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Soejima S, Wu CH, Matsuse H, Terakado M, Okano S, Inoue T, Kumai Y. Swallowing-related muscle inflammation and fibrosis induced by a single dose of radiation exposure in mice. Lab Anim Res 2024; 40:12. [PMID: 38561867 PMCID: PMC10983736 DOI: 10.1186/s42826-024-00199-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/12/2024] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Although radiotherapy is commonly used to treat head and neck cancer, it may lead to radiation-associated dysphagia (RAD). There are various causes of RAD, however, the mechanism has not yet been fully identified. Currently, the only effective treatment for RAD is rehabilitation. Additionally, there are few available animal models of RAD, necessitating the development of new models to establish and evaluate RAD treatments. We hypothesize that radiation-induced neck muscle fibrosis could be one of the causes of RAD due to impairment of laryngeal elevation. Therefore, in this study, we focused on the changes in inflammation and fibrosis of the strap muscles (Sternohyoid, Sternothyroid, and Thyrohyoid muscles) after a single-dose irradiation. This research aims to provide a reference animal model for future studies on RAD. RESULTS Compared to control mice, those treated with 72-Gy, but not 24-Gy, irradiation had significantly increased tumor necrosis factor-α (TNF-α) (p < 0.01) and α-smooth muscle actin (αSMA) (p < 0.05) expression at 10 days and significantly increased expression levels of motif chemokine ligand-2 (CCL2), α-SMA, tumor growth factor-β1 (TGF-β1), type1 collagen, and interleukin-1β (IL-1β) (p < 0.05) in the muscles at 1 month by real-time PCR analysis. The results of immunohistochemistry showed that the deposition of type 1 collagen gradually increased in extracellular space after radiation exposure, and the positive area was significantly increased at 3 months compared to non-irradiated control. CONCLUSIONS A single dose of 72-Gy irradiation induced significant inflammation and fibrosis in the strap muscles of mice at 1 month, with immunohistochemical changes becoming evident at 3 months. This cervical irradiation-induced fibrosis model holds potential for establishing an animal model for RAD in future studies. LEVEL OF EVIDENCE N/A.
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Affiliation(s)
- Shuntaro Soejima
- Department of Otolaryngology Head and Neck Surgery Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Chia-Hsien Wu
- Department of Physiology of Visceral Function and Body Fluid, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Haruna Matsuse
- Department of Otolaryngology Head and Neck Surgery Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Mariko Terakado
- Department of Otolaryngology Head and Neck Surgery Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Shinji Okano
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Tsuyoshi Inoue
- Department of Physiology of Visceral Function and Body Fluid, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yoshihiko Kumai
- Department of Otolaryngology Head and Neck Surgery Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
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Bakr NM, Balbola GA, Gawad Mohamed NA, Ahmed NA, Sapri AM, Mously EA, Felemban D, Elsayed SA, Hassan S. The effectiveness of Moringa oleifera in the preservation of periodontium after radiation therapy: An experimental animal study. Heliyon 2024; 10:e27495. [PMID: 38510057 PMCID: PMC10950587 DOI: 10.1016/j.heliyon.2024.e27495] [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: 12/14/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/22/2024] Open
Abstract
Background Radiation therapy produces reactive oxygen species, which have been linked to various degenerative conditions in periodontal attachment. This study aimed to assess the beneficial effects of aqueous Moringa oleifera leaf extract on the periodontium of albino rats exposed to fractionated gamma radiation. Materials and methods This experimental study involved 24 adult male albino rats divided into three groups: Group M received M. oleifera leaf extract (300 mg/kg) intraperitoneally for 14 days; Group R received 20 Gy fractionated gamma irradiation; and Group MR received the same M. oleifera regimen as Group M and then fractionated gamma irradiation dose as Group R. On the first and seventh days post-radiation, bone, cementum, and periodontal ligament samples were histologically and histomorphometrically examined. Results The periodontal ligament, alveolar bone, and cementum showed structural damage in Group R. A relative persistence of normal periodontal tissue structures was seen in Group MR, showing less disruption of the periodontal ligament and greater trabecular bone thickness than Group R. The histomorphometric analysis showed that the mean periodontal ligament width was highest in Group R7 (245.20 μm) and lowest in Group M7 (54.55 μm). In addition, the mean cementum width was highest in Group R1 (88.99 μm) and lowest in Group M1R1 (17.87 μm) and differed significantly between groups. Conclusion Within the limitations of this study, Moringa oleifera leaf aqueous extract showed the potential to reduce the adverse effects of radiation, control inflammation, and support tissue healing in a rat model.
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Affiliation(s)
- Noura Mohammed Bakr
- Department of Oral and Dental Biology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Gihan A. Balbola
- Department of Oral and Dental Pathology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Nora Abdel Gawad Mohamed
- Department of Oral Medicine and Periodontology, Diagnosis and Radiology Department, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Nehad A. Ahmed
- Department of Oral and Dental Biology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Ahmed Mohammed Sapri
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Egypt
| | - Eihab A. Mously
- Department of Preventive Dental Sciences and Periodontology, College of Dentistry, TaibahUniversity, Saudi Arabia
| | - Doaa Felemban
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, Taibah University, Saudi Arabia
| | - Shadia A. Elsayed
- Department of Oral and Dental Biology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, Taibah University, Saudi Arabia
| | - Sandy Hassan
- Department of Oral Medicine, Periodontology & Oral Diagnosis, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
- Ahram Canadian University (ACU), Egypt
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Borges JS, Paula IS, de Araújo Reis NT, de Lima Oliveira AP, Soares CJ, Soares PBF. Effects of different doses of ionizing radiation on alveolar bone repair in post-extraction tooth socket: an experimental study in rats. Clin Oral Investig 2023; 27:7583-7593. [PMID: 37906304 DOI: 10.1007/s00784-023-05348-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE This study aimed to evaluate the dose-response effects of ionizing radiation (IR) on alveolar bone repair and bone strength after tooth extraction. MATERIALS AND METHODS A total of 32 male Wistar rats were used in the study, 28 animals were included in the final analysis, and n = 7 for each experimental group. Mandibular first molars were extracted. After 7 days, the animals were randomly divided into four groups according to single-dose irradiation: NIr, control group; Ir15, irradiated at 15 Gy; Ir20, irradiated at 20 Gy; and Ir30, irradiated at 30 Gy. The tooth extraction sites were subjected to micro-computed tomography (micro-CT), histological, histomorphometric, and biomechanical analyses 14 days after extraction. Data were analyzed using one-way ANOVA followed by Tukey's post hoc test (α = 0.05). RESULTS Micro-CT analysis revealed that IR led to lower values of bone volume (BV, in mm3) (0.68 ± 0.08, P < 0.001) and bone volume fraction, ratio of the segmented bone volume to the total volume of the region of interest (BV/TV, in %) (44.1 ± 8.3, P < 0.001) for the Ir30 group compared to the control group. A significantly lower amount of newly formed bone was observed in the Ir30 (P = 0.005) than in the Ir15 group. The histomorphometric results of quantification of bone matrix neoformation and the micro-CT were in agreement, demonstrating greater damage to the Ir30 group. IR30 cells showed a lower percentage of densely packed collagen than control cells. No significant differences were found in the biomechanical parameters. CONCLUSION IR affects alveolar bone repair. A dose of 30 Gy reduced the bone healing process owing to a smaller amount of newly formed bone and a lower percentage of densely packed collagen. Therefore, a dose of 30 Gy can be used to successfully establish an animal model of an irradiated mandible that mimics the irradiated clinical conditions. CLINICAL RELEVANCE Radiotherapy can lead to severe side effects and tooth extraction is a major risk factor. A proper understanding of the pathological mechanisms of radiation in alveolar bone repair requires the establishment of a suitable animal model of clinical conditions.
