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Ege D, Lu HH, Boccaccini AR. Bioactive Glass and Silica Particles for Skeletal and Cardiac Muscle Tissue Regeneration. TISSUE ENGINEERING. PART B, REVIEWS 2024; 30:448-461. [PMID: 38126329 DOI: 10.1089/ten.teb.2023.0277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
When skeletal and cardiac tissues are damaged, surgical approaches are not always successful and tissue regeneration approaches are investigated. Reports in the literature indicate that silica nanoparticles and bioactive glasses (BGs), including silicate bioactive glasses (e.g., 45S5 BG), phosphate glass fibers, boron-doped mesoporous BGs, borosilicate glasses, and aluminoborates, are promising for repairing skeletal muscle tissue. Silica nanoparticles and BGs have been combined with polymers to obtain aligned nanofibers and to maintain controlled delivery of nanoparticles for skeletal muscle repair. The literature indicates that cardiac muscle regeneration can be also triggered by the ionic products of BGs. This was observed to be due to the release of vascular endothelial growth factor and other growth factors from cardiomyocytes, which regulate endothelial cells to form capillary structures (angiogenesis). Specific studies, including both in vitro and in vivo approaches, are reviewed in this article. The analysis of the literature indicates that although the research field is still very limited, BGs are showing great promise for muscle tissue engineering and further research in the field should be carried out to expand our basic knowledge on the application of BGs in muscle (skeletal and cardiac) tissue regeneration. Impact statement This review highlights the potential of silica particles and bioactive glasses (BGs) for skeletal and cardiac tissue regeneration. These biomaterials create scaffolds triggering muscle cell differentiation. Ionic products from BGs stimulate growth factors, supporting angiogenesis in cardiac tissue repair. Further research is required to expand our know-how on silica particles and BGs in muscle tissue engineering.
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Affiliation(s)
- Duygu Ege
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
- Department of Materials Science and Engineering, Institute of Biomaterials, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Hsuan-Heng Lu
- Department of Materials Science and Engineering, Institute of Biomaterials, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Aldo R Boccaccini
- Department of Materials Science and Engineering, Institute of Biomaterials, University of Erlangen-Nuremberg, Erlangen, Germany
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Chen RP, Wang QH, Li MY, Su XF, Wang DY, Liu XH, Li ZL. Progress in diagnosis and treatment of acute injury to the anterior talofibular ligament. World J Clin Cases 2023; 11:3395-3407. [PMID: 37383912 PMCID: PMC10294195 DOI: 10.12998/wjcc.v11.i15.3395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/07/2023] [Accepted: 04/14/2023] [Indexed: 05/25/2023] Open
Abstract
Injury to the anterior talofibular ligament (ATFL) is a common acute injury of the lateral foot ligament. Untimely and improper treatment significantly affects the quality of life and rehabilitation progress of patients. The purpose of this paper is to review the anatomy and the current methods of diagnosis and treatment of acute injury to the ATFL. The clinical manifestations of acute injury to the ATFL include pain, swelling, and dysfunction. At present, non-surgical treatment is the first choice for acute injury of the ATFL. The standard treatment strategy involves the “peace and love” principle. After initial treatment in the acute phase, personalized rehabilitation training programs can be followed. These may involve proprioception training, muscle training, and functional exercise to restore limb coordination and muscle strength. Static stretching and other techniques to loosen joints, acupuncture, moxibustion massage, and other traditional medical treatments can relieve pain, restore range of motion, and prevent joint stiffness. If the non-surgical treatment is not ideal or fails, surgical treatment is feasible. Currently, arthroscopic anatomical repair or anatomical reconstruction surgery is commonly used in clinical practice. Although open Broström surgery provides good results, the modified arthroscopic Broström surgery has many advantages, such as less trauma, rapid pain relief, rapid postoperative recovery, and fewer complications, and is more popular with patients. In general, when treating acute injury to the ATFL, treatment management and methods should be timely and reasonably arranged according to the specific injury scenario and attention should be paid to the timely combination of multiple therapies to achieve the best treatment results.
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Affiliation(s)
- Run-Peng Chen
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
| | - Qing-Hua Wang
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
| | - Ming-Yue Li
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
| | - Xiao-Fang Su
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
| | - Dong-Yang Wang
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
- Faculty of Nursing, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Xing-Hui Liu
- Department of Office, Shandong Vheng Data Technology Co., Ltd, Yantai 264003, Shandong Province, China
| | - Zhi-Li Li
- Department of Office, Shandong Vheng Data Technology Co., Ltd, Yantai 264003, Shandong Province, China
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3
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Zhao N, Liu B, Liu SW, Zhang W, Li HN, Pang G, Luo XF, Wang JG. The Combination of Electroacupuncture and Massage Therapy Alleviates Myofibroblast Transdifferentiation and Extracellular Matrix Production in Blunt Trauma-Induced Skeletal Muscle Fibrosis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:5543468. [PMID: 34306140 PMCID: PMC8282377 DOI: 10.1155/2021/5543468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/17/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022]
Abstract
Complementary therapies, such as acupuncture and massage, had been previously reported to have therapeutic effects on skeletal muscle contusions. However, the recovery mechanisms on skeletal muscles after blunt trauma via the combination of electroacupuncture (EA) and massage therapy remain unclear. In the present study, a rat model of the skeletal muscle fibrosis following blunt trauma to rat skeletal muscle was established, and the potential molecular mechanisms of EA + massage therapy on the skeletal muscle fibrosis were investigated. The results suggested that EA + massage therapy could significantly decrease inflammatory cells infiltration and collagenous fiber content and ameliorate the disarrangement of sarcomeres within myofibrils compared to the model group. Further analysis revealed that EA + massage therapy could reduce the degree of fibrosis and increase the degree of myofibroblast apoptosis by downregulating the mRNA and protein expression of transforming growth factor- (TGF-) β1 and connective tissue growth factor (CTGF). Furthermore, the fibrosis of injured skeletal muscle was inhibited after treatment through the normalization of balance between matrix metalloproteinase- (MMP-) 1 and tissue inhibitor of matrix metalloproteinase (TIMP). These findings suggested that the combination of electroacupuncture and massage therapy could alleviate the fibrotic process by regulating TGF β1-CTGF-induced myofibroblast transdifferentiation and MMP-1/TIMP-1 balance for extracellular matrix production.
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Affiliation(s)
- Na Zhao
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China
| | - Bo Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China
| | - Si-Wen Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China
| | - Wei Zhang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China
| | - Hua-Nan Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China
| | - Geng Pang
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Xiong-Fei Luo
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China
| | - Jin-Gui Wang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China
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Westman AM, Peirce SM, Christ GJ, Blemker SS. Agent-based model provides insight into the mechanisms behind failed regeneration following volumetric muscle loss injury. PLoS Comput Biol 2021; 17:e1008937. [PMID: 33970905 PMCID: PMC8110270 DOI: 10.1371/journal.pcbi.1008937] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/01/2021] [Indexed: 12/22/2022] Open
Abstract
Skeletal muscle possesses a remarkable capacity for repair and regeneration following a variety of injuries. When successful, this highly orchestrated regenerative process requires the contribution of several muscle resident cell populations including satellite stem cells (SSCs), fibroblasts, macrophages and vascular cells. However, volumetric muscle loss injuries (VML) involve simultaneous destruction of multiple tissue components (e.g., as a result of battlefield injuries or vehicular accidents) and are so extensive that they exceed the intrinsic capability for scarless wound healing and result in permanent cosmetic and functional deficits. In this scenario, the regenerative process fails and is dominated by an unproductive inflammatory response and accompanying fibrosis. The failure of current regenerative therapeutics to completely restore functional muscle tissue is not surprising considering the incomplete understanding of the cellular mechanisms that drive the regeneration response in the setting of VML injury. To begin to address this profound knowledge gap, we developed an agent-based model to predict the tissue remodeling response following surgical creation of a VML injury. Once the model was able to recapitulate key aspects of the tissue remodeling response in the absence of repair, we validated the model by simulating the tissue remodeling response to VML injury following implantation of either a decellularized extracellular matrix scaffold or a minced muscle graft. The model suggested that the SSC microenvironment and absence of pro-differentiation SSC signals were the most important aspects of failed muscle regeneration in VML injuries. The major implication of this work is that agent-based models may provide a much-needed predictive tool to optimize the design of new therapies, and thereby, accelerate the clinical translation of regenerative therapeutics for VML injuries.
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Affiliation(s)
- Amanda M. Westman
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States of America
| | - Shayn M. Peirce
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States of America
- Ophthalmology, University of Virginia, Charlottesville, Virginia, United States of America
| | - George J. Christ
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States of America
- Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, United States of America
- * E-mail: (GJC); (SSB)
| | - Silvia S. Blemker
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States of America
- Ophthalmology, University of Virginia, Charlottesville, Virginia, United States of America
- Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, United States of America
- Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, Virginia, United States of America
- * E-mail: (GJC); (SSB)
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5
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Park J, Lee J, Song KD, Kim SJ, Kim DC, Lee SC, Son YJ, Choi HW, Shim K. Growth factors improve the proliferation of Jeju black pig muscle cells by regulating myogenic differentiation 1 and growth-related genes. Anim Biosci 2021; 34:1392-1402. [PMID: 33561926 PMCID: PMC8255883 DOI: 10.5713/ab.20.0585] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/12/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The growth rate of pigs is related to differentiation and proliferation of muscle cells, which are regulated by growth factors and expression of growth-related genes. Thus, the objective of this study was to establish optimal culture conditions for Jeju black pig (JBP) muscle cells and determine the relationship of various factors involved in muscle growth with the proliferation of JBP muscle cells. METHODS Muscles were taken from the femur skeletal muscle of JBP embryos. After isolation of the muscle cells, cells were cultured in a 6-well plate under four different culture conditions to optimize culture conditions for JBP muscle cells. To analyze proliferation rate of JBP muscle cells, these muscle cells were seeded into 6-well plates at a density of 1.5×105 cells per well and cultured for 3 days. Western blot and quantitative real-time polymerase chain reaction were applied to verify the myogenic differentiation 1 (MyoD) expression and growth-related gene expression in JBP muscle cells, respectively. RESULTS We established a muscle cell line from JBP embryos and optimized its culture conditions. These muscle cells were positive for MyoD, but not for paired box 7. The proliferation rate of these muscle cells was significantly higher in a culture medium containing bFGF and epidermal growth factor + basic fibroblast growth factor (EGF+bFGF) than that without a growth factor or containing EGF alone. Treatment with EGF and bFGF significantly induced the expression of MyoD protein, an important transcription factor in muscle cells. Moreover, we checked the changes of expression of growth-related genes in JBP muscle cells by presence or absence of growth factors. Expression level of collagen type XXI alpha 1 gene was changed only when EGF and bFGF were added together to culture media for JBP muscle cells. CONCLUSION Concurrent use of EGF and bFGF increased the expression of MyoD protein, thus regulating the proliferation of JBP muscle cells and the expression of growth-related genes.
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Affiliation(s)
- Jinryong Park
- Department of Animal Biotechnology, Jeonbuk National University, Jeonju 54896, Korea
| | - Jeongeun Lee
- Department of Animal Biotechnology, Jeonbuk National University, Jeonju 54896, Korea
| | - Ki-Duk Song
- The Animal Molecular Genetics and Breeding Center, Jeonbuk National University, Jeonju 54896, Korea.,Department of Agricultural Convergence Technology, Jeonbuk National University, Jeonju 54896, Korea
| | - Sung-Jo Kim
- Division of Cosmetics and Biotechnology, Hoseo University, Asan 31499, Korea
| | - Dae Cheol Kim
- Livestock Promotion Institute, Jeju Special Self-Governing Province, Jeju 63122, Korea
| | | | | | - Hyun Woo Choi
- Department of Agricultural Convergence Technology, Jeonbuk National University, Jeonju 54896, Korea.,Department of Animal Science, Jeonbuk National University, Jeonju 54896, Korea
| | - Kwanseob Shim
- Department of Animal Biotechnology, Jeonbuk National University, Jeonju 54896, Korea.,Department of Agricultural Convergence Technology, Jeonbuk National University, Jeonju 54896, Korea
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Castillo AC, Kaltwasser K, Morris R, Sanchez ER, Rai S, Lombana N, Tran D, Branski L, Zhang AY. Comparing 3 Suture Techniques After Muscle Laceration Repair. Hand (N Y) 2021; 16:67-72. [PMID: 30924359 PMCID: PMC7818024 DOI: 10.1177/1558944719837021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Skeletal muscle lacerations are a relatively common injury. Compared with nonrepaired lacerations, surgically repaired muscle lacerations regenerate faster, develop less scar tissue, have a higher return to baseline strength, and have lower incidence of hematomas. Despite the benefits of repair, the optimal repair technique is still unknown. The purpose of this study was to examine the biomechanical properties of common muscle repair techniques to determine the optimal repair. Methods: Forty-two fusiform porcine muscle specimens were dissected and used for this study. Three suture techniques were used for comparative analysis: Figure-eight, Mason Allen, and Perimeter. Each muscle was transected and then repaired using one of the 3 techniques. Fourteen muscle-tendon specimens were prepared for each group and tested for tensile failure using a material testing system. Biomechanical properties, including peak failure point and stiffness, were compared for differences between the suture groups by 1-way analysis of variance. The average time per repair technique was also recorded. Results: The Perimeter technique showed a statistically significant higher peak failure point than the Mason Allen technique (P = .03). Both the Figure-eight (P = .047) and Perimeter techniques (P < .001) were significantly stiffer than the Mason Allen technique. The repair time was comparable across all 3 techniques. Conclusions: The Figure-eight and Perimeter repairs were found to be similar in peak failure point and stiffness, whereas the Mason Allen technique showed significantly lower stiffness and peak failure point. The Figure-eight was the quickest repair to perform. The Figure-eight technique may be strongly considered for muscle laceration repairs due to its simplicity and efficiency.
