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Lee SJ, Kang MS, Park YM, Choi HS, Lim JY. Predictive Factors Affecting the Outcomes Of angiolytic Laser-Assisted Glottoplasty for Sulcus Vocalis. J Voice 2024; 38:524-531. [PMID: 34740498 DOI: 10.1016/j.jvoice.2021.09.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Glottoplasty using an angiolytic laser is an option for the surgical treatment of sulcus vocalis. In this study, we sought to evaluate the clinical outcomes of using a 532-nm diode laser in sulcus vocalis patients and to identify predictive factors of improved voice outcomes after angiolytic laser-assisted glottoplasty. METHODS A total of 66 patients with sulcus vocalis who underwent laser-assisted glottoplasty with a 532-nm diode laser were included in this study. RESULTS 3 months after surgery, GRBAS scores, patient-reported outcome measures, fundamental frequency (F0), jitter percent, and noise-to-harmonic ratio decreased significantly, while cepstral peak prominence (CPP) of vowel and sentence production increased. Patients with auditory-perceptual improvements showed greater improvement in the Voice Handicap Index (VHI) scores, F0, and CPP of vowel and sentence production compared to those with no improvement. While young male patients with preoperatively high F0 were predicted to have favorable outcomes, the type of sulcus vocalis was not predictive of treatment outcomes. Patients treated with lower laser power showed better improvement in the VHI scores postoperatively than those who received higher laser power per vocal fold. Combined injection laryngoplasty with laser glottoplasty was effective in lowering the F0, especially in male patients with high F0. CONCLUSION A 532-nm diode laser is useful for treating sulcus vocalis. Young male patients and individuals with preoperatively high F0 showed better voice outcomes after laser glottoplasty. Laser power and combined injection laryngoplasty are considered to affect improvement in the VHI and lowering F0 after laser glottoplasty in sulcus vocalis.
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Affiliation(s)
- Seung Jin Lee
- Division of Speech Pathology and Audiology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon, Republic of Korea
| | - Min Seok Kang
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Young Min Park
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam-gu, Seoul, Republic of Korea
| | | | - Jae-Yol Lim
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam-gu, Seoul, Republic of Korea.
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Svistushkin M, Shpichka A, Bikmulina P, Fayzullin A, Zolotova A, Kosheleva N, Selezneva L, Shavkuta B, Lobacheva V, Nikiforova A, Kochetkov P, Kotova S, Starostina S, Shekhter A, Svistunov A, Svistushkin V, Timashev P. Vocal fold restoration after scarring: biocompatibility and efficacy of an MSC-based bioequivalent. Stem Cell Res Ther 2023; 14:303. [PMID: 37865795 PMCID: PMC10590531 DOI: 10.1186/s13287-023-03534-x] [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: 05/22/2023] [Accepted: 10/11/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND There is growing interest to application of regenerative medicine approaches in otorhinolaryngological practice, especially in the framework of the therapy of vocal fold (VF) scar lesions. The used conservative and surgical methods, despite the achieved positive outcomes, are frequently unpredictable and do not result in the restoration of the VF's lamina propria's structure, which provides the mechanical properties necessary for vibration. In this connection, the aim of this study was to ascertain the safety and efficacy of a bioequivalent in the treatment of VF scars using a rabbit model of chronic damage. METHODS The bioequivalent consisted of a hydrogel system based on a PEG-fibrin conjugate and human bone marrow-derived MSC. It was characterized and implanted heterotopically into rats and orthotopically into rabbits after VF scar excision. RESULTS We showed that the fabricated bioequivalent consisted of viable cells retaining their metabolic and proliferative activity. While being implanted heterotopically, it had induced the low inflammatory reaction in 7 days and was well tolerated. The orthotopic implantation showed that the gel application was characterized by a lower hemorrhage intensity (p = 0.03945). The intensity of stridor and respiratory rate between the groups in total and between separate groups had no statistically significant difference (p = 0.96 and p = 1; p = 0.9593 and p = 0.97…1, respectively). In 3 days post-implantation, MSC were detected only in the tissues closely surrounding the VF defect. The bioequivalent injection caused that the scar collagen fibers were packed looser and more frequently mutually parallel that is inherent in the native tissue (p = 0.018). In all experimental groups, the fibrous tissue's ingrowth in the adjacent exterior muscle tissue was observed; however, in Group 4 (PEG-Fibrin + MSC), it was much less pronounced than it was in Group 1 (normal saline) (p = 0.008). The difference between the thicknesses of the lamina propria in the control group and in Group 4 was not revealed to be statistically significant (p = 0.995). The Young's modulus of the VF after the bioequivalent implantation (1.15 ± 0.25 kPa) did not statistically significantly differ from the intact VF modulus (1.17 ± 0.45 kPa); therefore, the tissue properties in this group more closely resembled the intact VF. CONCLUSIONS The developed bioequivalent showed to be biocompatible and highly efficient in the restoration of VF's tissue.
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Affiliation(s)
| | - Anastasia Shpichka
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
- Chemistry Department, Lomonosov Moscow State University, Moscow, Russia
| | - Polina Bikmulina
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
| | - Alexey Fayzullin
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
| | - Anna Zolotova
- Department for ENT Diseases, Sechenov University, Moscow, Russia
| | - Nastasia Kosheleva
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
- FSBSI Institute of General Pathology and Pathophysiology, Moscow, Russia
| | - Liliya Selezneva
- Department for ENT Diseases, Sechenov University, Moscow, Russia
| | - Boris Shavkuta
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
| | | | - Anna Nikiforova
- Department for ENT Diseases, Sechenov University, Moscow, Russia
| | - Peter Kochetkov
- Department for ENT Diseases, Sechenov University, Moscow, Russia
| | - Svetlana Kotova
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
- Department of Polymers and Composites, N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, Moscow, Russia
| | | | - Anatoly Shekhter
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
| | | | | | - Peter Timashev
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia.
- Chemistry Department, Lomonosov Moscow State University, Moscow, Russia.
- World-Class Research Center "Digital Biodesign and Personalized Healthcare", Sechenov University, Moscow, Russia.
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3
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Regenerative potential of different extracellular vesicle subpopulations derived from clonal mesenchymal stem cells in a mouse model of chemotherapy-induced premature ovarian failure. Life Sci 2023; 321:121536. [PMID: 36868400 DOI: 10.1016/j.lfs.2023.121536] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/16/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023]
Abstract
AIMS Some studies have shown that mesenchymal stem cells (MSCs) and their derived extracellular vesicles (MSC-EVs) can restore ovarian function in premature ovarian failure (POF), however, concerns about their efficacy are attributed to the heterogeneity of the cell populations and EVs. Here, we assessed the therapeutic potential of a homogeneous population of clonal MSCs (cMSCs) and their EVs subpopulations in a mouse model of POF. MAIN METHODS Granulosa cells were treated with cyclophosphamide (Cy) in the absence or presence of cMSCs, or cMSCs-derived EV subpopulations (EV20K and EV110K, isolated by high-speed centrifugation and differential ultracentrifugation, respectively). In addition, POF mice were treated with cMSCs, EV20K and/or EV110K. KEY FINDINGS cMSC and both EV types protected granulosa cells from Cy-induced damage. Calcein-EVs were detected in the ovaries. Moreover, cMSC and both EV subpopulations significantly increased body weight, ovary weight, and the number of follicles, restored FSH, E2, and AMH levels, increased the granulosa cell numbers and restored the fertility of POF mice. cMSC, EV20K, and EV110K alleviated inflammatory-related genes expression (Tnf-α and IL8), and improved angiogenesis via upregulation expression of Vegf and Igf1 at the mRNA level and VEGF and αSMA at the protein level. They also inhibited apoptosis through the PI3K/AKT signaling pathway. SIGNIFICANCE The administration of cMSCs and two cMSC-EVs subpopulations improved ovarian function and restored fertility in a POF model. EV20K is more cost-effective and feasible in terms of isolation, particularly in good manufacturing practice (GMP) facilities for treatment of POF patients in comparison with conventional EVs (EV110K).
