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Soares CBG, Araújo IDD, Teixeira LEM, Michelin MA, Machado CJ, Silveira MP. Fracture in Irradiated Rat Femur: A Description of an Experimental Model and Evaluation of its Effectiveness. Rev Bras Ortop 2023; 58:e653-e658. [PMID: 37663191 PMCID: PMC10468228 DOI: 10.1055/s-0042-1758359] [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: 06/02/2022] [Accepted: 09/12/2022] [Indexed: 09/05/2023] Open
Abstract
Objective We aim to describe an experimental model for studying femoral fractures in rats after exposure to ionizing radiation, demonstrating a way to apply a substance for analysis, the method for patterning fracture and irradiation, and how to evaluate its effectiveness based on radiographic studies. Methods We used 24 rats divided into 2 groups of 12 animals each. The STUDY group was exposed to ionizing radiation and treated with saline solution, and the CONTROL group was not exposed to radiation and was treated with saline solution. All animals were subjected to standardized fracture of the right femur that was fixed with intramedullary wire. The efficiency of the bone union was assessed by radiographic exam. Results Fracture healing was more efficient in bones not exposed to ionizing radiation ( p = 0.012). All fractures met the criteria of being simple, diaphyseal, transverse or short oblique. Conclusion The experimental model presented is an efficient alternative for the study of fractures in irradiated bones in rats.
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Affiliation(s)
- Cláudio Beling Gonçalves Soares
- Médico Preceptor, Departamento de Cirurgia, Faculdade de Medicina Federal, Universidade de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Ivana Duval de Araújo
- Professor, Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal, Minas Gerais, Belo Horizonte, MG, Brasil
| | - Luiz Eduardo Moreira Teixeira
- Professor, Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal, Minas Gerais, Belo Horizonte, MG, Brasil
| | | | - Carla Jorge Machado
- Professor, Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal, Minas Gerais, Belo Horizonte, MG, Brasil
| | - Marcelo Peixoto Silveira
- Médico Ortopedista, Departamento de Ortopedia, Faculdade de Medicina, Federal, Universidade de Minas Gerais, Belo Horizonte, MG, Brasil
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Bowen CM, Ditmars FS, Gupta A, Reems JA, Fagg WS. Cell-Free Amniotic Fluid and Regenerative Medicine: Current Applications and Future Opportunities. Biomedicines 2022; 10:biomedicines10112960. [PMID: 36428527 PMCID: PMC9687956 DOI: 10.3390/biomedicines10112960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/09/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Amniotic fluid (AF) provides critical biological and physical support for the developing fetus. While AF is an excellent source of progenitor cells with regenerative properties, recent investigations indicate that cell-free AF (cfAF), which consists of its soluble components and extracellular vesicles, can also stimulate regenerative and reparative activities. This review summarizes published fundamental, translational, and clinical investigations into the biological activity and potential use of cfAF as a therapeutic agent. Recurring themes emerge from these studies, which indicate that cfAF can confer immunomodulatory, anti-inflammatory, and pro-growth characteristics to the target cells/tissue with which they come into contact. Another common observation is that cfAF seems to promote a return of cells/tissue to a homeostatic resting state when applied to a model of cell stress or disease. The precise mechanisms through which these effects are mediated have not been entirely defined, but it is clear that cfAF can safely and effectively treat cutaneous wounds and perhaps orthopedic degenerative conditions. Additional applications are currently being investigated, but require further study to dissect the fundamental mechanisms through which its regenerative effects are mediated. By doing so, rational design can be used to fully unlock its potential in the biotechnology lab and in the clinic.
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Affiliation(s)
- Charles M. Bowen
- Department of Surgery, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
- John Sealy School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
| | - Frederick S. Ditmars
- Department of Surgery, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
- John Sealy School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA
- BioIntegrate, Lawrenceville, GA 30043, USA
- South Texas Orthopaedic Research Institute (STORI Inc.), Laredo, TX 78045, USA
- Regenerative Orthopaedics, Noida 201301, UP, India
| | - Jo-Anna Reems
- Merakris Therapeutics, RTP Frontier 800 Park Offices Dr. Suite 3322, Research Triangle Park, NC 27709, USA
- Department of Engineering, University of Utah, Salt Lake City, UT 84112, USA
| | - William Samuel Fagg
- Department of Surgery, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
- Regenerative Orthopaedics, Noida 201301, UP, India
- Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
- Correspondence:
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Liu N, Bowen CM, Shoja MM, Castro de Pereira KL, Dongur LP, Saad A, Russell WK, Broderick TC, Fair JH, Fagg WS. Comparative Analysis of Co-Cultured Amniotic Cell-Conditioned Media with Cell-Free Amniotic Fluid Reveals Differential Effects on Epithelial–Mesenchymal Transition and Myofibroblast Activation. Biomedicines 2022; 10:biomedicines10092189. [PMID: 36140291 PMCID: PMC9495976 DOI: 10.3390/biomedicines10092189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
Myofibroblast activation is a cellular response elicited by a variety of physiological or pathological insults whereby cells initiate a coordinated response intended to eradicate the insult and then revert back to a basal state. However, an underlying theme in various disease states is persistent myofibroblast activation that fails to resolve. Based on multiple observations, we hypothesized that the secreted factors harvested from co-culturing amniotic stem cells might mimic the anti-inflammatory state that cell-free amniotic fluid (AF) elicits. We optimized an amnion epithelial and amniotic fluid cell co-culture system, and tested this hypothesis in the context of myofibroblast activation. However, we discovered that co-cultured amniotic cell conditioned media (coACCM) and AF have opposing effects on myofibroblast activation: coACCM activates the epithelial–mesenchymal transition (EMT) and stimulates gene expression patterns associated with myofibroblast activation, while AF does the opposite. Intriguingly, extracellular vesicles (EVs) purified from AF are necessary and sufficient to activate EMT and inflammatory gene expression patterns, while the EV-depleted AF potently represses these responses. In summary, these data indicate that coACCM stimulates myofibroblast activation, while AF represses it. We interpret these findings to suggest that coACCM, AF, and fractionated AF represent unique biologics that elicit different cellular responses that are correlated with a wide variety of pathological states, and therefore could have broad utility in the clinic and the lab.
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Affiliation(s)
- Naiyou Liu
- Division of Transplant, Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Charles M. Bowen
- Division of Transplant, Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Mohammadali M. Shoja
- Division of Transplant, Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
| | | | - Laxmi Priya Dongur
- Division of Transplant, Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Antonio Saad
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - William K. Russell
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Thomas Christopher Broderick
- Merakris Therapeutics, RTP Frontier, Research Triangle Park, NC 27709, USA
- Golden LEAF Biomanufacturing Training and Education Center, North Carolina State University, Raleigh, NC 27606, USA
| | - Jeffrey H. Fair
- Division of Transplant, Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - William Samuel Fagg
- Division of Transplant, Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX 77555, USA
- Merakris Therapeutics, RTP Frontier, Research Triangle Park, NC 27709, USA
- Correspondence: ; Tel.: +1-(409)-772-2412; Fax: +1-(409)-747-7364
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Plumping up a Cushion of Human Biowaste in Regenerative Medicine: Novel Insights into a State-of-the-Art Reserve Arsenal. Stem Cell Rev Rep 2022; 18:2709-2739. [PMID: 35505177 PMCID: PMC9064122 DOI: 10.1007/s12015-022-10383-3] [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] [Accepted: 04/25/2022] [Indexed: 12/03/2022]
Abstract
Major breakthroughs and disruptive methods in disease treatment today owe their thanks to our inch by inch developing conception of the infinitive aspects of medicine since the very beginning, among which, the role of the regenerative medicine can on no account be denied, a branch of medicine dedicated to either repairing or replacing the injured or diseased cells, organs, and tissues. A novel means to accomplish such a quest is what is being called “medical biowaste”, a large assortment of biological samples produced during a surgery session or as a result of physiological conditions and biological activities. The current paper accentuating several of a number of promising sources of biowaste together with their plausible applications in routine clinical practices and the confronting challenges aims at inspiring research on the existing gap between clinical and basic science to further extend our knowledge and understanding concerning the potential applications of medical biowaste.