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Affiliation(s)
| | | | - Randal Morris
- The University of Texas Medical Branch
at Galveston, USA
| | | | - Surjit Rai
- The University of Texas Medical Branch
at Galveston, USA
| | | | - Dat Tran
- The University of Texas Medical Branch
at Galveston, USA
| | - Ludwik Branski
- The University of Texas Medical Branch
at Galveston, USA
| | - Andrew Y. Zhang
- University of Texas Southwestern,
Dallas, USA,Andrew Y. Zhang, Department of Plastic
Surgery, University of Texas Southwestern, 1801 Inwood Road, 4th Floor, Dallas,
TX 75390-1932, USA.
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7
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Qazi TH, Duda GN, Ort MJ, Perka C, Geissler S, Winkler T. Cell therapy to improve regeneration of skeletal muscle injuries. J Cachexia Sarcopenia Muscle 2019; 10:501-516. [PMID: 30843380 PMCID: PMC6596399 DOI: 10.1002/jcsm.12416] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 01/27/2019] [Indexed: 12/14/2022] Open
Abstract
Diseases that jeopardize the musculoskeletal system and cause chronic impairment are prevalent throughout the Western world. In Germany alone, ~1.8 million patients suffer from these diseases annually, and medical expenses have been reported to reach 34.2bn Euros. Although musculoskeletal disorders are seldom fatal, they compromise quality of life and diminish functional capacity. For example, musculoskeletal disorders incur an annual loss of over 0.8 million workforce years to the German economy. Among these diseases, traumatic skeletal muscle injuries are especially problematic because they can occur owing to a variety of causes and are very challenging to treat. In contrast to chronic muscle diseases such as dystrophy, sarcopenia, or cachexia, traumatic muscle injuries inflict damage to localized muscle groups. Although minor muscle trauma heals without severe consequences, no reliable clinical strategy exists to prevent excessive fibrosis or fatty degeneration, both of which occur after severe traumatic injury and contribute to muscle degeneration and dysfunction. Of the many proposed strategies, cell-based approaches have shown the most promising results in numerous pre-clinical studies and have demonstrated success in the handful of clinical trials performed so far. A number of myogenic and non-myogenic cell types benefit muscle healing, either by directly participating in new tissue formation or by stimulating the endogenous processes of muscle repair. These cell types operate via distinct modes of action, and they demonstrate varying levels of feasibility for muscle regeneration depending, to an extent, on the muscle injury model used. While in some models the injury naturally resolves over time, other models have been developed to recapitulate the peculiarities of real-life injuries and therefore mimic the structural and functional impairment observed in humans. Existing limitations of cell therapy approaches include issues related to autologous harvesting, expansion and sorting protocols, optimal dosage, and viability after transplantation. Several clinical trials have been performed to treat skeletal muscle injuries using myogenic progenitor cells or multipotent stromal cells, with promising outcomes. Recent improvements in our understanding of cell behaviour and the mechanistic basis for their modes of action have led to a new paradigm in cell therapies where physical, chemical, and signalling cues presented through biomaterials can instruct cells and enhance their regenerative capacity. Altogether, these studies and experiences provide a positive outlook on future opportunities towards innovative cell-based solutions for treating traumatic muscle injuries-a so far unmet clinical need.
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Affiliation(s)
- Taimoor H Qazi
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Georg N Duda
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin-Brandenburg School for Regenerative Therapies, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Melanie J Ort
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin-Brandenburg School for Regenerative Therapies, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Carsten Perka
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sven Geissler
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tobias Winkler
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Park PYS, Cai C, Bawa P, Kumaravel M. Platelet-rich plasma vs. steroid injections for hamstring injury-is there really a choice? Skeletal Radiol 2019; 48:577-582. [PMID: 30225608 DOI: 10.1007/s00256-018-3063-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/26/2018] [Accepted: 08/29/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the effectiveness of pain relief in patients with grade 2 proximal hamstring injury, treated with platelet-rich plasma (PRP) or corticosteroid injection, by using the primary outcome of visual analog scale (VAS) at 1 week and 4 weeks of follow-up. MATERIALS AND METHODS A single institution retrospective study was performed for image-guided PRP or steroid injections between 12/1/2015 and 10/30/2017 for proximal hamstring injuries. VAS was measured at 1 week and 4 weeks post-injection via telephone interviews and the pain response was recorded into two groups (negative/no change vs. positive). A comparison of pain responses between PRP and steroid was conducted by generalized estimating equation. RESULTS Among 56 patients, 32 received PRP and 24 received steroid injections with ages from 13 to 75 years old. At 1 week post-injection follow-up, 23 patients (71.9%) from the PRP group and 11 patients (45.8%) from the steroid group showed positive response. After controlling for age, pre-procedure pain level, and gender, the positive response rate in the PRP group was higher than the steroid group (aOR: 4.04, 95% CI: 1.04-15.63, p value = 0.04). At 4 weeks post-injection, 23 patients (71.9%) from the PRP group and 13 patients (54.2%) from the steroid group showed positive response with no statistical significance (aOR: 2.48, 95% CI: 0.63-9.79, p value = 0.19). CONCLUSIONS The PRP group had shown more favorable response compared to steroid group at 1 week post-injection, which suggests that PRP therapy can be considered as a conservative treatment choice for grade 2 proximal hamstring injuries with better short-term pain relief based on limited pilot data.
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Affiliation(s)
- Peter Yong Soo Park
- Department of Diagnostic & Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin St. MSB 2.130B, Houston, TX, 77030, USA.
| | - Chunyan Cai
- Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6410 Fannin St. UTPB 1100.08, Houston, TX, 77030, USA
| | - Pritish Bawa
- Department of Diagnostic & Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin St. MSB 2.130B, Houston, TX, 77030, USA
| | - Manickam Kumaravel
- Department of Diagnostic & Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin St. MSB 2.130B, Houston, TX, 77030, USA
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9
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Influence of Platelet-Rich and Platelet-Poor Plasma on Endogenous Mechanisms of Skeletal Muscle Repair/Regeneration. Int J Mol Sci 2019; 20:ijms20030683. [PMID: 30764506 PMCID: PMC6387315 DOI: 10.3390/ijms20030683] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 01/29/2019] [Accepted: 02/01/2019] [Indexed: 12/11/2022] Open
Abstract
The morpho-functional recovery of injured skeletal muscle still represents an unmet need. None of the therapeutic options so far adopted have proved to be resolutive. A current scientific challenge remains the identification of effective strategies improving the endogenous skeletal muscle regenerative program. Indeed, skeletal muscle tissue possesses an intrinsic remarkable regenerative capacity in response to injury, mainly thanks to the activity of a population of resident muscle progenitors called satellite cells, largely influenced by the dynamic interplay established with different molecular and cellular components of the surrounding niche/microenvironment. Other myogenic non-satellite cells, residing within muscle or recruited via circulation may contribute to post-natal muscle regeneration. Unfortunately, in the case of extended damage the tissue repair may become aberrant, giving rise to a maladaptive fibrotic scar or adipose tissue infiltration, mainly due to dysregulated activity of different muscle interstitial cells. In this context, plasma preparations, including Platelet-Rich Plasma (PRP) and more recently Platelet-Poor Plasma (PPP), have shown advantages and promising therapeutic perspectives. This review focuses on the contribution of these blood-derived products on repair/regeneration of damaged skeletal muscle, paying particular attention to the potential cellular targets and molecular mechanisms through which these products may exert their beneficial effects.
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10
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Kim W, Kim J, Park HS, Jeon JS. Development of Microfluidic Stretch System for Studying Recovery of Damaged Skeletal Muscle Cells. MICROMACHINES 2018; 9:E671. [PMID: 30567359 PMCID: PMC6315523 DOI: 10.3390/mi9120671] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/09/2018] [Accepted: 12/16/2018] [Indexed: 12/13/2022]
Abstract
The skeletal muscle occupies about 40% mass of the human body and plays a significant role in the skeletal movement control. Skeletal muscle injury also occurs often and causes pain, discomfort, and functional impairment in daily living. Clinically, most studies observed the recovery phenomenon of muscle by massage or electrical stimulation, but there are limitations on quantitatively analyzing the effects on recovery. Although additional efforts have been made within in vitro biochemical research, some questions still remain for effects of the different cell microenvironment for recovery. To overcome these limitations, we have developed a microfluidic system to investigate appropriate conditions for repairing skeletal muscle injury. First, the muscle cells were cultured in the microfluidic chip and differentiated to muscle fibers. After differentiation, we treated hydrogen peroxide and 18% axial stretch to cause chemical and physical damage to the muscle fibers. Then the damaged muscle fibers were placed under the cyclic stretch condition to allow recovery. Finally, we analyzed the damage and recovery by quantifying morphological change as well as the intensity change of intracellular fluorescent signals and showed the skeletal muscle fibers recovered better in the cyclic stretched condition. In total, our in situ generation of muscle damage and induction recovery platform may be a key system for investigating muscle recovery and rehabilitation.
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Affiliation(s)
- Wanho Kim
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Korea.
| | - Jaesang Kim
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Korea.
| | - Hyung-Soon Park
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Korea.
| | - Jessie S Jeon
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Korea.
- KI HST, Korea Advanced Institute of Science and Technology, Daejeon 34141, Korea.
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Cieślik-Bielecka A, Pierchała M, Królikowska A, Reichert P. Effect of L-PRP treatment on wound healing after surgical skin incision in an experimental animal model. Connect Tissue Res 2018; 59:550-560. [PMID: 29316815 DOI: 10.1080/03008207.2018.1424148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AIM OF THE STUDY The aim of the study was to evaluate the effect of leukocyte- and platelet-rich plasma (L-PRP) treatment on a noncomplicated would healing after surgical skin incision in an experimental animal model. MATERIALS AND METHODS The blood from 64 male Wistar rats was used to prepare L-PRP before a transverse dorsal incision was made and consecutively closed. At the same time after the surgery was completed, autologous L-PRP in the rats from the L-PRP group (n = 32) and NaCl in the control group (n = 32) were injected subcutaneously into the wound. The examination included clinical observations, laboratory examination, and examination of biopsy specimens taken from sacrificed animals on the second, third, fourth, and sixth days after the surgery (histopathological examination, immunochemistry, molecular examination). RESULTS In all cases, no healing process complications were noted. The intergroup comparison revealed no statistically significant differences in terms of histopathological, immunohistochemical, and molecular examinations results. In the intragroup analysis, statistically significant differences were observed within each group between periods of observations in terms of immunohistochemical and molecular examinations results. CONCLUSIONS L-PRP treatment does not significantly accelerate a noncomplicated wound healing after surgical skin incision in an experimental animal model.
