In vivo cultured skin composed of two-layer collagen sponges with preconfluent cells

The Alteration of the Epidermal Basement Membrane Complex of Human Nevus Tissue and Keratinocyte Attachment after High Hydrostatic Pressurization

We previously reported that human nevus tissue was inactivated after high hydrostatic pressure (HHP) higher than 200 MPa and that human cultured epidermis (hCE) engrafted on the pressurized nevus at 200 MPa but not at 1000 MPa. In this study, we explore the changes to the epidermal basement membrane in detail and elucidate the cause of the difference in hCE engraftment. Nevus specimens of 8 mm in diameter were divided into five groups (control and 100, 200, 500, and 1000 MPa). Immediately after HHP, immunohistochemical staining was performed to detect the presence of laminin-332 and type VII collagen, and the specimens were observed by transmission electron microscopy (TEM). hCE was placed on the pressurized nevus specimens in the 200, 500, and 1000 MPa groups and implanted into the subcutis of nude mice; the specimens were harvested at 14 days after implantation. Then, human keratinocytes were seeded on the pressurized nevus and the attachment was evaluated. The immunohistochemical staining results revealed that the control and 100 MPa, 200 MPa, and 500 MPa groups were positive for type VII collagen and laminin-332 immediately after HHP. TEM showed that, in all of the groups, the lamina densa existed; however, anchoring fibrils were not clearly observed in the 500 or 1000 MPa groups. Although the hCE took in the 200 and 500 MPa groups, keratinocyte attachment was only confirmed in the 200 MPa group. This result indicates that HHP at 200 MPa is preferable for inactivating nevus tissue to allow its reuse for skin reconstruction in the clinical setting.

Comparison studies of the in vivo treatment of full-thickness excisional wounds and burns by an artificial bilayer dermal equivalent and J-1 acellular dermal matrix

The effects upon skin repair were compared between a homemade bilayer dermal equivalent (BDE), composed of a collagen/chitosan porous scaffold and a silicone membrane, and J-1 acellular dermal matrix (ADM), a commercial ADM that is used widely in China to treat various skin defects. Full-thickness excisional and burn wounds were prepared on the backs of pigs and then treated with the BDE and J-1 ADM. Biopsy specimens were harvested on days 7, 14, and 21 after surgery for gross, biochemical, and molecular examinations. In comparison with the burn wounds, the excisional wounds showed accelerated granular tissue formation and superior integration with the equivalents, regardless of their type. Immunohistochemical, immunofluorescence, real time quantitative polymerase chain reaction and Western blotting analyses showed that the vascularization rates in the excisional wounds group were also significantly faster than those of the burn group for both dermal equivalents. There was no significant difference between J-1 ADM and BDE treatment on the formation of newly formed blood vessels for the excisional wounds at days 7, 14, and 21. However, there was a significant difference in the number of nascent blood vessels formed in the burn wounds after treatment with J-1 ADM compared with BDE. The highest numbers of newly formed and mature blood vessels were present in the J-1 ADM-treated excisional wounds after 21 days. Ultrathin skin grafts were further transplanted on to the regenerated dermis for 28 days, resulting in the repair of the full-thickness wounds and production of a structure similar to normal skin.

Effects of fiber density and plasma modification of nanofibrous membranes on the adhesion and growth of HaCaT keratinocytes

It may be possible to regulate the cell colonization of biodegradable polymer nanofibrous membranes by plasma treatment and by the density of the fibers. To test this hypothesis, nanofibrous membranes of different fiber densities were treated by oxygen plasma with a range of plasma power and exposure times. Scanning electron microscopy and mechanical tests showed significant modification of nanofibers after plasma treatment. The intensity of the fiber modification increased with plasma power and exposure time. The exposure time seemed to have a stronger effect on modifying the fiber. The mechanical behavior of the membranes was influenced by the plasma treatment, the fiber density, and their dry or wet state. Plasma treatment increased the membrane stiffness; however, the membranes became more brittle. Wet membranes displayed significantly lower stiffness than dry membranes. X-ray photoelectron spectroscopy (XPS) analysis showed a slight increase in oxygen-containing groups on the membrane surface after plasma treatment. Plasma treatment enhanced the adhesion and growth of HaCaT keratinocytes on nanofibrous membranes. The cells adhered and grew preferentially on membranes of lower fiber densities, probably due to the larger area of void spaces between the fibers.

