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Mittal A, Kumar N. A new, bioactive, antibacterial-eluting, composite graft for infection-free wound healing. Wound Repair Regen 2015; 22:527-36. [PMID: 24899130 DOI: 10.1111/wrr.12194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 04/01/2014] [Indexed: 11/28/2022]
Abstract
The current work focuses on the in vivo performance of a newly developed injectable composite graft in infected full-thickness wounds. The composite graft was composed of bioactive porous Poly dl-lactide-co-glycolide scaffolds, antibiotic gentamicin, and crosslinked gelatin as carrier gel. Treated infected wounds exhibited a faster wound closure, rapid weight gain, lower neutrophil count, higher breaking strength, and 100 times lesser microbial count (10(2) colony forming units/g in infected treated vs. 10(4) colony forming units/g in infected control group) in comparison with infected control group 28 days post treatment. During healing, collagen production was more in the treated groups at day 7 than controls and thereafter gradually reduced to normal levels. Histology revealed a mature scar tissue formation, fibroblast proliferation, epidermal resurfacing, and collagen deposition in reticular alignment similar to normal healthy skin in treated wounds. Further, the plasma concentration of gentamicin was 35-45 μg/mL during the initial 12 hours and reduced to 1 μg/mL in 24 hours, which indicated safe levels of the antibiotic drug during healing. These results clearly indicate a faster, infection-free, and safe after treatment with the developed graft.
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Affiliation(s)
- Anupama Mittal
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), SAS Nagar, India
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Marcos-Garcés V, Molina Aguilar P, Bea Serrano C, García Bustos V, Benavent Seguí J, Ferrández Izquierdo A, Ruiz-Saurí A. Age-related dermal collagen changes during development, maturation and ageing - a morphometric and comparative study. J Anat 2014; 225:98-108. [PMID: 24754576 DOI: 10.1111/joa.12186] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2014] [Indexed: 12/16/2022] Open
Abstract
The tissue organisation of dermal collagen is gaining importance as a contributing factor both in development and ageing, as well as in skin maturation processes. In this work we aim to study different representative parameters of this structural organisation in 45 human skin samples of assorted ages, by means of image analysis. The variation of these parameters on the basis of age was assessed using several regression models (linear, quadratic and cubic). The area occupied by collagen was significantly reduced as a function of age in the papillary dermis (R(2) = 0.437, P < 0.0001), as well as the thickness of the collagen bundles (R(2) = 0.461, P < 0.0001), following statistical models of cubic and quadratic regression, respectively. The width of the papillary dermis increased in a significant manner over a linear regression model (R(2) = 0.26, P < 0.0001). In the reticular dermis, the cubic regression indicated a significant decline (R(2) = 0.392, P = 0.002) of the area filled with collagen according to the age. Both collagen thickness and bundle orientation parameters fit a quadratic regression over the age in a significant way (R(2) = 0.433 and R(2) = 0.334, respectively, both P < 0.0001). The width of the reticular dermis followed also a significant quadratic distribution according to age (R(2) = 0.193, P = 0.011). These parameters could partially explain the lifelong functional changes taking place in the skin and propose a baseline providing a useful entry point for future investigation.
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Affiliation(s)
- V Marcos-Garcés
- Department of Pathology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain
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Khairy P, Guerra PG, Rivard L, Tanguay JF, Landry E, Guertin MC, Macle L, Thibault B, Tardif JC, Talajic M, Roy D, Dubuc M. Enlargement of Catheter Ablation Lesions in Infant Hearts With Cryothermal Versus Radiofrequency Energy. Circ Arrhythm Electrophysiol 2011; 4:211-7. [DOI: 10.1161/circep.110.958082] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Paul Khairy
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Peter G. Guerra
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Lena Rivard
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Jean-François Tanguay
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Evelyn Landry
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Marie-Claude Guertin
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Laurent Macle
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Bernard Thibault
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Jean-Claude Tardif
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Mario Talajic
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Denis Roy
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Marc Dubuc
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
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Carter R, Jain K, Sykes V, Lanning D. Differential Expression of Procollagen Genes Between Mid- and Late-Gestational Fetal Fibroblasts. J Surg Res 2009; 156:90-4. [DOI: 10.1016/j.jss.2009.03.056] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Revised: 03/10/2009] [Accepted: 03/22/2009] [Indexed: 11/30/2022]
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Cuttle L, Nataatmadja M, Fraser JF, Kempf M, Kimble RM, Hayes MT. Collagen in the scarless fetal skin wound: Detection with Picrosirius-polarization. Wound Repair Regen 2005; 13:198-204. [PMID: 15828945 DOI: 10.1111/j.1067-1927.2005.130211.x] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Our group has developed an ovine model of deep dermal, partial-thickness burn where the fetus heals scarlessly and the lamb heals with scar. The comparison of collagen structure between these two different mechanisms of healing may elucidate the process of scarless wound healing. Picrosirius staining followed by polarized light microscopy was used to visualize collagen fibers, with digital capture and analysis. Collagen deposition increased with fetal age and the fibers became thicker, changing from green (type III collagen) to yellow/red (type I collagen). The ratio of type III collagen to type I was high in the fetus (166), whereas the lamb had a much lower ratio (0.2). After burn, the ratios of type III to type I collagen did not differ from those in control skin for either fetus or lamb. The fetal tissue maintained normal tissue architecture after burn while the lamb tissue showed irregular collagen organization. In conclusion, the type or amount of collagen does not alter significantly after injury. Tissue architecture differed between fetal and lamb tissue, suggesting that scar development is related to collagen cross-linking or arrangement. This study indicates that healing in the scarless fetal wound is representative of the normal fetal growth pattern, rather than a "response" to burn injury.
