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Stone KR, Walgenbach AW, Slatter S, Turek TJ, Ferguson-Dryden C, Dicker M, Miltenberger E, Cowles H, Liu V, Wu S, Vessal M. Meniscus Allograft Transplantation in Conjunction With Arthroscopic Biologic Knee Restoration Delays Arthroplasty in Patients Older Than 50 Years. Arthroscopy 2024:S0749-8063(24)00418-3. [PMID: 38897483 DOI: 10.1016/j.arthro.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/20/2024] [Accepted: 06/02/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE To evaluate the utility of meniscus allografts in combination with other procedures to delay knee arthroplasty in patients older than 50 years previously advised joint arthroplasty. METHODS A total of 108 meniscus allograft transplants using the arthroscopic 3-tunnel technique between 1997 and 2019 in patients older than 50 years were retrospectively reviewed with a 2-year minimum follow-up period. Inclusion criteria were patients recommended for knee arthroplasty with pain and preservation of some joint space by standing flexion radiographs. Exclusion criteria were lack of joint space, failure to comply with rehabilitation protocol, and failure to complete research questionnaires. International Knee Documentation Committee composite and isolated pain scale were evaluated longitudinally. Time from meniscus allograft transplant to arthroplasty was measured, with failure defined as allograft excision or revision, progression to arthroplasty, or same or increased pain. RESULTS Eighty-six of 108 (79.6%) patients met eligibility criteria. Over the follow-up mean 8.55 (range 0.68 to 25.2) years, 42 of 87 (48.2%) grafts progressed to arthroplasty with mean time of 8.64 (median 8.05) years. Concomitant procedures did not have significant impact on survival; however, survival medians were higher among paste graft and chondroplasty and lower among osteotomy groups. At the time of reporting, 41 of 84 (48.8%) patients had intact meniscus transplants, demonstrating significant improvements (P < .001) in pain and function as assessed by International Knee Documentation Committee Score. These improvements were sustained 10 years postoperatively, correlated to a mean of 65.8 years of age. At least 50% of patients achieved Minimal Clinically Important Difference through 10 years postoperatively. CONCLUSIONS Meniscus allografts in combination with other arthroscopic interventions delay knee arthroplasty and improve knee symptoms of pain and function in a population of knee arthroplasty candidates older than 50 years. Influences of concomitant procedures cannot be defined. LEVEL OF EVIDENCE Level IV, therapeutic case series, retrospective.
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Affiliation(s)
- Kevin R Stone
- The Stone Clinic, San Francisco, CA 94123, U.S.A.; Stone Research Foundation for Sports Medicine and Arthritis Research, San Francisco, CA 94123, USA.
| | - Ann W Walgenbach
- The Stone Clinic, San Francisco, CA 94123, U.S.A.; Stone Research Foundation for Sports Medicine and Arthritis Research, San Francisco, CA 94123, USA
| | - Shadera Slatter
- Stone Research Foundation for Sports Medicine and Arthritis Research, San Francisco, CA 94123, USA
| | - Thomas J Turek
- Stone Research Foundation for Sports Medicine and Arthritis Research, San Francisco, CA 94123, USA
| | - Caroline Ferguson-Dryden
- Stone Research Foundation for Sports Medicine and Arthritis Research, San Francisco, CA 94123, USA
| | - Marie Dicker
- Stone Research Foundation for Sports Medicine and Arthritis Research, San Francisco, CA 94123, USA
| | - Emma Miltenberger
- Stone Research Foundation for Sports Medicine and Arthritis Research, San Francisco, CA 94123, USA
| | - Haley Cowles
- Stone Research Foundation for Sports Medicine and Arthritis Research, San Francisco, CA 94123, USA
| | - Vivian Liu
- Stone Research Foundation for Sports Medicine and Arthritis Research, San Francisco, CA 94123, USA
| | - Stephanie Wu
- Stone Research Foundation for Sports Medicine and Arthritis Research, San Francisco, CA 94123, USA
| | - Mani Vessal
- Stone Research Foundation for Sports Medicine and Arthritis Research, San Francisco, CA 94123, USA
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Zhong Y, Zhou L, Guo Y, Wang F, He F, Cheng Y, Meng X, Xie H, Zhang Y, Li J. Downregulated SPESP1-driven fibroblast senescence decreases wound healing in aged mice. Clin Transl Med 2024; 14:e1660. [PMID: 38764260 PMCID: PMC11103130 DOI: 10.1002/ctm2.1660] [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: 11/27/2023] [Revised: 03/23/2024] [Accepted: 04/02/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND Human dermal fibroblasts (HDFs) are essential in the processes of skin ageing and wound healing. However, the underlying mechanism of HDFs in skin healing of the elderly has not been well defined. This study aims to elucidate the mechanisms of HDFs senescence and how senescent HDFs affect wound healing in aged skin. METHODS The expression and function of sperm equatorial segment protein 1 (SPESP1) in skin ageing were evaluated via in vivo and in vitro experiments. To delve into the potential molecular mechanisms by which SPESP1 influences skin ageing, a combination of techniques was employed, including proteomics, RNA sequencing, immunoprecipitation, chromatin immunoprecipitation and liquid chromatography-mass spectrometry analyses. Clearance of senescent cells by dasatinib plus quercetin (D+Q) was investigated to explore the role of SPESP1-induced senescent HDFs in wound healing. RESULTS Here, we define the critical role of SPESP1 in ameliorating HDFs senescence and retarding the skin ageing process. Mechanistic studies demonstrate that SPESP1 directly binds to methyl-binding protein, leading to Decorin demethylation and subsequently upregulation of its expression. Moreover, SPESP1 knockdown delays wound healing in young mice and SPESP1 overexpression induces wound healing in old mice. Notably, pharmacogenetic clearance of senescent cells by D+Q improved wound healing in SPESP1 knockdown skin. CONCLUSIONS Taken together, these findings reveal the critical role of SPESP1 in skin ageing and wound healing, expecting to facilitate the development of anti-ageing strategies and improve wound healing in the elderly.
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Affiliation(s)
- Yun Zhong
- Department of DermatologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
- Hunan Key Laboratory of Aging BiologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
| | - Lei Zhou
- Hunan Key Laboratory of Aging BiologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
- Department of DermatologyThe Third Affiliated HospitalSun Yat‐sen UniversityGuangzhouPeoples Republic of China
| | - Yi Guo
- Department of DermatologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
- Hunan Key Laboratory of Aging BiologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
| | - Fan Wang
- Department of DermatologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
- Hunan Key Laboratory of Aging BiologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
| | - Fanping He
- Department of DermatologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
- Hunan Key Laboratory of Aging BiologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
| | - Yufan Cheng
- Department of DermatologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
- Hunan Key Laboratory of Aging BiologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
| | - Xin Meng
- Department of DermatologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
- Hunan Key Laboratory of Aging BiologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
| | - Hongfu Xie
- Department of DermatologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
- Hunan Key Laboratory of Aging BiologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
| | - Yiya Zhang
- Department of DermatologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
- Hunan Key Laboratory of Aging BiologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
- National Clinical Research Center for Geriatric DisordersXiangya HospitalCentral South UniversityChangshaHunanPeoples Republic of China
| | - Ji Li
- Department of DermatologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
- Hunan Key Laboratory of Aging BiologyXiangya HospitalCentral South UniversityChangshaPeoples Republic of China
- National Clinical Research Center for Geriatric DisordersXiangya HospitalCentral South UniversityChangshaHunanPeoples Republic of China
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3
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Sankar S, Kodiveri Muthukaliannan G. Deciphering the crosstalk between inflammation and biofilm in chronic wound healing: Phytocompounds loaded bionanomaterials as therapeutics. Saudi J Biol Sci 2024; 31:103963. [PMID: 38425782 PMCID: PMC10904202 DOI: 10.1016/j.sjbs.2024.103963] [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] [Received: 10/03/2023] [Revised: 02/15/2024] [Accepted: 02/17/2024] [Indexed: 03/02/2024] Open
Abstract
In terms of the economics and public health, chronic wounds exert a significant detrimental impact on the health care system. Bacterial infections, which cause the formation of highly resistant biofilms that elude standard antibiotics, are the main cause of chronic, non-healing wounds. Numerous studies have shown that phytochemicals are effective in treating a variety of diseases, and traditional medicinal plants often include important chemical groups such alkaloids, phenolics, tannins, terpenes, steroids, flavonoids, glycosides, and fatty acids. These substances are essential for scavenging free radicals which helps in reducing inflammation, fending off infections, and hastening the healing of wounds. Bacterial species can survive in chronic wound conditions because biofilms employ quorum sensing as a communication technique which regulates the expression of virulence components. Fortunately, several phytochemicals have anti-QS characteristics that efficiently block QS pathways, prevent drug-resistant strains, and reduce biofilm development in chronic wounds. This review emphasizes the potential of phytocompounds as crucial agents for alleviating bacterial infections and promoting wound healing by reducing the inflammation in chronic wounds, exhibiting potential avenues for future therapeutic approaches to mitigate the healthcare burden provided by these challenging conditions.
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Affiliation(s)
- Srivarshini Sankar
- Department of Biotechnology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore 632 014, Tamil Nadu, India
| | - Gothandam Kodiveri Muthukaliannan
- Department of Biotechnology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore 632 014, Tamil Nadu, India
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Passos JGR, Gomes JAS, Xavier-Santos JB, Yamashita FO, Cavalcanti-Cruz JV, Siqueira EMS, Garcia VB, Zucolotto SM, de Araujo-Junior RF, Ferreira LS, Silva-Junior AA, Félix-Silva J, Fernandes-Pedrosa MF. Anti-inflammatory, healing and antiophidic potential of Jatropha mollissima (Pohl) Baill. (Euphorbiaceae): From popular use to pharmaceutical formulation in gel. Biomed Pharmacother 2024; 173:116290. [PMID: 38458010 DOI: 10.1016/j.biopha.2024.116290] [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: 11/30/2023] [Revised: 02/05/2024] [Accepted: 02/17/2024] [Indexed: 03/10/2024] Open
Abstract
Jatropha mollissima (Pohl) Baill. (Euphorbiaceae) is widely used in traditional medicine to treat inflammatory disorders. So, a topical gel containing the hydroethanolic extract of its leaves was developed and evaluated for its anti-inflammatory, wound healing, and antiophidic properties in mice. First, the chemical profile of different parts of the plant was characterized by liquid chromatography coupled to mass spectrometry (LC-MS) using molecular networking. In the leaf extract, 11 compounds were characterized, with a particular emphasis on the identification of flavonoids. The gel efficiently inhibited carrageenan-induced paw edema, as well as acute and chronic croton oil-induced ear edema models, thereby reducing inflammatory and oxidative parameters in inflamed tissues. Besides anti-inflammatory activity, the herbal gel showed significant wound healing activity. The edematogenic, hemorrhagic and dermonecrotic activities induced by Bothrops jararaca snake venom were effectively inhibited by the treatment with J. mollissima gel. The association with the herbal gel improved in up to 90% the efficacy of commercial snake antivenom in reduce venom-induced edema. Additionally, while antivenom was not able to inhibit venom-induced dermonecrosis, treatment with herbal gel reduced in 55% the dermonocrotic halo produced. These results demonstrate the pharmacological potential of the herbal gel containing J. mollissima extract, which could be a strong candidate for the development of herbal products that can be used to complement the current antivenom therapy against snake venom local toxicity.
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Affiliation(s)
- Júlia G R Passos
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), Faculty of Pharmacy, Federal University of Rio Grande do Norte, Av. General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal 59012-570, Brazil.
| | - Jacyra A S Gomes
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), Faculty of Pharmacy, Federal University of Rio Grande do Norte, Av. General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal 59012-570, Brazil.
| | - Jacinthia B Xavier-Santos
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), Faculty of Pharmacy, Federal University of Rio Grande do Norte, Av. General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal 59012-570, Brazil.
| | - Fabiana O Yamashita
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), Faculty of Pharmacy, Federal University of Rio Grande do Norte, Av. General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal 59012-570, Brazil.
| | - Joelly V Cavalcanti-Cruz
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), Faculty of Pharmacy, Federal University of Rio Grande do Norte, Av. General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal 59012-570, Brazil.
| | - Emerson M S Siqueira
- Laboratory of Pharmacognosy (PNBio), Department of Pharmacy, Faculty of Pharmacy, Federal University of Rio Grande do Norte, Av. General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal 59012-570, Brazil.
| | - Vinícius Barreto Garcia
- Cancer and Inflammatory Research Laboratory, Department of Morphology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 3000, Lagoa Nova, Natal 59078-970, Brazil.
| | - Silvana M Zucolotto
- Laboratory of Pharmacognosy (PNBio), Department of Pharmacy, Faculty of Pharmacy, Federal University of Rio Grande do Norte, Av. General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal 59012-570, Brazil.
| | - Raimundo Fernandes de Araujo-Junior
- Cancer and Inflammatory Research Laboratory, Department of Morphology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 3000, Lagoa Nova, Natal 59078-970, Brazil.
| | - Leandro S Ferreira
- Laboratory of Quality Control, Department of Pharmacy, Faculty of Pharmacy, Federal University of Rio Grande do Norte, Av. General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal 59012-570, Brazil.
| | - Arnóbio A Silva-Junior
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), Faculty of Pharmacy, Federal University of Rio Grande do Norte, Av. General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal 59012-570, Brazil.
| | - Juliana Félix-Silva
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), Faculty of Pharmacy, Federal University of Rio Grande do Norte, Av. General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal 59012-570, Brazil; Laboratory of Clinical Haematology, Faculty of Pharmacy, Department of Clinical and Toxicological Analysis, Federal University of Rio Grande do Norte, Natal, Brazil.
| | - Matheus F Fernandes-Pedrosa
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), Faculty of Pharmacy, Federal University of Rio Grande do Norte, Av. General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal 59012-570, Brazil.
