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Wang F, Zhang X, Zhang J, Xu Q, Yu X, Xu A, Yi C, Bian X, Shao S. Recent advances in the adjunctive management of diabetic foot ulcer: Focus on noninvasive technologies. Med Res Rev 2024; 44:1501-1544. [PMID: 38279968 DOI: 10.1002/med.22020] [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] [Received: 08/13/2022] [Revised: 12/15/2023] [Accepted: 01/10/2024] [Indexed: 01/29/2024]
Abstract
Diabetic foot ulcer (DFU) is one of the most costly and serious complications of diabetes. Treatment of DFU is usually challenging and new approaches are required to improve the therapeutic efficiencies. This review aims to update new and upcoming adjunctive therapies with noninvasive characterization for DFU, focusing on bioactive dressings, bioengineered tissues, mesenchymal stem cell (MSC) based therapy, platelet and cytokine-based therapy, topical oxygen therapy, and some repurposed drugs such as hypoglycemic agents, blood pressure medications, phenytoin, vitamins, and magnesium. Although the mentioned therapies may contribute to the improvement of DFU to a certain extent, most of the evidence come from clinical trials with small sample size and inconsistent selections of DFU patients. Further studies with high design quality and adequate sample sizes are necessitated. In addition, no single approach would completely correct the complex pathogenesis of DFU. Reasonable selection and combination of these techniques should be considered.
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Affiliation(s)
- Fen Wang
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Xiaoling Zhang
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Jing Zhang
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Qinqin Xu
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Xuefeng Yu
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Anhui Xu
- Division of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chengla Yi
- Division of Trauma Surgery, Tongji Hospital, Tongji Medical College, Wuhan, China
| | - Xuna Bian
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Shiying Shao
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
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Yaghobee S, Rouzmeh N, Taheri M, Aslroosta H, Mahmoodi S, Mohammadnejad Hardoroodi M, Soleimanzadeh Azar P, Khorsand A. Evaluation of topical erythropoietin application on the healing outcome of gingival graft recipient site; a randomized controlled clinical trial. BMC Oral Health 2021; 21:578. [PMID: 34772399 PMCID: PMC8588661 DOI: 10.1186/s12903-021-01948-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/04/2021] [Indexed: 11/28/2022] Open
Abstract
Background Free gingival graft (FGG) is a highly predictable method to increase the width of keratinized gingiva. Various materials have been reported to accelerate the wound healing process. Considering the positive effect of EPO on dermal wound healing this study aimed to investigate the effects of EPO on the rate of healing and degree of inflammation in free gingival grafts. Methods Seventeen patients with bilateral lack of keratinized gingiva in mandible were selected for this clinical trial. The surgical intervention was performed after phase I periodontal therapy. Recipient site was prepared apical to the mucogingival line, and FGG was harvested from the palate. Before graft placement, the test side and control side were treated with 1 ml of EPO 4000 IU/ml and distilled water, respectively, for 2 min. On days 7, 14, 21, 28, 60, and 90 after surgery, the grafted sites were examined by blinded observers to compare the healing and inflammation of the areas. Results All the 17 patients completed the surgeries and follow-up examinations. Direct examination revealed significantly better healing in EPO group only on the 28th day. Assessment of the photographs showed a significant value in favor of the test group at some other time points as well. The EPO group demonstrated less inflammation, which was statistically significant in many time points. The graft area was 80.88 ± 30.21 mm2 and 71.35 ± 15.62 mm2 in the EPO and control groups, respectively. The difference was not significant, though. Conclusions Topical application of erythropoietin can accelerate the healing of gingival grafts and reduce the inflammation during healing period. The final graft outcome, nevertheless, does not seem to be influenced by EPO. Trial registration This was a split-mouth randomized controlled clinical trial (IRCT201201278830N1). The first registration date: 2016-10-22
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Affiliation(s)
- Siamak Yaghobee
- Periodontics Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Nina Rouzmeh
- Periodontics Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mina Taheri
- Periodontics Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hoori Aslroosta
- Periodontics Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Mahmoodi
- Independent Researcher, Novin Formula Consulting Group, Tehran, Iran
| | | | | | - Afshin Khorsand
- Periodontics Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Development and Evaluation of the Wound Healing Effect of a Novel Topical Cream Formula Based on Ginkgo biloba Extract on Wounds in Diabetic Rats. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6474706. [PMID: 34692837 PMCID: PMC8528584 DOI: 10.1155/2021/6474706] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/18/2021] [Accepted: 09/13/2021] [Indexed: 02/08/2023]
Abstract
Despite advances in diabetes care, impaired diabetic wound healing remains a significant clinical problem. The present study was aimed at developing a novel cream based on Ginkgo biloba extract and investigating its wound healing effect on full-thickness wounds in diabetic rats. The topical formulated oil-in-water emulsion-based cream contains Ginkgo biloba aqueous extract in an amount of about 1% to 5% as an active agent. The prepared formula was subjected to physicochemical assessment and pharmacotechnical characterization. Eighteen alloxan-induced diabetic rats completing full-thickness excisional skin wounds were randomly divided into three groups topically treated with either a normal saline (control group), the reference drug (“Cytol Centella cream®”), and cream based on the Ginkgo biloba extract. The response to treatment was assessed by macroscopic, qualitative, and quantitative histopathological analysis. The prepared formula showed good physicochemical properties. The rheological behavior of the prepared cream followed a non-Newtonian pseudoplastic pattern at different storage temperatures. The cream, which is a macroemulsion with uniform size distribution, remained stable for 6 months. Skin tolerance studies confirmed the compatibility of the cream with the skin. During the experimental trial, the cream based on the Ginkgo biloba-treated group showed significant improvements over the control and reference groups for both general wound appearance and healing dynamics. This increased rate of closure of wounds in diabetic rats was associated with increased collagen synthesis. Our findings showed that the cream could be a promising and innovative topical treatment with Ginkgo biloba extract for the management of acute diabetic wounds.
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da Costa MC, Ferreira BA, de Moura FBR, de Lima LG, Araujo FDA, Mota FCD. Evaluation of 4% stabilized Sodium Hypochlorite activity in the repair of cutaneous excisional wounds in mice. Injury 2021; 52:2075-2083. [PMID: 34147247 DOI: 10.1016/j.injury.2021.05.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 02/02/2023]
Abstract
Wounds are conditions largely present in the clinical routine, and even though frequent, their complete resolution can be challenging. Several solutions can aid or stimulate the healing process, and for this reason, this work used a stabilized solution of 4% sodium hypochlorite for the treatment of excisional wounds in mice. This study was carried out in two distinct stages: in the first stage, the optimal concentration of the chlorinated solution was determined by using the sponge implantation technique in mouse subcutaneous tissue to evaluate the dose-response curve; and in the second phase, this concentration was tested in an experimental model of excisional skin wounds in mice. Soluble collagen, hemoglobin, myeloperoxidase (MPO) and N-acetyl-β-D-glycosaminidase (NAG) activity were assessed, and total, type I and type III collagen deposition were quantified in both stages. Based on the results presented in the sponge implantation study, the chlorinated solution at 150 ppm (0.015%) was chosen for use in a preclinical trial of skin healing in mice. At 1, 3, 7 and 14 days of treatment, the % wound area repair in the group treated with 150 ppm chlorinated solution was higher when compared to the control group, with statistical differences at all time points (*p≤ 0.05 and **p≤ 0.01). 150 ppm chlorinated solution obtained from a stabilized 4% sodium hypochlorite solution was effective in accelerating cutaneous excision wound repair in mice, showing a positive influence on tissue repair.
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Affiliation(s)
- Marcelo C da Costa
- Department of Veterinary Surgery, Paulista State University Júlio de Mesquita Filho, Access Road Highway Professor Paulo Donato Castelane Castelane S / N, Vila Industrial, [Zip Code]: 14884-900, Jaboticabal-SP, Brazil.
| | - Bruno A Ferreira
- Institute of Biomedical Sciences, Federal University of Uberlândia, Avenue. João Naves de Ávila, 2121 - Santa Monica, [Zip Code]: 1720, 38400-902, Uberlândia-MG, Brazil
| | - Francyelle B R de Moura
- Institute of Biology, Campinas State University, Street Monteiro Lobato, 255. [Zip Code]: 1308-862, Campinas-SP, Brazil
| | - Lara G de Lima
- Veterinarian, Federal University of Uberlândia, Avenue Mato Grosso, 3289 - Código postal [Zip Code]: 38405-314, Bloco 2S - Umuarama, Uberlândia - MG, Brazil
| | - Fernanda de A Araujo
- Institute of Biomedical Sciences, Federal University of Uberlândia, Avenue. João Naves de Ávila, 2121 - Santa Monica, [Zip Code]: 1720, 38400-902, Uberlândia-MG, Brazil
| | - Francisco C D Mota
- Department of Veterinary Surgery, Federal University of Uberlândia, Av. Mato Grosso, 3289 - [Zip Code]: 38405-314, Bloco 2S - Umuarama, Uberlândia - MG, Brazil.
