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Huntingford J, Looney A, Johnson J, Miller L. The use of platelet rich plasma in the treatment of degenerative joint disease in cats: an exploratory case series. Front Vet Sci 2024; 11:1394055. [PMID: 38863451 PMCID: PMC11165359 DOI: 10.3389/fvets.2024.1394055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/26/2024] [Indexed: 06/13/2024] Open
Abstract
Objective To evaluate the effectiveness of intra-articular autologous Platelet Rich Plasma (PRP) in managing Degenerative Joint Disease (DJD) in cats. Design Prospective pilot clinical trial. Methods Six domestic cats with clinically and radiographically diagnosed DJD received intra-articular injections of autologous PRP. Clinical assessments pre and post intra-articular injections were conducted using the Feline Musculoskeletal Pain Index (FMPI, owner assessed) and Visual Analog Scale (VAS, clinician assessed) at baseline, Day 14, Day 28, and Day 42-45. Results Significant improvements were noted in both FMPI and VAS scores at the end of the study period, indicating enhanced joint function and reduced pain. Conclusion and clinical relevance The study suggests the potential of PRP therapy as a safe and effective treatment for feline DJD, warranting further research with larger cohorts and longer follow-up to establish comprehensive treatment guidelines.
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Affiliation(s)
| | - Andrea Looney
- Central Hospital for Veterinary Medicine, North Haven, CT, United States
| | - James Johnson
- Companion Animal Health, New Castle, DE, United States
| | - Lisa Miller
- Companion Animal Health, New Castle, DE, United States
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Chen N, Li M, Yang J, Wang P, Song G, Wang H. Slow-sculpting graphene oxide/alginate gel loaded with platelet-rich plasma to promote wound healing in rats. Front Bioeng Biotechnol 2024; 12:1334087. [PMID: 38390356 PMCID: PMC10882075 DOI: 10.3389/fbioe.2024.1334087] [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: 11/06/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
Wounds, especially chronic wounds, have become an important problem that endangers human health. At present, there are many repair methods, and among them combines materials science and biology is one of the important repair methods. This study explored the preparation method, physicochemical properties, biological activity and safety of Platelet-Rich plasma (PRP)-loaded slow-sculpting graphene oxide (GO)/alginate gel, and applied it to acute full-thickness skin defect wounds in rats to observe its role in wound healing. The results show that the slow-sculpting GO/alginate gel has excellent plasticity and is suitable for a variety of irregularly shaped wounds. At the same time, its porous structure and water content can maintain the activity of platelets and their released growth factors in PRP, thereby promoting wound collagen synthesis and angiogenesis to accelerate wound healing. This indicates that the slow-sculpting GO/alginate gel is an excellent loading material for PRP, and the combination of the two may become one of the methods to promote wound repair.
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Affiliation(s)
- Ningjie Chen
- Shandong University, Jinan, Shandong, China
- Department of Burns and Plastic Surgery, Weihai Municipal Hospital, Weihai, China
| | - Mengjie Li
- Binzhou Medical University, Binzhou, Shandong, China
| | - Jincun Yang
- Department of Burns and Plastic Surgery, Weihai Municipal Hospital, Weihai, China
| | - Peng Wang
- Ministry of Scientific and Technological Innovation, Yantai Hi-tech Industrial Development Zone, Yantai, Shandong, China
| | - Guodong Song
- Shandong University, Jinan, Shandong, China
- Department of Burns and Orthopedic Surgery, Jinan Central Hospital, Jinan, Shandong, China
| | - Haitao Wang
- Department of Burns and Plastic Surgery, Weihai Municipal Hospital, Weihai, China
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Dai H, Zhang H, Qiu Z, Shi Q. Periosteum-derived skeletal stem cells encapsulated in platelet-rich plasma enhance the repair of bone defect. Tissue Cell 2023; 83:102144. [PMID: 37354707 DOI: 10.1016/j.tice.2023.102144] [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: 03/27/2023] [Revised: 06/09/2023] [Accepted: 06/14/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Spontaneous restoration of large bone defects remains a challenge under infections, tumors, and crushing conditions. Current stem cell-based therapies for treating bone defects need improvement, because the used stem cells are isolated by a traditional protocol, which is based on their properties of in-vitro plastic adherence and fibroblastic colony formation. The stem cells isolated by the traditional protocol belong to a multicellular type mixture, individual cells vary in proliferative and osteogenic potential. Thus, developing a protocol capable of isolating stem cell subset with higher purity is required and urgent. AIM This study aimed to sort a subpopulation of stem cells from periosteum using flow cytometry (named as FC-PSCs), and evaluate the proliferative and osteogenic capacity of FC-PSCs in-vitro, and then establish a new stem cell-based therapies for treating bone defects by delivering the FC-PSCs within platelet-rich plasma (PRP). METHODS Mouse periosteum was used to sort FC-PSCs using flow cytometry with CD45-TER119-TIE2-ITGAV+CD90 + 6C3-CD105- markers, or isolate periosteum-derived stem cells with the traditional protocol (TP-PSCs) as control. After evaluating the FC-PSCs proliferation and osteogenic differentiation in-vitro as well as the promotive efficacy of platelet-rich plasma (PRP) on FC-PSCs proliferation and osteogenic differentiation, the FC-PSCs were delivered into the femoral epiphysis bone defect site of a mouse model by platelet-rich plasma (PRP). At postoperative 14 or 28 days, these mice were euthanized for harvest the femur specimens for micro-CT, histological evaluation. RESULTS In-vitro results determined that the FC-PSCs showed more capacity for proliferation and osteogenic differentiation compared with the TP-PSCs. In addition, in-vitro results showed the promotive efficacy of PRP on FC-PSCs proliferation and osteogenic differentiation. In-vivo results showed that the FC-PSCs delivered by PRP was able to facilitate the repair of bone defects by stimulating new bone formation and remodeling. CONCLUSION FC-PSCs delivered by PRP enhance the repair of bone defects by stimulating new bone formation and remodeling.