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Bales KL, Karesh AM, Hogan K, Chacko AS, Douglas GL, Feola AJ, Nickerson JM, Pybus A, Wood L, Boatright JH, Pardue MT. Voluntary exercise preserves visual function and reduces inflammatory response in an adult mouse model of autosomal dominant retinitis pigmentosa. Sci Rep 2024; 14:6940. [PMID: 38521799 PMCID: PMC10960803 DOI: 10.1038/s41598-024-57027-9] [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: 06/08/2023] [Accepted: 03/12/2024] [Indexed: 03/25/2024] Open
Abstract
Whole-body physical exercise has been shown to promote retinal structure and function preservation in animal models of retinal degeneration. It is currently unknown how exercise modulates retinal inflammatory responses. In this study, we investigated cytokine alterations associated with retinal neuroprotection induced by voluntary running wheel exercise in a retinal degeneration mouse model of class B1 autosomal dominant retinitis pigmentosa, I307N Rho. I307N Rho mice undergo rod photoreceptor degeneration when exposed to bright light (induced). Our data show, active induced mice exhibited significant preservation of retinal and visual function compared to inactive induced mice after 4 weeks of exercise. Retinal cytokine expression revealed significant reductions of proinflammatory chemokines, keratinocyte-derived chemokine (KC) and interferon gamma inducible protein-10 (IP-10) expression in active groups compared to inactive groups. Through immunofluorescence, we found KC and IP-10 labeling localized to retinal vasculature marker, collagen IV. These data show that whole-body exercise lowers specific retinal cytokine expression associated with retinal vasculature. Future studies should determine whether suppression of inflammatory responses is requisite for exercise-induced retinal protection.
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Affiliation(s)
- Katie L Bales
- Atlanta VA Medical Center for Visual and Neurocognitive Rehabilitation, Decatur, GA, USA
| | - Austin M Karesh
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Kelleigh Hogan
- Atlanta VA Medical Center for Visual and Neurocognitive Rehabilitation, Decatur, GA, USA
| | - Alicia S Chacko
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - GianMarco L Douglas
- Atlanta VA Medical Center for Visual and Neurocognitive Rehabilitation, Decatur, GA, USA
| | - Andrew J Feola
- Atlanta VA Medical Center for Visual and Neurocognitive Rehabilitation, Decatur, GA, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Department of Ophthalmology, Emory University, Atlanta, GA, USA
| | | | - Alyssa Pybus
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Levi Wood
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- George W. Woodruff School of Mechanical Engineering and Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Jeffrey H Boatright
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Department of Ophthalmology, Emory University, Atlanta, GA, USA
| | - Machelle T Pardue
- Atlanta VA Medical Center for Visual and Neurocognitive Rehabilitation, Decatur, GA, USA.
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
- Department of Ophthalmology, Emory University, Atlanta, GA, USA.
- Department of Ophthalmology, Emory University, 1365B Clifton Road NE, Rm. 2600, Atlanta, GA, 30332, USA.
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Akhtari N, Ahmadi M, Kiani Doust Vaghe Y, Asadian E, Behzad S, Vatanpour H, Ghorbani-Bidkorpeh F. Natural agents as wound-healing promoters. Inflammopharmacology 2024; 32:101-125. [PMID: 38062178 DOI: 10.1007/s10787-023-01318-6] [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: 07/08/2023] [Accepted: 08/08/2023] [Indexed: 03/03/2024]
Abstract
The management of acute and chronic wounds resulting from diverse injuries poses a significant challenge to clinical practices and healthcare providers. Wound healing is a complex biological process driven by a natural physiological response. This process involves four distinct phases, namely hemostasis, inflammation, proliferation, and remodeling. Despite numerous investigations on wound healing and wound dressing materials, complications still persist, necessitating more efficacious therapies. Wound-healing materials can be categorized into natural and synthetic groups. The current study aims to provide a comprehensive review of highly active natural animal and herbal agents as wound-healing promoters. To this end, we present an overview of in vitro, in vivo, and clinical studies that led to the discovery of potential therapeutic agents for wound healing. We further elucidated the effects of natural materials on various pharmacological pathways of wound healing. The results of previous investigations suggest that natural agents hold great promise as viable and accessible products for the treatment of diverse wound types.
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Affiliation(s)
- Negin Akhtari
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahnaz Ahmadi
- Medical Nanotechnology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yasaman Kiani Doust Vaghe
- Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Elham Asadian
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Behzad
- Evidence-Based Phytotherapy and Complementary Medicine Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hossein Vatanpour
- Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Fatemeh Ghorbani-Bidkorpeh
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Karimi N. Approaches in line with human physiology to prevent skin aging. Front Physiol 2023; 14:1279371. [PMID: 37954446 PMCID: PMC10634238 DOI: 10.3389/fphys.2023.1279371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023] Open
Abstract
Skin aging is a complex process that is influenced by intrinsic and extrinsic factors that impact the skin's protective functions and overall health. As the body's outermost layer, the skin plays a critical role in defending it against external threats, regulating body temperature, providing tactile sensation, and synthesizing vitamin D for bone health, immune function, and body homeostasis. However, as individuals age, the skin undergoes structural and functional changes, leading to impairments in these essential functions. In contemporary society, there is an increasing recognition of skin health as a significant indicator of overall wellbeing, resulting in a growing demand for anti-aging products and treatments. However, these products often have limitations in terms of safety, effective skin penetration, and potential systemic complications. To address these concerns, researchers are now focusing on approaches that are safer and better aligned with physiology of the skin. These approaches include adopting a proper diet and maintaining healthy lifestyle habits, the development of topical treatments that synchronize with the skin's circadian rhythm, utilizing endogenous antioxidant molecules, such as melatonin and natural products like polyphenols. Moreover, exploring alternative compounds for sun protection, such as natural ultraviolet (UV)-absorbing compounds, can offer safer options for shielding the skin from harmful radiation. Researchers are currently exploring the potential of adipose-derived stem cells, cell-free blood cell secretome (BCS) and other endogenous compounds for maintaining skin health. These approaches are more secure and more effective alternatives which are in line with human physiology to tackle skin aging. By emphasizing these innovative strategies, it is possible to develop effective treatments that not only slow down the skin aging process but also align better with the natural physiology of the skin. This review will focus on recent research in this field, highlighting the potential of these treatments as being safer and more in line with the skin's physiology in order to combat the signs of aging.
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Affiliation(s)
- Nazli Karimi
- Department of Physiology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
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Thiem DGE, Donkiewicz P, Rejaey R, Wiesmann-Imilowski N, Deschner J, Al-Nawas B, Kämmerer PW. The impact of electronic and conventional cigarettes on periodontal health-a systematic review and meta-analysis. Clin Oral Investig 2023; 27:4911-4928. [PMID: 37526741 PMCID: PMC10492702 DOI: 10.1007/s00784-023-05162-4] [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: 04/11/2023] [Accepted: 07/13/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis examined the effects of electronic cigarettes on periodontal health compared to conventional cigarette smoke and a non-smoking population. MATERIALS AND METHODS MEDLINE, Embase, Web of Science, CENTRAL, and ClinicalTrials.gov were screened for literature. Eligibility criteria included clinical studies published between 2006 and 2022 that compare e-cigarettes and conventional cigarettes on periodontal health (bleeding on probing (BoP), plaque index (PI), probing depth (PD), attachment loss (AL), marginal bone loss (MBL), tooth loss, molecular inflammation markers, salivary flow rate). Meta-regression analysis was used to examine the influence of moderator variables. RESULTS Sixteen studies were found to be eligible for qualitative synthesis. Individual analyses showed that cigarette smokers had significantly higher PI, PD, AL, and MBL and increased concentrations of proinflammatory mediators than e-cigarette users and non-smokers. Meta-analysis revealed a 0.33-fold lower chance for BoP in e-cigarette users compared to smokers (p = 0.03), whereby meta-regression failed to detect any effects regarding the age of users and frequency of smoking. A 0.01-fold decreased chance for positive BoP in e-cigarette users compared with non-smokers was seen (p < 0.01). CONCLUSIONS The current findings suggest that that e-cigarette use might be considered a healthier alternative to cigarette smoking concerning periodontal health. Even so, harmful effects of electronic nicotine delivery system (ENDS) usage on periodontal health were seen as well. However, a definitive decision on this research question remains elusive due to the absence of randomized controlled trials. CLINICAL RELEVANCE Electronic cigarettes, marketed as a safer alternative to traditional cigarettes, are becoming increasingly popular. Evidence on the use of electronic cigarettes as a cessation aid and its beneficial impact compared to cigarette smoke remains inconclusive, so the analysis conducted in this review addresses a recent question of high clinical relevance.
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Affiliation(s)
- Daniel G. E. Thiem
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Phil Donkiewicz
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
- Department of Periodontology and Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
- BioHorizons Camlog, Maybachstr. 5, 71299 Wimsheim, Germany
| | - Raha Rejaey
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Nadine Wiesmann-Imilowski
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
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9
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Xiao P, Zhang Y, Zeng Y, Yang D, Mo J, Zheng Z, Wang J, Zhang Y, Zhou Z, Zhong X, Yan W. Impaired angiogenesis in ageing: the central role of the extracellular matrix. J Transl Med 2023; 21:457. [PMID: 37434156 PMCID: PMC10334673 DOI: 10.1186/s12967-023-04315-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/30/2023] [Indexed: 07/13/2023] Open
Abstract
Each step in angiogenesis is regulated by the extracellular matrix (ECM). Accumulating evidence indicates that ageing-related changes in the ECM driven by cellular senescence lead to a reduction in neovascularisation, reduced microvascular density, and an increased risk of tissue ischaemic injury. These changes can lead to health events that have major negative impacts on quality of life and place a significant financial burden on the healthcare system. Elucidating interactions between the ECM and cells during angiogenesis in the context of ageing is neceary to clarify the mechanisms underlying reduced angiogenesis in older adults. In this review, we summarize ageing-related changes in the composition, structure, and function of the ECM and their relevance for angiogenesis. Then, we explore in detail the mechanisms of interaction between the aged ECM and cells during impaired angiogenesis in the older population for the first time, discussing diseases caused by restricted angiogenesis. We also outline several novel pro-angiogenic therapeutic strategies targeting the ECM that can provide new insights into the choice of appropriate treatments for a variety of age-related diseases. Based on the knowledge gathered from recent reports and journal articles, we provide a better understanding of the mechanisms underlying impaired angiogenesis with age and contribute to the development of effective treatments that will enhance quality of life.
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Affiliation(s)
- Ping Xiao
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yanli Zhang
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Yuting Zeng
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Dehong Yang
- Department of Orthopedics Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Jiayao Mo
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Ziting Zheng
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Jilei Wang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yuxin Zhang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Zhiyan Zhou
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Xincen Zhong
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Wenjuan Yan
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
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10
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Gaebel R, Lang C, Vasudevan P, Lührs L, de Carvalho KAT, Abdelwahid E, David R. New Approaches in Heart Research: Prevention Instead of Cardiomyoplasty? Int J Mol Sci 2023; 24:ijms24109017. [PMID: 37240361 DOI: 10.3390/ijms24109017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/10/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
Cardiovascular diseases are the leading cause of death in industrialized nations. Due to the high number of patients and expensive treatments, according to the Federal Statistical Office (2017) in Germany, cardiovascular diseases account for around 15% of total health costs. Advanced coronary artery disease is mainly the result of chronic disorders such as high blood pressure, diabetes, and dyslipidemia. In the modern obesogenic environment, many people are at greater risk of being overweight or obese. The hemodynamic load on the heart is influenced by extreme obesity, which often leads to myocardial infarction (MI), cardiac arrhythmias, and heart failure. In addition, obesity leads to a chronic inflammatory state and negatively affects the wound-healing process. It has been known for many years that lifestyle interventions such as exercise, healthy nutrition, and smoking cessation drastically reduce cardiovascular risk and have a preventive effect against disorders in the healing process. However, little is known about the underlying mechanisms, and there is significantly less high-quality evidence compared to pharmacological intervention studies. Due to the immense potential of prevention in heart research, the cardiologic societies are calling for research work to be intensified, from basic understanding to clinical application. The topicality and high relevance of this research area are also evident from the fact that in March 2018, a one-week conference on this topic with contributions from top international scientists took place as part of the renowned "Keystone Symposia" ("New Insights into the Biology of Exercise"). Consistent with the link between obesity, exercise, and cardiovascular disease, this review attempts to draw lessons from stem-cell transplantation and preventive exercise. The application of state-of-the-art techniques for transcriptome analysis has opened new avenues for tailoring targeted interventions to very individual risk factors.