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Toleubayev M, Dmitriyeva M, Kozhakhmetov S, Sabitova A. Efficacy of erythropoietin for wound healing: A systematic review of the literature. Ann Med Surg (Lond) 2021; 65:102287. [PMID: 33948167 PMCID: PMC8079955 DOI: 10.1016/j.amsu.2021.102287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives To systematically review the available literature on the efficacy of erythropoietin for wound healing in human patients. Design The review was reported following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A descriptive-analytical method was used to analyse and integrate review findings. Data sources A primary search of electronic databases was performed using a combination of search terms related to the following areas of interest: ‘efficacy’, ‘erythropoietin’ and ‘wound healing’. A secondary search of the grey literature was conducted in addition to checking the reference list of included studies and review papers. Results Seven distinct studies involving 150 patients met the inclusion criteria for the review. The included studies suggest that topical and subcutaneous application of erythropoietin improves the wound healing process via faster re-epithelialization and reducing wound area and depth. Conclusions There were a limited number of studies and a great degree of heterogeneity of evidence due to differences in the course of concomitant illness, wound aetiology, and the time and dosing regimens adopted. Further research adopting validated and consistent outcome measures is recommended to determine the efficacy and safety of erythropoietin for wound healing. Topical and subcutaneous application of erythropoietin improves the wound healing process in human patients. Topical and subcutaneous application of erythropoietin contributes to reducing wound area and depth in human patients. Topical and subcutaneous application of erythropoietin has the potential to prevent wounds from becoming chronic.
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Affiliation(s)
- Medet Toleubayev
- Department of Plastic Surgery, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Mariya Dmitriyeva
- Department of Plastic Surgery, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Saken Kozhakhmetov
- Department of Plastic Surgery, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Alina Sabitova
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Service Development, Queen Mary University of London, London, UK
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Toleubayev M, Dmitriyeva M, Kozhakhmetov S, Igissinov N, Turebayev M, Omarbekov A, Adaibayev K, Shakenov A, Izimbergenov M. Regenerative Properties of Recombinant Human Erythropoietin in the Wound Healing. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND: Erythropoietin (EPO) is the main stimulator of erythropoiesis, but EPO also has non-hematopoietic effects. The recent data show the positive effects of EPO on tissue regeneration.
AIM: This review aims to know highlights the pathophysiological mechanisms of EPO at different stages of tissue regeneration, and possible clinical applications in wound healing.
METHODS: A review of the literature considering reviews, clinical studies, original papers, and articles from electronic data has been used.
RESULTS: Analysis of animal studies and several clinical trials using EPO in context of wound healing revealed that EPO has a positive effect on all stages of regeneration process and may be a promising therapeutic strategy for the treatment of chronic wounds.
CONCLUSION: An improved understanding of the functions and regulatory mechanisms of EPO in the context of wound healing may lead to new considerations of this growth hormone for its regular clinical application in patients.
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Akdemir O, Tatar BE, Gökhan A, Şirin C, Çavuşoğlu T, Erbaş O, Uyanıkgil Y, Çetin EÖ, Zhang F, Lineaweaver W. Preventive effect of trimetazidine against ischemia-reperfusion injury in rat epigastric island flaps: an experimental study. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021; 44:177-188. [DOI: 10.1007/s00238-020-01757-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022]
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Cha JK, Pla R, Vignoletti F, Jung UW, Sanz-Esporrin J, Sanz M. Immunohistochemical characteristics of lateral bone augmentation using different biomaterials around chronic peri-implant dehiscence defects: An experimental in vivo study. Clin Oral Implants Res 2021; 32:569-580. [PMID: 33629461 DOI: 10.1111/clr.13726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 01/04/2021] [Accepted: 02/17/2021] [Indexed: 11/27/2022]
Abstract
AIM To investigate the immunohistochemical characteristics of a highly porous synthetic bone substitute and a cross-linked collagen membrane for guided bone regeneration. METHODS Three experimental groups were randomly allocated at chronic peri-implant dehiscence defect in 8 beagle dogs: (i) biphasic calcium phosphate covered by a cross-linked collagen membrane (test group), (ii) deproteinized bovine bone mineral covered by a natural collagen membrane (positive control) and (iii) no treatment (negative control). After 8 and 16 weeks of submerged healing, dissected tissue blocks were processed for immunohistochemical analysis. Seven antibodies were used to detect the remaining osteogenic and angiogenic potential, and quantitative immunohistochemical analysis was done by software. RESULTS The antigen reactivity of alkaline phosphatase was significantly higher in the test group compared to the positive and negative controls, and it maintained till 16 weeks. The intensity of osteocalcin was significantly higher in the positive control at 8 weeks than the other groups, but significantly decreased at 16 weeks and no difference was found between the groups. A significant large number of TRAP-positive cells were observed in the test group mainly around the remaining particles at 16 weeks. The angiogenic potential was comparable between the groups showing no difference in the expression of transglutaminase II and vascular endothelial growth factor. CONCLUSION Guided bone regeneration combining a highly porous biphasic calcium phosphate synthetic biomaterial with a crosslinked collagen membrane, resulted in extended osteogenic potential when compared to the combination of deproteinized bovine bone mineral and a native collagen membrane.
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Affiliation(s)
- Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Rafael Pla
- Department of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Fabio Vignoletti
- Department of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Javier Sanz-Esporrin
- Department of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- Department of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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Pecoraro AR, Hosfield BD, Li H, Shelley WC, Markel TA. Angiogenesis: A Cellular Response to Traumatic Injury. Shock 2021; 55:301-310. [PMID: 32826807 DOI: 10.1097/shk.0000000000001643] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
ABSTRACT The development of new vasculature plays a significant role in a number of chronic disease states, including neoplasm growth, peripheral arterial disease, and coronary artery disease, among many others. Traumatic injury and hemorrhage, however, is an immediate, often dramatic pathophysiologic insult that can also necessitate neovascularization to promote healing. Traditional understanding of angiogenesis involved resident endothelial cells branching outward from localized niches in the periphery. Additionally, there are a small number of circulating endothelial progenitor cells that participate directly in the process of neovessel formation. The bone marrow stores a relatively small number of so-called pro-angiogenic hematopoietic progenitor cells-that is, progenitor cells of a hematopoietic potential that differentiate into key structural cells and stimulate or otherwise support local cell growth/differentiation at the site of angiogenesis. Following injury, a number of cytokines and intercellular processes are activated or modulated to promote development of new vasculature. These processes initiate and maintain a robust response to vascular insult, allowing new vessels to canalize and anastomose and provide timely oxygen delivering to healing tissue. Ultimately as we better understand the key players in the process of angiogenesis we can look to develop novel techniques to promote healing following injury.
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Affiliation(s)
- Anthony R Pecoraro
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
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Ferris AE, Harding KG. Does localized iron loss in venous disease lead to systemic iron deficiency? A descriptive pilot study. Wound Repair Regen 2019; 28:33-38. [PMID: 31605501 DOI: 10.1111/wrr.12769] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 09/23/2019] [Indexed: 01/22/2023]
Abstract
Haemosiderin deposition in the legs of patients with venous leg ulcers is well established, and several theories suggest this stored iron has a role in disease pathophysiology. In this novel pilot study of patients with chronic venous leg ulcers, we aimed to establish the relationship between wound fluid iron levels, serum iron parameters and healing. Fifteen patients with venous ulcers were included in the study. Blood samples were taken for full blood count and iron studies, while simultaneously wound fluid was obtained from the wound surface using filter paper. Wound areas were measured at initial and 4 week (+/- 2 day) follow-up visits. We found a positive correlation between wound fluid and serum iron (correlation co-efficient 0.27) and those with the lowest wound fluid iron level were also anemic. No association was found between initial wound area and wound fluid iron level but the largest wound areas were found in patients with anemia. Only 38% of patients demonstrated a reduction in wound area during the 4 week study, and 80% of those were not anemic or iron deficient. Conversely in those patients whose wounds did not reduce in size 88% were anemic or iron deficient. These findings demonstrate a previously unrecognized phenomenon of systemic iron store depletion secondary to leaching out of the body in wound exudate. In addition, these results suggest a high prevalence of anemia in patients with chronic venous ulcers, though whether this is cause or effect requires further research. Our findings also suggest that patients with venous ulcers have a high prevalence of iron deficiency and anemia, which appears to be often undiagnosed, and that diagnostic criteria for iron deficiency in patients with chronic wounds need to be revised to reflect the effect of chronic inflammation on iron metabolism.
