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Zakine G, Perruisseau-Carrier A, Becker C, Sedel F, Téot L, Barritault D. A Retrospective Self-Controlled Study Evaluating the Prophylactic Effects of CACIPLIQ20 on Postsurgical Scars. Aesthet Surg J Open Forum 2023; 5:ojad031. [PMID: 37051418 PMCID: PMC10084089 DOI: 10.1093/asjof/ojad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
Background CACIPLIQ20 (OTR3, Paris, France) is a medical device used for the treatment of chronic skin ulcers. It contains a heparan sulfate mimetic that accelerates tissue healing by stabilizing matrix proteins and protecting heparin-binding growth factors. In humans, an open self-controlled study suggested that the topical application of CACIPLIQ20 optimizes skin healing following surgery. Objectives To expand previous findings using a different CACIPLIQ20 administration regimen. Methods Twenty-four females were referred for breast-reduction surgery. Each patient had their own control with 1 CACIPLIQ20-treated and 1 saline-treated control breast. The treated side (right or left) was randomly assigned by the operating surgeon. Scar appearance was assessed by 6 independent raters using a global visual scar comparison scale based on scar photographs. All raters were blinded toward the CACIPLIQ20-treated side. Results The follow-up period following surgery ranged from 1 to 12 months with a median follow-up of 6 months. Overall, there was a mean improvement of 15.2% (SD = 26.7) in favor of CACIPLIQ20 (P = .016). On the CACIPLIQ20-treated side, the mean score per patient was above 20% in 11 patients and above 30% improvement in 8 cases. In contrast, only 3 patients were considered improved by at least 20% on the control side and only 1 above 30%. A comparison of different application regimens suggested that the best trend was obtained with a single administration of CACIPLIQ20 at Day 0. Conclusions In conclusion, CACIPLIQ20 could represent an interesting scar prophylactic therapy, based on a single administration at the time of surgery, and without any known adverse effects. Level of Evidence 3
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Affiliation(s)
- Gilbert Zakine
- Corresponding Author: Dr Gilbert Zakine, 107 Avenue Victor HUGO, 75016 Paris, France. E-mail:
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Alcalde I, Sánchez-Fernández C, Del Olmo-Aguado S, Martín C, Olmiere C, Artime E, Quirós LM, Merayo-Lloves J. Synthetic Heparan Sulfate Mimetic Polymer Enhances Corneal Nerve Regeneration and Wound Healing after Experimental Laser Ablation Injury in Mice. Polymers (Basel) 2022; 14:polym14224921. [PMID: 36433048 PMCID: PMC9694493 DOI: 10.3390/polym14224921] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Abnormal corneal wound healing compromises visual acuity and can lead to neuropathic pain. Conventional treatments usually fail to restore the injured corneal tissue. In this study, we evaluated the effectiveness of a synthetic heparan sulfate mimetic polymer (HSmP) in a mouse model of corneal wound healing. (2) Methods: A surgical laser ablation affecting the central cornea and subbasal nerve plexus of mice was used as a model of the wound-healing assay. Topical treatment with HSmP was contrasted to its vehicle and a negative control (BSS). Corneal repair was studied using immunofluorescence to cell proliferation (Ki67), apoptosis (TUNEL assay), myofibroblast transformation (αSMA), assembly of epithelial cells (E-cadherin) and nerve regeneration (β-tubulin III). (3) Results: At the end of the treatment, normal epithelial cytoarchitecture and corneal thickness were achieved in HSmP-treated animals. HSmP treatment reduced myofibroblast occurrence compared to eyes irrigated with vehicle (p < 0.01) or BSS (p < 0.001). The HSmP group showed 50% more intraepithelial nerves than the BSS or vehicle groups. Only HSmP-treated corneas improved the visual quality to near transparent. (4) Conclusions: These results suggest that HSmP facilitates the regeneration of the corneal epithelium and innervation, as well as restoring transparency and reducing myofibroblast scarring after laser experimental injury.
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Affiliation(s)
- Ignacio Alcalde
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Correspondence:
| | - Cristina Sánchez-Fernández
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Susana Del Olmo-Aguado
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Carla Martín
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Functional Biology, University of Oviedo, 33006 Oviedo, Spain
| | - Céline Olmiere
- Laboratoires Thea S.A.S., 63000 Clermont-Ferrand, France
| | - Enol Artime
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Luis M. Quirós
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Functional Biology, University of Oviedo, 33006 Oviedo, Spain
| | - Jesús Merayo-Lloves
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
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Lumintang L, Adnyana MS, Riasa INP, Asmarajaya AAGN, Hamid AR, Sanjaya H. A Systematic Review: Topical Sucralfate for Burn Wound. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Topical sucralfate has been used for burn and non-burn skin and mucosal lesion with remarkable results. The healing rate of mucosa is faster than skin lesion.
