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Ujvary PL, Blebea CM, Maniu AA, Pop S, Sarpataki O, Cosgarea M. Vocal fold injury models in rats: a literature review on techniques and methodology. J Med Life 2022; 15:336-343. [PMID: 35449991 PMCID: PMC9015177 DOI: 10.25122/jml-2022-0032] [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: 01/12/2022] [Accepted: 03/02/2022] [Indexed: 11/19/2022] Open
Abstract
This study reviewed the current literature on technical aspects regarding controlled vocal fold injuries in the rat model. Data from PubMed, Embase, and Scopus database for English language literature was collected to identify methodological steps leading to a controlled surgical injury of the rat vocal fold. Inclusion criteria: full disclosure of anesthesia protocol, positioning of the rat for surgery, vocal fold visualization method, instrumentation for vocal fold injury, vocal fold injury type. Articles with partial contribution were evaluated and separately included due to the limited number of original methodologies. 724 articles were screened, and eleven articles were included in the analysis. Anesthesia: ketamine hydrochloride and xylazine hydrochloride varied in dose from 45 mg/kg and 4.5 mg/kg to 100 mg/kg and 10 mg/kg. Visualization: The preferred method was the 1.9 mm, 25-30 degree endoscopes. The widest diameter endoscope used was 2.7 mm with a 0 or 30 degree angle of view. Instruments for lesion induction range from 18 to 31G needles, microscissors, micro forceps to potassium titanyl phosphate, and blue light lasers. Injury types: vocal fold stripping was the main injury type, followed by vocal fold scarring and charring. One article describes scaffold implantation with injury to the superior aspect of the vocal fold. Rats are good candidates for in vivo larynx and vocal folds research. A more standardized approach should be considered regarding the type of vocal fold injury to ease data comparison.
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Affiliation(s)
- Peter Laszlo Ujvary
- Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristina Maria Blebea
- Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,Corresponding Author: Cristina Maria Blebea, Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. E-mail:
| | - Alma Aurelia Maniu
- Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sever Pop
- Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Orsolya Sarpataki
- Department of Physiology, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Marcel Cosgarea
- Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Abstract
PURPOSE OF REVIEW Vocal fold (VF) fibrosis remains an insoluble problem in most cases, with a severe impact on vocal quality and effort. This review examines current investigations and research strands that explore the understanding of VF wound healing and applied treatments for the management of VF scar. RECENT FINDINGS Recent work focused on VF fibrosis has examined wound healing in the glottis, fibrosis-modifying medication, and tissue engineering approaches that span cytokine and growth factor therapy, scaffold and cell delivery platforms, seeded scaffolds, conditioned media and stem cell therapy. Many show promise and may deliver improvements in the wound bed favouring less fibrogenic healing patterns, ultimately with the goal of preserving or restoring VF vibration. Further collaborative research is required that examines combined approaches, long term outcomes, better three-dimensional modelling of cell-cell interactions and delivery modalities for molecular therapies. SUMMARY VF fibrosis research continues to expand and explore a variety of mechanistic pathways in order to understand VF healing and identify novel and complementary targets for manipulation. Many different approaches show promise and may also offer synergistic benefits. Research continues to strive for healing that more closely resembles true VF architecture and function.
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Hertegård S, Nagubothu SR, Malmström E, Ström CE, Tolf A, Davies LC, Le Blanc K. Hyaluronan Hydrogels for the Local Delivery of Mesenchymal Stromal Cells to the Injured Vocal Fold. Stem Cells Dev 2019; 28:1177-1190. [PMID: 31244387 DOI: 10.1089/scd.2019.0102] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Mesenchymal stromal cells (MSCs) promote wound healing by expediting the inflammatory phase. Local injection of MSCs into injured vocal folds (VFs) is effective in animal models, suggesting suitability for clinical translation. Despite their therapeutic potential, MSCs do not persist within the VF. This study evaluates whether hyaluronan (HA) hydrogels offer a safe delivery vehicle for local injection of MSCs into VFs, and increase longevity of the cells within the injured tissue. MSCs ± HA hydrogel were exposed to interleukin (IL)1β, IL8, and chemokine (C-C motif) ligand 4, and evaluated for mRNA expression of matrix remodeling genes and secretion of immunomodulatory/prohealing factors. Chemotaxis/invasion in response to inflammation was evaluated. A lapin model of VF injury evaluated in vivo effects of MSCs ± HA hydrogel on enhancing VF healing. Histological evaluation of inflammation, type I collagen expression, HA hydrogel resorption, and MSC persistence was evaluated at 3 and 25 days after injury. MSCs within HA hydrogel were responsive to their extracellular environment, upregulating immunomodulatory factors when exposed to inflammation. Despite delayed migration out of the gel in vitro, the MSCs did not persist longer within the injured tissue in vivo. MSCs ± HA hydrogel exerted equivalent dampening of inflammation in vivo. The gel was resorbed within 25 days and no edema was evident. HA hydrogels can be safely used in the delivery of MSCs to injured VFs, minimizing leakage of administered cells. MSCs within the HA hydrogel did not persist longer than those in suspension, but did exert comparable therapeutic effects.