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Affiliation(s)
- Ralf Gaebel
- Department of Cardiac Surgery, Rostock University Medical Center, 18057 Rostock, Germany
- Department of Life, Light & Matter, Interdisciplinary Faculty, Rostock University, 18059 Rostock, Germany
| | - Cajetan Lang
- Department of Cardiac Surgery, Rostock University Medical Center, 18057 Rostock, Germany
- Department of Life, Light & Matter, Interdisciplinary Faculty, Rostock University, 18059 Rostock, Germany
| | - Praveen Vasudevan
- Department of Cardiac Surgery, Rostock University Medical Center, 18057 Rostock, Germany
- Department of Life, Light & Matter, Interdisciplinary Faculty, Rostock University, 18059 Rostock, Germany
| | - Larissa Lührs
- Advanced Therapy and Cellular Biotechnology in Regenerative Medicine Department, Pelé Pequeno Prίncipe Research Institute & Pequeno Prίncipe Faculties, Ave. Silva Jardim, P.O. Box 80240-020, Curitiba 1632, Brazil
| | - Katherine Athayde Teixeira de Carvalho
- Advanced Therapy and Cellular Biotechnology in Regenerative Medicine Department, Pelé Pequeno Prίncipe Research Institute & Pequeno Prίncipe Faculties, Ave. Silva Jardim, P.O. Box 80240-020, Curitiba 1632, Brazil
| | - Eltyeb Abdelwahid
- Feinberg School of Medicine, Feinberg Cardiovascular Research Institute, Northwestern University, Chicago, IL 60611, USA
| | - Robert David
- Department of Cardiac Surgery, Rostock University Medical Center, 18057 Rostock, Germany
- Department of Life, Light & Matter, Interdisciplinary Faculty, Rostock University, 18059 Rostock, Germany
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11
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Hom DB, Davis ME. Reducing Risks for Poor Surgical Wound Healing. Facial Plast Surg Clin North Am 2023; 31:171-181. [PMID: 37001921 PMCID: PMC11081059 DOI: 10.1016/j.fsc.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
This review summarizes common risk factors for poor surgical healing on the face and neck and a generalized approach to treating a delayed healing wound. During the preoperative evaluation patients should be screened for prior irradiation, cigarette or e-cigarette use, chronic steroid use, alcoholism, diabetes, malnutrition, and other chronic medical conditions and medications. Despite the surgeon's best efforts to prevent poor surgical healing, some wounds may display signs of persistent inflammation. The facial plastic surgeon should be astute in recognizing delayed healing and identifying intrinsic and extrinsic risk factors so that timely intervention can be performed.
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Affiliation(s)
- David B Hom
- Department of Otolaryngology Head and Neck Surgery, University of California San Diego School of Medicine.
| | - Morgan E Davis
- Department of Otolaryngology Head and Neck Surgery, University of California San Diego School of Medicine
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12
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Callegari IOM, Rocha GZ, Oliveira AG. Physical exercise, health, and disease treatment: The role of macrophages. Front Physiol 2023; 14:1061353. [PMID: 37179836 PMCID: PMC10166825 DOI: 10.3389/fphys.2023.1061353] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/11/2023] [Indexed: 05/15/2023] Open
Abstract
Subclinical inflammation is linked to comorbidities and risk factors, consolidating the diagnosis of chronic non-communicable diseases, such as insulin resistance, atherosclerosis, hepatic steatosis, and some types of cancer. In this context, the role of macrophages is highlighted as a marker of inflammation as well as for the high power of plasticity of these cells. Macrophages can be activated in a wide range between classical or proinflammatory, named M1, and alternative or anti-inflammatory, also known as M2 polarization. All nuances between M1 and M2 macrophages orchestrate the immune response by secreting different sets of chemokines, while M1 cells promote Th1 response, the M2 macrophages recruit Th2 and Tregs lymphocytes. In turn, physical exercise has been a faithful tool in combating the proinflammatory phenotype of macrophages. This review proposes to investigate the cellular and molecular mechanisms in which physical exercise can help control inflammation and infiltration of macrophages within the non-communicable diseases scope. During obesity progress, proinflammatory macrophages predominate in adipose tissue inflammation, which reduces insulin sensitivity until the development of type 2 diabetes, progression of atherosclerosis, and diagnosis of non-alcoholic fatty liver disease. In this case, physical activity restores the balance between the proinflammatory/anti-inflammatory macrophage ratio, reducing the level of meta-inflammation. In the case of cancer, the tumor microenvironment is compatible with a high level of hypoxia, which contributes to the advancement of the disease. However, exercise increases the level of oxygen supply, favoring macrophage polarization in favor of disease regression.
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Affiliation(s)
- Irineu O. M. Callegari
- Department of Physical Education, Bioscience Institute, São Paulo State University (UNESP), São Paulo, Brazil
| | - Guilherme Z. Rocha
- Department of Internal Medicine, State University of Campinas, Campinas, Brazil
| | - Alexandre G. Oliveira
- Department of Physical Education, Bioscience Institute, São Paulo State University (UNESP), São Paulo, Brazil
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13
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Therapeutic Efficacy of Polymeric Biomaterials in Treating Diabetic Wounds-An Upcoming Wound Healing Technology. Polymers (Basel) 2023; 15:polym15051205. [PMID: 36904445 PMCID: PMC10007618 DOI: 10.3390/polym15051205] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
Diabetic wounds are one of the serious, non-healing, chronic health issues faced by individuals suffering from diabetic mellitus. The distinct phases of wound healing are either prolonged or obstructed, resulting in the improper healing of diabetic wounds. These injuries require persistent wound care and appropriate treatment to prevent deleterious effects such as lower limb amputation. Although there are several treatment strategies, diabetic wounds continue to be a major threat for healthcare professionals and patients. The different types of diabetic wound dressings that are currently used differ in their properties of absorbing wound exudates and may also cause maceration to surrounding tissues. Current research is focused on developing novel wound dressings incorporated with biological agents that aid in a faster rate of wound closure. An ideal wound dressing material must absorb wound exudates, aid in the appropriate exchange of gas, and protect from microbial infections. It must support the synthesis of biochemical mediators such as cytokines, and growth factors that are crucial for faster healing of wounds. This review highlights the recent advances in polymeric biomaterial-based wound dressings, novel therapeutic regimes, and their efficacy in treating diabetic wounds. The role of polymeric wound dressings loaded with bioactive compounds, and their in vitro and in vivo performance in diabetic wound treatment are also reviewed.
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14
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White A, Carding P, Booth V, Logan P, McGlashan J, Awad R. Pre- and Postoperative Voice Therapy for Benign Vocal Fold Lesions: An International Electronic Delphi Consensus Study. J Voice 2023:S0892-1997(22)00397-6. [PMID: 36624018 DOI: 10.1016/j.jvoice.2022.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/08/2022] [Accepted: 12/08/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Voice therapy management of benign vocal fold lesions (BVFLs) is variable and there are currently no clinical guidelines. Poor descriptions of voice therapy interventions lead to unwarranted variation in treatment. Triangulation of the current evidence identifies a number of potential best practice elements, but also a number of outstanding questions to be explored. The aim of this study was to refine and gain global consensus on "best practice" for a pre- and postoperative voice therapy intervention for adults with BVFLs. METHODS An international sample of expert voice therapists (n = 42) were recruited to take part in this three-round electronic modified Delphi study. Participants were presented with statements concerning a pre- and postoperative voice therapy intervention. Statements were developed from previous research and based on the TIDieR checklist (eg, why, when, what, how?) Participants rated the extent to which they agreed or disagreed with a statement and gave comments to support their response. Consensus was defined as >75% of participants agreeing or strongly agreeing with a given statement. If consensus was not reached, participant comments were used to generate new statements and were rated in the next round. Stability of consensus between rounds was assessed. RESULTS The 42 international experts achieved consensus on 33 statements relating to components of a best practice pre- and postoperative voice therapy intervention for patients with BVFLs. Consensus on statements ranged from 81% to 100%. These statements were explicitly mapped to the TIDieR checklist to ensure that all aspects of the intervention were considered and the questions of "why, what, how, when and individual tailoring" were addressed. CONCLUSIONS This study has significantly enhanced our understanding of what should be in a best practice pre- and postoperative voice therapy intervention. It is important to now test these findings for acceptability and feasibility, prior to considering effectiveness research.
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Affiliation(s)
- Anna White
- Centre for Rehabilitation & Ageing Research, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK; Nottingham University Hospitals NHS Trust, Nottingham, UK.
| | - Paul Carding
- Oxford Institute of Midwifery, Nursing and Allied Health Research, Oxford, UK
| | - Vicky Booth
- Centre for Rehabilitation & Ageing Research, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK; Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Pip Logan
- Centre for Rehabilitation & Ageing Research, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Rehab Awad
- University Hospital Lewisham NHS Trust, London, UK; Kasr Al-Aini Hospital, Cairo University, Cairo, Egypt
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White A, Carding P, Booth V, Logan P. Pre- and post-operative voice therapy (PaPOV): Development of an intervention for patients with benign vocal fold lesions. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:94-110. [PMID: 36047250 PMCID: PMC10086784 DOI: 10.1111/1460-6984.12771] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Pre- and post-operative voice therapy may improve voice and quality-of-life outcomes for patients undergoing phonosurgery to remove benign vocal fold lesions (BVFLs). However, what constitutes voice therapy in this population is poorly described, resulting in a poor evidence base, lack of clinical guidelines and unwarranted variation in management. In order to develop the evidence base, a robust, iterative process of intervention development work should precede feasibility testing and effectiveness studies. METHODS & PROCEDURES Guidance for developing complex interventions, drawing on evidence, theory and modelling, was used to inform the development of a pre- and post-operative voice therapy intervention entitled 'PaPOV'. Data from four sources of evidence were synthesized using a published triangulation protocol. Data from a systematic review, national survey of current practice, expert interview study, and patient and public involvement conversations were used to populate a triangulation matrix, outlining components of a PaPOV. Data were coded to reflect areas of agreement, dissonance and silence with each component of the intervention. Based on this evidence, an assessment of convergence for each intervention component could be made. OUTCOMES & RESULTS In total, 61 components of the PaPOV intervention were explored. Of these, 27 were categorized as having stability of consensus according to a priori criteria. A total of 34 failed to meet the criteria. This was more frequently due to silence (27) rather than dissonance (seven) in the data. By evidencing areas of agreement and stability of consensus across data sources, the validity of individual findings has been enhanced. Furthermore, the study has exposed specific areas of the intervention that lack consensus and require exploration through further intervention development studies. CONCLUSIONS & IMPLICATIONS This systematic triangulation process has contributed to the development of a PaPOV intervention for patients with BVFLs. Exploration of specific components relating to the intervention will allow outstanding questions to be answered in preparation for feasibility testing. WHAT THIS PAPER ADDS What is already known on the subject BVFLs cause dysphonia by preventing vocal fold closure, impacting on vibratory characteristics and increasing compensatory muscle tension. Management for these patients is variable with them being offered phonosurgery, voice therapy, pharmacological management or a combined approach. Pre- and post-operative voice therapy may improve both voice and quality-of-life outcomes. This patient group has unique complexities when considering voice therapy, including surgical preparation, wound healing and epithelial mobilization. What this paper adds to existing knowledge This study uses a robust triangulation process to synthesize current evidence and patient experiences in order to inform the development of a PaPOV. It outlines some of the key components and considerations when delivering pre- and post-operative voice therapy to adults with BVFLs. Furthermore, it serves as a methodological example for intervention development in complex interventions, highlighting key guidance and recommended processes for developing and evaluating complex interventions. What are the potential or actual clinical implications of this work? The 61 components discussed as potential 'ingredients' for a PaPOV enable clinicians to reflect on key considerations when planning and delivering voice therapy to adults with BVFLs. This study highlights the pitfalls both clinically and in research of failing to describe interventions adequately and the benefits of using accurate, specific and agreed terminology in clinical practice, such as that outlined in the Rehabilitation Treatment Specification System (TRSS).
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Affiliation(s)
- Anna White
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of MedicineUniversity of NottinghamNottinghamUK
| | - Paul Carding
- Faculty of Health and Life SciencesOxford Institute of Nursing, Midwifery and Allied Health ResearchOxfordUK
| | - Vicky Booth
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of MedicineUniversity of NottinghamNottinghamUK
| | - Pip Logan
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of MedicineUniversity of NottinghamNottinghamUK
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Qiu Y, Fernández-García B, Lehmann HI, Li G, Kroemer G, López-Otín C, Xiao J. Exercise sustains the hallmarks of health. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:8-35. [PMID: 36374766 PMCID: PMC9923435 DOI: 10.1016/j.jshs.2022.10.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/10/2022] [Accepted: 09/02/2022] [Indexed: 05/23/2023]
Abstract
Exercise has long been known for its active role in improving physical fitness and sustaining health. Regular moderate-intensity exercise improves all aspects of human health and is widely accepted as a preventative and therapeutic strategy for various diseases. It is well-documented that exercise maintains and restores homeostasis at the organismal, tissue, cellular, and molecular levels to stimulate positive physiological adaptations that consequently protect against various pathological conditions. Here we mainly summarize how moderate-intensity exercise affects the major hallmarks of health, including the integrity of barriers, containment of local perturbations, recycling and turnover, integration of circuitries, rhythmic oscillations, homeostatic resilience, hormetic regulation, as well as repair and regeneration. Furthermore, we summarize the current understanding of the mechanisms responsible for beneficial adaptations in response to exercise. This review aimed at providing a comprehensive summary of the vital biological mechanisms through which moderate-intensity exercise maintains health and opens a window for its application in other health interventions. We hope that continuing investigation in this field will further increase our understanding of the processes involved in the positive role of moderate-intensity exercise and thus get us closer to the identification of new therapeutics that improve quality of life.