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Affiliation(s)
- Haibo Dai
- Department of Orthopedics (Second ward), Xiangtan Central Hospital, Xiangtan 411199, China; Xiangtan Clinical College, Xiangya Medical School, Central South University, Xiangtan 411199, China
| | - Haici Zhang
- Department of Orthopedics (Second ward), Xiangtan Central Hospital, Xiangtan 411199, China; Xiangtan Clinical College, Xiangya Medical School, Central South University, Xiangtan 411199, China
| | - Zhilong Qiu
- Department of Orthopedics (Second ward), Xiangtan Central Hospital, Xiangtan 411199, China; Xiangtan Clinical College, Xiangya Medical School, Central South University, Xiangtan 411199, China
| | - Qiang Shi
- Department of Spine Surgery, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha 410018, China; Clinical College of Changsha Central Hospital, Xiangya Medical College, Central South University, Changsha 410018, China; Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.
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Song Y, Li P, Xu Y, Lin Z, Deng Z, Chen C. Menstrual Blood-Derived Mesenchymal Stem Cells Encapsulated in Autologous Platelet-Rich Gel Facilitate Rotator Cuff Healing in a Rabbit Model of Chronic Tears. Am J Sports Med 2023:3635465231168104. [PMID: 37184028 DOI: 10.1177/03635465231168104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Successful management of chronic rotator cuff (RC) tears remains a challenge owing to its limited intrinsic healing capacity and unsatisfactory failure rate. Menstrual blood-derived mesenchymal stem cells (MenSCs) have the potential to differentiate into the chondrogenic or osteogenic lineage. Autologous platelet-rich gel (APG), a gel material derived from platelet-rich plasma (PRP), can be applied as a carrier system for cell delivery and also as a releasing system for endogenous growth factors. PURPOSE To investigate the effect of human MenSCs encapsulated in APG (MenSCs@APG) on the healing of chronic RC tears in a rabbit model. STUDY DESIGN Controlled laboratory study. METHODS After evaluation of the effect of PRP on MenSC proliferation or differentiation, the stem cells were encapsulated in APG for in vivo injection. Supraspinatus tenotomy from the right greater tuberosity was performed on 45 New Zealand White rabbits. After 6 weeks, these rabbits were randomly allocated to 3 supplemental treatments during supraspinatus repair: saline injection (control [CTL] group), APG injection (APG group), and MenSCs@APG injection (MenSCs@APG group). At week 18, these rabbits were sacrificed to harvest the humerus-supraspinatus tendon complexes for micro-computed tomography (CT), histological evaluation, tensile test, and MenSC tracking. RESULTS In vitro results showed that APG can stimulate MenSC proliferation and enhance chondrogenic or osteogenic differentiation. In vivo results showed that APG can act as a carrier for delivering MenSCs into the healing site, and also as a stimulator for enhancing the in vivo performance of MenSCs. Micro-CT showed that bone volume/total volume and trabecular thickness of the new bone in the MenSCs@APG group presented significantly larger values than those of the APG or CTL group (P < .05 for all). Histologically, compared with the CTL or APG group, significantly more mature fibrocartilage regenerated at the healing site in the MenSCs@APG group. A large number of human nuclei-stained cells were observed in the MenSCs@APG group, presenting a similar appearance to fibrochondrocytes or osteocytes. Biomechanically, the MenSCs@APG group showed significantly higher failure load and stiffness than the APG or CTL group (P < .05 for all). CONCLUSION Human MenSCs@APG facilitated RC healing in a rabbit model of chronic tears. CLINICAL RELEVANCE Autogenous MenSCs@APG may be a new stem cell-based therapy for augmenting RC healing in the clinic.
