Tissue engineering of skin

Synthesis and Physicochemical Characterization of Gelatine-Based Biodegradable Aerogel-like Composites as Possible Scaffolds for Regenerative Medicine

Regenerative medicine is an interdisciplinary field aiming at restoring pathologically damaged tissues and whole organs by cell transplantation in combination with proper supporting scaffolds. Gelatine-based ones are very attractive due to their biocompatibility, rapid biodegradability, and lack of immunogenicity. Gelatine-based composite hydrogels, containing strengthening agents to improve their modest mechanical properties, have been demonstrated to act as extracellular matrices (ECMs), thus playing a critical role in "organ manufacturing". Inspired by the lysyl oxidase (LO)-mediated process of crosslinking, which occurs in nature to reinforce collagen, we have recently developed a versatile protocol to crosslink gelatine B (Gel B) in the presence or absence of LO, using properly synthesized polystyrene- and polyacrylic-based copolymers containing the amine or aldehyde groups needed for crosslinking reactions. Here, following the developed protocol with slight modifications, we have successfully crosslinked Gel B in different conditions, obtaining eight out of nine compounds in high yield (57-99%). The determined crosslinking degree percentage (CP%) evidenced a high CP% for compounds obtained in presence of LO and using the styrenic amine-containing (CP5/DMAA) and acrylic aldehyde-containing (CPMA/DMAA) copolymers as crosslinking agents. ATR-FTIR analyses confirmed the chemical structure of all compounds, while optical microscopy demonstrated cavernous, crater-like, and labyrinth-like morphologies and cavities with a size in the range 15-261 µm. An apparent density in the range 0.10-0.45 g/cm3 confirmed the aerogel-like structure of most samples. Although the best biodegradation profile was observed for the sample obtained using 10% CP5/DMAA (M3), high swelling and absorption properties, high porosity, and good biodegradation profiles were also observed for samples obtained using the 5-10% CP5/DMAA (M4, 5, 6) and 20% CPMA/DMAA (M9) copolymers. Collectively, in this work of synthesis and physicochemical characterization, new aerogel-like composites have been developed and, based on their characteristics, which fit well within the requirements for TE, five candidates (M3, M4, M5, M6, and M9) suitable for future biological experiments on cell adhesion, infiltration and proliferation, to confirm their effective functioning, have been identified.

Human Fibroblast-Derived Matrix Hydrogel Accelerates Regenerative Wound Remodeling Through the Interactions with Macrophages

Herein, a novel extracellular matrix (ECM) hydrogel is proposed fabricated solely from decellularized, human fibroblast-derived matrix (FDM) toward advanced wound healing. This FDM-gel is physically very stable and viscoelastic, while preserving the natural ECM diversity and various bioactive factors. Subcutaneously transplanted FDM-gel provided a permissive environment for innate immune cells infiltration. Compared to collagen hydrogel, excellent wound healing indications of FDM-gel treated in the full-thickness wounds are noticed, particularly hair follicle formation via highly upregulated β-catenin. Sequential analysis of the regenerated wound tissues disclosed that FDM-gel significantly alleviated pro-inflammatory cytokine and promoted M2-like macrophages, along with significantly elevated vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) level. A mechanistic study demonstrated that macrophages-FDM interactions through cell surface integrins α5β1 and α1β1 resulted in significant production of VEGF and bFGF, increased Akt phosphorylation, and upregulated matrix metalloproteinase-9 activity. Interestingly, blocking such interactions using specific inhibitors (ATN161 for α5β1 and obtustatin for α1β1) negatively affected those pro-healing growth factors secretion. Macrophages depletion animal model significantly attenuated the healing effect of FDM-gel. This study demonstrates that the FDM-gel is an excellent immunomodulatory material that is permissive for host cells infiltration, resorbable with time, and interactive with macrophages, where it thus enables regenerative matrix remodeling toward a complete wound healing.

Graph Network-Based Simulation of Multicellular Dynamics Driven by Concentrated Polymer Brush-Modified Cellulose Nanofibers

Manipulating the three-dimensional (3D) structures of cells is important for facilitating to repair or regenerate tissues. A self-assembly system of cells with cellulose nanofibers (CNFs) and concentrated polymer brushes (CPBs) has been developed to fabricate various cell 3D structures. To further generate tissues at an implantable level, it is necessary to carry out a large number of experiments using different cell culture conditions and material properties; however this is practically intractable. To address this issue, we present a graph-neural network-based simulator (GNS) that can be trained by using assembly process images to predict the assembly status of future time steps. A total of 24 (25 steps) time-series images were recorded (four repeats for each of six different conditions), and each image was transformed into a graph by regarding the cells as nodes and the connecting neighboring cells as edges. Using the obtained data, the performances of the GNS were examined under three scenarios (i.e., changing a pair of the training and testing data) to verify the possibility of using the GNS as a predictor for further time steps. It was confirmed that the GNS could reasonably reproduce the assembly process, even under the toughest scenario, in which the experimental conditions differed between the training and testing data. Practically, this means that the GNS trained by the first 24 h images could predict the cell types obtained 3 weeks later. This result could reduce the number of experiments required to find the optimal conditions for generating cells with desired 3D structures. Ultimately, our approach could accelerate progress in regenerative medicine.

