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Erçelik O, Karadaş H, Kaptan Z, Bilgen AS, Samaraz Olgun P, Çaydere M, Hücümenoğlu S. The effect of adipose tissue-derived stromal vascular fraction/gel material on wound healing in a rat model of nasal mucosa injury. Acta Otolaryngol 2024:1-8. [PMID: 39141586 DOI: 10.1080/00016489.2024.2385594] [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: 05/13/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Stromal Vascular fraction/gel (SVF/gel) is prepared mechanically from autologous adipose tissue, and it is known for its regenerative and anti-inflammatory properties. AIMS To assess histopathological effects of adipose tissue-derived SVF/gel and nasal steroids on nasal mucosal healing. MATERIAL AND METHODS Forty-two Wistar Albino rats with right nasal mucosal injury were randomly divided into three groups: control (saline), Mometasone Furoate (MF), and SVF/gel. Control group (n = 14) received saline for 7 days, while MF group (n = 14) was administered MF to the right nasal cavity for 7 days. SVF/gel group (n = 14) was treated once with SVF/gel in the right nasal cavity. Histological analysis on days 14 and 28 post-injury focused on evaluating epithelial thickness, inflammation, disarray, subepithelial thickness, goblet cell count, subepithelial fibrosis, presence of ciliated cells, lacunae, adhesion, and neo-osteogenesis. RESULTS When comparing the MF and SVF/gel groups, statistically significant differences were found on day 14 in indices of epithelial thickness, subepithelial thickness, goblet cells, subepithelial fibrosis, and ciliated cells. On day 28, SVF/gel group exhibited higher ciliated cell counts and lower subepithelial fibrosis values (p = .027; p = .016). Additionally, epithelial disarray, adhesions, lacunae, and neo-osteogenesis were not observed in the SVF/gel group. CONCLUSIONS AND SIGNIFICANCE SVF/gel accelerates re-epithelialization, reduces fibrosis and adhesions, and enhances cilia formation compared to nasal steroids. These findings suggest that SVF/gel is an autologous and cost-effective treatment for improving nasal mucosal healing post-injury.
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Affiliation(s)
- Onur Erçelik
- Department of Otolaryngology-Head and Neck Surgery, Bandırma State Hospital, Bandırma, Balıkesir, Turkey
| | - Hatice Karadaş
- Department of Otolaryngology-Head and Neck Surgery, Ankara Research and Training Hospital, Ankara, Turkey
| | - Zeynep Kaptan
- Department of Otolaryngology-Head and Neck Surgery, Ankara Research and Training Hospital, Ankara, Turkey
| | - Akif Sinan Bilgen
- Department of Otolaryngology-Head and Neck Surgery, Ankara Research and Training Hospital, Ankara, Turkey
| | - Pelin Samaraz Olgun
- Department of Otolaryngology-Head and Neck Surgery, Kırşehir Research and Training Hospital, Kırşehir, Turkey
| | - Muzaffer Çaydere
- Department of Pathology, Ankara Research and Training Hospital, Ankara, Turkey
| | - Sema Hücümenoğlu
- Department of Pathology, Ankara Research and Training Hospital, Ankara, Turkey
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Tsuda T, Suzuki M, Kato Y, Kidoguchi M, Kumai T, Fujieda S, Sakashita M. The current findings in eosinophilic chronic rhinosinusitis. Auris Nasus Larynx 2024; 51:51-60. [PMID: 37574421 DOI: 10.1016/j.anl.2023.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/15/2023]
Abstract
Chronic rhinosinusitis (CRS) is a persistent inflammatory disease of the nasal cavity and paranasal sinuses. Traditional classification is denoted by the presence (CRSwNP) or absence of nasal polyps (CRSsNP). Particularly, CRSwNP is distinguished by the presence of infiltrating cells and inflammatory markers in the nasal mucosa. Patients with CRSwNP in Western countries predominantly display a type 2 endotype, whereas those in Asian regions display a mixed type 2 endotype. Nevertheless, recent transcriptome analyses have revealed two types of nasal polyps - type 2 and non-type 2 polyps, suggesting that geographical differences in endotypes likely resulted from the different proportions of each endotype. Moreover, various endotypes of CRSsNP have been identified, making phenotype a crucial factor for predicting treatment efficacy. Type 2 endotypes, designated as eosinophilic CRS (ECRS) in Japan, are characterized by severe eosinophilic infiltration into the paranasal sinus tissue and are particularly refractory. In this review, we discuss the latest developments in ECRS. We also provide recent findings on the involvement of nasal epithelial cells in pathogenesis.
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Affiliation(s)
- Takeshi Tsuda
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - Masanobu Suzuki
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 14-jo nishi 5, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Yukinori Kato
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Yoshida, Eiheiji, Fukui 910-1193, Japan
| | - Masanori Kidoguchi
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Yoshida, Eiheiji, Fukui 910-1193, Japan
| | - Takumi Kumai
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa 078-8510, Japan
| | - Shigeharu Fujieda
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Yoshida, Eiheiji, Fukui 910-1193, Japan
| | - Masafumi Sakashita
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Yoshida, Eiheiji, Fukui 910-1193, Japan.
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Chua AJ, Francesco VD, Huang D, D'Souza A, Bleier BS, Amiji MM. Nanotechnology-enabled topical delivery of therapeutics in chronic rhinosinusitis. Nanomedicine (Lond) 2023; 18:1399-1415. [PMID: 37800470 DOI: 10.2217/nnm-2023-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the paranasal sinuses which represents a significant health burden due to its widespread prevalence and impact on patients' quality of life. As the molecular pathways driving and sustaining inflammation in CRS become better elucidated, the diversity of treatment options is likely to widen significantly. Nanotechnology offers several tools to enhance the effectiveness of topical therapies, which has been limited by factors such as poor drug retention, mucosal permeation and adhesion, removal by epithelial efflux pumps and the inability to effectively penetrate biofilms. In this review, we highlight the successful application of nanomedicine in the field of CRS therapeutics, discuss current limitations and propose opportunities for future work.