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Affiliation(s)
- Stellan Hertegård
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm. Sweden.,Department of Otorhinolaryngology, Karolinska University Hospital Huddinge, Stockholm. Sweden
| | | | - Emma Malmström
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm. Sweden.,Department of Otorhinolaryngology, Karolinska University Hospital Huddinge, Stockholm. Sweden
| | - Cecilia E Ström
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Tolf
- Department of Pathology, Akademiska University Hospital, Uppsala, Sweden
| | - Lindsay C Davies
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Katarina Le Blanc
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
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Pathophysiology of Fibrosis in the Vocal Fold: Current Research, Future Treatment Strategies, and Obstacles to Restoring Vocal Fold Pliability. Int J Mol Sci 2019; 20:ijms20102551. [PMID: 31137626 PMCID: PMC6567075 DOI: 10.3390/ijms20102551] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 05/21/2019] [Indexed: 12/22/2022] Open
Abstract
Communication by voice depends on symmetrical vibrations within the vocal folds (VFs) and is indispensable for various occupations. VF scarring is one of the main reasons for permanent dysphonia and results from injury to the unique layered structure of the VFs. The increased collagen and decreased hyaluronic acid within VF scars lead to a loss of pliability of the VFs and significantly decreases their capacity to vibrate. As there is currently no definitive treatment for VF scarring, regenerative medicine and tissue engineering have become increasingly important research areas within otolaryngology. Several recent reviews have described the problem of VF scarring and various possible solutions, including tissue engineered cells and tissues, biomaterial implants, stem cells, growth factors, anti-inflammatory cytokines antifibrotic agents. Despite considerable research progress, these technical advances have not been established as routine clinical procedures. This review focuses on emerging techniques for restoring VF pliability using various approaches. We discuss our studies on interactions among adipose-derived stem/stromal cells, antifibrotic agents, and VF fibroblasts using an in vitro model. We also identify some obstacles to advances in research.
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Zhu J, Wang Y, Yu W, Xia K, Huang Y, Wang J, Liu B, Tao H, Liang C, Li F. Long Noncoding RNA: Function and Mechanism on Differentiation of Mesenchymal Stem Cells and Embryonic Stem Cells. Curr Stem Cell Res Ther 2019; 14:259-267. [PMID: 30479219 DOI: 10.2174/1574888x14666181127145809] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/20/2018] [Accepted: 11/22/2018] [Indexed: 12/30/2022]
Abstract
Background:Long suspected as transcriptional noise, recently recognized, long non-coding
RNAs (lncRNAs) are emerging as an indicator, biomarker and therapy target in the physiologic and
pathologic process. Mesenchymal stem cells and embryonic stem cells are important source for normal
and therapeutic tissue repair. However, the mechanism of stem cell differentiation is not completely
understood. Research on lncRNAs may provide novel insights into the mechanism of differentiation
process of the stem cell which is important for the application of stem cell therapy. The lncRNAs field
is still very young, new insights into lncRNAs function are emerging to a greater understanding of biological
processes.
Objective:
In this review, we summarize the recent researches studying lncRNAs and illustrate how
they act in the differentiation of the mesenchymal stem cells and embryonic stem cells, and discuss
some future directions in this field.
Results:
Numerous lncRNAs were differentially expressed during differentiation of mesenchymal stem
cells and embryonic stem cells. LncRNAs were able to regulate the differentiation processes through
epigenetic regulation, transcription regulation and post-transcription regulation.
Conclusion:
LncRNAs are involved in the differentiation process of mesenchymal stem cells and embryonic
stem cells, and they could become promising indicator, biomarker and therapeutic targets in the
physiologic and pathologic process. However, the mechanisms of the role of lncRNAs still require further
investigation.