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Scala VA, Kikuchi CK. Sesamoid Avascular Necrosis and Stress Fracture Treated with Core Decompression and Biologic Augmentation. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2022; 81:16-18. [PMID: 35340940 PMCID: PMC8941614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sesamoid bone disorders are disabling conditions with limited treatment options. This case report describes a 17-year-old football player with avascular necrosis (AVN) in both the tibial and fibular hallux sesamoids with a concomitant non-displaced stress fracture of the tibial hallux sesamoid. After a short period of conservative management, the patient underwent open sesamoid core decompression with an application of concentrated bone marrow aspirate and amnion matrix. After postoperative physical therapy, the patient achieved a painless range of motion of the first metatarsophalangeal joint. He returned to full athletic activities by 6 months postoperatively. Core decompression with biologic augmentation is a viable treatment option for sesamoid AVN. Earlier surgical intervention for sesamoid AVN can also be considered, particularly in younger active patients.
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Affiliation(s)
- Victoria A. Scala
- Division of Orthopaedic Surgery, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI
| | - Christian K. Kikuchi
- Division of Orthopaedic Surgery, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI
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Efficacy of hyaluronic acid, absorbable collagen sponge, and their combination in minimizing bisphosphonate-related osteonecrosis of the jaws (BRONJ) after dental extraction: a preliminary animal histomorphometric study. Maxillofac Plast Reconstr Surg 2022; 44:8. [PMID: 35230522 PMCID: PMC8888787 DOI: 10.1186/s40902-022-00337-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 02/10/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction There is no study on the effectiveness of hyaluronic acid (HA) placement either with or without absorbable collagen sponge (ACS) in reducing or preventing bisphosphonate-related osteonecrosis of the jaws (BRONJ). This preliminary animal study examined the efficacy of this clinically important treatment. Methods For simulating BRONJ, zoledronic acid was administered to 40 rats for 5 weeks. Two weeks later, a right first molar was extracted from each rat. The rats were randomized into four groups of socket treatments: control (empty extraction socket) or with sockets filled with ACS, HA, or HA+ACS (n=4×10). After 2 weeks, 5 rats in each group were sacrificed and subjected to histopathologic and histomorphometric evaluation. Eight weeks post-surgically, the rest of rats were euthanized and histologically examined. The Kruskal-Wallis test was used to compare the four treatments at each time point (α=0.05). Results Six rats were lost overall. In the second week, vascularization was higher in ACS group (P<0.05); osteoclast activity was not different between groups (P>0.05); empty lacunae were the most and fewest in control and HA+ACS groups, respectively (P<0.05); eosinophil infiltration was maximum in HA group (P<0.05); lymphocyte counts were maximum and minimum in the HA+ACS and ACS groups, respectively (P<0.05); the highest and lowest neutrophil counts were seen in ACS and control groups, respectively (P<0.05); and the extent of live bone did not differ between groups (P>0.05). In the eighth week, vascularization was not different in groups (P>0.05); the highest and lowest osteoclast activities were seen in the control and HA+ACS groups, respectively (P<0.05); empty lacunae were the most and fewest in control and HA+ACS, respectively (P<0.05); maximum and minimum numbers of eosinophils were in control and HA+ACS groups, respectively (P<0.05); HA and control groups exhibited the highest and lowest lymphocyte counts, respectively (P<0.05); the lowest and highest neutrophil counts were observed in HA+ACs and control groups, respectively (P<0.05); and the highest and lowest extents of the live bone were observed in HA+ACS and control groups, respectively (P<0.05). Conclusions Within the limitations of this preliminary animal study, HA and especially HA+ACS seem a proper method for preventing or treating BRONJ.
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Aydogdu I, Karaca E, Coban G, Cay A, Guler EM, Kocyigit A, Uzun E, Aydoğdu YE, Metin H, Miçooğullari U, Ilbey YO, Keskin MZ. An investigation of the effects of amniotic fluid on experimental ischemia/reperfusion damage in rat testes. J Pediatr Urol 2021; 17:761.e1-761.e6. [PMID: 34518124 DOI: 10.1016/j.jpurol.2021.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/18/2021] [Accepted: 08/06/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Various agents have been tested as preventive treatments for ischemia/reperfusion (IR) damage. In this study, we have investigated for the first time in the literature the efficacy of injection of amniomax (AMX) into testicular parenchyma, which is a commercial medium of rat amniotic fluid, in preventing testicular IR damage related to testicular torsion. OBJECTIVE This study aims to evaluate whether or not amniomax has an effect on experimental IR damage in rat testes using biochemical and histopathological methods based on data in the literature. Even if testicular torsion is repaired surgically in early term injury because of de IR damage still occurs. Is it possible to reduce the ischemia reperfusion injury with amniotic fluid and increase the success of treatment? STUDY DESIGN 40 male Wistar albino rats were included. Four groups were formed with 10 rats in each group: Sham, Ischemia/Reperfusion (IR), injection 1 min before detorsion (AMX-BD), injection 1 min after detorsion (AMX-AD). Total Oxidant Status (TOS) and Oxidative Stress Index (OSI) were computed for oxidative stress, and Total Antioxidant Status (TAS) levels were computed for the antioxidant system, for both serum and tissue. Necrosis and microcalcification levels were assessed in the evaluation of testicular histology. P < 0.05 was considered statistically significant. RESULTS AMX-AD group has low necrosis degree than IR, Mean serum and tissue levels of TAS, TOS, and OSI parameters were respectively determined as; for TAS: 0.64 ± 0.11 and 0.96 ± 0.25 mmol Trolox Equivalent/L; for TOS: 6.71 ± 0.87 and 9.40 ± 1.03 μmol H2O2 equivalent/L; for OSI: 11.94 ± 3.74 and 10.70 ± 4.23 arbitrary unit. DISCUSSION Our study has investigated for the first time in the literature the efficacy of amniotic fluid in preventing testicular IR damage, and used amniomax (AMX) for this purpose. The limitation of our study may be the small number of rat in the groups. CONCLUSION We think an injection after detorsion is more favorable considering that the AMX-AD group demonstrated significantly lower levels of TOS in serum and tissue and OSI in serum, and significantly higher serum levels of TAS compared to the AMX-BD group, as well as the fact that the morphological protection effect was only observed for injections performed immediately after detorsion.