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Affiliation(s)
- Ya Song
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ping Li
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Obstetrics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yan Xu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Zhangyuan Lin
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhenhan Deng
- Department of Sports Medicine, First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen University, Shenzhen, China
| | - Can Chen
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Department of Sports Medicine, First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen University, Shenzhen, China
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Fernandez-Medina T, Vaquette C, Gomez-Cerezo MN, Ivanovski S. Characterization of the Protein Corona of Three Chairside Hemoderivatives on Melt Electrowritten Polycaprolactone Scaffolds. Int J Mol Sci 2023; 24:ijms24076162. [PMID: 37047135 PMCID: PMC10094244 DOI: 10.3390/ijms24076162] [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: 02/10/2023] [Revised: 03/10/2023] [Accepted: 03/19/2023] [Indexed: 04/14/2023] Open
Abstract
In tissue engineering, the relationship between a biomaterial surface and the host's immune response during wound healing is crucial for tissue regeneration. Despite hemoderivative functionalization of biomaterials becoming a common tissue-engineering strategy for enhanced regeneration, the characteristics of the protein-biomaterial interface have not been fully elucidated. This study characterized the interface formed by the adsorbed proteins from various hemoderivatives with pristine and calcium phosphate (CaP)-coated polycaprolactone (PCL) melt electrowritten scaffolds. PCL scaffolds were fabricated by using melt electrospinning writing (MEW). Three hemoderivatives (pure platelet-rich plasma (P-PRP), leucocyte platelet-rich plasma (L-PRP) and injectable platelet-rich fibrin (i-PRF)) and total blood PLASMA (control) were prepared from ovine blood. Hemoderivatives were characterized via SEM/EDX, cross-linking assay, weight loss, pH and protein quantification. The interface between PCL/CaP and hemoderivative was examined via FTIR, XPS and electrophoresis. i-PRF/PCL-CaP (1653 cm-1), PLASMA/PCL-CaP (1652 cm-1) and i-PRF/PCL (1651 cm-1) demonstrated a strong signal at the Amide I region. PLASMA and i-PRF presented similar N1s spectra, with most of the nitrogen involved in N-C=O bonds (≈400 eV). i-PRF resulted in higher adsorption of low molecular weight (LMW) proteins at 60 min, while PLASMA exhibited the lowest adsorption. L-PRP and P-PRP had a similar pattern of protein adsorption. The characteristics of biomaterial interfaces can be customized, thus creating a specific hemoderivative-defined layer on the PCL surface. i-PRF demonstrated a predominant adsorption of LMW proteins. Further investigation of hemoderivative functionalized biomaterials is required to identify the differential protein corona composition, and the resultant immune response and regenerative capacity.
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Affiliation(s)
- T Fernandez-Medina
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
- College of Medicine and Dentistry, James Cook University, Cairns Campus, Cairns 4870, Australia
| | - C Vaquette
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
| | - M N Gomez-Cerezo
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
- Departamento de Química en Ciencias Farmacéuticas, Facultad de Farmacia, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre i+12, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
| | - S Ivanovski
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
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Emerging Delivery Strategies of Platelet-Rich Plasma with Hydrogels for Wound Healing. ADVANCES IN POLYMER TECHNOLOGY 2022. [DOI: 10.1155/2022/5446291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Platelet-rich plasma (PRP), a platelet-rich plasma concentrate obtained from whole blood, has been widely used to treat wounds due to its high contents of growth factors that can not only play a role in the hemostasis, repair, and anti-infection of wounds but also promote cell proliferation, maturation, and angiogenesis. However, after PRP activation, its clinical effect was limited because of burst and uncontrolled release of growth factors and poor mechanical properties of PRP gels. In recent years, increasing attention has been moved to the loading and sustained release of growth factors in PRP by polymeric carriers. Hydrogels, as an interesting carrier, enable controlled delivery of growth factors by structural designs. Moreover, using hydrogels to encapsulate PRP is favorable to controlling the mechanical properties and water maintenance of PRP gels, which can provide a stable and moist wound repair environment to promote coordinated operations of skin tissue cells and cytokines as well as wound healing. In this review, the state of the art of hydrogels that have been used to load PRP for wound treatments is introduced, and further prospects in the research area are proposed.
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Preparation and Characterization of Plasma-Derived Fibrin Hydrogels Modified by Alginate di-Aldehyde. Int J Mol Sci 2022; 23:ijms23084296. [PMID: 35457113 PMCID: PMC9029004 DOI: 10.3390/ijms23084296] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 12/04/2022] Open
Abstract
Fibrin hydrogels are one of the most popular scaffolds used in tissue engineering due to their excellent biological properties. Special attention should be paid to the use of human plasma-derived fibrin hydrogels as a 3D scaffold in the production of autologous skin grafts, skeletal muscle regeneration and bone tissue repair. However, mechanical weakness and rapid degradation, which causes plasma-derived fibrin matrices to shrink significantly, prompted us to improve their stability. In our study, plasma-derived fibrin was chemically bonded to oxidized alginate (alginate di-aldehyde, ADA) at 10%, 20%, 50% and 80% oxidation, by Schiff base formation, to produce natural hydrogels for tissue engineering applications. First, gelling time studies showed that the degree of ADA oxidation inhibits fibrin polymerization, which we associate with fiber increment and decreased fiber density; moreover, the storage modulus increased when increasing the final volume of CaCl2 (1% w/v) from 80 µL to 200 µL per milliliter of hydrogel. The contraction was similar in matrices with and without human primary fibroblasts (hFBs). In addition, proliferation studies with encapsulated hFBs showed an increment in cell viability in hydrogels with ADA at 10% oxidation at days 1 and 3 with 80 µL of CaCl2; by increasing this compound (CaCl2), the proliferation does not significantly increase until day 7. In the presence of 10% alginate oxidation, the proliferation results are similar to the control, in contrast to the sample with 20% oxidation whose proliferation decreases. Finally, the viability studies showed that the hFB morphology was maintained regardless of the degree of oxidation used; however, the quantity of CaCl2 influences the spread of the hFBs.