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Affiliation(s)
- Juliana Simeão Borges
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Isabella Santos Paula
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Nayara Teixeira de Araújo Reis
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Ana Paula de Lima Oliveira
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Carlos José Soares
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Priscilla Barbosa Ferreira Soares
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
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Li Y, Wu M, Xing X, Li X, Shi C. Effect of Wnt10a/β-catenin signaling pathway on promoting the repair of different types of dentin-pulp injury. In Vitro Cell Dev Biol Anim 2023; 59:486-504. [PMID: 37700204 PMCID: PMC10520212 DOI: 10.1007/s11626-023-00785-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/06/2023] [Indexed: 09/14/2023]
Abstract
How to repair dentin-pulp injury effectively has always been a clinical problem, and the comparative study of repair process between different injuries is unknown. Dental pulp stem cells (DPSCs) often are selected as seed cells for the study of dentin-pulp injury repair due to excellent advantages in odontogenesis and pulp differentiation. Although many previous researches have indicated that the Wnt protein and Wnt/β-catenin signaling pathway were crucial for dental growth, development, and injury repair, the specific mechanism remained unknown. In this study, different dentine-pulp injury models of adult mice were established successfully by abrasion and cutting methods. The gross morphology and micro-CT were used to observe the repair of injured mice incisor in different groups. We found that the repair time of each group was different. The repair time of the cutting group was longer than the abrasion group and the qRT-PCR detection showed that the expression of DSPP in the cutting group was higher than that in the abrasion group, but there was no significant difference in proliferation among the groups. In vivo and cell experiments showed that activation of Wnt/β-catenin signaling pathway can promote the proliferation and odontoblast differentiation of DPSCs. In addition, by using RNAscope staining, we observed that Wnt10a was mainly expressed in the proliferative region and partially expressed in the odontoblast region. The Western blotting results showed that in the early stage of repair, the expression of Wnt10a increased with the extension of days after injury in both abrasion and cutting group and the increase of Wnt10a was tested obviously on the 5th day after injury. But on the 7th day after injury, the expression of Wnt10a was still obvious in the cutting group, while the expression of Wnt10a was significantly reduced in the abrasion group, which was close to the control group. It is suggested that Wnt10a acts as a repair-related protein and has an important role in tooth injury repair. Wnt10a was activated by R-spondin and LiCl, and Wnt10a-siRNA DPSCs were constructed to inhibit Wnt10a. The results showed that Wnt10a/β-catenin signaling pathway promoted the proliferation and odontoblast differentiation of DPSCs. It plays a crucial role in the repair process of different injuries. This study enriched the mechanisms of Wnt10a /β-catenin signaling pathways in different types of dentin-pulp injury repair, which could provide experimental evidences for the target gene screening and also give some new ideas for the subsequent research on the molecular mechanisms of tooth regeneration.
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Affiliation(s)
- Yue Li
- Department of Orthodontics, Kunming Medical University School and Hospital of Stomatology, Kunming, 650106, China
- Yunnan Key Laboratory of Stomatology, Kunming, 650106, China
| | - Meiying Wu
- Department of Orthodontics, Kunming Medical University School and Hospital of Stomatology, Kunming, 650106, China
- Yunnan Key Laboratory of Stomatology, Kunming, 650106, China
| | - Xinyu Xing
- Department of Orthodontics, Kunming Medical University School and Hospital of Stomatology, Kunming, 650106, China
- Yunnan Key Laboratory of Stomatology, Kunming, 650106, China
| | - Xingxing Li
- Yunnan Key Laboratory of Stomatology, Kunming, 650106, China
- Department of Prosthodontics, Kunming Medical University School and Hospital of Stomatology, Kunming, 650106, China
| | - Congchong Shi
- Department of Orthodontics, Kunming Medical University School and Hospital of Stomatology, Kunming, 650106, China.
- Yunnan Key Laboratory of Stomatology, Kunming, 650106, China.
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Juvkam IS, Zlygosteva O, Arous D, Galtung HK, Malinen E, Søland TM, Edin NJ. A preclinical model to investigate normal tissue damage following fractionated radiotherapy to the head and neck. JOURNAL OF RADIATION RESEARCH 2023; 64:44-52. [PMID: 36253091 PMCID: PMC9855321 DOI: 10.1093/jrr/rrac066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/09/2022] [Indexed: 06/16/2023]
Abstract
Radiotherapy (RT) of head and neck (H&N) cancer is known to cause both early- and late-occurring toxicities. To better appraise normal tissue responses and their dependence on treatment parameters such as radiation field and type, as well as dose and fractionation scheme, a preclinical model with relevant endpoints is required. 12-week old female C57BL/6 J mice were irradiated with 100 or 180 kV X-rays to total doses ranging from 30 to 85 Gy, given in 10 fractions over 5 days. The radiation field covered the oral cavity, swallowing structures and salivary glands. Monte Carlo simulations were employed to estimate tissue dose distribution. The follow-up period was 35 days, in order to study the early radiation-induced effects. Baseline and post irradiation investigations included macroscopic and microscopic examinations of the skin, lips, salivary glands and oral mucosa. Saliva sampling was performed to assess the salivary gland function following radiation exposure. A dose dependent radiation dermatitis in the skin was observed for doses above 30 Gy. Oral mucositis in the tongue appeared as ulcerations on the ventral surface of the tongue for doses of 75-85 Gy. The irradiated mice showed significantly reduced saliva production compared to controls. In summary, a preclinical model to investigate a broad panel of normal tissue responses following fractionated irradiation of the H&N region was established. The optimal dose to study early radiation-induced effects was found to be around 75 Gy, as this was the highest tolerated dose that gave acute effects similar to that observed in cancer patients.
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Affiliation(s)
- Inga Solgård Juvkam
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo, 0372 Oslo, Norway
| | - Olga Zlygosteva
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Oslo, 0371 Oslo, Norway
| | - Delmon Arous
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Oslo, 0371 Oslo, Norway
- Department of Medical Physics, Cancer Clinic, Oslo University Hospital, 0379 Oslo, Norway
| | - Hilde Kanli Galtung
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo, 0372 Oslo, Norway
| | - Eirik Malinen
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Oslo, 0371 Oslo, Norway
- Department of Medical Physics, Cancer Clinic, Oslo University Hospital, 0379 Oslo, Norway
| | - Tine Merete Søland
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo, 0372 Oslo, Norway
- Department of Pathology, Oslo University Hospital, 0372 Oslo, Norway
| | - Nina Jeppesen Edin
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Oslo, 0371 Oslo, Norway
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6
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Zhang P, Yao L, Shan G, Chen Y. A model of radiation-induced temporomandibular joint damage in mice. Int J Radiat Biol 2022; 98:1-10. [PMID: 35467478 DOI: 10.1080/09553002.2022.2069298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 02/24/2022] [Accepted: 04/14/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE A small animal radiation research platform (SARRP) equipped with a miniature beam system, an image-guided positioning system, and a dose planning system was used to develop and evaluate a mouse model of radiation-induced temporomandibular damage. METHODS Left jaw disks of adult male C57BL/6 mice and C3H mice were targeted using the SARRP for image-guided irradiation. The total radiation dose was 75 Gy. Experiment 1 (Scoping study): Mice in the C57BL/6 mouse test and control groups were sacrificed at 1, 3, 6, 9, 12, 15, and 18 weeks after irradiation, whereas mice in the C3H test and control groups were sacrificed at 1, 3, 6, 9, and 12 weeks after irradiation. Experiment 2 (Full -scale validation study): Mice in the C57BL/6 mouse test and control groups were sacrificed at 1, 3 and 6 weeks after irradiation. Histopathological analysis of the temporomandibular skeletal muscle in each group was performed using hematoxylin and eosin (H&E) and Masson staining; the temporal mandibular bone was examined through H&E staining. RESULTS SARRP delivered the rated dose to the temporomandibular joints of C57BL/6 and C3H mice. C3H and C57BL/6 mice in the test group showed different degrees of osteocytic necrosis and osteoporosis at different time points. H&E staining of skeletal muscle tissue showed slight fibrosis in the C57BL/6 test at 3 and 6 weeks time point. CONCLUSION We established a model of radiation-induced damage in the temporomandibular joint of C57BL/6 mice and demonstrated that the observed physiological and histological changes correspond to radiation damage observed in humans. Furthermore, the SARRP can deliver precise radiation doses.
