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Walter AS, Volkmer E, Gauglitz G, Böcker W, Saller MM. Systematic review of molecular pathways in burn wound healing. Burns 2023; 49:1525-1533. [PMID: 37821280 DOI: 10.1016/j.burns.2023.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 06/29/2022] [Accepted: 03/07/2023] [Indexed: 03/13/2023]
Abstract
Depending on extent and depth, burn injuries and resulting scars may be challenging and expensive to treat and above all heavily impact the patients' lives. This systematic review represents the current state of knowledge on molecular pathways activated during burn wound healing. All currently known molecular information about gene expression and molecular interactions in mammals has been summarized. An ample interaction of regenerative cytokines, growth factors, ECM-regenerative molecules and proinflammatory immune response became apparent. We identified three molecules to be most often involved in the pathways: TGFB1, ACTA1 and COL1A1. Yet, other factors including FLII, AKT1 and miR-145 were shown to play pivotal roles in burn wound healing as well. This systematic review helps to explain the fundamental molecular proceedings participating in burn wound healing. A number of new molecular interactions and functional connections were identified yielding intriguing new research targets. An interactive version of the first network about molecular pathways and interactions during burn wound healing is provided in the online edition and on WikiPathways.
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Affiliation(s)
- Annika S Walter
- Musculoskeletal University Center Munich (MUM), Department of Orthopeadics and Trauma Surgery, Ludwig-Maximilians-University (LMU), Fraunhoferstraße 20, 82152 Martinsried, Germany
| | - Elias Volkmer
- Musculoskeletal University Center Munich (MUM), Department of Orthopeadics and Trauma Surgery, Ludwig-Maximilians-University (LMU), Fraunhoferstraße 20, 82152 Martinsried, Germany; Division of Hand Surgery, Helios Klinikum München West, Steinerweg 5, 81241 Munich, Germany
| | - Gerd Gauglitz
- Department of Dermatology and Allergy, Ludwig-Maximillians-University (LMU), Frauenlobstraße 9-11, 80337 Munich, Germany
| | - Wolfgang Böcker
- Musculoskeletal University Center Munich (MUM), Department of Orthopeadics and Trauma Surgery, Ludwig-Maximilians-University (LMU), Fraunhoferstraße 20, 82152 Martinsried, Germany
| | - Maximilian M Saller
- Musculoskeletal University Center Munich (MUM), Department of Orthopeadics and Trauma Surgery, Ludwig-Maximilians-University (LMU), Fraunhoferstraße 20, 82152 Martinsried, Germany.
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Lee D, Kim MJ, Park HJ, Rah GC, Choi H, Anh S, Ji GH, Kim MS, Kim G, Shin DW, Oh SM. Current practices and perceived effectiveness of polynucleotides for treatment of facial erythema by cosmetic physicians. Skin Res Technol 2023; 29:e13466. [PMID: 37753681 PMCID: PMC10485387 DOI: 10.1111/srt.13466] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Polynucleotides (PN) are increasingly used for the treatment of facial erythema in the Republic of Korea. However, there are limited pre-clinical and clinical data on the efficacy of polynucleotides for facial erythema. In this study, we investigated the current practice and perceived effectiveness of polynucleotide treatment for facial erythema among cosmetic physicians. METHODS By conducting a survey among clinicians who use PN in clinical practice, we explored the current practices and assessed the perceived effectiveness of polynucleotides in treating facial erythema. RESULTS A total of 557 physicians who used polynucleotides for facial erythema participated in the survey. Polynucleotides were used by 84.4%, 66.4%, and 47.4% of physicians for facial erythema caused by inflammatory facial dermatosis, repeated laser/microneedle radiofrequency, and steroid overuse, respectively. Among those users, 88.1%, 90%, and 83.7% respectively in those same categories answered that polynucleotides were "highly effective" or "effective." Furthermore, they agreed that polynucleotides have the following properties: wound healing/regeneration (95.8%), protection of skin barrier (92.2%), hydration (90.5%), vascular stabilization (81.0%), and anti-inflammation (79.5%). CONCLUSION Our findings showed that cosmetic physicians in the Republic of Korea have used PN as a part of combination treatment for facial erythema resulting from inflammatory facial dermatosis and repeated laser/ microneedle radiofrequency, rather than from steroid overuse. Also, most clinicians agreed that PN was effective for treatment of facial erythema. Given the lack of pre-clinical and clinical trial evidence, the empirical responses of practicing physicians provide useful information to guide clinical practice and further research.
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Affiliation(s)
- Dagyeong Lee
- Department of Family Medicine/Supportive Care CenterSamsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
| | | | | | | | | | | | | | | | - Geebum Kim
- Misogain Dermatology ClinicGimpoRepublic of Korea
| | - Dong Wook Shin
- Department of Family Medicine/Supportive Care CenterSamsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
- Department of Clinical Research Design & EvaluationSamsung Advanced Institute for Health Science & Technology (SAIHST)Sungkyunkwan UniversitySeoulRepublic of Korea
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Lee YJ, Moon YS, Kwon DR, Cho SC, Kim EH. Polydeoxyribonucleotide and Shock Wave Therapy Sequence Efficacy in Regenerating Immobilized Rabbit Calf Muscles. Int J Mol Sci 2023; 24:12820. [PMID: 37629001 PMCID: PMC10454565 DOI: 10.3390/ijms241612820] [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: 07/25/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
This study primarily aimed to investigate the combined effects of polydeoxyribonucleotide (PDRN) and extracorporeal shock wave therapy (ESWT) sequences on the regenerative processes in atrophied animal muscles. Thirty male New Zealand rabbits, aged 12 weeks, were divided into five groups: normal saline (Group 1), PDRN (Group 2), ESWT (Group 3), PDRN injection before ESWT (Group 4), and PDRN injection after ESWT (Group 5). After 2 weeks of cast immobilization, the respective treatments were administered to the atrophied calf muscles. Radial ESWT was performed twice weekly. Calf circumference, tibial nerve compound muscle action potential (CMAP), and gastrocnemius (GCM) muscle thickness after 2 weeks of treatment were evaluated. Histological and immunohistochemical staining, as well as Western blot analysis, were conducted 2 weeks post-treatment. Staining intensity and extent were assessed using semi-quantitative scores. Groups 4 and 5 demonstrated significantly greater calf muscle circumference, GCM muscle thickness, tibial nerve CMAP, and GCM muscle fiber cross-sectional area (type I, type II, and total) than the remaining three groups (p < 0.05), while they did not differ significantly in these parameters. Groups 2 and 3 showed higher values for all the mentioned parameters than Group 1 (p < 0.05). Group 4 had the greatest ratio of vascular endothelial growth factor (VEGF) to platelet endothelial cell adhesion molecule-1 (PECAM-1) in the GCM muscle fibers compared to the other four groups (p < 0.05). Western blot analysis revealed significantly higher expression of angiogenesis cytokines in Groups 4 and 5 than in the other groups (p < 0.05). The combination of ESWT and PDRN injection demonstrated superior regenerative efficacy for atrophied calf muscle tissue in rabbit models compared to these techniques alone or saline. In particular, administering ESWT after PDRN injection yielded the most favorable outcomes in specific parameters.
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Affiliation(s)
- Yoon-Jin Lee
- Department of Biochemistry, College of Medicine, Soonchunhyang University, Cheonan 31538, Republic of Korea;
| | - Yong Suk Moon
- Department of Anatomy, Catholic University of Daegu School of Medicine, Daegu 42472, Republic of Korea;
| | - Dong Rak Kwon
- Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu 42472, Republic of Korea;
| | - Sung Cheol Cho
- Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu 42472, Republic of Korea;
| | - Eun Ho Kim
- Department of Biomedical Engineering & Radiology, School of Medicine, Daegu Catholic University, Daegu 42472, Republic of Korea;
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Yun J, Park S, Park HY, Lee KA. Efficacy of Polydeoxyribonucleotide in Promoting the Healing of Diabetic Wounds in a Murine Model of Streptozotocin-Induced Diabetes: A Pilot Experiment. Int J Mol Sci 2023; 24:ijms24031932. [PMID: 36768255 PMCID: PMC9916466 DOI: 10.3390/ijms24031932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/20/2023] Open
Abstract
We assessed the efficacy of polydeoxyribonucleotide (PDRN) in accelerating the healing of diabetic wounds in a murine model of streptozotocin (STZ)-induced diabetes. After the creation of diabetic wounds, the mice of the PDRN SC, PDRN IP and PBS groups received a subcutaneous, an intra-peritoneal injection of PDRN and a subcutaneous injection of PBS, respectively. After euthanasia, time-dependent changes in the wound diameter and histologic scores were measured and vascular endothelial growth factor (VEGF), transforming growth factor-β1 (TGF-β1) and collagen types I and III were assessed for their expression levels. The PDRN SC and the PDRN IP groups showed a significantly smaller diameter of diabetic wounds, significantly higher histologic scores, a significantly greater expression of VEGF, a significantly lower expression of TGF-β1 and a significantly greater expression of collagen types I and III as compared with the PBS group (p < 0.05 or 0.0001). In conclusion, PDRN might be effective in promoting the healing of diabetic wounds in a murine model of STZ-induced diabetes.