Synthesis and Characterization of Amine and Aldehyde-Containing Copolymers for Enzymatic Crosslinking of Gelatine

In tissue engineering (TE), the support structure (scaffold) plays a key role necessary for cell adhesion and proliferation. The protein constituents of the extracellular matrix (ECM), such as collagen, its derivative gelatine, and elastin, are the most attractive materials as possible scaffolds. To improve the modest mechanical properties of gelatine, a strategy consists of crosslinking it, as naturally occurs for collagen, which is stiffened by the oxidative action of lysyl oxidase (LO). Here, a novel protocol to crosslink gelatine has been developed, not using the commonly employed crosslinkers, but based on the formation of imine bonds or on aldolic condensation reactions occurring between gelatine and properly synthesized copolymers containing amine residues via LO-mediated oxidation. Particularly, we first synthesized and characterized an amino butyl styrene monomer (5), its copolymers with dimethylacrylamide (DMAA), and its terpolymer with DMAA and acrylic acid (AA). Three acryloyl amidoamine monomers (11a-c) and their copolymers with DMAA were then prepared. A methacrolein (MA)/DMAA copolymer already possessing the needed aldehyde groups was finally developed to investigate the relevance of LO in the crosslinking process. Oxidation tests of amine copolymers with LO were performed to identify the best substrates to be used in experiments of gelatine reticulation. Copolymers obtained with 5, 11b, and 11c were excellent substrates for LO and were employed with MA/DMAA copolymers in gelatine crosslinking tests in different conditions. Among the amine-containing copolymers, that obtained with 5 (CP5/DMMA-43.1) afforded a material (M21) with the highest crosslinking percentage (71%). Cytotoxicity experiments carried out on two cell lines (IMR-32 and SH SY5Y) with the analogous (P5) of the synthetic constituent of M21 (CP5/DMAA) had evidenced no significant reduction in cell viability, but proliferation promotion, thus establishing the biocompatibility of M21 and the possibility to develop it as a new scaffold for TE, upon further investigations.

Recent Advances in Biodegradable Polymers and Their Biological Applications: A Brief Review

The rising significance of the field of biopolymers has driven the rapid progress of this distinctive class of polymeric materials in the past decades. Biodegradable polymers have acquired much attention because they play an essential role in humans' lives due to their specific tunable electrical conductivity and biodegradability characteristics, making them fascinating in many applications. Herein, we debated the recent progress in developing biodegradable polymers and their applications. Initially, we introduce the basics of conducting and biodegradable polymers, trailed by debates about the effective strategies currently used to develop biopolymers. Special importance will focus on the uses of biodegradable polymers in drug delivery and tissue engineering, as well as wound healing, demonstrating the recent findings, and uses of several biodegradable polymers in modern biological uses. In this review, we have provided comprehensive viewpoints on the latest progress of the challenges and future prospects involving biodegradable polymers' advancement and commercial applications.

Progress in hydrogels for skin wound repair

As the first defensive line between the human body and the outside world, the skin is vulnerable to damage from the external environment. Skin wounds can be divided into acute wounds (mechanical injuries, chemical injuries and surgical wounds, etc.) and chronic wounds (burns, infections, diabetes, etc.). In order to manage skin wound, a variety of wound dressings have been developed, including gauze, films, foams, nanofibers, hydrocolloids and hydrogels. Recently, hydrogels have received much attention because of their natural extracellular matrix (ECM)-mimik structure, tunable mechanical properties, and facile bioactive substance delivery capability. They show great potential application in skin wound repair. This paper first introduces the anatomy and function of the skin, the process of wound healing and conventional wound dressings, and then introduces the composition and construction methods of hydrogels. Next, this paper introduces the necessary properties of hydrogels in skin wound repair and the latest research progress of hydrogel dressings for skin wound repair. Finally, the future development goals of hydrogel materials in the field of wound healing are proposed. This article is protected by copyright. All rights reserved.

Human Organs-on-Chips: A Review of the State-of-the-Art, Current Prospects, and Future Challenges

New emerging technologies, remarkably miniaturized 3D organ models and microfluidics, enable simulation of the real in vitro microenvironment ex vivo more closely. There are many fascinating features of innovative organ-on-a-chip (OOC) technology, including the possibility of integrating semipermeable and/or stretchable membranes, creating continuous perfusion of fluids into microchannels and chambers (while maintaining laminar flow regime), embedding microdevices like microsensors, microstimulators, micro heaters, or different cell lines, along with other 3D cell culture technologies. OOC systems are designed to imitate the structure and function of human organs, ranging from breathing lungs to beating hearts. This technology is expected to be able to revolutionize cell biology studies, personalized precision medicine, drug development process, and cancer diagnosis/treatment. OOC systems can significantly reduce the cost associated with tedious drug development processes and the risk of adverse drug reactions in the body, which makes drug screening more effective. The review mainly focus on presenting an overview of the several previously developed OOC systems accompanied by subjects relevant to pharmacy-, cancer-, and placenta-on-a-chip. The challenging issues and opportunities related to these systems are discussed, along with a future perspective for this technology.