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Affiliation(s)
- Ibrahim Aydogdu
- Bezmialem Vakif University, School of Medicine, Department of Pediatric Surgery, Istanbul, Turkey.
| | - Erkin Karaca
- Izmir Saglik Bilimleri University, Tepecik Training and Research Hospital, Department of Urology, Izmir, Turkey.
| | - Ganime Coban
- Bezmialem Vakif University, School of Medicine, Department of Pathology, Istanbul, Turkey.
| | - Ali Cay
- Bezmialem Vakif University, School of Medicine, Department of Pediatric Surgery, Istanbul, Turkey.
| | - Eray Metin Guler
- Bezmialem Vakif University, Medical Laboratory Techniques Program, Istanbul, Turkey.
| | - Abdurrahim Kocyigit
- Bezmialem Vakif University, School of Medicine, Department of Biochemistry, Istanbul, Turkey.
| | - Ersan Uzun
- Istanbul Medeniyet University, School of Medicine, Department of Pediatric Surgery, Istanbul, Turkey.
| | | | - Hüseyin Metin
- Bezmialem Vakif University, Scgool of Medicine, Emergency Medicine, Istanbul, Turkey.
| | - Uygar Miçooğullari
- Izmir Saglik Bilimleri University, Tepecik Training and Research Hospital, Department of Urology, Izmir, Turkey.
| | - Yusuf Ozlem Ilbey
- Izmir Saglik Bilimleri University, Tepecik Training and Research Hospital, Department of Urology, Izmir, Turkey.
| | - Mehmet Zeynel Keskin
- Izmir Saglik Bilimleri University, Tepecik Training and Research Hospital, Department of Urology, Izmir, Turkey.
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Becktell L, Matuska AM, Hon S, Delco ML, Cole BJ, Begum L, Zhang S, Fortier LA. Proteomic Analysis and Cell Viability of Nine Amnion, Chorion, Umbilical Cord, and Amniotic Fluid-Derived Products. Cartilage 2021; 13:495S-507S. [PMID: 33356465 PMCID: PMC8804846 DOI: 10.1177/1947603520976767] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Amnion products are used in various musculoskeletal surgeries and as injections for joint pain with conflicting reports of cell viability and protein contents. The objective of this study was to determine the full proteome and examine cell viability in 9 commercial amnion products using an unbiased bottom-up shotgun proteomics approach and confocal microscopy. DESIGN Products were subjected to liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis and searched against a UniProt Homo sapiens database. Relative protein abundance was determined for each sample. Based on proteomics results, lumican was measured by enzyme-linked immunosorbent assay (ELISA) and Western blot analysis was performed for interleukin-1 receptor antagonist (IL-1Ra) and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2). Cell viability was determined by calcein AM (live) and ethidium homodimer (dead) staining and confocal microscopy. RESULTS Proteomic analysis revealed 919 proteins in the nine products. Proteins were primarily collagens, keratin, and albumin. Lumican, a small leucine-rich proteoglycan (SLRP) was found in all samples. Western blot analysis for IL-1Ra and TIMP-2 indicated presence of both proteins, with nonspecific antibody binding also present in all samples. No live cells were identified in any product. CONCLUSIONS Several novel proteins were identified through proteomics that might impart the beneficial effects of amnion products, including SLRPs, collagens, and regulators of fibroblast activity. IL-1Ra and TIMP-2 were identified, but concentrations measured by ELISA may be falsely increased due to nonspecific antibody binding. The concept that the amnion tissues provide live cells to aid in tissue regeneration cannot be supported by the findings of this study.
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Affiliation(s)
- Liliya Becktell
- College of Veterinary Medicine, Cornell
University, Ithaca, NY, USA
| | | | - Stephanie Hon
- College of Veterinary Medicine, Cornell
University, Ithaca, NY, USA
| | | | - Brian J. Cole
- Midwest Orthopedics at Rush, Rush
University Medical Center, Chicago, IL, USA
| | - Laila Begum
- College of Veterinary Medicine, Cornell
University, Ithaca, NY, USA
| | - Sheng Zhang
- Proteomics and Metabolomics Facility,
Institute of Biotechnology, Cornell University, Ithaca, NY, USA
| | - Lisa A. Fortier
- College of Veterinary Medicine, Cornell
University, Ithaca, NY, USA,Lisa A. Fortier, Department of Clinical
Sciences, College of Veterinary Medicine, Cornell University, 930 Campus Road,
Ithaca, NY 14853, USA.
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Wibowo H, Widiyanti P, Asmiragani S. The role of chondroitin sulfate to bone healing indicators and compressive strength. J Basic Clin Physiol Pharmacol 2021; 32:631-635. [PMID: 34214381 DOI: 10.1515/jbcpp-2020-0406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/21/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The function of bone is to protect the vital organs of the body. Mechanical strength, especially compressive strength, plays an important role in fulfilling its function. Fracture healing depends on several substances, such as collagen, glucosaminoglycane and proteoglycan. Chondroitin sulfate as part of proteoglycane is an important component in the formation of callus in fracture healing. The aim of this study is to prove chondroitin sulfate role in supporting fracture healing. METHODS The in vivo experiment has been performed to Rattus novergicus which met the inclusion criteria (age 3 months, 200-300 g weight), 18 males of R. norvegicus, Wistar strain, were divided into three equal groups of six rats each. After being anesthetized, fracturation was performed in a sterile manner to get simple fracture. The area of dissection is in half length of tibial bone and the fracture incision is about 1 cm. Then it followed by immobilization of the lower leg bone on one side with a cast. The first group was given chondroitin sulfate 7 mg in 2 mL distilled water/200 g weight for 2 weeks. The second group was given chondroitin sulfate 7 mg in 2 mL distilled water/200 g weight for 4 weeks. The third group was given distilled water. This research was focused on treatment of cartilage. The callus position is in half length of tibial bone. RESULTS There were significant differences in the increase of TGF-β, the number of osteoblasts and callus compressive strength in the groups with chondroitin sulfate treatment for 2 and 4 weeks, compared to the control group (p<0.01). CONCLUSIONS Administering chondroitin sulfate in a dose of 7 mg in 2 mL distilled water for 2 and 4 weeks may increase production of TGF-β, the osteoblast numbers and the callus compressive strength in fracture healing.
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Affiliation(s)
- Herry Wibowo
- Laboratory of Physiology, Department of Biomedical, Faculty of Medicine, Universitas Surabaya, Surabaya, Indonesia
| | - Prihartini Widiyanti
- Biomedical Engineering Study Program, Department of Physics, Faculty of Science and Technology, Universitas Airlangga, Surabaya, Indonesia.,Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Syaifullah Asmiragani
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
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Mitrani MI, Bellio MA, Sagel A, Saylor M, Kapp W, VanOsdol K, Haskell G, Stewart D, Abdullah Z, Santos I, Milberg J, Arango A, Mitrani A, Shapiro GC. Case Report: Administration of Amniotic Fluid-Derived Nanoparticles in Three Severely Ill COVID-19 Patients. Front Med (Lausanne) 2021; 8:583842. [PMID: 33816515 PMCID: PMC8010176 DOI: 10.3389/fmed.2021.583842] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 02/16/2021] [Indexed: 12/16/2022] Open
Abstract
Rationale/Objectives: A human coronavirus (HCoV-19) has caused the novel coronavirus disease (COVID-19) outbreak worldwide. There is an urgent need to develop new interventions to suppress the excessive immune response, protect alveolar function, and repair lung and systemic organ damage. Zofin (previously known as Organicell Flow) is a novel therapeutic that is derived from the soluble and nanoparticle fraction (extracellular vesicles and exosomes) of human amniotic fluid. Here within, we present the clinical outcomes after Zofin treatment in three critically ill patients suffering from severe, multi-organ complications induced by COVID-19 infection. All patients were diagnosed with COVID-19, developed respiratory failure, and were hospitalized for more than 40 days. Methods: Zofin was administered to patients concurrently with ongoing medical care who were monitored for 28-days post-therapy. SOFA score assessment, chest X-rays, and inflammatory biomarker testing was performed. Main Results: There were no adverse events associated with the therapy. The patients showed improvements in ICU clinical status and experienced respiratory improvements. Acute delirium experienced by patients completely resolved and inflammatory biomarkers improved. Conclusions: Primary outcomes demonstrate the therapy was safe, accessible, and feasible. This is the first demonstration of human amniotic fluid-derived nanoparticles as a safe and potentially efficacious therapeutic treatment for respiratory failure induced by COVID-19 infection.