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Tran EK, Alhiyari Y, Juarez K, Gowda BS, Schrader F, Sajed DP, Long JL. A xenograft study of human adipose stromal cell-based vocal fold mucosal replacement in rabbits. Laryngoscope Investig Otolaryngol 2022; 7:1521-1531. [PMID: 36258854 PMCID: PMC9575091 DOI: 10.1002/lio2.929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/04/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives Vocal fold (VF) scarring, manifested by increased collagen, decreased glycosaminoglycans (GAGs), and disrupted elastic fibers, remains a negative consequence of VF injury or resection. The objective of this study is to compare four reconstructive options after Vf mucosal resection in rabbits. A Cell-Based Outer Vocal fold Replacement (COVR) using human adipose-derived mesenchymal stromal cells (hASCs) in fibrin scaffold is directly compared with a decellularized scaffold implant, hASC injection, and resection alone without reconstruction. The primary hypothesis is that the cells-in-scaffold construct better reconstitutes the VF structure than either cells or scaffold alone, or than healing by secondary intention. Methods A total of49 rabbits received bilateral VF cordectomy, followed by either COVR implant, decellularized scaffold implant, hASC injection, or no reconstruction (injured control group). Larynges were harvested after 6 weeks. Results Histology demonstrated greater lamina propria thickness, less collagen deposition, and more GAGs in COVR animals versus all other treatment groups. Evidence of persistent human cells was found in about half of the cell-treated animals. RNA levels of fibrosis pathway and macrophage phenotype markers were statistically unchanged among treatment groups at 6 weeks. Conclusion These data support the efficacy of COVR implantation in restoring VF microstructure in rabbits. The intact COVR was required; isolated components of decellularized scaffold or injected hASC still produced histologic scarring. We propose that the unique bilayered cell structure within fibrin enables controlled matrix remodeling to minimize wound contraction and fibrosis, and to promote GAG deposition. Level of Evidence Basic science study.
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Affiliation(s)
- Eric K. Tran
- Department of Head and Neck SurgeryDavid Geffen School of Medicine at University of California, Los AngelesLos AngelesCaliforniaUSA
| | - Yazeed Alhiyari
- Department of Head and Neck SurgeryDavid Geffen School of Medicine at University of California, Los AngelesLos AngelesCaliforniaUSA
| | - Kevin Juarez
- Department of Head and Neck SurgeryDavid Geffen School of Medicine at University of California, Los AngelesLos AngelesCaliforniaUSA
- Department of Anesthesiology and Perioperative CareUniversity of California‐San Francisco HealthSan FranciscoCaliforniaUSA
| | - Bhavani Shankara Gowda
- Department of Head and Neck SurgeryDavid Geffen School of Medicine at University of California, Los AngelesLos AngelesCaliforniaUSA
- Greater Los Angeles Veterans Affairs Healthcare SystemLos AngelesCaliforniaUSA
| | - Feng Schrader
- Department of Head and Neck SurgeryDavid Geffen School of Medicine at University of California, Los AngelesLos AngelesCaliforniaUSA
- Greater Los Angeles Veterans Affairs Healthcare SystemLos AngelesCaliforniaUSA
| | - Dipti P. Sajed
- Department of Pathology and Laboratory Medicine, Los AngelesDavid Geffen School of Medicine at University of CaliforniaLos AngelesCaliforniaUSA
| | - Jennifer L. Long
- Department of Head and Neck SurgeryDavid Geffen School of Medicine at University of California, Los AngelesLos AngelesCaliforniaUSA
- Greater Los Angeles Veterans Affairs Healthcare SystemLos AngelesCaliforniaUSA
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5
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Svistushkin MV, Kotova S, Shpichka A, Starostina S, Shekhter A, Bikmulina P, Nikiforova A, Zolotova A, Royuk V, Kochetkov PA, Timashev S, Fomin V, Vosough M, Svistushkin V, Timashev P. Stem cell therapy for vocal fold regeneration after scarring: a review of experimental approaches. Stem Cell Res Ther 2022; 13:176. [PMID: 35505357 PMCID: PMC9066721 DOI: 10.1186/s13287-022-02853-9] [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: 11/24/2021] [Accepted: 04/13/2022] [Indexed: 11/12/2022] Open
Abstract
This review aims at becoming a guide which will help to plan the experimental design and to choose adequate methods to assess the outcomes when testing cell-based products in the treatment of the damaged vocal folds. The requirements to preclinical trials of cell-based products remain rather hazy and dictated by the country regulations. Most parameters like the way the cells are administered, selection of the cell source, selection of a carrier, and design of in vivo studies are decided upon by each research team and may differ essentially between studies. The review covers the methodological aspects of preclinical studies such as experimental models, characterization of cell products, assessment of the study outcome using molecular, morphological and immunohistochemical analyses, as well as measuring the tissue physical properties. The unified recommendations to perform preclinical trials could significantly facilitate the translation of cell-based products into the clinical practice.
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Affiliation(s)
- Mikhail V Svistushkin
- Department for ENT Diseases, Sechenov University, Moscow, Russia.,World-Class Research Center "Digital Biodesign and Personalized Healthcare", Sechenov University, Moscow, Russia
| | - Svetlana Kotova
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia.,Department of Polymers and Composites, N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, Moscow, Russia
| | - Anastasia Shpichka
- World-Class Research Center "Digital Biodesign and Personalized Healthcare", Sechenov University, Moscow, Russia. .,Institute for Regenerative Medicine, Sechenov University, Moscow, Russia. .,Chemistry Department, Lomonosov Moscow State University, Moscow, Russia.
| | | | - Anatoliy Shekhter
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
| | - Polina Bikmulina
- World-Class Research Center "Digital Biodesign and Personalized Healthcare", Sechenov University, Moscow, Russia.,Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
| | - Anna Nikiforova
- Department for ENT Diseases, Sechenov University, Moscow, Russia
| | - Anna Zolotova
- Department for ENT Diseases, Sechenov University, Moscow, Russia
| | - Valery Royuk
- University Hospital No 1, Sechenov University, Moscow, Russia
| | - P A Kochetkov
- Department for ENT Diseases, Sechenov University, Moscow, Russia
| | - Serge Timashev
- National Research Nuclear University «MEPhI», Moscow, Russia
| | - Victor Fomin
- Department of Internal Medicine No 1, Sechenov University, Moscow, Russia
| | - Massoud Vosough
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
| | | | - Peter Timashev
- World-Class Research Center "Digital Biodesign and Personalized Healthcare", Sechenov University, Moscow, Russia. .,Institute for Regenerative Medicine, Sechenov University, Moscow, Russia. .,Department of Polymers and Composites, N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, Moscow, Russia. .,Chemistry Department, Lomonosov Moscow State University, Moscow, Russia.