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Affiliation(s)
- Yan Qiu
- Institute of Geriatrics (Shanghai University), Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), School of Medicine, Shanghai University, Nantong 226011, China; Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, Shanghai Engineering Research Center of Organ Repair, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Benjamin Fernández-García
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo 33011, Spain; Department of Morphology and Cell Biology, Anatomy, University of Oviedo, Oviedo 33006, Spain
| | - H Immo Lehmann
- Cardiovascular Division of the Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Guoping Li
- Cardiovascular Division of the Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Guido Kroemer
- Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Université de Paris Cité, Sorbonne Université, Inserm U1138, Institut Universitaire de France, Paris 75231, France; Metabolomics and Cell Biology Platforms, Institut Gustave Roussy, Villejuif 94805, France; Institut du Cancer Paris CARPEM, Department of Biology, Hôpital Européen Georges Pompidou, AP-HP, Paris 75015, France.
| | - Carlos López-Otín
- Departamento de Bioquímica y Biología Molecular, Facultad de Medicina, Instituto Universitario de Oncología, Universidad de Oviedo, Oviedo 33006, Spain; Centro de Investigación Biomédica en Red Enfermedades Cáncer (CIBERONC), Oviedo 33006, Spain.
| | - Junjie Xiao
- Institute of Geriatrics (Shanghai University), Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), School of Medicine, Shanghai University, Nantong 226011, China; Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, Shanghai Engineering Research Center of Organ Repair, School of Life Science, Shanghai University, Shanghai 200444, China.
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Sharma P, Kumar A, Dey AD. Cellular Therapeutics for Chronic Wound Healing: Future for Regenerative Medicine. Curr Drug Targets 2022; 23:1489-1504. [PMID: 35748548 DOI: 10.2174/138945012309220623144620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/10/2021] [Accepted: 02/01/2022] [Indexed: 01/25/2023]
Abstract
Chronic wounds are associated with significant morbidity and mortality, which demand long-term effective treatment and represent a tremendous financial strain on the global healthcare systems. Regenerative medicines using stem cells have recently become apparent as a promising approach and are an active zone of investigation. They hold the potential to differentiate into specific types of cells and thus possess self-renewable, regenerative, and immune-modulatory effects. Furthermore, with the rise of technology, various cell therapies and cell types such as Bone Marrow and Adipose-derived Mesenchymal Cell (ADMSC), Endothelial Progenitor Cells (EPCs), Embryonic Stem Cells (ESCs), Mesenchymal Stem Cell (MSCs), and Pluripotent Stem Cells (PSCs) are studied for their therapeutic impact on reparative processes and tissue regeneration. Cell therapy has proven to have substantial control over enhancing the quality and rate of skin regeneration and wound restoration. The literature review brings to light the mechanics of wound healing, abnormalities resulting in chronic wounds, and the obstacles wound care researchers face, thus exploring the multitude of opportunities for potential improvement. Also, the review is focused on providing particulars on the possible cell-derived therapeutic choices and their associated challenges in healing, in the context of clinical trials, as solutions to these challenges will provide fresh and better future opportunities for improved study design and therefore yield a substantial amount of data for the development of more specialized treatments.
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Affiliation(s)
- Preety Sharma
- Chitkara College of Pharmacy, Chitkara University, Punjab, India.,Government Pharmacy College Kangra, Nagrota Bhagwan, Himachal Pradesh, India
| | - Arun Kumar
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Asmita Deka Dey
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
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18
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Molecular mechanisms of exercise contributing to tissue regeneration. Signal Transduct Target Ther 2022; 7:383. [PMID: 36446784 PMCID: PMC9709153 DOI: 10.1038/s41392-022-01233-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/03/2022] [Accepted: 10/17/2022] [Indexed: 12/03/2022] Open
Abstract
Physical activity has been known as an essential element to promote human health for centuries. Thus, exercise intervention is encouraged to battle against sedentary lifestyle. Recent rapid advances in molecular biotechnology have demonstrated that both endurance and resistance exercise training, two traditional types of exercise, trigger a series of physiological responses, unraveling the mechanisms of exercise regulating on the human body. Therefore, exercise has been expected as a candidate approach of alleviating a wide range of diseases, such as metabolic diseases, neurodegenerative disorders, tumors, and cardiovascular diseases. In particular, the capacity of exercise to promote tissue regeneration has attracted the attention of many researchers in recent decades. Since most adult human organs have a weak regenerative capacity, it is currently a key challenge in regenerative medicine to improve the efficiency of tissue regeneration. As research progresses, exercise-induced tissue regeneration seems to provide a novel approach for fighting against injury or senescence, establishing strong theoretical basis for more and more "exercise mimetics." These drugs are acting as the pharmaceutical alternatives of those individuals who cannot experience the benefits of exercise. Here, we comprehensively provide a description of the benefits of exercise on tissue regeneration in diverse organs, mainly focusing on musculoskeletal system, cardiovascular system, and nervous system. We also discuss the underlying molecular mechanisms associated with the regenerative effects of exercise and emerging therapeutic exercise mimetics for regeneration, as well as the associated opportunities and challenges. We aim to describe an integrated perspective on the current advances of distinct physiological mechanisms associated with exercise-induced tissue regeneration on various organs and facilitate the development of drugs that mimics the benefits of exercise.
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19
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Kawanishi M, Kami K, Nishimura Y, Minami K, Senba E, Umemoto Y, Kinoshita T, Tajima F. Exercise-induced increase in M2 macrophages accelerates wound healing in young mice. Physiol Rep 2022; 10:e15447. [PMID: 36200164 PMCID: PMC9535257 DOI: 10.14814/phy2.15447] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 05/27/2023] Open
Abstract
Moderate-intensity exercise performed during wound healing has been reported to decrease inflammatory cytokines and chemokines and accelerate wound healing. However, its effect on macrophage phenotype and the mechanism by which exercise accelerates wound healing remain unclear. The purpose of this study was to investigate the effect of exercise on macrophage phenotype during wound healing and to clarify the relationship between angiogenesis and wound healing. 12-week-old male C57BL/6J mice were divided into sedentary (n = 6) and exercise groups (n = 6). The exercise group performed moderate-intensity treadmill running exercise (9.0 m/min, 60 min) for 10 days. Double immunofluorescence analysis was performed using F4/80+ inducible nitric oxide synthase (iNOS)+ for M1 macrophages, F4/80+ transforming growth factor-beta (TGF-β)1+ for M2 macrophages, and CD31+ alpha smooth muscle actin (α-SMA)+ for angiogenesis. The exercise group showed significantly accelerated wound healing compared with the sedentary group. From early wound healing onward, exercise significantly inhibited M1 macrophage infiltration and increased M2 macrophage count. Exercise also significantly increased angiogenesis. Furthermore, the M2 macrophage phenotype was significantly correlated with angiogenesis in the exercise group, indicating that M2 macrophages and angiogenesis are related to accelerated wound healing. These findings suggest that moderate-intensity exercise increases TGF-β1 derived from M2 macrophages, which may be associated with enhanced angiogenesis and wound healing in young mice.
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Affiliation(s)
- Makoto Kawanishi
- Department of Rehabilitation MedicineWakayama Medical UniversityWakayamaJapan
| | - Katsuya Kami
- Department of Rehabilitation MedicineWakayama Medical UniversityWakayamaJapan
- Department of Rehabilitation, Wakayama Faculty of Health Care SciencesTakarazuka University of Medical and Health CareWakayamaJapan
| | - Yukihide Nishimura
- Department of Rehabilitation MedicineIwate Medical UniversityMoriokaJapan
| | - Kohei Minami
- Department of Rehabilitation MedicineWakayama Medical UniversityWakayamaJapan
| | - Emiko Senba
- Department of Rehabilitation MedicineWakayama Medical UniversityWakayamaJapan
- Department of Physical TherapyOsaka Yukioka College of Health ScienceIbarakiJapan
| | - Yasunori Umemoto
- Department of Rehabilitation MedicineWakayama Medical UniversityWakayamaJapan
| | - Tokio Kinoshita
- Department of Rehabilitation MedicineWakayama Medical UniversityWakayamaJapan
| | - Fumihiro Tajima
- Department of Rehabilitation MedicineWakayama Medical UniversityWakayamaJapan
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20
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Ma H, Peng Y, Zhang S, Zhang Y, Min P. Effects and Progress of Photo-Crosslinking Hydrogels in Wound Healing Improvement. Gels 2022; 8:609. [PMID: 36286110 PMCID: PMC9601727 DOI: 10.3390/gels8100609] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 09/18/2023] Open
Abstract
Wound healing is a dynamic physiological process, including three stages: inflammation, tissue formation, and remodeling. The quality of wound healing is affected by many topical and systemic factors, while any small factor may affect the process. Therefore, improving the quality of wound healing is a complex and arduous challenge. Photo-crosslinking reaction using visible light irradiation is a novel method for hydrogel preparation. Photo-crosslinking hydrogels can be controlled in time and space, and are not interfered by temperature conditions, which have been widely used in the fields of medicine and engineering. This review aims to summarize the application of photo-crosslinking hydrogels in improving the quality of wound healing, mainly including the material design, application mechanism, and effect of photo-crosslinking hydrogels applied in wound healing, followed by the applicable animal models for experimental research. Finally, this review analyzes the clinical application prospects of photo-crosslinking hydrogels in the field of wound healing.
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Affiliation(s)
| | | | | | - Yixin Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
| | - Peiru Min
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
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21
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Composite Membrane Dressings System with Metallic Nanoparticles as an Antibacterial Factor in Wound Healing. MEMBRANES 2022; 12:membranes12020215. [PMID: 35207136 PMCID: PMC8876280 DOI: 10.3390/membranes12020215] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/26/2022] [Accepted: 02/09/2022] [Indexed: 02/04/2023]
Abstract
Wound management is the burning problem of modern medicine, significantly burdening developed countries’ healthcare systems. In recent years, it has become clear that the achievements of nanotechnology have introduced a new quality in wound healing. The application of nanomaterials in wound dressing significantly improves their properties and promotes the healing of injuries. Therefore, this review paper presents the subjectively selected nanomaterials used in wound dressings, including the metallic nanoparticles (NPs), and refers to the aspects of their application as antimicrobial factors. The literature review was supplemented with the results of our team’s research on the elements of multifunctional new-generation dressings containing nanoparticles. The wound healing multiple molecular pathways, mediating cell types, and affecting agents are discussed herein. Moreover, the categorization of wound dressings is presented. Additionally, some materials and membrane constructs applied in wound dressings are described. Finally, bacterial participation in wound healing and the mechanism of the antibacterial function of nanoparticles are considered. Membranes involving NPs as the bacteriostatic factors for improving wound healing of skin and bones, including our experimental findings, are discussed in the paper. In addition, some studies of our team concerning the selected bacterial strains’ interaction with material involving different metallic NPs, such as AuNPs, AgNPs, Fe3O4NPs, and CuNPs, are presented. Furthermore, nanoparticles’ influence on selected eukaryotic cells is mentioned. The ideal, universal wound dressing still has not been obtained; thus, a new generation of products have been developed, represented by the nanocomposite materials with antibacterial, anti-inflammatory properties that can influence the wound-healing process.
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22
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Basu S, Goswami AG, David LE, Mudge E. Psychological Stress on Wound Healing: A Silent Player in a Complex Background. INT J LOW EXTR WOUND 2022:15347346221077571. [PMID: 35102769 DOI: 10.1177/15347346221077571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Stress is hard to define and is further complicated by varied perceptions in the population and differing responses in different situations. Psychological stress brings about certain physiological changes through manipulation of the neural, humoral and immunological systems. Observational studies have showed that fear and anxiety before surgery can complicate normal wound healing. Two different pathways appear to be involved: one directly through hypothalamic-pituitary-adrenal axis and sympathetic-adrenomedullary axis, and another indirectly through negative psychological stressors such as anxiety, depression and social isolation. The pathogenesis includes decreased expression of pro-inflammatory cytokines, resulting in poor angiogenesis, matrix regeneration and delayed healing. Prolonged immunological activation in itself is a stressor and can precipitate a sickness behaviour syndrome manifested by disturbed sleep, anorexia, reduction in activity, increased responsiveness to pain and addiction to alcohol and tobacco. It has been observed that cortisol release suppresses pro-inflammatory cytokine release, while down-regulation of cortisol causes unabated inflammatory response. In individuals with chronic wounds, on the other hand, it is thought that physical stress has different effects such as foul odor, pain, exudate and social and familial isolation, which may act independently as psychological stressors. This article attempts to appraise the influence of psychological stress on the immunological system and its effect on wound healing.
