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Hosseini H, Heydari S, Raesi R, Hushmandi K, Payande A, Gholami A, Daneshi S. Comparison of spring ankle braces versus splints and casts in treating ankle sprains in patients diagnosed with ankle sprains. BMC Musculoskelet Disord 2024; 25:786. [PMID: 39367359 PMCID: PMC11451001 DOI: 10.1186/s12891-024-07901-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 09/23/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND Various treatment approaches for individuals with ankle sprains can reduce treatment costs and enhance recovery. This study aimed to compare the efficacy of spring ankle braces with splints and casts in treating ankle sprains. MATERIALS AND METHODS This cross-sectional study involved 60 patients diagnosed with ankle sprains at the orthopedic clinic of Imam Khomeini Hospital in Jiroft in 2022. Following diagnosis confirmation through additional examinations and imaging, patients with ankle sprains not requiring surgery were selected and placed in two groups: one treated with spring ankle braces and the other with splints or casts. Both groups underwent a 4-week treatment regimen, comprising 30 individuals each. Data were collected and analyzed using SPSS version 26. RESULTS The average age of patients was 32.5 ± 13.4 years. Of the ankle sprain patients, 56.7% were male. Patients reported the highest satisfaction levels with the plaster cast treatment method. A statistically significant relationship was found between patient satisfaction and the treatment methods of spring ankle braces and plaster casting (P < 0.05). Patients treated with plaster casts reported the lowest pain levels, with a significant relationship between pain levels and the two treatment methods (P < 0.05). Range of motion results were similar for both treatment methods, while the cast treatment showed the highest incidence of skin complications. A significant relationship was observed between spring ankle braces and plaster casts regarding skin complications (P < 0.05). CONCLUSION Treating ankle sprains with plaster casts leads to higher satisfaction and lower pain levels compared to using spring ankle braces.
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Affiliation(s)
- Hasan Hosseini
- Department of Orthopedics, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sina Heydari
- School of Medicine, Imam Khomeini Hospital, Jiroft University of Medical Science, Jiroft, Iran
| | - Rasoul Raesi
- Department of Nursing, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
- Department of Health Services Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kiavash Hushmandi
- Nephrology and Urology Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amirhossein Payande
- School of Medicine, Imam Khomeini Hospital, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Akram Gholami
- Department of Nursing, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| | - Salman Daneshi
- Department of Public Health, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran.
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Adamska O, Wnuk A, Kamińska A, Poniatowska M, Maciąg B, Kamiński M, Stolarczyk A, Matin M, Atanasov AG, Łapiński M, Jóźwik A. Melatonin supplementation counteracts fiber loss in knee ligaments of diabetes-induced rats. Front Pharmacol 2024; 15:1399719. [PMID: 39135805 PMCID: PMC11317382 DOI: 10.3389/fphar.2024.1399719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/24/2024] [Indexed: 08/15/2024] Open
Abstract
Diabetes mellitus (DM) is a prevalent metabolic disease. The clinical impact of sustained hyperglycemia on ligament healing has not been well characterized. Diabetes is a known cause of macro-, microvascular, and diabetic ulcer healing difficulties among tissues. Therefore, we aimed to investigate the healing potential occurring in injured and healthy ligaments among diabetic and healthy individuals using a rat model. We hypothesize that DM may contribute to altering the knee medial collateral ligament (MCL), thus its morphology, biochemical fitness, and functionality. The study cohort consisted of 40 rats. The animals were randomized into four equal groups. Groups I and II (20 rats) received saline subcutaneously and served as controls. Groups III and IV (20 rats) were injected with a single dose of streptozotocin (STZ). All animals underwent surgery to cut the left tibial collateral ligament in the hind limb and suture it. The access site was sutured to create inflammation and study the regenerative capacities of animals with normal carbohydrate metabolism and pharmacologically induced diabetes. Each animal then underwent sham surgery to access and suture the right tibial collateral ligament in the hind limb without ligament intervention. After the animals had undergone surgeries, groups II and IV were given melatonin supplementation for 4 weeks. Rats with DM presented with more fibrosis and calcification of the MCL and decreased healing potential. Treatment with melatonin in diabetic rats mitigated alterations and improved the antioxidant status of ligaments from the diabetic group.