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Affiliation(s)
- Peng Zhang
- Department of Radiology Physics, Zhejiang Key Laboratory of Radiation Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Lejing Yao
- Department of Radiology Physics, Zhejiang Key Laboratory of Radiation Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Guoping Shan
- Department of Radiology Physics, Zhejiang Key Laboratory of Radiation Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Yuanyuan Chen
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
- Department of Radiology Oncology, Zhejiang Key Laboratory of Radiation Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
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7
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Amler AK, Schlauch D, Tüzüner S, Thomas A, Neckel N, Tinhofer I, Heiland M, Lauster R, Kloke L, Stromberger C, Nahles S. Pilot investigation on the dose-dependent impact of irradiation on primary human alveolar osteoblasts in vitro. Sci Rep 2021; 11:19833. [PMID: 34615948 PMCID: PMC8494843 DOI: 10.1038/s41598-021-99323-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/20/2021] [Indexed: 12/29/2022] Open
Abstract
Radiotherapy of head and neck squamous cell carcinoma can lead to long-term complications like osteoradionecrosis, resulting in severe impairment of the jawbone. Current standard procedures require a 6-month wait after irradiation before dental reconstruction can begin. A comprehensive characterization of the irradiation-induced molecular and functional changes in bone cells could allow the development of novel strategies for an earlier successful dental reconstruction in patients treated by radiotherapy. The impact of ionizing radiation on the bone-forming alveolar osteoblasts remains however elusive, as previous studies have relied on animal-based models and fetal or animal-derived cell lines. This study presents the first in vitro data obtained from primary human alveolar osteoblasts. Primary human alveolar osteoblasts were isolated from healthy donors and expanded. After X-ray irradiation with 2, 6 and 10 Gy, cells were cultivated under osteogenic conditions and analyzed regarding their proliferation, mineralization, and expression of marker genes and proteins. Proliferation of osteoblasts decreased in a dose-dependent manner. While cells recovered from irradiation with 2 Gy, application of 6 and 10 Gy doses not only led to a permanent impairment of proliferation, but also resulted in altered cell morphology and a disturbed structure of the extracellular matrix as demonstrated by immunostaining of collagen I and fibronectin. Following irradiation with any of the examined doses, a decrease of marker gene expression levels was observed for most of the investigated genes, revealing interindividual differences. Primary human alveolar osteoblasts presented a considerably changed phenotype after irradiation, depending on the dose administered. Mechanisms for these findings need to be further investigated. This could facilitate improved patient care by re-evaluating current standard procedures and investigating faster and safer reconstruction concepts, thus improving quality of life and social integrity.
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Affiliation(s)
- Anna-Klara Amler
- Cellbricks GmbH, Berlin, Germany. .,Department of Medical Biotechnology, Technische Universität Berlin, Berlin, Germany.
| | - Domenic Schlauch
- Cellbricks GmbH, Berlin, Germany.,Department of Medical Biotechnology, Technische Universität Berlin, Berlin, Germany
| | - Selin Tüzüner
- Cellbricks GmbH, Berlin, Germany.,Department of Medical Biotechnology, Technische Universität Berlin, Berlin, Germany
| | - Alexander Thomas
- Cellbricks GmbH, Berlin, Germany.,Department of Medical Biotechnology, Technische Universität Berlin, Berlin, Germany
| | - Norbert Neckel
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Berlin, Germany
| | - Ingeborg Tinhofer
- Department of Radiation Oncology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,German Cancer Consortium (DKTK) Partner Site Berlin, Berlin, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Berlin, Germany
| | - Roland Lauster
- Department of Medical Biotechnology, Technische Universität Berlin, Berlin, Germany
| | | | - Carmen Stromberger
- Department of Radiation Oncology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Susanne Nahles
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Berlin, Germany
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8
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Bálentová S, Hnilicová P, Kalenská D, Baranovičová E, Muríň P, Hajtmanová E, Adamkov M. Effect of fractionated whole-brain irradiation on brain and plasma in a rat model: Metabolic, volumetric and histopathological changes. Neurochem Int 2021; 145:104985. [PMID: 33582163 DOI: 10.1016/j.neuint.2021.104985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
In the present study, we investigated the correlation between histopathological, metabolic, and volumetric changes in the brain and plasma under experimental conditions. Adult male Wistar rats received fractionated whole-brain irradiation (fWBI) with a total dose of 32 Gy delivered in 4 fractions (dose 8 Gy per fraction) once a week on the same day for 4 consecutive weeks. Proton magnetic resonance spectroscopy (1H MRS) and imaging were used to detect metabolic and volumetric changes in the brain and plasma. Histopathological changes in the brain were determined by image analysis of immunofluorescent stained sections. Metabolic changes in the brain measured by 1H MRS before, 48 h, and 9 weeks after the end of fWBI showed a significant decrease in the ratio of total N-acetylaspartate to total creatine (tNAA/tCr) in the corpus striatum. We found a significant decrease in glutamine + glutamate/tCr (Glx/tCr) and, conversely, an increase in gamma-aminobutyric acid to tCr (GABA/tCr) in olfactory bulb (OB). The ratio of astrocyte marker myoinositol/tCr (mIns/tCr) significantly increased in almost all evaluated areas. Magnetic resonance imaging (MRI)-based brain volumetry showed a significant increase in volume, and a concomitant increase in the T2 relaxation time of the hippocampus. Proton nuclear magnetic resonance (1H NMR) plasma metabolomics displayed a significant decrease in the level of glucose and glycolytic intermediates and an increase in ketone bodies. The histomorphological analysis showed a decrease to elimination of neuroblasts, increased astrocyte proliferation, and a mild microglia response. The results of the study clearly reflect early subacute changes 9-11 weeks after fWBI with strong manifestations of brain edema, astrogliosis, and ongoing ketosis.