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Affiliation(s)
- Leila Cuttle
- Department of Paediatrics and Child Health, University of Queensland, Royal Children's Hospital, Queensland, Australia.
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Khurana JS, Ogino S, Shen T, Parekh H, Scherbel U, Delong W, Feldman MD, Zhang PJ, Wolfe HJ, Alman BA. Bone Morphogenetic Proteins Are Expressed by Both Bone-Forming and Non-Bone-Forming Lesions. Arch Pathol Lab Med 2004; 128:1267-1269. [PMID: 15506826 DOI: 10.5858/2004-128-1267-bmpaeb] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.-Bone morphogenetic proteins (BMPs) are thought to be responsible for bone formation; they cause bone to form in soft tissues and are clinically used in helping fracture union or tumor reconstructions. Skeletal metastases from epithelial tumors may be either bone-forming (blastic) or non-bone-forming (lytic).Objective.-We studied the expression of BMPs in a variety of primary and secondary lesions of bone (both bone-forming and non-bone-forming) to determine if there was a consistent relationship between bone formation and BMP expression.Design.-We compared a bone-forming lesion (fibrous dysplasia) with a non-bone-forming lesion (desmoid tumor), using reverse transcription-polymerase chain reaction, Northern blot analysis, and immunohistochemistry to detect BMPs. We also studied a number of non-bone-forming secondary lesions (carcinomas that formed lytic metastases to the skeleton) and found BMP production in most of these tumors.Results.-We found that BMPs were expressed in both bone-forming and non-bone-forming benign musculoskeletal lesions. In the first part of the study, BMPs were found in both fibrous dysplasia and desmoid tumors. Bone morphogenetic proteins were also expressed by several tumors. In the next part of the study (paraffin-embedded tissue), BMPs were expressed by a variety of tumors, irrespective of the radiological nature (blastic or lytic) of their metastases.Conclusions.-We conclude that BMP production alone cannot explain bone formation, and other factors either alone or in combination may be responsible for blastic metastases to the skeleton and for bone formation by primary bone lesions, such as fibrous dysplasia.
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Affiliation(s)
- Jasvir S Khurana
- From the Department of Pathology, Temple University Hospital, Philadelphia, Pa (Drs Khurana, Shen, and Parekh); the Department of Pathology, Brigham and Women's Hospital, Boston, Mass (Dr Ogino); the Departments of Orthopedics (Drs Scherbel and DeLong) and Pathology (Drs Feldman and Zhang), Hospital for the University of Pennsylvania, Philadelphia; the Department of Pathology, New England Medical Center, Boston, Mass (Dr Wolfe); and the Department of Orthopedic Surgery, Hospital for Sick Children, Toronto, Canada (Dr Alman)
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Abstract
Early in gestation, fetal wounds are capable of healing scarlessly. Scarless healing in the fetus is characterized by regeneration of an organized dermis with normal appendages and by a relative lack of inflammation. Although there is a transition period between scarless and scar-forming repair, scarless healing also depends on wound size and the organ involved. The ability to heal scarlessly, furthermore, appears to be intrinsic to fetal skin. Unique characteristics of fetal fibroblasts, inflammatory cells, extra-cellular matrix, cytokine profile, and developmental gene regulation may be responsible for the scarless phenotype of early gestation fetal wounds. With the current knowledge, only minimal success has been achieved with the topical application of neutralizing antibodies, antisense oligonucleotides, and growth factors to improve wound-healing outcomes. Thus, further investigation into the mechanisms underlying scarless repair is crucial in order to devise more effective therapies for scar reduction and the treatment of cirrhosis, scleroderma, and other diseases of excessive fibrosis.
