter-group heterogeneity. In addition, type I collagen contribution was evaluated by HES and picrosirius red staining as well as with IRSH. Both techniques showed a strong remodeling of the ECM in Lum^–/– mice due to the looseness of collagen fibers in the increased dermis space. These results confirmed the impact of lumican on the ECM integrity. The loss of collagen fibers organization due to the absence of lumican can potentially increase the accessibility of anti-cancer drugs to the tumor. These results are qualitatively interesting and would need further structural characterization of type I collagen fibers in terms of size, organization, and orientation.

Directional dependent variation in mechanical properties of planar anisotropic porcine skin tissue

Nonlinear and anisotropic mechanical behavior of skin is essential in various applications such as dermatology, cosmetic products, forensic science, and computational studies. The present study quantifies the mechanical anisotropy of skin using the bulge method and full-field imaging technique. In bulging, the saline solution at 37 °C mimics the in vivo body temperature and fluid conditions, and all experiments were performed in the control environment. Assumption of thin spherical shell membrane theory and imaging techniques were implemented to obtain the anisotropic stress strain relations. Further, stress strain relations at an interval of 10° were calculated to obtain the variation in modulus with direction. Histological examinations were performed to signify the role of the collagen fibers orientation on the mechanical properties. The maximum and minimum linear modulus and collagen fiber orientation intensity were found in good agreement. The angular difference between maximum and minimum linear modulus and orientation intensity was found 71° ± 7° and 76° ± 5° respectively, and the percentage difference was 43.4 ± 8.2 and 52.5 ± 6.4 respectively. Further, a significant difference in the maximum and minimum collagen orientation intensity between the untested and tested specimens indicates the realignment of the fibers. Additionally, a cubic polynomial empirical relation was established to calculate the quantitative variation in the apparent modulus with the directions, which serves for the anisotropic modeling of the skin. The experimental technique used in this study can be applied for anisotropic quantification of planar soft tissues as well as can be utilized to imitate the tissue expansion procedure used in reconstructive surgery.

Automated image segmentation-assisted flattening of atomic force microscopy images

Atomic force microscopy (AFM) images normally exhibit various artifacts. As a result, image flattening is required prior to image analysis. To obtain optimized flattening results, foreground features are generally manually excluded using rectangular masks in image flattening, which is time consuming and inaccurate. In this study, a two-step scheme was proposed to achieve optimized image flattening in an automated manner. In the first step, the convex and concave features in the foreground were automatically segmented with accurate boundary detection. The extracted foreground features were taken as exclusion masks. In the second step, data points in the background were fitted as polynomial curves/surfaces, which were then subtracted from raw images to get the flattened images. Moreover, sliding-window-based polynomial fitting was proposed to process images with complex background trends. The working principle of the two-step image flattening scheme were presented, followed by the investigation of the influence of a sliding-window size and polynomial fitting direction on the flattened images. Additionally, the role of image flattening on the morphological characterization and segmentation of AFM images were verified with the proposed method.