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Affiliation(s)
- Andy J Chua
- Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, Northeastern University, 360 Huntington Avenue, Boston, 140 The Fenway Building, MA 02115, USA
- Department of Otolaryngology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA
- Department of Otorhinolaryngology - Head & Neck Surgery, Sengkang General Hospital, 110 Sengkang E Way, 544886, Singapore
| | - Valentina Di Francesco
- Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, Northeastern University, 360 Huntington Avenue, Boston, 140 The Fenway Building, MA 02115, USA
| | - Di Huang
- Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, Northeastern University, 360 Huntington Avenue, Boston, 140 The Fenway Building, MA 02115, USA
- Department of Otolaryngology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA
| | - Anisha D'Souza
- Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, Northeastern University, 360 Huntington Avenue, Boston, 140 The Fenway Building, MA 02115, USA
- Department of Otolaryngology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA
| | - Benjamin S Bleier
- Department of Otolaryngology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA
| | - Mansoor M Amiji
- Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, Northeastern University, 360 Huntington Avenue, Boston, 140 The Fenway Building, MA 02115, USA
- Department of Chemical Engineering, College of Engineering, Northeastern University, 360 Huntington Avenue, 140 The Fenway Building, Boston, MA 02115, USA
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Sakashita M, Takabayashi T, Imoto Y, Homma T, Yoshida K, Ogi K, Kimura Y, Kato A, Stevens WW, Smith SS, Welch KC, Norton JE, Suh LA, Carter RG, Hulse KE, Seshadri S, Min JY, Pothoven KL, Conley DB, Tan BK, Harris KE, Kern RC, Haruna S, Matsuwaki Y, Ochiai R, Fujieda S, Schleimer RP. Retinoic acid promotes fibrinolysis and may regulate polyp formation. J Allergy Clin Immunol 2022; 150:1114-1124.e3. [PMID: 35728655 PMCID: PMC11152199 DOI: 10.1016/j.jaci.2022.05.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/19/2022] [Accepted: 05/31/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Patients with aspirin-exacerbated respiratory disease (AERD) regularly exhibit severe nasal polyposis. Studies suggest that chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by excessive fibrin deposition associated with a profound decrease in epithelial tissue plasminogen activator (tPA). Retinoids, including vitamin A and its active metabolite retinoic acid (RA), are necessary for maintaining epithelial function and well-known inducers of tPA in endothelial cells. OBJECTIVES This study sought to determine whether endogenous retinoids are involved in NP pathophysiology and disease severity in patients with CRSwNP and AERD. METHODS NP tissue was collected from patients with AERD or CRSwNP, and concentrations of retinoids and fibrinolysis markers were measured using ELISA. Normal human bronchial epithelial cells were stimulated alone or in combination with RA and IL-13 for 24 hours. RESULTS This study observed lower retinoid levels in nasal polyps of patients with AERD than those with CRSwNP or healthy controls (P < .01). Levels of the fibrin-breakdown product d-dimer were the lowest in AERD polyps (P < .01), which is consistent with lower tPA expression (P < .01). In vitro, all-trans RA upregulated tPA levels in normal human bronchial epithelial cells by 15-fold and reversed the IL-13-induced attenuation of tPA expression in cultured cells (P < .01). CONCLUSIONS RA, a potent inducer of epithelial tPA in vitro, is reduced in tissue from patients with AERD, a finding that may potentially contribute to decreased levels of tPA and fibrinolysis in AERD. RA can induce tPA in epithelial cells and can reverse IL-13-induced tPA suppression in vitro, suggesting the potential utility of RA in treating patients with CRSwNP and/or AERD.
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Affiliation(s)
- Masafumi Sakashita
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Fukui, Japan.
| | - Tetsuji Takabayashi
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Fukui, Japan
| | - Yoshimasa Imoto
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Fukui, Japan
| | - Tetsuya Homma
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Kanako Yoshida
- Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Fukui, Japan
| | - Kazuhiro Ogi
- Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Fukui, Japan
| | - Yukihiro Kimura
- Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Fukui, Japan
| | - Atsushi Kato
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Whitney W Stevens
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Stephanie S Smith
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Otolaryngology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Kevin C Welch
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Otolaryngology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - James E Norton
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Lydia A Suh
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Roderick G Carter
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Kathryn E Hulse
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Sudarshan Seshadri
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Jin-Young Min
- Department of Otolaryngology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Kathryn L Pothoven
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - David B Conley
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Otolaryngology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Bruce K Tan
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Otolaryngology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Kathleen E Harris
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Robert C Kern
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Otolaryngology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Shinichi Haruna
- Department of Otorhinolaryngology, Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
| | | | - Ryosuke Ochiai
- Shimadzu Techno-Research, Inc. Pharmaceuticals and Life Sciences Division, Kyoto, Japan
| | - Shigeharu Fujieda
- Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Fukui, Japan
| | - Robert P Schleimer
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
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Yiğit E, Erdil D, Çınar Z, Can E, Yiğit Ö. Effects of Oral Isotretinoin Therapy on Nasal Dryness and Nasal Obstruction in Patients with Acne Vulgaris: Objective and Subjective Assessments Based on the Dose and Duration of Therapy. ISTANBUL MEDICAL JOURNAL 2022. [DOI: 10.4274/imj.galenos.2021.99835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Schilling AL, Carcella AR, Moore J, Zahid M, Lo C, Wang EW, Lee SE, Little SR. Compatibility of a Thermoresponsive and Controlled Release System for Promoting Sinonasal Cilia Regeneration. Macromol Biosci 2021; 21:e2100277. [PMID: 34390164 DOI: 10.1002/mabi.202100277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/02/2021] [Indexed: 11/11/2022]
Abstract
The current clinical goal for managing chronic rhinosinusitis (CRS), a heterogenous disease of the paranasal sinuses, is to control inflammation, yet adjunct therapies that promote mucosal regeneration can improve the long-term health of the upper airways. The small natural openings to the sinuses, however, limit the efficacy of traditional drug delivery methods (i.e., nasal sprays and irrigation). Accordingly, a conformable thermoresponsive and controlled release system ("TEMPS", Thermogel, Extended-release Microsphere-based delivery to the Paranasal Sinuses) is developed. The poly(lactic-co-glycolic acid) microsphere component enables the encapsulation of numerous therapeutics, such as retinoic acid (RA), an analog of vitamin A (VA). Studies in CRS patients and preclinical models have shown that aqueous RA or VA gels promoted the differentiation of ciliated cells and improved mucosal healing following repeat applications. In the present study, TEMPS is designed for the controlled release of RA such that a single dose of RA-TEMPS delivers bioactive drug for at least 30 days. Furthermore, as TEMPS will be in direct contact with sinonasal tissue, its compatibility with ciliated human nasal epithelium is explored. After ex vivo incubation in thermogel for 24 h, cilia motility is maintained, providing evidence that TEMPS can be compatible for application along the sinonasal epithelium.