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6
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Tchoukalova YD, Zacharias SRC, Mitchell N, Madsen C, Myers CE, Gadalla D, Skinner J, Kopaczka K, Gramignoli R, Lott DG. Human amniotic epithelial cell transplantation improves scar remodeling in a rabbit model of acute vocal fold injury: a pilot study. Stem Cell Res Ther 2022; 13:31. [PMID: 35073957 PMCID: PMC8787902 DOI: 10.1186/s13287-022-02701-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/24/2021] [Indexed: 01/22/2023] Open
Abstract
Objective To gain insight into the molecular mechanisms underlying the early stages of vocal fold extracellular matrix (ECM) remodeling after a mid-membranous injury resulting from the use of human amniotic epithelial cells (hAEC), as a novel regenerative medicine cell-based therapy. Methods Vocal folds of six female, New Zealand White rabbits were bilaterally injured. Three rabbits had immediate bilateral direct injection of 1 × 106 hAEC in 100 µl of saline solution (hAEC) and three with 100 µl of saline solution (controls, CTR). Rabbits were euthanized 6 weeks after injury. Proteomic analyses (in-gel trypsin protein digestion, LC–MS/MS, protein identification using Proteome Discoverer and the Uniprot Oryctolagus cuniculus (Rabbit) proteome) and histological analyses were performed. Results hAEC treatment significantly increased the expression of ECM proteins, elastin microfibril interface-located protein 1 (EMILIN-1) and myocilin that are primarily involved in elastogenesis of blood vessels and granulation tissue. A reactome pathway analysis showed increased activity of the anchoring fibril formation by collagen I and laminin, providing mechanical stability and activation of cell signaling pathways regulating cell function. hAEC increased the abundance of keratin 1 indicating accelerated induction of the differentiation programming of the basal epithelial cells and, thereby, improved barrier function. Lastly, upregulation of Rab GDP dissociation inhibitor indicates that hAEC activate the vesicle endocytic and exocytic pathways, supporting the exosome-mediated activation of cell–matrix and cell-to-cell interactions. Conclusions This pilot study suggests that injection of hAEC into an injured rabbit vocal fold favorably alters ECM composition creating a microenvironment that accelerates differentiation of regenerated epithelium and promotes stabilization of new blood vessels indicative of accelerated and improved repair. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-022-02701-w.
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Affiliation(s)
- Yourka D Tchoukalova
- Head and Neck Regenerative Medicine Laboratory, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Stephanie R C Zacharias
- Head and Neck Regenerative Medicine Laboratory, Mayo Clinic Arizona, Scottsdale, AZ, USA.,Division of Pediatric Otolaryngology, Phoenix Children's Hospital, Phoenix, AZ, USA.,Division of Laryngology, Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA
| | | | - Cathy Madsen
- Head and Neck Regenerative Medicine Laboratory, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Cheryl E Myers
- Head and Neck Regenerative Medicine Laboratory, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Dina Gadalla
- Head and Neck Regenerative Medicine Laboratory, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Jessica Skinner
- Langley Forensic Research Laboratory, Mayo Clinic Arizona, Scottsdale, AZ, 85259, USA
| | - Katarzyna Kopaczka
- Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Roberto Gramignoli
- Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - David G Lott
- Head and Neck Regenerative Medicine Laboratory, Mayo Clinic Arizona, Scottsdale, AZ, USA. .,Division of Laryngology, Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA.
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7
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Kaboodkhani R, Mehrabani D, Karimi-Busheri F. Achievements and Challenges in Transplantation of Mesenchymal Stem Cells in Otorhinolaryngology. J Clin Med 2021; 10:2940. [PMID: 34209041 PMCID: PMC8267672 DOI: 10.3390/jcm10132940] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 12/15/2022] Open
Abstract
Otorhinolaryngology enrolls head and neck surgery in various tissues such as ear, nose, and throat (ENT) that govern different activities such as hearing, breathing, smelling, production of vocal sounds, the balance, deglutition, facial animation, air filtration and humidification, and articulation during speech, while absence of these functions can lead to high morbidity and even mortality. Conventional therapies for head and neck damaged tissues include grafts, transplants, and artificial materials, but grafts have limited availability and cause morbidity in the donor site. To improve these limitations, regenerative medicine, as a novel and rapidly growing field, has opened a new therapeutic window in otorhinolaryngology by using cell transplantation to target the healing and replacement of injured tissues. There is a high risk of rejection and tumor formation for transplantation of embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs); mesenchymal stem cells (MSCs) lack these drawbacks. They have easy expansion and antiapoptotic properties with a wide range of healing and aesthetic functions that make them a novel candidate in otorhinolaryngology for craniofacial defects and diseases and hold immense promise for bone tissue healing; even the tissue sources and types of MSCs, the method of cell introduction and their preparation quality can influence the final outcome in the injured tissue. In this review, we demonstrated the anti-inflammatory and immunomodulatory properties of MSCs, from different sources, to be safely used for cell-based therapies in otorhinolaryngology, while their achievements and challenges have been described too.
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Affiliation(s)
- Reza Kaboodkhani
- Otorhinolaryngology Research Center, Department of Otorhinolaryngology, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71936-36981, Iran;
| | - Davood Mehrabani
- Stem Cell Technology Research Center, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz 71987-74731, Iran
- Comparative and Experimental Medicine Center, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
- Li Ka Shing Center for Health Research and Innovation, University of Alberta, Edmonton, AB T6G 2E1, Canada
| | - Feridoun Karimi-Busheri
- Department of Oncology, Faculty of Medicine, University of Alberta, Edmonton, AB T6G 1Z2, Canada
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Kolosova K, Gao Q, Tuznik M, Bouhabel S, Kost KM, Wang H, Li-Jessen NYK, Mongeau L, Wiseman PW. Characterizing Vocal Fold Injury Recovery in a Rabbit Model With Three-Dimensional Virtual Histology. Laryngoscope 2020; 131:1578-1587. [PMID: 32809236 DOI: 10.1002/lary.29028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/22/2020] [Accepted: 07/28/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES/HYPOTHESIS In animal studies of vocal fold scarring and treatment, imaging-based evaluation is most often conducted by tissue slicing and histological staining. Given variation in anatomy, injury type, severity, and sacrifice timepoints, planar histological sections provide limited spatiotemporal details of tissue repair. Three-dimensional (3D) virtual histology may provide additional contextual spatial information, enhancing objective interpretation. The study's aim was to evaluate the suitability of magnetic resonance imaging (MRI), microscale computed tomography (CT), and nonlinear laser-scanning microscopy (NM) as virtual histology approaches for rabbit studies of vocal fold scarring. METHODS A unilateral injury was created using microcup forceps in the left vocal fold of three New Zealand White rabbits. Animals were sacrificed at 3, 10, and 39 days postinjury. ex vivo imaging of excised larynges was performed with MRI, CT, and NM modalities. RESULTS The MRI modality allowed visualization of injury location and morphological internal features with 100-μm spatial resolution. The CT modality provided a view of the injury defect surface with 12-μm spatial resolution. The NM modality with optical clearing resolved second-harmonic generation signal of collagen fibers and two-photon autofluorescence in vocal fold lamina propria, muscle, and surrounding cartilage structures at submicrometer spatial scales. CONCLUSIONS Features of vocal fold injury and wound healing were observed with MRI, CT, and NM. The MRI and CT modalities provided contextual spatial information and dissection guidance, whereas NM resolved extracellular matrix structure. The results serve as a proof of concept to motivate incorporation of 3D virtual histology techniques in future vocal fold injury animal studies. LEVEL OF EVIDENCE NA Laryngoscope, 131:1578-1587, 2021.