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Affiliation(s)
- Somprakas Basu
- 442339All India Institute of Medical Sciences Rishikesh, India
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23
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Liu Z, Liu J, Sun T, Zeng D, Yang C, Wang H, Yang C, Guo J, Wu Q, Chen HJ, Xie X. Integrated Multiplex Sensing Bandage for In Situ Monitoring of Early Infected Wounds. ACS Sens 2021; 6:3112-3124. [PMID: 34347450 DOI: 10.1021/acssensors.1c01279] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Infection, the most common complication of chronic wounds, has placed tremendous burden on patients and society. Existing care strategies could hardly reflect in situ wound status, resulting in overly aggressive or conservative therapeutic options. Multiplexed tracking of wound markers to obtain diagnostic information in a more accurate way is highly promising and in great demand for the emerging development of personalized medicine. Here, an integrated multiplex sensing bandage (MSB) system, including a multiplex sensor array (MSA), a corresponding flexible circuit, and a mobile application, was developed for real-time monitoring of sodium, potassium, calcium, pH, uric acid, and temperature indicators in the wound site to provide a quantitative diagnostic basis. The MSB was optimized for wound-oriented management applications, which exhibits a broad linear response, excellent selectivity, temporal stability, mechanical stability, reproducibility, and reliable signal transmission performance on the aforementioned physiological indicators. The results of in vivo experiments demonstrate that the MSA is capable of real-time monitoring of actual wounds as well as early prediction of infection. The results ultimately point to the potential clinical applicability of the MSB, which might benefit the quantifications of the complexity and diversity of the wound healing process. This work provides a unique strategy that holds promise for broad application in optimizing wound management and even coping with other diseases.
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Affiliation(s)
- Ziqi Liu
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou 510006, China
| | - Junqing Liu
- Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Tiancheng Sun
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou 510006, China
| | - Deke Zeng
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou 510006, China
| | - Chengduan Yang
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou 510006, China
| | - Hao Wang
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou 510006, China
| | - Cheng Yang
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou 510006, China
| | - Jun Guo
- Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Qianni Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Hui-Jiuan Chen
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou 510006, China
| | - Xi Xie
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, Sun Yat-Sen University, Guangzhou 510006, China
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Yamaguchi R, Guo X, Zheng J, Zhang J, Han J, Shioya A, Uramoto H, Mochizuki T, Yamada S. PRDX4 Improved Aging-Related Delayed Wound Healing in Mice. J Invest Dermatol 2021; 141:2720-2729. [PMID: 34029576 DOI: 10.1016/j.jid.2021.04.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/15/2021] [Accepted: 04/14/2021] [Indexed: 01/09/2023]
Abstract
Aging-related delayed wound healing is an issue of concern worldwide. Oxidative stress is involved in wound healing. Antioxidative enzymes have various roles in this process. PRDX4, a member of the PRDX family, is upregulated after injury. To investigate the effects of PRDX4 on aging-related wound healing, we subjected C57BL/6J (wild-type), human Prdx4‒transgenic (i.e., hPrdx4+/+), Prdx4-knockout (i.e., Prdx4-/y) mice of three age groups (young, adult, and aged) to skin wound formation. The overexpression of PRDX4 accelerated wound healing in adult and aged mice but not in young mice. Aged hPrdx4+/+ mice showed reduced oxidative stress and inflammation, lower numbers of neutrophils, increased macrophage infiltration, increased angiogenesis, and increased GF levels. The granulation tissue of adult and aged hPrdx4+/+ mice was richer in fibroblasts than that in the matched wild-type mice. PRDX4 deficiency was associated with mortality in adult and aged mice. In vitro, the overexpression of PRDX4 promoted the proliferation and migration of fibroblasts derived from adult or aged mice and made fibroblasts more resistant to the cytotoxicity of hydrogen peroxide. PRDX4 is essential for wound healing and can improve the healing process from multiple aspects, suggesting that it may be very beneficial to wound treatment, especially for the elderly.
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Affiliation(s)
- Reimon Yamaguchi
- Department of Pathology and Laboratory Medicine, School of Medicine, Kanazawa Medical University, Uchinada, Japan; Department of Dermatology, School of Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Xin Guo
- Department of Pathology and Laboratory Medicine, School of Medicine, Kanazawa Medical University, Uchinada, Japan.
| | - Jianbo Zheng
- Department of Pathology and Laboratory Medicine, School of Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Jing Zhang
- Department of Pathology and Laboratory Medicine, School of Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Jia Han
- Department of Pathology and Laboratory Medicine, School of Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Akihiro Shioya
- Department of Pathology and Laboratory Medicine, School of Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Hidetaka Uramoto
- Department of Thoracic Surgery, School of Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Takashi Mochizuki
- Department of Dermatology, School of Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Sohsuke Yamada
- Department of Pathology and Laboratory Medicine, School of Medicine, Kanazawa Medical University, Uchinada, Japan
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25
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Wang AZ, Husak JF. Endurance and sprint training affect immune function differently in green anole lizards ( Anolis carolinensis). J Exp Biol 2020; 223:jeb232132. [PMID: 32917817 DOI: 10.1242/jeb.232132] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/02/2020] [Indexed: 01/08/2023]
Abstract
Limited resources must be partitioned among traits that enhance fitness. Although survival-related traits often trade off with reproduction, survival-related traits themselves may trade off with each other under energy limitations. Whole-organism performance and the immune system both enhance survival, yet are costly, but it is unclear how the two might trade off with each other under energy-limited conditions. Resources can be allocated to very different types of performance (e.g. aerobic endurance versus anaerobic sprinting), just as they can be allocated to different components of the immune system (e.g. innate versus acquired) to maximize survival. We forced allocation to different performance traits in green anole lizards (Anolis carolinensis) using specialized exercise training, to determine how different components of the immune system would be impacted by shifts in energy use. We measured immunocompetence in endurance-trained, sprint-trained and untrained control lizards by evaluating swelling response to phytohemagglutinin (cell-mediated immunity), antibody response to sheep red blood cells (acquired humoral immunity) and wound healing (integrated immunity). Endurance-trained lizards had reduced cell-mediated immunity, whereas sprint-trained lizards had reduced rates of wound healing. The acquired immune response was not affected by either type of training. Because each immune measure responded differently to the different types of training, our results do not support the hypothesis that simple energy limitation determines overall investment in immunity. Instead, different components of the immune system appear to be affected in ways specific to how energy is invested in performance.
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Affiliation(s)
- Andrew Z Wang
- Department of Biology, University of St Thomas, St. Paul, MN 55105, USA
| | - Jerry F Husak
- Department of Biology, University of St Thomas, St. Paul, MN 55105, USA
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26
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Aagaard TV, Moeini S, Skou ST, Madsen UR, Brorson S. Benefits and Harms of Exercise Therapy for Patients With Diabetic Foot Ulcers: A Systematic Review. INT J LOW EXTR WOUND 2020; 21:219-233. [PMID: 32924691 DOI: 10.1177/1534734620954066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM Exercise therapy is a core element in the treatment of diabetes, but the benefits and harms for patients with a diabetic foot ulcer (DFU) are unknown. We therefore aimed to systematically review the benefits on health-related quality of life (HRQoL) and harms of exercise therapy for patients with DFU. METHODS We searched 6 major databases. We performed citation and reference searches of included studies and contacted authors of ongoing trials. We included randomized controlled trials (RCTs) to assess potential benefits on HRQoL and harms of exercise therapy. Observational studies were included to identify potential harms of exercise therapy. RESULTS We included 10 published publications of 9 trials and results from 2 unpublished trials including a total of 281 individuals with DFUs receiving various forms of exercise therapy. Due to lack of HRQoL measurements and high heterogeneity, it was not possible to perform meta-analyses. Results on HRQoL was present in one unpublished study. Harms reported ranged from musculoskeletal problems, increased wound size, to amputation; however, no safe conclusions could be drawn from the available data due to high heterogeneity and risk of bias in the trials. CONCLUSIONS/INTERPRETATION Protective strategies are often preferred over therapeutic exercise that might have unforeseen consequences for patients over time. Based on the current literature, no evidence-based recommendations can be provided on the benefits and harms of exercise therapy for patients with DFUs. Well-conducted RCTs are needed to guide rehabilitation including detailed description of adverse events and an exercise program in a semisupervised or fully supervised setting.
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Affiliation(s)
- Thomas Vedste Aagaard
- Department of Physiotherapy and Occupational Therapy, Holbaek Hospital, Holbaek, Denmark.,Department of Orthopaedic Surgery, Holbaek Hospital, Holbaek, Denmark.,Department of Orthopaedic Surgery, Zealand University Hospital, Koege, Denmark
| | - Sahar Moeini
- Department of Orthopaedic Surgery, Zealand University Hospital, Koege, Denmark
| | - Søren T Skou
- Department of Physiotherapy and Occupational Therapy, Naestved-Slagelse-Ringsted Hospitals, Slagelse, Denmark.,Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Ulla Riis Madsen
- Department of Orthopaedic Surgery, Holbaek Hospital, Holbaek, Denmark.,The Danish Knowledge Centre for Rehabilitation and Palliative Care. University of Southern Denmark, Odense, Denmark
| | - Stig Brorson
- Department of Orthopaedic Surgery, Zealand University Hospital, Koege, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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27
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Pillai MR, Keylock KT, Cromwell HC, Meserve LA. Exercise influences the impact of polychlorinated biphenyl exposure on immune function. PLoS One 2020; 15:e0237705. [PMID: 32833973 PMCID: PMC7444807 DOI: 10.1371/journal.pone.0237705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 07/25/2020] [Indexed: 12/17/2022] Open
Abstract
Polychlorinated biphenyls (PCBs) are environmental pollutants and endocrine disruptors, harmfully affecting reproductive, endocrine, neurological and immunological systems. This broad influence has implications for processes such as wound healing, which is modulated by the immunological response of the body. Conversely, while PCBs can be linked to diminished wound healing, outside of PCB pollution systems, exercise has been shown to accelerate wound healing. However, the potential for moderate intensity exercise to modulate or offset the harmful effects of a toxin like PCB are yet unknown. A key aim of the present study was to examine how PCB exposure at different doses (0, 100, 500, 1000 ppm i.p.) altered wound healing in exercised versus non-exercised subgroups of mice. We examined PCB effects on immune function in more depth by analyzing the concentrations of cytokines, interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), Interleukin-6 (IL-6) and granulocyte macrophage colony stimulating factor (GM-CSF) in these wounds inflicted by punch biopsy. Mice were euthanized at Day 3 or Day 5 after PCB injection (n = 3-6) and skin excised from the wound area was homogenized and analyzed for cytokine content. Results revealed that wound healing was not signficantly impacted by either PCB exposure or exercise, but there were patterns of delays in healing that depended on PCB dose. Changes in cytokines were also observed and depended on PCB dose and exercise experience. For example, IL-1β concentrations in Day 5 mice without PCB administration were 33% less in exercised mice than mice not exercised. However, IL-1β concentrations in Day 3 mice administered 100 ppm were 130% greater in exercised mice than not exercisedmice. Changes in the other measured cytokines varied with mainly depressions at lesser PCB doses and elevations at higher doses. Exercise had diverse effects on cytokine levels, but increased cytokine levels in the two greater doses. Explanations for these diverse effects include the use of young animals with more rapid wound healing rates less affected by toxin exposure, as well as PCB-mediated compensatory effects at specific doses which could actually enhance immune function. Future work should examine these interactions in more detail across a developmental time span. Understanding how manipulating the effects of exposure to environemntal contaminants using behavioral modification could be very useful in certain high risk populations or exposed individuals.
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Affiliation(s)
- Mahesh R. Pillai
- Dept. of Biological Sciences, Bowling Green State University, Bowling Green, Ohio, United States of America
| | - K. Todd Keylock
- Dept. of Exercise Science, Bowling Green State University, Bowling Green, Ohio, United States of America
| | - Howard C. Cromwell
- Dept. of Psychology and J.P. Scott Center for Neuroscience, Mind and Behavior, Bowling Green State University, Bowling Green, Ohio, United States of America
| | - Lee A. Meserve
- Dept. of Biological Sciences, Bowling Green State University, Bowling Green, Ohio, United States of America
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28
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Thanigaimani S, Phie J, Golledge J. Animal models of ischemic limb ulcers: a systematic review and meta-analysis. BMJ Open Diabetes Res Care 2020; 8:e001676. [PMID: 32847840 PMCID: PMC7451953 DOI: 10.1136/bmjdrc-2020-001676] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/24/2020] [Accepted: 07/02/2020] [Indexed: 01/01/2023] Open
Abstract
The aims of this systematic review were to assess the clinical relevance and quality of previously published animal models of ischemic ulceration and examine the available evidence for interventions improving ulcer healing in these models. Publicly available databases were searched for original studies investigating the effect of limb ischemia on wound healing in animal models. The quality of studies was assessed using two tools based on the Animal research: Reporting of In Vivo Experiments (ARRIVE) guidelines and the clinical relevance of the models. A total of 640 wounds (ischemic=314; non-ischemic=326) were assessed in 252 animals (92 mice, 140 rats, 20 rabbits) from 7 studies. Meta-analyses showed that wound healing was consistently delayed by ischemia at all time-points examined (day-7 standard median difference (SMD) 5.36, 95% CI 3.67 to 7.05; day-14 SMD 4.50, 95% CI 2.90 to 6.10 and day-21 SMD 2.53, 95% CI 1.25 to 3.80). No significant difference in wound healing was observed between 32 diabetic and 32 non-diabetic animals with ischemic wounds. Many studies lacked methods to reduce bias, such as outcome assessors blinded to group allocation and sample size calculations and clinically relevant model characteristics, such as use of older animals and a peripheral location of the wound. Five different interventions were reported to improve wound healing in these models. The impaired wound healing associated with limb ischemia can be modeled in a variety of different animals. Improvements in study design could increase clinical relevance, reduce bias and aid the discovery of translatable therapies.