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Affiliation(s)
- Andrea L Schilling
- Department of Chemical Engineering, University of Pittsburgh, 940 Benedum Hall, 3700 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Adam R Carcella
- Department of Chemical Engineering, University of Pittsburgh, 940 Benedum Hall, 3700 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - John Moore
- Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh Medical, Center, 1400 Locust Street, Suite 2100, Pittsburgh, PA, 15219, USA
| | - Maliha Zahid
- Department of Developmental Biology, University of Pittsburgh School of Medicine, 8112, Rangos Research Center, 530 45th Street, Pittsburgh, PA, 15201, USA
| | - Cecilia Lo
- Department of Developmental Biology, University of Pittsburgh School of Medicine, 8112, Rangos Research Center, 530 45th Street, Pittsburgh, PA, 15201, USA
| | - Eric W Wang
- Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh Medical, Center, 1400 Locust Street, Suite 2100, Pittsburgh, PA, 15219, USA
| | - Stella E Lee
- Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh Medical, Center, 1400 Locust Street, Suite 2100, Pittsburgh, PA, 15219, USA
| | - Steven R Little
- Department of Chemical Engineering, University of Pittsburgh, 940 Benedum Hall, 3700 O'Hara Street, Pittsburgh, PA, 15213, USA.,Department of Bioengineering, University of Pittsburgh, 302 Benedum Hall, 3700 O'Hara Street, Pittsburgh, PA, 15213, USA.,Department of Clinical and Translational Science, University of Pittsburgh, Forbes Tower, Suite 7057, Pittsburgh, PA, 15213, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, 450 Technology Drive, Suite 300, Pittsburgh, PA, 15219, USA.,Department of Immunology, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA, 15213, USA.,Department of Pharmaceutical Science, University of Pittsburgh, 3501 Terrace Street, Pittsburgh, PA, 15213, USA
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Semenov FV, Leonov GK. [The use of retinoids to stimulate the regenerative process in trepanation cavity after "open" sanitizing surgery on the middle ear]. Vestn Otorinolaringol 2020; 85:28-31. [PMID: 32628379 DOI: 10.17116/otorino20208503128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION One of the methods of surgical treatment of patients with chronic purulent otitis media is an "open" sanitizing surgery on the middle ear. One of its important features is the formation of a wound surface that communicates with the external environment, which subsequently leads to infection, lengthening the time for epithelization, and in 13-30% of cases, the latter is incomplete with the development of a "trepanation cavity disease". OBJECTIVE To establish the nature of the effect of retinoid-based drugs on the severity of the inflammatory process and the regeneration processes in the tissues of the trepanation cavity after sanitizing operations on the middle ear. MATERIAL AND METHODS The subjects of the study were 78 patients who underwent the first "open" sanitizing operation on the middle ear. At the final stage, turunda with a 1% dioxin solution in combination with a sterile ointment of 13-cis-retinoic acid, concentration 0.05% was injected into the postsurgery cavity. 30 patients additionally took 13-cis-retinoic acid in tablet form. In the control group, retinoids were not used. CONCLUSION The obtained data allow us to recommend the use of retinoid-based drugs as a means of suppressing the inflammatory reaction and stimulating the regeneration process in the trepanation cavity after an "open" sanitizing surgery on the middle ear.
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Affiliation(s)
- F V Semenov
- Kuban State Medical University of the Ministry of Health of Russia, Krasnodar, Russia
| | - G K Leonov
- Kuban State Medical University of the Ministry of Health of Russia, Krasnodar, Russia
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Carey RM, Freund JR, Hariri BM, Adappa ND, Palmer JN, Lee RJ. Polarization of protease-activated receptor 2 (PAR-2) signaling is altered during airway epithelial remodeling and deciliation. J Biol Chem 2020; 295:6721-6740. [PMID: 32241907 DOI: 10.1074/jbc.ra120.012710] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/31/2020] [Indexed: 12/14/2022] Open
Abstract
Protease-activated receptor 2 (PAR-2) is activated by secreted proteases from immune cells or fungi. PAR-2 is normally expressed basolaterally in differentiated nasal ciliated cells. We hypothesized that epithelial remodeling during diseases characterized by cilial loss and squamous metaplasia may alter PAR-2 polarization. Here, using a fluorescent arrestin assay, we confirmed that the common fungal airway pathogen Aspergillus fumigatus activates heterologously-expressed PAR-2. Endogenous PAR-2 activation in submerged airway RPMI 2650 or NCI-H520 squamous cells increased intracellular calcium levels and granulocyte macrophage-colony-stimulating factor, tumor necrosis factor α, and interleukin (IL)-6 secretion. RPMI 2650 cells cultured at an air-liquid interface (ALI) responded to apically or basolaterally applied PAR-2 agonists. However, well-differentiated primary nasal epithelial ALIs responded only to basolateral PAR-2 stimulation, indicated by calcium elevation, increased cilia beat frequency, and increased fluid and cytokine secretion. We exposed primary cells to disease-related modifiers that alter epithelial morphology, including IL-13, cigarette smoke condensate, and retinoic acid deficiency, at concentrations and times that altered epithelial morphology without causing breakdown of the epithelial barrier to model early disease states. These altered primary cultures responded to both apical and basolateral PAR-2 stimulation. Imaging nasal polyps and control middle turbinate explants, we found that nasal polyps, but not turbinates, exhibit apical calcium responses to PAR-2 stimulation. However, isolated ciliated cells from both polyps and turbinates maintained basolateral PAR-2 polarization, suggesting that the calcium responses originated from nonciliated cells. Altered PAR-2 polarization in disease-remodeled epithelia may enhance apical responses and increase sensitivity to inhaled proteases.
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Affiliation(s)
- Ryan M Carey
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104
| | - Jenna R Freund
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104
| | - Benjamin M Hariri
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104
| | - Nithin D Adappa
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104
| | - James N Palmer
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104
| | - Robert J Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104 .,Department of Physiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104
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Comparative Analysis of the Healing Effects of the Transplanted Cell Sheets to the Experimentally Injured Maxillary Sinuses. J Craniofac Surg 2019; 30:2285-2292. [PMID: 31232985 DOI: 10.1097/scs.0000000000005638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND In our study, the authors aimed to obtain a live and functional sinus epithelium with mesenchymal stem cells and nasal mucosa epithelial cells from rabbits which are cultured in temperature-responsive culture plates to get a single-layer. METHODOLOGY/PRINCIPAL Twenty-two female New Zealand rabbits were included in the study. Two of them were used to obtain mesenchymal stem cells. A total of 40 maxillary sinuses were randomly divided into 5 groups: 1) control group which is used to investigate normal rabbit maxillary mucosa, 2) secondary healing group, 3) mesenchymal stem cell graft group, 4) differentiated mesenchymal stem cell group, and 5) nasal mucosal graft group. The animals were sacrificed at the 28th day after the surgery.Scanning electron microscopy, transmission electron microscopy, and immunohistochemical investigations were performed. RESULTS With these investigations, it was shown that; all graft groups were histologically better than secondary healing group and when the authors compared the graft groups, differentiated mesenchymal stem cell group were the best. CONCLUSION Our study results showed that endoscopic sinus surgery and treatment with cell sheets, which were generated in temperature-responsive culture dishes, had more functional respiratory epithelium.