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Affiliation(s)
| | - Michael A Bellio
- Organicell Regenerative Medicine, Inc., Miami, FL, United States
| | | | - Marie Saylor
- Landmark Hospital Athens, Athens, GA, United States
| | - William Kapp
- Landmark Hospital Naples, Naples, FL, United States
| | | | | | - Danique Stewart
- Organicell Regenerative Medicine, Inc., Miami, FL, United States
| | - Zanub Abdullah
- Organicell Regenerative Medicine, Inc., Miami, FL, United States
| | - Ivan Santos
- Organicell Regenerative Medicine, Inc., Miami, FL, United States
| | - Julian Milberg
- Organicell Regenerative Medicine, Inc., Miami, FL, United States
| | - Alissa Arango
- Organicell Regenerative Medicine, Inc., Miami, FL, United States
| | - Albert Mitrani
- Organicell Regenerative Medicine, Inc., Miami, FL, United States
| | - George C Shapiro
- Organicell Regenerative Medicine, Inc., Miami, FL, United States
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11
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Barrett DW, Okesola BO, Costa E, Thrasivoulou C, Becker DL, Mata A, Deprest JA, David AL, Chowdhury TT. Potential sealing and repair of human FM defects after trauma with peptide amphiphiles and Cx43 antisense. Prenat Diagn 2020; 41:89-99. [PMID: 33045764 DOI: 10.1002/pd.5826] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 08/01/2020] [Accepted: 09/04/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE We examined whether peptide amphiphiles functionalised with adhesive, migratory or regenerative sequences could be combined with amniotic fluid (AF) to form plugs that repair fetal membrane (FM) defects after trauma and co-culture with connexin 43 (Cx43) antisense. METHODS We assessed interactions between peptide amphiphiles and AF and examined the plugs in FM defects after trauma and co-culture with the Cx43antisense. RESULTS Confocal microscopy confirmed directed self-assembly of peptide amphiphiles with AF to form a plug within minutes, with good mechanical properties. SEM of the plug revealed a multi-layered, nanofibrous network that sealed the FM defect after trauma. Co-culture of the FM defect with Cx43 antisense and plug increased collagen levels but reduced GAG. Culture of the FM defect with peptide amphiphiles incorporating regenerative sequences for 5 days, increased F-actin and nuclear cell contraction, migration and polarization of collagen fibers across the FM defect when compared to control specimens with minimal repair. CONCLUSIONS Whilst the nanoarchitecture revealed promising conditions to seal iatrogenic FM defects, the peptide amphiphiles need to be designed to maximize repair mechanisms and promote structural compliance with high mechanical tolerance that maintains tissue remodeling with Cx43 antisense for future treatment.
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Affiliation(s)
- David W Barrett
- Institute of Bioengineering, School of Engineering and Materials Science, Queen Mary University of London, London, UK
| | - Babatunde O Okesola
- Institute of Bioengineering, School of Engineering and Materials Science, Queen Mary University of London, London, UK
| | - Eleni Costa
- Institute of Bioengineering, School of Engineering and Materials Science, Queen Mary University of London, London, UK
| | | | - David L Becker
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Alvaro Mata
- Institute of Bioengineering, School of Engineering and Materials Science, Queen Mary University of London, London, UK.,Biodiscovery Institute, School of Pharmacy, Department of Chemical and Environmental Engineering, University of Nottingham, Nottingham, UK
| | - Jan A Deprest
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.,Institute for Women's Health, University College London, London, UK
| | - Anna L David
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.,Institute for Women's Health, University College London, London, UK.,NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - Tina T Chowdhury
- Institute of Bioengineering, School of Engineering and Materials Science, Queen Mary University of London, London, UK
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Sarı E, Yalçınozan M, Polat B, Özkayalar H. The effects of cryopreserved human amniotic membrane on fracture healing: Animal study. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2019; 53:485-489. [PMID: 31526574 PMCID: PMC6939026 DOI: 10.1016/j.aott.2019.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/29/2019] [Accepted: 08/22/2019] [Indexed: 01/01/2023]
Abstract
Objective The aim of this study was to investigate the effects of human amniotic membrane (HAM) on fracture healing in an animal model. Methods Standard tibial diaphysial fractures were created in twenty-eight Wistar-Albino rats and treated with intramedullary Kirschner wire (K-wire) and HAM (HAM (+) group) or K-wire only (HAM (–) group). Fracture healing was evaluated by histological analysis, radiologic X-ray views and callus diameter measurements at 3rd and 6th weeks postoperatively. Results Fracture healing was histologically better in the HAM (+) group and the difference was statistically significant at both 3rd and 6th weeks postoperatively (p < 0.05). The highest histologic scores and entire woven bone formation (Huo Stage 8–9) were obtained at 6th weeks postoperatively in the HAM (+) group. Histological examination also revealed predominant fibrous tissue and partial cartilage formation (Huo Stage 2) at the postoperative 3rd week in the HAM (-) group. Equal amounts of woven bone and cartilage formation (Huo Stage 6–7) were observed at 3rd weeks postoperatively in the HAM (+) group and at 6th weeks postoperatively in the HAM (-) group. The callus diameters were greater in the HAM (+) group and the difference was statistically significant (p < 0.05) at 3rd and 6th weeks postoperatively. Although there was only a statistically significant difference (p < 0.05) at the postoperative 3rd week, radiological scores tended to be higher in the HAM (+) group at both the 3rd and 6th weeks postoperatively. Conclusion HAM is a cheap and easily accessible alternative biological material. HAM may be used to support surgical treatment of fractures, particularly where bone healing is expected to last longer.