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Affiliation(s)
- Ksenia Kolosova
- Department of Physics, McGill University, Montreal, Quebec, Canada
| | - Qiman Gao
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Marius Tuznik
- Small Animal Imaging Laboratory of the McConnell Brain Imaging Centre at the Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Sarah Bouhabel
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Karen M Kost
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Huijie Wang
- Department of Mechanical Engineering, McGill University, Montreal, Quebec, Canada
| | - Nicole Y K Li-Jessen
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada.,School of Communication Sciences and Disorders, McGill University, Montreal, Quebec, Canada
| | - Luc Mongeau
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Mechanical Engineering, McGill University, Montreal, Quebec, Canada.,Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada
| | - Paul W Wiseman
- Department of Physics, McGill University, Montreal, Quebec, Canada.,Department of Chemistry, McGill University, Montreal, Quebec, Canada
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9
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Choi JS, Heang Oh S, Kim YM, Lim JY. Hyaluronic Acid/Alginate Hydrogel Containing Hepatocyte Growth Factor and Promotion of Vocal Fold Wound Healing. Tissue Eng Regen Med 2020; 17:651-658. [PMID: 32676953 DOI: 10.1007/s13770-020-00280-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/17/2020] [Accepted: 06/07/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Hepatocyte growth factor (HGF) has been shown to facilitate vocal fold (VF) wound healing. This study was undertaken to determine whether the therapeutic efficacy of HGF could be enhanced by applying it in hyaluronic acid and alginate (HA/ALG) composite hydrogels into VFs after injury in a rabbit model. METHODS HGF was loaded into HA/ALG composite hydrogel (HGF-HA/ALG) and its in vitro release profile was evaluated. In addition, HGF-HA/ALG was injected into the VFs of rabbits immediately after direct injury and HGF or PBS was injected in the same manner into control groups. Macroscopic features were observed by endoscopy at 3 months post-injury. Functional analyses including mucosal waves of VFs and viscoelastic properties were performed by kymography following high-speed digital imaging and rheometer. Histopathological and immunohistochemical evaluations were also conducted on VFs. RESULTS HGF release from HGF-HA/ALG was sustained for up to 3 weeks. Rabbits treated with HGF-HA/ALG showed improved mucosal vibrations and VF viscoelastic properties as compared with the PBS and HGF controls. Histopathological staining revealed HGF-HA/ALG treated VFs showed less fibrosis than PBS and HGF controls, and immunohistochemical analysis demonstrated amounts of type I collagen and fibronectin were lower in HGF-HA/ALG treated animals than in PBS and HGF controls at 3 months post-injury. CONCLUSION HGF containing HA/ALG hydrogel enhanced healing in our rabbit model of VF injury.
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Affiliation(s)
- Jeong-Seok Choi
- Department of Otorhinolaryngology - Head and Neck Surgery, Inha University School of Medicine, 100 Inha-ro, Michuhol-gu, Incheon, 22212, Republic of Korea
| | - Se Heang Oh
- Department of Nanobiomedical Science, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam, 31116, Republic of Korea
| | - Young-Mo Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, Inha University School of Medicine, 100 Inha-ro, Michuhol-gu, Incheon, 22212, Republic of Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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10
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Abstract
Head and neck structures govern the vital functions of breathing and swallowing. Additionally, these structures facilitate our sense of self through vocal communication, hearing, facial animation, and physical appearance. Loss of these functions can lead to loss of life or greatly affect quality of life. Regenerative medicine is a rapidly developing field that aims to repair or replace damaged cells, tissues, and organs. Although the field is largely in its nascence, regenerative medicine holds promise for improving on conventional treatments for head and neck disorders or providing therapies where no current standard exists. This review presents milestones in the research of regenerative medicine in head and neck surgery.
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Affiliation(s)
- Michael J McPhail
- Head and Neck Regenerative Medicine Laboratory, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Jeffrey R Janus
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Florida, Jacksonville, FL, USA
| | - David G Lott
- Head and Neck Regenerative Medicine Laboratory, Mayo Clinic Arizona, Scottsdale, AZ, USA
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA
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11
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Svistushkin MV, Kotova SL, Shekhter AB, Svistushkin VM, Akovantseva AA, Frolova AA, Fayzullin AL, Starostina SV, Bezrukov EA, Sukhanov RB, Timashev SF, Butnaru DV, Timashev PS. Collagen fibrillar structures in vocal fold scarring and repair using stem cell therapy: a detailed histological, immunohistochemical and atomic force microscopy study. J Microsc 2019; 274:55-68. [PMID: 30740689 DOI: 10.1111/jmi.12784] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/15/2019] [Accepted: 01/24/2019] [Indexed: 12/11/2022]
Abstract
Regenerative medicine opens new opportunities in the repair of cicatricial lesions of the vocal folds. Here, we present a thorough morphological study, with the focus on the collagen structures in the mucosa of the vocal folds, dedicated to the effects of stem cells on the vocal folds repair after cicatricial lesions. We used a conventional experimental model of a mature scar of the rabbit vocal folds, which was surgically excised with a simultaneous implantation of autologous bone marrow-derived mesenchymal stem cells (MSC) into the defect. The restoration of the vocal folds was studied 3 months postimplantation of stem cells and 6 months after the first surgery. The collagen structure assessment included histology, immunohistochemistry and atomic force microscopy (AFM) studies. According to the data of optical microscopy and AFM, as well as to immunohistochemical analysis, MSC implantation into the vocal fold defect leads not only to the general reduction of scarring, normal ratio of collagens type I and type III, but also to a more complete restoration of architecture and ultrastructure of collagen fibres in the mucosa, as compared to the control. The collagen structures in the scar tissue in the vocal folds with implanted MSC are more similar to those in the normal mucosa of the vocal folds than to those of the untreated scars. AFM has proven to be an instrumental technique in the assessment of the ultrastructure restoration in such studies. LAY DESCRIPTION: Regenerative medicine opens new opportunities in the repair of the vocal fold scars. Because collagen is a main component in the vocal fold mucosa responsible for the scar formation and repair, we focus on the collagen structures in the mucosa of the vocal folds, using a thorough morphological study based on histology and atomic force microscopy (AFM). Atomic force microscopy is a scanning microscopic technique which allows revealing the internal structure of a tissue with a resolution up to nanometres. We used a conventional experimental model of a mature scar of the rabbit vocal folds, surgically excised and treated with a mesenchymal stem cells transplant. Our morphological study, primarily AFM, explicitly shows that the collagen structures in the scarred vocal folds almost completely restore after the stem cell treatment. Thus, the modern microscopic methods, and especially AFM are instrumental tools for monitoring the repair of the vocal folds scars.