Novel ECM Patch Combines Poly(vinyl alcohol), Human Fibroblast-Derived Matrix, and Mesenchymal Stem Cells for Advanced Wound Healing

Decellularized extracellular matrix (ECM)-based scaffold has been a very useful resource for effective tissue regeneration. In this study, we report a novel ECM patch that physically combines human fibroblast-derived matrix (hFDM) and poly(vinyl alcohol) (PVA) hydrogel. hFDM was obtained after decellularization of in vitro cultured human fibroblasts. We investigated the basic characteristics of hFDM alone using immunofluorescence (fibronectin, collagen type I) and angiogenesis-related factor analysis. Successful incorporation of hFDM with PVA produced an hFDM/PVA patch, which showed excellent cytocompatibility with human mesenchymal stem cells (hMSCs), as assessed via cell adhesion, viability, and proliferation. Moreover, in vitro scratch assay using human dermal fibroblasts showed a significant improvement of cell migration when treated with the paracrine factors originated from the hMSC-incorporated hFDM. To evaluate the therapeutic effect on wound healing, hMSCs were seeded on the hFDM/PVA patch and they were then transplanted into a mouse full-thickness wound model. Among four experimental groups (control, PVA, hFDM/PVA, hMSC/hFDM/PVA), we found that hMSC/hFDM/PVA patch accelerated the wound closure with time. More notably, histology and immunofluorescence demonstrated that compared to the other interventions tested, hMSC/hFDM/PVA patch could lead to significantly advanced tissue regeneration, as confirmed via nearly normal epidermis thickness, skin adnexa regeneration (hair follicle), mature collagen deposition, and neovascularization. Additionally, cell tracking of prelabeled hMSCs suggests the in vivo retention of transplanted cells in the wound region after the transplantation of hMSC/hFDM/PVA patch. Taken together, our engineered ECM patch supports a strong regenerative potential toward advanced wound healing.

Current development of biodegradable polymeric materials for biomedical applications

In the last half-century, the development of biodegradable polymeric materials for biomedical applications has advanced significantly. Biodegradable polymeric materials are favored in the development of therapeutic devices, including temporary implants and three-dimensional scaffolds for tissue engineering. Further advancements have occurred in the utilization of biodegradable polymeric materials for pharmacological applications such as delivery vehicles for controlled/sustained drug release. These applications require particular physicochemical, biological, and degradation properties of the materials to deliver effective therapy. As a result, a wide range of natural or synthetic polymers able to undergo hydrolytic or enzymatic degradation is being studied for biomedical applications. This review outlines the current development of biodegradable natural and synthetic polymeric materials for various biomedical applications, including tissue engineering, temporary implants, wound healing, and drug delivery.

Comparison of human umbilical cord blood-derived mesenchymal stem cells with healthy fibroblasts on wound-healing activity of diabetic fibroblasts

Various types of skin substitutes composed of fibroblasts and/or keratinocytes have been used for the treatment of diabetic ulcers. However, the effects have generally not been very dramatic. Recently, human umbilical cord blood-derived mesenchymal stromal cells (hUCB-MSCs) have been commercialised for cartilage repair as a first cell therapy product using allogeneic stem cells. In a previous pilot study, we reported that hUCB-MSCs have a superior wound-healing capability compared with fibroblasts. The present study was designed to compare the treatment effect of hUCB-MSCs with that of fibroblasts on the diabetic wound healing in vitro. Diabetic fibroblasts were cocultured with healthy fibroblasts or hUCB-MSCs. Five groups were evaluated: group I, diabetic fibroblasts without coculture; groups II and III, diabetic fibroblasts cocultured with healthy fibroblasts or hUCB-MSCs; and groups IV and V, no cell cocultured with healthy fibroblasts or hUCB-MSCs. After a 3-day incubation, cell proliferation, collagen synthesis levels and glycosaminoglycan levels, which are the major contributing factors in wound healing, were measured. As a result, a hUCB-MSC-treated group showed higher cell proliferation, collagen synthesis and glycosaminoglycan level than a fibroblast-treated group. In particular, there were significant statistical differences in collagen synthesis and glycosaminoglycan levels (P = 0·029 and P = 0·019, respectively). In conclusion, these results demonstrate that hUCB-MSCs may have a superior effect to fibroblasts in stimulating diabetic wound healing.

Oral mucosa: an alternative epidermic cell source to develop autologous dermal-epidermal substitutes from diabetic subjects

Oral mucosa has been highlighted as a suitable source of epidermal cells due to its intrinsic characteristics such as its higher proliferation rate and its obtainability. Diabetic ulcers have a worldwide prevalence that is variable (1%-11%), meanwhile treatment of this has been proven ineffective. Tissue-engineered skin plays an important role in wound care focusing on strategies such autologous dermal-epidermal substitutes.

Survival of Allogeneic Self-Assembled Cultured Skin

BACKGROUND

Deficiency of autologous skin for reconstruction of severe wounds is a major problem in plastic surgery. Autologous substitutes can provide additional coverage, but due to the duration of production, treatment is significantly delayed. The allogeneic approach offers a potential of having an off-the-shelf solution for the immediate application.