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Jeyaraman M, Shivaraj B, Bingi SK, Ranjan R, Muthu S, Khanna M. Does vehicle-based delivery of mesenchymal stromal cells give superior results in knee osteoarthritis? Meta-analysis of randomized controlled trials. J Clin Orthop Trauma 2022; 25:101772. [PMID: 35127439 PMCID: PMC8803619 DOI: 10.1016/j.jcot.2022.101772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 02/08/2023] Open
Abstract
STUDY DESIGN Meta-analysis. OBJECTIVES We aim to analyze and compare the efficacy and safety of vehicle-based delivery of Mesenchymal Stromal Cells (MSCs) in the management of osteoarthritis of the knee from Randomized Controlled Trials (RCTs) available in the literature. MATERIALS AND METHODS We conducted independent and duplicate electronic database searches including PubMed, Embase, Web of Science, and Cochrane Library till August 2021 for RCTs analyzing the efficacy and safety of vehicle-based delivery of MSCs in the management of knee osteoarthritis. Visual Analog Score (VAS) for Pain, Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score, and adverse events were the outcomes analyzed. Analysis was performed in R-platform using OpenMeta [Analyst] software. RESULTS 21 studies involving 936 patients were included for analysis. None of the studies made a direct comparison of the direct and vehicle-based delivery of MSCs, hence we pooled the results of all the included studies of both groups and made a comparative analysis of their outcomes. Although at 6 months, both direct and vehicle-based delivery of MSCs showed significantly better VAS improvement (p = 0.002, p = 0.010), it was not consistent at 1 year for the vehicle delivery (p = 0.973). During 6 months and 12 months, direct delivery of MSCs (p < 0.001, p < 0.001) outperformed vehicle delivery (p = 0.969, p = 0.922) compared to their control based on WOMAC scores respectively. Both direct (p = 0.713) and vehicle-based delivery (p = 0.123) of MSCs did not produce significant adverse events compared to their controls. CONCLUSION Our analysis of literature showed that current clinically employed methods of vehicle-based delivery of MSCs such as platelet-rich plasma, hyaluronic acid did not demonstrate superior results compared to direct delivery, concerning the efficacy of treatment measured by improvement in pain, functional outcomes, and safety. Hence, we urge future clinical trials to be conducted to validate the effectiveness of advanced delivery vehicles such as composite bioscaffolds to establish their practical utility in cartilage regeneration with respect to its encouraging in-vitro evidence.
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Affiliation(s)
- Madhan Jeyaraman
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh, India
- Indian Stem Cell Study Group (ISCSG) Association, Lucknow, Uttar Pradesh, India
| | - B Shivaraj
- Indian Stem Cell Study Group (ISCSG) Association, Lucknow, Uttar Pradesh, India
- Dr. RML National Law University, Lucknow, Uttar Pradesh, India
| | - Shiva Kumar Bingi
- Indian Stem Cell Study Group (ISCSG) Association, Lucknow, Uttar Pradesh, India
- Dr. RML National Law University, Lucknow, Uttar Pradesh, India
| | - Rajni Ranjan
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Sathish Muthu
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh, India
- Indian Stem Cell Study Group (ISCSG) Association, Lucknow, Uttar Pradesh, India
- Department of Orthopaedics, Government Medical College and Hospital, Dindigul, Tamil Nadu, India
| | - Manish Khanna
- Indian Stem Cell Study Group (ISCSG) Association, Lucknow, Uttar Pradesh, India
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Laschke MW, Menger MD. The simpler, the better: tissue vascularization using the body's own resources. Trends Biotechnol 2021; 40:281-290. [PMID: 34404555 DOI: 10.1016/j.tibtech.2021.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/23/2021] [Accepted: 07/23/2021] [Indexed: 12/24/2022]
Abstract
Tissue regeneration is crucially dependent on sufficient vascularization. In regenerative medicine, this can be effectively achieved by autologous vascularization strategies using the body's own resources. These strategies include the administration of blood-derived factor preparations, adipose tissue-based vascularization, and the in situ engineering of vascularized tissue. Due to their simplicity, the translation of these strategies into clinical practice is easier in terms of feasibility, safety requirements, and regulatory hurdles compared with complex and time-consuming procedures involving intensive cell manipulation. Hence, they are close to clinical application or are already being used to successfully treat patients by distinct personalized medicine concepts.