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Panero AJ, Hirahara AM, Andersen WJ, Rothenberg J, Fierro F. Are Amniotic Fluid Products Stem Cell Therapies? A Study of Amniotic Fluid Preparations for Mesenchymal Stem Cells With Bone Marrow Comparison. Am J Sports Med 2019; 47:1230-1235. [PMID: 30844295 DOI: 10.1177/0363546519829034] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND In vivo amniotic fluid is known to contain a population of mesenchymal stem cells (MSCs) and growth factors and has been shown to assist in healing when used as an adjunct in procedures across multiple medical specialties. It is unclear whether amniotic fluid products (AFPs) contain MSCs and, if so, whether the cells remain viable after processing. PURPOSE To determine whether MSCs, growth factors, and hyaluronan are present in commercially available AFPs. STUDY DESIGN Descriptive laboratory study. METHODS Seven commercial companies that provide amniotic fluid were invited to participate in the study; 3 companies (the manufacturers of PalinGen, FloGraft, and Genesis AFPs) agreed to participate and donated AFPs for analysis. The AFPs were evaluated for the presence of MSCs, various growth factors relevant to orthopaedics (platelet-derived growth factor ββ, vascular endothelial growth factor, interleukin 8, bone morphogenetic protein 2, transforming growth factor β1), and hyaluronan by enzyme-linked immunosorbent assay and culture of fibroblast colony-forming units. These products were compared with unprocessed amniotic fluid and 2 separate samples of MSCs derived from human bone marrow aspirates. All groups used the same culture medium and expansion techniques. Identical testing and analysis procedures were used for all samples. RESULTS MSCs could not be identified in the commercial AFPs or the unprocessed amniotic fluid. MSCs could be cultured from the bone marrow aspirates. Nucleated cells were found in 2 products (PalinGen and FloGraft), but most of these cells were dead. The few living cells did not exhibit established characteristics of MSCs. Growth factors and hyaluronan were present in all groups at varying levels. CONCLUSION The AFPs studied should not be considered "stem cell" therapies, and researchers should use caution when evaluating commercial claims that products contain stem cells. Given their growth factor content, however, AFPs may still represent a promising tool for orthopaedic treatment. CLINICAL RELEVANCE Amniotic fluid has been proposed as an allogenic means for introducing MSCs. This study was unable to confirm that commercial AFPs contain MSCs.
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Affiliation(s)
| | | | | | - Joshua Rothenberg
- Regenerative Medicine and Orthopedic Biologics, Boca Raton Hospital, BocaCare Orthopedics, Deerfield Beach, Florida, USA
| | - Fernando Fierro
- University of California, Davis, Stem Cell Program, Davis, California, USA
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Zieba J, Walczak M, Gordiienko O, Gerstenhaber JA, Smith GM, Krynska B. Altered Amniotic Fluid Levels of Hyaluronic Acid in Fetal Rats with Myelomeningocele: Understanding Spinal Cord Injury. J Neurotrauma 2018; 36:1965-1973. [PMID: 30284959 DOI: 10.1089/neu.2018.5894] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Myelomeningocele (MMC) is a devastating congenital neural tube defect that results in the exposure of spinal cord to the intrauterine environment, leading to secondary spinal cord injury and severe impairment. Although the mechanisms underlying the secondary pathogenesis are clinically relevant, the exact cause of in utero-acquired spinal cord damage remains unclear. The objective of this study was to determine whether the hyaluronic acid (HA) concentration in amniotic fluid (AF) in the retinoic acid-induced model of MMC is different from that in normal controls and whether these differences could have an impact on the viscosity of AF. Our data shows that the concentration of HA in AF samples from fetuses with MMC (MMC-AF) and normal control samples (Norm-AF) were not significantly different at embryonic day 18 (E18) and E20. Thereafter, the HA concentration significantly increased in Norm-AF but not in MMC-AF. Compared with Norm-AF, the concentration of HA in MMC-AF and the viscosity of MMC-AF were significantly lower at E21. Agarose gel electrophoresis confirmed a significant reduction in the HA level of MMC-AF compared with Norm-AF at E21. No HA-degrading activity was detected in MMC-AF. In summary, we identified a deficiency in the AF level of HA and the viscosity of AF in fetal rats with MMC. These data are discussed in relation to a potential role the reduction in the AF viscosity due to the low level of HA may play in the exacerbating effects of mechanical trauma on spinal cord damage at the MMC lesion site.
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Affiliation(s)
- Jolanta Zieba
- 1 Shriners Hospitals Pediatric Research Center, Center for Neural Repair and Rehabilitation, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Maciej Walczak
- 1 Shriners Hospitals Pediatric Research Center, Center for Neural Repair and Rehabilitation, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Oleg Gordiienko
- 1 Shriners Hospitals Pediatric Research Center, Center for Neural Repair and Rehabilitation, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Jonathan A Gerstenhaber
- 2 Department of Bioengineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
| | - George M Smith
- 1 Shriners Hospitals Pediatric Research Center, Center for Neural Repair and Rehabilitation, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Barbara Krynska
- 1 Shriners Hospitals Pediatric Research Center, Center for Neural Repair and Rehabilitation, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
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Ghalei S, Nourmohammadi J, Solouk A, Mirzadeh H. Enhanced cellular response elicited by addition of amniotic fluid to alginate hydrogel-electrospun silk fibroin fibers for potential wound dressing application. Colloids Surf B Biointerfaces 2018; 172:82-89. [PMID: 30138790 DOI: 10.1016/j.colsurfb.2018.08.028] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 08/01/2018] [Accepted: 08/14/2018] [Indexed: 01/10/2023]
Abstract
This study aimed to evaluate a novel bioactive wound dressing from alginate hydrogel-electrospun silk fibroin (SF) fibers with the ability to deliver amniotic fluid (AF) to the wound site. AF is highly enriched with multiple therapeutic agents that can promote cellular response and wound healing. In this study, electrospun SF fibers were first fabricated by electrospinning method and then combined with the alginate hydrogel (ALG) containing AF. Different dressings were made by changing the alginate to AF ratio. The scanning electron microscopy images revealed that SF fibers were fully covered with alginate hydrogel. In addition, the modulus of the dressing decreased by lowering ALG/AF ratios, while a reverse trend was observed for the elongation-at-break. In vitro AF release profiles indicated that an increase in the concentration of ALG leads to a reduction in the AF amount. Fibroblast culturing on the fabricated dressings demonstrated that cellular proliferation, spreading, and secretion of collagen enhanced with increasing AF. Taken together, our results provide a novel bioactive dressing with great potentials for speeding up the healing process in severe wounds.
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Affiliation(s)
- Sama Ghalei
- Faculty of New Sciences and Technologies, Department of Life Science Engineering, University of Tehran, Tehran, Iran
| | - Jhamak Nourmohammadi
- Faculty of New Sciences and Technologies, Department of Life Science Engineering, University of Tehran, Tehran, Iran.
| | - Atefeh Solouk
- Biomedical Engineering Faculty, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Hamid Mirzadeh
- Polymer Engineering Faculty, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
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Placenta and Placental Derivatives in Regenerative Therapies: Experimental Studies, History, and Prospects. Stem Cells Int 2018. [PMID: 29535770 PMCID: PMC5822788 DOI: 10.1155/2018/4837930] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Placental structures, capable to persist in a genetically foreign organism, are a natural model of allogeneic engraftment carrying a number of distinctive properties. In this review, the main features of the placenta and its derivatives such as structure, cellular composition, immunological and endocrine aspects, and the ability to invasion and deportation are discussed. These features are considered from a perspective that determines the placental material as a unique source for regenerative cell therapies and a lesson for immunological tolerance. A historical overview of clinical applications of placental extracts, cells, and tissue components is described. Empirically accumulated data are summarized and compared with modern research. Furthermore, we define scopes and outlooks of application of placental cells and tissues in the rapidly progressing field of regenerative medicine.