METHODS

In this study, we assess the engraftment and immunogenicity of allogeneic bilayered bioengineered skin prepared by a self-assembly method. Bioengineered skin has the potential immunological advantage of lacking passenger leukocytes including antigen-presenting cells. The skin constructs were transplanted across major histocompatibility complex (MHC) barriers in a porcine animal model. Animals received a second grafting of the same skin construct 7 weeks after the first set of grafts together with MHC-matched constructs to assess for clinical sensitization.

RESULTS

All alloconstructs successfully engrafted with histologic evidence of neovascularization by day 4. Complete cellular rejection and tissue loss occurred by day 8 for most grafts. After the second application, accelerated rejection (<4 days) took place with the development of swine MHC-specific cytotoxic alloantibody.

CONCLUSIONS

These data demonstrate preclinically that self-assembled allogeneic constructs engraft and reject similar to allogeneic skin despite the absence of professional donor antigen-presenting cells.

Aloe emodin, an anthroquinone from Aloe vera acts as an anti aggregatory agent to the thermally aggregated hemoglobin

Aggregation of proteins is a physiological process which contributes to the pathophysiology of several maladies including diabetes mellitus, Huntington's and Alzheimer's disease. In this study we have reported that aloe emodin (AE), an anthroquinone, which is one of the active components of the Aloe vera plant, acts as an inhibitor of hemoglobin (Hb) aggregation. Hb was thermally aggregated at 60°C for four days as evident by increased thioflavin T and ANS fluorescence, shifted congo red absorbance, appearance of β sheet structure, increase in turbidity and presence of oligomeric aggregates. Increasing concentration of AE partially reverses the aggregation of the model heme protein (hemoglobin). The maximum effect of AE was observed at 100μM followed by saturation at 125μM. The results were confirmed by UV-visible spectrometry, intrinsic fluorescence, ThT, ANS, congo red assay as well as transmission electron microscopy (TEM). These results were also supported by fourier transform infrared spectroscopy (FTIR) and circular dichroism (CD) which shows the disappearance of β sheet structure and appearance of α helices. This study will serve as baseline for translatory research and the development of AE based therapeutics for diseases attributed to protein aggregation.

Bioengineered Self-assembled Skin as an Alternative to Skin Grafts

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For patients with extensive burns or donor site scarring, the limited availability of autologous and the inevitable rejection of allogeneic skin drive the need for new alternatives. Existing engineered biologic and synthetic skin analogs serve as temporary coverage until sufficient autologous skin is available. Here we report successful engraftment of a self-assembled bilayered skin construct derived from autologous skin punch biopsies in a porcine model. Dermal fibroblasts were stimulated to produce an extracellular matrix and were then seeded with epidermal progenitor cells to generate an epidermis. Autologous constructs were grafted onto partial- and full-thickness wounds. By gross examination and histology, skin construct vascularization and healing were comparable to autologous skin grafts and were superior to an autologous bilayered living cellular construct fabricated with fibroblasts cast in bovine collagen. This is the first demonstration of spontaneous vascularization and permanent engraftment of a self-assembled bilayered bioengineered skin that could supplement existing methods of reconstruction.

A novel dermal matrix generated from burned skin as a promising substitute for deep-degree burns therapy

The extensive skin defects induced by severe burns are dangerous and can be fatal. Currently, the most common therapy is tangential excision to remove the necrotic or denatured areas of skin, followed by skin grafting. Xenogeneic dermal substitutes, such as porcine acellular dermal matrix (ADM), are typically used to cover the burn wounds, and may accelerate wound healing. It is assumed that burned skin that still maintains partial biological activity may be recycled to construct an autologous acellular dermal matrix, termed 'deep‑degree burned dermal matrix (DDBDM)'. In theory, DDBDM may avoid the histoincompatibility issues associated with foreign or xenogeneic dermal matrices, and reduce therapy costs by making full use of discarded skin. In the present study, the collagens within prepared DDBDM were thickened, disorganized and partially fractured, however, they still maintained their reticular structure and tensile strength (P<0.01). Through microarray analysis of the cytokines present in ADM and DDBDM, it was determined that the DDBDM did not produce excessive levels of harmful burn toxins. Following 4 weeks of subcutaneous implantation, ADM and DDBDM were incompletely degraded and maintained good integrity. No significant inflammatory reaction or rejection were observed, which indicated that ADM and DDBDM have good histocompatibility. Therefore, DDBDM may be a useful material for the treatment of deep‑degree burns.

In vitro study on proliferation kinetics of oral mucosal keratinocytes

OBJECTIVE

The limited availability of autogenous oral mucosa in oral and maxillofacial surgery for intraoral grafting after trauma or tumor resection can be balanced by the use of tissue-engineered oral mucosa. However, the use of tissue engineering in autologous grafts is still subject to further research. The aim of this study was to evaluate conditions that lead to a rapid proliferation of vital and highly proliferative oral keratinocytes, which can be used in tissue engineering and consequently help improve surgical management of intraoral mucosal defects.

MATERIAL AND METHODS

Human oral keratinocytes were obtained from oral mucosal specimens and cultivated. According to their affinity to β1-integrin, epidermal stem cell populations were isolated by using collagen type IV and laminin-coated dishes. Cell proliferation and cell viability were measured by using the CASY cell counter, WST-1 assays, and real-time cell analysis (xCELLigence).