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Affiliation(s)
- Amy E Ferris
- Cardiff and Vale University Health Board, Cardiff, UK
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Sun X, Zhang H, He J, Cheng R, Cao Y, Che K, Cheng L, Zhang L, Pan G, Ni P, Deng L, Zhang Y, Santos HA, Cui W. Adjustable hardness of hydrogel for promoting vascularization and maintaining stemness of stem cells in skin flap regeneration. APPLIED MATERIALS TODAY 2018; 13:54-63. [DOI: 10.1016/j.apmt.2018.08.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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YAGHOBEE S, ROUZMEH N, ASLROOSTA H, MAHMOODI S, KHORSAND A, KHARRAZIFARD MJ. Effect of Topical Erythropoietin (EPO) on palatal wound healing subsequent to Free Gingival Grafting (FGG). Braz Oral Res 2018; 32:e55. [DOI: 10.1590/1807-3107bor-2018.vol32.0055] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 05/09/2018] [Indexed: 12/14/2022] Open
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Development and Characterisation of a Human Chronic Skin Wound Cell Line-Towards an Alternative for Animal Experimentation. Int J Mol Sci 2018; 19:ijms19041001. [PMID: 29584680 PMCID: PMC5979489 DOI: 10.3390/ijms19041001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/21/2018] [Accepted: 03/23/2018] [Indexed: 12/30/2022] Open
Abstract
Background: Chronic skin wounds are a growing financial burden for healthcare providers, causing discomfort/immobility to patients. Whilst animal chronic wound models have been developed to allow for mechanistic studies and to develop/test potential therapies, such systems are not good representations of the human chronic wound state. As an alternative, human chronic wound fibroblasts (CWFs) have permitted an insight into the dysfunctional cellular mechanisms that are associated with these wounds. However, such cells strains have a limited replicative lifespan and therefore a limited reproducibility/usefulness. Objectives: To develop/characterise immortalised cell lines of CWF and patient-matched normal fibroblasts (NFs). Methods and Results: Immortalisation with human telomerase resulted in both CWF and NF proliferating well beyond their replicative senescence end-point (respective cell strains senesced as normal). Gene expression analysis demonstrated that, whilst proliferation-associated genes were up-regulated in the cell lines (as would be expected), the immortalisation process did not significantly affect the disease-specific genotype. Immortalised CWF (as compared to NF) also retained a distinct impairment in their wound repopulation potential (in line with CWF cell strains). Conclusions: These novel CWF cell lines are a credible animal alternative and could be a valuable research tool for understanding both the aetiology of chronic skin wounds and for therapeutic pre-screening.
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Devalliere J, Dooley K, Hu Y, Kelangi SS, Uygun BE, Yarmush ML. Co-delivery of a growth factor and a tissue-protective molecule using elastin biopolymers accelerates wound healing in diabetic mice. Biomaterials 2017; 141:149-160. [DOI: 10.1016/j.biomaterials.2017.06.043] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/29/2017] [Accepted: 06/29/2017] [Indexed: 01/14/2023]
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The Effect of Coenzyme Q10 (Ubiquinone) on Random Pattern Skin Flap Survival in Rat Model. Ann Plast Surg 2017; 77:e9-e14. [PMID: 25954836 DOI: 10.1097/sap.0000000000000504] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In this study, the effect of coenzyme Q10 (CQ10) on flap survival was investigated. METHODS Fifty Wistar Albino rats were divided into 5 groups. The survival rates of the skin flaps were assessed 10 days after complete elevation of the flaps. Regions of survival and necrosis were drawn on transparent acetate sheets and scanned into a computer. Tissue samples were assessed histopathologically after staining with hematoxylin-eosin, vascular endothelial growth factor staining and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-Biotin Nick End-labeling staining. To evaluate the antioxidant effect of CQ10; malondialdehyde, nitric oxide levels were measured. RESULTS Viable flaps area was found higher in groups 3 and 4 as compared to groups 1, 2, and 5. In terms of vascular proliferation, elevated angiogenesis was observed in pathological specimens of groups 3 and 4 as compared to groups 1, 2, and 5. Malondialdehyde levels in groups 3 and 4 were found to be significantly decreased as compared to groups 1, 2 and 5 (P < 0.05). Moreover, serum levels of CQ10 were found significantly increased in groups 3 and 4 (P < 0.05). CONCLUSIONS In conclusion, CQ10 significantly improves flap viability in rat model, and the highest levels of serum CQ10 can be obtained by oral administration.
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Becerik S, Öztürk VÖ, Celec P, Kamodyova N, Atilla G, Emingil G. Gingival crevicular fluid and plasma oxidative stress markers and TGM-2 levels in chronic periodontitis. Arch Oral Biol 2017; 83:47-54. [PMID: 28711023 DOI: 10.1016/j.archoralbio.2017.06.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 06/24/2017] [Accepted: 06/28/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study was aimed to evaluate the gingival crevicular fluid (GCF) and plasma transglutaminase-2 (TGM-2), total antioxidant capacity (TAC), total oxidant status (TOS), ferric reducing antioxidant power (FRAP) and thiobarbituric acid reactive substances (TBARS) in patients with chronic periodontal disease. MATERIALS AND METHODS Twenty patients with chronic periodontitis (CP), 20 patients with gingivitis and 20 healthy subjects were enrolled in the study. Clinical periodontal parameters including probing depth, clinical attachment level, plaque index and papillary bleeding index were recorded. GCF and plasma levels of TGM-2, TAC, TOS, TBARS and FRAP were analyzed. RESULTS GCF TGM-2 was significantly lower in CP group than in gingivitis patients (P=0.006). GCF FRAP in CP and gingivitis groups was significantly lower than in healthy subjects (P<0.001). Plasma FRAP level was lower in gingivitis group when compared to healthy subjects (P=0.003). There was no significant difference in GCF and plasma TAC, TOS, TBARS and plasma TGM-2 levels among the study groups (P>0.05). GCF TGM-2 level was positively correlated with GCF TAC and negatively correlated with CAL. CONCLUSIONS Decreased FRAP in GCF and plasma indicating lower antioxidant status of CP patients might suggest the role of oxidative stress in periodontitis. GCF TGM-2 data might suggest that TGM2 is associated with stabilization of the extracellular matrix and wound healing in periodontium rather than gingival inflammation.
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Affiliation(s)
- Sema Becerik
- Ege University, School of Dentistry, Department of Periodontology, İzmir, Turkey.
| | - Veli Özgen Öztürk
- Adnan Menderes University, School of Dentistry, Department of Periodontology, Aydın, Turkey
| | - Peter Celec
- Institute of Molecular Biomedicine, Comenius University, Bratislava, Slovakia; Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Natalia Kamodyova
- Institute of Molecular Biomedicine, Comenius University, Bratislava, Slovakia; Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Gül Atilla
- Ege University, School of Dentistry, Department of Periodontology, İzmir, Turkey
| | - Gülnur Emingil
- Ege University, School of Dentistry, Department of Periodontology, İzmir, Turkey
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Schneppendahl J, Jungbluth P, Sager M, Benga L, Herten M, Scholz A, Wild M, Hakimi M, Windolf J, Grassmann JP. Synergistic effects of HBO and PRP improve bone regeneration with autologous bone grafting. Injury 2016; 47:2718-2725. [PMID: 27817884 DOI: 10.1016/j.injury.2016.09.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 09/29/2016] [Indexed: 02/02/2023]
Abstract
Bone defects remain a challenge for patients and orthopaedic surgeons. Autologous transfer of cancellous bone grafts remains the standard of care. However, in recent years various osteoinductive substitute materials, such as platelet rich plasma (PRP) and hyperbaric oxygen therapy (HBO) have been shown to improve bone healing. This study evaluates the effects of a combined application of PRP and HBO with autologous bone grafting in an animal model. In 48 New Zealand White rabbits bone defects at the radius were filled with autologous bone harvested at the iliac crest. This was combined with application of autologous PRP and/or HBO treatment for the duration of this study. After 3 and 6 weeks histomorphometric, immunohistochemical and radiologic evaluations were performed. All animals tolerated the treatment well. Improved bone regeneration was shown in all groups at 6 weeks compared to 3 weeks. Additional application of PRP and HBO resulted in an increase in new bone formation and increased neovascularization at 3 and 6 weeks. There was no statistical significant difference between PRP and HBO application in these regards. A combinatory use of PRP and HBO resulted in an increased bone regeneration and neovascularization compared to all other groups. This study provides evidence for an improvement of bone regeneration with the combinatory application of PRP and HBO to autologous cancellous bone grafts in a model of weight bearing bone defects in rabbits. Also synergistic effects of these two measures on angiogenesis were evident.