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Effects of oral ısotretinoin on normal and wounded nasal mucosa: an experimental study. Eur Arch Otorhinolaryngol 2018; 275:3025-3031. [PMID: 30382397 DOI: 10.1007/s00405-018-5190-2] [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] [Received: 10/10/2018] [Accepted: 10/29/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND We aimed to investigate the effect of systemic isotretinoin therapy on normal and wounded nasal septal mucosa histopathologically in an experimental rabbit model. METHODS Circular mucosal defect with a 7 mm diameter was made in the left septum of 12 New Zealand white rabbits. The rabbits were divided into two groups (six rabbits in each group) oral isotretinoin was given with olive oil at the operation day to the first group. The control group was only oil given group. The harvested septum mucosas were divided into four groups (1-wounded-drug given side, 2-unwounded and drug-given side, 3-wounded-control and 4-unwounded-control side). The diameter of the defect, mucosal thickness, epithelial thickness, ciliated cell level, goblet cell level and inflammation were evaluated every week for 4 weeks. RESULTS At both wounded and normal side, thinning of normal respiratory ciliated epithelium was observed in the postoperative period. In study group at the wounded side; mean mucosal thickness was measured 139.66 µ (± 26.24), and in the control group, mean mucosal thickness was 238.33 µ (± 39.7) at the wounded side. (p < 0.001). The difference between the groups in thickness of normal septal mucosa was also statistically significant (p = 0.016) [190 µ (± 14.6) and 256.66 µ (± 44.66)]. The average cilia level was observed 1.16 in the wounded study group, while the average level was 2.33 in the wounded control group (p = 0.012). Average score measurements of the regenerated mucosa suggested that isotretinoin-given wounded animals have reduced goblet cell recovery, compared to the control both on the regenerated and unwounded mucosas (p = 0.007, p = 0.002, respectively). Inflammation was significantly higher in the wounded isotretinoin group (p = 0.018). CONCLUSION Oral isotretinoin has negative effects on epithelial and ciliary regeneration, significantly reduces mucosal thickness and goblet cell counts of the normal and regenerated mucosa, causes severe inflammation and significant reactive changes.
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Aksoy F, Dogan R, Ozturan O, Altuntas E, Yener FG, Topcu G, Guler B. Effect of a combination of mometasone furoate, levofloxacin, and retinyl palmitate with an in situ gel-forming nasal delivery system on nasal mucosa damage repair in an experimental rabbit model. Biomed Pharmacother 2017; 96:603-611. [PMID: 29035825 DOI: 10.1016/j.biopha.2017.10.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 09/11/2017] [Accepted: 10/02/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In this study a combination of Mometasone Furoate (MF)+Levofloxacin hemihydrate (LH)+Retinyl palmitate (RP) with an in situ gel-forming delivery system was evaluated at different stages of nasal mucosal damage repair in a rabbit maxillary sinus model. METHODS In this study, 28 rabbits were included and assigned randomly to four groups. In all rabbits, a standard ostium was opened in the medial wall of the maxillary sinus by using a drill. Two different subsequently prepared gels with an in situ gel-forming delivery system were used. Of these 14 nasal cavities, combination 1 (active combination) was applied daily to 5, combination 2 (placebo) to 5, while 4 did not receive any pharmaceutical treatment. The diameter of the ostium was measured. Histopathological assessment was performed. RESULTS After 2, 3 and 4 weeks, the ostium diameter was significantly wider in the group where gel 1 had been applied compared to both the placebo group and control group. In the group treated with gel 1, after 2, 3 and 4 weeks the presence of superficial cilia was significantly greater, surface epithelium significantly less. In the 4th week, histologic scores for fibroblastic proliferation and vascular proliferation in the group treated with gel 1 were better than in either the control group or the placebo group. With gel 1, chronic inflammation parameters were also significantly lower than in the other groups. CONCLUSION The MF+LH+RP mixture with an in situ gel-forming nasal delivery system applied for wound healing after FESS prevents the formation of stenosis and is favorable for proper wound healing.
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Affiliation(s)
- Fadlullah Aksoy
- Bezmialem Vakif University, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey
| | - Remzi Dogan
- Bezmialem Vakif University, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey.
| | - Orhan Ozturan
- Bezmialem Vakif University, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey
| | - Ebru Altuntas
- Istanbul University, Department of Pharmacy, Pharmaceutical Technology, Istanbul, Turkey
| | - Fatma Gülgün Yener
- Istanbul University, Department of Pharmacy, Pharmaceutical Technology, Istanbul, Turkey
| | - Gulactı Topcu
- Bezmialem Vakif University, Department of Pharmacy, Fatih, Istanbul, Turkey
| | - Beril Guler
- Bezmialem Vakif University, Department of Pathology, Fatih, Istanbul, Turkey
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12
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Semenov FV, Leonov GK. [The influence of retinoids on the regeneration of an open osteal wound]. Vestn Otorinolaringol 2017. [PMID: 28631680 DOI: 10.17116/otorino201782342-44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of the present study was to elucidate the influence of retinoid-based pharmaceutical products on the process of regeneration of the tissues surrounding an open osteal wound under the experimental conditions. The experiments were carried out using 20 'Sovetskaya shinshilla' rabbits (12 males and 8 females). The animals with the modelled open osteal wound underwent daily treatment by the placement of the dressings impregnated with a mixture of dioxo-methyltetrahydropyrimidine and chloramphenicol ointments supplemented by 0.05% retinoic acid (1:1:1). The rabbits of the control group were treated using the dressings impregnated only with a mixture of dioxo-methyltetrahydropyrimidine and chloramphenicol ointments containing no retinoic acid. The study has demonstrated that the application of the retinoid-based medications for the treatment of the open osteal wound resulted in the well apparent positive dynamics of the wound process in comparison with that in the control animals. It is concluded that the data obtained give evidence that retinoid-based preparations can be used as an adjuvant treatment for the acceleration and promotion of the wound healing process in the trepanation cavity following sanation surgery on the middle ear.