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Affiliation(s)
- Matthias W Laschke
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany.
| | - Michael D Menger
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
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Montero A, Quílez C, Valencia L, Girón P, Jorcano JL, Velasco D. Effect of Fibrin Concentration on the In Vitro Production of Dermo-Epidermal Equivalents. Int J Mol Sci 2021; 22:ijms22136746. [PMID: 34201667 PMCID: PMC8269027 DOI: 10.3390/ijms22136746] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/10/2021] [Accepted: 06/17/2021] [Indexed: 01/18/2023] Open
Abstract
Human plasma-derived bilayered skin substitutes were successfully used by our group to produce human-based in vitro skin models for toxicity, cosmetic, and pharmaceutical testing. However, mechanical weakness, which causes the plasma-derived fibrin matrices to contract significantly, led us to attempt to improve their stability. In this work, we studied whether an increase in fibrin concentration from 1.2 to 2.4 mg/mL (which is the useful fibrinogen concentration range that can be obtained from plasma) improves the matrix and, hence, the performance of the in vitro skin cultures. The results show that this increase in fibrin concentration indeed affected the mechanical properties by doubling the elastic moduli and the maximum load. A structural analysis indicated a decreased porosity for the 2.4 mg/mL hydrogels, which can help explain this mechanical behavior. The contraction was clearly reduced for the 2.4 mg/mL matrices, which also allowed for the growth and proliferation of primary fibroblasts and keratinocytes, although at a somewhat reduced rate compared to the 1.2 mg/mL gels. Finally, both concentrations of fibrin gave rise to organotypic skin cultures with a fully differentiated epidermis, although their lifespans were longer (25–35%) in cultures with more concentrated matrices, which improves their usefulness. These systems will allow the generation of much better in vitro skin models for the testing of drugs, cosmetics and chemicals, or even to “personalized” skin for the diagnosis or determination of the most effective treatment possible.
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Affiliation(s)
- Andrés Montero
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), 28903 Madrid, Spain; (A.M.); (C.Q.); (L.V.); (P.G.)
| | - Cristina Quílez
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), 28903 Madrid, Spain; (A.M.); (C.Q.); (L.V.); (P.G.)
| | - Leticia Valencia
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), 28903 Madrid, Spain; (A.M.); (C.Q.); (L.V.); (P.G.)
| | - Paula Girón
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), 28903 Madrid, Spain; (A.M.); (C.Q.); (L.V.); (P.G.)
| | - José Luis Jorcano
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), 28903 Madrid, Spain; (A.M.); (C.Q.); (L.V.); (P.G.)
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
- Correspondence: (J.L.J.); (D.V.)
| | - Diego Velasco
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), 28903 Madrid, Spain; (A.M.); (C.Q.); (L.V.); (P.G.)
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
- Correspondence: (J.L.J.); (D.V.)
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11
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Fang J, Wang X, Jiang W, Zhu Y, Hu Y, Zhao Y, Song X, Zhao J, Zhang W, Peng J, Wang Y. Platelet-Rich Plasma Therapy in the Treatment of Diseases Associated with Orthopedic Injuries. TISSUE ENGINEERING PART B-REVIEWS 2020; 26:571-585. [PMID: 32380937 DOI: 10.1089/ten.teb.2019.0292] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Platelet-rich plasma (PRP) is an autologous platelet concentrate prepared from the whole blood that is activated to release growth factors (GFs) and cytokines and has been shown to have the potential capacity to reduce inflammation and improve tissue anabolism for regeneration. The use of PRP provides a potential for repair due to its abundant GFs and cytokines, which are key in initiating and modulating regenerative microenvironments for soft and hard tissues. Among outpatients, orthopedic injuries are common and include bone defects, ligament injury, enthesopathy, musculoskeletal injury, peripheral nerve injury, chronic nonhealing wounds, articular cartilage lesions, and osteoarthritis, which are caused by trauma, sport-related or other types of trauma, or tumor resection. Surgical intervention is often required to treat these injuries. However, for numerous reasons regarding limited regeneration capacity and insufficient blood supply of the defect region, these treatments commonly result in unsatisfactory outcomes, and follow-up treatment is challenging. The aim of the present review is to explore future research in the field of PRP therapy in the treatment of diseases associated with orthopedic injuries. Impact statement In recent years, platelet-rich plasma (PRP) has become widely used in the treatment of diseases associated with orthopedic injuries, and the results of numerous studies are encouraging. Due to diseases associated with orthopedic injuries being common in clinics, as a conservative treatment, more and more doctors and patients are more likely to accept PRP. Importantly, PRP is a biological product of autologous blood that is obtained by a centrifugation procedure to enrich platelets from whole blood, resulting in few complications, such as negligible immunogenicity from an autologous source, and it is also simple to produce through an efficient and cost-effective method in a sterile environment. However, the applicability, advantages, and disadvantages of PRP therapy have not yet been fully elucidated. The aim of the present review is to explore future research in the field of PRP therapy in the treatment of diseases associated with orthopedic injuries, as well as to provide references for clinics.