Viscoelastic characteristics of contracted collagen gels populated with rat fibroblasts or cardiomyocytes

The viscoelastic characteristics of contracted collagen gels populated with rat fibroblasts or cardiomyocytes were investigated by uniaxial tensile testing. Rat type I collagen-Dulbecco's modified Eagle's medium solution (each 2 ml in volume, 0.5 mg/ml collagen concentration) containing 2.0 million rat fibroblasts or cardiomyocytes were cast in a circular shape. After gelation and culture for 10 days the contracted gels were first stretched to a tensile strain of approximately 0.20 at 4.6 × 10(-3)/s strain rate, and then the strain was kept unchanged for 3 min. The tensile stress in the gels was recorded. The results were regressed against the equations of the Kelvin viscoelastic model. It was found that the two elastic coefficients in the model were 6.5 ± 1.7 and 10.2 ± 3.2 kPa, respectively, for gels with cardiomyocytes and 5.1 ± 1.6 and 4.5 ± 0.9 kPa for those with fibroblasts; the values for gels with cardiomyocytes were significantly higher than those for gels with fibroblasts. The viscous coefficient was 169.6 ± 60.7 kPa s for the cardiomyocytes and 143.6 ± 44.7 kPa s for the fibroblasts. The relaxation time constant for gels with cardiomyocytes was 19.6 ± 10.6 s, significantly smaller than for gels with fibroblasts (36.4 ± 13.3 s). This study is the first to obtain viscoelastic data for living cell-contracted collagen gels. These data show that the viscous effect has a vital effect on the mechanical behavior of the gels and cannot be neglected in the culture and function of artificial substitutes based on contracted collagen gels. Furthermore, the data may imply that viscous coefficient of the gels might be closely related to collagen density rather than to cross linking among collagen fibrils.

Enhanced angiogenesis of gene-activated dermal equivalent for treatment of full thickness incisional wounds in a porcine model

Angiogenesis of dermal equivalent is one of the key issues for treatment of full thickness skin defects. To develop a gene-activated bilayer dermal equivalent (BDE), N,N,N-trimethyl chitosan chloride (TMC), a cationic gene delivery vector, was used to form complexes with the plasmid DNA encoding vascular endothelial growth factor-165 (VEGF-165), which was then incorporated into a collagen-chitosan/silicone membrane scaffold. To evaluate the angiogenesis property in vivo, full thickness skin defects were made on the back of pigs, into which the TMC/pDNA-VEGF complexes loaded BDE and other three control BDEs, i.e. the blank BDE, and the BDEs loaded with pDNA-VEGF and TMC/pDNA-eGFP complexes, respectively, were transplanted. Biopsy specimens were harvested at day 7, 10 and 14 after surgery for histology, immunohistochemistry, immunofluorescence, real-time quantitative PCR (RT-qPCR) and western blotting analyses. The results showed that the TMC/pDNA-VEGF group had the strongest VEGF expression in mRNA and protein levels, resulting in the highest densities of newly-formed and mature vessels. The ultra-thin skin graft was further transplanted onto the dermis regenerated by the TMC/pDNA-VEGF complexes loaded BDE at day 10 and well survived. At 112 days grafting, the healing skin had a similar structure and approximately 80% tensile strength of the normal skin.