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Affiliation(s)
- Soňa Bálentová
- Department of Histology and Embryology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Malá Hora 4, 036 01, Martin, Slovak Republic.
| | - Petra Hnilicová
- Biomedical Center Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, Malá Hora 4D, 036 01, Martin, Slovak Republic
| | - Dagmar Kalenská
- Department of Anatomy, Jessenius Faculty of Medicine, Comenius University in Bratislava, Malá Hora 4, 036 01, Martin, Slovak Republic
| | - Eva Baranovičová
- Biomedical Center Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, Malá Hora 4D, 036 01, Martin, Slovak Republic
| | - Peter Muríň
- Department of Radiotherapy and Oncology, Martin University Hospital, Kollárova 2, 036 59, Martin, Slovak Republic
| | - Eva Hajtmanová
- Department of Radiotherapy and Oncology, Martin University Hospital, Kollárova 2, 036 59, Martin, Slovak Republic
| | - Marian Adamkov
- Department of Histology and Embryology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Malá Hora 4, 036 01, Martin, Slovak Republic
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9
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Anderson J, Belafsky P, Clayton S, Archard J, Pavlic J, Rao S, Farwell DG, Kuhn M, Deng P, Halmai J, Bauer G, Fink K, Fury B, Perotti N, Walker J, Beliveau A, Birkeland A, Abouyared M, Cary W, Nolta J. Model of radiation-induced ambulatory dysfunction. JOURNAL OF MEDICAL SCIENCES 2021. [DOI: 10.4103/jmedsci.jmedsci_259_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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10
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Afanasyev DE, Liubarets SF. ODONTOLOGICAL EFFECTS OF IONIZING RADIATION (review). PROBLEMY RADIAT︠S︡IĬNOÏ MEDYT︠S︡YNY TA RADIOBIOLOHIÏ 2020; 25:18-55. [PMID: 33361828 DOI: 10.33145/2304-8336-2020-25-18-55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Odontological effects of ionizing radiation (IR) as a result of radiotherapy, the consequences of accidents at nuclear power plants and industry, individual occupational exposure, etc. deserve significant attention interns of radiation medicine and radiation safety. OBJECTIVE to analyze and summarize clinical and experimental data on the odontological radiation effects. MATERIALS AND METHODS OBJECT the pathological changes in the hard tissues of teeth, pulp, periodontium, mucousmembranes of the mouth and jaws due to exposure to IR. METHOD search in the PubMed / MEDLINE, Google Scholarabstract medical and biological databases, scientific libraries of the relevant sources of scientific information. RESULTS Radiobiological effects of IR due to its direct and indirect action are manifested throughout the period ofodontogenesis and formation of the facial skeleton. Experimental and clinical data (in children and adults) indicatethe increased risk of dental caries, reduction of pain threshold and vascularization of tooth pulp along with its fibrosis and atrophy, periodontal dysfunction, which predispose to a high probability of tooth loss. Abnormalities in theactivity of osteoblasts and cementoblasts of dental periosteum and osteoblasts of alveolar process in combinationwith circulatory disorders due to endothelial cell death, hyalinization, thrombosis and vascular obliteration increasethe risk of jaw osteoradionecrosis. Children who have undergone a prenatal exposure to IR as a result of theChornobyl NPP accident have a premature change of teeth. Deterioration of periodontal tissues and early development of acute and complicated dental caries are typical for children and adults affected by the Chornobyl disaster. CONCLUSIONS Summarized data on the effects of radiation exposure under different conditions on teeth primordia(i.e. immature teeth), their formation and eruption in experimental and clinical settings, as well as on the odontological radiation effects in adults are summarized. Condition of the teeth in the Chornobyl NPP accident survivorsis described. Understanding and taking into account the radiobiological odontological effects is necessary in thelight of planning, preparing, and conducting local radiation therapy and developing the standards of radiation safety and measures to protect professionals and the public in the event of possible radiation accidents at the nuclearpower plants and industry facilities.
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Affiliation(s)
- D E Afanasyev
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine
| | - S F Liubarets
- O. O. Bogomolets National Medical University of the Ministry of Health of Ukraine, 13 Tarasa Shevchenka Blvd., Kyiv, 01601, Ukraine
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11
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Helmers R, Milstein DMJ, Straat NF, Rodermond HM, Franken NAP, Savci-Heijink CD, de Boer HH, de Lange J. Outcome of a rabbit model for late irradiation effects in mandibular oral mucosa and bone: A pilot study. J Clin Transl Res 2020; 6:225-235. [PMID: 33564727 PMCID: PMC7868115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/02/2020] [Accepted: 10/04/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND/AIM/OBJECTIVE Late side effects of radiotherapy (RT) in the treatment for head and neck (HN) malignancies involve an inadequate healing response of the distressed tissue due to RT-induced hypovascularity. The aim of this study was to develop a pilot model in which vascular alterations associated with the onset of late irradiation (IR) injury could be measured in rabbit oral mucosa and mandibular bone. MATERIALS AND METHODS Eight male New Zealand white rabbits were divided over four treatment groups. Group I-III received four fractions of RT (5.6 Gy, 6.5 Gy, and 8 Gy, respectively) and Group IV received 1 fraction of 30 Gy. Oral microcirculatory measurements were performed at baseline (before RT) and once a week during 11 consecutive weeks after RT assessing perfusion parameters, that is, total vessel density (TVD), perfused vessel density (PVD), proportion of perfused vessels (PPV), and microvascular flow index (MFI). Post-mortem histopathology specimens were analyzed. RESULTS Five weeks after RT, TVD, and PVD in all groups showed a decrease of >10% compared to baseline, a significant difference was observed for Groups I, II, and IV (P<0.05). At T11, no lasting effect of decreased vessel density was observed. PPV and MFI remained unaltered at all-time points. Group IV showed a marked difference in scattered telangiectasia such as microangiopathies, histological necrosis, and loss of vasculature. CONCLUSION No significant lasting effect in mucosal microcirculation density due to IR damage was detected. Observed changes in microcirculation vasculature and histology may align preliminary tissue transition towards clinical pathology in a very early state associated with late IR injury in the oral compartment. RELEVANCE FOR PATIENTS Enhancing knowledge on the onset of late vascular IR injury in the HN region could help the development, monitoring, and timing of therapies that act on prevention, discontinuation, or repair of radiation pathology.
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Affiliation(s)
- R. Helmers
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centre (UMC), Location: AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - D. M. J. Milstein
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centre (UMC), Location: AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - N. F. Straat
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centre (UMC), Location: AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - H. M. Rodermond
- Laboratory of Experimental Oncology and Radiobiology, Amsterdam UMC, Location: AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Radiation Oncology, Amsterdam UMC, Location: AMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands
| | - N. A. P. Franken
- Laboratory of Experimental Oncology and Radiobiology, Amsterdam UMC, Location: AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Radiation Oncology, Amsterdam UMC, Location: AMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands
| | - C. D. Savci-Heijink
- Department of Pathology, Amsterdam UMC, Location: AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - H. H. de Boer
- Department of Pathology, Amsterdam UMC, Location: AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - J. de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centre (UMC), Location: AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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12
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Experimental Animal Model Systems for Understanding Salivary Secretory Disorders. Int J Mol Sci 2020; 21:ijms21228423. [PMID: 33182571 PMCID: PMC7696548 DOI: 10.3390/ijms21228423] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/03/2020] [Accepted: 11/05/2020] [Indexed: 12/12/2022] Open
Abstract
Salivary secretory disorders are life-disrupting pathologic conditions with a high prevalence, especially in the geriatric population. Both patients and clinicians frequently feel helpless and get frustrated by the currently available therapeutic strategies, which consist mainly of palliative managements. Accordingly, to unravel the underlying mechanisms and to develop effective and curative strategies, several animal models have been developed and introduced. Experimental findings from these models have contributed to answer biological and biomedical questions. This review aims to provide various methodological considerations used for the examination of pathological fundamentals in salivary disorders using animal models and to summarize the obtained findings. The information provided in this review could provide plausible solutions for overcoming salivary disorders and also suggest purpose-specific experimental animal systems.