RESULTS

Measurements on cell proliferation (CASY cell counter) and cell viability (WST-1 assay) showed the characteristic proliferation stages of in vitro-cultivated cells. No statistically significant differences could be monitored (P > .05). Real-time cell analysis, as a more direct and precise technique, revealed a steeper growth curve of adherent cells and therefore generally higher proliferation kinetics compared with cells derived from the supernate.

CONCLUSION

Data from real-time cell analysis showed an increased proliferation of adherent cells compared with those derived from the supernate. These results demonstrate the increase of the proliferation capacity by cultivation of keratinocytes derived by adhesion to extracellular matrix proteins.

Mussel-Inspired Electrospun Nanofibers Functionalized with Size-Controlled Silver Nanoparticles for Wound Dressing Application

Electrospun nanofibers that contain silver nanoparticles (AgNPs) have a strong antibacterial activity that is beneficial to wound healing. However, most of the literature available on the bactericidal effects of this material is based on the use of AgNPs with uncontrolled size, shape, surface properties, and degree of aggregation. In this study, we report the first versatile synthesis of novel catechol moieties presenting electrospun nanofibers functionalized with AgNPs through catechol redox chemistry. The synthetic strategy allows control of the size and amount of AgNPs on the surface of nanofibers with the minimum degree of aggregation. We also evaluated the rate of release of the AgNPs, the biocompatibility of the nanofibers, the antibacterial activity in vitro, and the wound healing capacity in vivo. Our results suggest that these silver-releasing nanofibers have great potential for use in wound healing applications.

The Review on Properties of Aloe Vera in Healing of Cutaneous Wounds

Treatment of wounds is very important and was subject of different investigations. In this regard, natural substance plays crucial role as complementary medicine. Various studies reported that aloe vera has useful effects on wounds especially cutaneous wounds healing. Therefore in the current review, we examined the effect of aloe vera on cutaneous wound healing and concluded that although aloe vera improves the wound healing as well as other procedures both clinically and experimentally, more studies are still needed to approve the outcomes.

An update on clinical applications of electrospun nanofibers for skin bioengineering

Mimicking morphological similarities of the natural extra cellular matrix (ECM), described by ultrafine continuous fibers, high surface to volume ratio, and high porosity is valuable for effective regeneration of injured skin tissue. Electrospun nanofibers, being one of the most favorable and fast developing products of technology today, display a tremendous potential in wound healing and skin tissue engineering. Under the remarkable attention being given to electrospun nanofibrous scaffolds in promoting wound healing and skin regeneration, this review focuses on the potential of the electrospinning technique as a promising tool for constructing polymeric nanofibrous scaffolds with the favorable physicochemical properties needed for skin bioengineering. In addition, current applications of electrospun nanofibrous matrices for skin bioengineering are detailed in this review.

Intraoral grafting of tissue-engineered human oral mucosa

PURPOSE

The primary objective of this study was to evaluate the safety of a tissue-engineered human ex vivo-produced oral mucosa equivalent (EVPOME) in intraoral grafting procedures. The secondary objective was to assess the efficacy of the grafted EVPOME in producing a keratinized mucosal surface epithelium.

MATERIALS AND METHODS

Five patients who met the inclusion criteria of having one mucogingival defect or a lack of keratinized gingiva on a nonmolar tooth, along with radiographic evidence of sufficient interdental bone height, were recruited as subjects to increase the width of keratinized gingiva at the defect site. A punch biopsy specimen of the hard palate was taken to acquire oral keratinocytes, which were expanded, seeded, and cultured on an acellular dermal matrix for fabrication of an EVPOME. EVPOME grafts were applied directly over an intact periosteal bed and secured in place. At baseline (biopsy specimen retrieval) and at 7, 14, 30, 90, and 180 days postsurgery, Plaque Index and Gingival Index were recorded for each subject. In addition, probing depths, keratinized gingival width, and keratinized gingival thickness were recorded at baseline, 30, 90, and 180 days.

RESULTS

No complications or adverse reactions to EVPOME were observed in any subjects during the study. The mean gain in keratinized gingival width was 3 mm (range, 3 to 4 mm). The mean gain in keratinized gingival thickness was 1 mm (range, 1 to 2 mm). No significant changes in probing depths were observed.

CONCLUSION

Based on these findings, it can be concluded that EVPOME is safe for intraoral use and has the ability to augment keratinized tissue around teeth. Future clinical trials are needed to further explore this potential.

Novel biodegradable porous scaffold applied to skin regeneration

Skin wound healing is an important lifesaving issue for massive lesions. A novel porous scaffold with collagen, hyaluronic acid and gelatin was developed for skin wound repair. The swelling ratio of this developed scaffold was assayed by water absorption capacity and showed a value of over 20 g water/g dried scaffold. The scaffold was then degraded in time- and dose-dependent manners by three enzymes: lysozyme, hyaluronidase and collagenase I. The average pore diameter of the scaffold was 132.5±8.4 µm measured from SEM images. With human skin cells growing for 7 days, the SEM images showed surface fractures on the scaffold due to enzymatic digestion, indicating the biodegradable properties of this scaffold. To simulate skin distribution, the human epidermal keratinocytes, melanocytes and dermal fibroblasts were seeded on the porous scaffold and the cross-section immunofluorescent staining demonstrated normal human skin layer distributions. The collagen amount was also quantified after skin cells seeding and presented an amount 50% higher than those seeded on culture wells. The in vivo histological results showed that the scaffold ameliorated wound healing, including decreasing neutrophil infiltrates and thickening newly generated skin compared to the group without treatments.