AIM: A current systematic review was conducted to objectively evaluate wound healing benefits of topical sucralfate for burn wound and to show on which degree of burn wound it works compare with another topical agents of burn wound therapy.
METHODS: Databases were searched for relevant studies: Google Scholar, PUBMED, and ProQuest. Data sources were searched using MeSH terms: “topical sucralfate” and “burn wound” for all publications up to December 2018. All English papers were included. Only studies performed in humans were included in this study. A total of 2437 publications were found, of which 3 studies met the inclusion criteria and were relevant to be used in this systematic review. The primary outcome was burn wound healing.
DATA EXTRACTION: Data from retrieved studies were reviewed and tabulated according to year of publication, study design, human or animal studies, characteristics of the population, and outcomes.
DATA SYNTHESIS: A total of 2 randomized controlled trials (RCTs) and 1 observational comparative study were found. All trials are on second degree burn wound patients. Jadad score was used to assess the methodological quality of the RCTs. One RCT and one comparative study demonstrated favorable outcomes with the use of topical sucralfate. There is one publication with no significant differences.
CONCLUSIONS: This systematic review shows a noticeably beneficial effect of topical sucralfate for burn wound. It is better than other topical agent in wound healing rate, decreased infection rate and enhancement of epithelialization also granulation with no local or systemic adverse reactions. However, multicenter RCT with larger sample size are needed to make recommendation for burn wound treatment.
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Hirokawa E, Sato T, Fujino T, Gotoh Y, Yokogawa H, Ichioka S. Hydrosurgical debridement as an approach to wound healing: an animal thermal burn model. J Wound Care 2020; 28:304-311. [PMID: 31067159 DOI: 10.12968/jowc.2019.28.5.304] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study investigates the advantages of hydrosurgical debridement compared with surgical debridement. METHOD Thermal skin burns were created on the backs of male Wistar rats. Surgical debridement was used to treat one wound and hydrosurgical debridement (Versajet Hydrosurgery System, Smith&Nephew, UK) used to treat the second wound. Debridement time, blood loss volume, time-to-heal and histologic changes in the wound areas were compared. RESULTS A total of 23 rats were used in the study. Debridement time and time-to-heal were significantly shorter with hydrosurgical debridement than with surgical debridement (p<0.01 and p<0.05, respectively). Blood loss volume was significantly less with hydrosurgical debridement (p<0.01), and the wound surface area was significantly smaller on days two (p<0.01), four (p<0.05) and seven (p<0.05). Dense inflammatory cell infiltration into dermal muscle was deeper after surgical debridement (p=0.017). Reactive fibrotic tissue at the wound surface was significantly thinner (p<0.001) and the vascular endothelial cell count was significantly higher (p<0.001) after hydrosurgical debridement. CONCLUSION The hydrosurgical system used appears to provide for minimally invasive debridement that can be performed in a relatively short period of time. Use of the device appears to minimise injury to healthy tissue and ameliorate inflammation, which in turn promotes early wound healing and reduces scar contracture. Hydrosurgical debridement appears to cause less damage to normal tissues. Furthermore, it is easier and requires less time.
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Affiliation(s)
- Eiko Hirokawa
- Department of Plastic and Reconstructive Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tomoya Sato
- Department of Plastic and Reconstructive Surgery, Saitama Medical University Hospital, Saitama, Japan
| | - Takashi Fujino
- Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yoshiya Gotoh
- Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hideki Yokogawa
- Department of Plastic and Reconstructive Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Shigeru Ichioka
- Department of Plastic and Reconstructive Surgery, Saitama Medical University Hospital, Saitama, Japan
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Schulze J, Sasse S, Prenzler N, Staecker H, Mellott AJ, Roemer A, Durisin M, Lenarz T, Warnecke A. Microenvironmental support for cell delivery to the inner ear. Hear Res 2018; 368:109-122. [PMID: 29945803 DOI: 10.1016/j.heares.2018.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/10/2018] [Accepted: 06/19/2018] [Indexed: 12/20/2022]
Abstract
Transplantation of mesenchymal stromal cells (MSC) presents a promising approach not only for the replacement of lost or degenerated cells in diseased organs but also for local drug delivery. It can potentially be used to enhance the safety and efficacy of inner ear surgeries such as cochlear implantation. Options for enhancing the effects of MSC therapy include modulating cell behaviour with customized bio-matrixes or modulating their behaviour by ex vivo transfection of the cells with a variety of genes. In this study, we demonstrate that MSC delivered to the inner ear of guinea pigs or to decellularized cochleae preferentially bind to areas of high heparin concentration. This presents an opportunity for modulating cell behaviour ex vivo. We evaluated the effect of carboxymethylglucose sulfate (Cacicol®), a heparan sulfate analogue on spiral ganglion cells and MSC and demonstrated support of neuronal survival and support of stem cell proliferation.