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Affiliation(s)
- Olga Adamska
- Department of Ophthalmology, Collegium Medicum, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Artur Wnuk
- Hospital in Ostrow Mazowiecka, Ostrów Mazowiecka, Poland
| | - Agnieszka Kamińska
- Department of Ophthalmology, Collegium Medicum, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Małgorzata Poniatowska
- Department of Nuclear Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Bartosz Maciąg
- Orthopedic and Rehabilitation Department, Medical University of Warsaw, Warsaw, Poland
| | | | - Artur Stolarczyk
- Orthopedic and Rehabilitation Department, Medical University of Warsaw, Warsaw, Poland
| | - Maima Matin
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Magdalenka, Poland
| | - Atanas G. Atanasov
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Magdalenka, Poland
- Laboratory of Natural Products and Medicinal Chemistry (LNPMC), Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Marcin Łapiński
- Orthopedic and Rehabilitation Department, Medical University of Warsaw, Warsaw, Poland
| | - Artur Jóźwik
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Magdalenka, Poland
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Zhang X, Cheng F, Islam MR, Li H. The fabrication of the chitosan-based bioink for in vitro tissue repair and regeneration: A review. Int J Biol Macromol 2024; 257:128504. [PMID: 38040155 DOI: 10.1016/j.ijbiomac.2023.128504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 12/03/2023]
Abstract
The repair and regeneration of the injured tissues or organs is a major challenge for biomedicine, and the emerging 3D bioprinting technology as a class of promising techniques in biomedical research for the development of tissue engineering and regenerative medicine. Chitosan-based bioinks, as the natural biomaterials, are considered as ideal materials for 3D bioprinting to design and fabricate the various scaffold due to their unique dynamic reversibility and fantastic biological properties. Our review aims to provide an overview of chitosan-based bioinks for in vitro tissue repair and regeneration, starting from modification of chitosan that affect these bioprinting processes. In addition, we summarize the advances in chitosan-based bioinks used in the various 3D printing strategies. Moreover, the biomedical applications of chitosan-based bioinks are discussed, primarily centered on regenerative medicine and tissue modeling engineering. Finally, current challenges and future opportunities in this field are discussed. The combination of chitosan-based bioinks and 3D bioprinting will hold promise for developing novel biomedical scaffolds for tissue or organ repair and regeneration.
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Affiliation(s)
- Xiao Zhang
- School of Materials Science and Engineering, School of Chemistry and Chemical Engineering, MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, Harbin Institute of Technology, Harbin, Heilongjiang 150001, PR China
| | - Feng Cheng
- School of Materials Science and Engineering, School of Chemistry and Chemical Engineering, MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, Harbin Institute of Technology, Harbin, Heilongjiang 150001, PR China.
| | - Md Rashidul Islam
- College of Light Industry and Textile, Qiqihar University, Qiqihar, Heilongjiang 161000, PR China
| | - Hongbin Li
- School of Materials Science and Engineering, School of Chemistry and Chemical Engineering, MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, Harbin Institute of Technology, Harbin, Heilongjiang 150001, PR China; College of Light Industry and Textile, Qiqihar University, Qiqihar, Heilongjiang 161000, PR China.
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Dannaway J, Sharma G, Raniga S, Graham P, Bokor D. Is preoperative elevated glycated hemoglobin (HbA1c) a risk factor for postoperative shoulder stiffness after posterior-superior rotator cuff repair? JSES Int 2024; 8:47-52. [PMID: 38312295 PMCID: PMC10837722 DOI: 10.1016/j.jseint.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024] Open
Abstract
Background Postoperative shoulder stiffness (POSS) affects a large number of patients undergoing rotator cuff repair (RCR). Diabetes may increase the risk of POSS. Preoperative glycated hemoglobin (HbA1c) is a convenient measure of glucose control in this group. The aim of the present study was to determine a relationship between preoperative HbA1c and POSS in patients undergoing postero-superior RCR. Methods Two hundred fifty patients with full-thickness postero-superior rotator cuffs who underwent RCR were followed for 6 months. Pre- and post-operative external rotation with arm by the side at 3 and 6 months were measured. Patient demographics, tear characteristics, preoperative HbA1c level, and surgical details were recorded. Patients with subscapularis tears, concomitant instability, partial thickness tears, arthritis, and irreparable rotator cuff tears were excluded. Univariate and multivariate logistic regression were used to determine the association between patient characteristics and POSS at 6 months. Results At the end of 6 months, 16% (41/250) of patients had POSS. Multivariate analysis demonstrated an elevated preoperative HbA1c level was a statistically significant predictor of POSS at 6 months (odds ratio 7.04, P < .01) after posterior superior RCR. Lower preoperative external rotation (P = .02) and female sex (P < .01) were also risk factors associated with POSS. Age, hand dominance, worker's compensation claim status, etiology, and size of the tear, surgical technique, and additional treatments were not statistically significant predictors. Conclusion Elevated preoperative HbA1c level is associated with POSS after RCR. Measuring HbA1c preoperatively may assist clinicians to identify patients at risk of POSS. HbA1c is a modifiable parameter that could then be optimized preoperatively in order to improve outcomes.