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Affiliation(s)
- F V Semenov
- Kuban State Medical University, Ministry of Health of the Russian Federation, Krasnodar, 350063
| | - G K Leonov
- Kuban State Medical University, Ministry of Health of the Russian Federation, Krasnodar, 350063
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Kavuzlu A, Tatar EÇ, Karagöz T, Pınarlı FA, Tatar İ, Bayır Ö, Korkmaz MH. The effects of the stem cell on ciliary regeneration of injured rabbit sinonasal epithelium. Eur Arch Otorhinolaryngol 2017; 274:3057-3064. [PMID: 28466357 DOI: 10.1007/s00405-017-4595-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 04/27/2017] [Indexed: 12/14/2022]
Abstract
Defects in mucosal healing after sinonasal surgery cause infection, scar formation causing obstruction, relapse of the disease within a shorter period and revision surgery. The present study aimed to create a functional ciliated epithelium using a stem cell and stem cell sheet of adipose tissue origin and to show such regeneration ultra-structurally on experimentally injured rabbit nasal epithelium. This was an experimental animal study and basic research. A total of 18 white New Zealand rabbits were divided into three groups. The medial wall of the maxillary sinus of the subjects was peeled off bilaterally. No additional procedure was applied to the subjects in Group 1. In Group 2, adipose tissue-derived mesenchymal stem cell was implanted on the wound edges of the subjects. In Group 3, a stem cell sheet of three layers was laid onto the defect area. All subjects were killed after 3 weeks. The presence of the stem cell stained with bromo-deoxyuridine was assessed with a light microscope, whereas cilia density, ciliated orientation and cilia structure were evaluated with a scanning electron microscope. Ciliary densities in Group 2 and Group 3 were statistically superior compared to the control group (p < 0.001, p = 0.007). Cilia morphology in Group 2 and Group 3 was also better than the control group (p < 0.01, p = 0.048). Ciliary orientation in Group 2 was scored highest (p < 0.01). The ratio of BrDu-stained cells was observed to be 27% in Group 3 and 8% in Group 2. Sub-epithelial recovery was observed to be better in Group 3. Adipose tissue-derived mesenchymal stem cell increased the healing of the injured maxillary sinus mucosa of the rabbits in terms of cilia presence, density and morphology regardless of the implementation technique. Level of evidence NA.
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Affiliation(s)
- Ali Kavuzlu
- Department of Otorhinolaryngology and Head and Neck Surgery, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ministiry of Health, Ankara, Turkey.
| | - Emel Çadallı Tatar
- Department of Otorhinolaryngology and Head and Neck Surgery, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ministiry of Health, Ankara, Turkey
| | - Tuğba Karagöz
- Department of Otorhinolaryngology and Head and Neck Surgery, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ministiry of Health, Ankara, Turkey
| | - Ferda Alpaslan Pınarlı
- Department of Stem Cell and Genetic Diagnosis Center, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ministiry of Health, Ankara, Turkey
| | - İlkan Tatar
- Department of Anatomy, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ömer Bayır
- Department of Otorhinolaryngology and Head and Neck Surgery, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ministiry of Health, Ankara, Turkey
| | - Mehmet Hakan Korkmaz
- Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
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14
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Fang KM, Wang CT, Chen YW, Huang TW. Reduction of adhesions and antrostomy stenosis with topical vitamin A after endoscopic sinus surgery. Am J Rhinol Allergy 2016; 29:430-4. [PMID: 26637582 DOI: 10.2500/ajra.2015.29.4235] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Prevention of adhesion formation and restoration of mucociliary mucosa are major determinants of the success of endoscopic sinus surgery (ESS). Vitamin A (VA) can promote mucociliary differentiation of respiratory epithelium. However, whether topical VA can promote sinonasal wound healing or reduce adhesion formation after ESS in humans remains unexplored. OBJECTIVE To investigate the effect of topical VA on sinonasal wound healing and adhesion formation after ESS. METHODS This is a within-subject control study. Patients with chronic rhinosinusitis were included. Each patient underwent ESS, and topical VA was applied over the sinonasal wound. Postoperative outcomes were assessed by using the Lund-Kennedy score, and the antrostomy size was measured. In vitro wound healing assay of fibroblasts with or without VA was evaluated. Restoration of ciliated epithelium was examined by using scanning electron microscopy. RESULTS Thirty patients were enrolled. The mean (standard deviation {SD}) scores for scarring/adhesion in the VA-treated side at 3 and 12 months after surgery (0.20 ± 0.40 and 0.23 ± 0.42, respectively) were significantly lower than those in the controls (0.47 ± 0.50 and 0.53 ± 0.62, respectively). The mean (SD) antrostomy size in the VA treated side at 1, 3, and 12 months after surgery (0.85 ± 0.30 cm(2), 0.7 ± 0.30 cm(2), and 0.70 ± 0.27 cm(2), respectively) were significantly larger than those in the controls (0.79 ± 0.26 cm(2), 0.60 ± 0.25 cm(2), and 0.57 ± 0.24 cm(2), respectively). Wound healing assay revealed that VA significantly inhibited the proliferation and migration of fibroblasts. Scanning electron microscopy showed mature ciliated cells in the VA-treated side. CONCLUSION Topical VA is a promising agent for sinonasal wound healing after ESS because it can promote mucociliary reepithelization, reduce adhesion, and prevent antrostomy stenosis.
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Affiliation(s)
- Kai-Min Fang
- Graduate Institute of Basic Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
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15
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Topdag M, Kara A, Konuk E, Demir N, Ozturk M, Calıskan S, Topdag DO, Ulubil A, Keskin IG, Iseri M. The Healing Effects of Autologous Mucosal Grafts in Experimentally Injured Rabbit Maxillary Sinuses. Clin Exp Otorhinolaryngol 2016; 9:44-50. [PMID: 26976026 PMCID: PMC4792244 DOI: 10.21053/ceo.2016.9.1.44] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/18/2015] [Accepted: 02/23/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Healing processes of the nose and paranasal sinuses are quite complex, and poorly understood. In this study, we aimed to compare the effect of mucosal autologous grafts on the degenerated rabbit maxillary sinus mucosa with spontaneous wound healing. It is hypothesized that mucosal grafts will enhance ciliogenesis and improve the morphology of regenerated cilia. METHODS Ten female New Zealand rabbits were included in the study. They underwent external maxillary sinus surgery through a transcutaneous approach. A total of 20 maxillary sinuses were randomly divided into 2 groups: 'spontaneous healing group' and 'autologous graft group.' The animals were sacrificed at the 14th day after the surgery. Scanning electron microscope (SEM), and light microscope were used for the evaluation. RESULTS Cellular composition of the graft group is better than the spontaneous healing group. The graft group had larger areas covered with ciliary epithelium than the spontaneous healing group, and the mean length of the cilias were also longer. Additionally, there were wider cilia with abnormal morphology areas in the spontaneous healing group. CONCLUSION In our opinion, covering of the denuded areas with a graft improves re-epithelization, and may prevent the early complications after sinus surgeries.