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Affiliation(s)
- Shivshankar Thanigaimani
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - James Phie
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
- Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Queensland, Australia
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29
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Pre- and Postoperative Voice Therapy for Benign Vocal Fold Lesions: Factors Influencing a Complex Intervention. J Voice 2020; 36:59-67. [DOI: 10.1016/j.jvoice.2020.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/27/2020] [Accepted: 04/06/2020] [Indexed: 01/18/2023]
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30
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Preoperative Exercise Habits are Associated with Post-gastrectomy Complications. World J Surg 2020; 44:2736-2742. [DOI: 10.1007/s00268-020-05493-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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31
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Kopcewicz M, Walendzik K, Bukowska J, Kur-Piotrowska A, Machcinska S, Gimble JM, Gawronska-Kozak B. Cutaneous wound healing in aged, high fat diet-induced obese female or male C57BL/6 mice. Aging (Albany NY) 2020; 12:7066-7111. [PMID: 32294622 PMCID: PMC7202484 DOI: 10.18632/aging.103064] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/25/2020] [Indexed: 12/26/2022]
Abstract
Since there are limited studies analyzing the impact of age, sex and obesity on cutaneous repair, the current study evaluated excisional skin wound healing as a function of age, sex and diet in C57BL/6 mice subjected to either low (LFD) or high (HFD) fat diet. Older mice accumulated increased body fat relative to younger mice under HFD. Skin wound healing at particular stages was affected by age in the aspect of Tgfβ-1, MCP-1, Mmp-9 and Mmp-13 expression. The most profound, cumulative effect was observed for the combination of two parameters: age and sex. While skin of younger males displayed extremely high collagen 1 and collagen 3 expression, younger females showed exceptionally high Mmp-13 expression at day 3 and 7 after injury. Diet as a single variable modified the thickness of dermis due to increased dermal White Adipose Tissue (dWAT) accumulation in mice fed HFD. The combination of age and diet affected the re-epithelialization and inflammatory response of injured skin. Overall, our data indicate that age has the most fundamental impact although all components (age, sex and diet) contribute to skin repair.
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Affiliation(s)
- Marta Kopcewicz
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Katarzyna Walendzik
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Joanna Bukowska
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Anna Kur-Piotrowska
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Sylwia Machcinska
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Jeffrey M Gimble
- LaCell LLC, New Orleans, LA 70112, USA.,Obatala Sciences Inc., New Orleans, LA 70148, USA.,Departments of Medicine, Structural and Cellular Biology, and Surgery and Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Barbara Gawronska-Kozak
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
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Bogachkov YY, Chen L, Le Master E, Fancher IS, Zhao Y, Aguilar V, Oh MJ, Wary KK, DiPietro LA, Levitan I. LDL induces cholesterol loading and inhibits endothelial proliferation and angiogenesis in Matrigels: correlation with impaired angiogenesis during wound healing. Am J Physiol Cell Physiol 2020; 318:C762-C776. [PMID: 31995410 DOI: 10.1152/ajpcell.00495.2018] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Hypercholesterolemia is a major risk factor for adverse cardiovascular outcomes, but its effect on angiogenesis and wound healing is not well understood. In this study, using a combination of mass spectrometry and laurdan two-photon imaging, we show that elevated levels of low-density lipoprotein (LDL), like those seen in hypercholesterolemic patients, lead to an increase in both free cholesterol and cholesterol esters, as well as increase in lipid order of endothelial cell membranes. Notably, these effects are distinct and opposite to the lack of cholesterol loading and the disruption of lipid order observed in our earlier studies in response to oxidized LDL (oxLDL). The same pathological level of LDL leads to a significant inhibition of endothelial proliferation and cell cycle arrest in G2/M phase, whereas oxLDL enhances endothelial proliferation in S phase of the cycle. LDL but not oxLDL suppresses the expression of vascular endothelial growth factor receptor-2 while enhancing the expression of vascular endothelial growth factor (VEGF). Furthermore, we show that aged (8-10 mo) hypercholesterolemic apolipoprotein E-deficient (ApoE-/-) mice display delayed wound closure compared with age-matched C57/BL6 wild-type controls following a skin punch biopsy. The delay in wound healing is associated with a decreased expression of cluster of differentiation 31 platelet endothelial cell adhesion molecule endothelial marker and decreased angiogenesis within the wound bed. Furthermore, decreased endothelial responsiveness to the growth factors VEGF and basic fibroblast growth factor is observed in ApoE-/- mice in Matrigel plugs and in Matrigels with high levels of LDL in wild-type mice. We propose that plasma hypercholesterolemia is antiangiogenic due to elevated levels of LDL.
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Affiliation(s)
- Yedida Y Bogachkov
- Division of Pulmonary and Critical Care, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.,Department of Cellular and Molecular Pharmacology, University of Illinois at Chicago, Chicago, Illinois
| | - Lin Chen
- Center for Wound Healing and Tissue Regeneration, College of Dentistry, University of Illinois at Chicago, Chicago, Illinois
| | - Elizabeth Le Master
- Division of Pulmonary and Critical Care, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Ibra S Fancher
- Division of Pulmonary and Critical Care, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Yan Zhao
- Center for Wound Healing and Tissue Regeneration, College of Dentistry, University of Illinois at Chicago, Chicago, Illinois
| | - Victor Aguilar
- Division of Pulmonary and Critical Care, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Myung-Jin Oh
- Division of Pulmonary and Critical Care, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Kishore K Wary
- Department of Cellular and Molecular Pharmacology, University of Illinois at Chicago, Chicago, Illinois
| | - Luisa A DiPietro
- Center for Wound Healing and Tissue Regeneration, College of Dentistry, University of Illinois at Chicago, Chicago, Illinois
| | - Irena Levitan
- Division of Pulmonary and Critical Care, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.,Department of Cellular and Molecular Pharmacology, University of Illinois at Chicago, Chicago, Illinois
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33
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Hagan ML, Yu K, Zhu J, Vinson BN, Roberts RL, Montesinos Cartagena M, Johnson MH, Wang L, Isales CM, Hamrick MW, McNeil PL, McGee‐Lawrence ME. Decreased pericellular matrix production and selection for enhanced cell membrane repair may impair osteocyte responses to mechanical loading in the aging skeleton. Aging Cell 2020; 19:e13056. [PMID: 31743583 PMCID: PMC6974724 DOI: 10.1111/acel.13056] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 09/16/2019] [Accepted: 10/09/2019] [Indexed: 12/13/2022] Open
Abstract
Transient plasma membrane disruptions (PMD) occur in osteocytes with in vitro and in vivo loading, initiating mechanotransduction. The goal here was to determine whether osteocyte PMD formation or repair is affected by aging. Osteocytes from old (24 months) mice developed fewer PMD (-76% females, -54% males) from fluid shear than young (3 months) mice, and old mice developed fewer osteocyte PMD (-51%) during treadmill running. This was due at least in part to decreased pericellular matrix production, as studies revealed that pericellular matrix is integral to formation of osteocyte PMD, and aged osteocytes produced less pericellular matrix (-55%). Surprisingly, osteocyte PMD repair rate was faster (+25% females, +26% males) in osteocytes from old mice, and calcium wave propagation to adjacent nonwounded osteocytes was blunted, consistent with impaired mechanotransduction downstream of PMD in osteocytes with fast PMD repair in previous studies. Inducing PMD via fluid flow in young osteocytes in the presence of oxidative stress decreased postwounding cell survival and promoted accelerated PMD repair in surviving cells, suggesting selective loss of slower-repairing osteocytes. Therefore, as oxidative stress increases during aging, slower-repairing osteocytes may be unable to successfully repair PMD, leading to slower-repairing osteocyte death in favor of faster-repairing osteocyte survival. Since PMD are an important initiator of mechanotransduction, age-related decreases in pericellular matrix and loss of slower-repairing osteocytes may impair the ability of bone to properly respond to mechanical loading with bone formation. These data suggest that PMD formation and repair mechanisms represent new targets for improving bone mechanosensitivity with aging.
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Affiliation(s)
- Mackenzie L. Hagan
- Department of Cellular Biology and AnatomyMedical College of GeorgiaAugusta UniversityAugustaGA
| | - Kanglun Yu
- Department of Cellular Biology and AnatomyMedical College of GeorgiaAugusta UniversityAugustaGA
| | - Jiali Zhu
- Department of Cellular Biology and AnatomyMedical College of GeorgiaAugusta UniversityAugustaGA
| | - Brooke N. Vinson
- Department of Cellular Biology and AnatomyMedical College of GeorgiaAugusta UniversityAugustaGA
| | - Rachel L. Roberts
- Department of Cellular Biology and AnatomyMedical College of GeorgiaAugusta UniversityAugustaGA
| | | | - Maribeth H. Johnson
- Department of Neuroscience and Regenerative MedicineAugusta UniversityAugustaGA
| | - Liyun Wang
- Department of Mechanical EngineeringUniversity of DelawareNewarkDE
| | - Carlos M. Isales
- Department of Neuroscience and Regenerative MedicineAugusta UniversityAugustaGA
| | - Mark W. Hamrick
- Department of Cellular Biology and AnatomyMedical College of GeorgiaAugusta UniversityAugustaGA
| | - Paul L. McNeil
- Department of Cellular Biology and AnatomyMedical College of GeorgiaAugusta UniversityAugustaGA
| | - Meghan E. McGee‐Lawrence
- Department of Cellular Biology and AnatomyMedical College of GeorgiaAugusta UniversityAugustaGA
- Department of Orthopaedic SurgeryAugusta UniversityAugustaGA
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Hanne NJ, Easter ED, Cole JH. Minimally invasive laser Doppler flowmetry is suitable for serial bone perfusion measurements in mice. Bone Rep 2019; 11:100231. [PMID: 31867412 PMCID: PMC6900537 DOI: 10.1016/j.bonr.2019.100231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/17/2019] [Accepted: 11/18/2019] [Indexed: 01/02/2023] Open
Abstract
In vivo laser Doppler flowmetry (LDF) has previously been used to quantify blood perfusion accurately at a single timepoint in the murine tibial metaphysis. However, this procedure entailed substantial disruption to soft tissues overlying the bone and caused notable localized inflammation for several weeks after the procedure, impeding serial measurements in the same mouse. In this study, we tested a less invasive technique to measure perfusion in the tibia with LDF and determined that it can be used serially in the same mouse without causing signs of inflammation or gait perturbations. Twenty 14-week-old C57Bl/6J mice were evenly divided into groups that either had daily treadmill exercise or remained sedentary. Within these activity groups, mice were evenly subdivided into groups that received LDF measurements either weekly or only once at the study endpoint. Bone perfusion was measured with LDF in the anteromedial region of the right tibial metaphysis. Serum concentrations of interleukin 6, incision site wound area, and interlimb coordination during gait were measured weekly for four weeks. Tibial perfusion did not differ significantly between exercise and sedentary groups within the weekly or endpoint-only LDF groups at any timepoint. Perfusion was significantly increased in the third week in the weekly LDF group relative to measurements in the second and fourth weeks. Ligation of the femoral artery caused consistent, rapid reductions in tibial perfusion, validating that LDF is sensitive to changes in tibial blood supply. Weekly LDF procedures did not adversely affect gait, as interlimb coordination during treadmill locomotion was similar between weekly and endpoint-only LDF groups at every timepoint. Images of the incision site show wound closure within one week, and serum concentrations of interleukin 6 were not significantly different between weekly and endpoint-only groups. Together, these findings demonstrate that our minimally invasive LDF technique is suitable for serial in vivo measurements of intraosseous blood perfusion without inducing localized inflammation or negatively affecting gait patterns in mice.
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Affiliation(s)
- Nicholas J Hanne
- Joint Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA, and North Carolina State University, Raleigh, NC, USA
| | - Elizabeth D Easter
- Materials Science and Engineering, North Carolina State University, Raleigh, NC, USA
| | - Jacqueline H Cole
- Joint Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA, and North Carolina State University, Raleigh, NC, USA
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Wong W, Crane ED, Kuo Y, Kim A, Crane JD. The exercise cytokine interleukin-15 rescues slow wound healing in aged mice. J Biol Chem 2019; 294:20024-20038. [PMID: 31748415 DOI: 10.1074/jbc.ra119.010740] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/12/2019] [Indexed: 01/05/2023] Open
Abstract
Impaired wound healing in elderly individuals increases infection risk and prolongs surgical recovery, but current treatment options are limited. Low doses of interleukin-15 (IL-15) that mimic exercise responses in the circulation improve skin structure and increase mitochondria in uninjured aged skin, suggesting that IL-15 is an essential mitochondrial signal for healing that is lost during aging. Here we used gene microarray analysis of old and young murine epidermal stem cells and demonstrate that aging results in a gene signature characteristic of bioenergetic dysfunction. Intravenous IL-15 treatment rescued chronological aging-induced healing defects and restored youthful wound closure in old, sedentary mice. Additionally, exercise-mediated improvements in the healing of aged skin depend upon circulating IL-15. We show that IL-15 induces signal transducer and activator of transcription 3 (STAT3) signaling characteristic of young animals, reduces markers of growth arrest, and increases keratinocyte and fibroblast growth. Moreover, exercise or exercise-mimicking IL-15 treatment rescued the age-associated decrease in epidermal mitochondrial complex IV activity. Overall, these results indicate that IL-15 or its analogs represent promising therapies for treating impaired wound healing in elderly patients.