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Affiliation(s)
| | - Svetlana L Kotova
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia.,N.N. Semenov Institute of Chemical Physics, Moscow, Russia
| | - Anatoly B Shekhter
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
| | | | - Anastasia A Akovantseva
- Institute of Photonic Technologies, Research Center 'Crystallography and Photonics', Moscow, Russia
| | | | - Alexey L Fayzullin
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
| | | | | | | | - Sergey F Timashev
- N.N. Semenov Institute of Chemical Physics, Moscow, Russia.,National Research Nuclear University MEPhI, Moscow, Russia
| | - Denis V Butnaru
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
| | - Peter S Timashev
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia.,N.N. Semenov Institute of Chemical Physics, Moscow, Russia.,Institute of Photonic Technologies, Research Center 'Crystallography and Photonics', Moscow, Russia
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12
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Current Status of Canine Umbilical Cord Blood-Derived Mesenchymal Stem Cells in Veterinary Medicine. Stem Cells Int 2018; 2018:8329174. [PMID: 30123294 PMCID: PMC6079340 DOI: 10.1155/2018/8329174] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 06/19/2018] [Indexed: 12/26/2022] Open
Abstract
Stem cell therapy has prompted the expansion of veterinary medicine both experimentally and clinically, with the potential to contribute to contemporary treatment strategies for various diseases and conditions for which limited or no therapeutic options are presently available. Although the application of various types of stem cells, such as bone marrow-derived mesenchymal stem cells (BM-MSCs), adipose tissue-derived mesenchymal stem cells (AT-MSCs), and umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs), has promising potential to improve the health of different species, it is crucial that the benefits and drawbacks are completely evaluated before use. Umbilical cord blood (UCB) is a rich source of stem cells; nonetheless, isolation of mesenchymal stem cells (MSCs) from UCB presents technical challenges. Although MSCs have been isolated from UCB of diverse species such as human, equine, sheep, goat, and canine, there are inherent limitations of using UCB from these species for the expansion of MSCs. In this review, we investigated canine UCB (cUCB) and compared it with UCB from other species by reviewing recent articles published from February 2003 to June 2017 to gain an understanding of the limitations of cUCB in the acquisition of MSCs and to determine other suitable sources for the isolation of MSCs from canine. Our review indicates that cUCB is not an ideal source of MSCs because of insufficient volume and ethical issues. However, canine reproductive organs discarded during neutering may help broaden our understanding of effective isolation of MSCs. We recommend exploring canine reproductive and adipose tissue rather than UCB to fulfill the current need in veterinary medicine for the well-designed and ethically approved source of MSCs.
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13
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Lee S, Kim Y, Shin HS, Lim JY. Comparative characteristics of laryngeal-resident mesenchymal stromal cell populations isolated from distinct sites in the rat larynx. Stem Cell Res Ther 2017; 8:200. [PMID: 28962587 PMCID: PMC5622476 DOI: 10.1186/s13287-017-0650-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 08/11/2017] [Accepted: 08/22/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Although tissue-resident mesenchymal stromal cells (MSCs) in the larynx have been described, their distinct characteristics and roles have not been thoroughly explored. Therefore, we investigated stem cell characteristics and regenerative potentials of single clonal populations isolated from rat epiglottic mucosa (EM), lamina propria (LP), and macula flava (MF) to determine whether they comprised laryngeal tissue-resident stem cells. METHODS Single clonal laryngeal cells were isolated following microdissection of the EM, LP, and MF from the rat larynx. Several clonal populations from the three laryngeal subsites were selected and expanded in vitro. We compared the stem cell characteristics of self-renewal and differentiation potential, as well as the cell surface phenotypes and gene expression profiles, of laryngeal MSC-like cells to that of bone marrow MSCs (BM-MSCs). We also investigated the regenerative potential of the laryngeal cells in a radiation-induced laryngeal injury animal model. RESULTS Self-renewing, clonal cell populations were obtained from rat EM, LP, and MF. EM-derived and LP-derived clonal cells had fibroblast-like features, while MF-resident clonal cells had stellate cell morphology and lipid droplets containing vitamin A. All laryngeal clonal cell populations had MSC-like cell surface marker expression (CD29, CD44, CD73, and CD90) and the potential to differentiate into bone and cartilage cell lineages; EM-derived and MF-derived cells, but not LP-derived cells, were also able to differentiate into adipocytes. Clonal cells isolated from the laryngeal subsites exhibited differential extracellular matrix-related gene expression. We found that the mesenchymal and stellate cell-related genes desmin and nestin were enriched in laryngeal MSC-like cells relative to BM-MSCs (P < 0.001). Growth differentiation factor 3 (GDF3) and glial fibrillary acidic protein (GFAP) transcript and protein levels were higher in MF-derived cells than in other laryngeal populations (P < 0.001). At 4 weeks after transplantation, laryngeal MF-derived and EM-derived cells contributed to laryngeal epithelial and/or glandular regeneration in response to radiation injury. CONCLUSIONS These results suggest that cell populations with MSC characteristics reside in the EM, LP, and MF of the larynx. Laryngeal MSC-like cells contribute to regeneration of the larynx following injury; further investigation is needed to clarify the differential roles of the populations in laryngeal tissue regeneration, as well as the clinical implications for the treatment of laryngeal disease.
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Affiliation(s)
- Songyi Lee
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Yeseulmi Kim
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Hyun-Soo Shin
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea.
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14
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Morisaki T, Kishimoto Y, Tateya I, Kawai Y, Suzuki R, Tsuji T, Hiwatashi N, Nakamura T, Omori K, Kitano H, Takeuchi H, Hirano S. Adipose-derived mesenchymal stromal cells prevented rat vocal fold scarring. Laryngoscope 2017; 128:E33-E40. [DOI: 10.1002/lary.26855] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 06/30/2017] [Accepted: 07/24/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Tsuyoshi Morisaki
- Department of Otolaryngology-Head and Neck Surgery; Faculty of Medicine, Tottori University; Tottori Japan
| | - Yo Kishimoto
- Department of Otolaryngology-Head and Neck Surgery Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Ichiro Tateya
- Department of Otolaryngology-Head and Neck Surgery Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Yoshitaka Kawai
- Department of Otolaryngology-Head and Neck Surgery Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Ryo Suzuki
- Department of Otolaryngology-Head and Neck Surgery Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Takuya Tsuji
- Department of Otolaryngology-Head and Neck Surgery Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Nao Hiwatashi
- Department of Otolaryngology-Head and Neck Surgery Graduate School of Medicine; Kyoto University; Kyoto Japan
- Department of Otolaryngology-Head and Neck Surgery; NYU Voice Center, New York University School of Medicine; New York New York U.S.A
| | - Tatsuo Nakamura
- Department of Bioartificial Organs; Institute for Frontier Medical Science, Kyoto University; Kyoto Japan
| | - Koichi Omori
- Department of Otolaryngology-Head and Neck Surgery Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Hiroya Kitano
- Department of Otolaryngology-Head and Neck Surgery; Faculty of Medicine, Tottori University; Tottori Japan
| | - Hiromi Takeuchi
- Department of Otolaryngology-Head and Neck Surgery; Faculty of Medicine, Tottori University; Tottori Japan
| | - Shigeru Hirano
- Department of Otolaryngology-Head and Neck Surgery; Kyoto Prefectural University of Medicine; Kyoto Japan
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15
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Mattei A, Magalon J, Bertrand B, Philandrianos C, Veran J, Giovanni A. Cell therapy and vocal fold scarring. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:339-345. [PMID: 28689790 DOI: 10.1016/j.anorl.2017.06.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Vocal fold microstructure is complex and can be affected by laryngeal microsurgery, inducing scarring that prevents mechanical uncoupling of epithelium and muscle, leading to vibration disorder and disabling dysphonia. Treatment options presently are few, and often without efficacy for vibration, having only an impact on volume to reduce glottal closure defect. The present review of the literature had two aims: (i) to report the current state of the literature on cell therapy in vocal fold scarring; and (ii) to analyze the therapeutic interest of the adipose-derived stromal vascular fraction in the existing therapeutic armamentarium. A PubMed® search conducted in September 2016 retrieved English or French-language original articles on the use of stem cells to treat vocal fold scarring. Twenty-seven articles published between 2003 and 2016 met the study selection criteria. Mesenchymal stem cells were most widely used, mainly derived from bone marrow or adipose tissue. Four studies were performed in vitro on fibroblasts, and 18 in vivo on animals. End-points comprised: (i) scar analysis (macro- and micro-scopic morphology, viscoelastic properties, extracellular matrix, fibroblasts); and (ii) assessment of stem cell survival and differentiation. The studies testified to the benefit of mesenchymal stem cells, and especially those of adipose derivation. The stromal vascular fraction exhibits properties that might improve results by facilitating production logistics.