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Affiliation(s)
- Jie Fang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China.,Graduate School of The North China University of Science and Technology, Hebei, P.R. China.,Department of Hand and Foot Surgery, Tianjin Union Medical Center, Tianjin, P.R. China
| | - Xin Wang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Wen Jiang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Yaqiong Zhu
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Yongqiang Hu
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Yanxu Zhao
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Xueli Song
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Jinjuan Zhao
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Wenlong Zhang
- Department of Hand and Foot Surgery, Tianjin Union Medical Center, Tianjin, P.R. China
| | - Jiang Peng
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China.,Co-innovation Center of Neuroregeneration Nantong University, Nantong, Jiangsu Province, P.R. China
| | - Yu Wang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China.,Co-innovation Center of Neuroregeneration Nantong University, Nantong, Jiangsu Province, P.R. China
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12
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Kou L, Jiang X, Xiao S, Zhao YZ, Yao Q, Chen R. Therapeutic options and drug delivery strategies for the prevention of intrauterine adhesions. J Control Release 2019; 318:25-37. [PMID: 31830539 DOI: 10.1016/j.jconrel.2019.12.007] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 12/15/2022]
Abstract
Intrauterine adhesions (IUAs) are bands of fibrous tissue that form in the endometrial cavity and associated with the increased risk of abnormal menstruation, recurrent pregnancy loss, secondary infertility, and pregnancy complications. Physical barriers, including intrauterine device and hydrogel, were clinical available to prevent the post-operational IUAs. But physically separation of the injured endometrium relies on the own limited healing power and often ends with recurrence. In recent years, the mechanisms driving IUAs treatment has validated the application of hormones, and further stem cell therapy has also led to the development of novel therapeutic agents with promising efficacy in pre-clinical and initial clinical studies. Still, it is challenging to delivery the therpaeutic factors to the injured uterus. Herein, in this review, we discuss the traditional intervention methods for the prevention of IUAs, as well as novel therapeutics and delivery strategies that will most likely change the treatment paradigms for better clinical outcomes. The combination strategy that using physical barriers as the delivery carriers for therapeutics might provide new alternatives for the prevention of IUAs.
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Affiliation(s)
- Longfa Kou
- Department of Pharmacy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Xue Jiang
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Shuyi Xiao
- Department of Pharmacy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Ying-Zheng Zhao
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Qing Yao
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou 325035, China.
| | - Ruijie Chen
- Department of Pharmacy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.
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13
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Özmert E, Arslan U. Management of Deep Retinal Capillary Ischemia by Electromagnetic Stimulation and Platelet-Rich Plasma: Preliminary Clinical Results. Adv Ther 2019; 36:2273-2286. [PMID: 31385285 DOI: 10.1007/s12325-019-01040-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Indexed: 12/22/2022]
Abstract
INTRODUCTION To investigate the efficacy of retinal electromagnetic stimulation and sub-tenon autologous platelet-rich plasma in the treatment of deep retinal capillary ischemia. METHODS The study included 28 eyes of 17 patients aged 15-76 years (mean 37.9 years) who had deep retinal capillary ischemia. Patients who had acute-onset paracentral scotoma in the last 1 month were included in the study between January 2018 and January 2019. The diagnosis of deep retinal capillary ischemia was based on clinical history and typical findings of optical coherence tomography angiography. The eyes were divided into three groups: group 1 (n = 7 eyes) received electromagnetic stimulation alone; group 2 (n = 7 eyes) received electromagnetic stimulation and sub-tenon autologous platelet-rich plasma injection; group 3 had no intervention and served as a control group (n = 14 eyes). The patients underwent ten sessions of electromagnetic stimulation in groups 1 and 2. Sub-tenon autologous platelet-rich plasma injection was performed immediately after the first, fifth, and tenth sessions of electromagnetic stimulation in group 2. The deep retinal capillary density and best corrected visual acuity changes were investigated before and after treatment at the first month. RESULTS The mean deep retinal capillary density was 52.0% before electromagnetic stimulation and 56.1% after ten sessions of application in group 1; this improvement was statistically significant (p = 0.01). In the combined treatment group (group 2), the mean deep retinal capillary density was 46.9% before the treatment and 56.5% after the treatment; this increase was also statistically significant (p = 0.01). Statistically significant best corrected visual acuity improvement (p = 0.01) could be achieved only in group 2. The combined treatment was significantly superior (p < 0.01) to treatment with only electromagnetic stimulation regarding best corrected visual acuity and deep retinal capillary density. In the control group (group 3), there was no statistically significant change (p = 0.09) in the mean deep retinal capillary density and best corrected visual acuity. CONCLUSION Treatment of the underlying cause is a priority in the treatment of deep retinal capillary ischemia. However, in the acute period, local ischemia treatment is necessary to prevent permanent retinal damage and scotomas. In mild cases, only electromagnetic stimulation, which is non-invasive and easy to use, might have a beneficial effect on deep retinal capillary density. In more severe cases, sub-tenon fresh autologous platelet-rich plasma injection together with electromagnetic stimulation may be more effective in the treatment of local ischemia of the retina in order to augment the response. FUNDING The Rapid Service Fees were funded by the Ankara University Tecnopolis Institute. CLINICAL TRIAL REGISTRATION titck.gov.tr identifier, 2018-136.
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Affiliation(s)
- Emin Özmert
- Department of Ophthalmology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Umut Arslan
- Ankara University Technopolis, Ankara, Turkey.