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Affiliation(s)
- Jennifer Schulze
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Carl Neuberg-Str. 1, 30625 Hannover, Germany; Cluster of Excellence "Hearing4all" of the German Research Foundation, Germany
| | - Susanne Sasse
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Carl Neuberg-Str. 1, 30625 Hannover, Germany
| | - Nils Prenzler
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Carl Neuberg-Str. 1, 30625 Hannover, Germany
| | - Hinrich Staecker
- Department of Otolaryngology Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Adam J Mellott
- Department of Plastic Surgery, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Ariane Roemer
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Carl Neuberg-Str. 1, 30625 Hannover, Germany
| | - Martin Durisin
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Carl Neuberg-Str. 1, 30625 Hannover, Germany
| | - Thomas Lenarz
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Carl Neuberg-Str. 1, 30625 Hannover, Germany; Cluster of Excellence "Hearing4all" of the German Research Foundation, Germany
| | - Athanasia Warnecke
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Carl Neuberg-Str. 1, 30625 Hannover, Germany; Cluster of Excellence "Hearing4all" of the German Research Foundation, Germany.
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Utine CA, Engin Durmaz C, Koçak N. Corneal matrix repair therapy with the regenerating agent in neurotrophic persistent epithelial defects. Int J Ophthalmol 2017; 10:1935-1939. [PMID: 29259918 DOI: 10.18240/ijo.2017.12.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 08/29/2017] [Indexed: 11/23/2022] Open
Affiliation(s)
- Canan Asli Utine
- Department of Ophthalmology, Faculty of Medicine, Dokuz Eylül University, Izmir 35340, Turkey
| | - Ceren Engin Durmaz
- Department of Ophthalmology, Faculty of Medicine, Dokuz Eylül University, Izmir 35340, Turkey
| | - Nilufer Koçak
- Department of Ophthalmology, Faculty of Medicine, Dokuz Eylül University, Izmir 35340, Turkey
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Multicenter Randomized Double-Blind, Placebo-Controlled Trial GORTEC (Groupe Oncologie Radiotherapie Tete et Cou) 2009-01 Evaluating the Effect of the Regenerating Agent on Radiodermatitis of Head and Neck Cancer Patients. Int J Radiat Oncol Biol Phys 2017; 99:590-595. [DOI: 10.1016/j.ijrobp.2017.07.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 03/10/2017] [Indexed: 11/22/2022]
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Barritault D, Gilbert-Sirieix M, Rice KL, Siñeriz F, Papy-Garcia D, Baudouin C, Desgranges P, Zakine G, Saffar JL, van Neck J. RGTA ® or ReGeneraTing Agents mimic heparan sulfate in regenerative medicine: from concept to curing patients. Glycoconj J 2016; 34:325-338. [PMID: 27924424 PMCID: PMC5487810 DOI: 10.1007/s10719-016-9744-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 10/18/2016] [Accepted: 10/20/2016] [Indexed: 01/12/2023]
Abstract
The importance of extracellular matrix (ECM) integrity in maintaining normal tissue function is highlighted by numerous pathologies and situations of acute and chronic injury associated with dysregulation or destruction of ECM components. Heparan sulfate (HS) is a key component of the ECM, where it fulfils important functions associated with tissue homeostasis. Its degradation following tissue injury disrupts this delicate equilibrium and may impair the wound healing process. ReGeneraTing Agents (RGTA®s) are polysaccharides specifically designed to replace degraded HS in injured tissues. The unique properties of RGTA® (resistance to degradation, binding and protection of ECM structural and signaling proteins, like HS) permit the reconstruction of the ECM, restoring both structural and biochemical functions to this essential substrate, and facilitating the processes of tissue repair and regeneration. Here, we review 25 years of research surrounding this HS mimic, supporting the mode of action, pre-clinical studies and therapeutic efficacy of RGTA® in the clinic, and discuss the potential of RGTA® in new branches of regenerative medicine.