Two methods for modelling the propagation of terahertz radiation in a layered structure

Modelling the interaction of terahertz(THz) radiation with biological tissueposes many interesting problems. THzradiation is neither obviously described byan electric field distribution or anensemble of photons and biological tissueis an inhomogeneous medium with anelectronic permittivity that is bothspatially and frequency dependent making ita complex system to model.A three-layer system of parallel-sidedslabs has been used as the system throughwhich the passage of THz radiation has beensimulated. Two modelling approaches havebeen developed a thin film matrix model anda Monte Carlo model. The source data foreach of these methods, taken at the sametime as the data recorded to experimentallyverify them, was a THz spectrum that hadpassed though air only.Experimental verification of these twomodels was carried out using athree-layered in vitro phantom. Simulatedtransmission spectrum data was compared toexperimental transmission spectrum datafirst to determine and then to compare theaccuracy of the two methods. Goodagreement was found, with typical resultshaving a correlation coefficient of 0.90for the thin film matrix model and 0.78 forthe Monte Carlo model over the full THzspectrum. Further work is underway toimprove the models above 1 THz.

Analysis of transferred keratinocyte-like cells derived from mouse embryonic stem cells on experimental surgical skin wounds of mouse

Autologous/allogenic skin grafts constituted from differentiated adult or embryonic stem cells can be used in treatment of skin disorders. In our study we aimed to differentiate keratinocytes from mouse embryonic stem cells and the transfer of viable keratinocyte-like cells to a model of surgical skin wound of mouse. Embryoid bodies, derived from mouse embryonic stem cells, were cultured on basement membrane matrix with added BMP-4 for 10 days. The identification of differentiated keratinocyte-like cells was done by detection of cytokeratin-8 and cytokeratin-14 localization using an indirect immunoperoxidase technique and transmission electron microscopy evaluation. Distribution of BrdU, cytokeratin-8 and cytokeratin-14 were evaluated using an indirect immunoperoxidase technique from the experimental (dressing including BrdU labelled cells applied after the surgical wound was created on mouse), control (only the surgical wound was created on mouse) and sham (only the dressing applied after the surgical wound was created on mouse) in groups after 3, 5 and 7 days. Immunohistochemically and ultrastructurally, cells derived from mouse embryonic stem cells were similar to differentiated keratinocyte-like cells. Differentiated keratinocyte-like cells were demonstrated by positive BrdU, cytokeratin-8 and cytokeratin-14 staining after transfer to the wound area. In the experimental group wound healing was better after transferring differentiated keratinocytes when compared to the sham and control groups. In vivo continuity and usability of derived cells are very important issues. In wound repair mechanisms, keratinocyte-like cells could provide positive effects during the wound healing and could be used in clinical treatments of wound repair process.

Bioengineered skin substitutes: key elements and novel design for biomedical applications

Significant progress has been made in the development of in vitro-engineered skin substitutes that mimic human skin, either to be used for the replacement of lost skin or for the establishment of in vitro skin research models. However, at the present time, there are no models of bioengineered skin that completely replicate the nature of uninjured skin. Obviously, there is still much room for improvement of the components of bioengineered skin and their interplay. This review summarises the important new discoveries in key elements of engineering of tissue-engineered skin including cell sources, biomaterials and growth factors, etc. Furthermore, basic and clinical applications for engineered skin substitutes in cell therapy, tissue engineering, and biomedical research continue to drive design improvements premised on these structure and function-based engineering paradigms.

Expression profile of drosomycin-like defensin in oral epithelium and oral carcinoma cell lines

OBJECTIVE

Drosomycin-like defensin (DLD) is a recently discovered antimicrobial peptide mainly active against filamentous fungi. The present study investigated the expression profile of DLD in oral epithelium and oral squamous cell carcinoma (SCC) cell lines.

METHODS

Tissue sections of human oral mucosa, keratinocytes derived from oral mucosa (NOK) and eight kinds of SCC cell lines were used. In situ hybridization was performed on tissue sections of oral mucosa. Expression levels of DLD in the cells were observed by reverse transcription polymerase chain reaction (RT-PCR) and real-time RT-PCR assays. The cells were treated with IL-1β, IL-8 and TNF-α, and agonists for TLR2, TLR4 and β-glucan. DLD expression in cells was increased and decreased by the DLD gene and its siRNA transfection, respectively. The proliferation rates were assessed by cell counting.

RESULTS

By means of in situ hybridization, DLD mRNA positive staining was detected in the epithelial layer of the oral mucosa. An RT-PCR assay confirmed the expression of DLD mRNA in keratinocytes derived from oral epithelium. Expression of DLD in two out of eight cell lines was significantly lower than in NOK cells. The expression levels of DLD mRNA were not significantly changed in the cells stimulated with any cytokines or agonists. The cell proliferation rate where there was decreased expression of DLD was significantly lower than in the control.