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Affiliation(s)
- Jasan Dannaway
- Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Gaurav Sharma
- Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Sumit Raniga
- Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Petra Graham
- Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Desmond Bokor
- Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, NSW, Australia
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Pedreanez A, Robalino J, Tene D, Salazar P. Advanced glycation end products of dietary origin and their association with inflammation in diabetes - A minireview. Endocr Regul 2024; 58:57-67. [PMID: 38563294 DOI: 10.2478/enr-2024-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Advanced glycation end products (AGEs) are a diverse group of compounds that are formed as a result of the non-enzymatic reaction between a reducing sugar such as glucose and the free NH2 groups of an amino acid in a protein or other biomolecule. The chemical reaction, by which these products are generated, is known as the Maillard reaction and occurs as a part of the body's normal metabolism. Such a reaction is enhanced during diabetes due to hyperglycemia, but it can also occur during the preparation, processing, and preservation of certain foods. Therefore, AGEs can also be obtained from the diet (d-AGE) and contribute to an increase of the total serum pool of these compounds. They have been implicated in a wide variety of pathological processes, mainly because of their ability to induce inflammatory responses and oxidative stress increase. They are extensively accumulated as a part of the normal aging, especially in tissues rich in long half-life proteins, which can compromise the physiology of these tissues. d-AGEs are abundant in diets rich in processed fats and sugars. This review is addressed to the current knowledge on these products and their impact on the immunomodulation of various mechanisms that may contribute to exacerbation of the diabetes pathophysiology.
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Affiliation(s)
- Adriana Pedreanez
- Catedra de Inmunologia, Escuela de Bioanalisis, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | | | - Diego Tene
- Universidad Nacional del Chimborazo, Facultad de Ciencias de la Salud, Riobamba, Ecuador
| | - Patricio Salazar
- Departamento de Nutricion Clinica, Hospital General Santo Domingo, Ecuador
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Ligament Alteration in Diabetes Mellitus. J Clin Med 2022; 11:jcm11195719. [PMID: 36233586 PMCID: PMC9572847 DOI: 10.3390/jcm11195719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
Connective tissue ageing is accelerated by the progressive accumulation of advanced glycation end products (AGEs). The formation of AGEs is characteristic for diabetes mellitus (DM) progression and affects only specific proteins with relatively long half-lives. This is the case of fibrillar collagens that are highly susceptible to glycation. While collagen provides a framework for plenty of organs, the local homeostasis of specific tissues is indirectly affected by glycation. Among the many age- and diabetes-related morphological changes affecting human connective tissues, there is concurrently reduced healing capacity, flexibility, and quality among ligaments, tendons, bones, and skin. Although DM provokes a wide range of known clinical disorders, the exact mechanisms of connective tissue alteration are still being investigated. Most of them rely on animal models in order to conclude the patterns of damage. Further research and more well-designed large-cohort studies need to be conducted in order to answer the issue concerning the involvement of ligaments in diabetes-related complications. In the following manuscript, we present the results from experiments discovering specific molecules that are engaged in the degenerative process of connective tissue alteration. This review is intended to provide the report and sum up the investigations described in the literature concerning the topic of ligament alteration in DM, which, even though significantly decreasing the quality of life, do not play a major role in research.