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Affiliation(s)
- Catherine Dang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, Los Angeles, CHS 73-060, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
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Abstract
Variations in certain mesenchymal tissue healing processes are not widely recognized. The current review summarizes key differences in healing mechanisms and healing potential after injury to soft tissues having different healing outcomes.
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Affiliation(s)
- W H Akeson
- Department of Orthopaedics, UC San Diego and VA Medical Center, CA 92161, USA
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Gosiewska A, Yi CF, Brown LJ, Cullen B, Silcock D, Geesin JC. Differential expression and regulation of extracellular matrix-associated genes in fetal and neonatal fibroblasts. Wound Repair Regen 2001; 9:213-22. [PMID: 11472618 DOI: 10.1046/j.1524-475x.2001.00213.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Adults and neonates heal wounds by a repair process associated with scarring in contrast to scar-free wound healing in the fetus. In the present study, human dermal fetal fibroblasts, representing the scarless phenotype, and neonatal human dermal fibroblasts, representing scar-forming phenotype, were examined for potential differences that might influence the wound healing process. Fetal fibroblasts secreted four- to tenfold more latent transforming growth factor-beta1 depending on the cell strains compared. Fetal fibroblasts also produced higher levels of collagen protein and mRNA for most types of collagen (particularly type III) as compared to neonatal cells. Interestingly, mRNA for type V collagen was significantly reduced in fetal cells. Neonatal fibroblasts expressed significantly higher levels of latent transforming growth factor-beta1 binding protein mRNA, in contrast to almost undetectable levels in fetal fibroblasts. By ligand blot analysis, the levels of insulin-like growth factor binding protein-3, a reported mediator of transforming growth factor-beta1 activity, was eightfold higher in neonatal versus fetal fibroblasts. Approximately 20 other mRNAs for various cytokines, matrix molecules and receptors were examined and found to be similar between the two cell types. The phenotypic differences described in this article may represent potentially important mechanisms to explain the differences in the quality of wound repair observed in fetal versus adult/neonatal tissues.
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Affiliation(s)
- A Gosiewska
- Johnson & Johnson Wound Healing Technology Resource Center, Skillman, New Jersey 08558-9418, USA.
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Lanning DA, Nwomeh BC, Montante SJ, Yager DR, Diegelmann RF, Haynes JH. TGF-beta1 alters the healing of cutaneous fetal excisional wounds. J Pediatr Surg 1999; 34:695-700. [PMID: 10359166 DOI: 10.1016/s0022-3468(99)90358-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND/PURPOSE In a number of species, fetal wound healing differs from the adult in the absence of inflammation, fibrosis, scar formation, and excisional wound contraction. The lack of inflammation also may explain the relative absence of any cytokine levels at the wound site, such as transforming growth factor (TGF)-beta, and therefore the unique characteristics of fetal wound healing. The authors hypothesized that exogenous TGF-beta1 would induce contraction, inflammation, fibrosis, and scar formation in cutaneous excisional wounds in the fetal rabbit. METHODS Cellulose discs (3 mm in diameter) were formulated with either 1.0 microg TGF-beta1 (n = 6) or bovine serum albumin (BSA; n = 7), as a control, for sustained-release over 3 days. Each disc was implanted into the subcutaneous tissue on the backs of fetal New Zealand White Rabbits in utero on day 24 of gestation (term, 31 days). A full-thickness, 3-mm excisional wound (7.4 mm2) was then made next to the implanted cellulose disc. All wounds were harvested 3 days later. RESULTS At harvest, the excisional wounds in the TGF-beta1 group had contracted (5.6 +/- 2.0 mm2), whereas those in the control group had expanded (13.5 +/- 1.2 mm2, P< .01). The surrounding dermis in the TGF-beta1 group had 16.3 inflammatory cells per grid block compared with 12.4 cells in the control group (not significant). In addition, a greater amount of fibrosis was induced by the TGF-beta1 implant (1.7 +/- 0.3) than the control implant (0.4 +/- 0.2) on a scale of 0 to 3, P < .01. In situ hybridization analysis showed an increase in procollagen type 1alpha1 gene expression in the surrounding dermis of the TGF-beta1 group (36.7 +/- 3.6 grains per grid block) compared with the control group (7.1 +/- 0.9 grains per grid block, P < .001). CONCLUSIONS These results demonstrate that the cytokine TGF-beta1 can induce fetal excisional wounds to contract, stimulate fibrosis, and increase procollagen type 1alpha1 gene expression. These findings further suggest that the absence of TGF-beta1 atthe wound site may be responsible in part for the lack of a postnatal healing response.
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Affiliation(s)
- D A Lanning
- Medical College of Virginia/Virginia Commonwealth University, Richmond 23298, USA
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