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Yeoh JC, Taylor BA. Osseous Healing in Foot and Ankle Surgery with Autograft, Allograft, and Other Orthobiologics. Orthop Clin North Am 2017; 48:359-369. [PMID: 28577785 DOI: 10.1016/j.ocl.2017.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In the surgical treatment of foot and ankle abnormality, many problems require bone grafting for successful osseous union. Nonunion, reconstruction, and arthrodesis procedures pose specific challenges due to bony defects secondary to trauma, malunions, or previous surgery. Nonunion in foot and ankle arthrodesis is a significant risk and is well documented in recent literature. This article is a review of the recent literature regarding the use of bone graft and orthobiologics in foot and ankle surgery.
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Affiliation(s)
- Jane C Yeoh
- Campbell Clinic Foot & Ankle Department, 1400 South Germantown Road, Germantown, TN 38138, USA
| | - Brandon A Taylor
- Campbell Clinic Foot & Ankle Department, 1400 South Germantown Road, Germantown, TN 38138, USA.
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18
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Bone Healing Improvements Using Hyaluronic Acid and Hydroxyapatite/Beta-Tricalcium Phosphate in Combination: An Animal Study. BIOMED RESEARCH INTERNATIONAL 2016; 2016:8301624. [PMID: 28070520 PMCID: PMC5192297 DOI: 10.1155/2016/8301624] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 11/23/2016] [Indexed: 12/20/2022]
Abstract
The purpose of this study was to investigate whether the use of HLA as an aqueous binder of hydroxyapatite/beta-tricalcium phosphate (HA-βTCP) particles can reduce the amount of bone graft needed and increase ease of handling in clinical situations. In this study, HA/βTCP was loaded in commercially available crosslinking HLA to form a novel HLA/HA-βTCP composite. Six New Zealand White rabbits (3.0-3.6 kg) were used as test subjects. Four 6 mm defects were prepared in the parietal bone. The defects were filled with the HLA/HA-βTCP composite as well as HA-βTCP particle alone. New bone formation was analyzed by micro-CT and histomorphometry. Our results indicated that even when the HA-βTCP particle numbers were reduced, the regenerative effect on bone remained when the HLA existed. The bone volume density (BV/TV ratio) of HLA/HA-βTCP samples was 1.7 times larger than that of the control sample at week 2. The new bone increasing ratio (NBIR) of HLA/HA-βTCP samples was 1.78 times higher than the control group at week 2. In conclusion, HA-βTCP powder with HLA contributed to bone healing in rabbit calvarial bone defects. The addition of HLA to bone grafts not only promoted osteoconduction but also improved handling characteristics in clinical situations.
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Interpositional Arthroplasty Technique for Hallux Rigidus Using Amniotic Membrane and Regenerative Tissue Matrix. TECHNIQUES IN FOOT & ANKLE SURGERY 2016. [DOI: 10.1097/btf.0000000000000134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pierce J, Jacobson P, Benedetti E, Peterson E, Phibbs J, Preslar A, Reems JA. Collection and characterization of amniotic fluid from scheduled C-section deliveries. Cell Tissue Bank 2016; 17:413-25. [PMID: 27460879 DOI: 10.1007/s10561-016-9572-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 07/15/2016] [Indexed: 02/06/2023]
Abstract
Amniotic fluid (AF) possesses anti-inflammatory, anti-microbial and regenerative properties that make it attractive for use in clinical applications. The goals of this study were to assess the feasibility of collecting AF from full-term pregnancies and to evaluate non-cellular and cellular properties of AF for clinical applications. Donor informed consent and medical histories were obtained from pregnant women scheduled for C-sections and infectious disease testing was performed the day of collection. AFs were evaluated for total volume, fluid chemistries, total protein, and hyaluronic acid (HA) levels. AF was also assessed with quantitative antibody arrays, cellular content and for an ability to support angiogenesis. Thirty-six pregnant women consented and passed donor screening to give birth tissue. AF was successfully collected from 17 individuals. Median AF volumes were 70 mL (range 10-815 mL; n = 17). Fluid chemistries were similar, but some differences were noted in HA levels and cytokine profiles. Cytokine arrays revealed that an average of 304 ± 20 of 400 proteins tested were present in AF with a majority of cytokines associated with host defense. AF supported angiogenesis. Epithelioid cells were the major cell type in AF with only a minor population of lymphoid cells. Cultures revealed a highly proliferative population of adherent cells capable of producing therapeutic doses of mesenchymal stromal cells (MSCs). These findings showed that significant volumes of AF were routinely collected from full-term births. AF contained a number of bioactive proteins and only a rare population of MSCs. Variations noted in components present in different AFs, warrant further investigations to determine their relevance for specific clinical applications.
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Affiliation(s)
- Jan Pierce
- Cell Therapy and Regenerative Medicine Facility, University of Utah, 676 Arapeen Drive, Suite 300, Salt Lake City, UT, 84108, USA
| | - Pam Jacobson
- Cell Therapy and Regenerative Medicine Facility, University of Utah, 676 Arapeen Drive, Suite 300, Salt Lake City, UT, 84108, USA
| | - Eric Benedetti
- Cell Therapy and Regenerative Medicine Facility, University of Utah, 676 Arapeen Drive, Suite 300, Salt Lake City, UT, 84108, USA
| | - Emily Peterson
- Cell Therapy and Regenerative Medicine Facility, University of Utah, 676 Arapeen Drive, Suite 300, Salt Lake City, UT, 84108, USA
| | - Jessica Phibbs
- Cell Therapy and Regenerative Medicine Facility, University of Utah, 676 Arapeen Drive, Suite 300, Salt Lake City, UT, 84108, USA
| | - Amber Preslar
- Cell Therapy and Regenerative Medicine Facility, University of Utah, 676 Arapeen Drive, Suite 300, Salt Lake City, UT, 84108, USA
| | - Jo-Anna Reems
- Cell Therapy and Regenerative Medicine Facility, University of Utah, 676 Arapeen Drive, Suite 300, Salt Lake City, UT, 84108, USA. .,Division of Hematology and Hematologic Malignancies, University of Utah, Salt Lake City, UT, USA.
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Nunley PD, Kerr EJ, Utter PA, Cavanaugh DA, Frank KA, Moody D, McManus B, Stone MB. Preliminary Results of Bioactive Amniotic Suspension with Allograft for Achieving One and Two-Level Lumbar Interbody Fusion. Int J Spine Surg 2016; 10:12. [PMID: 27162714 DOI: 10.14444/3012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Bone graft material for lumbar fusion was historically autologous bone graft (ABG). In recent years alternatives such as allograft, demineralized bone matrix (DBM), ceramics, and bone morphogenetic protein (BMP) have gained favor, although the complications of these are not fully understood. Bioactive amniotic suspension (BAS) with allograft is a new class of material derived from human amniotic tissue. METHODS Eligible patients receiving a one or two level lumbar interbody fusion with Nucel, a BAS with allograft, were contacted and scheduled for a mininmim 12 month follow-up visit. Patients were evaluated for fusion using CT's and plain radiographs. Clincal outcomes, including ODI, VAS back and leg were collected, as well as comorbidities including BMI, smoking status, diabetes and previous lumbar surgery. RESULTS One-level patients (N=38) were 71.1% female with mean age of 58.4 ± 12.7 and mean BMI of 30.6 ± 6.08. Two-level patients (N=34) were 58.8% female with mean age of 49.3 ±10.9 and mean BMI of 30.1 ± 5.82. Kinematic fusion was achieved in 97.4% of one-level patients and 100% of two-level patients. Baseline comorbidities were present in 89.5% of one-level patients and 88.2% of two-level patients. No adverse events related to BAS were reported in this study. CONCLUSION Fusion status is evaluated with many different biologics and varying methods in the literature. BAS with allograft in this study demonstrated high fusion rates with no complications within a largely comorbid population. Although a small population, BAS with allograft results were encouraging for one and two-level lumbar interbody fusion in this study. Further prospective studies should be conducted to investigate safety and efficacy in a larger population.