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Gallagher KE, Alberto EC, Mallow PJ, Hermans MH, Cardenas L. A Retrospective Health Economic Analysis of a Stable Hypochlorous Acid Preserved Wound Cleanser Versus 0.9% Saline Solution as Instillation for Negative-Pressure Wound Therapy in Severe and Infected Wounds. Cureus 2022; 14:e24321. [PMID: 35607546 PMCID: PMC9123387 DOI: 10.7759/cureus.24321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Negative-pressure wound therapy (NPWT) with instillation and dwell time is an accepted adjunct therapy for infected wounds. A study was conducted to assess whether the use of hypochlorous acid preserved wound cleanser (HAPWOC) (Vashe, Urgo Medical North America, Fort Worth, TX, USA) as the irrigant would reduce the cost of care in comparison to 0.9% saline (NaCl). Method A comparative, observational, retrospective analysis assessed 27 serious and infected wounds in 24 patients. The lesions were of different and complex etiologies, including necrotizing fasciitis and stage IV diabetic foot ulcers. NPWT was used as part of the overall multimodal treatment regimen. The only variance in the treatment protocol was the use of saline (N=8) or HAPWOC (N=19) as the irrigant. Results When compared to NaCl, wounds treated with HAPWOC trended toward fewer operating room (OR) visits versus NaCl (3.3 versus 4.1) and a shorter length of hospital stay (LOS) (24.3 days versus 37.9 days). The Orlando Health Transparency guide shows the cost of OR debridement as $2,525. Thus, debridement for HAPWOC-treated wounds ($8,332) costs $2,020 (24%) less than for NaCl-treated wounds ($10,352). Using the 2016 Kaiser Health data (average daily hospital cost, excludingall interventions: $2,052), the cost of HAPWOC and NaCl instill translates to $49,864 and $77,771, respectively, a difference of $27,906 (56%) more for NaCl treatment. The Agency for Healthcare Research and Quality (AHRQ) 2012 data indicate an average daily cost of hospital stay, including all interventions, of $10,400. Thus, HAPWOC treatment cost translates to $252,720 versus NaCl-related costs of $394,160; in these calculations, using NaCl costs $141.440 (+56%) more per patient than HAPWOC. Conclusion The use of NPWT with HAPWOC versus NaCl as instillation in NPWT reduces the number of visits to the operating room and LOS. This has a significant impact on lowering the cost of care when HAPWOC is used.
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Affiliation(s)
- Kathy E Gallagher
- Surgery/Acute Surgical Wound Service, ChristianaCare Health System, Newark, USA
| | | | - Peter J Mallow
- Health Economic and Clinical Outcomes Research, Xavier University School of Medicine, Cincinnati, USA
| | | | - Luis Cardenas
- Surgery/Acute Surgical Wound Service, ChristianaCare Health System, Newark, USA
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Hong JP, Huang SW, Lee CH, Chen HC, Charoenpong P, Lin HW. Osteoporosis increases the risk of rotator cuff tears: a population-based cohort study. J Bone Miner Metab 2022; 40:348-356. [PMID: 35059890 DOI: 10.1007/s00774-021-01293-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/14/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Osteoporosis has been demonstrated to be a risk factor for rotator cuff retears after surgery; however, no studies have directly investigated the association between osteoporosis and the development of rotator cuff tears. To investigate whether osteoporosis is associated with an increased risk of rotator cuff tears. MATERIALS AND METHODS We conducted a population-based, matched-cohort study with a 7-year follow-uTwo matched cohorts (n = 3511 with osteoporosis and 17,555 without osteoporosis) were recruited from Taiwan's Longitudinal Health Insurance Dataset. Person-year data and incidence rates were evaluated. A multivariable Cox model was used to derive an adjusted hazard ratio (aHR) after controlling for age, sex, and various prespecified comorbidities. Age and sex were added in the model to test for interaction with osteoporosis. RESULTS Women constituted 88.5% of the cohorts. During follow-up of 17,067 and 100,501 person-years for the osteoporosis and nonosteoporosis cohorts, 166 and 89 rotator cuff tears occurred, respectively. The cumulative incidence of rotator cuff tears was significantly higher in the osteoporosis cohort than in the nonosteoporosis cohort (p < 0.001, log-rank). The Cox model revealed a 1.79-fold increase in rotator cuff tears in the osteoporosis cohort, with an aHR of 1.79 (95% confidence interval, 1.55-2.05). Effect modification of sex and age on rotator cuff tears was not found in patients with osteoporosis. CONCLUSION This population-based study supports the hypothesis that compared with individuals without osteoporosis, those with osteoporosis have a higher risk of developing rotator cuff tears.