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Affiliation(s)
| | - Marcin Pierchała
- b Department and Clinic of Orthopaedics, Trauma and Reconstructive Surgery, Trauma Center St. Barbara Hospital , Medical University of Silesia , Sosnowiec , Poland
| | - Aleksandra Królikowska
- c Department of Physiotherapy, The College of Physiotherapy in Wroclaw , Wroclaw , Poland
| | - Paweł Reichert
- d Division of Sports Medicine, Department of Physiotherapy, Faculty of Health Sciences , Wroclaw Medical University , Wroclaw , Poland
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de Lázaro I, Yilmazer A, Nam Y, Qubisi S, Razak FMA, Degens H, Cossu G, Kostarelos K. Non-viral, Tumor-free Induction of Transient Cell Reprogramming in Mouse Skeletal Muscle to Enhance Tissue Regeneration. Mol Ther 2018; 27:59-75. [PMID: 30470628 DOI: 10.1016/j.ymthe.2018.10.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/16/2018] [Accepted: 10/19/2018] [Indexed: 01/14/2023] Open
Abstract
Overexpression of Oct3/4, Klf4, Sox2, and c-Myc (OKSM) transcription factors can de-differentiate adult cells in vivo. While sustained OKSM expression triggers tumorigenesis through uncontrolled proliferation of toti- and pluripotent cells, transient reprogramming induces pluripotency-like features and proliferation only temporarily, without teratomas. We sought to transiently reprogram cells within mouse skeletal muscle with a localized injection of plasmid DNA encoding OKSM (pOKSM), and we hypothesized that the generation of proliferative intermediates would enhance tissue regeneration after injury. Intramuscular pOKSM administration rapidly upregulated pluripotency (Nanog, Ecat1, and Rex1) and early myogenesis genes (Pax3) in the healthy gastrocnemius of various strains. Mononucleated cells expressing such markers appeared in clusters among myofibers, proliferated only transiently, and did not lead to dysplasia or tumorigenesis for at least 120 days. Nanog was also upregulated in the gastrocnemius when pOKSM was administered 7 days after surgically sectioning its medial head. Enhanced tissue regeneration after reprogramming was manifested by the accelerated appearance of centronucleated myofibers and reduced fibrosis. These results suggest that transient in vivo reprogramming could develop into a novel strategy toward the acceleration of tissue regeneration after injury, based on the induction of transiently proliferative, pluripotent-like cells in situ. Further research to achieve clinically meaningful functional regeneration is warranted.
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Affiliation(s)
- Irene de Lázaro
- Nanomedicine Lab, Faculty of Biology, Medicine and Health, AV Hill Building, The University of Manchester, Manchester M13 9PT, UK; UCL School of Pharmacy, Faculty of Life Sciences, University College London (UCL), London WC1N 1AX, UK
| | - Acelya Yilmazer
- Nanomedicine Lab, Faculty of Biology, Medicine and Health, AV Hill Building, The University of Manchester, Manchester M13 9PT, UK
| | - Yein Nam
- Nanomedicine Lab, Faculty of Biology, Medicine and Health, AV Hill Building, The University of Manchester, Manchester M13 9PT, UK; UCL School of Pharmacy, Faculty of Life Sciences, University College London (UCL), London WC1N 1AX, UK
| | - Sara Qubisi
- Nanomedicine Lab, Faculty of Biology, Medicine and Health, AV Hill Building, The University of Manchester, Manchester M13 9PT, UK; UCL School of Pharmacy, Faculty of Life Sciences, University College London (UCL), London WC1N 1AX, UK
| | - Fazilah Maizatul Abdul Razak
- Nanomedicine Lab, Faculty of Biology, Medicine and Health, AV Hill Building, The University of Manchester, Manchester M13 9PT, UK; UCL School of Pharmacy, Faculty of Life Sciences, University College London (UCL), London WC1N 1AX, UK
| | - Hans Degens
- School of Healthcare Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, UK
| | - Giulio Cossu
- Division of Cell Matrix Biology & Regenerative Medicine, Faculty of Biology, Medicine and Health, Michael Smith Building, The University of Manchester, Manchester M13 9PL, UK
| | - Kostas Kostarelos
- Nanomedicine Lab, Faculty of Biology, Medicine and Health, AV Hill Building, The University of Manchester, Manchester M13 9PT, UK; UCL School of Pharmacy, Faculty of Life Sciences, University College London (UCL), London WC1N 1AX, UK.
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13
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Virgilio KM, Martin KS, Peirce SM, Blemker SS. Agent-based model illustrates the role of the microenvironment in regeneration in healthy and mdx skeletal muscle. J Appl Physiol (1985) 2018; 125:1424-1439. [PMID: 30070607 DOI: 10.1152/japplphysiol.00379.2018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is a progressive muscle-wasting disease with no effective treatment. Multiple mechanisms are thought to contribute to muscle wasting, including increased susceptibility to contraction-induced damage, chronic inflammation, fibrosis, altered satellite stem cell (SSC) dynamics, and impaired regenerative capacity. The goals of this project were to 1) develop an agent-based model of skeletal muscle that predicts the dynamic regenerative response of muscle cells, fibroblasts, SSCs, and inflammatory cells as a result of contraction-induced injury, 2) calibrate and validate the model parameters based on comparisons with published experimental measurements, and 3) use the model to investigate how changing isolated and combined factors known to be associated with DMD (e.g., altered fibroblast or SSC behaviors) influence muscle regeneration. Our predictions revealed that the percent of injured muscle that recovered 28 days after injury was dependent on the peak SSC counts following injury. In simulations with near-full cross-sectional area recovery (healthy, 4-wk mdx, 3-mo mdx), the SSC counts correlated with the extent of initial injury; however, in simulations with impaired regeneration (9-mo mdx), the peak SSC counts were suppressed relative to initial injury. The differences in SSC counts between these groups were emergent predictions dependent on altered microenvironment factors known to be associated with DMD. Multiple cell types influenced the peak number of SSCs, but no individual parameter predicted the differences in SSC counts. This finding suggests that interventions to target the microenvironment rather than SSCs directly could be an effective method for improving regeneration in impaired muscle. NEW & NOTEWORTHY A computational model predicted that satellite stem cell (SSC) counts are correlated with muscle cross-sectional area (CSA) recovery following injury. In simulations with impaired CSA recovery, SSC counts are suppressed relative to healthy muscle. The suppressed SSC counts were an emergent model prediction, because all simulations had equal initial SSC counts. Fibroblast and anti-inflammatory macrophage counts influenced SSC counts, but no single factor was able to predict the pathological differences in SSC counts that lead to impaired regeneration.
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Affiliation(s)
- Kelley M Virgilio
- Department of Biomedical Engineering, University of Virginia , Charlottesville, Virginia
| | - Kyle S Martin
- Department of Biomedical Engineering, University of Virginia , Charlottesville, Virginia
| | - Shayn M Peirce
- Department of Biomedical Engineering, University of Virginia , Charlottesville, Virginia
| | - Silvia S Blemker
- Department of Biomedical Engineering, University of Virginia , Charlottesville, Virginia.,Department of Orthopaedic Surgery, University of Virginia , Charlottesville, Virginia.,Department of Mechanical and Aerospace Engineering, University of Virginia , Charlottesville, Virginia
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14
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Cianforlini M, Ulisse S, Coppa V, Grassi M, Rotini M, Gigante A. Can Elastosonography Be Useful in Improving Diagnosis and Prognosis of Acute Muscle Injuries? JOINTS 2018; 6:116-121. [PMID: 30051109 PMCID: PMC6059860 DOI: 10.1055/s-0038-1660814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 05/07/2018] [Indexed: 11/24/2022]
Abstract
Purpose
The objective of this study was to investigate the ability of elastosonography (USE) in the identification of different grades of muscular injuries, comparing its effectiveness with traditional ultrasound (US) survey and by relating the results to the clinical classification of muscular pain.
Methods
In the period between August 2014 and May 2016, we conducted a prospective cohort study on a population of 34 young male professional athletes belonging to the same under-17 football club (Ancona 1905). Injuries were recorded according to location, type, mechanism, recurrence, and whether they occurred with or without contact. Muscle pain was classified, after a physical examination, according to the classification of Mueller-Wohlfahrt et al. All athletes were evaluated by musculoskeletal US and USE in hours following the trauma/onset of pain.
Results
Seventy injuries were documented among 19 players. Muscle/tendon injuries were the most common type of injury (49%). USE showed areas of edema in nine lesions that were negative at the US examination and previously classified as fatigue-induced muscle disorders. These nine players took more time to return to physical activity compared with others with injuries classified into the same group, but negative at USE evaluation.
Conclusion
USE is a valuable aid in the diagnosis and prognostic evaluation of muscle injury, as it detects pathologic changes that are not visible with the B-mode US.
Level of Evidence
This is a Level III, observational cohort study.
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Affiliation(s)
- Marco Cianforlini
- Department of Clinical and Molecular Sciences, School of Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Serena Ulisse
- Department of Radiological Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Valentino Coppa
- Department of Clinical and Molecular Sciences, School of Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Marco Grassi
- Department of Clinical and Molecular Sciences, School of Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Marco Rotini
- Department of Clinical and Molecular Sciences, School of Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Antonio Gigante
- Department of Clinical and Molecular Sciences, School of Medicine, Università Politecnica delle Marche, Ancona, Italy
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15
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Tonogai I, Hayashi F, Iwame T, Takasago T, Matsuura T, Sairyo K. Platelet-rich plasma does not reduce skeletal muscle fibrosis after distraction osteogenesis. J Exp Orthop 2018; 5:26. [PMID: 30006750 PMCID: PMC6045562 DOI: 10.1186/s40634-018-0143-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 07/09/2018] [Indexed: 12/22/2022] Open
Abstract
Background Skeletal muscle fibrosis caused by an increase in collagen deposition often occurs after distraction osteogenesis. Although studies are available reporting the effects of platelet-rich plasma (PRP) on tissue healing following injury, current findings remain controversial. This study focused on determining whether PRP reduces skeletal muscle fibrosis caused by distraction osteogenesis. Methods Tibial osteotomies were performed on 8-week-old wild type mice, and tibiae were distracted at a rate of 0.42 mm/day for 2 weeks, starting 1 week after osteotomy. Immediately after distraction was completed (3 weeks after osteotomy), PRP or phosphate buffered saline (as a sham) was injected into the gastrocnemius (GC) muscle. The GC muscles were harvested and analyzed. Results The amount and area of collagenous tissue increased in both the PRP and control groups following distraction osteogenesis, but the changes were not significantly different between both groups at all time points (p = 0.89, 0.45, 0.33 and 0.52 at 4, 6, 8 and 10 weeks). Conclusion From this study, our results suggest that PRP did not significantly reduce skeletal muscle fibrosis due to distraction osteogenesis.
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Affiliation(s)
- Ichiro Tonogai
- Department of Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Fumio Hayashi
- Department of Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Toshiyuki Iwame
- Department of Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Tomoya Takasago
- Department of Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Tetsuya Matsuura
- Department of Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Koichi Sairyo
- Department of Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
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16
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Scully D, Naseem KM, Matsakas A. Platelet biology in regenerative medicine of skeletal muscle. Acta Physiol (Oxf) 2018; 223:e13071. [PMID: 29633517 DOI: 10.1111/apha.13071] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/07/2018] [Accepted: 04/01/2018] [Indexed: 12/13/2022]
Abstract
Platelet-based applications such as platelet-rich plasma (PRP) and platelet releasate have gained unprecedented attention in regenerative medicine across a variety of tissues as of late. The rationale behind utilizing PRP originates in the delivery of key cytokines and growth factors from α-granules to the targeted area, which in turn act as cell cycle regulators and promote the healing process across a variety of tissues. The aim of the present review is to assimilate current experimental evidence on the role of platelets as biomaterials in tissue regeneration, particularly in skeletal muscle, by integrating findings from human, animal and cell studies. This review is composed of 3 parts: firstly, we review key aspects of platelet biology that precede the preparation and use of platelet-related applications for tissue regeneration. Secondly, we critically discuss relevant evidence on platelet-mediated regeneration in skeletal muscle focusing on findings from (i) clinical trials, (ii) experimental animal studies and (iii) cell culture studies; and thirdly, we discuss the application of platelets in the regeneration of several other tissues including tendon, bone, liver, vessels and nerve. Finally, we review key technical variations in platelet preparation that may account for the large discrepancy in outcomes from different studies. This review provides an up-to-date reference tool for biomedical and clinical scientists involved in platelet-mediated tissue regenerative applications.