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Affiliation(s)
- Denis Barritault
- OTR3, 4 rue Française, 75001 Paris, France
- Laboratory Cell Growth and Tissue Repair (CRRET), UPEC 4397/ERL CNRS 9215, Université Paris Est Cretéil, Université Paris Est, F-94000 Créteil, France
| | | | | | | | - Dulce Papy-Garcia
- Laboratory Cell Growth and Tissue Repair (CRRET), UPEC 4397/ERL CNRS 9215, Université Paris Est Cretéil, Université Paris Est, F-94000 Créteil, France
| | - Christophe Baudouin
- Institut de la Vision, 17 rue Moreau, 75012 Paris, France
- Universite Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), 55 Avenue de Paris, 78000 Versailles, France
- Centre Hospitalier National d’Opthalmologie des Quinze Vingts, 28 rue de Charenton, 75012 Paris, France
| | - Pascal Desgranges
- Department of Vascular Surgery, Hopital Henri Mondor, Université Paris-Est Créteil, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Gilbert Zakine
- Service de Chirurgie Plastique et Reconstructrice, 33 rue de la Tour, Paris, 75016 France
| | - Jean-Louis Saffar
- EA2496 Laboratoire Pathologies, Imagerie et Biothérapies Oro-Faciales, Faculté de Chirurgie Dentaire, Université Paris Descartes, Sorbonne Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Johan van Neck
- Department of Plastic and Reconstructive Surgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
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Alcalde I, Íñigo-Portugués A, Carreño N, Riestra AC, Merayo-Lloves JM. Effects of new biomimetic regenerating agents on corneal wound healing in an experimental model of post-surgical corneal ulcers. ACTA ACUST UNITED AC 2015; 90:467-74. [PMID: 26101128 DOI: 10.1016/j.oftal.2015.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 03/23/2015] [Accepted: 04/13/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The purpose of this study is to assess the effectiveness of the topical application of cacicol regenerating agent (RGTA) in an experimental model of corneal ulcer after photorefractive keratectomy (PRK) in mice. METHODS Mice were subjected to PRK surgery with a 2.0mm ablation zone on the central cornea and 45mm of depth on a VISX Star S2 excimer laser. Corneas were treated topically with cacicol drops 1hour and 48hours after injury. Control groups received balanced salt solution (BSS) in the same dosage. Clinical and histopathological events were evaluated at 1, 2, 3 and 7 days after surgery. Sections obtained through the central region of the corneas were used to analyze the histopathological events of injured and healed corneas. αSMA (myofibroblast transformation), E cadherin (assembly of epithelial cells) and neuronal class III β-tubulin (innervation) were performed. RESULTS Corneas treated topically with cacicol for 7 days showed a greater degree of transparency compared to controls. cacicol treated corneas showed improved epithelial cytoarchitecture. Analysis of αSMA profiles in the stroma showed that cacicol reduced or delayed the presence of myofibroblasts in the stroma compared to BSS (P<0.001). Finally, a putative neuroregenerative effect of cacicol was found in corneas subjected to an experimental PRK lesion. In some cases some interindividual variability could be observed due to the design of the experimental model. This is a limitation to consider, despite the statistical significance of the data. CONCLUSIONS In a model of laser induced surgical lesions in the cornea, topical application of an RGTA (i.e. cacicol) could be involved in avoiding myofibroblast scarring formation and promoting nerve regeneration.
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Affiliation(s)
- I Alcalde
- Fundación de Investigación Oftalmológica, Oviedo, España; Universidad de Oviedo, Oviedo, España.