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Affiliation(s)
- Murat Topdag
- Department of Otorhinolaryngology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Ahmet Kara
- Department of Otorhinolaryngology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Esma Konuk
- Department of Histology and Embryology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Necdet Demir
- Department of Histology and Embryology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Murat Ozturk
- Department of Otorhinolaryngology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Sebla Calıskan
- Department of Otorhinolaryngology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Deniz Ozlem Topdag
- Department of Otorhinolaryngology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Arif Ulubil
- Department of Otorhinolaryngology, Acıbadem University Faculty of Medicine, Istanbul, Turkey
| | - Ibrahim Gurkan Keskin
- Department of Otorhinolaryngology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Mete Iseri
- Department of Otorhinolaryngology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
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16
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Jain R, Kim R, Waldvogel-Thurlow S, Hwang P, Cornish J, Douglas R. The effects of topical agents on paranasal sinus mucosa healing: a rabbit study. Int Forum Allergy Rhinol 2015; 5:310-7. [PMID: 25677963 DOI: 10.1002/alr.21470] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 10/13/2014] [Accepted: 11/11/2014] [Indexed: 01/18/2023]
Abstract
BACKGROUND Numerous topical agents have been used intraoperatively to enhance postoperative mucosal healing or reduce scar formation. However, the histological effects of many of these treatments have not been well described. This study investigates the impact of topical mometasone furoate, acitretin, lactoferrin, and Silastic sheet (Medtronic) on sinus mucosal healing in a rabbit model. METHODS Forty-eight New Zealand white rabbits underwent defined, localized stripping of a bilateral region of maxillary sinus mucosa. One of 6 treatments was placed in 1 maxillary sinus, and the treatment carrier was applied contralaterally (0.1% mometasone furoate, 0.25% and 0.5% acitretin, lactoferrin, Silastic, and no treatment; n = 8 each group). Rabbits were euthanized after 2 weeks and histological sections were examined with light microscopy. RESULTS Treatment with acitretin 0.25% and 0.5% improved cilial recovery by 0.9 ± 0.5 (p = 0.003) and 0.5 ± 0.5 (p < 0.05), respectively. Acitretin 0.25% treatment also significantly reduced collagen in healing mucosa (5.1% ± 4.8%, p = 0.04). Conversely, rabbits treated with mometasone furoate 0.1% were more likely to have reduced cilial and goblet cell recovery. Intergroup comparisons demonstrated a significant improvement in cilial recovery scores with both acitretin doses compared with mometasone furoate (p < 0.05) and less collagen deposition in rabbits treated with placebo gel over Silastic (p < 0.05). Mucosa directly underlying a blood clot had a lower cilia score and impaired epithelial recovery (p < 0.001). CONCLUSION Intraoperatively applied agents have the potential to significantly affect wound healing. Acitretin improved cilial recovery and reduced collagen deposition.
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Affiliation(s)
- Ravi Jain
- Department of Surgery, The University of Auckland, Auckland, New Zealand
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17
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Czerny MS, Namin A, Gratton MA, Antisdel JL. Histopathological and clinical analysis of chronic rhinosinusitis by subtype. Int Forum Allergy Rhinol 2014; 4:463-9. [DOI: 10.1002/alr.21304] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Revised: 12/08/2013] [Accepted: 01/04/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Mary S. Czerny
- Department of Otolaryngology-Head and Neck Surgery; Saint Louis University School of Medicine; St. Louis MO
| | - Arya Namin
- Medical Degree Program; Saint Louis University School of Medicine; St. Louis MO
| | - Michael Anne Gratton
- Department of Otolaryngology-Head and Neck Surgery; Saint Louis University School of Medicine; St. Louis MO
| | - Jastin L. Antisdel
- Department of Otolaryngology-Head and Neck Surgery; Saint Louis University School of Medicine; St. Louis MO
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18
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Castillo-Briceno P, Kodjabachian L. Xenopus embryonic epidermis as a mucociliary cellular ecosystem to assess the effect of sex hormones in a non-reproductive context. Front Zool 2014; 11:9. [PMID: 24502321 PMCID: PMC4015847 DOI: 10.1186/1742-9994-11-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 01/28/2014] [Indexed: 12/15/2022] Open
Abstract
Background How important are sexual hormones beyond their function in reproductive biology has yet to be understood. In this study, we analyzed the effects of sex steroids on the biology of the embryonic amphibian epidermis, which represents an easily amenable model of non-reproductive mucociliary epithelia (MCE). MCE are integrated systems formed by multiciliated (MC), mucus-secreting (MS) and mitochondrion-rich (MR) cell populations that are shaped by their microenvironment. Therefore, MCE could be considered as ecosystems at the cellular scale, found in a wide array of contexts from mussel gills to mammalian oviduct. Results We showed that the natural estrogen (estradiol, E2) and androgen (testosterone, T) as well as the synthetic estrogen (ethinyl-estradiol, EE2), all induced a significant enhancement of MC cell numbers. The effect of E2, T and EE2 extended to the MS and MR cell populations, to varying degrees. They also modified the expression profile of RNA MCE markers, and induced a range of “non-typical” cellular phenotypes, with mixed identities and aberrant morphologies, as revealed by imaging analysis through biomarker confocal detection and scanning electron microscopy. Finally, these hormones also affected tadpole pigmentation, revealing an effect on the entire cellular ecosystem of the Xenopus embryonic skin. Conclusions This study reveals the impact in vivo, at the molecular, cellular, tissue and organism levels, of sex steroids on non-reproductive mucociliary epithelium biogenesis, and validates the use of Xenopus as a relevant model system in this field.
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Affiliation(s)
- Patricia Castillo-Briceno
- Aix-Marseille Université, CNRS UMR 7288, IBDM, Campus de Luminy Case 907, 13288 Marseille Cedex 9, France.
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Retana C, Sanchez EI, Gonzalez S, Perez-Lopez A, Cruz A, Lagunas-Munoz J, Alfaro-Cruz C, Vital-Flores S, Reyes JL. Retinoic acid improves morphology of cultured peritoneal mesothelial cells from patients undergoing dialysis. PLoS One 2013; 8:e79678. [PMID: 24223992 PMCID: PMC3817121 DOI: 10.1371/journal.pone.0079678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 09/23/2013] [Indexed: 01/24/2023] Open
Abstract
Patients undergoing continuous ambulatory peritoneal dialysis are classified according to their peritoneal permeability as low transporter (low solute permeability) or High transporter (high solute permeability). Factors that determine the differences in permeability between them have not been fully disclosed. We investigated morphological features of cultured human peritoneal mesothelial cells from low or high transporter patients and its response to All trans retinoic Acid (ATRA, vitamin A active metabolite), as compared to non-uremic human peritoneal mesothelial cells. Control cells were isolated from human omentum. High or low transporter cells were obtained from dialysis effluents. Cells were cultured in media containing ATRA (0, 50, 100 or 200 nM). We studied length and distribution of microvilli and cilia (scanning electron microscopy), epithelial (cytokeratin, claudin-1, ZO-1 and occludin) and mesenchymal (vimentin and α-smooth muscle actin) transition markers by immunofluorescence and Western blot, and transforming growth factor β1 expression by Western blot. Low and high transporter exhibited hypertrophic cells, reduction in claudin-1, occludin and ZO-1 expression, cytokeratin and vimentin disorganization and positive α-smooth muscle actin label. Vimentin, α-smooth muscle actin and transforming growth factor-β1 were overexpressed in low transporter. Ciliated cells were diminished in low and high transporters. Microvilli number and length were severely reduced in high transporter. ATRA reduced hypertrophic cells number in low transporter. It also improved cytokeratin and vimentin organization, decreased vimentin and α-smooth muscle actin expression, and increased claudin 1, occludin and ZO-1 expression, in low and high transporter. In low transporter, ATRA reduced transforming growth factor-β1 expression. ATRA augmented percentage of ciliated cells in low and high transporter. It also augmented cilia length in high transporter. Alterations in structure, epithelial mesenchymal markers and transforming growth factor-β1 expression were differential between low and high transporter. Beneficial effects of ATRA were improved human peritoneal mesothelial cells morphology tending to normalize structures.