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Affiliation(s)
- Jiyoung Yun
- Department of Plastic and Reconstructive Surgery, Inje University Busan Paik Hospital, College of Medicine, Inje University, Busan 47392, Republic of Korea
| | - SaeGwang Park
- Department of Microbiology and Immunology, College of Medicine, Inje University, Busan 47392, Republic of Korea
- Innovative Therapeutic Research Institute, Inje University Busan Paik Hospital, College of Medicine, Inje University, Busan 47392, Republic of Korea
| | - Ha Young Park
- Department of Pathology, Inje University Busan Paik Hospital, College of Medicine, Inje University, Busan 47392, Republic of Korea
| | - Kyung Ah Lee
- Department of Plastic and Reconstructive Surgery, Inje University Haeundae Paik Hospital, College of Medicine, Inje University, Busan 48108, Republic of Korea
- Correspondence:
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Kim BR, Kwon SH, Kim JW, Jeong WJ, Cha W, Jung YH, Na JI, Huh CH, Shin JW. Early Postoperative Polydeoxyribonucleotide Injections Prevent Hypertrophic Scarring after Thyroidectomy: A Randomized Controlled Trial. Adv Wound Care (New Rochelle) 2022; 12:361-370. [PMID: 35713247 DOI: 10.1089/wound.2022.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Polydeoxyribonucleotide (PDRN) is known to enhance wound healing, but there has been no clinical trial investigating the effect of PDRN on scar prevention in surgical wounds. This study aimed to evaluate the efficacy of PDRN administration in preventing postoperative scars. APPROACH In this randomized controlled trial (NCT05149118), 44 patients who underwent open thyroidectomy were randomly assigned to the PDRN treatment or untreated control group. Only patients in the treatment group received two consecutive injections of PDRN one and two days after surgery. The modified Vancouver Scar Scale (mVSS), patients' subjective symptoms, erythema index (EI), melanin index (MI), and scar height were assessed three months after surgery. RESULTS Patients in the treatment group had lower mVSS scores (1.619 ± 1.244 vs. 2.500 ± 1.540, respectively; P = 0.059) and a significantly lower vascularity subscore (0.476 ± 0.512 vs. 0.900 ± 0.447, respectively; P = 0.010) than those in the control group at the 3-month follow-up. Compared with the control group, the level of subjective symptoms, EI, and scar height were all significantly lowered in the PDRN injection group. No specific side effects related to PDRN injection were observed. INNOVATION This is the first clinical study which demonstrated that PDRN injections rapidly decreased postsurgical wound erythema and as a result, significantly reduced both excessive scar formation and accompanying symptoms. CONCLUSION Early postoperative injection of PDRN is an effective and safe treatment to prevent hypertrophic scars and improve scar outcomes.
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Affiliation(s)
- Bo Ri Kim
- Seoul National University Bundang Hospital, 65462, Department of Dermatology, 82 Gumi-Ro 173 Beon-Gil, Seongnam, Korea (the Republic of), 13620;
| | - Soon Hyo Kwon
- Seoul National University Bundang Hospital, 65462, Department of Dermatology, Seongnam, Korea (the Republic of);
| | - Jee Woo Kim
- Seoul National University Bundang Hospital, 65462, Seongnam, Korea (the Republic of);
| | - Woo-Jin Jeong
- Seoul National University Bundang Hospital, 65462, Seongnam, Korea (the Republic of);
| | - Wonjae Cha
- Seoul National University Bundang Hospital, 65462, Seongnam, Korea (the Republic of);
| | - Young Ho Jung
- Seoul National University Bundang Hospital, 65462, Seongnam, Korea (the Republic of);
| | - Jung Im Na
- Seoul National University Bundang Hospital, 65462, Seongnam, Korea (the Republic of);
| | - Chang Hun Huh
- Seoul National University Bundang Hospital, 65462, Seongnam, Korea (the Republic of);
| | - Jung Won Shin
- Seoul National University Bundang Hospital, 65462, Seongnam, Korea (the Republic of);
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Polydeoxyribonucleotide: A Promising Biological Platform to Accelerate Impaired Skin Wound Healing. Pharmaceuticals (Basel) 2021; 14:ph14111103. [PMID: 34832885 PMCID: PMC8618295 DOI: 10.3390/ph14111103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/22/2021] [Accepted: 10/27/2021] [Indexed: 12/26/2022] Open
Abstract
The normal wound healing process is characterized by a complex, highly integrated cascade of events, requiring the interactions of many cell types, including inflammatory cells, fibroblasts, keratinocytes and endothelial cells, as well as the involvement of growth factors and enzymes. However, several diseases such as diabetes, thermal injury and ischemia could lead to an impaired wound healing process characterized by wound hypoxia, high levels of oxygen radicals, reduced angiogenesis, decreased collagen synthesis and organization. Polydeoxyribonucleotide (PDRN) has been used to improve wound healing through local and systemic administration thanks to its ability to promote cell migration and growth, angiogenesis, and to reduce inflammation on impaired wound healing models in vitro, in vivo and clinical studies. In light of all these observations, the aim of this review is to provide a full overview of PDRN applications on skin regeneration. We reviewed papers published in the last 25 years on PubMed, inserting “polydeoxyribonucleotide and wound healing” as the main search term. All data obtained proved the ability of PDRN in promoting physiological tissue repair through adenosine A2A receptor activation and salvage pathway suggesting that PDRN has proven encouraging results in terms of healing time, wound regeneration and absence of side effects.
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Bone regeneration in ceramic scaffolds with variable concentrations of PDRN and rhBMP-2. Sci Rep 2021; 11:11470. [PMID: 34075179 PMCID: PMC8169763 DOI: 10.1038/s41598-021-91147-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 05/18/2021] [Indexed: 02/04/2023] Open
Abstract
This study evaluated the bone regeneration capacity and mechanical properties of block-type hydroxyapatite (HA)/tricalcium phosphate (TCP) scaffolds in response to different concentrations of polydeoxyribonucleotide (PDRN) and recombinant human bone morphogenic protein 2 (rhBMP-2). Thirty-two male white rabbits were used as a model of calvarial bone defect and classified into eight groups according to type and concentration of growth factor administered, viz., control group (only HA/TCP scaffold), scaffold + PDRN (0.1, 1, 5, and 10 mg/mL each) and scaffold + rhBMP-2 (0.01, 0.05, and 0.1 mg/mL each). The specimens were evaluated using histomorphometric and radiological analyses. Histomorphometric analyses indicated that the administration of PDRN did not increase bone formation. However, significant increases in bone formation were observed with the administration of rhBMP-2 at 0.05 and 0.10 mg/mL on week 8 compared to the control (p < 0.05). Radiological analyses revealed a significant increase in bone formation at week 8 with the administration of PDRN at 5 mg/mL and 10 mg/mL, and rhBMP-2 at 0.05 or 0.10 mg/mL compared to the control (p < 0.05). Our findings show that block-type HA/TCP scaffolds possess sufficient mechanical strength and bone regeneration capacity when used with optimal concentrations of growth factors.
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Colangelo MT, Galli C, Guizzardi S. Polydeoxyribonucleotide Regulation of Inflammation. Adv Wound Care (New Rochelle) 2020. [DOI: 10.1089/wound.2019.1031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Maria Teresa Colangelo
- Histology and Embryology Laboratory, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Carlo Galli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Stefano Guizzardi
- Histology and Embryology Laboratory, Department of Medicine and Surgery, University of Parma, Parma, Italy
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Belmontesi M. Polydeoxyribonucleotide for the improvement of a hypertrophic retracting scar-An interesting case report. J Cosmet Dermatol 2020; 19:2982-2986. [PMID: 32892437 PMCID: PMC7693169 DOI: 10.1111/jocd.13710] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 07/18/2020] [Accepted: 08/10/2020] [Indexed: 02/01/2023]
Abstract
Background Post‐surgery disabling scars are frequent after surgical interventions. Aim We evaluated a new strategy for scars management. Methods A woman with a postsurgery disabling scar, consequent to an accident that needed surgical intervention, had serious difficulties to walk and perform normal daily activities. A few months after the intervention, she was treated with a combined therapy consisting of polydeoxyribonucleotide (PDRN) vials 5.625 mg/3 mL (administered subcutaneously as a biostimulant treatment through the scars and throughout the whole atrophic area), associated with nucleotide administered topically and as a food supplement. The patient was treated with an additional topical nighttime treatment cream based on nucleotides, hyaluronic acid, Allium cepa extract, and vitamin E, plus a daily treatment with a cream containing nucleotides, and a nutraceutical systemic treatment with 25 mg/cps of nucleotides and 5 mg/cps of Q10‐coenzyme (1 cps/d). Results This reasonably cheap treatment was effective and safe for this disabling scar at the right foot. One year after starting treatment, the patient confirmed her complete satisfaction. This is the first case report describing an unexpectedly successful outcome while using this combination therapy on a woman with a postsurgery disabling scar.
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Colangelo MT, Galli C, Guizzardi S. The effects of polydeoxyribonucleotide on wound healing and tissue regeneration: a systematic review of the literature. Regen Med 2020; 15:1801-1821. [PMID: 32757710 DOI: 10.2217/rme-2019-0118] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aim: The present study evaluated the effects of polydeoxyribonucleotide (PDRN) on tissue regeneration, paying special attention to the molecular mechanisms that underlie its tissue remodeling actions to better identify its effective therapeutic potential in wound healing. Materials & methods: Strategic searches were conducted through MEDLINE/PubMed, Google Scholar, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials, from their earliest available dates to March 2020. The studies were included with the following eligibility criteria: studies evaluating tissue regeneration, and being an in vitro, in vivo and clinical study. Results: Out of more than 90 articles, 34 fulfilled the eligibility criteria. All data obtained proved the ability of PDRN in promoting a physiological tissue repair through salvage pathway and adenosine A2A receptor activation. Conclusion: Up to date PDRN has proved promising results in term of wound regeneration, healing time and absence of side effects.
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Affiliation(s)
- Maria T Colangelo
- Department of Medicine & Surgery, Histology & Embryology Lab, University of Parma, Parma, Italy
| | - Carlo Galli
- Department of Medicine & Surgery, University of Parma, Parma, Italy
| | - Stefano Guizzardi
- Department of Medicine & Surgery, Histology & Embryology Lab, University of Parma, Parma, Italy
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Lee SH, Yoo SH, Lee HJ, Han D, Lee J, Jeon SH, Cho EA, Park HJ. Anti-Allodynic Effects of Polydeoxyribonucleotide in an Animal Model of Neuropathic Pain and Complex Regional Pain Syndrome. J Korean Med Sci 2020; 35:e225. [PMID: 32627441 PMCID: PMC7338212 DOI: 10.3346/jkms.2020.35.e225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 05/14/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Spinal nerve ligation (SNL) model is one of the representative models of the neuropathic pain model. Neuropathic pain in a chronic post-ischemic pain (CPIP) mimics the symptoms of complex regional pain syndrome (CRPS). The administration of polydeoxyribonucleotide (PDRN), which has regenerative and anti-inflammatory effects, has been studied and is used in clinical practice treating various diseases. However, the analgesic effect of PDRN in a neuropathic pain or CRPS model remains unknown. METHODS PDRN (3.3, 10, and 20 mg/kg) was administered into the subcutaneous (SC) layer of the hind paws of SNL and CPIP models. Mechanical anti-allodynic effects were then investigated using the von Frey test. In the immunohistochemical examination, dorsal root ganglia (DRG) and the spinal cord were harvested and examined for the expression of glial fibrillary acidic protein (GFAP) after the 20 mg PDRN injection. RESULTS Mechanical allodynia was significantly alleviated by administration of PDRN in SNL and CPIP mice at all of the time point. As the dose of PDRN increased, the effect was greater. The 20 mg PDRN injection was found to have the most effective anti-allodynic effect. The increased expression of GFAP in DRG and the spinal cord of SNL and CPIP model decreased following the administration of PDRN than vehicle. CONCLUSION SC administration of PDRN results in the attenuation of allodynia and activation of astrocytes in neuropathic pain or CRPS models. We propose that PDRN can have significant potential advantages in neuropathic pain treatment.