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Affiliation(s)
- Jia-Pei Hong
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih-Hong Lee
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and Department of Neurology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Prangthip Charoenpong
- Department of Internal Medicine, Division of Pulmonary and Critical Care, Louisiana State University, Shreveport, LA, USA
| | - Hui-Wen Lin
- Department of Mathematics, Soochow University, 70 Linhsi Road, Shihlin, Taipei, 111, Taiwan.
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Shashar S, Polischuk V, Friesem T. Internal medicine physician embedded in an orthopedic service in a level 1 hospital: clinical impact. Intern Emerg Med 2022; 17:339-348. [PMID: 33904116 DOI: 10.1007/s11739-021-02745-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aim of our study was to evaluate the impact of an internist physician specialized in diabetes, appointed as an in-house physician in the orthopedic wards, on improving clinical outcomes and in particular 30-day mortality. METHODS We analyzed a cohort of patients hospitalized more than 24 h in the orthopedic service. The analyses included a comparative analysis between the pre- and post-intervention time periods and an interrupted time series (ITS) analysis, which were conducted in stratification to three populations: whole population, patients with at least one chronic disease and/or older than 75 years of age and patients diagnosed with diabetes. The primary outcome was 30-day mortality following the hospitalization. RESULTS A total of 11,546 patients were included in the study, of which 19% (2212) were hospitalized in the post intervention period. Although in the comparative analysis there was no significant change in 30-day mortality, in the ITS there was a decrease in the mortality trend during the post intervention period in the entire and chronic disease/elderly populations, compared to no change during the pre-intervention period: a post-intervention slope of - 0.14(p value < 0.001) and - 0.11(p value = 0.03), respectively. Additionally, we found decrease in length of stay, increase in transfers to the internal medicine department with a negative trend, increase in HbA1c testing during the hospitalization and changes in diabetes drugs administration. CONCLUSION The presence of an internist in the orthopedic wards is associated with health care improvement; decrease in the 30-day mortality trend, decrease in length of stay, increase in HbA1c testing during the hospitalization and an increase in diabetes drugs administration.
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Affiliation(s)
- Sagi Shashar
- Clinical Research Center, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O.Box 151, 84101, Be'er Sheva, Israel.
| | - Vera Polischuk
- Orthopedic Surgery Service, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Tai Friesem
- Chairmen of Orthopedic Surgery, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel
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Zeng K, Xi W, Qiao Y, Huang X, Liu X. Paeoniflorin inhibits epithelial mesenchymal transformation and oxidative damage of lens epithelial cells in diabetic cataract via sirtuin 1 upregulation. Bioengineered 2022; 13:5903-5914. [PMID: 35184653 PMCID: PMC8974002 DOI: 10.1080/21655979.2021.2018534] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Paeoniflorin (Pae) has been reported to serve an important role in complications associated with diabetes. To the best of our knowledge, the role of Pae in diabetic cataracts has not yet been reported. Human lens epithelial SRA01/04 cells were induced by high glucose (HG) and subsequently treated with Pae. Cell viability was detected using the MTT assay. Moreover, LDH levels were detected. Immunofluorescence (IF) and Western blotting were used to determine the protein expression levels of N-cadherin and E-cadherin. ELISA was performed to determine oxidative stress-related indicator levels. TUNEL and Western blotting detected the apoptotic rate. The mRNA and protein expression levels of sirtuin 1 (SIRT1) in SRA01/04 cells were measured via reverse transcription-quantitative PCR and Western blotting, respectively. Subsequently, cell transfection techniques were used to inhibit the expression of SIRT1 in cells. MTT, ELISA, IF, Western blotting and TUNEL assays were used to investigate the mechanisms of epithelial-mesenchymal transition (EMT) and oxidative damage with Pae in the diabetic cataract. Pae significantly increased cell viability and possibly inhibit the EMT and oxidative damage of SRA01/04 cells induced by HG. Pae was demonstrated to upregulate SIRT1 expression levels. The results therefore suggested that the downregulation of SIRT1 reversed the protective effect of Pae on EMT and oxidative damage in SRA01/04 cells induced by HG. In conclusion, Pae may inhibit EMT of lens epithelial cells and reduce oxidative damage in diabetic cataracts via the upregulation of SIRT1.