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Affiliation(s)
- Carmen Retana
- Pharmacology Department Centre for Research and Advanced Studies National Polytechnic Institute, Mexico, D.F., Mexico
| | - Elsa I. Sanchez
- Physiology, Biophysics and Neurosciences Department Centre for Research and Advanced Studies National Polytechnic Institute, Mexico, D.F., Mexico
| | - Sirenia Gonzalez
- Central Laboratories Centre for Research and Advanced Studies National Polytechnic Institute, Mexico, D.F., Mexico
| | - Alejandro Perez-Lopez
- Nephrology Department, Hospital Central Norte de Petroleos Mexicanos, Mexico, D.F., Mexico
| | - Armando Cruz
- Nephrology and Gynecology Departments Unidad Medica Alta Especialidad, Hospital General la Raza, Instituto Mexicano del Seguro Social, Mexico, D.F., Mexico
| | - Jesus Lagunas-Munoz
- Nephrology and Gynecology Departments Unidad Medica Alta Especialidad, Hospital General la Raza, Instituto Mexicano del Seguro Social, Mexico, D.F., Mexico
| | - Carmen Alfaro-Cruz
- Nephrology. Dept. Hospital Regional No. 1 del Instituto Mexicano del Seguro Social, Mexico, D.F., Mexico
| | | | - José L. Reyes
- Physiology, Biophysics and Neurosciences Department Centre for Research and Advanced Studies National Polytechnic Institute, Mexico, D.F., Mexico
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Wang JCC, Hathorn I, Habib AR, Chang E, Javer AR. Evaluation of domestic and Yucatan swine nasal sinus anatomy as models for future sinonasal research of medications delivered by standard instruments used in functional endoscopic sinus surgery. Int Forum Allergy Rhinol 2012; 3:150-6. [PMID: 23038683 DOI: 10.1002/alr.21081] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 06/05/2012] [Accepted: 06/26/2012] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is a need to find an animal model to study new medications to improve mucosal wound healing after functional endoscopic sinus surgery (FESS). Current literature suggests swine as a potential candidate. The lack of information correlating swine computer tomography (CT) and endoscopic sinonasal anatomy prompted us to investigate them in the domestic and Yucatan swine to determine their feasibility as models to test new medications and drug-embedded stents applied using FESS techniques. METHODS Two domestic pig heads and 2 Yucatan pig heads were imaged using helical thin slice (1 mm) CT. Two rhinologists analyzed the images and performed endoscopy on the swine. Particular attention was given to accessing the frontal sinus and suturing stents to the nasal septum using standard endoscopic instruments. RESULTS CT confirmed that swine sinonasal anatomy is largely similar to human, with all major sinuses present. The middle and inferior turbinates of swine arise from a single uniturbinate. The superior turbinates contain large concha bullosa. Unlike human, swine nasal septum is bone anteriorly and cartilage posteriorly. The frontal sinus ostia, regardless of head size, were consistently around 10 cm from the nasal aperture. On endoscopy, domestic swine frontal sinus ostia were easily accessible for topical medication deposition. Silastic splints can be sutured to the domestic swine septum through the posterior cartilaginous portion, allowing for studies involving medication-eluting material. The narrower nasal cavity of Yucatan pigs prohibited endoscopic maneuvers. CONCLUSION Domestic swine, but not Yucatan, are a feasible model for future sinonasal research using standard FESS instruments.
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Affiliation(s)
- Jay Ching Chieh Wang
- Department of Otolaryngology, Sinus Center, St Paul's Hospital, Vancouver, BC, Canada
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21
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Weber RK. Nasal packing and stenting. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2011; 8:Doc02. [PMID: 22073095 PMCID: PMC3199821 DOI: 10.3205/cto000054] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Nasal packs are indispensable in ENT practice. This study reviews current indications, effectiveness and risks of nasal packs and stents. In endoscopic surgery, nasal packs should always have smooth surfaces to minimize mucosal damage, improve wound healing and increase patient comfort. Functional endoscopic endonasal sinus surgery allows the use of modern nasal packs, since pressure is no longer required. So called hemostatic/resorbable materials are a first step in this direction. However, they may lead to adhesions and foreign body reactions in mucosal membranes. Simple occlusion is an effective method for creating a moist milieu for improved wound healing and avoiding dryness. Stenting of the frontal sinus is recommended if surgery fails to produce a wide, physiologically shaped drainage path that is sufficiently covered by intact tissue.
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Affiliation(s)
- Rainer K Weber
- Sektion Nasennebenhöhlen- und Schädelbasischirurgie, Traumatologie, HNO-Klinik, Städtisches Klinikum Karlsruhe, Germany
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22
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Valentine R, Wormald PJ, Sindwani R. Advances in absorbable biomaterials and nasal packing. Otolaryngol Clin North Am 2010; 42:813-28, ix. [PMID: 19909861 DOI: 10.1016/j.otc.2009.07.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Absorbable biomaterials are commonly used after endoscopic sinus surgery, both for hemostatic and wound healing considerations. Although removable nasal packing is the traditional method of controlling ongoing bleeding and modulating wound healing, it is uncomfortable for patients and associated with several complications. Currently available absorbable agents frequently incite an inflammatory reaction and have been shown in animal and human trials to adversely affect the wound healing process. Newer agents offer distinct advantages because of their unique composition and rapid clearance profiles. The selection of packing material used in any given sinus procedure should be based on surgeon preference and the details of the specific case.