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Affiliation(s)
- Sung Hyun Lee
- Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sie Hyeon Yoo
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hae Jin Lee
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Donggyu Han
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jiyoung Lee
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Hwan Jeon
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Ah Cho
- Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hue Jung Park
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Effect of Polydeoxyribonucleotide on Chondrocutaneous Composite Grafts Survival. Aesthetic Plast Surg 2019; 43:1071-1077. [PMID: 31114951 DOI: 10.1007/s00266-019-01400-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/07/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND A composite graft is considered the best choice for facial reconstruction because of proper texture, color, and simple surgical techniques. However, due to revascularization by the bridging phenomenon, it has limitations with unpredictable survival rates and can be applied only to small defects. Polydeoxyribonucleotide (PDRN) plays an important role in multiple vascular processes such as angiogenesis via production of a vascular endothelial growth factor and by providing an anti-inflammatory effect by reducing pro-inflammatory cytokines through the adenosine A2 receptor stimulation. Thus, here, we investigated PDRN as a supportive method to improve survival of composite grafts. METHODS Chondrocutaneous composite grafts were applied to both ears of 20 New Zealand White rabbits. The grafts were then rotated and returned to their positions to prevent the original blood flow from the base of the grafts. On postoperative days 1, 3, 6, 9, and 12, PDRN was injected intradermally into the experimental group (20 ears) and normal saline was injected into the control group (20 ears) to exclude bias of pressure effect. After 12 days, graft survival and cutaneous blood flow were examined under laser speckle contrast imaging. RESULTS Gross observation indicated that the graft viability in the PDRN group was significantly higher than that in the control group (p < 0.05). Through laser speckle contrast imaging, signal intensity increased from the periphery and progressed centrally with treatment. CONCLUSION Our findings suggest that PDRN may increase blood flow around at the base of the graft, restore the perfusion, and improve the survival of the composite grafts. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Kwon TR, Han SW, Kim JH, Lee BC, Kim JM, Hong JY, Kim BJ. Polydeoxyribonucleotides Improve Diabetic Wound Healing in Mouse Animal Model for Experimental Validation. Ann Dermatol 2019; 31:403-413. [PMID: 33911618 PMCID: PMC7992745 DOI: 10.5021/ad.2019.31.4.403] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 01/02/2019] [Accepted: 02/12/2019] [Indexed: 12/13/2022] Open
Abstract
Background Wound healing mechanisms is believed to have effects similar to wound healing disorders in diabetic patients, including abnormal inflammatory cells, angiogenesis disorders, and reduced collagen synthesis. Therefore, reestablishment of structural and promoted angiogenesis could be beneficial to promote wound healing process. Objective Therefore, we investigated whether the polydeoxyribonucleotide (PDRN) that was self-production in Korea, could be useful as an intradermal injection for promoting wound healing. Also, we validate for wound healing effect of PDRN using healing-impaired (db/db) mice. Methods In this study, we confirmed the effects of PDRN by creating wound models in in vitro and in vivo model. Using an in vitro wound healing assay, we observed that PDRN stimulated closure of wounded monolayers of human fibroblast cells. PDRN (8.25 mg/ml) or phosphate-buffered saline (0.9% NaCl) was injected once daily into the dermis adjacent to the wound for 12 days after skin injury. Results Time course observations revealed that mice treated with PDRN showed accelerated wound closure and epidermal and dermal regeneration, enhanced angiogenesis. The wound area and depth decreased at 3, 6, 9, and 12 days after skin injury. Histological evaluation showed an increase of vascular endothelial growth factor, CD31, and collagen fibers in the PDRN group compared with the control group, indicating that PDRN was effective in the treatment of delayed wound healing caused by diabetes. Conclusion This study suggests that our PDRN has a wound healing effect in transgenic animal models with cells and diabetes through angiogenesis.
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Affiliation(s)
- Tae-Rin Kwon
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sung Won Han
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.,Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea
| | - Jong Hwan Kim
- Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea
| | - Byung Chul Lee
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.,Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea
| | - Jae Min Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ji Yeon Hong
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Beom Joon Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.,Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea
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Paik SH, Choi ME, Lee WJ, Chang SE, Lee MW, Choi JH, Kim BJ, Won CH. The efficacy and safety of BM-PHA for the correction of nasolabial folds: a multicenter, randomized, double-blind, split-face clinical trial. J DERMATOL TREAT 2019; 32:95-100. [PMID: 31195857 DOI: 10.1080/09546634.2019.1623859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Multiple types of fillers have been developed for soft tissue augmentation.Objective: We investigated the efficacy and safety of the novel filler BM-PHA.Methods: In this multicenter, randomized, split-face study, 91 participants received injections of BM-PHA and Restylane Perlane (PER) into the nasolabial folds. Efficacy was determined by the improvements in the Wrinkle Severity Rating Score (WSRS) and Global Esthetic Improvement Scale (GAIS), and safety by adverse events, laboratory tests, and a check of vital signs.Results: WSRS scores assessed by independent evaluators at Week 24, the primary efficacy measure, showed no significant difference between the two treatments. The treatments also showed no significant differences in WSRS scores assessed by the evaluators at Week 8 and WSRS and GAIS scores assessed by the treating investigators and participants at Weeks 8 and 24. The proportion of nasolabial folds whose WSRS scores improved by at least one grade at Week 24 was similar between the treatments. Only minor local side effects were reported without sequelae.Conclusion: BM-PHA was not inferior to PER in the treatment of moderate to severe nasolabial folds and may be an appropriate alternative product for their improvement. Further studies are needed to confirm the long-term safety of BM-PHA.
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Affiliation(s)
- Seung Hwan Paik
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Myoung Eun Choi
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Woo Jin Lee
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Sung Eun Chang
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Mi Woo Lee
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jee Ho Choi
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Beom Joon Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Chong Hyun Won
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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The Effect of Polydeoxyribonucleotide Extracted from Salmon Sperm on the Restoration of Bisphosphonate-Related Osteonecrosis of the Jaw. Mar Drugs 2019; 17:md17010051. [PMID: 30641942 PMCID: PMC6356836 DOI: 10.3390/md17010051] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/12/2018] [Accepted: 01/09/2019] [Indexed: 01/10/2023] Open
Abstract
Bisphosphonates (BPs) used for treating skeletal diseases can induce bisphosphonate-related osteonecrosis of the jaw (BRONJ). Despite much effort, effective remedies are yet to be established. In the present study, we investigated the feasibility of polydeoxyribonucleotide (PDRN) extracted from salmon sperm for the treatment of BRONJ, in a BRONJ-induced rat model. Compared with BRONJ-induced samples, PDRN-treated samples exhibited lower necrotic bone percentages and increased numbers of blood vessels and attached osteoclast production. Moreover, local administration of PDRN at a high concentration (8 mg/kg) remarkably resolved the osteonecrosis. Findings from this study suggest that local administration of PDRN at a specific concentration may be considered clinically for the management of BRONJ.
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Baek A, Kim Y, Lee JW, Lee SC, Cho SR. Effect of Polydeoxyribonucleotide on Angiogenesis and Wound Healing in an In Vitro Model of Osteoarthritis. Cell Transplant 2018; 27:1623-1633. [PMID: 30311500 PMCID: PMC6299200 DOI: 10.1177/0963689718804130] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Osteoarthritis (OA) is degenerative disease, leading to pain and functional disability. It is reported that polydeoxyribonucleotide (PDRN) is a suitable therapy for OA. However, the therapeutic mechanisms of PDRN in OA are not fully understood. To investigate the effect of PDRN in an in vitro model of OA, interleukin (IL)-1β or phosphate-buffered saline (PBS) was used to treat a human chondrocytic cell line in hypoxic conditions for 24 h (IL-1β group or control group). PDRN was then used to treat IL-1β group cells for 24 h (PDRN group). By Label-Based Human Antibody Array 1000, angiopoietin-2 (ANG-2), platelet-derived growth factor (PDGF), angiostatin, and endostatin, which were related to angiogenesis, were chosen for further validation studies. Quantitative real-time reverse transcription polymerase chain reaction and western blot analysis validated that the levels of PDGF and ANG-2, which were related to pro-angiogenesis, were significantly increased in the PDRN group compared with those in the control group or the IL-1β group. However, the levels of endostatin and angiostatin, which were related in anti-angiogenesis, were significantly decreased in the PDRN group compared with those in the control group or the IL-1β group. In the same manner, vascular endothelial growth factor, which was a mediator of angiogenesis, was significantly increased in the PDRN group compared with those in the control group or the IL-1β group. Furthermore, wound closure was significantly increased in the PDRN group compared with the control group or the IL-1β group by in vitro scratch assay. Moreover, PDRN decreased expression of metalloproteinase 13, as a catabolic factor for OA, but increased expression of aggrecan, which was an anabolic factor for OA. These data suggest that PDRN may promote angiogenesis and wound healing via down-regulation of catabolism and up-regulation of anabolism in an in vitro model of OA.