CONCLUSION

DLD may be partially involved in the defence against filamentous fungal infection in the oral mucosa, and may also serve other functions, such as contribution to cell growth.

Improvement of bone strength and dermal thickness due to dietary edible bird's nest extract in ovariectomized rats

Oral administration of edible bird's nest extract (EBNE) improved bone strength and calcium concentration in the femur of ovariectomized rats. Dermal thickness was also increased by EBNE supplementation, whereas EBNE administration did not affect the serum estradiol concentration. These results suggest that EBNE is effective for the improvement of bone loss and skin aging in postmenopause all women.

Quantitative assessments of burn degree by high-frequency ultrasonic backscattering and statistical model

An accurate and quantitative modality to assess the burn degree is crucial for determining further treatments to be properly applied to burn injury patients. Ultrasounds with frequencies higher than 20 MHz have been applied to dermatological diagnosis due to its high resolution and noninvasive capability. Yet, it is still lacking a substantial means to sensitively correlate the burn degree and ultrasonic measurements quantitatively. Thus, a 50 MHz ultrasound system was developed and implemented to measure ultrasonic signals backscattered from the burned skin tissues. Various burn degrees were achieved by placing a 100 °C brass plate onto the dorsal skins of anesthetized rats for various durations ranged from 5 to 20 s. The burn degrees were correlated with ultrasonic parameters, including integrated backscatter (IB) and Nakagami parameter (m) calculated from ultrasonic signals acquired from the burned tissues of a 5 × 1.4 mm (width × depth) area. Results demonstrated that both IB and m decreased exponentially with the increase of burn degree. Specifically, an IB of -79.0 ± 2.4 (mean ± standard deviation) dB for normal skin tissues tended to decrease to -94.0 ± 1.3 dB for those burned for 20 s, while the corresponding Nakagami parameters tended to decrease from 0.76 ± 0.08 to 0.45 ± 0.04. The variation of both IB and m was partially associated with the change of properties of collagen fibers from the burned tissues verified by samples of tissue histological sections. Particularly, the m parameter may be more sensitive to differentiate burned skin due to the fact that it has a greater rate of change with respect to different burn durations. These ultrasonic parameters in conjunction with high-frequency B-mode and Nakagami images could have the potential to assess the burn degree quantitatively.

Poly(amidoamine) Hydrogels as Scaffolds for Cell Culturing and Conduits for Peripheral Nerve Regeneration

Biodegradable and biocompatible poly(amidoamine)-(PAA-) based hydrogels have been considered for different tissue engineering applications. First-generation AGMA1 hydrogels, amphoteric but prevailing cationic hydrogels containing carboxylic and guanidine groups as side substituents, show satisfactory results in terms of adhesion and proliferation properties towards different cell lines. Unfortunately, these hydrogels are very swellable materials, breakable on handling, and have been found inadequate for other applications. To overcome this problem, second-generation AGMA1 hydrogels have been prepared adopting a new synthetic method. These new hydrogels exhibit good biological propertiesin vitrowith satisfactory mechanical characteristics. They are obtained in different forms and shapes and successfully testedin vivofor the regeneration of peripheral nerves. This paper reports on our recent efforts in the use of first-and second-generation PAA hydrogels as substrates for cell culturing and tubular scaffold for peripheral nerve regeneration.

A review of three-dimensional in vitro tissue models for drug discovery and transport studies

The use of animal models in drug discovery studies presents issues with feasibility and ethical concerns. To address these limitations, in vitro tissue models have been developed to provide a means for systematic, repetitive, and quantitative investigation of drugs. By eliminating or reducing the need for animal subjects, these models can serve as platforms for more tightly controlled, high-throughput screening of drugs and for pharmacokinetic and pharmacodynamic analyses of drugs. The focus of this review is three-dimensional (3D) tissue models that can capture cell-cell and cell-matrix interactions. Compared to the 2D culture of cell monolayers, 3D models more closely mimic native tissues since the cellular microenvironment established in the 3D models often plays a significant role in disease progression and cellular responses to drugs. A growing body of research has been published in the literature, which highlights the benefits of the 3D in vitro models of various tissues. This review provides an overview of some successful 3D in vitro models that have been developed to mimic liver, breast, cardiac, muscle, bone, and corneal tissues as well as malignant tissues in solid tumors.

Effect of low-level laser treatment of tissue-engineered skin substitutes: contraction of collagen lattices

Fibroblast-populated collagen lattices (FPCL) are widely used in tissue-engineered artificial skin substitutes, but their main drawback is that interaction of fibroblasts and matrix causes contraction of the lattice, reducing it to about 20% of its original area. The effect of low-level laser treatment (LLLT) on the behavior of 3T3 fibroblasts seeded in collagen lattices containing 20% chondroitin-6-sulphate was investigated to determine whether LLLT could control the contraction of FPCL. A He-Ne laser was used at 632.8 nm to deliver a 5-mW continuous wave with fluences from 1 to 4 J/cm(2). Laser treatment at 3 J/cm(2) increased contraction of collagen lattices in the absence of cells but decreased contraction of cell seeded lattices over a 7-day period. The effect was energy dependent and was not observed at 1, 2, or 4 J/cm(2). There was no alteration in fibroblast viability, morphology, or mitochondrial membrane potential after any laser treatments, but the distribution of actin fibers within the cells and collagen fibers in the matrices was disturbed at 3 J/cm(2). These effects contribute to the decrease in contraction observed. LLLT may offer a means to control contraction of FPCL used as artificial skin substitutes.