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Affiliation(s)
- Wesley Wong
- Department of Biology, Northeastern University, Boston, Massachusetts 02115
| | - Elizabeth D Crane
- Department of Biology, Northeastern University, Boston, Massachusetts 02115
| | - Yikai Kuo
- Department of Biology, Northeastern University, Boston, Massachusetts 02115
| | - Austin Kim
- Department of Biology, Northeastern University, Boston, Massachusetts 02115
| | - Justin D Crane
- Department of Biology, Northeastern University, Boston, Massachusetts 02115
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Arriagada F, Nonell S, Morales J. Silica-based nanosystems for therapeutic applications in the skin. Nanomedicine (Lond) 2019; 14:2243-2267. [PMID: 31411537 DOI: 10.2217/nnm-2019-0052] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aging, exposure to oxidants, infectious pathogens, inflammogens, ultraviolet radiation and other environmental and genetic factors can result in the development of various skin disorders. Despite immense progress being made in dermatological treatments, many skin-associated problems still remain difficult to treat and various therapies have limitations. Progress in silica-based nanomaterials research provides an opportunity to overcome these drawbacks and improve therapies and is a promising tool for inclusion in clinical practice to treat skin diseases. This review focuses on the use of various types of silica nanoparticles with therapeutic applications in various skin disorders. These nanosystems improve treatment efficacy by maintaining or enhancing the effect of several drugs and are useful tools for nanomedicine, pharmaceutical sciences and future clinical applications.
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Affiliation(s)
- Francisco Arriagada
- Departamento de Ciencias y Tecnología Farmacéuticas, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago 8380494, Chile
| | - Santi Nonell
- Institut Químic de Sarrià (IQS), University Ramon Llull, Via Augusta 390, 08017 Barcelona, Spain
| | - Javier Morales
- Departamento de Ciencias y Tecnología Farmacéuticas, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago 8380494, Chile
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Bang M, Ryu O, Kim DG, Mabunga DF, Cho KS, Kim Y, Han SH, Kwon KJ, Shin CY. Tenovin-1 Induces Senescence and Decreases Wound-Healing Activity in Cultured Rat Primary Astrocytes. Biomol Ther (Seoul) 2019; 27:283-289. [PMID: 30092626 PMCID: PMC6513186 DOI: 10.4062/biomolther.2018.107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 06/27/2018] [Accepted: 07/03/2018] [Indexed: 01/01/2023] Open
Abstract
Brain aging induces neuropsychological changes, such as decreased memory capacity, language ability, and attention; and is also associated with neurodegenerative diseases. However, most of the studies on brain aging are focused on neurons, while senescence in astrocytes has received less attention. Astrocytes constitute the majority of cell types in the brain and perform various functions in the brain such as supporting brain structures, regulating blood-brain barrier permeability, transmitter uptake and regulation, and immunity modulation. Recent studies have shown that SIRT1 and SIRT2 play certain roles in cellular senescence in peripheral systems. Both SIRT1 and SIRT2 inhibitors delay tumor growth in vivo without significant general toxicity. In this study, we investigated the role of tenovin-1, an inhibitor of SIRT1 and SIRT2, on rat primary astrocytes where we observed senescence and other functional changes. Cellular senescence usually is characterized by irreversible cell cycle arrest and induces senescence- associated β-galactosidase (SA-β-gal) activity. Tenovin-1-treated astrocytes showed increased SA-β-gal-positive cell number, senescence-associated secretory phenotypes, including IL-6 and IL-1β, and cell cycle-related proteins like phospho-histone H3 and CDK2. Along with the molecular changes, tenovin-1 impaired the wound-healing activity of cultured primary astrocytes. These data suggest that tenovin-1 can induce cellular senescence in astrocytes possibly by inhibiting SIRT1 and SIRT2, which may play particular roles in brain aging and neurodegenerative conditions.
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Affiliation(s)
- Minji Bang
- Department of Neuroscience, School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul 05029, Republic of Korea
| | - Onjeon Ryu
- Department of Neuroscience, School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul 05029, Republic of Korea
| | - Do Gyeong Kim
- Department of Neuroscience, School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul 05029, Republic of Korea
| | - Darine Froy Mabunga
- Department of Neuroscience, School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul 05029, Republic of Korea
| | - Kyu Suk Cho
- Department of Neuroscience, School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul 05029, Republic of Korea
| | - Yujeong Kim
- Department of Neuroscience, School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul 05029, Republic of Korea
| | - Seol-Heui Han
- Department of Neuroscience, School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul 05029, Republic of Korea
| | - Kyoung Ja Kwon
- Department of Neuroscience, School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul 05029, Republic of Korea
| | - Chan Young Shin
- Department of Neuroscience, School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul 05029, Republic of Korea
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Krisciunas GP, Vakharia A, Lazarus C, Taborda SG, Martino R, Hutcheson K, McCulloch T, Langmore SE. Application of Manual Therapy for Dysphagia in Head and Neck Cancer Patients: A Preliminary National Survey of Treatment Trends and Adverse Events. Glob Adv Health Med 2019; 8:2164956119844151. [PMID: 31041144 PMCID: PMC6482656 DOI: 10.1177/2164956119844151] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/24/2019] [Accepted: 03/11/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Radiation-associated dysphagia is a common and debilitating consequence of treatment for head and neck cancer (HNC). Since commonly employed dysphagia therapy programs for HNC patients still lack authoritative efficacy, some speech-language pathologists (SLPs) have started employing manual therapy (MT) techniques in an attempt to prevent or rehabilitate dysphagia in this patient population. However, exceptionally little is known about the use of MT in this patient population. OBJECTIVES The purpose of this study was to describe practice patterns as well as the rate, type, and severity of adverse events associated with SLP provision of MT to HNC patients. METHODS An Internet-based questionnaire geared toward SLPs who practice MT was developed and sent to SLPs practicing in the United States, 3 times, through 3 national listservs (American Speech Language Hearing Association [ASHA] Special Interest Division 13, ASHA Special Interest Division 3, and University of Iowa Voiceserv), over the course of 4 weeks. RESULTS Of the 255 respondents, 116 (45.5%) performed MT on HNC patients. Of these 116 SLPs, 27.6% provided proactive MT during radiation, 62.1% provided 1 to 2 sessions per week, and 94.8% prescribed a MT home program. The rate, type, and severity of reported adverse events were similar between HNC and non-HNC patients. CONCLUSION This preliminary survey demonstrated that SLPs provide MT to HNC patients during and after cancer treatment, and that reported adverse events paralleled those experienced by noncancer patients. However, these results should be taken with caution, and a well-designed prospective study is needed to formally establish the safety and the preliminary efficacy of this novel clinical intervention.
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Affiliation(s)
- Gintas P Krisciunas
- Department of Otolaryngology, Boston University Medical Center, Boston, Massachusetts
| | - Aneri Vakharia
- Department of Otolaryngology, Boston University Medical Center, Boston, Massachusetts
- Aneri Vakharia, Boston University Medical Center, BCD Building, 800 Harrison Avenue, Boston, MA 02218, USA.
| | - Cathy Lazarus
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Rosemary Martino
- Department of Otolaryngology, University of Toronto, Toronto, Ontario, Canada
| | - Katherine Hutcheson
- Department of Head & Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Timothy McCulloch
- Department of Otolaryngology, University of Wisconsin, Madison, Wisconsin
| | - Susan E Langmore
- Department of Otolaryngology, Boston University Medical Center, Boston, Massachusetts
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Tapia B, Valles C, Ribeiro-Amaral T, Mor C, Herrera D, Sanz M, Nart J. The adjunctive effect of a titanium brush in implant surface decontamination at peri‐implantitis surgical regenerative interventions: A randomized controlled clinical trial. J Clin Periodontol 2019; 46:586-596. [DOI: 10.1111/jcpe.13095] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/08/2019] [Accepted: 02/20/2019] [Indexed: 01/09/2023]
Affiliation(s)
- Beatriz Tapia
- Universitat International de Catalunya Barcelona Spain
| | | | | | - Carolina Mor
- Universitat International de Catalunya Barcelona Spain
| | - David Herrera
- Etiology and Therapy of Periodontal Diseases Research Group University Complutense of Madrid Madrid Spain
| | - Mariano Sanz
- Etiology and Therapy of Periodontal Diseases Research Group University Complutense of Madrid Madrid Spain
| | - José Nart
- Universitat International de Catalunya Barcelona Spain
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Flynn MG, Markofski MM, Carrillo AE. Elevated Inflammatory Status and Increased Risk of Chronic Disease in Chronological Aging: Inflamm-aging or Inflamm-inactivity? Aging Dis 2019; 10:147-156. [PMID: 30705775 PMCID: PMC6345337 DOI: 10.14336/ad.2018.0326] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 03/26/2018] [Indexed: 12/12/2022] Open
Abstract
Age-associated hyper-inflammation or "inflamm-aging" has been linked to the development of chronic diseases and characterized as an unavoidable aspect of aging. However, the inflamm-aging model does not adequately address the potential anti-inflammatory effects of exercise training and the potential for exercise to ameliorate several age-related diseases. In this brief review, we introduce a new paradigm-inflamm-inactivity-that describes a potent counter-measure to age-associated inflammatory illness.
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Affiliation(s)
- Michael G. Flynn
- HCA South Atlantic Division, Charleston, SC 29492, USA
- College of Charleston, Charleston, SC 29424, USA
| | - Melissa M. Markofski
- University of Houston, Department of Health and Human Performance, Houston, TX 77204, USA
| | - Andres E. Carrillo
- Department of Exercise Science, Chatham University, Pittsburgh, PA 15232, USA
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece
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Huh MG, Park DJ. Analysis of Donor-site Complications after Conjunctivo-limbal Autograft to Treat Pterygium. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.2.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Min Gu Huh
- Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea
| | - Dae Jin Park
- Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea
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Shimojo G, Joseph B, Shah R, Consolim-Colombo FM, De Angelis K, Ulloa L. Exercise activates vagal induction of dopamine and attenuates systemic inflammation. Brain Behav Immun 2019; 75:181-191. [PMID: 30394312 PMCID: PMC6334665 DOI: 10.1016/j.bbi.2018.10.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/26/2018] [Accepted: 10/23/2018] [Indexed: 12/16/2022] Open
Abstract
Physical exercise is one of the most important factors improving quality of life, but it is not feasible for patients with morbidity or limited mobility. Most previous studies focused on high-intensity or long-term exercise that causes metabolic stress or physiological adaption, respectively. Here, we studied how moderate-intensity swimming affects systemic inflammation in 6-8 week old C57BL/6J male mice during endotoxemia. One-hour swimming prevented hypokalemia, hypocalcemia, attenuated serum levels of inflammatory cytokines, increased anti-inflammatory cytokines but affected neither IL6 nor glycemia before or after the endotoxic challenge. Exercise attenuated serum TNF levels by inhibiting its production in the spleen through a mechanism mediated by the subdiaphragmatic vagus nerve but independent of the splenic nerve. Exercise increased serum levels of dopamine, and adrenalectomy prevented the potential of exercise to induce dopamine and to attenuate serum TNF levels. Dopaminergic agonist type-1, fenoldopam, inhibited TNF production in splenocytes. Conversely, dopaminergic antagonist type-1, butaclamol, attenuated exercise control of serum TNF levels. These results suggest that vagal induction of dopamine may contribute to the anti-inflammatory potential of physical exercise.
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Affiliation(s)
- Guilherme Shimojo
- Department of Surgery, Rutgers-New Jersey Medical School, Newark, NJ 07103, USA; Nove de Julho University (UNINOVE), Sao Paulo, Brazil
| | - Biju Joseph
- Department of Surgery, Rutgers-New Jersey Medical School, Newark, NJ 07103, USA
| | - Roshan Shah
- Department of Surgery, Rutgers-New Jersey Medical School, Newark, NJ 07103, USA
| | - Fernanda M Consolim-Colombo
- Nove de Julho University (UNINOVE), Sao Paulo, Brazil; Hypertension Unit, Heart Institute (INCOR) School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Kátia De Angelis
- Nove de Julho University (UNINOVE), Sao Paulo, Brazil; Department of Physiology, Federal University of Sao Paulo (UNIFESP), Brazil
| | - Luis Ulloa
- Department of Surgery, Rutgers-New Jersey Medical School, Newark, NJ 07103, USA; Center for Immunity and Inflammation, Rutgers-New Jersey Medical School, Rutgers Biomedical Health Sciences, Newark, NJ 07103, USA.