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Affiliation(s)
- Ahreum Baek
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Yoon Kim
- Department of Medicine, The Graduate School of Yonsei University, Seoul, Korea
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jin Woo Lee
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, South Korea
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, South Korea
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang Chul Lee
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Sang Chul Lee, Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul 03722, South Korea.
| | - Sung-Rae Cho
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, South Korea
- Yonsei Stem Cell Center, Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, South Korea
- Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, South Korea
- Sung-Rae Cho, Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
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Kang SH, Choi MS, Kim HK, Kim WS, Bae TH, Kim MK, Chang SH. Polydeoxyribonucleotide improves tendon healing following achilles tendon injury in rats. J Orthop Res 2018; 36:1767-1776. [PMID: 29094396 DOI: 10.1002/jor.23796] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/26/2017] [Indexed: 02/04/2023]
Abstract
Tendon injuries are major musculoskeletal disorders. Polydeoxyribonucleotide activates the adenosine receptor subtype A2A, resulting in tissue growth and neogenesis. This experimental study confirms that polydeoxyribonucleotide can improve secretion of various growth factors, promote collagen synthesis, and restore tensile strength of the Achilles tendon in a rat model with Achilles tendon injury. Thirty-six male Sprague-Dawley rats, aged 7 weeks, were divided into two groups, and the Achilles tendon was transected and repaired using the modified Kessler's method. In the experimental group (n = 18), the rats received daily intraperitoneal administration of polydeoxyribonucleotide (8 mg/kg/day for 1, 2, or 4 weeks). The control groups received the same amount of normal saline. The rats were euthanized at 1, 2, and 4 weeks, and tissues from the repair site were harvested. The cross-sectional area of the tendon was significantly increased at 2 and 4 weeks in polydeoxyribonucleotide group (p = 0.008 and p = 0.017, respectively). Moreover, tendons in the polydeoxyribonucleotide group were more resistant to mechanical stress at 2 and 4 weeks (p = 0.041 and p = 0.041, respectively). The staining levels of collagen type I in the experimental group were significantly stronger at 2 and 4 weeks (p = 0.026 and p = 0.009, respectively). Furthermore, higher expression levels of fibroblast growth factor, vascular endothelial growth factor, and transforming growth factor β1 were detected in the experimental group at 4 weeks (p = 0.041, p = 0.026, and p = 0.041, respectively). This study confirms that polydeoxyribonucleotide can improve the tensile strength of the rats' Achilles tendon following injury and repair. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1767-1776, 2018.
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Affiliation(s)
- Shin Hyuk Kang
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, 224-1 Heuksuk-Dong, Dongjak-Gu, Seoul, 156-755, Korea
| | - Min Seok Choi
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, 224-1 Heuksuk-Dong, Dongjak-Gu, Seoul, 156-755, Korea
| | - Han Koo Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, 224-1 Heuksuk-Dong, Dongjak-Gu, Seoul, 156-755, Korea
| | - Woo Seob Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, 224-1 Heuksuk-Dong, Dongjak-Gu, Seoul, 156-755, Korea
| | - Tae Hui Bae
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, 224-1 Heuksuk-Dong, Dongjak-Gu, Seoul, 156-755, Korea
| | - Mi Kyung Kim
- Department of Pathology, Chung-Ang University Hospital, 224-1 Heuksuk-Dong, Dongjak-Gu, Seoul, 156-755, Korea
| | - Seung Hwan Chang
- School of Mechanical Engineering, Chung-Ang University, 84 Heuksuk-Ro, Dongjak-Gu, Seoul, 156-755, Korea
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18
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Ko IG, Kim SE, Jin JJ, Hwang L, Ji ES, Kim CJ, Han JH, Hong IT, Kwak MS, Yoon JY, Shin HP, Jeon JW. Combination therapy with polydeoxyribonucleotide and proton pump inhibitor enhances therapeutic effectiveness for gastric ulcer in rats. Life Sci 2018; 203:12-19. [PMID: 29665355 DOI: 10.1016/j.lfs.2018.04.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 04/08/2018] [Accepted: 04/10/2018] [Indexed: 12/26/2022]
Abstract
AIMS The main action of proton pump inhibitors (PPIs) is to inhibit gastric acid secretion, and PPIs are widely used to treat gastric ulcer (GU). However, if the action of promoting gastric mucosal regeneration is added, the effectiveness of GU treatment can be enhanced. Thus, in order to improve the therapeutic effect on GU, we tried to develop combination therapy promoting regeneration in injured tissue besides suppressing gastric acid secretion. MAIN METHODS Polydeoxyribonucleotide (PDRN) was selected to evaluate tissue regeneration, and pantoprazole was chosen as one of the PPIs. GU was induced by oral administration of indomethacin once a day for 7 days. Rats in drug-administered groups were intraperitoneally injected with 100 μL normal saline, containing each drug at the indicated concentration, once a day for 14 days after inducing GU. KEY FINDINGS PDRN and PPI combination therapy potently improved tissue regeneration and inhibited production of pro-inflammatory cytokines. PDRN treatment with or without PPI increased the concentration of cyclic adenosine-3,5'-monophosphate (cAMP) and the ratio of phosphorylated cAMP response element-binding protein (p-CREB) to cAMP response element-binding protein (CREB). PDRN treatment with or without PPI also increased the expressions of vascular endothelial growth factor (VEGF) and adenosine A2A receptor. SIGNIFICANCE PDRN and PPI combination therapy showed more potent therapeutic effect on GU compared to the PDRN monotherapy or PPI monotherapy. The excellent therapeutic effect of PDRN and PPI combination therapy on GU appeared by promoting regeneration of damaged tissue as well as inhibiting gastric acid secretion.
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Affiliation(s)
- Il-Gyu Ko
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Sung-Eun Kim
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Jun-Jang Jin
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Lakkyong Hwang
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Eun-Sang Ji
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Chang-Ju Kim
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Jin-Hee Han
- Department of Anesthesiology and Pain Medicine, Kyung Hee Medical Center, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - In Taik Hong
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Republic of Korea
| | - Min Seop Kwak
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Republic of Korea
| | - Jin Young Yoon
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Republic of Korea
| | - Hyun Phil Shin
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Republic of Korea
| | - Jung Won Jeon
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Republic of Korea.
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Ultrasound-Guided Prolotherapy with Polydeoxyribonucleotide for Painful Rotator Cuff Tendinopathy. Pain Res Manag 2018; 2018:8286190. [PMID: 29770163 PMCID: PMC5889899 DOI: 10.1155/2018/8286190] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 02/20/2018] [Indexed: 12/12/2022]
Abstract
Background Rotator cuff tendinopathy is a primary cause of shoulder pain and dysfunction. Several effective nonsurgical treatment methods have been described for chronic rotator cuff tendinopathy. Prolotherapy with polydeoxyribonucleotide (PDRN), which consists of active deoxyribonucleotide polymers that stimulate tissue repair, is a nonsurgical regenerative injection that may be a viable treatment option. The objective of this study was to assess the efficacy of PDRN in the treatment of chronic rotator cuff tendinopathy. Method The records of patients with chronic rotator cuff tendinopathy (n=131) were reviewed retrospectively, and the patients treated with PDRN prolotherapy (n=32) were selected. We measured the main outcome of the shoulder pain and disability index score on a numerical rating scale of average shoulder pain. Results Compared with baseline data, significant improvements in the shoulder pain and disability index and pain visual analog scale scores were demonstrated at one week after the end of treatment, and at one month and three months later. Conclusions PDRN prolotherapy may improve the conservative treatment of painful rotator cuff tendinopathy for a specific subset of patients.
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Lee JH, Han JW, Byun JH, Lee WM, Kim MH, Wu WH. Comparison of wound healing effects between Oncorhynchus keta-derived polydeoxyribonucleotide (PDRN) and Oncorhynchus mykiss-derived PDRN. Arch Craniofac Surg 2018; 19:20-34. [PMID: 29609429 PMCID: PMC5894545 DOI: 10.7181/acfs.2018.19.1.20] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/14/2018] [Accepted: 03/15/2018] [Indexed: 12/02/2022] Open
Abstract
Background Polydeoxyribonucleotide (PDRN) influencing cellular growth and differentiation is recognized to promote wound healing by stimulating tissue repair. Although PDRN can be extracted from human placentas, PDRN medications have recently been extracted from the semen of trout (Oncorhynchus mykiss) and salmon (Oncorhynchus keta). The present study was designed to evaluate the wound healing effects of O. keta-derived PDRN for injection (Rejuvenex) and PDRN cream (Rejuvenex Cream) in comparison with those of O. mykiss-derived PDRN injection (Placentex). Methods Full-thickness skin defects were made on the back of mice (n=60). The mice were divided into the following four groups according to the dressing used for the wounds: O. mykiss-derived PDRN injection group, O. keta-derived PDRN injection group, O. keta-derived PDRN cream group, and normal saline soaked dressing group (control group). We analyzed the gross findings, wound sizes, histological findings, immunohistochemistry and enzyme-linked immunosorbent assays for the groups immediately after the treatment, and again after 4, 7, and 10 days of treatment. Results The wound healing effects were the greatest in the O. keta-derived PDRN injection and O. mykiss-derived PDRN injection groups, which showed similar scores, followed by the O. keta-derived cream and normal saline soaked dressing groups. Conclusion The injection of PDRN extracted from O. keta was found to be as effective at healing full-thickness skin defects as the O. mykiss-derived PDRN injection, which is currently used in the clinic. Moreover, the O. keta-derived PDRN injection was also found to reduce the time required for wound healing.