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Affiliation(s)
- Johannes Schneppendahl
- Heinrich Heine University Hospital Düsseldorf, Department of Trauma and Hand Surgery, Moorenstrasse 5, 40225 Düsseldorf, Germany
| | - Pascal Jungbluth
- Heinrich Heine University Hospital Düsseldorf, Department of Trauma and Hand Surgery, Moorenstrasse 5, 40225 Düsseldorf, Germany.
| | - Martin Sager
- Heinrich Heine University Hospital Duesseldorf, Animal Research Institute, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Laurentiu Benga
- Heinrich Heine University Hospital Duesseldorf, Animal Research Institute, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Monika Herten
- University Hospital Muenster, Department for Vascular and Endovascular Surgery, Waldeyerstraße 30, 48149 Münster, Germany
| | - Armin Scholz
- Heinrich Heine University Hospital Düsseldorf, Department of Trauma and Hand Surgery, Moorenstrasse 5, 40225 Düsseldorf, Germany
| | - Michael Wild
- Department of Orthopaedic, Trauma, and Hand Surgery, Klinikum Darmstadt, Grafenstraße 9, 64283 Darmstadt, Germany
| | - Mohssen Hakimi
- Department of Trauma, Orthopaedic, and Hand Surgery, Vivantes Klinikum am Urban, Dieffenbachstraße 1, 10967 Berlin, Germany
| | - Joachim Windolf
- Heinrich Heine University Hospital Düsseldorf, Department of Trauma and Hand Surgery, Moorenstrasse 5, 40225 Düsseldorf, Germany
| | - Jan-Peter Grassmann
- Heinrich Heine University Hospital Düsseldorf, Department of Trauma and Hand Surgery, Moorenstrasse 5, 40225 Düsseldorf, Germany
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Cernaro V, Sfacteria A, Rifici C, Macrì F, Maricchiolo G, Lacquaniti A, Ricciardi CA, Buemi A, Costantino G, Santoro D, Buemi M. Renoprotective effect of erythropoietin in zebrafish after administration of gentamicin: an immunohistochemical study for β-catenin and c-kit expression. J Nephrol 2016; 30:385-391. [PMID: 27679401 DOI: 10.1007/s40620-016-0353-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 09/11/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Gentamicin is an aminoglycoside antibiotic widely used in the treatment of infections caused by Gram-negative bacteria. The main limitation to its therapeutic effectiveness is the potential nephrotoxicity. Erythropoietin has a tissue protective effect widely demonstrated in the kidney. The aim of the present study was to evaluate the renoprotective effects of erythropoietin in a model of zebrafish (Danio rerio) after administration of gentamicin. METHODS Sixty adult zebrafish were subdivided into three groups: group A was treated with gentamicin; group B received gentamicin and, 24 h later, epoetin alpha; group C received drug diluent only. In order to analyze the renoprotective activity of erythropoietin, the expression of c-kit and β-catenin was evaluated by immunohistochemistry. RESULTS Generally, the zebrafish renal tubule regenerates 15 days after an injury. Conversely, 7 days after gentamicin administration, animals treated with erythropoietin (group B) showed a better renal injury repair as documented by: increased expression of β-catenin, less degenerated tubules, greater number of centers of regeneration, positivity for c-kit only in immature-looking tubules and lymphohematopoietic cells. CONCLUSION The expression of c-kit and β-catenin suggests that erythropoietin may exert a role in regeneration reducing the extent of tubular damage from the outset after gentamicin administration.
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Affiliation(s)
- Valeria Cernaro
- Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria n. 1, 98124, Messina, Italy.
| | | | - Claudia Rifici
- Department of Veterinary Science, University of Messina, 98100, Messina, Italy
| | - Francesco Macrì
- Department of Veterinary Science, University of Messina, 98100, Messina, Italy
| | - Giulia Maricchiolo
- IAMC (Institute for Coastal Marine Environment), CNR, U.O.S. Messina, Spianata S. Raineri, 86, 98122, Messina, Italy
| | - Antonio Lacquaniti
- Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria n. 1, 98124, Messina, Italy
| | - Carlo Alberto Ricciardi
- Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria n. 1, 98124, Messina, Italy
| | - Antoine Buemi
- Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria n. 1, 98124, Messina, Italy
| | - Giuseppe Costantino
- Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria n. 1, 98124, Messina, Italy
| | - Domenico Santoro
- Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria n. 1, 98124, Messina, Italy
| | - Michele Buemi
- Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria n. 1, 98124, Messina, Italy
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Wahedi HM, Park YU, Moon EY, Kim SY. Juglone ameliorates skin wound healing by promoting skin cell migration through Rac1/Cdc42/PAK pathway. Wound Repair Regen 2016; 24:786-794. [PMID: 27283994 DOI: 10.1111/wrr.12452] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 06/02/2016] [Indexed: 01/03/2023]
Abstract
Skin cell regeneration and wound healing are key processes in the recovery from skin injuries. Rapid cell migration and regeneration of skin cells lead to faster and better healing of wounded skin. In the present study, we aimed to investigate the wound healing potential of juglone, a naturally occurring Pin1 inhibitor found in walnuts. Cultured skin cells (NHDF and HaCaT) and hairless mice were treated with juglone after wound creation to examine its effects on cell migration and wound healing rate. The expressions of cell migration related proteins (Rac1, Cdc42, and α-PAK), collagen deposition, and angiogenesis were analyzed. Juglone treatment resulted in faster rate of growth and migration and recovered cell morphology, particularly at a concentration of 5 µM, in skin cells compared to the untreated group. In vivo experiments showed that mice treated with juglone showed faster wound healing rate with better skin morphology and collagen deposition than the vehicle group. Furthermore, juglone increased the activation and/or expression of Cdc42, Rac1, and α-pak in HaCaT cells, and resulted in enhanced angiogenesis in endothelial cells (HUVECs). Juglone also activated MAPKs signaling by activation of ERK, JNK, and p38 proteins. Taken together, these data suggest that juglone may be a potential candidate for wound healing and skin regeneration which ameliorates wound healing mainly by promoting skin cell migration through Rac1/Cdc42/PAK pathway.
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Affiliation(s)
- Hussain M Wahedi
- Department of Pharmacognosy, College of Pharmacy, Gachon University, Incheon, Republic of Korea
| | - Yong U Park
- Department of Pharmacognosy, College of Pharmacy, Gachon University, Incheon, Republic of Korea
| | - Eun-Yi Moon
- Department of Bioscience and Biotechnology, Sejong University, Seoul, Republic of Korea
| | - Sun Y Kim
- Department of Pharmacognosy, College of Pharmacy, Gachon University, Incheon, Republic of Korea. .,Gachon Institute of Pharmaceutical Science, Gachon University, Incheon, Republic of Korea. .,Gachon Medical Research Institute, Gil Medical Center, Incheon, Republic of Korea.
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20
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Bilal O, Guney A, Kalender AM, Kafadar IH, Yildirim M, Dundar N. The effect of erythropoietin on biomechanical properties of the Achilles tendon during the healing process: an experimental study. J Orthop Surg Res 2016; 11:55. [PMID: 27125266 PMCID: PMC4850695 DOI: 10.1186/s13018-016-0390-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 04/19/2016] [Indexed: 11/27/2022] Open
Abstract
Background The aim of this study was to examine the potential biomechanical and histological benefits of systemic erythropoietin administration during the healing of Achilles tendon injury in a rat experimental model. Methods Eighty Sprague-Dawley female rats were included in this study. Animals were randomly assigned into two groups with 40 animals in each: erythropoietin group and control group. Then each group was further divided into four subgroups corresponding to four time points with 10 animals in each. A full-thickness cut was made on the Achilles tendon of each animal and then the tendon was sutured with modified Kessler method. Erythropoietin groups received intraperitoneal erythropoietin (500 IU/kg/day) every day at same time throughout the study period, and the control groups received saline in a similar manner. Animals were sacrificed at four time points, and tensile test was performed on each tendon sample to assess maximum load for each sample. In addition, histopathological examination and scoring was done. Results Both groups had improvement on tensile test (maximum load) over time. However, groups did not differ with regard to maximum load in any of the time points. Similarly, groups did not differ with regard to any of the histopathological scores over time. Conclusions The findings of this study do not support the benefit of systemic erythropoietin administration in Achilles tendon healing process. Further evidence from larger experimental studies is required to justify any such potential benefit. Electronic supplementary material The online version of this article (doi:10.1186/s13018-016-0390-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Okkes Bilal
- Department of Orthopaedics and Traumatology, Sutcu Imam University Medical Faculty, Kahramanmaras, Turkey.