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13
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Patel V, Di Silvio L, Kwok J, Burns M, Henley Smith R, Thavaraj S, Veschini L. The impact of intensity-modulated radiation treatment on dento-alveolar microvasculature in pharyngeal cancer implant patients. J Oral Rehabil 2020; 47:1411-1421. [PMID: 32841377 DOI: 10.1111/joor.13084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/09/2020] [Accepted: 07/29/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Dental rehabilitation post-radiotherapy often requires the consideration of dental implants. However, these are tentatively prescribed due to the concern of hypovascularisation and possible osteoradionecrosis. Hence, the current study assessed the microvasculature of the dento-alveolar bone at implant sites taking into consideration the exact radiotherapy dose received to the region. MATERIALS AND METHODS Bone cores were taken from nine patients during implant treatment and compared to nine control patients. Specimens were stained using CD31 and digitalised using a high-resolution scanner for qualitative and quantitative assessment of the microvasculature. Monaco® treatment planning system was used to volume the implant site providing mean dose (Dmean ) and maximum dose (Dmax ). RESULTS A total of 23 bone cores were retrieved for analysis. The cohort had a Dmean of 38.4 Gy (59.6-24.3 Gy). Qualitative analysis identified a clear reduction in the miniscule terminal capillaries and high incidence of obliterated lumens with increasing radiotherapy. Microvasculature density of irradiated patients was markedly reduced (P = .0034) compared to the control group with an inverse correlation to RT doses (P < .0001). Specifically, doses up to 30 Gy appear to preserve sufficient vascularisation (~77% in comparison with control) and tissue architecture. By contrast, exposure to higher doses 40%-61% of the micro-vessels were lost. CONCLUSION Intensity-modulated radiotherapy doses above 30 Gy identified reduction in microvasculature which is a lower threshold than previously accepted. In pharyngeal cancer patients' doses to the jaw bones often exceed this threshold. Coupled with favourable survival in certain oropharyngeal and nasopharyngeal cancer, dental rehabilitation via implants provides a significant clinical challenge.
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Affiliation(s)
- Vinod Patel
- Oral Surgery Department, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Lucy Di Silvio
- King's College London, Centre for Clinical, Oral & Translational Science, Guys Dental Hospital, London, UK
| | - Jerry Kwok
- Oral Surgery Department, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Megan Burns
- Oral Surgery Department, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Rhonda Henley Smith
- King's Health Partners Head and Neck Cancer Biobank, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Selvam Thavaraj
- Department of Head and Neck pathology, King's College London, Centre for Clinical, Oral & Translational Science, Guys Hospital, London, UK
| | - Lorenzo Veschini
- Academic Centre of Reconstructive Science, King's College London, Centre for Clinical, Oral & Translational Science, Guys Dental Hospital, London, UK
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14
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Sheng X, Zhou Y, Wang H, Shen Y, Liao Q, Rao Z, Deng F, Xie L, Yao C, Mao H, Liu Z, Peng M, Long Y, Zeng Y, Xue L, Gao N, Kong Y, Zhou X. Establishment and characterization of a radiation-induced dermatitis rat model. J Cell Mol Med 2019; 23:3178-3189. [PMID: 30821089 PMCID: PMC6484338 DOI: 10.1111/jcmm.14174] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/27/2018] [Accepted: 12/28/2018] [Indexed: 12/18/2022] Open
Abstract
Radiation‐induced dermatitis is a common and serious side effect after radiotherapy. Current clinical treatments cannot efficiently or fully prevent the occurrence of post‐irradiation dermatitis, which remains a significant clinical problem. Resolving this challenge requires gaining a better understanding of the precise pathophysiology, which in turn requires establishment of a suitable animal model that mimics the clinical condition, and can also be used to investigate the mechanism and explore effective treatment options. In this study, a single dose of 90 Gy irradiation to rats resulted in ulceration, dermal thickening, inflammation, hair follicle loss, and sebaceous glands loss, indicating successful establishment of the model. Few hair follicle cells migrated to form epidermal cells, and both the severity of skin fibrosis and hydroxyproline levels increased with time post‐irradiation. Radiation damaged the mitochondria and induced both apoptosis and autophagy of the skin cells. Therefore, irradiation of 90 Gy can be used to successfully establish a rat model of radiation‐induced dermatitis. This model will be helpful for developing new treatments and gaining a better understanding of the pathological mechanism of radiation‐induced dermatitis. Specifically, our results suggest autophagy regulation as a potentially effective therapeutic target.
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Affiliation(s)
- Xiaowu Sheng
- Hunan Branch Center, National Tissue Engineering Center of China, Translational Medical Center, Central Laboratory, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Yue Zhou
- Department of Radiation Oncology, Key Laboratory of Translational Radiation Oncology, Changsha, Hunan Province, China.,Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China.,Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Hui Wang
- Department of Radiation Oncology, Key Laboratory of Translational Radiation Oncology, Changsha, Hunan Province, China.,Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Yongyi Shen
- Nursing Department, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, Hunan Province, China
| | - Qianjin Liao
- Hunan Branch Center, National Tissue Engineering Center of China, Translational Medical Center, Central Laboratory, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Zhen Rao
- Department of Head and Neck Surgery, The First People's Hospital of Changde City, Changsha, Hunan Province, China
| | - Feiyan Deng
- University of South China, Hengyang, Hunan Province, China.,Department of Head and Neck Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, Hunan Province, China
| | - Luyuan Xie
- University of South China, Hengyang, Hunan Province, China.,Department of Head and Neck Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, Hunan Province, China
| | - Chaoling Yao
- Department of Head and Neck Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, Hunan Province, China
| | - Huangxing Mao
- Department of Head and Neck Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, Hunan Province, China
| | - Zhiyan Liu
- Department of Head and Neck Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, Hunan Province, China
| | - Mingjing Peng
- Hunan Branch Center, National Tissue Engineering Center of China, Translational Medical Center, Central Laboratory, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Ying Long
- Hunan Branch Center, National Tissue Engineering Center of China, Translational Medical Center, Central Laboratory, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Yong Zeng
- Hunan Branch Center, National Tissue Engineering Center of China, Translational Medical Center, Central Laboratory, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Lei Xue
- Pathology Department, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, Hunan Province, China
| | - Nina Gao
- Pathology Department, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, Hunan Province, China
| | - Yu Kong
- Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Xiao Zhou
- Hunan Branch Center, National Tissue Engineering Center of China, Translational Medical Center, Central Laboratory, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China.,Department of Head and Neck Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, Hunan Province, China
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15
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Limirio PHJO, Soares PBF, Emi ETP, Lopes CDCA, Rocha FS, Batista JD, Rabelo GD, Dechichi P. Ionizing radiation and bone quality: time-dependent effects. Radiat Oncol 2019; 14:15. [PMID: 30670063 PMCID: PMC6343359 DOI: 10.1186/s13014-019-1219-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 01/14/2019] [Indexed: 12/31/2022] Open
Abstract
Background The aim of this study was to evaluate the ionizing radiation (IR) effects on rat bone 30 and 60 days after irradiation. Methods Wistar rats were submitted to IR (30 Gy) on the left leg and were euthanized after 30 and 60 days. The legs were divided into four groups according to the treatment and euthanization time: C30 and C60 (right leg–without IR), IR30 and IR60 (left leg-with IR). Results CT analysis showed more radiodensity in C60 compared with other groups, and IR60 showed more radiodensity than IR30. In histomorphometric analysis, C30 showed lower bone matrix values compared with IR30 and C60. Lacunarity analyses showed more homogeneous bone channel distribution in C30 than IR30. ATR-FTIR showed decrease in ratio of mature and immature crosslinks in IR30 compared with C30. Crystallinity Index was decrease in IR60 compared with C60. The Amide III + Collagen/HA ratio was increased in C60 compared with C30; however this ratio decreased in IR60 compared with IR30. Biomechanical analysis showed lower values in IR groups in both time. Conclusions IR damaged bone quality and decreased stiffness. Moreover, the results suggested that the deleterious effects of IR increased in the late time points.