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Affiliation(s)
- Rowan Valentine
- Department of Surgery-Otorhinolaryngology, Head and Neck Surgery, The Queen Elizabeth Hospital, University of Adelaide, 28 Woodville Road, Woodville, Adelaide, SA 5011, Australia
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Lasisi AO. The role of retinol in the etiology and outcome of suppurative otitis media. Eur Arch Otorhinolaryngol 2008; 266:647-52. [PMID: 18704470 DOI: 10.1007/s00405-008-0794-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Accepted: 07/30/2008] [Indexed: 10/21/2022]
Abstract
Vitamin A deficiency is still a serious public health problem affecting an estimated 127 million preschool children. The resulting immunological dysfunctions lead to increased risks of respiratory tract infections, diarrhoeal diseases and blindness, among others. The aim of this study is to determine the significance of the role of serum retinol in the etiology of acute suppurative otitis media (ASOM) and its chronicity (CSOM). In a prospective follow-up of patients with ASOM for 6-9 months, serum retinol determination was done using the high performance liquid chromatography. Participants comprised 358 ASOM and 52 control subjects. Six-month follow-up was achieved in 264 subjects (74%); of these, there was persistence of otorrhoea (CSOM) in 116, while 148 had resolved ASOM. Of the 264 subjects, 146 were males and 118 were females, between the ages of 6 months and 9 years and a mean of 7 years (SD = 2.32), whereas the control subjects comprised 29 males and 22 females, between the ages of 6 months and 11 years and a mean of 7.8 years (SD = 3.6). The range of serum retinol in the ASOM subjects was 1.63-2.64 microg/L, mean of 1.53 microg/L, median value of 2.61 microg/L and (SD = 0.16). Among control subjects, the range was 2.5-2.8 microg/L, mean of 2.58 microg/L and median value of 2.61 microg/L (SD = 0.14) (Table 1). The range of serum retinol in the resolved ASOM subjects was 1.61-2.63 microg/L, mean of 2.07 microg/L and median value of 2.09 microg/L (SD = 0.16) while the CSOM subjects ranged between 0.8-2.86 microg/L, mean of 1.58 microg/L and median value of 1.28 microg/L, (SD = 0.48) (Table 2). Univariate analysis using unpaired t test to compare the mean serum retinol revealed significant difference between ASOM and control (P = 0.0000) and between resolved ASOM and CSOM (P = 0.0000). In conclusion, hyporetinolaemia was a significant etiological factor in the etiology ASOM and CSOM, suggesting retinol supplementation as one strategy in control of SOM.
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Affiliation(s)
- Akeem O Lasisi
- Department of Otorhinolaryngology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria.
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Erickson VR, Antunes M, Chen B, Cohen NA, Hwang PH. The effects of retinoic acid on ciliary function of regenerated sinus mucosa. ACTA ACUST UNITED AC 2008; 22:334-6. [PMID: 18588770 DOI: 10.2500/ajr.2008.22.3176] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Retinoic acid (RA) has been shown to enhance ciliary ultrastructure in regenerated sinus mucosa compared with controls. However, the functional status of the regenerated cilia has not been studied. Our objective was to evaluate the ciliary beat frequency (CBF) of regenerated sinus mucosa treated with topical RA in a rabbit model. METHODS Twelve rabbits underwent bilateral surgical stripping of the maxillary sinuses, followed by treatment with RA gel in the right side and an inert gel control in the left side. The rabbits were then killed at either 2 or 4 weeks, and CBF analysis of the regenerated mucosa was performed. Three unoperated rabbits were used to establish normative CBF data. RESULTS Functional cilia were recovered from 11/12 RA-treated sinuses and 12/12 gel control sinuses. At 2 weeks postoperatively, the RA-treated sinuses showed an average CBF of 19.78 Hz, which was statistically comparable with the normal unoperated controls (p < 0.26). The inert gel-treated mucosa showed a CBF of 29.24 Hz, which was significantly elevated compared with normals (p < 0.05). At 4 weeks, ciliary activity persisted, but both RA-treated sinuses and gel controls showed elevated CBF compared with normals (p < 0.03). CONCLUSION Topical RA placed in a demucosalized maxillary sinus yields functional cilia. RA appears to have a normalizing effect on CBF early in the mucosal wound healing process compared with control. This effect appears to be mitigated in later stages of wound healing. RA may be beneficial in enhancing morphological and functional aspects of regenerating cilia.
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Affiliation(s)
- Vanessa R Erickson
- Division of Rhinology, Department of Otolaryngology, Stanford University, Stanford, California, USA
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Abstract
Background Nasal packing usually is placed after endoscopic sinus surgery (ESS) to control hemorrhage, but also may be used to prevent adhesions from forming and promote faster healing of damaged mucosa. Methods A literature review was performed to identify all forms of scientifically evaluated absorbable packing for ESS. Only English studies identifiable within the PubMed database were included. Studies were categorized by level of evidence and evaluated for methodological errors. Results Thirty-eight studies met the inclusion criteria. There was a diverse range of article evidence and quality. Conclusion The most effective hemostatic agent currently available is FloSeal; however, this product causes an increase in adhesion formation. For the purpose of preventing adhesions, resorbable packs appear to have no benefit over either nonresorbables or no packing. If the middle turbinate is unstable at the conclusion of surgery, suturing it to the septum may reduce adhesions. Although mitomycin C, hyaluronic acid, and retinoic acid all have shown potential in these roles, to date, none have shown to be useful in the post-ESS chronic sinusitis human patient.
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Affiliation(s)
- Erik Kent Weitzel
- Department of Surgery-Otolaryngology, University of Adelaide, South Australia, Australia
| | - Peter-John Wormald
- Department of Surgery-Otolaryngology, University of Adelaide, South Australia, Australia
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Leung MK, Hwang PH. Rehabilitation of surgically traumatized paranasal sinus mucosa using retinoic acid. ACTA ACUST UNITED AC 2007; 21:271-5. [PMID: 17621807 DOI: 10.2500/ajr.2007.21.3035] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Paranasal sinus mucosa that regenerates after surgical stripping is characterized by sparse, dysmorphic cilia. Although such dysfunctional mucosal changes are thought to be irreversible, the potential rehabilitation of deciliated mucosa by topical therapies has not been explored. This study evaluated the effect of topical retinoic acid (RA) in rehabilitating deciliated sinus mucosa that has regenerated after surgical stripping. METHODS Twelve New Zealand rabbits underwent bilateral maxillary sinus mucosal stripping and were allowed to remucosalize for 10 days. In the first treatment arm (n = 6), 0.01% RA was applied to the regenerated mucosa of the left maxillary sinus and an aqueous control was placed contralaterally. In the second treatment arm, the regenerated mucosa was surgically restripped bilaterally before applying RA and control. After 14 additional days, mucosa was harvested and examined by scanning electron microscopy for ciliary density, orientation, and morphology. RESULTS In the first treatment arm, no significant differences in ciliary density, orientation, or morphology were noted between RA-treated sinuses and controls. In the second arm, RA-treated sinuses showed improved ciliary density, morphology, and orientation compared with controls. CONCLUSION RA does not appear to significantly enhance ciliogenesis when applied after mucosal regeneration has occurred. However, if deciliated mucosa is restripped and allowed to regenerate in the presence of RA, ciliary ultrastructural features may be enhanced. RA may have therapeutic value in rehabilitating deciliated sinus mucosa when applied before mucociliary differentiation of regenerating mucosa.
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Affiliation(s)
- Man-Kit Leung
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, Stanford University School of Medicine, Stanford, California, USA
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Bibliography. Current world literature. Nose and paranasal sinuses. Curr Opin Otolaryngol Head Neck Surg 2007; 15:48-55. [PMID: 17211184 DOI: 10.1097/moo.0b013e32802e6d9b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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