| | - A Íñigo-Portugués
- Fundación de Investigación Oftalmológica, Oviedo, España; Universidad de Oviedo, Oviedo, España
| | - N Carreño
- Instituto Oftalmológico Fernández-Vega, Oviedo, España
| | - A C Riestra
- Instituto Oftalmológico Fernández-Vega, Oviedo, España
| | - J M Merayo-Lloves
- Fundación de Investigación Oftalmológica, Oviedo, España; Instituto Oftalmológico Fernández-Vega, Oviedo, España; Universidad de Oviedo, Oviedo, España
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RGTA-based matrix therapy in severe experimental corneal lesions: safety and efficacy studies. J Fr Ophtalmol 2013; 36:740-7. [PMID: 23958066 DOI: 10.1016/j.jfo.2013.01.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 01/11/2013] [Accepted: 01/14/2013] [Indexed: 11/24/2022]
Abstract
Corneal alteration potentially leading to ulceration remains a major health concern in ocular surface diseases. A treatment that would improve both the quality and speed of healing and control the inflammation would be of great interest. Regenerating agents (RGTAs) have been shown to stimulate wound healing and modulate undesired fibrosis in various in vivo systems. We investigated the effects of RGTA-OTR4120(®) in a rabbit corneal model in order to assess its potential use in ocular surface diseases. First, we assessed its safety for 7 and 28 days using the Draize test criteria in healthy rabbit eyes; then, we investigated the effect of a single dose (50μl, 5μg) in an alkali-burned cornea model. Daily follow-up of clinical signs of healing was scored, and histology was performed at D7. RGTA was well tolerated; no signs of ocular irritation were observed. In the corneal alkali-burn model, non-RGTA-treated eyes showed inflammatory clinical signs, and histology confirmed a loss of superficial corneal layers with epithelial disorganization, neovascularization and infiltration of inflammatory cells. When compared to NaCl control, RGTA treatment appeared effective in reducing clinical signs of inflammation, enhancing re-epithelialization, and improving histological patterns: edema, fibrosis, neovascularization and inflammation. Three to four layers of epithelial cells were already organized, stroma was virtually unvascularized and keratocytes well implanted in parallel collagen fibers with an overall reorganization similar to normal cornea. RGTA appears to be a promising agent for controlling ocular surface inflammation and promoting corneal healing and was well tolerated. This study offers preclinical information and supports the findings of other (compassionate or pilot) studies conducted in patients with various ocular surface diseases.
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Thompson SM, Connell MG, van Kuppevelt TH, Xu R, Turnbull JE, Losty PD, Fernig DG, Jesudason EC. Structure and epitope distribution of heparan sulfate is disrupted in experimental lung hypoplasia: a glycobiological epigenetic cause for malformation? BMC DEVELOPMENTAL BIOLOGY 2011; 11:38. [PMID: 21672206 PMCID: PMC3127989 DOI: 10.1186/1471-213x-11-38] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Accepted: 06/14/2011] [Indexed: 12/14/2022]
Abstract
BACKGROUND Heparan sulfate (HS) is present on the surface of virtually all mammalian cells and is a major component of the extracellular matrix (ECM), where it plays a pivotal role in cell-cell and cell-matrix cross-talk through its large interactome. Disruption of HS biosynthesis in mice results in neonatal death as a consequence of malformed lungs, indicating that HS is crucial for airway morphogenesis. Neonatal mortality (~50%) in newborns with congenital diaphragmatic hernia (CDH) is principally associated with lung hypoplasia and pulmonary hypertension. Given the importance of HS for lung morphogenesis, we investigated developmental changes in HS structure in normal and hypoplastic lungs using the nitrofen rat model of CDH and semi-synthetic bacteriophage ('phage) display antibodies, which identify distinct HS structures. RESULTS The pulmonary pattern of elaborated HS structures is developmentally regulated. For example, the HS4E4V epitope is highly expressed in sub-epithelial mesenchyme of E15.5 - E17.5 lungs and at a lower level in more distal mesenchyme. However, by E19.5, this epitope is expressed similarly throughout the lung mesenchyme.We also reveal abnormalities in HS fine structure and spatiotemporal distribution of HS epitopes in hypoplastic CDH lungs. These changes involve structures recognised by key growth factors, FGF2 and FGF9. For example, the EV3C3V epitope, which was abnormally distributed in the mesenchyme of hypoplastic lungs, is recognised by FGF2. CONCLUSIONS The observed spatiotemporal changes in HS structure during normal lung development will likely reflect altered activities of many HS-binding proteins regulating lung morphogenesis. Abnormalities in HS structure and distribution in hypoplastic lungs can be expected to perturb HS:protein interactions, ECM microenvironments and crucial epithelial-mesenchyme communication, which may contribute to lung dysmorphogenesis. Indeed, a number of epitopes correlate with structures recognised by FGFs, suggesting a functional consequence of the observed changes in HS in these lungs. These results identify a novel, significant molecular defect in hypoplastic lungs and reveals HS as a potential contributor to hypoplastic lung development in CDH. Finally, these results afford the prospect that HS-mimetic therapeutics could repair defective signalling in hypoplastic lungs, improve lung growth, and reduce CDH mortality.
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Affiliation(s)
- Sophie M Thompson
- Institute of Integrative Biology, University of Liverpool, Liverpool, UK.
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