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Affiliation(s)
- Jong Hun Lee
- Department of Plastic and Reconstructive Surgery, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.,Eulji Medi-Bio Research Institute, Eulji University, Seoul, Korea
| | - Jin Woo Han
- Department of Plastic and Reconstructive Surgery, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Jin Hwan Byun
- Department of Plastic and Reconstructive Surgery, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Won Mi Lee
- Department of Pathology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Min Ho Kim
- Eulji Medi-Bio Research Institute, Eulji University, Seoul, Korea
| | - Wen Hao Wu
- Eulji Medi-Bio Research Institute, Eulji University, Seoul, Korea
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Polydeoxyribonucleotide Improves Peripheral Tissue Oxygenation and Accelerates Angiogenesis in Diabetic Foot Ulcers. Arch Plast Surg 2017; 44:482-489. [PMID: 29076318 PMCID: PMC5801786 DOI: 10.5999/aps.2017.00801] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 09/07/2017] [Accepted: 10/10/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Polydeoxyribonucleotide (PDRN) is known to have anti-inflammatory and angiogenic effects and to accelerate wound healing. The aim of this study was to investigate whether PDRN could improve peripheral tissue oxygenation and angiogenesis in diabetic foot ulcers. METHODS This was a prospective randomized controlled clinical trial. Twenty patients with a non-healing diabetic foot ulcer were randomly distributed into a control group (n=10) and a PDRN group (n=10). Initial surgical debridement and secondary surgical procedures such as a split-thickness skin graft, primary closure, or local flap were performed. Between the initial surgical debridement and secondary surgical procedures, 0.9% normal saline (3 mL) or PDRN was injected for 2 weeks by the intramuscular (1 ampule, 3 mL, 5.625 mg, 5 days per week) and perilesional routes (1 ampule, 3 mL, 5.625 mg, 2 days per week). Transcutaneous oxygen tension (TcPO2) was evaluated using the Periflux System 5000 with TcPO2/CO2 unit 5040 before the injections and on days 1, 3, 7, 14, and 28 after the start of the injections. A pathologic review (hematoxylin and eosin stain) of the debrided specimens was conducted by a pathologist, and vessel density (average number of vessels per visual field) was calculated. RESULTS Compared with the control group, the PDRN-treated group showed improvements in peripheral tissue oxygenation on day 7 (P<0.01), day 14 (P<0.001), and day 28 (P<0.001). The pathologic review of the specimens from the PDRN group showed increased angiogenesis and improved inflammation compared with the control group. No statistically significant difference was found between the control group and the PDRN group in terms of vessel density (P=0.094). Complete healing was achieved in every patient. CONCLUSIONS In this study, PDRN improved peripheral tissue oxygenation. Moreover, PDRN is thought to be effective in improving inflammation and angiogenesis in diabetic foot ulcers.
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Scar Prevention and Enhanced Wound Healing Induced by Polydeoxyribonucleotide in a Rat Incisional Wound-Healing Model. Int J Mol Sci 2017; 18:ijms18081698. [PMID: 28771195 PMCID: PMC5578088 DOI: 10.3390/ijms18081698] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 07/15/2017] [Accepted: 08/01/2017] [Indexed: 01/06/2023] Open
Abstract
High-mobility group box protein-1 (HMGB-1) plays a central role in the inflammatory network, and uncontrolled chronic inflammation can lead to excessive scarring. The aim of this study was to evaluate the anti-inflammatory effects of polydeoxyribonucleotide (PDRN) on scar formation. Sprague-Dawley rats (n = 30) underwent dorsal excision of the skin, followed by skin repair. PDRN (8 mg/kg) was administered via intraperitoneal injection for three (PDRN-3 group, n = 8) or seven (PDRN-7 group, n = 8) days, and HMGB-1 was administered via intradermal injection in addition to PDRN treatment for three days (PDRN-3+HMGB-1 group; n = 6). The scar-reducing effects of PDRN were evaluated in the internal scar area and by inflammatory cell counts using histology and immunohistochemistry. Western blot, immunohistochemistry and immunofluorescence assays were performed to observe changes in type I and type III collagen and the expression of HMGB-1 and CD45. Treatment with PDRN significantly reduced the scar area, inflammatory cell infiltration and the number of CD45-positive cells. In addition, the increased expression of HMGB-1 observed in the sham group was significantly reduced after treatment with PDRN. Rats administered HMGB-1 in addition to PDRN exhibited scar areas with inflammatory cell infiltration similar to the sham group, and the collagen synthesis effects of PDRN were reversed. In summary, PDRN exerts anti-inflammatory and collagen synthesis effects via HMGB-1 suppression, preventing scar formation. Thus, we believe that the anti-inflammatory and collagen synthesis effects of PDRN resulted in faster wound healing and decreased scar formation.
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23
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Squadrito F, Bitto A, Irrera N, Pizzino G, Pallio G, Minutoli L, Altavilla D. Pharmacological Activity and Clinical Use of PDRN. Front Pharmacol 2017; 8:224. [PMID: 28491036 PMCID: PMC5405115 DOI: 10.3389/fphar.2017.00224] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 04/10/2017] [Indexed: 12/26/2022] Open
Abstract
PDRN is a proprietary and registered drug that possesses several activities: tissue repairing, anti-ischemic, and anti-inflammatory. These therapeutic properties suggest its use in regenerative medicine and in diabetic foot ulcers. PDRN holds a mixture of deoxyribonucleotides with molecular weights ranging between 50 and 1,500 KDa, it is derived from a controlled purification and sterilization process of Oncorhynchus mykiss (Salmon Trout) or Oncorhynchus keta (Chum Salmon) sperm DNA. The procedure guarantees the absence of active protein and peptides that may cause immune reactions. In vitro and in vivo experiments have suggested that PDRN most relevant mechanism of action is the engagement of adenosine A2A receptors. Besides engaging the A2A receptor, PDRN offers nucleosides and nucleotides for the so called “salvage pathway.” The binding to adenosine A2A receptors is a unique property of PDRN and seems to be linked to DNA origin, molecular weight and manufacturing process. In this context, PDRN represents a new advancement in the pharmacotherapy. In fact adenosine and dipyridamole are non-selective activators of adenosine receptors and they may cause unwanted side effects; while regadenoson, the only other A2A receptor agonist available, has been approved by the FDA as a pharmacological stress agent in myocardial perfusion imaging. Finally, defibrotide, another drug composed by a mixture of oligonucleotides, has different molecular weight, a DNA of different origin and does not share the same wound healing stimulating effects of PDRN. The present review analyses the more relevant experimental and clinical evidences carried out to characterize PDRN therapeutic effects.
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Affiliation(s)
- Francesco Squadrito
- Section of Pharmacology, Department of Clinical and Experimental Medicine, University of MessinaMessina, Italy
| | - Alessandra Bitto
- Section of Pharmacology, Department of Clinical and Experimental Medicine, University of MessinaMessina, Italy
| | - Natasha Irrera
- Section of Pharmacology, Department of Clinical and Experimental Medicine, University of MessinaMessina, Italy
| | - Gabriele Pizzino
- Section of Pharmacology, Department of Clinical and Experimental Medicine, University of MessinaMessina, Italy
| | - Giovanni Pallio
- Section of Pharmacology, Department of Clinical and Experimental Medicine, University of MessinaMessina, Italy
| | - Letteria Minutoli
- Section of Pharmacology, Department of Clinical and Experimental Medicine, University of MessinaMessina, Italy
| | - Domenica Altavilla
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of MessinaMessina, Italy
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Squadrito F, Micali A, Rinaldi M, Irrera N, Marini H, Puzzolo D, Pisani A, Lorenzini C, Valenti A, Laurà R, Germanà A, Bitto A, Pizzino G, Pallio G, Altavilla D, Minutoli L. Polydeoxyribonucleotide, an Adenosine-A2 A Receptor Agonist, Preserves Blood Testis Barrier from Cadmium-Induced Injury. Front Pharmacol 2017; 7:537. [PMID: 28119612 PMCID: PMC5222826 DOI: 10.3389/fphar.2016.00537] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 12/23/2016] [Indexed: 12/15/2022] Open
Abstract
Cadmium (Cd) impairs blood-testis barrier (BTB). Polydeoxyribonucleotide (PDRN), an adenosine A2A agonist, has positive effects on male reproductive system. We investigated the effects of PDRN on the morphological and functional changes induced by Cd in mice testes. Adult Swiss mice were divided into four groups: controls administered with 0.9% NaCl (1 ml/kg, i.p., daily) or with PDRN (8 mg/kg, i.p. daily), animals challenged with Cd chloride (CdCl2; 2 mg/kg, i.p, daily) and animals challenged with CdCl2 (2 mg/kg, i.p., daily) and treated with PDRN (8 mg/kg, i.p., daily). Experiments lasted 14 days. Testes were processed for biochemical, structural, and ultrastructural evaluation and hormones were assayed in serum. CdCl2 increased pERK 1/2 expression and Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) levels; it decreased testosterone (TE) and inhibin-B levels and induced structural damages in extratubular compartment and in seminiferous epithelium, with ultrastructural features of BTB disruption. Many TUNEL-positive germ cells were present. CdCl2 increased tubular TGF-β3 immunoreactivity and reduced claudin-11, occludin, and N-cadherin immunoreactivity. PDRN administration reduced pERK 1/2 expression, FSH, and LH levels; it increased TE and inhibin-B levels, ameliorated germinal epithelium changes and protected BTB ultrastructure. Few TUNEL-positive germ cells were present and the extratubular compartment was preserved. Furthermore, PDRN decreased TGF-β3 immunoreactivity and enhanced claudin-11, occludin, and N-cadherin immunoreactivity. We demonstrate a protective effect of PDRN on Cd-induced damages of BTB and suggest that PDRN may play an important role against Cd, particularly against its harmful effects on gametogenesis.
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Affiliation(s)
- Francesco Squadrito
- Department of Clinical and Experimental Medicine, University of Messina Messina, Italy
| | - Antonio Micali
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina Messina, Italy
| | - Mariagrazia Rinaldi
- Department of Clinical and Experimental Medicine, University of Messina Messina, Italy
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina Messina, Italy
| | - Herbert Marini
- Department of Clinical and Experimental Medicine, University of Messina Messina, Italy
| | - Domenico Puzzolo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina Messina, Italy
| | - Antonina Pisani
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina Messina, Italy
| | - Cesare Lorenzini
- Department of Human Pathology, University of Messina Messina, Italy
| | - Andrea Valenti
- Department of Clinical and Experimental Medicine, University of Messina Messina, Italy
| | - Rosaria Laurà
- Department of Veterinary Sciences, University of Messina Messina, Italy
| | - Antonino Germanà
- Department of Veterinary Sciences, University of Messina Messina, Italy
| | - Alessandra Bitto
- Department of Clinical and Experimental Medicine, University of Messina Messina, Italy
| | - Gabriele Pizzino
- Department of Clinical and Experimental Medicine, University of Messina Messina, Italy
| | - Giovanni Pallio
- Department of Clinical and Experimental Medicine, University of Messina Messina, Italy
| | - Domenica Altavilla
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina Messina, Italy
| | - Letteria Minutoli
- Department of Clinical and Experimental Medicine, University of Messina Messina, Italy
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Jeong EK, Jang HJ, Kim SS, Lee SY, Oh MY, Kim HJ, Eom DW, Ham JY, Han DJ. Protective Effect of Polydeoxyribonucleotide Against Renal Ischemia-Reperfusion Injury in Mice. Transplant Proc 2016; 48:1251-7. [PMID: 27320598 DOI: 10.1016/j.transproceed.2016.01.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 01/14/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Polydeoxyribonucleotide (PDRN) is an A2A receptor agonist that induces vascular endothelial growth factor (VEGF) production during the pathological condition of low tissue perfusion. Ischemia-reperfusion injury (IRI) is a major problem after renal transplantation. In the present study, we investigated whether PDRN exhibits reno-protective effects against ischemia-reperfusion-induced acute kidney injury in mice. METHODS Renal ischemia-reperfusion injury was induced in male C57BL/6 mice by bilateral renal pedicle occlusion for 30 minutes, followed by reperfusion for 48 hours. PDRN (8 mg/kg body weight intraperitoneally) was administered 30 minutes before IRI. RESULTS Treatment with PDRN significantly decreased neutrophil gelatinase-associated lipocalin levels in the urine, blood urea nitrogen level, and serum creatinine levels as well as kidney tubular injury. Western blotting showed that PDRN significantly increased the levels of vascular endothelial growth factor and B-cell lymphoma protein and attenuated p38 mitogen-activated protein kinase, c-Jun N-terminal kinase, inducible nitric oxide synthase, and Bcl-2-associated X protein levels 48 hours after IRI. CONCLUSIONS Our findings suggest that PDRN is a potential therapeutic agent for acute ischemia-induced renal damage.