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Affiliation(s)
- D. Scully
- Molecular Physiology Laboratory; Centre for Atherothrombotic & Metabolic Disease; Hull York Medical School; University of Hull; Hull UK
| | - K. M. Naseem
- Leeds Institute of Cardiovascular and Metabolic Medicine; University of Leeds; Leeds UK
| | - A. Matsakas
- Molecular Physiology Laboratory; Centre for Atherothrombotic & Metabolic Disease; Hull York Medical School; University of Hull; Hull UK
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17
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18
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Dinulovic I, Furrer R, Handschin C. Plasticity of the Muscle Stem Cell Microenvironment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1041:141-169. [PMID: 29204832 DOI: 10.1007/978-3-319-69194-7_8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Satellite cells (SCs) are adult muscle stem cells capable of repairing damaged and creating new muscle tissue throughout life. Their functionality is tightly controlled by a microenvironment composed of a wide variety of factors, such as numerous secreted molecules and different cell types, including blood vessels, oxygen, hormones, motor neurons, immune cells, cytokines, fibroblasts, growth factors, myofibers, myofiber metabolism, the extracellular matrix and tissue stiffness. This complex niche controls SC biology-quiescence, activation, proliferation, differentiation or renewal and return to quiescence. In this review, we attempt to give a brief overview of the most important players in the niche and their mutual interaction with SCs. We address the importance of the niche to SC behavior under physiological and pathological conditions, and finally survey the significance of an artificial niche both for basic and translational research purposes.
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19
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Rajapaksa S, McIntosh D, Cowin A, Adams D, Wormald PJ. The Effect of Insulin-Like Growth Factor 1 Incorporated into a Hyaluronic Acid-Based Nasal Pack on Nasal Mucosal Healing in a Healthy Sheep Model and a Sheep Model of Chronic Sinusitis. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/194589240501900307] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Endoscopic sinus surgery (ESS) is the accepted surgical treatment for chronic refractory rhinosinusitis. Prolonged healing and adhesion formation remain common problems. This study investigates the use of a hyaluronic acid-based pack impregnated with insulin-like growth factor (IGF) 1 to facilitate more rapid and effective healing after ESS in a healthy sheep model and a sheep model of chronic sinusitis. Methods This study used 12 healthy sheep and 9 sheep with chronic sinusitis. In each sheep one side (computer randomized) was used as a control. Under endoscopic guidance, mucosal injuries and adhesions were created on both sides and were either packed with a hyaluronic acid pack impregnated with IGF-1 or left unpacked as a control. Serial biopsies were performed for 4 months. Results In the healthy sheep there was a statistically significant (p < 0.05) improvement in reepithelialization in IGF-1 packed wounds at day 28 (89% for IGF-1 versus 44% for controls). In both healthy sheep and sheep with sinusitis there was no significant difference in mucosal reepithelialization at any of the other measured time points. In the sinusitis group, there was a significant decrease in ciliary regeneration at day 56 in the Merogel/IGF-1 group compared with the control group: 59.20% versus 77.68% (p < 0.01) and at day 112, 69.70% versus 87.26% (p < 0.01). Conclusion Hyaluronic acid impregnated with IGF-1 improved reepithelialization in the healthy sheep but not in the sheep with chronic rhinosinusitis. These packs had a detrimental effect on mucosal ciliary regeneration in the sheep with chronic rhinosinusitis.
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Affiliation(s)
- Suresh Rajapaksa
- Department of Surgery–Otolaryngology, Head and Neck Surgery, The University of Adelaide and Flinders University, Adelaide, South Australia
- the Co-operative Research Centre for Tissue Growth and Repair, Adelaide, South Australia
| | - David McIntosh
- Department of Surgery–Otolaryngology, Head and Neck Surgery, The University of Adelaide and Flinders University, Adelaide, South Australia
- the Co-operative Research Centre for Tissue Growth and Repair, Adelaide, South Australia
| | - Allison Cowin
- the Co-operative Research Centre for Tissue Growth and Repair, Adelaide, South Australia
- Child Health Research Institute, Women's and Children's Hospital, North Adelaide, South Australia
| | - Damian Adams
- the Co-operative Research Centre for Tissue Growth and Repair, Adelaide, South Australia
- Child Health Research Institute, Women's and Children's Hospital, North Adelaide, South Australia
| | - Peter-John Wormald
- Department of Surgery–Otolaryngology, Head and Neck Surgery, The University of Adelaide and Flinders University, Adelaide, South Australia
- the Co-operative Research Centre for Tissue Growth and Repair, Adelaide, South Australia
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20
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Wang ML, Beredjiklian PK, Steplewski A, Fertala J, Fertala A. Engineering the Second Generation of Therapeutic Cells with Enhanced Targeting of Injured Tissues. Tissue Eng Part A 2018; 24:1293-1300. [PMID: 29478375 DOI: 10.1089/ten.tea.2017.0515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Experimental approaches to improving tissue repair utilize cells and growth factors needed to restore the architecture and function of damaged tissues and organs. Key limitations of these approaches include poor delivery of therapeutic cells and growth factors into injury sites, as well as their short-term retention in target areas. In our earlier studies, we demonstrated that artificial collagen-specific anchor (ACSA) expressed on the surface of therapeutic cells directs them into collagen-rich sites of injury. Moreover, we demonstrated that the ACSA improves the retention of these cells in target sites, thereby promoting tissue repair. To advance the ACSA-based technology, we engineered the second generation of the ACSA-expressing cells able to deliver growth factors to target sites. In this study, we specifically focused on insulin growth factor 1 (IGF1), which enhances the repair of a number of collagen-rich connective tissues, including ligament and tendon. Utilizing gene engineering, we produced IGF1 in the ACSA-expressing cells. Using relevant experimental models, we demonstrated that recombinant IGF1 secreted by these cells maintains its specificity and biological activity. Moreover, our studies show that IGF1 produced by the ACSA-expressing cells cultured in three-dimensional environment promotes the formation of the collagen-rich fibrillar matrix. Furthermore, the engineered cells integrated well with the native collagen-rich tendon tissue. Our study provides strong evidence for the great potential of cells with rationally engineered target-specific receptors to restore damaged connective tissues. Future studies in relevant animal models will determine the utility of these cells in vivo.
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Affiliation(s)
- Mark L Wang
- 1 Department of Orthopaedic Surgery, Division of Orthopaedic Research, Sidney Kimmel Medical School, Thomas Jefferson University , Philadelphia, Pennsylvania.,2 Hand Surgery Division, The Rothman Institute, Thomas Jefferson University , Philadelphia, Pennsylvania
| | - Pedro K Beredjiklian
- 1 Department of Orthopaedic Surgery, Division of Orthopaedic Research, Sidney Kimmel Medical School, Thomas Jefferson University , Philadelphia, Pennsylvania.,2 Hand Surgery Division, The Rothman Institute, Thomas Jefferson University , Philadelphia, Pennsylvania
| | - Andrzej Steplewski
- 1 Department of Orthopaedic Surgery, Division of Orthopaedic Research, Sidney Kimmel Medical School, Thomas Jefferson University , Philadelphia, Pennsylvania
| | - Jolanta Fertala
- 1 Department of Orthopaedic Surgery, Division of Orthopaedic Research, Sidney Kimmel Medical School, Thomas Jefferson University , Philadelphia, Pennsylvania
| | - Andrzej Fertala
- 1 Department of Orthopaedic Surgery, Division of Orthopaedic Research, Sidney Kimmel Medical School, Thomas Jefferson University , Philadelphia, Pennsylvania
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Allbright KO, Bliley JM, Havis E, Kim D, Dibernardo GA, Grybowski D, Waldner M, James IB, Sivak WN, Rubin JP, Marra KG. Delivery of adipose‐derived stem cells in poloxamer hydrogel improves peripheral nerve regeneration. Muscle Nerve 2018; 58:251-260. [DOI: 10.1002/mus.26094] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Kassandra O. Allbright
- Department of Plastic Surgery, School of MedicineUniversity of Pittsburgh3550 Terrace Street 6B, Scaife Hall Pittsburgh Pennsylvania15261 USA
| | - Jacqueline M. Bliley
- Department of Plastic Surgery, School of MedicineUniversity of Pittsburgh3550 Terrace Street 6B, Scaife Hall Pittsburgh Pennsylvania15261 USA
| | - Emmanuelle Havis
- Department of Plastic Surgery, School of MedicineUniversity of Pittsburgh3550 Terrace Street 6B, Scaife Hall Pittsburgh Pennsylvania15261 USA
| | - Deok‐Yeol Kim
- Department of Plastic Surgery, School of MedicineUniversity of Pittsburgh3550 Terrace Street 6B, Scaife Hall Pittsburgh Pennsylvania15261 USA
| | - Gabriella A. Dibernardo
- Department of Plastic Surgery, School of MedicineUniversity of Pittsburgh3550 Terrace Street 6B, Scaife Hall Pittsburgh Pennsylvania15261 USA
| | - Damian Grybowski
- Department of Plastic Surgery, School of MedicineUniversity of Pittsburgh3550 Terrace Street 6B, Scaife Hall Pittsburgh Pennsylvania15261 USA
| | - Matthias Waldner
- Department of Plastic Surgery, School of MedicineUniversity of Pittsburgh3550 Terrace Street 6B, Scaife Hall Pittsburgh Pennsylvania15261 USA
| | - Isaac B. James
- Department of Plastic Surgery, School of MedicineUniversity of Pittsburgh3550 Terrace Street 6B, Scaife Hall Pittsburgh Pennsylvania15261 USA
| | - Wesley N. Sivak
- Department of Plastic Surgery, School of MedicineUniversity of Pittsburgh3550 Terrace Street 6B, Scaife Hall Pittsburgh Pennsylvania15261 USA
| | - J. Peter Rubin
- Department of Plastic Surgery, School of MedicineUniversity of Pittsburgh3550 Terrace Street 6B, Scaife Hall Pittsburgh Pennsylvania15261 USA
| | - Kacey G. Marra
- Department of Plastic Surgery, School of MedicineUniversity of Pittsburgh3550 Terrace Street 6B, Scaife Hall Pittsburgh Pennsylvania15261 USA
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Mizuno S, Yoda M, Shimoda M, Chiba K, Nakamura M, Horiuchi K. Inhibition of ADAM10 in satellite cells accelerates muscle regeneration following muscle injury. J Orthop Res 2018; 36:2259-2265. [PMID: 29464750 DOI: 10.1002/jor.23878] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 02/15/2018] [Indexed: 02/04/2023]
Abstract
Muscle injury is one of the most common orthopedic and sports disorders. For severe cases, surgical repair may be indicated; however, other than immobilization and the administration of anti-inflammatory drugs there is currently no effective conservative treatment for this condition. Satellite cells (SCs) are muscle-specific stem cells and are indispensable for muscle regeneration after muscle injury. SCs are activated upon muscle injury to proliferate and differentiate into myoblasts, which subsequently fuse into myofibers and regenerate the damaged muscle. We have previously shown that ADAM10, a membrane-anchored proteolytic enzyme, is essential for the maintenance of SC quiescence by activating the Notch signaling pathway in SCs. Because suppression of ADAM10 activity in SCs can activate SC differentiation, we asked whether inactivation of ADAM10 in SCs after muscle injury could enhance muscle regeneration. Using Adam10 conditional knockout mice, in which ADAM10 activity can specifically be suppressed in SCs, we found that partial inactivation of ADAM10 accelerates muscle regeneration after muscle injury. Nearly identical results were obtained by the administration of GI254023X, a selective ADAM10 inhibitor. The findings of the present study thus indicate that transient enhancement of SC differentiation after muscle injury expedites muscle regeneration and that ADAM10 can be a potential molecular target in treating muscle injuries. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
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Affiliation(s)
- Sakiko Mizuno
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Orthopedics, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa City, Chiba, 272-8513, Japan
| | - Masaki Yoda
- Laboratory of Cell and Tissue Biology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masayuki Shimoda
- Department of Pathology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuhiro Chiba
- Department of Orthopedic Surgery, National Defense Medical College, Namiki 3-2, Tokorozawa, Saitama, 359-8513, Japan
| | - Masaya Nakamura
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Keisuke Horiuchi
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Orthopedic Surgery, National Defense Medical College, Namiki 3-2, Tokorozawa, Saitama, 359-8513, Japan
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Abreu P, Marzuca-Nassr GN, Hirabara SM, Curi R. Experimental Model of Skeletal Muscle Laceration in Rats. Methods Mol Biol 2018; 1735:397-401. [PMID: 29380330 DOI: 10.1007/978-1-4939-7614-0_27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This is a modified experimental model previously developed in mouse to study skeletal muscle laceration in rats. All experimental procedures are performed during the light period, including anesthesia and surgery. The animals are randomly distributed into control and injured groups prior to the procedure. This experimental model can be used to investigate skeletal muscle laceration repair.
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Affiliation(s)
- Phablo Abreu
- Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil.