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14
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Herrmann M, Stanić B, Hildebrand M, Alini M, Verrier S. In vitro simulation of the early proinflammatory phase in fracture healing reveals strong immunomodulatory effects of CD146-positive mesenchymal stromal cells. J Tissue Eng Regen Med 2019; 13:1466-1481. [PMID: 31132812 DOI: 10.1002/term.2902] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 03/27/2019] [Accepted: 04/29/2019] [Indexed: 01/06/2023]
Abstract
The impact of microenvironmental cues and changes due to injury on the phenotype and fate of mesenchymal stromal cells (MSCs) is poorly understood. Here, we aimed to simulate the microenvironment associated with the early stage of bone healing in vitro and to study the regenerative response of MSCs. We enriched CD146+ MSCs from the human bone marrow. Different physiological and pathological microenvironments were simulated by using conditioned medium (CM) from human endothelial cells and osteoblasts (healthy bone), femoral head-derived bone fragments (injured bone), and activated platelets (platelet-rich plasma [PRP], injury). Cells were incubated in CM and analyzed with respect to proliferation, gene expression, migration, osteogenic differentiation, and their effect on polyclonally induced proliferation of peripheral blood mononuclear cells. CD146+ MSCs showed a specific response to different microenvironments. Cell proliferation was observed in all media with the highest values in PRP-CM and injured bone-CM. Gene expression analysis revealed the upregulation of chemokines, proinflammatory, proangiogenic, and genes involved in immunomodulation in cells stimulated with PRP- and injured bone-CM, suggesting strong paracrine activity. PRP-CM led to pronounced inhibition of lymphocyte proliferation by CD146+MSCs. Our results indicate that a microenvironment simulating bone injury elicits strong immunomodulatory and proangiogenic activity of CD146+ MSCs. This suggests that in the early stage of bone healing, the prime function of MSCs and their CD146+ subpopulation is in regulating the immune response and inducing neovascularization. Future studies will investigate the key components in CM driving this function, which might be potential targets to therapeutically stimulate the regenerative potential of MSCs.
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Affiliation(s)
- Marietta Herrmann
- AO Research Institute Davos, Davos Platz, Switzerland.,IZKF Research Group Tissue Regeneration in Musculoskeletal Diseases, University Clinics Würzburg and Orthopedic Center for Musculoskeletal Research, University of Würzburg, Germany
| | | | | | - Mauro Alini
- AO Research Institute Davos, Davos Platz, Switzerland
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15
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Platelet Lysate Inhibits NF-κB Activation and Induces Proliferation and an Alert State in Quiescent Human Umbilical Vein Endothelial Cells Retaining Their Differentiation Capability. Cells 2019; 8:cells8040331. [PMID: 30970613 PMCID: PMC6523925 DOI: 10.3390/cells8040331] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 12/24/2022] Open
Abstract
Injured blood vessel repair and blood circulation re-establishment are crucial events for tissue repair. We investigated in primary cultures of human umbilical vein endothelial cells (HUVEC), the effects of platelet lysate (PL), a cocktail of factors released by activated platelets following blood vessel disruption and involved in the wound-healing process triggering. PL exerted a protective effect on HUVEC in an inflammatory milieu by inhibiting IL-1α-activated NF-κB pathway and by inducing the secretion of PGE2, a pro-resolving molecule in the wound microenvironment. Moreover, PL enhanced HUVEC proliferation, without affecting their capability of forming tube-like structures on matrigel, and activated resting quiescent cells to re-enter cell cycle. In agreement with these findings, proliferation-related pathways Akt and ERK1/2 were activated. The expression of the cell-cycle activator Cyclin D1 was also enhanced, as well as the expression of the High Mobility Group Box-1 (HMGB1), a protein of the alarmin group involved in tissue homeostasis, repair, and remodeling. These in vitro data suggest a possible in vivo contribution of PL to new vessel formation after a wound by activation of cells resident in vessel walls. Our biochemical study provides a rationale for the clinical use of PL in the treatment of wound healing-related pathologies.