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Affiliation(s)
| | - Eubulus J Kerr
- Spine Institute of Louisiana, Shreveport, Louisiana, USA
| | - Philip A Utter
- Spine Institute of Louisiana, Shreveport, Louisiana, USA
| | | | - Kelly A Frank
- Spine Institute of Louisiana, Shreveport, Louisiana, USA
| | - Devan Moody
- Spine Institute of Louisiana, Shreveport, Louisiana, USA
| | - Brian McManus
- Spine Institute of Louisiana, Shreveport, Louisiana, USA
| | - Marcus B Stone
- Spine Institute of Louisiana, Shreveport, Louisiana, USA
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Evaluation of Amniotic Multipotential Tissue Matrix to Augment Healing of Demineralized Bone Matrix in an Animal Calvarial Model. J Craniofac Surg 2016; 26:1408-12. [PMID: 26080207 DOI: 10.1097/scs.0000000000001741] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Amniotic multipotential tissue matrix (AmnioMTM) is a membrane material derived from placental tissues and rich in growth factors that have been reported to have potential in healing bone. This study hypothesized that demineralized bone matrix (DBM) supplemented with AmnioMTM would accelerate healing and bone formation as compared with DBM alone in a critical size (10 mm) rat calvarial bone defect model. Five DBM grafts and 5 DBM supplemented with AmnioMTM grafts were implanted in a 10-mm critical sized defect in 10 rats (1 implant per rat). After 4 weeks, animals were euthanized and defects evaluated by microCT and histology. There were no statistical differences in microCT data for mineral density, percent bone fill, or bone surface to volume ratios between groups, though the bone surface to volume ratio for the amnio-supplemented group suggested increased osteoid activity as compared with the DBM alone group. Histological data also indicated active osteoid activity and induced bone formation in the center of defects implanted with AmnioMTM supplemented graft as compared with DBM graft alone suggesting some potential osteoinductive potential. However, there was no significant difference at the mean percent of newly mineralized bone in the DBM group defect as compared with the AmnioMTM supplemented graft material. These data suggest that while bone formation was not increased at this early time point, the increased osteoid activity and the induction of new bone in the middle of the defect by the AmnioMTM indicates that further study is needed to assess its potential benefit to bone healing and regeneration.
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Abstract
UNLABELLED Fetal tissues are well known for their therapeutic potential. They contain numerous growth factors, cytokines, and matrix components that promote regeneration of tissues while downregulating inflammation and scar formation. As a result, use of these treatments has expanded over the previous 20 years throughout various surgical specialties, including orthopaedics. With improved methods of sterilization, processing, and storage, surgeons need to be informed about the potential benefits of fetal tissue in foot and ankle surgery. The aim of this review is to provide a brief historical background, basic anatomy and physiology, and a current review of the literature in regard to chronic wounds, diabetic foot ulcerations, plantar fasciitis, tendon repair, adhesion prevention, nerve repair, and bone healing. LEVELS OF EVIDENCE Level V: Expert Opinion.
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Affiliation(s)
- Andrew E Hanselman
- Department of Orthopaedics, West Virginia University, Morgantown, West Virginia (AEH, TAJL, RDS)
| | - Trapper A J Lalli
- Department of Orthopaedics, West Virginia University, Morgantown, West Virginia (AEH, TAJL, RDS)
| | - Robert D Santrock
- Department of Orthopaedics, West Virginia University, Morgantown, West Virginia (AEH, TAJL, RDS)
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The effects of human amniotic fluid and different bone grafts on vertebral fusion in an experimental rat model. Curr Ther Res Clin Exp 2015; 77:35-9. [PMID: 25737745 PMCID: PMC4339529 DOI: 10.1016/j.curtheres.2015.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2015] [Indexed: 12/04/2022] Open
Abstract
Objective The high risk of nonunion represents a challenge in vertebral surgery, thus stimulating new strategies to improve fusion rates. We investigated the effect of 2 different bone grafts and amniotic fluid application on radiologically and histologically evaluated vertebral fusion in an experimental rat model. Materials and methods Forty-eight 24-week-old Sprague Dawley rats were included and assigned into 1 of 4 groups: allograft group, allograft plus human amniotic fluid group, demineralized bone matrix (DBM) group, or DBM plus human amniotic fluid group. After decortication and L4–L6 spinal fusion, study treatments were applied. Fusion in each rat was examined radiologically and histologically 8 weeks after the intervention. Results The group that received only allograft had better radiologic scores (median = 3.5; range = 3–4) when compared with the group that received only DBM (median = 2; range = 1–4) (P = 0.002); however, histologic scores did not differ. When amniotic fluid was added to the grafting, allograft-based treatments performed better than DBM-based treatments both on radiologic (median = 4; range = 3–4 vs median = 3; range = 3–4; P = 0.003) and histologic (median = 7; range = 6–7 vs median = 5; range = 3–6; P < 0.001) evaluation. Addition of amniotic fluid did not result in better outcomes in the rats that received DBM-based treatments but based on histologic evaluation, rats that received allograft-based treatments benefited from this application. Conclusions Amniotic fluid seems to have an enhancing effect on posterior spinal fusion, particularly when combined with allograft.