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Affiliation(s)
- E K Jeong
- Department of Anesthesia and Pain Medicine, Ulsan University College of Medicine, Gangneung Asan Hospital, Gangneung, South Korea
| | - H J Jang
- Department of Surgery, Ulsan University College of Medicine, Gangneung Asan Hospital, Gangneung, South Korea.
| | - S S Kim
- Department of Anesthesia and Pain Medicine, Ulsan University College of Medicine, Gangneung Asan Hospital, Gangneung, South Korea
| | - S Y Lee
- Department of Surgery, Ulsan University College of Medicine, Gangneung Asan Hospital, Gangneung, South Korea
| | - M Y Oh
- Department of Surgery, Ulsan University College of Medicine, Gangneung Asan Hospital, Gangneung, South Korea
| | - H J Kim
- Department of Surgery, Ulsan University College of Medicine, Gangneung Asan Hospital, Gangneung, South Korea
| | - D W Eom
- Department of Pathology, Ulsan University College of Medicine, Gangneung Asan Hospital, Gangneung, South Korea
| | - J Y Ham
- Natural Medicine Center, Korea Institute of Science and Technology (KIST), Gangneung, South Korea
| | - D J Han
- Asan Medical Center, Seoul, South Korea
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Yu M, Lee JY. Polydeoxyribonucleotide improves wound healing of fractional laser resurfacing in rat model. J COSMET LASER THER 2016; 19:43-48. [PMID: 27762652 DOI: 10.1080/14764172.2016.1247966] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Polydeoxyribonucleotide (PDRN) is an active compound that can promote wound healing. PDRN stimulates wound healing by enhancing angiogenesis and increasing fibroblast growth rates. Laser skin resurfacing is a popular cosmetic procedure for skin rejuvenation. Despite excellent improvement of photo-damaged skin and acne scarring, it is accompanied with drawbacks, such as prolonged erythema and crusting. OBJECTIVE This study was designed to assess the effect of PDRN on wounds induced by fractional laser resurfacing. METHODS Twelve male rats aged 8 weeks were randomly assigned to the PDRN treatment group and the control group. Wounds were induced using a fractional ablative CO2 laser. The treatment group received daily injections of PDRN and the control group received injections of the vehicle. Wound healing assessed by clinical features and histopathologic findings. RESULTS The process of wound healing was faster in the treatment group than in the control group. In the histopathological examination, the granulation tissue thickness score of the treatment group was significantly higher than that of the control group. Results of immunohistochemical staining showed a marked increase of VEGF-positive cells and PECAM-1/CD31-positive microvessels in the treatment group. CONCLUSION PDRN may be a beneficial option to promote wound healing after laser treatment.
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Affiliation(s)
- Mi Yu
- a Graduate School, The Catholic University of Korea , Seoul , the Republic of Korea
| | - Jun Young Lee
- b Department of Dermatology , Seoul St. Mary's Hospital , Seoul , Republic of Korea
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Jang KS, Kim HS. Treatment for Acute Stage Complex Regional Pain Syndrome Type II with Polydeoxyribonucleotide Injection. J Korean Neurosurg Soc 2016; 59:529-32. [PMID: 27651875 PMCID: PMC5028617 DOI: 10.3340/jkns.2016.59.5.529] [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] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 07/03/2015] [Accepted: 07/03/2015] [Indexed: 11/30/2022] Open
Abstract
Complex regional pain syndrome (CRPS) type II is a syndrome that develops after nerve injury. Symptoms may be severe, and vary depending on the degree of sympathetic nerve involvement. As yet, there is no satisfactory treatment. We report the case of a female patient who had an L5 left transverse process fracture and an S2 body fracture, who developed symptoms of CRPS type II in her left lower leg that were aggravated during ambulation in spite of absolute bed rest for one month after the trauma. Several treatments, including bed rest, medication, and numerous nerve blocks were attempted, but the pain persisted. We finally tried injection of polydeoxyribonucleotide (PDRN) solution at the left L5 transverse process fracture site because we knew of the anti-inflammatory effect of PDRN. One day after this treatment, her symptoms had almost disappeared and three days later, she was discharged. We will also further discuss the possibility of using PDRN solution for the treatment of CRPS.
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Affiliation(s)
- Kun Soo Jang
- Department of Neurosurgery, SunHan Hospital, Gwangju, Korea
| | - Hyeun Sung Kim
- Department of Neurosurgery, SunHan Hospital, Gwangju, Korea
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Abstract
Polydeoxyribonucleotide (PDRN) has multiple vascular actions such as angiogenesis and production of a vascular endothelial growth factor (VEGF) through the adenosine A2 receptor stimulation. We applied PDRN on the ischemic flap of rat back and investigated whether it enhances the skin flap survival. A total of 28 Sprague-Dawley rats were divided into 3 groups, namely, PDRN group, control group 1 (no treatment), and group 2 (phosphate-buffered saline injection). On the distally based flap of 3 × 9 cm in size, it was subdermally injected with PDRN or phosphate-buffered saline, which were administered 48 hours prior and immediately after flap elevation. The PDRN group was daily maintained by intraperitoneal administration of PDRN from the postoperative 1st day to 10th day. The mean survival rates of flap in PDRN group [79.5% (6.3%)] are significantly larger than control groups [1, 53.0% (6.9%); 2, 51.7% (6.7%)]. Serial measurements of blood perfusion also showed that the blood flux was significantly increased in almost part of the flap on the 10 days after PDRN injection. The number of CD31 positively stained vessels and expression of VEGF protein were significantly higher in the PDRN group. We propose that administration of PDRN into the ischemic skin flaps increased blood flux to the flap, VEGF expression, and number of capillaries, thereby improving the rat skin flap survival.
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Kim SK, Huh CK, Lee JH, Kim KW, Kim MY. Histologic study of bone-forming capacity on polydeoxyribonucleotide combined with demineralized dentin matrix. Maxillofac Plast Reconstr Surg 2016; 38:7. [PMID: 26913276 PMCID: PMC4752573 DOI: 10.1186/s40902-016-0053-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 02/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study examined the osteoinductive activity of demineralized dentin matrix (DDM) from human and polydeoxyribonucleotide (PDRN) for nude mice. METHODS Twenty healthy nude mice, weighing about 15~20 g, were used for the study. DDM from human and PDRN were prepared and implanted subcutaneously into the dorsal portion of the nude mice. The nude mice were sacrificed at 1, 2, and 4 weeks after grafting and evaluated histologically by hematoxylin-eosin and Masson's trichrome staining. The specimens were also evaluated via a histomorphometric study. RESULTS The DDM and PDRN induced new bone, osteoblasts, and fibroblasts in soft tissues. The histological findings showed bone-forming cells like osteoblasts and fibroblasts at 1, 2, and 4 weeks. New bone formation was observed in the histomorphometric study. In particular, the ratio of new bone formation was the highest at 2 weeks compared with the first week and fourth week. CONCLUSIONS In this study, we showed that the PDRN used in this experimental model was able to induce bone regeneration when combined to the DDM.
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Affiliation(s)
- Seok-Kon Kim
- Department of Pain and Anesthesiology, College of Medicine, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam Korea
| | - Chang-Kyu Huh
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam Korea
| | - Jae-Hoon Lee
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam Korea
| | - Kyung-Wook Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam Korea
| | - Moon-Young Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam Korea
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Yoon KH, Kim WJ, Han SK, Han KI, Nam KW, Han MD. Polydeoxyribonucleotide administration promotes the expression of proliferating cell nuclear antigen during liver regeneration in rats. Anim Cells Syst (Seoul) 2015. [DOI: 10.1080/19768354.2014.997289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Jeon JW, Lee JI, Shin HP, Cha JM, Joo KR, Kim SH, Ko IG, Jin JJ, Kim SE, Kim CJ. Adenosine A2A-receptor agonist polydeoxyribonucleotide promotes gastric ulcer healing in Mongolian gerbils. Anim Cells Syst (Seoul) 2014. [DOI: 10.1080/19768354.2014.983968] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Kim JY, Pak CS, Park JH, Jeong JH, Heo CY. Effects of polydeoxyribonucleotide in the treatment of pressure ulcers. J Korean Med Sci 2014; 29 Suppl 3:S222-7. [PMID: 25473213 PMCID: PMC4248009 DOI: 10.3346/jkms.2014.29.s3.s222] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 08/12/2014] [Indexed: 11/20/2022] Open
Abstract
This study aimed to examine the positive effects of polydeoxyribonucleotide (PDRN) on the wound-healing process in pressure ulcers. In this randomized controlled trial, the effects of PDRN were compared over time between an experimental group (n=11) and a control group (n=12). The former was administered the same dose of PDRN intramuscularly (1 ampule, 3 mL, 5.625 mg, for 5 days) for 2 weeks and perilesionally (1 ampule, 3 mL, 5.625 mg, twice a week) for 4 weeks. The primary endpoint for determining efficacy was wound healing in the pressure ulcers, which was reflected by the wound surface area determined using VISITRAK Digital (Smith & Nephew, Largo, FL). The secondary endpoint was the pressure ulcer scale for healing score, determined using pressure ulcer scale for healing (PUSH Tool 3.0 developed by the National Pressure Ulcer Advisory Panel). After the 4-week treatment period, PDRN therapy was found to significantly reduce the wound size and PUSH score, without adverse effect during the treatment. The findings indicate that PDRN can positively modify the wound healing process in pressure ulcers, and its use could improve the clinical outcomes of patients and lower the need for additional therapies or hospital stay.