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Affiliation(s)
- Pedro Henrique Justino Oliveira Limirio
- Integrated Dental Clinic Program, Faculty of Dentistry, Federal University of Uberlândia, Avenida Pará s/n°, Campus Umuarama, Bloco 4L, Bairro Umuarama, Uberlândia, Minas Gerais, 38.400-902, Brazil
| | - Priscilla Barbosa Ferreira Soares
- Integrated Dental Clinic Program, Faculty of Dentistry, Federal University of Uberlândia, Avenida Pará s/n°, Campus Umuarama, Bloco 4L, Bairro Umuarama, Uberlândia, Minas Gerais, 38.400-902, Brazil
| | - Eduardo Tadashi Pinto Emi
- Integrated Dental Clinic Program, Faculty of Dentistry, Federal University of Uberlândia, Avenida Pará s/n°, Campus Umuarama, Bloco 4L, Bairro Umuarama, Uberlândia, Minas Gerais, 38.400-902, Brazil
| | - Camila de Carvalho Almança Lopes
- Integrated Dental Clinic Program, Faculty of Dentistry, Federal University of Uberlândia, Avenida Pará s/n°, Campus Umuarama, Bloco 4L, Bairro Umuarama, Uberlândia, Minas Gerais, 38.400-902, Brazil
| | - Flaviana Soares Rocha
- Integrated Dental Clinic Program, Faculty of Dentistry, Federal University of Uberlândia, Avenida Pará s/n°, Campus Umuarama, Bloco 4L, Bairro Umuarama, Uberlândia, Minas Gerais, 38.400-902, Brazil
| | - Jonas Dantas Batista
- Integrated Dental Clinic Program, Faculty of Dentistry, Federal University of Uberlândia, Avenida Pará s/n°, Campus Umuarama, Bloco 4L, Bairro Umuarama, Uberlândia, Minas Gerais, 38.400-902, Brazil
| | - Gustavo Davi Rabelo
- Faculty of Dentistry, Federal University of Juiz de Fora, Faculdade de Odontologia - Campus Universitário - Bairro Martelos -, Juiz de Fora, Minas Gerais, 36036-300, Brazil
| | - Paula Dechichi
- Integrated Dental Clinic Program, Faculty of Dentistry, Federal University of Uberlândia, Avenida Pará s/n°, Campus Umuarama, Bloco 4L, Bairro Umuarama, Uberlândia, Minas Gerais, 38.400-902, Brazil.
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16
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Therapeutic Effects of Human Adipose-Derived Products on Impaired Wound Healing in Irradiated Tissue. Plast Reconstr Surg 2019; 142:383-391. [PMID: 29787514 DOI: 10.1097/prs.0000000000004609] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Clinical sequelae of irradiation result in tissue devitalization (e.g., ischemia, fibrosis, and atrophy) where wound healing capacity is impaired. Fat-derived products may work to treat such pathology. METHODS Nonlethal irradiation at various doses (5, 10, and 15 Gy) and frequencies (one to three times on sequential days) was delivered to dorsal skin of nude mice, and subsequent gross and microscopic changes were evaluated for up to 4 weeks. Cutaneous punch wounds were then created to compare wound healing in irradiated and nonirradiated states. Wounds were also locally injected with vehicle, cultured adipose-derived stem cells, centrifuged fat tissue, or micronized cellular adipose matrix, and the therapeutic impact was monitored for up to 15 days. RESULTS Nude mice given total doses greater than 15 Gy spontaneously developed skin ulcers, and radiation damage was dose-dependent; however, a fractionated irradiation protocol was able to reduce the damage. Histologic assessment revealed dose-dependent dermal fibrosis/thickening and subcutaneous atrophy. Dose-dependent (5 to 15 Gy) impairment of wound healing was also evident. At the highest dosage (15 Gy three times), open wounds persisted on day 15. However, wounds injected with cultured adipose-derived stem cells were nearly healed on day 12, and those treated with injection of centrifuged fat or micronized tissue healed faster than untreated controls (p < 0.05). There was no significant differences between treated groups. CONCLUSIONS Tissue devitalization by irradiation was dose-dependent, although fractionated protocols helped to reduce it. Adipose-derived stem cells and other fat-derived products harboring adipose-derived stem cells successfully revitalized irradiated tissues and accelerated wound healing.
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17
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Dekker H, Bravenboer N, van Dijk D, Bloemena E, Rietveld D, ten Bruggenkate C, Schulten E. The irradiated human mandible: A quantitative study on bone vascularity. Oral Oncol 2018; 87:126-130. [DOI: 10.1016/j.oraloncology.2018.10.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/14/2018] [Accepted: 10/22/2018] [Indexed: 01/16/2023]
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18
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Benedict PA, Ruiz R, Verma A, Dion GR, Oh P, Wang B, Ahmed OH, Hiwatashi N, Bing R, Victor K, Hu KS, Johnson A, Branski RC, Amin MR. The effects of concurrent chemoradiation therapy to the base of tongue in a preclinical model. Laryngoscope 2017; 128:1783-1790. [PMID: 29280493 DOI: 10.1002/lary.27033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 10/16/2017] [Accepted: 11/06/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS To develop a clinically relevant model of oropharyngeal concurrent chemoradiation therapy (CCRT) in order to quantify the effects of CCRT on tongue function and structure. CCRT for advanced oropharyngeal cancer commonly leads to tongue base dysfunction and dysphagia. However, no preclinical models currently exist to study the pathophysiology of CCRT-related morbidity, thereby inhibiting the development of targeted therapeutics. STUDY DESIGN Animal model. METHODS Twenty-one male Sprague-Dawley rats were randomized into three groups: 2 week (2W), 5 month (5M), and control (C). The 2W and 5M animals received cisplatin, 5-fluorouracil, and five fractions of 7 Gy to the tongue base; the C animals received no intervention. In vivo tongue strength and displacement, as well as hyoglossus muscle collagen content, were assessed. Analyses were conducted 2 weeks or 5 months following completion of CCRT in the 2W and 5M groups, respectively. RESULTS Peak tetanic and twitch tongue forces were significantly reduced in both 2W and 5M animals compared to controls (tetanic: P = .0041, P = .0089, respectively; twitch: P = .0201, P = .0020, respectively). Twitch half-decay time was prolonged in 2W animals compared to controls (P = .0247). Tongue displacement was significantly reduced across all testing parameters in 5M animals compared to both the C and 2W groups. No differences in collagen content were observed between experimental groups. CONCLUSIONS The current study is the first to describe a preclinical model of CCRT to the head and neck with an emphasis on clinical relevance. Tongue strength decreased at 2 weeks and 5 months post-CCRT. Tongue displacement increased only at 5 months post-CCRT. Fibrosis was not detected, implicating alternative causative factors for these findings. LEVEL OF EVIDENCE NA Laryngoscope, 1783-1790, 2018.