| | - Ahmet Guney
- Department of Orthopaedics and Traumatology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ali Murat Kalender
- Department of Orthopaedics and Traumatology, Sutcu Imam University Medical Faculty, Kahramanmaras, Turkey
| | - Ibrahim Halil Kafadar
- Department of Orthopaedics and Traumatology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Muzaffer Yildirim
- Department of Pathology, The Ministry of Justice, Council of Forensic Medicine, Istanbul, Turkey
| | - Nuh Dundar
- Department of Orthopaedics and Traumatology, Sutcu Imam University Medical Faculty, Kahramanmaras, Turkey
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Rouhollahi E, Moghadamtousi SZ, Hajiaghaalipour F, Zahedifard M, Tayeby F, Awang K, Abdulla MA, Mohamed Z. Curcuma purpurascens BI. rhizome accelerates rat excisional wound healing: involvement of Hsp70/Bax proteins, antioxidant defense, and angiogenesis activity. DRUG DESIGN DEVELOPMENT AND THERAPY 2015; 9:5805-13. [PMID: 26604683 PMCID: PMC4629958 DOI: 10.2147/dddt.s88196] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE Curcuma purpurascens BI. is a member of Zingiberaceae family. The purpose of this study is to investigate the wound healing properties of hexane extract of C. purpurascens rhizome (HECP) against excisional wound healing in rats. MATERIALS AND METHODS Twenty four rats were randomly divided into 4 groups: A) negative control (blank placebo, acacia gum), B) low dose of HECP, C) high dose of HECP, and D) positive control, with 6 rats in each group. Full-thickness incisions (approximately 2.00 cm) were made on the neck area of each rat. Groups 1-4 were treated two-times a day for 20 days with blank placebo, HECP (100 mg/kg), HECP (200 mg/kg), and intrasite gel as a positive control, respectively. After 20 days, hematoxylin and eosin and Masson's trichrome stainings were employed to investigate the histopathological alterations. Protein expressions of Bax and Hsp70 were examined in the wound tissues using immunohistochemistry analysis. In addition, levels of enzymatic antioxidants and malondialdehyde representing lipid peroxidation were measured in wound tissue homogenates. RESULTS Macroscopic evaluation of wounds showed conspicuous elevation in wound contraction after topical administration of HECP at both doses. Moreover, histopathological analysis revealed noteworthy reduction in the scar width correlated with the enhanced collagen content and fibroblast cells, accompanied by a reduction of inflammatory cells in the granulation tissues. At the molecular level, HECP facilitates wound-healing process by downregulating Bax and upregulating Hsp70 protein at the wound site. The formation of new blood vessel was observed in Masson's trichrome staining of wounds treated with HECP (100 and 200 mg/kg). In addition, HECP administration caused a significant surge in enzymatic antioxidant activities and a decline in lipid peroxidation. CONCLUSION These findings suggested that HECP accelerated wound-healing process in rats via antioxidant activity, angiogenesis effect and anti-inflammatory responses involving Hsp70/Bax.
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Affiliation(s)
- Elham Rouhollahi
- Pharmacogenomics Laboratory, Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Fatemeh Hajiaghaalipour
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Maryam Zahedifard
- Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Faezeh Tayeby
- Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Khalijah Awang
- Department of Chemistry, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Mahmood Ameen Abdulla
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Zahurin Mohamed
- Pharmacogenomics Laboratory, Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Currò M, Matarese G, Isola G, Caccamo D, Ventura VP, Cornelius C, Lentini M, Cordasco G, Ientile R. Differential expression of transglutaminase genes in patients with chronic periodontitis. Oral Dis 2014; 20:616-23. [PMID: 24112124 DOI: 10.1111/odi.12180] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 08/06/2013] [Accepted: 08/19/2013] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Gingival epithelium plays a key role in the protection of oral tissues from microbial challenge, especially during the periodontal disease. This study was aimed to evaluate levels of mRNA transcripts of different forms of transglutaminase in the human gingival tissues from patients with chronic periodontitis and relative controls. SUBJECTS AND METHODS This study included 22 patients with chronic periodontitis (CP) and 22 healthy controls. For each patient, the values of probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded. Gene expression of transglutaminase 1, transglutaminase 2, transglutaminase 3, and metalloprotease 2 was evaluated by real-time PCR, while that of Factor XIIIA and metalloprotease 9 by RT-PCR. RESULTS The values of all the clinical parameters were significantly higher in the CP group than in the healthy control group (P < 0.05). In the CP group, the mRNA expression of transglutaminase 1 and transglutaminase 3 was significantly decreased in comparison with healthy control group. A slight nonsignificant changes of transglutaminase 2 gene expression were observed in samples from CP patients in comparison with controls. CONCLUSIONS These observations suggest that transglutaminase gene expression may be modified in response to chronic injury in the damaged gingival and emphasizes the key role of these enzymes in gingival remodelling/healing and adaptive processes.
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Affiliation(s)
- M Currò
- Department of Biomedical Sciences and Morphofunctional Imaging, AOU Policlinico "G. Martino", University of Messina, Messina, Italy
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Hamed S, Bennett CL, Demiot C, Ullmann Y, Teot L, Desmoulière A. Erythropoietin, a novel repurposed drug: an innovative treatment for wound healing in patients with diabetes mellitus. Wound Repair Regen 2013; 22:23-33. [PMID: 24471742 DOI: 10.1111/wrr.12135] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 10/24/2013] [Indexed: 12/22/2022]
Abstract
Developing a new drug is expensive: the cost of going from bench to bedside is about $US1 billion. Therefore, the repurposing of an approved drug is potentially rewarding because it expands the drug's existing therapeutic profile and preempts additional development costs. As the safety profile of a repurposed drug is already well known, any new investigations could then focus on its efficacy and other therapeutic benefits. Recombinant erythropoietin (EPO) is a potential candidate for repurposing because the results of numerous studies have shown that systemic and topical EPO is therapeutically beneficial when it is administered to healthy and diabetic animals with acute and chronic skin wounds and burns. Moreover, the molecular mechanisms of EPO's actions have been elucidated: EPO acts on those nonhematopoietic cells which are involved in the innate immune response where it promotes cellular proliferation and differentiation, exerts its cytoprotective actions, and inhibits apoptosis. In this review, the mechanism of EPO's action in skin wound healing is reviewed, and its potential for treating acute and chronic skin wounds and stimulating tissue regeneration in diabetic patients is discussed.
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Abstract
OBJECTIVE To investigate whether systemic erythropoietin administration can prevent secondary burn progression in an experimental model and to elucidate the underlying mechanisms. DESIGN Prospective study. SETTING University-based laboratory research. SUBJECTS Twenty-one male Wistar rats. INTERVENTIONS The burn comb model creates four rectangular burned surfaces that are intercalated by three unburned zones (interspaces) prone to secondary necrosis. Twenty-one animals were randomized to three experimental groups: 1) Local cooling with water for 20 minutes (control, 17°C); 2) and 3) local cooling with water and intraperitoneal erythropoietin once a day for five days starting 45 minutes after burn injury (500 IU/kg body weight: EPO 500 or 2500 IU/kg body weight: EPO 2500). MEASUREMENTS AND MAIN RESULTS Secondary burn progression-both in depth (histology) and in surface (planimetry)-as well as interspace perfusion (laser Doppler flowmetry) and hematocrit were analyzed. Further, dilatory response (inducible nitric oxide synthase expression), inflammation (leukocyte count), and angiogenesis (CD31 expression) were assessed. Finally, wound healing time and contracture rate were reported. Burn progression resulted in complete dermal destruction as well as in important interspace necrosis in control animals, whereas burn progression was significantly reduced in a dose-dependent manner in animals treated with erythropoietin. Tissue protection was associated with an increased interspace perfusion with EPO 500, but not with EPO 2500, and was paralleled by a significant increase in inducible nitric oxide synthase expression and decreased inflammation, independent of the erythropoietin dosage. EPO 2500 led to a significant increase of hematocrit at day 4. Finally, faster wound healing and less contracture were observed in animals treated with EPO 500 only. CONCLUSIONS Erythropoietin represents an easy-to-use therapeutic approach to prevent secondary burn progression, i.e., to control damage after burn injury. It preserves microcirculatory perfusion within the endangered areas in a dose-dependent manner.