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Affiliation(s)
- Jian Zhu
- Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, #88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China
| | - Yitian Wang
- Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, #88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China
| | - Wei Yu
- Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, #88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China
| | - Kaishun Xia
- Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, #88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China
| | - Yuluan Huang
- Department of Gynecologic Oncology, Women`s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Junjie Wang
- Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, #88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China
| | - Bing Liu
- Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, #88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China
| | - Huimin Tao
- Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, #88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China
| | - Chengzhen Liang
- Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, #88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China
| | - Fangcai Li
- Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, #88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China
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Kim CS, Choi H, Kim SW, Sun DI. The Ability of Conditioned Media From Stem Cells to Repair Vocal Fold Injuries. Laryngoscope 2019; 129:1867-1875. [PMID: 30613969 DOI: 10.1002/lary.27679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study investigated the ability of hypoxia-induced 25-fold concentrated conditioned media (hCM) from human nasal inferior turbinate-derived mesenchymal stem cells (hTMSC) to repair injured vocal folds during the early phase of the wound-healing process. METHODS The vocal fold was injured in Sprague-Dawley rats. Next, hCM from hTMSC (the hCM group) or hTMSC (the hTMSC group) were injected into the injured vocal folds. As a control, saline (the phosphate-buffered saline group) or 25-fold concentrated media (the media group) was injected in the same manner. The vocal folds were harvested for quantitative real-time polymerase chain reaction (PCR) at 1 week and 2 weeks after injury. Histologic evaluation was performed at 3 weeks postinjury. RESULTS In the hCM group at 1 week after injury, PCR showed that the genes encoding hyaluronan synthase (HAS), HAS 1, and HAS 2 were significantly upregulated compared to the media and normal groups. The gene encoding procollagen III was significantly downregulated compared to the media group. Nearly identical results were obtained for the hTMSC group at 1 week after injury. Histological examination showed that the hCM group was similar to or better than the hTMSC group in collagen deposition and hyaluronic acid production. CONCLUSION The injection of hCM into injured vocal folds produced antifibrotic effects in the early phase of wound healing. These effects were equivalent to those produced by the injection of hTMSC. These results provide a foundation for the future clinical use of hCM for vocal fold regeneration. LEVEL OF EVIDENCE NA Laryngoscope, 129:1867-1875, 2019.
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Affiliation(s)
- Choung-Soo Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyunsu Choi
- Clinical Research Institute, Daejeon St. Mary's Hospital, Daejeon, Republic of Korea
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Il Sun
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Therapeutic Potential of Human Turbinate-Derived Mesenchymal Stem Cells in Experimental Acute Ischemic Stroke. Int Neurourol J 2018; 22:S131-138. [PMID: 30396262 PMCID: PMC6234729 DOI: 10.5213/inj.1836220.110] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 10/08/2018] [Indexed: 12/24/2022] Open
Abstract
Purpose Mesenchymal stem cells (MSCs) have demonstrated great promises for the treatment of ischemic stroke. Previously, we identified a new source of MSCs located in the inferior turbinate. We investigated therapeutic potentials of human turbinate- derived mesenchymal stem cells (hTMSCs) in ischemic stroke. Methods Ischemic stroke was induced by the intraluminal occlusion of middle cerebral artery (MCAo) for 50 minutes in rats. At one day after MCAo, hTMSCs, adipose tissue-derived MSCs (AdMSCs), or phosphate buffered saline (PBS) were transplanted into the striatum. Functional recovery was assessed by repeating behavioral tests including modified neurologic severity score and corner test. At 14 days after MCAo, brains were stained with hematoxylin and eosin (H&E) for measuring infarct volume. The survival of grafted MSCs was evaluated by immunohistochemistry to human nuclei (hNU). Immunohistochemistry with anti-doublecortin (anti-DCX) was performed to assess hippocampal neurogenesis. Results Transplantation of hTMSCs following MCAo showed improvements of neurologic function, which was comparable with that of AdMSCs. H&E staining showed no difference in infarct volume among 3 groups. Regarding the survival of grafted MSCs, the number of hNU-expressing cells was not different between hTMSCs- and AdMSCs-treated groups. Finally, hTMSCs increased the number of subgranular DCX-positive cells compared to PBS-treated controls, without affecting hilar ectopic migration of newborn neurons. Conclusions hTMSCs could improve functional recovery following ischemic stroke, of which efficacy was similar to AdMSCs. Although hTMSCs showed comparable infarct size and survival of grafted MSCs, transplantation of hTMSCs could upregulate subgranular neurogenesis with no impact on ectopically migrating newborn neurons.
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