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Affiliation(s)
- Peter A Benedict
- Department of Otolaryngology-Head and Neck Surgery, New York University Voice Center, New York University School of Medicine, New York, New York
| | - Ryan Ruiz
- Department of Otolaryngology-Head and Neck Surgery, New York University Voice Center, New York University School of Medicine, New York, New York
| | - Avanti Verma
- Department of Otolaryngology-Head and Neck Surgery, New York University Voice Center, New York University School of Medicine, New York, New York
| | - Gregory R Dion
- Department of Otolaryngology-Head and Neck Surgery, New York University Voice Center, New York University School of Medicine, New York, New York.,Department of Otolaryngology-Head and Neck Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas, U.S.A
| | - Philmo Oh
- Department of Radiation Oncology, New York University School of Medicine, New York, New York
| | - Binhuan Wang
- Department of Population Heath, Division of Biostatistics, New York University School of Medicine, New York, New York
| | - Omar H Ahmed
- Department of Otolaryngology-Head and Neck Surgery, New York University Voice Center, New York University School of Medicine, New York, New York
| | - Nao Hiwatashi
- Department of Otolaryngology-Head and Neck Surgery, New York University Voice Center, New York University School of Medicine, New York, New York
| | - Renjie Bing
- Department of Otolaryngology-Head and Neck Surgery, New York University Voice Center, New York University School of Medicine, New York, New York
| | - Kristen Victor
- Department of Otolaryngology-Head and Neck Surgery, New York University Voice Center, New York University School of Medicine, New York, New York
| | - Kenneth S Hu
- Department of Radiation Oncology, New York University School of Medicine, New York, New York
| | - Aaron Johnson
- Department of Otolaryngology-Head and Neck Surgery, New York University Voice Center, New York University School of Medicine, New York, New York
| | - Ryan C Branski
- Department of Otolaryngology-Head and Neck Surgery, New York University Voice Center, New York University School of Medicine, New York, New York
| | - Milan R Amin
- Department of Otolaryngology-Head and Neck Surgery, New York University Voice Center, New York University School of Medicine, New York, New York
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19
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Sønstevold T, Johannessen AC, Reed RK, Salvesen GS, Stuhr L. Hyperbaric oxygen treatment did not significantly affect radiation injury in the mandibular area of rats. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 125:112-119. [PMID: 29248424 DOI: 10.1016/j.oooo.2017.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/11/2017] [Accepted: 10/24/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Hyperbaric oxygen therapy (HBOT) has been used to enhance microcirculation and thereby oxygen tension in tissues. The present study aimed to investigate the effect of HBOT on radiation injury in the mandibular area of rats. STUDY DESIGN The left mandibles of rats were irradiated by external radiotherapy (15 Gy every other week for a total of 75 Gy). Four HBOT strategies were used: 2 prophylactic groups receiving HBOT either between each radiation treatment or immediately following terminated radiation treatment, and 2 therapeutic groups receiving HBOT after the latent period of 6 weeks after irradiation either every day (standard HBOT protocol) or 3 days a week for 6 weeks. Tissue samples of the irradiated area were taken from skin, the salivary gland, and the mandible. All tissues were stained with hematoxylin and eosin for morphologic examination. Furthermore, skin samples were stained with CD31 for blood vessel analysis. RESULTS There was no change in blood vessel density or morphology between controls and HBOT tissues after radiation. The dentin of 2 of the 5 rats that received HBOT either normalized or was not affected by irradiation. CONCLUSIONS HBOT did not affect radiation injury of the mandibular area in rats within 12 weeks after irradiation.
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Affiliation(s)
- Tonje Sønstevold
- Department of Biomedicine, Faculty of Medicine and Dentistry, University of Bergen, Norway
| | - Anne Christine Johannessen
- The Gade Laboratory for Pathology, Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Norway
| | - Rolf K Reed
- Department of Biomedicine, Faculty of Medicine and Dentistry, University of Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Norway
| | - Gerd S Salvesen
- Department of Biomedicine, Faculty of Medicine and Dentistry, University of Bergen, Norway
| | - Linda Stuhr
- Department of Biomedicine, Faculty of Medicine and Dentistry, University of Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Norway.
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da Silva EM, Kischkel B, Shinobu-Mesquita CS, Bonfim-Mendonça PS, Mansano ES, da Silva MA, Barbosa JF, Fiorini A, Hernandes L, Furlaneto MC, Svidzinski TI. γ-irradiation from radiotherapy improves the virulence potential of Candida tropicalis. Future Microbiol 2017; 12:1467-1486. [PMID: 29110510 DOI: 10.2217/fmb-2017-0137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To evaluate if radiation used in radiotherapy can cause changes in the virulence potential of Candida tropicalis ATCC 750. MATERIALS & METHODS C. tropicalis was exposed in vitro to identical dose and scheme of irradiation would be used in patients with head and neck cancer. Some virulence parameters were analyzed before and after irradiation. RESULTS Colony morphologies were irreversibly affected by irradiation. Increase in growth rate, filamentation, adhesion on cell lines and phagocytosis process were also observed. Overall the irradiated C. tropicalis cells became more efficient at causing systemic infection in mice. CONCLUSION γ-radiation induced important changes in C. tropicalis increasing its virulence profile, which could directly affect the relationship between yeasts and hosts.
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Affiliation(s)
- Eliane M da Silva
- Department of Clinical Analysis & Biomedicine/Postgraduate Program in Biosciences & Pathophysiology, Centro de Ciências da Saúde, Universidade Estadual de Maringá, Maringá, Paraná, Avenida Colombo, 5790, Maringá, PR, CEP 87020-900, Brazil
| | - Brenda Kischkel
- Department of Clinical Analysis & Biomedicine/Postgraduate Program in Biosciences & Pathophysiology, Centro de Ciências da Saúde, Universidade Estadual de Maringá, Maringá, Paraná, Avenida Colombo, 5790, Maringá, PR, CEP 87020-900, Brazil
| | - Cristiane S Shinobu-Mesquita
- Department of Clinical Analysis & Biomedicine/Postgraduate Program in Biosciences & Pathophysiology, Centro de Ciências da Saúde, Universidade Estadual de Maringá, Maringá, Paraná, Avenida Colombo, 5790, Maringá, PR, CEP 87020-900, Brazil
| | - Patrícia S Bonfim-Mendonça
- Department of Clinical Analysis & Biomedicine/Postgraduate Program in Biosciences & Pathophysiology, Centro de Ciências da Saúde, Universidade Estadual de Maringá, Maringá, Paraná, Avenida Colombo, 5790, Maringá, PR, CEP 87020-900, Brazil
| | - Elaine Sb Mansano
- Department of Clinical Analysis & Biomedicine/Postgraduate Program in Biosciences & Pathophysiology, Centro de Ciências da Saúde, Universidade Estadual de Maringá, Maringá, Paraná, Avenida Colombo, 5790, Maringá, PR, CEP 87020-900, Brazil
| | | | | | - Adriana Fiorini
- Department of Microbiology, Universidade Federal do Paraná, Setor Palotina, Paraná, Brazil
| | - Luzmarina Hernandes
- Department of Clinical Analysis & Biomedicine/Postgraduate Program in Biosciences & Pathophysiology, Centro de Ciências da Saúde, Universidade Estadual de Maringá, Maringá, Paraná, Avenida Colombo, 5790, Maringá, PR, CEP 87020-900, Brazil
| | - Marcia C Furlaneto
- Department of Microbiology, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Terezinha Ie Svidzinski
- Department of Clinical Analysis & Biomedicine/Postgraduate Program in Biosciences & Pathophysiology, Centro de Ciências da Saúde, Universidade Estadual de Maringá, Maringá, Paraná, Avenida Colombo, 5790, Maringá, PR, CEP 87020-900, Brazil
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21
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Rancilio NJ, Dahl S, Athanasiadi I, Perez-Torres CJ. Design, construction, and in vivo feasibility of a positioning device for irradiation of mice brains using a clinical linear accelerator and intensity modulated radiation therapy. Int J Radiat Biol 2017; 93:1321-1326. [PMID: 28980498 DOI: 10.1080/09553002.2017.1387305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The goal of this study was to design a positioning device that would allow for selective irradiation of the mouse brain with a clinical linear accelerator. METHODS We designed and fabricated an immobilization fixture that incorporates three functions: head stabilizer (through ear bars and tooth bar), gaseous anesthesia delivery and scavenging, and tissue mimic/bolus. Cohorts of five mice were irradiated such that each mouse in the cohort received a unique dose between 1000 and 3000 cGy. DNA damage immunohistochemistry was used to validate an increase in biological effect as a function of radiation dose. Mice were then followed with hematoxylin and eosin (H&E) and anatomical magnetic resonance imaging (MRI). RESULTS There was evidence of DNA damage throughout the brain proportional to radiation dose. Radiation-induced damage at the prescribed doses, as depicted by H&E, appeared to be constrained to the white matter consistent with radiological observation in human patients. The severity of the damage correlated with the radiation dose as expected. CONCLUSIONS We have designed and manufactured a device that allows us to selectively irradiate the mouse brain with a clinical linear accelerator. However, some off-target effects are possible with large prescription doses.