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Sager M, Herten M, Dreiner L, Engelhardt E, Assheuer J, Kramer M, Jäger M. Histological Variations of the Glenoid Labrum in Dogs. Anat Histol Embryol 2013; 42:438-47. [DOI: 10.1111/ahe.12035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 12/01/2012] [Indexed: 11/30/2022]
Affiliation(s)
- M. Sager
- Central Animal Research Facility; University Hospital; Heinrich-Heine-University Düsseldorf; Moorenstr. 5 40225 Düsseldorf Germany
| | - M. Herten
- Department of Orthopaedics; Heinrich-Heine-University Düsseldorf; Moorenstr. 5 40225 Düsseldorf Germany
| | - L. Dreiner
- Central Animal Research Facility; University Hospital; Heinrich-Heine-University Düsseldorf; Moorenstr. 5 40225 Düsseldorf Germany
| | - E. Engelhardt
- Central Animal Research Facility; University Hospital; Heinrich-Heine-University Düsseldorf; Moorenstr. 5 40225 Düsseldorf Germany
| | - J. Assheuer
- Institute for Magnetic Resonance Imaging; Genovevastr. 24 51065 Köln Germany
| | - M. Kramer
- Small Animal Clinic; Veterinary School of the Justus-Liebig-University Giessen; Frankfurter Str. 108 35392 Gießen Germany
| | - M. Jäger
- Department of Orthopaedics; University Essen-Duisburg; Hufelandstr. 55 45147 Essen Germany
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Cernaro V, Lacquaniti A, Lupica R, Buemi A, Trimboli D, Giorgianni G, Bolignano D, Buemi M. Relaxin: new pathophysiological aspects and pharmacological perspectives for an old protein. Med Res Rev 2013; 34:77-105. [PMID: 23401142 DOI: 10.1002/med.21277] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Human relaxin-2 (hereafter simply defined as "relaxin") is a 6-kDa peptidic hormone best known for the physiological role played during pregnancy in the growth and differentiation of the reproductive tract and in the renal and systemic hemodynamic changes. This factor can also be involved in the pathophysiology of arterial hypertension and heart failure, in the molecular pathways of fibrosis and cancer, and in angiogenesis and bone remodeling. It belongs to the relaxin peptide family, whose members comprehensively exert numerous effects through interaction with different types of receptors, classified as relaxin family peptide (RXFP) receptors (RXFP1, RXFP2, RXFP3, RXFP4). Research looks toward the in-depth examination and complete understanding of relaxin in its various pleiotropic actions. The intent is to evaluate the likelihood of employing this substance for therapeutic purposes, for instance in diseases where a deficit could be part of the underlying pathophysiological mechanisms, also avoiding any adverse effect. Relaxin is already being considered as a promising drug, especially in acute heart failure. A careful study of the different RXFPs and their receptors and the comprehension of all biological activities of these hormones will probably provide new drugs with a potential wide range of therapeutic applications in the near future.
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Affiliation(s)
- Valeria Cernaro
- Department of Internal Medicine, University of Messina, Via Consolare Valeria, 1, 98100, Italy
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Abstract
In this chapter a review of animal model systems already being utilized to study normal and pathologic wound healing is provided. We also go into details on alternatives for animal wound model systems. The case is made for limitations in the various approaches. We also discuss the benefits/limitations of in vitro/ex vivo systems bringing everything up to date with our current work on developing a cell-based reporter system for diabetic wound healing.
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Affiliation(s)
- Phil Stephens
- Wound Biology Group, Cardiff Institute of Tissue Engineering and Repair Tissue Engineering and Reparative Dentistry, School of Dentistry, Cardiff University, Cardiff, Wales, UK
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Machens HG, Günter CI, Bader A. Skin. Regen Med 2013. [DOI: 10.1007/978-94-007-5690-8_43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Tobalem M, Harder Y, Schuster T, Rezaeian F, Wettstein R. Erythropoietin in the prevention of experimental burn progression. Br J Surg 2012; 99:1295-303. [DOI: 10.1002/bjs.8847] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2012] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Damage control is essential in first aid of burn lesions. The aim of the present study was to investigate whether systemic erythropoietin (EPO) administration could prevent secondary burn progression in an experimental model.
Methods
The burn comb model creates four rectangular burn surfaces intercalated by three unburned zones prone to progression. Twenty-one Wistar rats were randomized to a control group or to receive intraperitoneal EPO (500 units per kg) once a day for 5 days starting 45 min (EPO45min) or 6 h (EPO6h) after burn injury. Histological analyses assessing burn depth, inflammation and neoangiogenesis, planimetric evaluation of burn progression, and laser Doppler flowmetry to assess perfusion were performed after 1, 4 and 7 days. Final scarring time and contracture rate were assessed once a week.
Results
Burn progression was decreased significantly with EPO45min but not EPO6h; progression of burn depth stopped in the intermediate dermis (mean(s.e.m.) burn depth score 3·3(0·6) for EPO45min versus 4·7(0·3) and 5·0(0·0) for EPO6h and control respectively on day 7; P = 0·026) and the surface extension was significantly reduced (45(8), 65(4) and 78(4) respectively on day 7; P = 0·017). This was paralleled by faster re-establishment of perfusion with EPO45min (114(5) per cent on day 4 versus 85(6) and 91(3) per cent for EPO6h and control respectively; P = 0·096). The reduction in progression resulted in a decreased healing time (7·3(0·7) weeks for EPO45min versus 11·5(1·0) and 10·8(0·5) weeks for EPO6h and control; P = 0·020) and contracture rate (P = 0·024).
Conclusion
Early EPO prevented burn progression, mainly by improved vascular perfusion.
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Affiliation(s)
- M Tobalem
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Y Harder
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Geneva, Switzerland
- Department of Plastic Surgery and Hand Surgery, University Hospital Basle, Basle, Switzerland
| | - T Schuster
- Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar, Technische Universtät München, Munich, Germany
| | - F Rezaeian
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Plastic Surgery and Hand Surgery, University Hospital Basle, Basle, Switzerland
| | - R Wettstein
- Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Geneva, Switzerland
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basle, Basle, Switzerland
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Günter CI, Machens HG. New strategies in clinical care of skin wound healing. ACTA ACUST UNITED AC 2012; 49:16-23. [PMID: 22797612 DOI: 10.1159/000339860] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 06/06/2012] [Indexed: 11/19/2022]
Abstract
The prevalence of chronic wounds is closely correlated to the aging population and so-called civilizational diseases. Therefore, they are causing morbidity and mortality of millions of patients worldwide, with an unbroken upward trend. As a consequence, chronic wounds induce enormous and rapidly growing costs for our health care systems and society in general. Thus, medically effective and cost-efficient treatment methods are urgently needed. Methods of 'regenerative medicine' might offer innovative scientific solutions, including the use of stem cells, growth factors and new bioactive materials. These tools are experimentally well described but clinically poorly performed. The main reasons for this are both legislative and economic. This review describes state-of-the-art techniques, up-to-date research projects, innovative preclinical and clinical approaches in wound care, and activities to translate these innovative techniques into clinical routine.
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Affiliation(s)
- C I Günter
- Clinic for Plastic and Hand Surgery, University Hospital rechts der Isar, Technische Universität München, Munich, Germany.
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A comparison of wound healing rate following treatment with aftamed and chlorine dioxide gels in streptozotocin-induced diabetic rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:468764. [PMID: 22666291 PMCID: PMC3362038 DOI: 10.1155/2012/468764] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 02/19/2012] [Accepted: 03/14/2012] [Indexed: 11/18/2022]
Abstract
Background and Purpose. This study aimed to evaluate the wound healing activities of Aftamed and chlorine dioxide gels in
streptozotocin-induced diabetic rats. Experimental Approach. Forty-eight Sprague Dawley rats were chosen for this study, divided into 4 groups. Diabetes was induced. Two-centimeter-diameter full-thickness skin excision wounds were created. Animals were topically treated twice daily. Groups 1, the diabetic control group, were treated with 0.2 mL of sterile distilled water. Group 2 served as a reference standard were treated with 0.2 mL of Intrasite gel. Groups 3 and 4 were treated with 0.2 mL of Aftamed and 0.2 mL of chlorine dioxide gels respectively. Granulation tissue was excised on the 10th day and processed for histological and biochemical analysis. The glutathione peroxidase ,superoxide dismutase activities and the malondialdehyde (MDA) levels were determined. Results. Aftamed-treated wounds exhibited significant increases in hydroxyproline, cellular proliferation, the number of blood vessels, and the level of collagen synthesis. Aftamed induced an increase in the free radical-scavenging enzyme activity and significantly reduced the lipid peroxidation levels in the
wounds as measured by the reduction in the MDA level. Conclusions. This study showed that Aftamed gel is able to significantly accelerate the process of wound healing in diabetic rats.
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Sager M, Ferrari D, Wieland M, Dard M, Becker J, Schwarz F. Immunohistochemical characterization of wound healing at two different bone graft substitutes. Int J Oral Maxillofac Surg 2012; 41:657-66. [DOI: 10.1016/j.ijom.2011.11.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 10/07/2009] [Accepted: 11/08/2011] [Indexed: 01/13/2023]
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Sorg H, Harder Y, Krueger C, Reimers K, Vogt PM. The nonhematopoietic effects of erythropoietin in skin regeneration and repair: from basic research to clinical use. Med Res Rev 2012; 33:637-64. [PMID: 22430919 DOI: 10.1002/med.21259] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Erythropoietin (EPO) is the main regulator of red blood cell production but there exists also a variety of nonhematopoietic properties. More recent data show that EPO is also associated with the protection of tissues suffering from ischemia and reperfusion injury as well as with improved regeneration in various organ systems, in particular the skin. This review highlights the mechanisms of EPO in the different stages of wound healing and the reparative processes in the skin emphasizing pathophysiological mechanisms and potential clinical applications. There is clear evidence that EPO effectively influences all wound-healing phases in a dose-dependent manner. This includes inflammation, tissue, and blood vessel formation as well as the remodeling of the wound. The molecular mechanism is predominantly based on an increased expression of the endothelial and inducible nitric oxide (NO) synthase with a consecutive rapid supply of NO as well as an increased content of vascular endothelial growth factor (VEGF) in the wound. The improved understanding of the functions and regulatory mechanisms of EPO in the context of wound-healing problems and ischemia/reperfusion injury, especially during flap surgery, may lead to new considerations of this growth hormone for its regular clinical application in patients.