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25
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The effect of human amniotic fluid on mandibular distraction osteogenesis. Int J Oral Maxillofac Surg 2015; 44:404-11. [DOI: 10.1016/j.ijom.2014.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Revised: 08/05/2014] [Accepted: 10/03/2014] [Indexed: 12/19/2022]
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26
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Lee SG, Lee SD, Kim MK, Ryu WS, Jung SP, Kim S, Kim HY, Yoon ES, Kim CH, Nam SJ, Bae JW. Effect of Antiadhesion Barrier Solution and Fibrin on Capsular Formation After Silicone Implant Insertion in a White Rat Model. Aesthetic Plast Surg 2015; 39:162-70. [PMID: 25516275 DOI: 10.1007/s00266-014-0436-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 11/16/2014] [Indexed: 01/23/2023]
Abstract
INTRODUCTION One of the most serious complications of breast reconstruction and augmentation using silicone implants is capsular contracture. Several preventive treatments, including vitamin E, steroids, antibiotics, and cysteinyl leukotriene inhibitors, have been studied, and their clinical effects have been reported. However, the problem of capsular contracture has not yet been completely resolved. This study was performed to compare anti-adhesion barrier solution (AABS) and fibrin in their ability to prevent fibrotic capsule formation and simultaneously evaluated their effect when used in combination by capsular thickness analysis and quantitative analysis of matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs), and type I collagen within the fibrous capsule. MATERIALS AND METHODS This study used female six-week-old Sprague-Dawley rats. Eighty rats were equally subdivided into the four following groups: AABS-treated, fibrin-treated, AABS and fibrin combined-treated, and untreated control groups. Each rat received two silicone chips under the panniculus carnosus muscle layer. The test materials were applied around the silicon chips. Four weeks later, the implantation sites including the skin and muscle were excised to avoid the risk of losing the fibrous capsule around the implants. The capsular thickness was analyzed by Masson's trichrome stain. Quantitative analysis of type I collagen, MMPs, and TIMPs was performed by real-time PCR, Western blot, and zymography. RESULTS The mean capsular thickness was 668.10 ± 275.12 μm in the control group, 356.97 ± 112.11 μm in the AABS-treated group, 525.96 ± 130.97 μm in the fibrin-treated group, and 389.24 ± 130.51 μm in the AABS and fibrin combined-treated group. Capsular thickness was significantly decreased in all experimental groups (p < 0.05). Capsular thickness was greater in the fibrin-treated group than in the AABS-treated group (p < 0.05). There was no statistically significant difference in capsular thickness between the AABS and fibrin combined-treated group and the AABS- or fibrin-treated group (p > 0.05). Compared to the control group, the experimental groups had significantly lower expressions of type I collagen and MMP-1 (p < 0.05), but there was no statistically significant difference in expressions of type I collagen and MMP-1 between the AABS-, fibrin-, and AABS and fibrin combined-treated groups (p > 0.05). The expressions of MMP-2 and TIMP-2 were not significantly different between the control and the experimental groups (p > 0.05). CONCLUSION AABS is more effective in reducing capsular thickness compared with fibrin treatment in a white rat model.
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The use of temporalis muscle graft, fresh and cryopreserved amniotic membrane in preventing temporomandibular joint ankylosis after discectomy in rabbits. J Craniomaxillofac Surg 2014; 42:1868-76. [PMID: 25218148 DOI: 10.1016/j.jcms.2014.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 07/24/2014] [Accepted: 07/24/2014] [Indexed: 12/29/2022] Open
Abstract
PURPOSE The aim of the study was to evaluate the efficacy of temporalis muscle-fascia graft, fresh and cryopreserved human amniotic membrane as an interpositional material in preventing temporomandibular joint ankylosis in a rabbit model. MATERIALS AND METHODS In this experimental study, 21 New Zealand white rabbits were used. The condyle and the joint disc were removed to induce ankylosis in left TMJs. Reconstruction was immediately performed with temporalis muscle-fascia graft (tMFG) in group I (n = 7), fresh human amniotic membrane (fHAM) in group II (n = 7) and cryopreserved human amniotic membrane (cHAM) in group III (n = 7). All rabbits were sacrificed at 3 months after the operation. The comparison was made among three groups by means of vertical mouth opening and weight measurements, radiologic and histologic findings obtained before and after surgery. RESULTS In all rabbits, there was no statistically significant difference in the jaw movements and weight among groups at commencement and 3 months after surgery. The condylar surfaces were more irregular in HAM groups. There were mild osteophyte formations, sclerosis, fibrosis and calcification around the condyle in all groups however the joint gap was more preserved in group I. All interpositional materials were also seen to be partially present in the joint gap at 3 months. Ankylosis was not seen in the joint gap in any group. CONCLUSION With the results of this study it was concluded that interpositional arthroplasty with HAM and tMFG have an almost similar effect in preventing TMJ ankylosis after discectomy in the rabbit model.
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Bazrafshan A, Owji M, Yazdani M, Varedi M. Activation of mitosis and angiogenesis in diabetes-impaired wound healing by processed human amniotic fluid. J Surg Res 2014; 188:545-52. [DOI: 10.1016/j.jss.2014.01.041] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 12/12/2013] [Accepted: 01/24/2014] [Indexed: 01/13/2023]
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Nyman E, Huss F, Nyman T, Junker J, Kratz G. Hyaluronic acid, an important factor in the wound healing properties of amniotic fluid: in vitro studies of re-epithelialisation in human skin wounds. J Plast Surg Hand Surg 2013; 47:89-92. [PMID: 23356944 DOI: 10.3109/2000656x.2012.733169] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Foetal wounds are unique in their ability to heal rapidly without forming scars. The amniotic fluid, rich in nutrients, growth factors, and hyaluronic acid, surrounds the foetus and is essential to foetal wound healing. The wound healing properties of foetal wounds may be the result of high concentrations of hyaluronic acid. This study aimed to verify that amniotic fluid induces re-epithelialisation in human skin wounds in vitro and to study whether this ability is dependent on hyaluronic acid. Standard deep dermal wounds were produced in vitro in human skin. The skin samples, with a central wound, were incubated in different culture media. Varying concentrations of amniotic fluid and amniotic fluid with added hyaluronidase were tested, and re-epithelialisation was assessed at 3, 7, and 12 days using light microscopy, after staining with haematoxylin and eosin. Amniotic fluid 50% resulted in a significantly higher (p < 0.05) grade of re-epithelialisation than Dulbecco's modified Eagle's medium and 10% amniotic fluid at all time points. When 50% amniotic fluid was compared with 10% foetal calf serum, no significant difference was found in grades of re-epithelialisation on days 3 and 12 and significantly higher grades of re-epithelialisation on day 7 (p < 0.05). Degradation of hyaluronic acid in the medium that contained 50% amniotic fluid gave significantly impaired re-epithelialisation (p < 0.05) on culture days 3 and 7. In conclusion, amniotic fluid promotes accelerated re-epithelialisation and hyaluronic acid is an important ingredient.
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Affiliation(s)
- Erika Nyman
- Laboratory for Experimental Plastic Surgery, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, University of Linköping, Linköping, Sweden.
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Guilherme MR, Reis AV, Alves BR, Kunita MH, Rubira AF, Tambourgi EB. Smart hollow microspheres of chondroitin sulfate conjugates and magnetite nanoparticles for magnetic vector. J Colloid Interface Sci 2010; 352:107-13. [DOI: 10.1016/j.jcis.2010.08.051] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Revised: 08/13/2010] [Accepted: 08/17/2010] [Indexed: 11/17/2022]
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Chrissouli S, Pratsinis H, Velissariou V, Anastasiou A, Kletsas D. Human amniotic fluid stimulates the proliferation of human fetal and adult skin fibroblasts: The roles of bFGF and PDGF and of the ERK and Akt signaling pathways. Wound Repair Regen 2010; 18:643-54. [DOI: 10.1111/j.1524-475x.2010.00626.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kerimoğlu S, Livaoğlu M, Sönmez B, Yuluğ E, Aynacı O, Topbas M, Yarar S. Effects of Human Amniotic Fluid on Fracture Healing in Rat Tibia. J Surg Res 2009; 152:281-7. [DOI: 10.1016/j.jss.2008.02.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2007] [Revised: 01/24/2008] [Accepted: 02/12/2008] [Indexed: 11/26/2022]
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Reis AV, Guilherme MR, Mattoso LHC, Rubira AF, Tambourgi EB, Muniz EC. Nanometer- and Submicrometer-Sized Hollow Spheres of Chondroitin Sulfate as a Potential Formulation Strategy for Anti-inflammatory Encapsulation. Pharm Res 2008; 26:438-44. [DOI: 10.1007/s11095-008-9732-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Accepted: 09/19/2008] [Indexed: 11/24/2022]
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