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Affiliation(s)
- Nicholas J Rancilio
- a Department of Veterinary Clinical Sciences , Purdue University , West Lafayette , IN , USA
| | - Shaun Dahl
- b School of Health Sciences , Purdue University , West Lafayette , IN , USA
| | - Ilektra Athanasiadi
- a Department of Veterinary Clinical Sciences , Purdue University , West Lafayette , IN , USA
| | - Carlos J Perez-Torres
- b School of Health Sciences , Purdue University , West Lafayette , IN , USA.,c Purdue University Center for Cancer Research, Purdue University , West Lafayette , IN , USA
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22
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Rottensteiner-Brandl U, Distel L, Stumpf M, Fey T, Köhn K, Bertram U, Lingens LF, Greil P, Horch RE, Arkudas A. Influence of Different Irradiation Protocols on Vascularization and Bone Formation Parameters in Rat Femora. Tissue Eng Part C Methods 2017; 23:583-591. [PMID: 28741426 DOI: 10.1089/ten.tec.2017.0170] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Aim of the present study was the establishment of an efficient and reproducible model for irradiation of rat femora as a model for impaired osteogenesis and angiogenesis. Four different irradiation protocols were compared: single irradiation of the left femur with 20 Gy and explantation after 4 or 8 weeks (group A, B) and three irradiation fractions at 3-4 days intervals with 10 Gy and explantation after 4 or 8 weeks (group C, D). The contralateral, unirradiated femur served as control. Evaluation included histology, microcomputertomography (μCT), and real-time polymerase chain reaction. Histology showed a pronounced increase of vacuoles in bone marrow after irradiation, especially after 4 weeks (group A and C), demonstrating bone marrow edema and fatty degeneration. Irradiation provoked a decrease of total cell numbers in cortical bone and of hypoxia-inducible factor 1 alpha (HIF1α)-positive cells in bone marrow. The expression of several markers (osteocalcin [OCN], runt-related transcription factor 2 [RUNX2], transforming growth factor beta 1 [TGFβ1], tumor necrosis factor alpha [TNFα], vascular endothelial growth factor A [VEGFA], and HIF1α) was decreased in group A after irradiation. This might suggest a decreased metabolism after irradiation. A significant decrease in small-sized vessels was seen in μCT evaluation in group A and D. Single irradiation with 20 Gy had the most severe and reproducible impact on osteogenesis and angiogenesis after 4 weeks while being well tolerated by all animals, thus making it an excellent model for evaluation of bone healing and vascularization in irradiated tissue.
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Affiliation(s)
- Ulrike Rottensteiner-Brandl
- 1 Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg FAU , Erlangen, Germany .,2 Department of Biochemistry, Friedrich-Alexander-University Erlangen-Nürnberg FAU , Erlangen, Germany
| | - Luitpold Distel
- 3 Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg FAU , Erlangen, Germany
| | - Martin Stumpf
- 4 Department of Materials Science (Glass and Ceramics), Friedrich-Alexander-University Erlangen-Nürnberg FAU , Erlangen, Germany
| | - Tobias Fey
- 4 Department of Materials Science (Glass and Ceramics), Friedrich-Alexander-University Erlangen-Nürnberg FAU , Erlangen, Germany
| | - Katrin Köhn
- 1 Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg FAU , Erlangen, Germany
| | - Ulf Bertram
- 1 Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg FAU , Erlangen, Germany
| | - Lara F Lingens
- 1 Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg FAU , Erlangen, Germany
| | - Peter Greil
- 4 Department of Materials Science (Glass and Ceramics), Friedrich-Alexander-University Erlangen-Nürnberg FAU , Erlangen, Germany
| | - Raymund E Horch
- 1 Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg FAU , Erlangen, Germany
| | - Andreas Arkudas
- 1 Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg FAU , Erlangen, Germany
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23
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Effect of G-CSF on oral mucositis and traumatic ulcers produced in the tongue of rats undergoing radiotherapy: clinical and histologic evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:587-596. [DOI: 10.1016/j.oooo.2016.07.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/23/2016] [Accepted: 07/29/2016] [Indexed: 01/23/2023]
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24
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King SN, Dunlap NE, Tennant PA, Pitts T. Pathophysiology of Radiation-Induced Dysphagia in Head and Neck Cancer. Dysphagia 2016; 31:339-51. [PMID: 27098922 PMCID: PMC5340192 DOI: 10.1007/s00455-016-9710-1] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 04/08/2016] [Indexed: 11/25/2022]
Abstract
Oncologic treatments, such as curative radiotherapy and chemoradiation, for head and neck cancer can cause long-term swallowing impairments (dysphagia) that negatively impact quality of life. Radiation-induced dysphagia comprised a broad spectrum of structural, mechanical, and neurologic deficits. An understanding of the biomolecular effects of radiation on the time course of wound healing and underlying morphological tissue responses that precede radiation damage will improve options available for dysphagia treatment. The goal of this review is to discuss the pathophysiology of radiation-induced injury and elucidate areas that need further exploration.
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Affiliation(s)
- Suzanne N King
- Department of Neurological Surgery, Kentucky Spinal Cord Injury Research Center, University of Louisville, 511 South Floyd St MDR 616, Louisville, KY, 40202, USA
| | - Neal E Dunlap
- Department of Radiation Oncology, University of Louisville, Louisville, USA
| | - Paul A Tennant
- Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, University of Louisville, Louisville, USA
| | - Teresa Pitts
- Department of Neurological Surgery, Kentucky Spinal Cord Injury Research Center, University of Louisville, 511 South Floyd St MDR 616, Louisville, KY, 40202, USA.
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