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Affiliation(s)
- Heiko Sorg
- Department of Plastic, Hand- and Reconstructive Surgery, Hannover Medical School, 30625, Hannover, Germany.
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Tasdemir S, Parlakpinar H, Vardi N, Kaya E, Acet A. Effect of endogen-exogenous melatonin and erythropoietin on dinitrobenzene sulfonic acid-induced colitis. Fundam Clin Pharmacol 2011; 27:299-307. [PMID: 22151426 DOI: 10.1111/j.1472-8206.2011.01016.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Inflammatory bowel disease has been linked to elevated T cells. Excessive production of reactive oxygen species and apoptosis are known to be accompanied by intestinal inflammation. This study was designed to investigate the effects of melatonin (MEL) and erythropoietin (EPO), which is a known anti-inflammatory and antiapoptotic agent, in dinitrobenzene sulfonic acid (DNBS)-induced colitis in pinealectomized (Px) rats. In microscopically results, epithelial and goblet cell loss, absence of crypts, and increased colonic caspase-3 activity were observed in the DNBS group. Also, in flow cytometric analysis, the percentage of CD4+ T cells was highest in the DNBS group. Treatment with MEL or EPO had a curative effect on DNBS-induced colitis. The MEL + EPO groups showed significantly greater improvement when compared with the other treatment groups. Our results indicate that the combination of EPO and MEL may exert more beneficial effects than either agent used alone.
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Affiliation(s)
- Seda Tasdemir
- Department of Pharmacology, Inonu University, Medical Faculty, Malatya, Turkey.
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Demiot C, Sarrazy V, Javellaud J, Gourloi L, Botelle L, Oudart N, Achard JM. Erythropoietin Restores C-Fiber Function and Prevents Pressure Ulcer Formation in Diabetic Mice. J Invest Dermatol 2011; 131:2316-22. [DOI: 10.1038/jid.2011.211] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Erythropoietin improves the healing of skin necrosis resulting from Doxorubicin extravasation in a rat model. Curr Ther Res Clin Exp 2011; 72:141-9. [PMID: 24648584 DOI: 10.1016/j.curtheres.2011.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2011] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Doxorubicin is an antineoplastic agent that causes skin necrosis when extravasated. Various agents have been tried to reduce tissue damage owing to extravasation. Erythropoietin (EPO) is an obligatory growth factor for red blood cells and has beneficial effects on wound healing. OBJECTIVE The aim of this study was to test the hypothesis that local EPO injection can prevent and improve healing of necrosis at the doxorubicin injection site in rats. METHODS We used 31 female Sprague-Dawley rats. The dorsal area of each rat was shaved, and 2 mg of doxorubicin in 0.5 mL saline was injected intradermally. The rats were then divided into 3 groups: control; control with intradermal injection of saline; and treatment, which received an intradermal injection of EPO. EPO in saline was injected into 4 quadrants of the same site where doxorubicin was injected 1 hour before. The rats were monitored and the area of each ulcer was measured. Skin biopsies were excised at the end of 4 weeks using anesthetic pentobarbital. Inflammation, edema, epithelization, neovascularization, necrosis, fibroblast proliferation, and collagen synthesis were evaluated and compared between groups. RESULTS The average areas of the lesions were significantly smaller in the EPO-injected rats (P = 0.03). The histopathologic evaluation revealed that the scores for epithelization, neovascularization, fibroblast proliferation, and collagen synthesis were higher (P < 0.001, P < 0.001, P = 0.002, and P = 0.04, respectively) and the score for necrosis was lower (P < 0.001) in the EPO-injected group than in both the saline-injected and control groups. CONCLUSIONS In this study using female Sprague-Dawley rats, EPO treatment improved the healing of skin necrosis caused by doxorubicin injection. This finding may lead to a new therapeutic approach for the management of skin necrosis caused by doxorubicin extravasation.
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Akdemir O, Hede Y, Zhang F, Lineaweaver WC, Arslan Z, Songur E. Effects of taurine on reperfusion injury. J Plast Reconstr Aesthet Surg 2011; 64:921-928. [PMID: 21256822 DOI: 10.1016/j.bjps.2010.12.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 10/09/2010] [Accepted: 12/07/2010] [Indexed: 11/19/2022]
Abstract
Taurine is an organic acid, which has a very important function in the human body. Recently, the antioxidant property of taurine has been much emphasised. In this study, the gracilis muscle flap model was used to investigate the effect of taurine in ischaemia/reperfusion injury in rats. Totally 32 Sprague-Dawley rats were divided into two groups: control group (n = 16) and the treatment group with taurine (n = 16). After elevation of the gracilis muscle flap, 4 h of ischaemia was performed in both groups. Thirty min before the reperfusion, taurine (200 mg kg(-1)) was injected intravenously. After 24 h of reperfusion, the amount of malondialdehyde (MDA), tissue water content and flap viability were evaluated. After 72 h of reperfusion, histological findings were evaluated. Amount of MDA and tissue water content were significantly lower (p < 0.005), and the flap viability was significantly higher (p < 0.005) in the treatment group 24 h after reperfusion. On comparing the outcomes of histological analysis between control and treatment groups, the amounts of collagen, fibroblast and angiogenesis in treatment group were significantly higher than those in the control group. However, the amount of polymorphonuclear leucocyte and tissue necrosis in the treatment group were significantly lower than in the control group. Our results showed that taurine played an important role in the process of ischaemia/reperfusion injury and presented certain protective effects with the improvement in flap survival after ischaemia/reperfusion injury.
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Affiliation(s)
- Ovunc Akdemir
- Department of Plastic Surgery, University of Mississippi Medical Center, Jackson, MS 39216, USA
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Hamed S, Ullmann Y, Egozi D, Daod E, Hellou E, Ashkar M, Gilhar A, Teot L. Fibronectin potentiates topical erythropoietin-induced wound repair in diabetic mice. J Invest Dermatol 2011; 131:1365-74. [PMID: 21326299 DOI: 10.1038/jid.2011.15] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Diabetes mellitus disrupts all phases of the wound repair cascade and leads to development of chronic wounds. We previously showed that topical erythropoietin (EPO) can promote wound repair in diabetic rats. Fibronectin (FN) has a critical role throughout the process of wound healing, yet it is deficient in wound tissues of diabetic patients. Therefore, we investigated the effect of topical treatment of both EPO and FN (EPO/FN) on wound repair in diabetic mice. Full-thickness excisional skin wounds in diabetic and nondiabetic mice were treated with a cream containing vehicle, EPO, FN, or EPO/FN. We assessed the rate of wound closure, angiogenesis, apoptosis, and expression of inflammatory cytokines, endothelial nitric oxide synthase (eNOS) and β1-integrin, in the wound tissues. We also investigated the effect of EPO, FN, and EPO/FN on human dermal microvascular endothelial cells and fibroblasts cultured on fibrin-coated plates, or in high glucose concentrations. EPO/FN treatment significantly increased the rate of wound closure and this effect was associated with increased angiogenesis, increased eNOS and β1-integrin expression, and reduced expression of inflammatory cytokines and apoptosis. Our findings show that EPO and FN have an additive effect on wound repair in diabetic mice.