Skin tissue engineering for tissue repair and regeneration

Tissue-engineered skin is a significant advance in the field of wound healing. It has mainly been developed because of limitations associated with the use of autografts and allografts where the donor site suffers from pain, infection, and scarring. Recently, tissue-engineered skin replacements have been finding widespread application, especially in the case of burns, where the major limiting factor is the availability of autologous skin. The development of a bioartificial skin facilitates the treatment of patients with deep burns and various skin-related disorders. The present review gives a comprehensive overview of the developments and future prospects of scaffolds as skin substitutes for tissue repair and regeneration.

Role of beta-defensins in oral epithelial health and disease

The oral epithelium functions as a mechanical and protective barrier to resist bacterial infection. beta-Defensins are a group of antimicrobial peptides mainly produced by epithelial cells of many organs including skin, lung, kidney, pancreas, uterus, eye, and nasal and oral mucosa. This review focuses on beta-defensins (BDs) in oral epithelia and discusses their importance in oral epithelial health and disease. BDs exhibit antimicrobial activity against oral microbes including periodontitis-related bacteria, Candida, and papilloma virus. Alterative expression of BDs was observed in oral epithelial diseases, including oral inflammatory lesions with and without microbial infection and oral cancer. BDs may be useful in the treatment of oral infectious diseases, ulcerative lesions, and cancer. BDs play an important role in protection against oral microbes and may be used in clinical applications.

The use of cultured epithelial autograft in the treatment of major burn wounds: eleven years of clinical experience

INTRODUCTION

In patients with burns involving over 50% total body surface area (TBSA), donor skin is limited. Tissue engineering, particularly cultured epithelial autograft (CEA), offers a potential solution to assist in expedient wound closure.

MATERIALS AND METHODS

Prior to 1994, the application of CEA was restricted to confluent cell sheets. The introduction of an autologous cell suspension (CellSpray) in 1994 enabled cells to be delivered to the wound via aerosol onto debrided burn and donor skin graft wound areas. This retrospective clinical audit of major burn injured patients (n=84) describes the use of CEA in those with over 50%TBSA in Western Australia (WA) between 1992 and 2002.

RESULTS

The initial introduction of CEA was as confluent sheets, as this evolved to the use of CEA in suspension there was a reduction in the required surgical intervention and total length of stay (TLOS) divided by %TBSA.

DISCUSSION

With the audit covering an 11-year period, many facets of clinical burn care have evolved. The WA experience has demonstrated CEA has been positively integrated into clinical practice in association with traditional wound care techniques of skin grafting to augment wound healing.

The use of cultured epithelial autograft in the treatment of major burn injuries: a critical review of the literature

INTRODUCTION

The need to achieve rapid wound closure in patients with massive burns and limited skin donor sites led to the investigation of in vitro cellular expansion of keratinocytes. The use of cultured epithelial autografts (CEA) was first reported in the treatment of major burns in 1981. Since that time, support for the use of CEA has varied, ranging from 'a useful agent' to having 'no demonstrable effect on the outcome of extensively burned patients'.

METHODS

This critical review of the literature examines issues associated with the use of CEA and the introduction of the technology into clinical practice. The factors potentially limiting the use of cultured CEA are the time necessary to culture CEA sheets, the reliability of 'take', vulnerability of grafts on the newly healed surface, long-term durability and the cost implications of such treatment. The available literature was located and critically evaluated using the Australian National Health and Medical Research Council Guidelines.

FINDINGS

In the identified literature, the level of evidence to support the use of CEA in major burn injures is limited and often restricted to case studies and case series with no Level 1 evidence currently available.

CONCLUSION

The main question arising 'Does CEA have a role in the treatment of major burns?' has proven difficult to answer due to the wide variation in both the quality of study design and the findings. At best, the literature review has highlighted areas of concern that have hindered the successful use of CEA. Our review critically evaluates the use of CEA and explores the advances in techniques towards attempting to improve reliable clinical implementation of CEA. The need for higher level research into the use of CEA is emphasised by this review.

Stem cells in the mammalian eye: a tool for retinal repair

Degenerative diseases and traumatic injuries of the central nervous system (CNS) are major causes of long-term disability, whether such insults impact the brain, retina, or spinal cord. Substantial tissue destruction can be sustained by these complex structures without loss of life, while the lack of effective CNS regeneration frequently results in a marked degradation in quality of life. Only recently has it become clear that an enormous potential for regeneration is present within the mammalian CNS. The challenge now presented to researchers is to harness this potential to treat disease. Recent studies showing that stem and progenitor cells can be isolated from the mammalian retina have prompted many researchers to develop strategies aimed at restoring function to the diseased retina. This review summarizes a number of issues related to this goal, including retinal development, transplantation immunology, tissue engineering, and large animal studies. The application of these divergent disciplines to stem cell technology is vital to the development of the novel strategies needed to make retinal transplantation a clinical success.