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16
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Platelet-rich plasma improves therapeutic effects of menstrual blood-derived stromal cells in rat model of intrauterine adhesion. Stem Cell Res Ther 2019; 10:61. [PMID: 30770774 PMCID: PMC6377773 DOI: 10.1186/s13287-019-1155-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/26/2018] [Accepted: 01/24/2019] [Indexed: 12/18/2022] Open
Abstract
Background Intrauterine adhesion (IUA) is a major cause of female secondary infertility. We previously demonstrated that menstrual blood-derived stromal cell (MenSC) transplantation helped severe IUA patients have pregnancy and endometrium regeneration. We also initiated platelet-rich plasma (PRP) acted as a beneficial supplement in MenSC culturing and a potential endometrial receptivity regulator. Here, we investigated the therapeutic effect of combined transplantation of MenSCs with PRP in rat IUA models and the mechanisms of MenSCs in endometrium regeneration. Methods Rat IUA models were established by intrauterine mechanical injured. Nine days later, all rats were randomly assigned to four groups received different treatment: placebo, MenSC transplantation, PRP transplantation, and MenSCs + PRP transplantation. The traces of MenSCs were tracked with GFP label. Endometrial morphology and pathology, tissue proliferation, inflammation, pregnancy outcomes, and mechanism of MenSCs in the regeneration of endometrium were investigated. Results Notably, at days 9 and 18 post-treatment, MenSC transplantation significantly improved endometrial proliferation, angiogenesis, and morphology recovery and decreased collagen fibrosis and inflammation in the uterus. MenSCs had lesion chemotaxis, colonized around the endometrial glands. Gene expression of human-derived secretory protein IGF-1, SDF-1, and TSP-1 was detected in the uterus received MenSCs at day 18. The three treatments can all improve fertility in IUA rats. Moreover, gene expressions of cell proliferation, developmental processes, and other biological processes were induced in MenSC transplantation group. Hippo signaling pathway was the most significantly changed pathway, and the downstream factors CTGF, Wnt5a, and Gdf5 were significantly regulated in treatment groups. PRP enhanced these parameters through a synergistic effect. Conclusions In summary, MenSCs could effectively improve uterine proliferation, markedly accelerate endometrial damage repairment and promote fertility restoration in IUA rats, suggesting a paracrine restorative effect and Hippo signaling pathway stimulation. Our results indicate MenSCs, a valuable source of cells for transplantation in the treatment intrauterine adhesion. Combined with PRP, this cell therapy was more effective. Electronic supplementary material The online version of this article (10.1186/s13287-019-1155-7) contains supplementary material, which is available to authorized users.
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Garate A, Sánchez P, Delgado D, Bilbao AM, Muiños-López E, Granero-Moltó F, Orive G, Prosper F, Pedraz JL, Sánchez M. Autologous bioscaffolds based on different concentrations of platelet rich plasma and synovial fluid as a vehicle for mesenchymal stem cells. J Biomed Mater Res A 2017; 106:377-385. [PMID: 28960933 DOI: 10.1002/jbm.a.36247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/08/2017] [Accepted: 09/21/2017] [Indexed: 01/08/2023]
Abstract
In the field of tissue engineering, diverse types of bioscaffolds are being developed currently for osteochondral defect applications. In this work, a novel scaffold based on platelet rich plasma (PRP) and hyaluronic acid with mesenchymal stem cells (MSCs) has been evaluated to observe its effect on immobilized cells. The bioscaffolds were prepared by mixing different volumes of synovial fluid (SF) with PRP from patients obtaining three formulations at PRP-SF ratios of 3:1, 1:1 and 1:3 (v/v). The live/dead staining revealed that although the cell number of each type of bioscaffold was different, these this constructs provide cells with a suitable environment for their viability and proliferation. Moreover, immobilized MSCs showed their ability to secrete fibrinolytic enzymes, which vary depending on the fibrin amount of the scaffold. Immunohistochemical analysis revealed the positive staining for collagen type II in all cases, proving the biologic action of SF derived MSCs together with the suitable characteristics of the bioscaffold for chondrogenic differentiation. Considering all these aspects, this study demonstrates that these cells-based constructs represent an attractive method for cell immobilization, achieving completely autologous and biocompatible scaffolds. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 377-385, 2018.
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Affiliation(s)
- Ane Garate
- Advanced Biological Therapy Unit- UTBA, Hospital Vithas San Jose, Vitoria-Gasteiz, Spain
| | - Pello Sánchez
- Advanced Biological Therapy Unit- UTBA, Hospital Vithas San Jose, Vitoria-Gasteiz, Spain.,NanoBioCel group, Laboratory of Pharmaceutics, University of the Basque Country, School of Pharmacy, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz, Spain
| | - Diego Delgado
- Advanced Biological Therapy Unit- UTBA, Hospital Vithas San Jose, Vitoria-Gasteiz, Spain
| | - Ane Miren Bilbao
- Arthroscopic Surgery Unit-UCA, Hospital Vithas San Jose, Vitoria-Gasteiz, Spain
| | - Emma Muiños-López
- Cell Therapy and Experimental Orthopedics, University of Navarra Clinic, Pamplona, Spain
| | - Froilán Granero-Moltó
- Cell Therapy and Experimental Orthopedics, University of Navarra Clinic, Pamplona, Spain
| | - Gorka Orive
- NanoBioCel group, Laboratory of Pharmaceutics, University of the Basque Country, School of Pharmacy, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz, Spain
| | - Felipe Prosper
- Cell Therapy and Experimental Orthopedics, University of Navarra Clinic, Pamplona, Spain.,Hematology and Cell Therapy department, University of Navarra Clinic, Pamplona, Spain
| | - José Luis Pedraz
- NanoBioCel group, Laboratory of Pharmaceutics, University of the Basque Country, School of Pharmacy, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz, Spain
| | - Mikel Sánchez
- Advanced Biological Therapy Unit- UTBA, Hospital Vithas San Jose, Vitoria-Gasteiz, Spain.,Arthroscopic Surgery Unit-UCA, Hospital Vithas San Jose, Vitoria-Gasteiz, Spain
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