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Affiliation(s)
- Saher Hamed
- The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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Garcia P, Speidel V, Scheuer C, Laschke MW, Holstein JH, Histing T, Pohlemann T, Menger MD. Low dose erythropoietin stimulates bone healing in mice. J Orthop Res 2011; 29:165-72. [PMID: 20740668 DOI: 10.1002/jor.21219] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2010] [Accepted: 06/18/2010] [Indexed: 02/04/2023]
Abstract
Beyond its classical role in regulation of erythropoiesis, erythropoietin (EPO) has been shown to exert protective and regenerative actions in a variety of non-hematopoietic tissues. However, little is known about potential actions in bone regeneration. To analyze fracture healing in mice, a femoral 0.25 mm osteotomy gap was stabilized with a pin-clip technique. Animals were treated with 500 U EPO/kg bw per day or with vehicle only. After 2 and 5 weeks, fracture healing was analyzed biomechanically, radiologically and histologically. Expression of PCNA and NFκB was examined by Western blot analysis. Vascularization was analyzed by immunohistochemical staining of PECAM-1. Circulating endothelial progenitor cells were measured by flow-cytometry. Herein, we demonstrate that EPO-treatment significantly accelerates bone healing in mice. This is indicated by a significantly greater biomechanical stiffness and a higher radiological density of the periosteal callus at 2 and 5 weeks after fracture and stabilization. Histological analysis demonstrated significantly more bone and less cartilage and fibrous tissue in the periosteal callus. Endosteal vascularization was significantly increased in EPO-treated animals when compared to controls. The number of circulating endothelial progenitor cells was significantly greater in EPO-treated animals. The herein shown acceleration of healing by EPO may represent a promising novel treatment strategy for fractures with delayed healing and non-union formation.
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Affiliation(s)
- P Garcia
- Department of Trauma-, Hand- and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany.
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Machens HG, Günter CI, Bader A. Skin. Regen Med 2011. [DOI: 10.1007/978-90-481-9075-1_35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Erythropoietin ameliorates the reduced migration of human fibroblasts during in vitro hypoxia. J Physiol Biochem 2010; 67:1-13. [DOI: 10.1007/s13105-010-0043-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 08/21/2010] [Indexed: 12/11/2022]
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Lu KY, Ching LC, Su KH, Yu YB, Kou YR, Hsiao SH, Huang YC, Chen CY, Cheng LC, Pan CC, Lee TS. Erythropoietin suppresses the formation of macrophage foam cells: role of liver X receptor alpha. Circulation 2010; 121:1828-37. [PMID: 20385932 DOI: 10.1161/circulationaha.109.876839] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In addition to the hematopoietic effect of erythropoietin, increasing evidence suggests that erythropoietin also exerts protective effects for cardiovascular diseases. However, the role of erythropoietin and its underlying mechanism in macrophage foam cell formation are poorly understood. METHODS AND RESULTS Compared with wild-type specimens, erythropoietin was increased in atherosclerotic aortas of apolipoprotein E-deficient (apoE(-/-)) mice, mainly in the macrophage foam cells of the lesions. Erythropoietin levels in culture medium and macrophages were significantly elevated in response to oxidized low-density lipoprotein in a dose-dependent manner. Furthermore, erythropoietin markedly attenuated lipid accumulation in oxidized low-density lipoprotein-treated macrophages, a result that was due to an increase in cholesterol efflux. Erythropoietin treatment significantly increased ATP-binding cassette transporters (ABC) A1 and ABCG1 mRNA and protein levels without affecting protein expression of scavenger receptors, including scavenger receptor-A, CD36, and scavenger receptor-BI. The upregulation of ABCA1 and ABCG1 by erythropoietin resulted from liver X receptor alpha activation, which was confirmed by its prevention on expression of ABCA1 and ABCG1 after pharmacological or small interfering RNA inhibition of liver X receptor alpha. Moreover, the erythropoietin-mediated attenuation on lipid accumulation was abolished by such inhibition. Finally, reduced lipid accumulation and marked increase in ABCA1 and ABCG1 were demonstrated in erythropoietin-overexpressed macrophages. CONCLUSIONS Our data suggest that erythropoietin suppresses foam cell formation via the liver X receptor alpha-dependent upregulation of ABCA1 and ABCG1.
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Affiliation(s)
- Kuo-Yun Lu
- Department of Physiology, National Yang-Ming University, Taipei 112, Taiwan.
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Schwarz F, Ferrari D, Podolsky L, Mihatovic I, Becker JÃ. Initial pattern of angiogenesis and bone formation following lateral ridge augmentation using rhPDGF and guided bone regeneration: an immunohistochemical study in dogs. Clin Oral Implants Res 2010; 21:90-9. [DOI: 10.1111/j.1600-0501.2009.01845.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hamed S, Ullmann Y, Masoud M, Hellou E, Khamaysi Z, Teot L. Topical Erythropoietin Promotes Wound Repair in Diabetic Rats. J Invest Dermatol 2010; 130:287-94. [DOI: 10.1038/jid.2009.219] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Mihmanli A, Dolanmaz D, Avunduk MC, Erdemli E. Effects of recombinant human erythropoietin on mandibular distraction osteogenesis. J Oral Maxillofac Surg 2009; 67:2337-43. [PMID: 19837300 DOI: 10.1016/j.joms.2008.06.082] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2007] [Accepted: 06/23/2008] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the effects of subcutaneous administration of recombinant human erythropoietin (rHuEPO) on regeneration formation and quality during mandibular distraction osteogenesis. MATERIALS AND METHODS Sixteen adult male New Zealand rabbits were used in this study. Ethical approval was obtained from the Animal Research Institute of Selcuk University, Konya, Turkey. Subjects were randomly divided into 2 groups. Distraction osteogenesis (DO) was performed with a custom-made distractor on the left mandibles of rabbits. In the experimental group, 4 doses of 150 IU/kg rHuEPO were administered at 48-hour intervals. The first dose was given immediately after surgery. Control subjects received 0.5 mL/kg isotonic solution in the same manner. After 2 days of latency, mandibles were distracted 1 mm/day at 12-hour intervals for 5 days. A 5-mm lengthening was achieved. All animals were sacrificed after 30 days of consolidation. Afterward, samples were prepared for histomorphometric evaluation of newly formed bone area. RESULTS The number of osteoblasts and blood vessels was significantly higher, whereas the number of osteoclasts was significantly lower, in the experimental group than in the control group (P < .05). In the experimental group, the area of new bone formation was greater than in the control group (P < .05). Moreover, fibroblast and collagen numbers per unit area were higher in the experimental group. However, this finding was not statistically significant (P > .05). CONCLUSION The subcutaneous administration of rHuEPO improves the rate and quality of bone-healing during distraction osteogenesis. However, the short-term favorable effects of rHuEPO in this study should be extended with long-term investigations before clinical application.
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Affiliation(s)
- Ahmet Mihmanli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Selcuk University, Konya, Turkey.
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Schwarz F, Ferrari D, Sager M, Herten M, Hartig B, Becker J. Guided bone regeneration using rhGDF-5- and rhBMP-2-coated natural bone mineral in rat calvarial defects. Clin Oral Implants Res 2009; 20:1219-30. [DOI: 10.1111/j.1600-0501.2009.01796.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sasaki Y, Kjellén E, Mineta H, Wennerberg J, Ekblad L. No direct effects of erythropoietin beta on a head and neck squamous cell carcinoma cell line which is growth stimulated in vivo. Acta Oncol 2009; 48:1062-9. [PMID: 19412811 DOI: 10.1080/02841860902913553] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Erythropoiesis-stimulating agents (ESAs) are used in cancer therapy to reverse anaemia. It has been suggested that ESAs might improve treatment outcome by reducing tumour hypoxia, but ESAs might also increase tumour growth. In this work, the effect of recombinant human erythropoietin (rHuEpo) beta was investigated on a human head and neck squamous carcinoma cell (HNSCC) line in vitro. The cell line was previously growth stimulated in combination with surgery in a xenograft model and the investigation was initiated to see if rHuEpo directly affects the tumour cell line, alone or in combination with cell stress, or if the in vivo effect should be attributed to secondary effects. MATERIAL AND METHODS The cell line LU-HNSCC-7 was grown in vitro and treated with rHuEpo alone or in combination with radiation, cisplatin, hypoxia or tumour extracts. The expression of the Epo receptor (EpoR) was investigated by western blotting after one- and two-dimensional electrophoresis, RT-PCR and through analysis of the effect on EpoR signalling. RESULTS The cell line was shown not to express EpoR. Furthermore, it was only possible to detect a minor effect on cell growth (1.4 times over control, p < 0.001) under specific conditions and at supra-pharmacological concentrations of rHuEpo beta. No effect was detected on cell migration. None of the cell stressing treatments could enhance the minor growth stimulatory effect of rHuEpo beta. DISCUSSION The conclusion is that rHuEpo beta does not stimulate tumour growth of the investigated cell line through a direct interaction with tumour cells. We hypothesise that interactions with stromal cells and the stimulation of wound healing responses might, at least partly, explain the negative effects of ESA administration during cancer treatment. We propose that EpoR expression in HNSCC tumour cells might not be a good marker for prediction of ESA induced worsening of outcomes after cancer treatment.
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Schwarz F, Sager M, Ferrari D, Mihatovic I, Becker J. Influence of Recombinant Human Platelet-Derived Growth Factor on Lateral Ridge Augmentation Using Biphasic Calcium Phosphate and Guided Bone Regeneration: A Histomorphometric Study in Dogs. J Periodontol 2009; 80:1315-23. [DOI: 10.1902/jop.2009.090034] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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