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Abdelgaid SM, Moursy AF, Elgebaly EAA, Aboelenien AM. Minimally Invasive Treatment of Ankle Fractures in Patients at High Risk of Soft Tissue Wound Healing Complications. J Foot Ankle Surg 2018; 57:557-571. [PMID: 29685567 DOI: 10.1053/j.jfas.2017.11.041] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Indexed: 02/03/2023]
Abstract
The complex nature of ankle fractures is magnified when seen in patients at high risk of soft tissue wound healing complications. The major categories include associated soft tissue injury, diabetes, tobacco use, peripheral vascular disease, malnutrition, alcoholism, and corticosteroid use. Because of the potential for wound dehiscence and infection with open reduction and internal fixation of ankle fractures in these patients, minimally invasive procedures have been described. The aims of the present study were to assess the possibility for, and evaluate the results and complications of, minimally invasive techniques for different types of malleolar fractures in high-risk patients. We report the clinical results of 47 high-risk patients who presented with malleolar fractures from January 2007 to December 2012 and underwent minimally invasive reduction and fixation. One patient (0.5%) developed a superficial infection; however, none of the patients displayed wound dehiscence or deep infection. Five patients (10.6%) required open reduction because of intraoperative failure to achieve anatomic reduction. Using the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale, 15 of the patients (36%) treated with minimally invasive techniques experienced an excellent outcome. In contrast, 23 patients (55%) had a good, 3 (7%) a fair, and 1 (2.5%) a poor outcome. The results of our study have shown that minimally invasive fixation appears to be a satisfactory method for the management of malleolar fractures in high-risk patients and could be helpful in the avoidance of the complications associated with conventional open reduction and internal fixation.
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Crews RT, Smith SR, Ghazizadeh R, Yalla SV, Wu SC. Preliminary Evaluation of a Cycling Cleat Designed for Diabetic Foot Ulcers. J Am Podiatr Med Assoc 2017; 107:475-482. [PMID: 27824259 PMCID: PMC5422142 DOI: 10.7547/15-198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Offloading devices for diabetic foot ulcers (DFU) generally restrict exercise. In addition to traditional health benefits, exercise could benefit DFU by increasing blood flow and acting as thermotherapy. This study functionally evaluated a cycling cleat designed for forefoot DFU. METHODS Fifteen individuals at risk of developing a DFU used a recumbent stationary bicycle to complete one 5-minute cycling bout with the DFU cleat on their study foot and one 5-minute bout without it. Foot stress was evaluated by plantar pressure insoles during cycling. Laser Doppler perfusion monitored blood flow to the hallux. Infrared photographs measured foot temperature before and after each cycling bout. RESULTS The specialized cleat significantly reduced forefoot plantar pressure (9.9 kPa versus 62.6 kPa, P < .05) and pressure time integral (15.4 versus 76.4 kPa*sec, P < .05). Irrespective of footwear condition, perfusion to the hallux increased (3.97 ± 1.2 versus 6.9 ± 1.4 tissue perfusion units, P < .05) after exercise. Infrared images revealed no changes in foot temperature. CONCLUSIONS The specialized cleat allowed participants to exercise with minimal forefoot stress. The observed increase in perfusion suggests that healing might improve if patients with active DFU were to use the cleat. Potential thermotherapy for DFU was not supported by this study. Evaluation of the device among individuals with active DFU is now warranted.
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Affiliation(s)
- Ryan T. Crews
- Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, Center for Lower Extremity Ambulatory Research (CLEAR), North Chicago, IL
| | - Steven R. Smith
- HealthPartners Institute for Education and Research at Regions Hospital, St. Paul, MN
| | | | - Sai V. Yalla
- Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, Center for Lower Extremity Ambulatory Research (CLEAR), North Chicago, IL
| | - Stephanie C. Wu
- Department of Surgery, Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL
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Vileikyte L, Crews RT, Reeves ND. Psychological and Biomechanical Aspects of Patient Adaptation to Diabetic Neuropathy and Foot Ulceration. Curr Diab Rep 2017; 17:109. [PMID: 28942488 DOI: 10.1007/s11892-017-0945-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review was to elucidate how psychological and biomechanical factors interrelate in shaping patients' experience with diabetic symmetric polyneuropathy (DSPN) and its sequela-diabetic foot ulceration (DFU). RECENT FINDINGS Recent findings emphasize the importance not only of neuropathic pain but also of other DSPN symptoms, such as unsteadiness. We highlight the negative spiral between unsteadiness, falls, and psychological distress. Moreover, unsteadiness is a key determinant of non-adherence to offloading resulting in the delayed DFU healing. While depression is an established predictor of incident DFU, findings linking depression and DFU healing remain inconclusive. Examination of physical activity in DFU development and healing represents the most recent application of research to this field. Research evidence indicates that DSPN markedly impairs physical and emotional functioning and suggests that there is an unmet need for the development of multifaceted interventions that address both psychological distress and biomechanical challenges experienced by patients with this debilitating complication of diabetes.
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Affiliation(s)
- Loretta Vileikyte
- Department of Medicine, University of Manchester, Manchester, M13 9WL, UK.
| | - Ryan T Crews
- William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL, 60064, USA
| | - Neil D Reeves
- School of Healthcare Science, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, M1 5GD, UK
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Abstract
PURPOSE OF REVIEW This article aims to review previous research reports and to summarize current strategies for the optimal duration of voice rest and the effect of phonatory stimulation after phonomicrosurgery. RECENT FINDINGS Voice rest is commonly recommended after laryngeal surgery to prevent worsening of vocal fold injuries. However, there are no established standard protocol for voice rest, and the type and duration of voice rest vary among clinicians. The most effective duration of voice rest is unknown. Recently, early vocal stimulation was recommended as a means to improve wound healing, on the basis of the basic and clinical researches. SUMMARY It seems that early vocal stimulation may enhance the wound healing process in the vocal fold. More basic and clinical researches are warranted to investigate appropriate timing of initiation of stimulation, as well as the type and amount of stimulation that are available for human.
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Aksamitiene E, Baker AL, Roy S, Hota S, Zhang LH, Rodin J, Hobelmann K, Hoek JB, Pribitkin EA. Biochemical Effects of Exercise on a Fasciocutaneous Flap in a Rat Model. JAMA FACIAL PLAST SU 2017; 19:303-310. [PMID: 28278315 DOI: 10.1001/jamafacial.2016.2162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Importance An overwhelming amount of data suggest that cardiovascular exercise has a positive effect on the mind and body, although the precise mechanism is not always clear. Objective To assess the clinical and biochemical effects of voluntary cardiovascular exercise on pedicled flaps in a rodent model. Design, Setting, and Participants Eighteen adult Sprague-Dawley male rats were randomized into a resting animal group (RAG) (n=9) and an exercise animal group (EAG) (n=9) for 14 days (July 23, 2013, through July 30, 2013). A pedicled transposition flap was performed on the ventral surface of the rat, and biopsy specimens were taken from the proximal, middle, and distal portions on postoperative days 0, 2, 5, and 9. Flap survival was analyzed planimetrically, and biopsy specimens were analyzed by hematoxylin-eosin-stained microscopy and immunoblotting. The housing, exercise, surgery, and analysis of the rats were conducted at a single basic science research laboratory at the tertiary care center campus of Thomas Jefferson University in Philadelphia, Pennsylvania. Exposures The rats were caged for 14 days or housed in a cage connected to an exercise wheel and pedometer. Main Outcomes and Measures Study measures were gross and micrographic necrosis and expression of proteins within cell survival and apoptosis pathways. Results A total of 18 rats were studied, 9 in the RAG and 9 in the EAG. the mean (SEM) amount of necrosis in flaps was 41.3% (3%) in the RAG rats and 10.5% (3.5%) in the EAG rats (P < .001). Immunoblotting revealed increased Caspase-9 activity resulting in poly-(adenosine diphosphate-ribose) polymerase 1 cleavage in the RAG vs the EAG, as well as lower phosphorylated protein kinase B (also known as Akt), signal transducer and activator of transcription 3, and total B-cell leukemia/lymphoma 2 protein levels. Throughout the postoperative period, the cumulative vascular endothelial growth factor A levels of the EAG flaps were significantly higher than those of the RAG flaps (2.30 vs 1.25 fold induction [FI], P = .002), with differences of 2.76 vs 1.54 FI in the proximal segment, 2.40 vs 1.20 FI in the middle segment, and 1.90 vs 0.79 FI in the distal segment. A similar response was noted when comparing phosphorylated Akt, with cumulative mean (SEM) p-Akt expression levels of 0.62 (0.04) for RAG and 1.98 (0.09) for EAG (P = .002 between the 2 groups). Conclusions and Relevance Voluntary preoperative exercise improves survival in pedicled fasciocutaneous flaps; the EAG rats had less necrosis, decreased apoptotic markers, and increased amounts of vascular endothelial growth factor A and prosurvival proteins. These results have implications to increase flap survival in other mammal populations, such as humans. Level of Evidence 3.
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Affiliation(s)
- Edita Aksamitiene
- Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Adam L Baker
- Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sudeep Roy
- Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Salini Hota
- Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Li-Hui Zhang
- Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Julianna Rodin
- Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Kealan Hobelmann
- Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jan B Hoek
- Department of Pathology, Anatomy, and Cell Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Edmund A Pribitkin
- Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
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Najafi B, Grewal GS, Bharara M, Menzies R, Talal TK, Armstrong DG. Can't Stand the Pressure: The Association Between Unprotected Standing, Walking, and Wound Healing in People With Diabetes. J Diabetes Sci Technol 2017; 11:657-667. [PMID: 27510440 PMCID: PMC5588814 DOI: 10.1177/1932296816662959] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The objective was to report patterns of physical activity and their relationship to wound healing success in patients with diabetic foot ulcers protected with removable or irremovable offloading devices. METHODS Forty-nine people with diabetic foot ulcers were randomized to wear either a removable cast walker (RCW) or an irremovable instant total contact cast (iTCC). Primary outcome measures included change in wound size, physical activities including position (ie, sitting, standing, lying) and locomotion (speed, steps, etc). Outcomes parameters were assessed on weekly basis until wound healing or until 12 weeks. RESULTS A higher proportion of patients healed at 12 weeks in the iTCC group ( P = .038). Significant differences in activity were observed between groups starting at week 4. RCW patients became more active than the iTCC group (75% higher duration of standing, 100% longer duration of walking, and 126% longer unbroken walking bout, P < .05). Overall, there was an inverse association between rate of weekly wound healing and number of steps taken per day ( r < -.33, P < .05) for both groups. RCW patients had a significant inverse correlation between duration of daily standing and weekly rate of healing ( r = -.67, P < .05). Standing duration was the only significant predictor of healing at 12 weeks. CONCLUSION The results from this study suggest significant differences in activity patterns between removable and irremovable offloading devices. These patterns appear to start diverging at week 4, which may indicate a decline in adherence to offloading. Results suggest that while walking may delay wound healing, unprotected standing might be an even more unrealized and sinister culprit.
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Affiliation(s)
- Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Southern Arizona Limb Salvage Alliance (SALSA), College of Medicine, University of Arizona, Tucson, AZ, USA
- Bijan Najafi, PhD, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS:BCM390, Houston, TX 77030, USA. ;
| | - Gurtej S. Grewal
- Southern Arizona Limb Salvage Alliance (SALSA), College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Manish Bharara
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Robert Menzies
- Diabetic Foot and Wound Clinic, Department of Medicine, Hamad Medical Co, Doha, Qatar
| | - Talal K. Talal
- Diabetic Foot and Wound Clinic, Department of Medicine, Hamad Medical Co, Doha, Qatar
| | - David G. Armstrong
- Southern Arizona Limb Salvage Alliance (SALSA), College of Medicine, University of Arizona, Tucson, AZ, USA
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Saguie BO, Romana-Souza B, Martins RL, Monte-Alto-Costa A. Exercise prior to, but not concomitant with, stress reverses stress-induced delayed skin wound healing. Wound Repair Regen 2017. [PMID: 28628259 DOI: 10.1111/wrr.12556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Stress-induced prolonged inflammation impairs cutaneous wound healing. Exercise may inhibit this effect via an anti-inflammatory mechanism. Our aim was to investigate the effect of moderate exercise on skin wound healing in chronically stressed mice. Mice were trained five times per week on a treadmill or received no training. Mice underwent daily rotational stress from the 6th week until euthanasia. During the 8th week, two wounds were created in the dorsum and collected 10 days later. A control group only received wounds. Exercise was performed prior to and simultaneous with stress for 2 weeks or only prior to stress. Stress increased normetanephrine levels 10 days after wounding, resulting in an increased amount of inflammatory cells and reduced expression of inflammatory cytokines as well as angiogenesis, myofibroblast differentiation and matrix deposition. Concomitant exercise and stress potentiated these effects, intensifying the delayed wound contraction. When exercise was performed only prior to stress, however, the mice showed reduced inflammatory cells in granulation tissue 10 days after wounding and improved wound healing compared with animals with exercise and concomitant stress. Moderate exercise in association with stress potentiates the stress effect; however, when exercise was performed prior to stress, wound healing was improved.
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Affiliation(s)
- Bianca O Saguie
- Department of Histology and Embryology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruna Romana-Souza
- Department of Histology and Embryology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rayssa L Martins
- Department of Histology and Embryology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andréa Monte-Alto-Costa
- Department of Histology and Embryology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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