Incorporation of basic fibroblast growth factor into preconfluent cultured skin substitute to accelerate neovascularisation and skin reconstruction after transplantation

Cultured skin substitutes (CSS) with both epidermal and dermal components seem to be ideal, but they have not been widely used clinically, partly because it takes several weeks to produce them. Decreasing the number of seeding cells may reduce the period required for production, but it still takes a long time before the cells become confluent and neovascularisation is completed in CSS after grafting. As we have already succeeded in reducing the number of seeded keratinocytes in this study, we first attempted to reduce the number of seeded fibroblasts. Consequently, preconfluent CSS with 10 x 10(3) cells/cm2 of fibroblasts combined with 100 x 10(3) cells/cm2 of keratinocytes could be successfully grafted on to full-thickness wounds. bFGF-impregnated gelatin microspheres were then added to the preconfluent CSS before grafting. Incorporation of bFGF significantly accelerated neovascularisation and increased epidermal thickness, cellular components, and thickness of the dermis. The incorporation of bFGF makes CSS a potential therapeutic approach for management of skin wounds.

Real-time analysis of the kinetics of angiogenesis and vascular permeability in an animal model of wound healing

The use of engineered tissue for the treatment of a variety of acute to chronic wounds has become a clinical standard, and a better understanding of the cellular mechanisms of re-vascularization and barrier integrity could enhance clinical outcomes. Here, we focus on the characterization of the re-vascularization of acellular grafts such as Integra in an animal model to better understand the physiological properties of blood vessels growing in the collagen-glycosaminoglycan matrix vs. wound margins. While Integra has been extensively studied in pre-clinical models, the re-modeling mechanisms of the capillary bed under these matrices are not well understood. Therefore, our first objective was to quantify the kinetics of re-vascularization. The second objective was to assess changes in vascular permeability (VP) of the wound bed compared to normal adjacent skin. The third objective was to establish a non-invasive and quantitative assay for the measurement of VP to facilitate the rapid and reproducible characterization of vascular integrity. Using an excisional wound model in mice, we characterize the appearance, growth, and maturation of blood vessels in an Integra graft over 28 days after surgery. Initial appearance of blood vessels in the graft was observed at 7 days, with angiogenesis peaking between 7 and 14 days. The onset of VP coincided with the increase in re-vascularization of the wound bed and there was a sustained elevation of VP that declined to baseline by 28 days. We propose a non-invasive strategy to assess VP of the wound capillary bed will facilitate a better understanding of the cell and molecular basis of angiogenesis in wound healing.

In Vivo Culturing of a Bilayered Dermal Substitute with Adipo-Stromal Cells

BACKGROUND

Skin grafting is an important procedure to cover skin defects. Recently, cultured epidermal sheets and bilayered cultured skin have been used clinically, but they lack subcutaneous tissue. The objective of this study was to produce a bilayered dermal substitute with adipose tissue simultaneously in vivo.

MATERIALS AND METHODS

We disseminated adipo-stromal cells on one side of a collagen sponge at a density of 1,0 x 10(5)cells/cm(2) and incubated overnight. Then, we turned over the sponge and disseminated dermal fibroblasts and keratinocytes at a density of 1,0 x 10(6)cells/cm(2) on the other side of the sponge. Finally, we cultured this for 1 wk and implanted it on the backs of severe combined immunodeficiency mice with or without basic FGF.

RESULTS

Six weeks after implantation, specimens were harvested. Macroscopically, the formed tissue in the bFGF-administered group was thick, and the epidermal component, the dermal component, and adipose tissue were formed in the cross section. The thickness of newly formed tissue in bFGF-administered group was significantly greater than that in the group without bFGF administration. The area of the newly formed capillaries in the bFGF-administered group was significantly larger than that in the group without bFGF administration.

CONCLUSIONS

We could produce a thick composite tissue in vivo, combining three kinds of human cells, collagen scaffold, and bFGF. This composite graft was thicker than the bilayered dermal substitute and could be a substitute for a skin flap.