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Affiliation(s)
- Kun Zeng
- Cataract Department, Shenzhen Eye Hospital; Shenzhen Eye Institute; Shenzhen Eye Hospital Affiliated to Jinan University; School of Optometry, Shenzhen University, Shenzhen, Guangdong, China
| | - Wenqun Xi
- Cataract Department, Shenzhen Eye Hospital; Shenzhen Eye Institute; Shenzhen Eye Hospital Affiliated to Jinan University; School of Optometry, Shenzhen University, Shenzhen, Guangdong, China
| | - Yuanjiao Qiao
- Cataract Department, Shenzhen Eye Hospital; Shenzhen Eye Institute; Shenzhen Eye Hospital Affiliated to Jinan University; School of Optometry, Shenzhen University, Shenzhen, Guangdong, China
| | - Xiaosheng Huang
- Cataract Department, Shenzhen Eye Hospital; Shenzhen Eye Institute; Shenzhen Eye Hospital Affiliated to Jinan University; School of Optometry, Shenzhen University, Shenzhen, Guangdong, China
| | - Xinhua Liu
- Cataract Department, Shenzhen Eye Hospital; Shenzhen Eye Institute; Shenzhen Eye Hospital Affiliated to Jinan University; School of Optometry, Shenzhen University, Shenzhen, Guangdong, China
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Patel S, Baker L, Perez J, Vulcano E, Kaplan J, Aiyer A. Risk factors for nonunion following tibiotalocalcaneal arthrodesis: A systematic review and meta-analysis. Foot Ankle Surg 2022; 28:7-13. [PMID: 33685828 DOI: 10.1016/j.fas.2021.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The goal of this study is to review the literature to identify risk factors for nonunion after tibiotalocalcaneal arthrodesis (TTCA) and stratify them based on strength of evidence. METHODS Five databases were searched from inception to May 17th, 2020. Abstracts and full-text articles were screened for those that included risk factors predictive of nonunion following TTCA. RESULTS Eight studies involving 624 patients were included and 33 potential risk factors for nonunion were identified. Strong evidence supported prior peripheral neuropathic conditions as risk factors for nonunion following surgery (OR: 2.86, 95% CI: 1.56-5.23). CONCLUSION TTCA is an effective salvage procedure but is associated with high nonunion rates. The results of our meta-analysis suggest that prior peripheral neuropathic conditions have strong evidence for failure to achieve union. Surgeons should be cognizant of these risks when performing TTCA and carefully monitor patients with the aforementioned comorbidity to achieve successful results.
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Affiliation(s)
- Sumit Patel
- Department of Orthopaedics at Miller School of Medicine, University of Miami, Miami, FL, United States.
| | - Lauren Baker
- Department of Orthopaedics at Miller School of Medicine, University of Miami, Miami, FL, United States.
| | - Jose Perez
- Department of Orthopaedics at Miller School of Medicine, University of Miami, Miami, FL, United States.
| | - Ettore Vulcano
- Leni & Peter W. May Department of Orthopaedic Surgery, Mount Sinai, New York City, NY, United States.
| | | | - Amiethab Aiyer
- Department of Orthopaedics at Miller School of Medicine, University of Miami, Miami, FL, United States.
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High glucose represses the proliferation of tendon fibroblasts by inhibiting autophagy activation in tendon injury. Biosci Rep 2021; 42:231043. [PMID: 35293974 PMCID: PMC8935382 DOI: 10.1042/bsr20210640] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/28/2021] [Accepted: 08/09/2021] [Indexed: 11/17/2022] Open
Abstract
Diabetic foot ulcer (DFU) is a kind of common and disabling complication of Diabetes Mellitus (DM). Emerging studies have demonstrated that tendon fibroblasts play a crucial role in remodeling phase of wound healing. However, little is known about the mechanism underlying high glucose (HG)-induced decrease in tendon fibroblasts viability. In the present study, the rat models of DFU were established, and collagen deposition, autophagy activation and cell apoptosis in tendon tissues were assessed using Hematoxylin–Eosin (HE) staining, immunohistochemistry (IHC), and TdT-mediated dUTP Nick-End Labeling (TUNEL) assay, respectively. Tendon fibroblasts were isolated from Achilles tendon of the both limbs, and the effect of HG on autophagy activation in tendon fibroblasts was assessed using Western blot analysis, Cell Counting Kit-8 (CCK-8) assay, and flow cytometry. We found that cell apoptosis was increased significantly and autophagy activation was decreased in foot tendon tissues of DFU rats compared with normal tissues. The role of HG in regulating tendon fibroblasts viability was then investigated in vitro, and data showed that HG repressed cell viability and increased cell apoptosis. Furthermore, HG treatment reduced LC3-II expression and increased p62 expression, indicating that HG repressed autophagy activation of tendon fibroblasts. The autophagy activator rapamycin reversed the effect. More importantly, rapamycin alleviated the suppressive role of HG in tendon fibroblasts viability. Taken together, our data demonstrate that HG represses tendon fibroblasts proliferation by inhibiting autophagy activation in tendon injury.