- Department of Biochemistry, Institute of Chemistry, University of Sao Paulo, Sao Paulo, Brazil.
| | | | - Sandro Massao Hirabara
- Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil
| | - Rui Curi
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
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Implantation of platelet rich fibrin and allogenic mesenchymal stem cells facilitate the healing of muscle injury: An experimental study on animal. INTERNATIONAL JOURNAL OF SURGERY OPEN 2018. [DOI: 10.1016/j.ijso.2018.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Tsai WC, Yu TY, Lin LP, Lin MS, Tsai TT, Pang JHS. Platelet rich plasma promotes skeletal muscle cell migration in association with up-regulation of FAK, paxillin, and F-Actin formation. J Orthop Res 2017; 35:2506-2512. [PMID: 28233384 DOI: 10.1002/jor.23547] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 02/10/2017] [Indexed: 02/04/2023]
Abstract
Platelet rich plasma (PRP) contains various cytokines and growth factors which may be beneficial to the healing process of injured muscle. The aim of this study was to investigate the effect and molecular mechanism of PRP on migration of skeletal muscle cells. Skeletal muscle cells intrinsic to Sprague-Dawley rats were treated with PRP. The cell migration was evaluated by transwell filter migration assay and electric cell-substrate impedance sensing. The spreading of cells was evaluated microscopically. The formation of filamentous actin (F-actin) cytoskeleton was assessed by immunofluorescence staining. The protein expressions of paxillin and focal adhesion kinase (FAK) were assessed by Western blot analysis. Transfection of paxillin small-interfering RNA (siRNAs) to muscle cells was performed to validate the role of paxillin in PRP-mediated promotion of cell migration. Dose-dependently PRP promotes migration of and spreading and muscle cells. Protein expressions of paxillin and FAK were up-regulated dose-dependently. F-actin formation was also enhanced by PRP treatment. Furthermore, the knockdown of paxillin expression impaired the effect of PRP to promote cell migration. It was concluded that PRP promoting migration of muscle cells is associated with up-regulation of proteins expression of paxillin and FAK as well as increasing F-actin formation. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2506-2512, 2017.
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Affiliation(s)
- Wen-Chung Tsai
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taoyuan City, Taiwan.,College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Tung-Yang Yu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taoyuan City, Taiwan
| | - Li-Ping Lin
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taoyuan City, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan City, Taiwan
| | - Mioa-Sui Lin
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taoyuan City, Taiwan
| | - Ting-Ta Tsai
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taoyuan City, Taiwan
| | - Jong-Hwei S Pang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taoyuan City, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan City, Taiwan
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26
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Does platelet-rich plasma decrease time to return to sports in acute muscle tear? A randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 2017; 25:3319-3325. [PMID: 27085364 DOI: 10.1007/s00167-016-4129-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 04/05/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE The aim of this study is to report the effects of autologous PRP injections on time to return to play and recurrence rate after acute grade 2 muscle injuries in recreational and competitive athletes. METHODS Seventy-five patients diagnosed with acute muscle injuries were randomly allocated to autologous PRP therapy combined with a rehabilitation programme or a rehabilitation programme only. The primary outcome of this study was time to return to play. In addition, changes in pain severity and recurrence rates were evaluated. RESULTS Patients in the PRP group achieved full recovery significantly earlier than controls (P = 0.001). The mean time to return to play was 21.1 ± 3.1 days and 25 ± 2.8 days for the PRP and control groups, respectively (P = 0.001). Significantly lower pain severity scores were observed in the PRP group throughout the study. The difference in the recurrence rate after 2-year-follow-up was not statistically significant between groups. CONCLUSIONS A single PRP injection combined with a rehabilitation programme significantly shortened time to return to sports compared to a rehabilitation programme only. Recurrence rate was not significantly different between groups. LEVEL OF EVIDENCE I.
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Human myogenic reserve cells are quiescent stem cells that contribute to muscle regeneration after intramuscular transplantation in immunodeficient mice. Sci Rep 2017; 7:3462. [PMID: 28615691 PMCID: PMC5471254 DOI: 10.1038/s41598-017-03703-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 05/03/2017] [Indexed: 11/08/2022] Open
Abstract
Satellite cells, localized within muscles in vivo, are Pax7+ muscle stem cells supporting skeletal muscle growth and regeneration. Unfortunately, their amplification in vitro, required for their therapeutic use, is associated with reduced regenerative potential. In the present study, we investigated if human myogenic reserve cells (MRC) obtained in vitro, represented a reliable cell source for muscle repair. For this purpose, primary human myoblasts were freshly isolated and expanded. After 2 days of differentiation, 62 ± 2.9% of the nuclei were localized in myotubes and 38 ± 2.9% in the mononucleated non-fusing MRC. Eighty percent of freshly isolated human MRC expressed a phenotype similar to human quiescent satellite cells (CD56+/Pax7+/MyoD−/Ki67− cells). Fourteen days and 21 days after cell transplantation in immunodeficient mice, live human cells were significantly more numerous and the percentage of Pax7+/human lamin A/C+ cells was 2 fold higher in muscles of animals injected with MRC compared to those injected with human myoblasts, despite that percentage of spectrin+ and lamin A/C+ human fibers in both groups MRC were similar. Taken together, these data provide evidence that MRC generated in vitro represent a promising source of cells for improving regeneration of injured skeletal muscles.
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28
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Nuutila K, Sakthivel D, Kruse C, Tran P, Giatsidis G, Sinha I. Gene expression profiling of skeletal muscle after volumetric muscle loss. Wound Repair Regen 2017; 25:408-413. [DOI: 10.1111/wrr.12547] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/03/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Kristo Nuutila
- Division of Plastic Surgery, Department of Surgery, Brigham & Women's Hospital; Harvard Medical School; Boston Massachusetts
| | - Dharaniya Sakthivel
- Division of Plastic Surgery, Department of Surgery, Brigham & Women's Hospital; Harvard Medical School; Boston Massachusetts
| | - Carla Kruse
- Division of Plastic Surgery, Department of Surgery, Brigham & Women's Hospital; Harvard Medical School; Boston Massachusetts
| | - Peter Tran
- Division of Plastic Surgery, Department of Surgery, Brigham & Women's Hospital; Harvard Medical School; Boston Massachusetts
| | - Giorgio Giatsidis
- Division of Plastic Surgery, Department of Surgery, Brigham & Women's Hospital; Harvard Medical School; Boston Massachusetts
| | - Indranil Sinha
- Division of Plastic Surgery, Department of Surgery, Brigham & Women's Hospital; Harvard Medical School; Boston Massachusetts
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29
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Baker HB, Passipieri JA, Siriwardane M, Ellenburg MD, Vadhavkar M, Bergman CR, Saul JM, Tomblyn S, Burnett L, Christ GJ. Cell and Growth Factor-Loaded Keratin Hydrogels for Treatment of Volumetric Muscle Loss in a Mouse Model. Tissue Eng Part A 2017; 23:572-584. [PMID: 28162053 DOI: 10.1089/ten.tea.2016.0457] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Wounds to the head, neck, and extremities have been estimated to account for ∼84% of reported combat injuries to military personnel. Volumetric muscle loss (VML), defined as skeletal muscle injuries in which tissue loss results in permanent functional impairment, is common among these injuries. The present standard of care entails the use of muscle flap transfers, which suffer from the need for additional surgery when using autografts or the risk of rejection when cadaveric grafts are used. Tissue engineering (TE) strategies for skeletal muscle repair have been investigated as a means to overcome current therapeutic limitations. In that regard, human hair-derived keratin (KN) biomaterials have been found to possess several favorable properties for use in TE applications and, as such, are a viable candidate for use in skeletal muscle repair. Herein, KN hydrogels with and without the addition of skeletal muscle progenitor cells (MPCs) and/or insulin-like growth factor 1 (IGF-1) and/or basic fibroblast growth factor (bFGF) were implanted in an established murine model of surgically induced VML injury to the latissimus dorsi (LD) muscle. Control treatments included surgery with no repair (NR) as well as implantation of bladder acellular matrix (BAM). In vitro muscle contraction force was evaluated at two months postsurgery through electrical stimulation of the explanted LD in an organ bath. Functional data indicated that implantation of KN+bFGF+IGF-1 (n = 8) enabled a greater recovery of contractile force than KN+bFGF (n = 8)***, KN+MPC (n = 8)**, KN+MPC+bFGF+IGF-1 (n = 8)**, BAM (n = 8)*, KN+IGF-1 (n = 8)*, KN+MPCs+bFGF (n = 9)*, or NR (n = 9)**, (*p < 0.05, **p < 0.01, ***p < 0.001). Consistent with the physiological findings, histological evaluation of retrieved tissue revealed much more extensive new muscle tissue formation in groups with greater functional recovery (e.g., KN+IGF-1+bFGF) when compared with observations in tissue from groups with lower functional recovery (i.e., BAM and NR). Taken together, these findings further indicate the general utility of KN biomaterials in TE and, moreover, specifically highlight their potential application in the treatment of VML injuries.
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Affiliation(s)
- H B Baker
- 1 Fischell Department of Bioengineering, University of Maryland , College Park, Maryland.,2 Wake Forest Institute for Regenerative Medicine, Wake Forest University , Winston-Salem, North Carolina
| | - J A Passipieri
- 2 Wake Forest Institute for Regenerative Medicine, Wake Forest University , Winston-Salem, North Carolina.,3 Department of Biomedical Engineering, University of Virginia , Charlottesville, Virginia
| | - Mevan Siriwardane
- 2 Wake Forest Institute for Regenerative Medicine, Wake Forest University , Winston-Salem, North Carolina
| | | | - Manasi Vadhavkar
- 2 Wake Forest Institute for Regenerative Medicine, Wake Forest University , Winston-Salem, North Carolina
| | - Christopher R Bergman
- 2 Wake Forest Institute for Regenerative Medicine, Wake Forest University , Winston-Salem, North Carolina
| | - Justin M Saul
- 5 Department of Chemical, Paper and Biomedical Engineering, Miami University , Oxford, Ohio
| | - Seth Tomblyn
- 4 KeraNetics, LLC , Winston-Salem, North Carolina
| | - Luke Burnett
- 4 KeraNetics, LLC , Winston-Salem, North Carolina
| | - George J Christ
- 2 Wake Forest Institute for Regenerative Medicine, Wake Forest University , Winston-Salem, North Carolina.,3 Department of Biomedical Engineering, University of Virginia , Charlottesville, Virginia.,6 Department of Orthopaedics, University of Virginia , Charlottesville, Virginia
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Kieb M, Sander F, Prinz C, Adam S, Mau-Möller A, Bader R, Peters K, Tischer T. Platelet-Rich Plasma Powder: A New Preparation Method for the Standardization of Growth Factor Concentrations. Am J Sports Med 2017; 45:954-960. [PMID: 27903591 DOI: 10.1177/0363546516674475] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Platelet-rich plasma (PRP) is widely used in sports medicine. Available PRP preparations differ in white blood cell, platelet, and growth factor concentrations, making standardized research and clinical application challenging. PURPOSE To characterize a newly standardized procedure for pooled PRP that provides defined growth factor concentrations. STUDY DESIGN Controlled laboratory study. METHODS A standardized growth factor preparation (lyophilized PRP powder) was prepared using 12 pooled platelet concentrates (PCs) derived from different donors via apheresis. Blood samples and commercially available PRP (SmartPrep-2) served as controls (n = 5). Baseline blood counts were analyzed. Additionally, single PCs (n = 5) were produced by standard platelet apheresis. The concentrations of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), platelet-derived growth factor AB (PDGF-AB), transforming growth factor β1 (TGF-β1), insulin-like growth factor 1 (IGF-1), interleukin (IL)-1α, IL-1β, and IL-1 receptor agonist (IL-1RA) were analyzed by enzyme-linked immunosorbent assay, and statistical analyses were performed using descriptive statistics, mean differences, 95% CIs, and P values (analysis of variance). RESULTS All growth factor preparation methods showed elevated concentrations of the growth factors VEGF, bFGF, PDGF-AB, and TGF-β1 compared with those of whole blood. Large interindividual differences were found in VEGF and bFGF concentrations. Respective values (mean ± SD in pg/mL) for whole blood, SmartPrep-2, PC, and PRP powder were as follows: VEGF (574 ± 147, 528 ± 233, 1087 ± 535, and 1722), bFGF (198 ± 164, 410 ± 259, 151 ± 99, and 542), PDGF-AB (2394 ± 451, 17,846 ± 3087, 18,461 ± 4455, and 23,023), and TGF-β1 (14,356 ± 4527, 77,533 ± 13,918, 68,582 ± 7388, and 87,495). IGF-1 was found in SmartPrep-2 (1539 ± 348 pg/mL). For PC (2266 ± 485 pg/mL), IGF-1 was measured at the same levels of whole blood (2317 ± 711 pg/mL) but was not detectable in PRP powder. IL-1α was detectable in whole blood (111 ± 35 pg/mL) and SmartPrep-2 (119 ± 44 pg/mL). CONCLUSION Problems with PRP such as absent standardization, lack of consistency among studies, and black box dosage could be solved by using characterized PRP powder made by pooling and lyophilizing multiple PCs. The new PRP powder opens up new possibilities for PRP research as well as for the treatment of patients. CLINICAL RELEVANCE The preparation of pooled PRP by means of lyophilization may allow physicians to apply a defined amount of growth factors by using a defined amount of PRP powder. Moreover, PRP powder as a dry substance with no need for centrifugation could become ubiquitously available, thus saving time and staff resources in clinical practice. However, before transferring the results of this basic science study to clinical application, regulatory issues have to be cleared.