Reconstruction of living bilayer human skin equivalent utilizing human fibrin as a scaffold

Our aim of this study was to develop a new methodology for constructing a bilayer human skin equivalent to create a more clinical compliance skin graft composite for the treatment of various skin defects. We utilized human plasma derived fibrin as the scaffold for the development of a living bilayer human skin equivalent: fibrin-fibroblast and fibrin-keratinocyte (B-FF/FK SE). Skin cells from six consented patients were culture-expanded to passage 1. For B-FF/FK SE formation, human fibroblasts were embedded in human fibrin matrix and subsequently another layer of human keratinocytes in human fibrin matrix was stacked on top. The B-FF/FK SE was then transplanted to athymic mice model for 4 weeks to evaluate its regeneration and clinical performance. The in vivo B-FF/FK SE has similar properties as native human skin by histological analysis and expression of basal Keratin 14 gene in the epidermal layer and Collagen type I gene in the dermal layer. Electron microscopy analysis of in vivo B-FF/FK SE showed well-formed and continuous epidermal-dermal junction. We have successfully developed a technique to engineer living bilayer human skin equivalent using human fibrin matrix. The utilization of culture-expanded human skin cells and fibrin matrix from human blood will allow a fully autologous human skin equivalent construction.

Recovery Course of Full-Thickness Skin Defects With Exposed Bone: An Evaluation by a Quantitative Examination of New Blood Vessels

BACKGROUND

Full-thickness skin defects with exposed bone are often hard to heal. The lack or delayed re-vascularization is considered one of the major causes, and the periosteum is also suggested to have an important role in tissue regeneration.

MATERIALS AND METHODS

Full-thickness skin defect wounds with exposed bone were made in the parietal region of Wister rats. The periosteum of the exposed parietal bone was removed in the periosteum-lacking group, but maintained in the control group (periosteum-intact group). The wound was covered by an artificial dermis made of collagen. The wound healing process was histologically compared. Double immunostaining of alpha-smooth muscle actin (SMA) and von Willebrand factor (vWF) was used for re-vascularization examination, and the blood vessel density in the artificial dermis was quantified.

RESULTS

The density of the blood vessels in the uninjured parietal tissue was approximately 80 vessels/mm(2). To reach this density, 7 and 21 days were required for the control (periosteum-intact) and the periosteum-lacking groups, respectively. This coincided with complete revascularization, fibroblast migration and the reentry of blood vessels to the upper layer of the wound were observed.

CONCLUSION

The described results support the importance of the periosteum in the full-thickness skin defect healing process.

Investigation on the mechanical properties of contracted collagen gels as a scaffold for tissue engineering

In this article the mechanical properties of contracted collagen gels were investigated thoroughly by means of uniaxial tensile test. Large type I collagen-Dulbecco's Modified Eagle Medium (DMEM) gels (each was 26 ml in volume, 1.67 mg/ml collagen concentration), each populated with about 2.5 x 106 human fibroblasts, were made in 100 mm diameter plastic dishes precoated with albumin for floating the gels in DMEM. Such identically treated gels were divided into three groups for the mechanical measurements at different culture periods (2, 4, and 10 weeks). Rapid contraction occurred within the first 3 days and then the contraction went slowly in the rest period until it reached about 13% of its original size. The stress-strain curve of the contracted collagen gels demonstrated an exponential behavior at low stress region, followed by linear region, a point of yielding, and finally an ultimate stress point at which the maximum stress was reached. The mechanical strength increased in the first few weeks and then decreased as the culture went on. It is obvious that the collagen fibrils formed and were forced to orientate to the tensile direction after the test. The stress relaxation and cyclic creep phenomena were observed. Based on the morphological analysis of transmission electron microscopy (TEM) of the gels, a nonlinear visco-elastic-plastic constitutive formula was proposed, which was able to reproduce the rheological phenomena of the gels. This experiment shows that the human fibroblasts significantly contracted collagen gels so as to achieve certain mechanical strength, which makes it possible to be a scaffold for tissue engineering. However, a further method to reinforce the mechanical strength by several folds must be considered. Meanwhile, the rheological phenomena should be taken into account in the fabrication and application of the structure.