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Adouni M, Mbarki R, Al Khatib F, Eilaghi A. Multiscale modeling of knee ligament biomechanics. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2021; 37:e3413. [PMID: 33174350 DOI: 10.1002/cnm.3413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 10/02/2020] [Accepted: 11/01/2020] [Indexed: 06/11/2023]
Abstract
Knee connective tissues are mainly responsible for joint stability and play a crucial role in restraining excessive motion during regular activities. The damage mechanism of these tissues is directly linked to the microscale collagen level. However, this mechanical connection is still unclear. During this investigation, a multiscale fibril-reinforced hyper-elastoplastic model was developed and statistically calibrated. The model is accounting for the structural architecture of the soft tissue, starting from the tropocollagen molecule that forms fibrils to the whole soft tissue. Model predictions are in agreement with the results of experimental and numerical studies. Further, damage initiation and propagation in the collagen fiber were computed at knee ligaments and located mainly in the superficial layers. Results indicated higher crosslink density required higher tensile stress to elicit fibril damage. This approach is aligned with a realistic simulation of a damaging process and repair attempt. To the best of our knowledge, this is the first model published in which the connective tissue stiffness is simultaneously predicted by encompassing the mesoscopic scales between the molecular and macroscopic levels.
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Affiliation(s)
- Malek Adouni
- Physical Medicine and Rehabilitation Department, Northwestern University, Chicago, Illinois, USA
- Mechanical Engineering Department, Australian College of Kuwait, Kuwait city, Kuwait
| | - Raouf Mbarki
- Mechanical Engineering Department, Australian College of Kuwait, Kuwait city, Kuwait
| | - Fadi Al Khatib
- Mechanical Engineering Department, Australian College of Kuwait, Kuwait city, Kuwait
| | - Armin Eilaghi
- Mechanical Engineering Department, Australian College of Kuwait, Kuwait city, Kuwait
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Hudson DM, Archer M, King KB, Eyre DR. Glycation of type I collagen selectively targets the same helical domain lysine sites as lysyl oxidase-mediated cross-linking. J Biol Chem 2018; 293:15620-15627. [PMID: 30143533 PMCID: PMC6177574 DOI: 10.1074/jbc.ra118.004829] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/15/2018] [Indexed: 12/21/2022] Open
Abstract
Nonenzymatic glycation of collagen has long been associated with the progressive secondary complications of diabetes. How exactly such random glycations result in impaired tissues is still poorly understood. Because of the slow turnover rate of most fibrillar collagens, they are more susceptible to accumulate time-dependent glycations and subsequent advanced glycation end-products. The latter are believed to include cross-links that stiffen host tissues. However, diabetic animal models have also displayed weakened tendons with reduced stiffness. Strikingly, not a single experimentally identified specific molecular site of glycation in a collagen has been reported. Here, using targeted MS, we have identified partial fructosyl-hydroxylysine glycations at each of the helical domain cross-linking sites of type I collagen that are elevated in tissues from a diabetic mouse model. Glycation was not found at any other collagen lysine residues. Type I collagen in mouse tendons is cross-linked intermolecularly by acid-labile aldimine bonds formed by the addition of telopeptide lysine aldehydes to hydroxylysine residues at positions α1(I)Lys87, α1(I)Lys930, α2(I)Lys87, and α2(I)Lys933 of the triple helix. Our data reveal that site-specific glycations of these specific lysines may significantly impair normal lysyl oxidase-controlled cross-linking in diabetic tendons. We propose that such N-linked glycations can hinder the normal cross-linking process, thus altering the content and/or placement of mature cross-links with the potential to modify tissue material properties.
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Affiliation(s)
- David M Hudson
- From the Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington 98195 and
| | - Marilyn Archer
- From the Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington 98195 and
| | - Karen B King
- the Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado 80045
| | - David R Eyre
- From the Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington 98195 and
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