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Affiliation(s)
- Matthias Kieb
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany.,Center of Surgery, Ernst von Bergmann Hospital, Potsdam, Germany
| | - Frank Sander
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | | | - Stefanie Adam
- Department of Cell Biology, Rostock University Medical Center, Rostock, Germany
| | - Anett Mau-Möller
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Rainer Bader
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Kirsten Peters
- Department of Cell Biology, Rostock University Medical Center, Rostock, Germany
| | - Thomas Tischer
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
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Best TM, Caplan A, Coleman M, Goodrich L, Hurd J, Kaplan LD, Noonan B, Schoettle P, Scott C, Stiene H, Huard J. Not Missing the Future. Curr Sports Med Rep 2017; 16:202-210. [DOI: 10.1249/jsr.0000000000000357] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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32
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Tsai WC, Yu TY, Lin LP, Lin MS, Wu YC, Liao CH, Pang JHS. Platelet rich plasma releasate promotes proliferation of skeletal muscle cells in association with upregulation of PCNA, cyclins and cyclin dependent kinases. Platelets 2016; 28:491-497. [PMID: 27780401 DOI: 10.1080/09537104.2016.1227061] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Platelet rich plasma (PRP) contains various cytokines and growth factors which may be beneficial to the healing process of injured muscle. The purpose of this study is to investigate the effect and molecular mechanism of PRP releasate on proliferation of skeletal muscle cells. Skeletal muscle cells intrinsic to Sprague-Dawley rats were treated with PRP releasate. Cell proliferation was evaluated by 3-[4,5-Dimethylthiazol- 2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay and immunocytochemistry with Ki-67 stain. Flow cytometric analysis was used to evaluate the cell cycle progression. Western blot analysis was used to evaluate the protein expressions of PCNA, cyclin E1, cyclin A2, cyclin B1, cyclin dependent kinase (cdk)1 and cdk2. The results revealed that PRP releasate enhanced proliferation of skeletal muscle cells by shifting cells from G1 phase to S phase and G2/M phases. Ki-67 stain revealed the increase of proliferative capability after PRP releasate treatment. Protein expressions including cyclin A2, cyclin B1, cdk1, cdk2 and PCNA were up-regulated by PRP releasate in a dose-dependent manner. It was concluded that PRP releasate promoted proliferation of skeletal muscle cells in association with the up-regulated protein expressions of PCNA, cyclin A2, cyclin B1, cdk1 and cdk2.
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Affiliation(s)
- Wen-Chung Tsai
- a Department of Physical Medicine and Rehabilitation , Chang Gung Memorial Hospital at Linkou , Taoyuan City , Taiwan.,b College of Medicine , Chang Gung University , Taoyuan City , Taiwan
| | - Tung-Yang Yu
- a Department of Physical Medicine and Rehabilitation , Chang Gung Memorial Hospital at Linkou , Taoyuan City , Taiwan
| | - Li-Ping Lin
- a Department of Physical Medicine and Rehabilitation , Chang Gung Memorial Hospital at Linkou , Taoyuan City , Taiwan.,c Graduate Institute of Clinical Medical Sciences, Chang Gung University , Taoyuan City , Taiwan
| | - Miao-Sui Lin
- a Department of Physical Medicine and Rehabilitation , Chang Gung Memorial Hospital at Linkou , Taoyuan City , Taiwan
| | - Yi-Cheng Wu
- a Department of Physical Medicine and Rehabilitation , Chang Gung Memorial Hospital at Linkou , Taoyuan City , Taiwan
| | - Chih-Hao Liao
- a Department of Physical Medicine and Rehabilitation , Chang Gung Memorial Hospital at Linkou , Taoyuan City , Taiwan.,b College of Medicine , Chang Gung University , Taoyuan City , Taiwan
| | - Jong-Hwei S Pang
- a Department of Physical Medicine and Rehabilitation , Chang Gung Memorial Hospital at Linkou , Taoyuan City , Taiwan.,c Graduate Institute of Clinical Medical Sciences, Chang Gung University , Taoyuan City , Taiwan
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33
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Martin KS, Kegelman CD, Virgilio KM, Passipieri JA, Christ GJ, Blemker SS, Peirce SM. In Silico and In Vivo Experiments Reveal M-CSF Injections Accelerate Regeneration Following Muscle Laceration. Ann Biomed Eng 2016; 45:747-760. [PMID: 27718091 DOI: 10.1007/s10439-016-1707-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 08/04/2016] [Indexed: 12/17/2022]
Abstract
Numerous studies have pharmacologically modulated the muscle milieu in the hopes of promoting muscle regeneration; however, the timing and duration of these interventions are difficult to determine. This study utilized a combination of in silico and in vivo experiments to investigate how inflammation manipulation improves muscle recovery following injury. First, we measured macrophage populations following laceration injury in the rat tibialis anterior (TA). Then we calibrated an agent-based model (ABM) of muscle injury to mimic the observed inflammation profiles. The calibrated ABM was used to simulate macrophage and satellite stem cell (SC) dynamics, and suggested that delivering macrophage colony stimulating factor (M-CSF) prior to injury would promote SC-mediated injury recovery. Next, we performed an experiment wherein 1 day prior to injury, we injected M-CSF into the rat TA muscle. M-CSF increased the number of macrophages during the first 4 days post-injury. Furthermore, treated muscles experienced a swifter increase in the appearance of PAX7+ SCs and regenerating muscle fibers. Our study suggests that computational models of muscle injury provide novel insights into cellular dynamics during regeneration, and further, that pharmacologically altering inflammation dynamics prior to injury can accelerate the muscle regeneration process.
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Affiliation(s)
- Kyle S Martin
- Department of Biomedical Engineering, The University of Virginia, Health System, PO Box 800759, Charlottesville, VA 22908, USA
| | - Christopher D Kegelman
- Department of Biomedical Engineering, The University of Virginia, Health System, PO Box 800759, Charlottesville, VA 22908, USA
| | - Kelley M Virgilio
- Department of Biomedical Engineering, The University of Virginia, Health System, PO Box 800759, Charlottesville, VA 22908, USA
| | - Julianna A Passipieri
- Department of Biomedical Engineering, The University of Virginia, Health System, PO Box 800759, Charlottesville, VA 22908, USA
| | - George J Christ
- Department of Biomedical Engineering, The University of Virginia, Health System, PO Box 800759, Charlottesville, VA 22908, USA
- Department of Orthopaedic Surgery, The University of Virginia, Charlottesville, VA, USA
| | - Silvia S Blemker
- Department of Biomedical Engineering, The University of Virginia, Health System, PO Box 800759, Charlottesville, VA 22908, USA.
- Department of Mechanical and Aerospace Engineering, The University of Virginia, Charlottesville, VA, USA.
| | - Shayn M Peirce
- Department of Biomedical Engineering, The University of Virginia, Health System, PO Box 800759, Charlottesville, VA 22908, USA
- Department of Ophthalmology, The University of Virginia, Charlottesville, VA, USA
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34
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Changes in neurotrophic factors of adult rat laryngeal muscles during nerve regeneration. Neuroscience 2016; 333:44-53. [DOI: 10.1016/j.neuroscience.2016.07.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 07/01/2016] [Accepted: 07/02/2016] [Indexed: 02/06/2023]
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35
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Grosman-Rimon L, Parkinson W, Upadhye S, Clarke H, Katz J, Flannery J, Peng P, Kumbhare D. Circulating biomarkers in acute myofascial pain: A case-control study. Medicine (Baltimore) 2016; 95:e4650. [PMID: 27631214 PMCID: PMC5402557 DOI: 10.1097/md.0000000000004650] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The aims of the present study were to compare levels of circulating inflammatory biomarkers and growth factors between patients with myofascial pain syndrome (MPS) and healthy control participants, and to assess the relationship among inflammatory markers and growth factors in the two groups.Biomarkers levels were assessed in patients (n = 37) with myofascial pain complaints recruited from the hospital emergency department and non-MPS controls (n = 21), recruited via advertisements in the hospital and community.Blood levels of the cytokines, namely, interleukin-6 (IL-6), tumor necrosis factor (TNF), and interleukin-12 (IL-12), and the chemokine, namely, monocyte chemoattractant protein-1 (MCP-1), macrophage-derived chemokine (MDC), eotaxin, granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-8 (IL-8), and macrophage inflammatory proteins-1β (MIP-1β) were significantly higher in patients with MPS than controls. The results of the growth factor analyses revealed significantly higher levels of fibroblast growth factor-2 (FGF-2), platelet-derived growth factor (PDGF), and vascular endothelial growth factor (VEGF) in MPS patients versus controls. The pattern of correlation coefficients between cytokines and growth factors differed considerably for MPS patients and controls with far fewer significant positive coefficients observed in the controls. Serum inflammatory and growth factor biomarkers were elevated in MPS patients.Inflammatory biomarkers and growth factor levels may play an important role in the onset and maintenance of MPS and therefore may be useful in the diagnosis and treatment of MPS. Understanding the mechanisms of inflammation in MPS necessitates future research.
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Affiliation(s)
| | | | | | - Hance Clarke
- Department of Anesthesia, University of Toronto
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network
| | - Joel Katz
- Department of Anesthesia, University of Toronto
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network
- Department of Psychology, York University
| | - John Flannery
- Toronto Rehabilitation Institute, University Health Network
| | - Philip Peng
- Department of Anesthesia, University of Toronto
| | - Dinesh Kumbhare
- Toronto Rehabilitation Institute, University Health Network
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada
- Corresponding: Dinesh Kumbhare, Toronto Rehabilitation Institute, 550 University Avenue, Toronto, ON M5G 2A2, Canada (e-mail: )
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36
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Pumberger M, Qazi TH, Ehrentraut MC, Textor M, Kueper J, Stoltenburg-Didinger G, Winkler T, von Roth P, Reinke S, Borselli C, Perka C, Mooney DJ, Duda GN, Geißler S. Synthetic niche to modulate regenerative potential of MSCs and enhance skeletal muscle regeneration. Biomaterials 2016; 99:95-108. [DOI: 10.1016/j.biomaterials.2016.05.009] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/02/2016] [Accepted: 05/04/2016] [Indexed: 01/01/2023]
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37
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Laumonier T, Menetrey J. Muscle injuries and strategies for improving their repair. J Exp Orthop 2016; 3:15. [PMID: 27447481 PMCID: PMC4958098 DOI: 10.1186/s40634-016-0051-7] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/15/2016] [Indexed: 12/31/2022] Open
Abstract
Satellite cells are tissue resident muscle stem cells required for postnatal skeletal muscle growth and repair through replacement of damaged myofibers. Muscle regeneration is coordinated through different mechanisms, which imply cell-cell and cell-matrix interactions as well as extracellular secreted factors. Cellular dynamics during muscle regeneration are highly complex. Immune, fibrotic, vascular and myogenic cells appear with distinct temporal and spatial kinetics after muscle injury. Three main phases have been identified in the process of muscle regeneration; a destruction phase with the initial inflammatory response, a regeneration phase with activation and proliferation of satellite cells and a remodeling phase with maturation of the regenerated myofibers. Whereas relatively minor muscle injuries, such as strains, heal spontaneously, severe muscle injuries form fibrotic tissue that impairs muscle function and lead to muscle contracture and chronic pain. Current therapeutic approaches have limited effectiveness and optimal strategies for such lesions are not known yet. Various strategies, including growth factors injections, transplantation of muscle stem cells in combination or not with biological scaffolds, anti-fibrotic therapies and mechanical stimulation, may become therapeutic alternatives to improve functional muscle recovery.