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Affiliation(s)
- A Mattei
- Aix Marseille université, 13000 Marseille, France; Service d'oto-rhino-laryngologie et chirurgie cervicofaciale, La Conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13005 Marseille, France.
| | - J Magalon
- VRCM Inserm UMR 1076, faculté de pharmacie de Marseille, Aix Marseille université, 27, boulevard Jean-Moulin, 13385 Marseille cedex 5, France; Inserm CBT-1409, laboratoire de culture et thérapie cellulaire, La Conception, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - B Bertrand
- Service de chirurgie plastique et réparatrice, La Conception, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - C Philandrianos
- Service de chirurgie plastique et réparatrice, La Conception, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - J Veran
- Inserm CBT-1409, laboratoire de culture et thérapie cellulaire, La Conception, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - A Giovanni
- Service d'oto-rhino-laryngologie et chirurgie cervicofaciale, La Conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13005 Marseille, France; CNRS, laboratoire parole et langage, Aix Marseille université, 5, avenue Pasteur, 13100 Aix-en-Provence, France
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16
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Wingstrand VL, Grønhøj Larsen C, Jensen DH, Bork K, Sebbesen L, Balle J, Fischer-Nielsen A, von Buchwald C. Mesenchymal Stem Cell Therapy for the Treatment of Vocal Fold Scarring: A Systematic Review of Preclinical Studies. PLoS One 2016; 11:e0162349. [PMID: 27631373 PMCID: PMC5025194 DOI: 10.1371/journal.pone.0162349] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 08/22/2016] [Indexed: 01/02/2023] Open
Abstract
Objectives Therapy with mesenchymal stem cells exhibits potential for the development of novel interventions for many diseases and injuries. The use of mesenchymal stem cells in regenerative therapy for vocal fold scarring exhibited promising results to reduce stiffness and enhance the biomechanical properties of injured vocal folds. This study evaluated the biomechanical effects of mesenchymal stem cell therapy for the treatment of vocal fold scarring. Data Sources PubMed, Embase, the Cochrane Library and Google Scholar were searched. Methods Controlled studies that assessed the biomechanical effects of mesenchymal stem cell therapy for the treatment of vocal fold scarring were included. Primary outcomes were viscoelastic properties and mucosal wave amplitude. Results Seven preclinical animal studies (n = 152 single vocal folds) were eligible for inclusion. Evaluation of viscoelastic parameters revealed a decreased dynamic viscosity (η’) and elastic modulus (G’), i.e., decreased resistance and stiffness, in scarred vocal folds treated with mesenchymal stem cells compared to non-treated scarred vocal folds. Mucosal wave amplitude was increased in scarred vocal folds treated with mesenchymal stem cells vs. non-treated scarred vocal folds. Conclusion The results from these studies suggest an increased regenerative effect of therapy with mesenchymal stem cells for scarred vocal folds and are encouraging for further clinical studies.
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Affiliation(s)
- Vibe Lindeblad Wingstrand
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Christian Grønhøj Larsen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - David H. Jensen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Kristian Bork
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lars Sebbesen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Balle
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anne Fischer-Nielsen
- Cell Therapy Facility, Blood Bank, Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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17
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Fishman JM, Long J, Gugatschka M, De Coppi P, Hirano S, Hertegard S, Thibeault SL, Birchall MA. Stem cell approaches for vocal fold regeneration. Laryngoscope 2016; 126:1865-70. [PMID: 26774977 DOI: 10.1002/lary.25820] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/20/2015] [Accepted: 11/13/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVES/HYPOTHESIS Current interventions in the management of vocal fold (VF) dysfunction focus on conservative and surgical approaches. However, the complex structure and precise biomechanical properties of the human VF mean that these strategies have their limitations in clinical practice and in some cases offer inadequate levels of success. Regenerative medicine is an exciting development in this field and has the potential to further enhance VF recovery beyond conventional treatments. Our aim in this review is to discuss advances in the field of regenerative medicine; that is, advances in the process of replacing, engineering, or regenerating the VF through utilization of stem cells, with the intention of restoring normal VF structure and function. DATA SOURCES English literature (1946-2015) review. METHODS We conducted a systematic review of MEDLINE for cases and studies of VF tissue engineering utilizing stem cells. RESULTS The three main approaches by which regenerative medicine is currently applied to VF regeneration include cell therapy, scaffold development, and utilization of growth factors. CONCLUSION Exciting advances have been made in stem cell biology in recent years, including use of induced pluripotent stem cells. We expect such advances to be translated into the field in the forthcoming years. Laryngoscope, 126:1865-1870, 2016.
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Affiliation(s)
- Jonathan M Fishman
- UCL Institute of Child Health, London, United Kingdom.,UCL Ear Institute and Royal National Throat, Nose and Ear Hospital and, London, United Kingdom
| | - Jenny Long
- UCL Institute of Child Health, London, United Kingdom
| | - Markus Gugatschka
- Department of Phoniatrics, ENT University Hospital Graz, Medical University Graz, Graz, Austria
| | | | - Shigeru Hirano
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Stellan Hertegard
- Department of Otorhinolaryngology, Karolinska Institutet Clintec, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Susan L Thibeault
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, Madison, Wisconsin, U.S.A
| | - Martin A Birchall
- UCL Ear Institute and Royal National Throat, Nose and Ear Hospital and, London, United Kingdom
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18
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Adipose-Derived Mesenchymal Stem Cells in the Regeneration of Vocal Folds: A Study on a Chronic Vocal Fold Scar. Stem Cells Int 2016; 2016:9010279. [PMID: 26933440 PMCID: PMC4736582 DOI: 10.1155/2016/9010279] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 10/05/2015] [Accepted: 10/20/2015] [Indexed: 12/22/2022] Open
Abstract
Background. The aim of the study was to assess the histological effects of autologous infusion of adipose-derived stem cells (ADSC) on a chronic vocal fold scar in a rabbit model as compared to an untreated scar as well as in injection of hyaluronic acid. Study Design. Animal experiment. Method. We used 74 New Zealand rabbits. Sixteen of them were used as control/normal group. We created a bilateral vocal fold wound in the remaining 58 rabbits. After 18 months we separated our population into three groups. The first group served as control/scarred group. The second one was injected with hyaluronic acid in the vocal folds, and the third received an autologous adipose-derived stem cell infusion in the scarred vocal folds (ADSC group). We measured the variation of thickness of the lamina propria of the vocal folds and analyzed histopathologic changes in each group after three months. Results. The thickness of the lamina propria was significantly reduced in the group that received the ADSC injection, as compared to the normal/scarred group. The collagen deposition, the hyaluronic acid, the elastin levels, and the organization of elastic fibers tend to return to normal after the injection of ADSC. Conclusions. Autologous injection of adipose-derived stem cells on a vocal fold chronic scar enhanced the healing of the vocal folds and the reduction of the scar tissue, even when compared to other treatments.