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Affiliation(s)
- Jung Yoon Kim
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Sik Pak
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Hoon Park
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Hoon Jeong
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Chan Yeong Heo
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
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De Caridi G, Massara M, Acri I, Zavettieri S, Grande R, Butrico L, de Franciscis S, Serra R. Trophic effects of polynucleotides and hyaluronic acid in the healing of venous ulcers of the lower limbs: a clinical study. Int Wound J 2014; 13:754-8. [PMID: 25224018 DOI: 10.1111/iwj.12368] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 08/12/2014] [Accepted: 08/25/2014] [Indexed: 12/18/2022] Open
Abstract
The aim of this study was to evaluate the results of treatment of venous lower limbs ulcers through the topical application of polynucleotides and hyaluronic acid gel (PNHA): Nucliaskin S™ (Mastelli srl, San Remo, Italy). This study was carried out in 39 consecutive patients who were randomly allocated to two groups: group I (20 patients) received treatment with PNHA (topical gel application two times a week, for a total of 6 weeks); group II (19 patients) received only hyaluronic acid (HA) topical application. All patients received a surgical debridement of the ulcerative lesions before topical treatment with PNHA or HA. Pre-treatment data indicated the area of ulceration. The number of healed ulcers and the variation in area of ulceration were considered as endpoints. The endpoints were observed after 45 days from the beginning of treatment. Complete wound healing occurred in 60% of limbs of group I and in 22% of those of group II patients. The average area reduction was 67% versus 34% in patients of group I and II, respectively. No side effects were recorded in both groups. Our experience shows that PNHA has an elevated trophic effect and speeds the healing rate of venous lower limb ulcers. This treatment may be a valid option in clinical practice.
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Affiliation(s)
- Giovanni De Caridi
- Cardiovascular and Thoracic Department,"Policlinico G. Martino" Hospital, University of Messina, Messina, Italy
| | - Mafalda Massara
- Cardiovascular and Thoracic Department,"Policlinico G. Martino" Hospital, University of Messina, Messina, Italy
| | - Ignazio Acri
- Cardiovascular and Thoracic Department,"Policlinico G. Martino" Hospital, University of Messina, Messina, Italy
| | - Salvatore Zavettieri
- Cardiovascular and Thoracic Department,"Policlinico G. Martino" Hospital, University of Messina, Messina, Italy
| | - Raffaele Grande
- Department of Surgical and Medical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Lucia Butrico
- Department of Surgical and Medical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Stefano de Franciscis
- Department of Surgical and Medical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.,Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Raffaele Serra
- Department of Surgical and Medical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy. .,Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Catanzaro, Italy.
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Squadrito F, Bitto A, Altavilla D, Arcoraci V, De Caridi G, De Feo ME, Corrao S, Pallio G, Sterrantino C, Minutoli L, Saitta A, Vaccaro M, Cucinotta D. The effect of PDRN, an adenosine receptor A2A agonist, on the healing of chronic diabetic foot ulcers: results of a clinical trial. J Clin Endocrinol Metab 2014; 99:E746-53. [PMID: 24483158 DOI: 10.1210/jc.2013-3569] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
CONTEXT Foot ulcer is the principal cause of hospitalization for patients with diabetes. Polydeoxyribonucleotide (PDRN), an adenosine A2A receptor agonist, improves wound healing in diabetic mice. OBJECTIVE The aim of this study was to evaluate the effect of PDRN on chronic ulcer healing in patients with diabetes. DESIGN AND SETTING This randomized, double-blind, placebo-controlled trial, involved two medical centers in Italy. INTERVENTION Patients with diabetes showing hard-to-heal ulcers (Wagner grade 1 or 2) were randomly assigned to receive placebo (n = 106) or PDRN (n = 110). The treatments (PDRN and placebo) were performed for 8 weeks by intramuscular and perilesional route [corrected]. MAIN OUTCOME MEASURES The primary outcome was complete ulcer healing. Secondary outcomes were the days needed to complete wound closure and the reepithelialization of wound surface (as percentage of the original area). RESULTS After 8 weeks, 91 placebo and 101 PDRN subjects completed the study. Complete healing was achieved in 18.9% [95% confidence interval (CI) 11.4-26.3] of placebo and in 37.3% (95% CI 28.2-46.3) of PDRN-treated patients (P = .0027). After 8 weeks, PDRN increased the closure of foot ulcers in diabetic subjects (hazard ratio 2.20; 95% CI 1.29-3.75; P = .004). The median time to complete wound healing was 49 days for placebo (range 28-56 d) and 30 days for PDRN-treated subjects (range 14-56 d; P = .0027). The median epithelialized area of the ulcers (expressed as percentage) was 49.3% in the placebo and 82.2% in the PDRN group (P < .001). CONCLUSIONS PDRN facilitates the healing of Wagner 1 or 2 diabetic foot ulcers.
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Affiliation(s)
- Francesco Squadrito
- Departments of Clinical and Experimental Medicine (F.S., A.B., V.A., G.P., C.S., L.M., A.S., M.V., D.C.), Paediatric, Gynaecological, Microbiological, and Biomedical Sciences (D.A.), and Experimental Surgical Sciences and Dentistry (G.D.C.), University of Messina, 98125 Messina, Italy; Diabetology Unit (E.D.F.), Cardarelli Hospital, 80131 Naples, Italy; and Department of Internal Medicine (S.C.), University of Palermo, 90128 Palermo, Italy
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Bonfili P, Franzese P, Marampon F, La Verghetta ME, Parente S, Cerasani M, Di Genova D, Mancini M, Vittorini F, Gravina GL, Ruggieri V, Di Staso M, Popov VM, Tombolini V, Di Cesare E. Intravesical instillations with polydeoxyribonucleotides reduce symptoms of radiation-induced cystitis in patients treated with radiotherapy for pelvic cancer: a pilot study. Support Care Cancer 2013; 22:1155-9. [PMID: 24322388 DOI: 10.1007/s00520-013-2051-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 11/12/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE Chronic radiation cystitis (CRC) is a serious complication that can arise in patients with pelvic malignancies treated with radiotherapy. Polydeoxyribonucleotides (PDRNs) are known to reduce inflammation and improve tissue perfusion and angiogenesis. In this manuscript, we describe our observational experience regarding intravesical instillation of PDRNs in improving symptoms of CRC in subjects unresponsiveness to conventional medical therapy. METHODS Eight patients with persistent and/or worsening CRC symptoms, despite conventional therapy, received biweekly intravesical instillation of PDRNs for two consecutive months. Symptoms were scored according to the Late Effects of Normal Tissues-Subjective, Objective, Management, Analytic (LENT-SOMA) scale, before, at the end, and after 4 months following the PDRNs treatment. RESULTS Four months after instillations, a significant improvement in the subjective perception of CRC symptoms was experienced by participants. The mean LENT-SOMA score was reduced from 1.16+0.26 before to 0.34+0.035 after 4 months from instillations (p<0.001). No adverse effect related to instillations was reported. CONCLUSIONS Subjective perception of persistent and/or worsening CRC symptoms, despite conventional therapy, is improved after intravesical instillation with PDRNs without adverse events. Even though we deduced suggestive insights, the results need to be collected and verified from a large-scale study.
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Affiliation(s)
- Pierluigi Bonfili
- Division of Radiotherapy, San Salvatore Hospital, 67100, L'Aquila, Italy,
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The effects of polydeoxyribonucleotide on the survival of random pattern skin flaps in rats. Arch Plast Surg 2013; 40:181-6. [PMID: 23730590 PMCID: PMC3665858 DOI: 10.5999/aps.2013.40.3.181] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 02/25/2013] [Accepted: 03/18/2013] [Indexed: 11/17/2022] Open
Abstract
Background Partial or complete necrosis of a skin flap is a common problem. Polydeoxyribonucleotide (PDRN) can be extracted from trout sperm and used as a tissue repair agent. The aim of this study was to investigate whether PDRN could improve the survival of random pattern skin flaps in rats. Methods Twenty-two male Sprague-Dawley rats were randomly divided into two groups: the PDRN treatment group (n=11) and the control group (n=11). Caudally pedicled random pattern skin flaps were elevated on their dorsal skin and resutured. The treatment group received daily intraperitoneal administration of PDRN (8 mg/kg/day), and the control group received fluid vehicle (NaCl 0.9%, 8 mg/kg/day) from day 0 to day 6. On day 7, the flap survival was evaluated and the harvested tissue surrounding the demarcation line of the necrotic area was stained with H&E, anti-rat vascular endothelial cell growth factor (VEGF) antibody, and PECAM-1/CD31 antibody. Results The average necrotic area of the flap in the PDRN group was significantly smaller when compared with that of the control group. Histologic and immunohistochemical evaluation showed that granulation thickness score and VEGF-positive staining cells were marked higher in the PDRN group than in the control group. PECAM-1/CD31-positive microvascular densities were significantly higher in the PDRN group when compared with the control group. Conclusions This study confirms that PDRN improves the survival of random pattern skin flaps in rats. These results may represent a new therapeutic approach to enhancing flap viability and achieving faster wound repair.