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Affiliation(s)
- Thomas Laumonier
- Department of Orthopaedic Surgery, Geneva University Hospitals & Faculty of Medicine, 4, Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland.
| | - Jacques Menetrey
- Department of Orthopaedic Surgery, Geneva University Hospitals & Faculty of Medicine, 4, Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland
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38
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Effects of Traumeel (Tr14) on Exercise-Induced Muscle Damage Response in Healthy Subjects: A Double-Blind RCT. Mediators Inflamm 2016; 2016:1693918. [PMID: 27478305 PMCID: PMC4949332 DOI: 10.1155/2016/1693918] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 06/02/2016] [Accepted: 06/05/2016] [Indexed: 12/20/2022] Open
Abstract
The present double-blind, randomized, placebo-controlled clinical trial intended to test whether ingestion of a natural combination medicine (Tr14 tablets) affects serum muscle damage and inflammatory immune response after downhill running. 96 male subjects received Tr14 tablets, which consist of 14 diluted biological and mineral components, or a placebo for 72 h after the exercise test, respectively. Changes in postexercise levels of various serum muscle damage and immunological markers were investigated. The area under the curve with respect to the increase (AUCi) of perceived pain score and creatine kinase (CK) were defined as primary outcome measures. While for CK the p value of the difference between the two groups is borderline, the pain score and muscle strength were not statistically significant. However, a trend towards lower levels of muscle damage (CK, p = 0.05; LDH, p = 0.06) in the Tr14 group was shown. Less pronounced lymphopenia (p = 0.02), a trend towards a lower expression of CD69 count (p = 0.07), and antigen-stimulated ICAM-1 (p = 0.01) were found in the verum group. The Tr14 group showed a tendentially lower increase of neutrophils (p = 0.10), BDNF (p = 0.03), stem cell factor (p = 0.09), and GM-CSF (p = 0.09) to higher levels. The results of the current study indicate that Tr14 seems to limit exercise-induced muscle damage most likely via attenuation of both innate and adaptive immune responses. This study was registered with ClinicalTrials.gov (NCT01912469).
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Hayashi K, Katanosaka K, Abe M, Yamanaka A, Nosaka K, Mizumura K, Taguchi T. Muscular mechanical hyperalgesia after lengthening contractions in rats depends on stretch velocity and range of motion. Eur J Pain 2016; 21:125-139. [DOI: 10.1002/ejp.909] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2016] [Indexed: 01/12/2023]
Affiliation(s)
- K. Hayashi
- Department of Neuroscience II; Research Institute of Environmental Medicine; Nagoya University; Japan
| | - K. Katanosaka
- Department of Biomedical Sciences; College of Life and Health Sciences; Chubu University; Kasugai Japan
| | - M. Abe
- Medical Information Department; Vitacain Pharmaceutical Co. Ltd.; Osaka Japan
| | - A. Yamanaka
- Department of Neuroscience II; Research Institute of Environmental Medicine; Nagoya University; Japan
| | - K. Nosaka
- Centre for Exercise and Sports Science Research; School of Medical and Health Sciences; Edith Cowan University; Joondalup WA Australia
| | - K. Mizumura
- Department of Physical Therapy; College of Life and Health Sciences; Chubu University; Kasugai Japan
| | - T. Taguchi
- Department of Neuroscience II; Research Institute of Environmental Medicine; Nagoya University; Japan
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Kirk SP, Oldham JM, Jeanplong F, Bass JJ. Insulin-like Growth Factor-II Delays Early but Enhances Late Regeneration of Skeletal Muscle. J Histochem Cytochem 2016; 51:1611-20. [PMID: 14623929 DOI: 10.1177/002215540305101205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study tested whether administration of insulin-like growth factor-II (IGF-II) enhances muscle regeneration. Rat biceps femoris muscle was damaged with notexin and then IGF-II was administered for up to 7 days. Results show that the proportion of nuclei containing or surrounded by immunoreactivity to MyoD, myogenin, and developmental myosin heavy chain (dMHC) is less in the IGF-II treatment group relative to the control group on days 1 (p=0.057), 2 (p=0.034), and 3 (p=0.047), respectively. This indicates a delay in muscle precursor cell (MPC) proliferation and differentiation with IGF-II administration. This effect was not associated with decreased binding capacity of the type 1 IGF receptor, as determined by receptor autoradiography in day 1 muscle sections (NS), but was associated with inhibition of phagocytic processes. The cross-sectional area of regenerating muscle fibers was significantly greater in the IGF-II treatment group than in the control group by day 7 (p=0.0092). The enhancing effect of IGF-II on late muscle regeneration, when the main process taking place is fiber enlargement, coincides with the period in which IGF-II is normally expressed by regenerating muscle, indicating that greater endogenous production of IGF-II would be associated with improved regeneration.
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Affiliation(s)
- Sonnie P Kirk
- Functional Muscle Genomics, AgResearch, Ruakura Agricultural Research Centre, Hamilton, New Zealand
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41
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Zanon G, Combi F, Combi A, Perticarini L, Sammarchi L, Benazzo F. Platelet-rich plasma in the treatment of acute hamstring injuries in professional football players. JOINTS 2016; 4:17-23. [PMID: 27386443 DOI: 10.11138/jts/2016.4.1.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE muscle injuries have a high incidence in professional football and are responsible for the largest number of days lost from competition. Several in vitro studies have confirmed the positive role of platelet-rich plasma (PRP) in accelerating recovery and in promoting muscle regeneration, and not fibrosis, in the healing process. This study examines the results of intralesional administration of PRP in the treatment of primary hamstring injuries sustained by players belonging to a major league football club. METHODS twenty-five hamstring injuries (grade 2 according to MRI classification) sustained by professional football players during a 31-months observation period were treated with PRP and analyzed. Sport participation absence (SPA), in days, was considered to correspond to the healing time, and we also considered the re-injury rate, and tissue healing on MRI. The mean follow-up was 36.6 months (range 22-42). RESULTS there were no adverse events. The mean SPA for the treated muscle injuries was 36.76±19.02 days. The re-injury rate was 12%. Tissue healing, evaluated on MRI, was characterized by the presence of excellent repair tissue and a small scar. CONCLUSIONS this study confirmed the safety of PRP in treating hamstring lesions in a large series of professional football players. PRP-treated lesions did not heal more quickly than untreated lesions described in the literature, but they showed a smaller scar and excellent repair tissue. LEVEL OF EVIDENCE Level IV, therapeutic case series.
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Affiliation(s)
- Giacomo Zanon
- Clinica Ortopedica e Traumatologica, Università degli Studi di Pavia - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Alberto Combi
- Clinica Ortopedica e Traumatologica, Università degli Studi di Pavia - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Loris Perticarini
- Clinica Ortopedica e Traumatologica, Università degli Studi di Pavia - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Luigi Sammarchi
- Department of Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesco Benazzo
- Clinica Ortopedica e Traumatologica, Università degli Studi di Pavia - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Lenz R, Kieb M, Diehl P, Grim C, Vogt S, Tischer T. [Muscle, tendon and joint injections : What is the evidence?]. DER ORTHOPADE 2016; 45:459-68. [PMID: 27147429 DOI: 10.1007/s00132-016-3262-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Injections at tendon insertions, in muscles and in joints are an important instrument in the conservative treatment of musculoskeletal diseases, for acute injuries as well as for chronic degenerative diseases. Local anesthetic agents and glucocorticoids are well-established medications; however, severe side effects, such as chondrolysis have sometimes been reported, particularly for local anesthetic agents. In addition platelet rich plasma (PRP) and hyaluronic acid are also widely used; however, the clinical effectiveness has not always been proven. This article gives an overview on the most commonly used medications for injections and the mechanisms of action. The indications for treatment and the evidence for the clinical adminstration of muscle, tendon and joint injections are described based on the currently available literature.
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Affiliation(s)
- R Lenz
- Orthopädische Klinik und Poliklinik, Doberanerstr. 142, 18057, Universitätsmedizin Rostock, Deutschland
| | - M Kieb
- Chirurgische Klinik, Ernst von Bergmann Hospital, Potsdam/Bad Belzig, Deutschland
| | - P Diehl
- Orthopädische Klinik und Poliklinik, Doberanerstr. 142, 18057, Universitätsmedizin Rostock, Deutschland.,Orthopädiezentrum München Ost, München, Deutschland
| | - C Grim
- Klinik für Orthopädie, Unfall- und Handchirurgie, Klinikum Osnabrück, Osnabrück, Deutschland
| | - S Vogt
- Klinik für Sportorthopädie und arthroskopische Chirurgie, Hessing Stiftung, Augsburg, Deutschland.,Abteilung für Sportorthopädie, TU München, München, Deutschland
| | - T Tischer
- Orthopädische Klinik und Poliklinik, Doberanerstr. 142, 18057, Universitätsmedizin Rostock, Deutschland.
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A Study of Using Massage Therapy Accompanied with Stretching Exercise for Rehabilitation of Mammary Gland Hyperplasia. BIOMED RESEARCH INTERNATIONAL 2016; 2016:9426167. [PMID: 27022615 PMCID: PMC4789017 DOI: 10.1155/2016/9426167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 02/04/2016] [Indexed: 11/17/2022]
Abstract
PURPOSE To apply massage therapy accompanied with stretching exercises for treatment of mammary gland hyperplasia, evaluate the clinical outcome in patients, and estimate the therapy as a novel treatment method for mammary hyperplasia. METHODS 28 adult female patients were selected and treated with massage therapy and stretching exercises focusing on skeleton muscles of chest, abdomen, and axilla. The mammary gland oxyhemoglobin (OxyHb) and deoxyhemoglobin (DeoxyHb) levels were detected before and after treatment after 15, 30, and 45 days. RESULTS In this cohort, pretreatment OxyHb (mean ± SD) is 1.32 ± 0.14 (medium-high), and DeoxyHb is 0.87 ± 0.13 (normal). All patients were clinically diagnosed with benign mammary gland hyperplasia and mastitis. The posttreatment OxyHb levels are 1.23 ± 0.09 (normal-medium, 15-day), 1.16 ± 0.08 (normal, 30-day), and 1.05 ± 0.04 (normal, 45-day), and DeoxyHb levels are 0.90 ± 0.11 (normal, 15-day), 0.94 ± 0.18 (normal, 30-day), and 0.98 ± 0.12 (normal, 45-day). Patients were diagnosed with decreased hyperplasia 15 and 30 days after treatment and with no symptom of hyperplasia in mammary gland 45 days after treatment. CONCLUSION Mammary gland hyperplasia is closely correlated with pathological changes of skeletal muscles and could be significantly improved by massage therapy and stretching exercises targeting neighboring skeletal muscles.
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Tsikopoulos K, Tsikopoulos A, Natsis K. Autologous whole blood or corticosteroid injections for the treatment of epicondylopathy and plantar fasciopathy? A systematic review and meta-analysis of randomized controlled trials. Phys Ther Sport 2016; 22:114-122. [PMID: 27085490 DOI: 10.1016/j.ptsp.2016.02.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 11/29/2015] [Accepted: 02/16/2016] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To compare the efficacy of autologous whole blood with that of corticosteroid injections on epicondylopathy and plantar fasciopathy. DESIGN Systematic review and meta-analysis. METHODS The databases of PubMed, Web of Science, CENTRAL, and Scopus were searched up to 6th May 2015. Randomized trials comparing the effects of autologous whole blood and corticosteroid injections on epicondylopathy or plantar fasciopathy were included. Trials exploring the efficacy of platelet-rich plasma were excluded. The primary outcome was pain relief. The secondary outcome included the assessment of composite outcomes. All outcomes were assessed at 2-6 (short-term) weeks, 8-13 (intermediate-term) weeks and 24-26 (medium-term) weeks. Quality assessment was performed with the Cochrane risk of bias tool. RESULTS Nine trials were included. For pain relief, there was a statistically significant difference in favour of corticosteroids in the short term (SMD 0.52; 95%CIs 0.18 to 0.86; I2 = 53%; p < 0.01). A statistically significant difference in favour of autologous whole blood was indicated in the medium-term assessment of pain relief on epicondylopathy. CONCLUSIONS Corticosteroids were marginally superior to autologous whole blood in relieving pain on plantar fasciopathy at 2-6 weeks. Autologous whole blood provided significant clinical relief on epicondylopathy at 8-24 weeks. Conclusions were limited by the risk of bias.