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19
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Yi T, Kim SN, Lee HJ, Kim J, Cho YK, Shin DH, Tak SJ, Moon SH, Kang JE, Ji IM, Lim HJ, Lee DS, Jeon MS, Song SU. Manufacture of Clinical-Grade Human Clonal Mesenchymal Stem Cell Products from Single Colony Forming Unit-Derived Colonies Based on the Subfractionation Culturing Method. Tissue Eng Part C Methods 2015; 21:1251-62. [PMID: 26421757 DOI: 10.1089/ten.tec.2015.0017] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Stem cell products derived from mesenchymal stem cells (MSCs) have been widely used in clinical trials, and a few products have been already commercialized. However, the therapeutic effects of clinical-grade MSCs are still controversial owing to mixed results from recent clinical trials. A potential solution to overcome this hurdle may be to use clonal stem cells as the starting cell material to increase the homogeneity of the final stem cell products. We have previously developed an alternative isolation and culture protocol for establishing a population of clonal MSCs (cMSCs) from single colony forming unit (CFU)-derived colonies. In this study, we established a good manufacturing practice (GMP)-compatible procedure for the clinical-grade production of human bone marrow-derived cMSCs based on the subfractionation culturing method. We optimized the culture procedures to expand and obtain a clonal population of final MSC products from single CFU-derived colonies in a GMP facility. The characterization results of the final cMSC products met our preset criteria. Animal toxicity tests were performed in a good laboratory practice facility, and showed no toxicity or tumor formation in vivo. These tests include single injection toxicity, multiple injection toxicity, biodistribution analysis, and tumorigenicity tests in vivo. No chromosomal abnormalities were detected by in situ karyotyping using oligo-fluorescence in situ hydridization (oligo-FISH), providing evidence of genetic stability of the clinical-grade cMSC products. The manufacture and quality control results indicated that our GMP methodology could produce sufficient clonal population of MSC products from a small amount of bone marrow aspirate to treat a number of patients.
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Affiliation(s)
- TacGhee Yi
- 1 Translational Research Center, Inha University School of Medicine , Incheon, Republic of Korea.,2 Inha Research Institute for Medical Science, Inha University School of Medicine , Incheon, Republic of Korea.,3 SCM Lifescience Co., Ltd. , Incheon, Republic of Korea
| | - Si-na Kim
- 4 Drug Development Program, Department of Biomedical Science, Inha University School of Medicine , Incheon, Republic of Korea
| | - Hyun-Joo Lee
- 4 Drug Development Program, Department of Biomedical Science, Inha University School of Medicine , Incheon, Republic of Korea
| | - Junghee Kim
- 4 Drug Development Program, Department of Biomedical Science, Inha University School of Medicine , Incheon, Republic of Korea
| | - Yun-Kyoung Cho
- 3 SCM Lifescience Co., Ltd. , Incheon, Republic of Korea
| | - Dong-Hee Shin
- 1 Translational Research Center, Inha University School of Medicine , Incheon, Republic of Korea.,2 Inha Research Institute for Medical Science, Inha University School of Medicine , Incheon, Republic of Korea
| | - Sun-Ji Tak
- 1 Translational Research Center, Inha University School of Medicine , Incheon, Republic of Korea
| | - Sun-Hwa Moon
- 3 SCM Lifescience Co., Ltd. , Incheon, Republic of Korea
| | - Ji-Eun Kang
- 3 SCM Lifescience Co., Ltd. , Incheon, Republic of Korea
| | - In-Mi Ji
- 3 SCM Lifescience Co., Ltd. , Incheon, Republic of Korea
| | - Huyn-Ja Lim
- 3 SCM Lifescience Co., Ltd. , Incheon, Republic of Korea
| | - Dong-Soon Lee
- 5 Department of Pathology, Seoul National University School of Medicine , Seoul, Republic of Korea
| | - Myung-Shin Jeon
- 1 Translational Research Center, Inha University School of Medicine , Incheon, Republic of Korea
| | - Sun U Song
- 1 Translational Research Center, Inha University School of Medicine , Incheon, Republic of Korea.,3 SCM Lifescience Co., Ltd. , Incheon, Republic of Korea
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20
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Park JS, Yi TG, Park JM, Han YM, Kim JH, Shin DH, Tak SJ, Lee K, Lee YS, Jeon MS, Hahm KB, Song SU, Park SH. Therapeutic effects of mouse bone marrow-derived clonal mesenchymal stem cells in a mouse model of inflammatory bowel disease. J Clin Biochem Nutr 2015; 57:192-203. [PMID: 26566304 PMCID: PMC4639590 DOI: 10.3164/jcbn.15-56] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 04/20/2015] [Indexed: 12/13/2022] Open
Abstract
Mouse bone marrow-derived clonal mesenchymal stem cells (mcMSCs), which were originated from a single cell by a subfractionation culturing method, are recognized as new paradigm for stem cell therapy featured with its homogenous cell population. Next to proven therapeutic effects against pancreatitis, in the current study we demonstrated that mcMSCs showed significant therapeutic effects in dextran sulfate sodium (DSS)-induced experimental colitis model supported with anti-inflammatory and restorative activities. mcMSCs significantly reduced the disease activity index (DAI) score, including weight loss, stool consistency, and intestinal bleeding and significantly increased survival rates. The pathological scores were also significantly improved with mcMSC. We have demonstrated that especial mucosal regeneration activity accompanied with significantly lowered level of apoptosis as beneficiary actions of mcMSCs in UC models. The levels of inflammatory cytokines including TNF-α, IFN-γ, IL-1β, IL-6, and IL-17 were all significantly concurrent with significantly repressed NF-κB activation compared to the control group and significantly decreased infiltrations of responsible macrophage and neutrophil. Conclusively, our findings provide the rationale that mcMSCs are applicable as a potential source of cell-based therapy in inflammatory bowel diseases, especially contributing either to prevent relapse or to accelerate healing as solution to unmet medical needs in IBD therapy.