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Polito F, Bitto A, Galeano M, Irrera N, Marini H, Calò M, Squadrito F, Altavilla D. Polydeoxyribonucleotide restores blood flow in an experimental model of ischemic skin flaps. J Vasc Surg 2011; 55:479-88. [PMID: 22051873 DOI: 10.1016/j.jvs.2011.07.083] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 07/15/2011] [Accepted: 07/15/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND Ischemia is a major factor contributing to failure of skin flap surgery, which is routinely used for coverage of wounds to prevent infection and to restore form and function. An emerging concept is that adenosine A(2A) receptors can improve tissue oxygenation by stimulating angiogenesis, likely through vascular endothelial growth factor (VEGF). This study assessed the ability of polydeoxyribonucleotide (PDRN) to restore blood flow and improve wound healing, acting through the A(2A) receptor, in a rat model of ischemic skin flaps. METHODS The H-shaped double-flap model was used in male Sprague-Dawley rats. After surgical procedures, the animals were randomized to receive intraperitoneal PDRN (8 mg/kg) or vehicle (NaCl 0.9%). Rats were euthanized 3, 5, and 10 days after skin injury, after the evaluation of skin perfusion by laser Doppler. The wounds underwent histologic analysis and were measured for VEGF messenger RNA and protein expression, hypoxia inducible factor-1-α (HIF-1α), and inducible nitric oxide synthase (iNOS) protein expression, and nitrite content. RESULTS Blood flow markedly increased in blood flow in ischemic flaps treated with PDRN, with a complete recovery starting from day 5 (ischemic flap + vehicle, 1.80 ± 0.25; ischemic flap + PDRN, 2.46 ± 0.25; P < .001). Administration of PDRN enhanced the expression of VEGF (ischemic flap + vehicle, 5.3 ± 0.6; ischemic flap + PDRN, 6.2 ± 0.5; P < .01) at day 5, and iNOS (ischemic flap + vehicle, 3.9 ± 0.6; ischemic flap + PDRN, 5.3 ± 1; P < .01), but reduced HIF-1α expression (ischemic flap + vehicle, 7 ± 1.1; ischemic flap + PDRN, 4.8 ± 0.5; P < .05) at day 3. Histologically, the PDRN-treated group showed complete re-epithelialization and well-formed granulation tissue rich in fibroblasts. CONCLUSIONS These results suggest that PDRN restores blood flow and tissue architecture, probably by modulating HIF-1α and VEGF expression, and may be an effective therapeutic approach in improving healing of ischemic skin flaps.
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Affiliation(s)
- Francesca Polito
- Department of Biochemical, Physiological and Nutritional Sciences, Section of Physiology and Human Nutrition, University of Messina, Messina, Italy
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Bitto A, Polito F, Irrera N, D'Ascola A, Avenoso A, Nastasi G, Campo GM, Micali A, Bagnato G, Minutoli L, Marini H, Rinaldi M, Squadrito F, Altavilla D. Polydeoxyribonucleotide reduces cytokine production and the severity of collagen-induced arthritis by stimulation of adenosine A(₂A) receptor. ARTHRITIS AND RHEUMATISM 2011; 63:3364-71. [PMID: 21769841 DOI: 10.1002/art.30538] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Broad antiinflammatory effects following adenosine A(₂A) receptor stimulation have been demonstrated in acute inflammatory diseases, including arthritis. Polydeoxyribonucleotide (PDRN) activates the adenosine A(₂A) receptor. This study was undertaken to investigate the effects of PDRN in collagen-induced arthritis (CIA) in mice. METHODS Arthritis was induced in DBA/1 mice by an intradermal injection of 100 μl of bovine type II collagen in Freund's complete adjuvant. Mice were immunized a second time 21 days later. Control animals received 100 μl of a saline solution. Animals with CIA were randomized to receive one of the following: vehicle (1 ml/kg); PDRN (8 mg/kg intraperitoneally daily); 3,7-dimethyl-propargylxanthine (DMPX), a specific adenosine A(₂A) receptor antagonist (0.1 mg/kg intraperitoneally daily); or PDRN plus DMPX. The treatment was initiated immediately after the second immunization and continued to day 45. Clinical evaluation of arthritis was performed throughout the study. On day 45, the animals were killed and the severity of arthritis was evaluated histologically. Cartilage expression and circulating levels of high mobility group box chromosomal protein 1 (HMGB-1), tumor necrosis factor α (TNFα), interleukin-6 (IL-6), and IL-10 were investigated. Inflammatory cytokine production was also evaluated in stimulated human chondrocytes treated with PDRN. RESULTS PDRN treatment significantly ameliorated clinical signs of arthritis, improved histologic damage, reduced the cartilage expression and circulating levels of HMGB-1, TNFα, and IL-6, and enhanced IL-10 expression. The concomitant administration of DMPX and PDRN ablated the PDRN-induced protective effect in experimental arthritis. PDRN also reduced cytokine production from stimulated human chondrocytes. CONCLUSION Our findings indicate that PDRN may represent a new alternative for the treatment of arthritis.
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Minutoli L, Antonuccio P, Squadrito F, Bitto A, Nicotina PA, Fazzari C, Polito F, Marini H, Bonvissuto G, Arena S, Morgia G, Romeo C, Caputi AP, Altavilla D. Effects of polydeoxyribonucleotide on the histological damage and the altered spermatogenesis induced by testicular ischaemia and reperfusion in rats. ACTA ACUST UNITED AC 2011; 35:133-44. [PMID: 21651579 DOI: 10.1111/j.1365-2605.2011.01194.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The effects of polydeoxyribonucleotide (PDRN), an agonist of the A2A adenosine receptors which when activated positively influences sperm activity, were tested in an experimental testicular ischaemia/reperfusion injury model. Anaesthetized male Sprague-Dawley rats were subjected to testicular torsion-induced ischaemia, followed by reperfusion (TI/R). Immediately after detorsion, randomized animals, including SHAM, received intraperitoneal injections of: (i) vehicle (1 mL/kg 0.9% NaCl solution); (ii) PDRN (8 mg/kg); (iii) DMPX (3,7-dimethyl-1-propargilxanthine, 0.1 mg/kg); or (iv) PDRN (8 mg/kg) + DMPX (0.1 mg/kg). Animals were euthanized at 1, 7 and 30 days following reperfusion. Vascular endothelial growth factor (VEGF) expression is normally associated with adenosine A2A receptor stimulation. After treatment, VEGF mRNA/protein expression quantified by qPCR and Western blot, vascular endothelial growth factor receptor-1 (VEGFR1) and endothelial nitric oxide synthase (eNOS) mRNA measured by qPCR, VEGF and VEGFR1 assessed using immunohistochemical methods, histological staining and spermatogenic activity were all analysed. Testis ischaemia-reperfusion (TI/R) injury caused increases in VEGF mRNA and protein, VEGFR1 and eNOS mRNA, histological damage and reduced spermatogenic activity. Immunostaining showed a lower expression of VEGF in germinal epithelial cells and a strong expression of VEGFR1 in Leydig cells after TI/R. PDRN administration increased significantly VEGF message/protein, VEGFR1 and eNOS message, decreased histological damage and ameliorated spermatogenic activity. PDRN might be useful in the management of testicular torsion.
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Affiliation(s)
- L Minutoli
- Section of Pharmacology, Department of Experimental and Clinical Medicine and Pharmacology, University of Messina, Messina, Italy.
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Minutoli L, Arena S, Bonvissuto G, Bitto A, Polito F, Irrera N, Arena F, Fragalà E, Romeo C, Nicotina PA, Fazzari C, Marini H, Implatini A, Grimaldi S, Cantone N, Di Benedetto V, Squadrito F, Altavilla D, Morgia G. Activation of adenosine A2A receptors by polydeoxyribonucleotide increases vascular endothelial growth factor and protects against testicular damage induced by experimental varicocele in rats. Fertil Steril 2011; 95:1510-3. [PMID: 20797711 DOI: 10.1016/j.fertnstert.2010.07.1047] [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: 03/09/2010] [Revised: 06/21/2010] [Accepted: 07/05/2010] [Indexed: 12/17/2022]
Abstract
In rat experimental varicocele, polydeoxyribonucleotide (PDRN) induces vascular endothelial growth factor (VEGF) production, thereby enhancing testicular function. This may point to a new therapeutic approach in human varicocele.
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Affiliation(s)
- Letteria Minutoli
- Department of Clinical and Experimental Medicine and Pharmacology, University of Messina, Messina, Italy
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Bitto A, Polito F, Altavilla D, Minutoli L, Migliorato A, Squadrito F. Polydeoxyribonucleotide (PDRN) restores blood flow in an experimental model of peripheral artery occlusive disease. J Vasc Surg 2008; 48:1292-300. [PMID: 18971038 DOI: 10.1016/j.jvs.2008.06.041] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Revised: 06/10/2008] [Accepted: 06/10/2008] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study investigated whether polydeoxyribonucleotide (PDRN) may be efficacious in the treatment of peripheral artery occlusive diseases, which are a major cause of morbidity in Western countries and still lack standardized treatment. METHODS We investigated the effects of PDRN, a mixture of deoxyribonucleotides, in an experimental model of hind limb ischemia (HLI) in rats to stimulate vascular endothelial growth factor (VEGF)-A production and to avoid critical ischemia. The femoral artery was excised to induce HLI. Sham-operated on rats (sham HLI) were used as controls. Animals were treated daily with intraperitoneal PDRN (8 mg/kg) or its vehicle. Animals were euthanized at day 7, 14, and 21 after the evaluation of blood flow by laser Doppler. Dissected muscles were used to measure VEGF-A messenger RNA (mRNA) and protein expression, to evaluate edema, and to assess histologic damage. RESULTS Administration of PDRN dramatically increased VEGF mRNA throughout the study (day 14: HLI, 7 +/- 2.2 n-fold/beta-actin; HLI + PDRN, 13.3 +/- 3.8 n-fold/beta-actin; P < .0001) and protein expression (HLI, 11 +/- 3.4 integrated intensity; HLI + PDRN, 16 +/- 3.8 integrated intensity; P < .0001). The compound stimulated revascularization, as confirmed by blood flow restoration (P < .005 vs HLI + vehicle), and blunted the histologic damage and the degree of edema. PDRN did not modify VEGF-A expression and blood flow in sham HLI animals. Furthermore, the concomitant administration of 3,7-dimethyl-1-propargilxanthine (DMPX), a selective adenosine A(2A) receptor antagonist, abolished the positive effects of PDRN, confirming that PDRN acts through this receptor. CONCLUSION These results led us to hypothesize a role for PDRN in treating peripheral artery occlusive diseases.
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Affiliation(s)
- Alessandra Bitto
- Department of Clinical and Experimental Medicine and Pharmacology, Section of Pharmacology, University of Messina, Messina, Italy
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