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Affiliation(s)
| | - Alexios Tsikopoulos
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Konstantinos Natsis
- Department of Anatomy, Medical School, Aristotle University of Thessaloniki, Greece
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Figurová M, Ledecký V, Karasová M, Hluchý M, Trbolová A, Capík I, Horňák S, Reichel P, Bjordal JM, Gál P. Histological Assessment of a Combined Low-Level Laser/Light-Emitting Diode Therapy (685 nm/470 nm) for Sutured Skin Incisions in a Porcine Model: A Short Report. Photomed Laser Surg 2016; 34:53-5. [PMID: 26741109 DOI: 10.1089/pho.2015.4013] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE The aim of our study was to evaluate, from a histological point of view, the effect of photobiomodulation (PBM) with combined low-level laser therapy (LLLT)/light- emitting diode (LED) on porcine skin wound healing. BACKGROUND DATA Most LLLT/LED wound healing studies have been performed on various types of rat models, with their inherent limitations. Minipigs are evolutionary and physiologically closer to humans than rats. MATERIALS AND METHODS With the animals under general anesthesia, one full-thickness skin incision was performed on the back of each minipig (n = 10) and immediately closed using simple interrupted percutaneous sutures. The minipigs were randomly allocated into two groups: a PBM-treated group (LLLT λ = 685 nm, LED λ = 470 nm, both light sources producing power densities at 0.008 W/cm2; each light source delivering total daily doses of 3.36 J/cm2) and a sham-irradiated control group. Half of the animals in each group were killed on postoperative day 3, and the other half were killed on the postoperative day 7, and samples were removed for histological examination. RESULTS Combined red and blue PBM accelerated the process of re-epithelization and formation of cross-linked collagen fibers compared with sham irradiated control wounds. CONCLUSIONS Our results demonstrate that the current dose of combined red and blue PBM improves the healing of sutured skin incisions in minipigs.
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Affiliation(s)
- Mária Figurová
- 1 Department of Surgery, Orthopedics, Radiology, and Reproduction; Small Animal Clinic, University of Veterinary Medicine and Pharmacy , Košice, Slovak Republic
| | - Valent Ledecký
- 1 Department of Surgery, Orthopedics, Radiology, and Reproduction; Small Animal Clinic, University of Veterinary Medicine and Pharmacy , Košice, Slovak Republic
| | - Martina Karasová
- 1 Department of Surgery, Orthopedics, Radiology, and Reproduction; Small Animal Clinic, University of Veterinary Medicine and Pharmacy , Košice, Slovak Republic
| | - Marián Hluchý
- 1 Department of Surgery, Orthopedics, Radiology, and Reproduction; Small Animal Clinic, University of Veterinary Medicine and Pharmacy , Košice, Slovak Republic
| | - Alexandra Trbolová
- 1 Department of Surgery, Orthopedics, Radiology, and Reproduction; Small Animal Clinic, University of Veterinary Medicine and Pharmacy , Košice, Slovak Republic
| | - Igor Capík
- 1 Department of Surgery, Orthopedics, Radiology, and Reproduction; Small Animal Clinic, University of Veterinary Medicine and Pharmacy , Košice, Slovak Republic
| | - Slavomír Horňák
- 1 Department of Surgery, Orthopedics, Radiology, and Reproduction; Small Animal Clinic, University of Veterinary Medicine and Pharmacy , Košice, Slovak Republic
| | - Peter Reichel
- 2 Clinic for Swine, University of Veterinary Medicine and Pharmacy , Košice, Slovak Republic
| | - Jan M Bjordal
- 3 IGS, Physiotherapy Research Group, University of Bergen , Bergen, Norway
| | - Peter Gál
- 4 Department for Biomedical Research, East-Slovak Institute of Cardiovascular Diseases, Inc. , Košice, Slovak Republic.,5 Institute of Anatomy, 1st Faculty of Medicine, Charles University , Prague, Czech Republic .,6 Department of Pharmacology, Faculty of Medicine, Pavol Jozef Šafárik University , Košice, Slovak Republic.,7 Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University , Bratislava, Slovak Republic
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Effects of induced pluripotent stem cells-derived conditioned medium on the proliferation and anti-apoptosis of human adipose-derived stem cells. Mol Cell Biochem 2016; 413:69-85. [DOI: 10.1007/s11010-015-2640-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 12/23/2015] [Indexed: 01/09/2023]
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Novel Noxipoint Therapy versus Conventional Physical Therapy for Chronic Neck and Shoulder Pain: Multicentre Randomised Controlled Trials. Sci Rep 2015; 5:16342. [PMID: 26552835 PMCID: PMC4639784 DOI: 10.1038/srep16342] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 10/14/2015] [Indexed: 01/18/2023] Open
Abstract
As chronic pain affects 115 million people and costs $600B annually in the US alone, effective noninvasive nonpharmacological remedies are desirable. The purpose of this study was to determine the efficacy and the generalisability of Noxipoint therapy (NT), a novel electrotherapy characterised by site-specific stimulation, intensity-and-submodality-specific settings and a immobilization period, for chronic neck and shoulder pain. Ninety-seven heavily pretreated severe chronic neck/shoulder pain patients were recruited; 34 and 44 patients were randomly allocated to different treatment arms in two patient-and-assessor-blinded, randomised controlled studies. The participants received NT or conventional physical therapy including transcutaneous electrical nerve stimulation (PT-TENS) for three to six 90-minute sessions. In Study One, NT improved chronic pain (−89.6%, Brief Pain Inventory, p < 0.0001, 95% confidence interval), function (+77.4%, range of motion) and quality of life (+88.1%) at follow-up (from 4 weeks to 5 months), whereas PT-TENS resulted in no significant changes in these parameters. Study Two demonstrated similar advantages of NT over PT-TENS and the generalisability of NT. NT-like treatments in a randomised rat study showed a similar reduction in chronic hypersensitivity (−81%, p < 0.01) compared with sham treatments. NT substantially reduces chronic neck and shoulder pain, restores function, and improves quality of life in a sustained manner.
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Laver L, Carmont MR, McConkey MO, Palmanovich E, Yaacobi E, Mann G, Nyska M, Kots E, Mei-Dan O. Plasma rich in growth factors (PRGF) as a treatment for high ankle sprain in elite athletes: a randomized control trial. Knee Surg Sports Traumatol Arthrosc 2015; 23:3383-92. [PMID: 24938396 DOI: 10.1007/s00167-014-3119-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 06/03/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE Syndesmotic sprains are uncommon injuries that require prolonged recovery. The influence of ultrasound-guided injections of platelet-rich plasma (PRP) into the injured antero-inferior tibio-fibular ligaments (AITFL) in athletes on return to play (RTP) and dynamic stability was studied. METHODS Sixteen elite athletes with AITFL tears were randomized to a treatment group receiving injections of PRP or to a control group. All patients followed an identical rehabilitation protocol and RTP criteria. Patients were prospectively evaluated for clinical ability to return to full activity and residual pain. Dynamic ultrasound examinations were performed at initial examination and at 6 weeks post-injury to demonstrate re-stabilization of the syndesmosis joint and correlation with subjective outcome. RESULTS All patients presented with a tear to the AITFL with dynamic syndesmosis instability in dorsiflexion-external rotation, and larger neutral tibia-fibula distance on ultrasound. Early diagnosis and treatment lead to shorter RTP, with 40.8 (±8.9) and 59.6 (±12.0) days for the PRP and control groups, respectively (p = 0.006). Significantly less residual pain upon return to activity was found in the PRP group; five patients (62.5 %) in the control group returned to play with minor discomfort versus one patient in the treatment group (12.5 %). One patient in the control group had continuous pain and disability and subsequently underwent syndesmosis reconstruction. CONCLUSIONS Athletes suffering from high ankle sprains benefit from ultrasound-guided PRP injections with a shorter RTP, re-stabilization of the syndesmosis joint and less long-term residual pain. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Lior Laver
- Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir" Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel. .,Division of Sports Medicine, Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.
| | - Michael R Carmont
- Department of Trauma and Orthopaedic Surgery, Princess Royal Hospital, Telford, Shropshire, UK
| | - Mark O McConkey
- Pacific Orthopaedics and Sports Medicine, North Vancouver, BC, Canada
| | - Ezequiel Palmanovich
- Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir" Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel
| | - Eyal Yaacobi
- Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir" Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel
| | - Gideon Mann
- Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir" Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel.,Ribstein Center for Sport Medicine Sciences and Research, Wingate Institute, Netanya, Israel
| | - Meir Nyska
- Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir" Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel
| | - Eugene Kots
- Department of Radiology, Sports Medicine Unit, "Meir" Medical Center, Kfar-Saba, Israel
| | - Omer Mei-Dan
- Department of Sports Medicine, University of Colorado Hospitals, Boulder, CO, USA
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El Agha E, Kosanovic D, Schermuly RT, Bellusci S. Role of fibroblast growth factors in organ regeneration and repair. Semin Cell Dev Biol 2015; 53:76-84. [PMID: 26459973 DOI: 10.1016/j.semcdb.2015.10.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 10/08/2015] [Indexed: 02/04/2023]
Abstract
In its broad sense, regeneration refers to the renewal of lost cells, tissues or organs as part of the normal life cycle (skin, hair, endometrium etc.) or as part of an adaptive mechanism that organisms have developed throughout evolution. For example, worms, starfish and amphibians have developed remarkable regenerative capabilities allowing them to voluntarily shed body parts, in a process called autotomy, only to replace the lost parts afterwards. The bizarre myth of the fireproof homicidal salamander that can survive fire and poison apple trees has persisted until the 20th century. Salamanders possess one of the most robust regenerative machineries in vertebrates and attempting to draw lessons from limb regeneration in these animals and extrapolate the knowledge to mammals is a never-ending endeavor. Fibroblast growth factors are potent morphogens and mitogens that are highly conserved among the animal kingdom. These growth factors play key roles in organogenesis during embryonic development as well as homeostatic balance during postnatal life. In this review, we provide a summary about the current knowledge regarding the involvement of fibroblast growth factor signaling in organ regeneration and repair. We also shed light on the use of these growth factors in previous and current clinical trials in a wide array of human diseases.
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Affiliation(s)
- Elie El Agha
- Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary System (ECCPS), Justus-Liebig-University, Giessen, Hessen, Germany
| | - Djuro Kosanovic
- Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary System (ECCPS), Justus-Liebig-University, Giessen, Hessen, Germany
| | - Ralph T Schermuly
- Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary System (ECCPS), Justus-Liebig-University, Giessen, Hessen, Germany
| | - Saverio Bellusci
- Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary System (ECCPS), Justus-Liebig-University, Giessen, Hessen, Germany; Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia.
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Grasman JM, Zayas MJ, Page RL, Pins GD. Biomimetic scaffolds for regeneration of volumetric muscle loss in skeletal muscle injuries. Acta Biomater 2015. [PMID: 26219862 DOI: 10.1016/j.actbio.2015.07.038] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Skeletal muscle injuries typically result from traumatic incidents such as combat injuries where soft-tissue extremity injuries are present in one of four cases. Further, about 4.5 million reconstructive surgical procedures are performed annually as a result of car accidents, cancer ablation, or cosmetic procedures. These combat- and trauma-induced skeletal muscle injuries are characterized by volumetric muscle loss (VML), which significantly reduces the functionality of the injured muscle. While skeletal muscle has an innate repair mechanism, it is unable to compensate for VML injuries because large amounts of tissue including connective tissue and basement membrane are removed or destroyed. This results in a significant need to develop off-the-shelf biomimetic scaffolds to direct skeletal muscle regeneration. Here, the structure and organization of native skeletal muscle tissue is described in order to reveal clear design parameters that are necessary for scaffolds to mimic in order to successfully regenerate muscular tissue. We review the literature with respect to the materials and methodologies used to develop scaffolds for skeletal muscle tissue regeneration as well as the limitations of these materials. We further discuss the variety of cell sources and different injury models to provide some context for the multiple approaches used to evaluate these scaffold materials. Recent findings are highlighted to address the state of the field and directions are outlined for future strategies, both in scaffold design and in the use of different injury models to evaluate these materials, for regenerating functional skeletal muscle. STATEMENT OF SIGNIFICANCE Volumetric muscle loss (VML) injuries result from traumatic incidents such as those presented from combat missions, where soft-tissue extremity injuries are represented in one of four cases. These injuries remove or destroy large amounts of skeletal muscle including the basement membrane and connective tissue, removing the structural, mechanical, and biochemical cues that usually direct its repair. This results in a significant need to develop off-the-shelf biomimetic scaffolds to direct skeletal muscle regeneration. In this review, we examine current strategies for the development of scaffold materials designed for skeletal muscle regeneration, highlighting advances and limitations associated with these methodologies. Finally, we identify future approaches to enhance skeletal muscle regeneration.
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