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Affiliation(s)
- Jin Seok Park
- Department of Biological Sciences, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon 440-746, Korea
| | - Tac-Ghee Yi
- Translational Research Center and Inha Research Institute for Medical Sciences, Inha University School of Medicine, 100 Inharo, Nam-gu, Incheon 400-711, Korea ; SCM Lifescience Co., Ltd., 366 Saohae-daero, Jung-gu, Incheon 400-711, Korea
| | - Jong-Min Park
- Digestive Disease Center, CHA University Bundang Medical Center, 59 Yatap-ro, Bundang-gu, Seongnam 463-838, Korea
| | - Young Min Han
- Digestive Disease Center, CHA University Bundang Medical Center, 59 Yatap-ro, Bundang-gu, Seongnam 463-838, Korea
| | - Jun-Hyung Kim
- Department of Biological Sciences, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon 440-746, Korea
| | - Dong-Hee Shin
- Translational Research Center and Inha Research Institute for Medical Sciences, Inha University School of Medicine, 100 Inharo, Nam-gu, Incheon 400-711, Korea ; SCM Lifescience Co., Ltd., 366 Saohae-daero, Jung-gu, Incheon 400-711, Korea
| | - Seon Ji Tak
- Translational Research Center and Inha Research Institute for Medical Sciences, Inha University School of Medicine, 100 Inharo, Nam-gu, Incheon 400-711, Korea
| | - Kyuheon Lee
- Translational Research Center and Inha Research Institute for Medical Sciences, Inha University School of Medicine, 100 Inharo, Nam-gu, Incheon 400-711, Korea
| | - Youn Sook Lee
- Department of Biological Sciences, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon 440-746, Korea
| | - Myung-Shin Jeon
- Translational Research Center and Inha Research Institute for Medical Sciences, Inha University School of Medicine, 100 Inharo, Nam-gu, Incheon 400-711, Korea
| | - Ki-Baik Hahm
- Digestive Disease Center, CHA University Bundang Medical Center, 59 Yatap-ro, Bundang-gu, Seongnam 463-838, Korea
| | - Sun U Song
- Translational Research Center and Inha Research Institute for Medical Sciences, Inha University School of Medicine, 100 Inharo, Nam-gu, Incheon 400-711, Korea ; SCM Lifescience Co., Ltd., 366 Saohae-daero, Jung-gu, Incheon 400-711, Korea
| | - Seok Hee Park
- Department of Biological Sciences, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon 440-746, Korea
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21
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Yang W, Lee S, Yoon J, Lee JI. Stem cell therapy status in veterinary medicine. Tissue Eng Regen Med 2015. [DOI: 10.1007/s13770-014-0426-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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22
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Shim G, Lee S, Han J, Kim G, Jin H, Miao W, Yi TG, Cho YK, Song SU, Oh YK. Pharmacokinetics and in vivo fate of intra-articularly transplanted human bone marrow-derived clonal mesenchymal stem cells. Stem Cells Dev 2015; 24:1124-32. [PMID: 25519508 DOI: 10.1089/scd.2014.0240] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In this study, we report the pharmacokinetics and in vivo fate of intra-articularly transplanted human mesenchymal stem cells (MSCs) in comparison with those of intravenously administered cells. Bone marrow-derived human clonal mesenchymal stem cells (hcMSCs) were transplanted to nude mice through intravenous or intra-articular routes. The numbers of hcMSCs in blood and tissue samples were measured by the quantitative real-time-polymerase chain reaction (qPCR) with human Alu (hAlu) as a detection marker. Following intra-articular transplantation, the blood levels of hcMSCs peaked 8 h postdose and gradually diminished, showing a 95-fold higher mean residence time than hcMSCs delivered through the intravenous route. Unlike intravenously administered hcMSCs, intra-articularly injected hcMSCs were mainly retained at injection joint sites where their levels 8 h postdose were 116-fold higher than those in muscle tissues. Regardless of injection routes, biodistribution patterns did not significantly differ between normal and osteoarthritis-induced mice. Quantitative analysis using hAlu-specific qPCR revealed that hcMSC levels in joint tissues were significantly higher than those in muscle tissues 120 days postdose. These dramatic differences in kinetic behavior and fate of intra-articularly transplanted hcMSCs compared with intravenously administered hcMSCs may provide insights useful for the development of human MSCs for arthritis therapeutics.
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Affiliation(s)
- Gayong Shim
- 1 Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University , Seoul, Republic of Korea
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23
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Choi JS, Lee S, Kim DY, Kim YM, Kim MS, Lim JY. Functional remodeling after vocal fold injury by small intestinal submucosa gel containing hepatocyte growth factor. Biomaterials 2014; 40:98-106. [PMID: 25433606 DOI: 10.1016/j.biomaterials.2014.11.028] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 10/30/2014] [Accepted: 11/08/2014] [Indexed: 10/24/2022]
Abstract
A biomaterial derived from porcine small intestinal submucosa (SIS) was used in smart drug delivery and tissue remodeling. SIS suspensions were easily formulated by simple mixing with the drug of choice and formed an in situ gel upon injection into tissues, enabling them to act as protein drug depots. This study was conducted to determine whether functional remodeling of an injured vocal fold (VF) could be achieved by hepatocyte growth factor (HGF)-containing SIS in situ-forming gel after VF injury in a rabbit model. To accomplish this, we loaded HGF in SIS suspensions and observed a gradual, sustained release of HGF for at least 21 days in vitro. Evaluation of the in vivo efficacy demonstrated that the HGF and HGF-loaded SIS treated VFs showed improved mucosal healing when compared with the PBS-injected VFs. Histopathological evaluations revealed that treatment with the HGF/SIS group alone successfully ameliorated the deposition of type I collagen and increased synthesis of hyaluronic acids relative to the PBS group at three months post-injury. Functional analyses showed that the HGF/SIS group prevented deterioration of mucosal vibration and induced significant improvement in the mean viscoelastic modulus, but that other groups failed to achieve functional rescue of VF biomechanics. Additionally, the VF oscillation in the HGF/SIS group was superior to that in the HGF group. The results of this study suggest that SIS in situ gel has the potential for use as an HGF delivery carrier for enhancement of wound healing and improvement of functional remodeling following VF injury.
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Affiliation(s)
- Jeong-Seok Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Republic of Korea; Translational Research Center, Inha University School of Medicine, Incheon, Republic of Korea
| | - Songyi Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Republic of Korea; Translational Research Center, Inha University School of Medicine, Incheon, Republic of Korea
| | - Da Yeon Kim
- Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea
| | - Young-Mo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Republic of Korea; Translational Research Center, Inha University School of Medicine, Incheon, Republic of Korea
| | - Moon Suk Kim
- Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, Republic of Korea; Translational Research Center, Inha University School of Medicine, Incheon, Republic of Korea.
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24
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Yi T, Kim WK, Choi JS, Song SY, Han J, Kim JH, Kim WS, Park SG, Lee HJ, Cho YK, Hwang SJ, Song SU, Sung JH. Isolation of adipose-derived stem cells by using a subfractionation culturing method. Expert Opin Biol Ther 2014; 14:1551-60. [DOI: 10.1517/14712598.2014.943661] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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25
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Kim YM, Oh SH, Choi JS, Lee S, Ra JC, Lee JH, Lim JY. Adipose-derived stem cell-containing hyaluronic acid/alginate hydrogel improves vocal fold wound healing. Laryngoscope 2013; 124:E64-72. [DOI: 10.1002/lary.24405] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/06/2013] [Accepted: 08/26/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Young-Mo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery; Inha University School of Medicine; Incheon
- Translational Research Center; Inha University School of Medicine; Incheon
| | - Se H. Oh
- Department of Nanobiomedical Science and WCU Research Center; Dankook University; Cheonan
| | - Jeong-Seok Choi
- Department of Otorhinolaryngology-Head and Neck Surgery; Inha University School of Medicine; Incheon
- Translational Research Center; Inha University School of Medicine; Incheon
| | - Songyi Lee
- Department of Otorhinolaryngology-Head and Neck Surgery; Inha University School of Medicine; Incheon
- Translational Research Center; Inha University School of Medicine; Incheon
| | - Jeong C. Ra
- Stem Cell Research Center, RNL Bio Co., Ltd.; Seoul
| | - Jin H. Lee
- Department of Advanced Materials; Hannam University; Daejeon Republic of Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology-Head and Neck Surgery; Inha University School of Medicine; Incheon
- Translational Research Center; Inha University School of Medicine; Incheon
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