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Muller KS, Tibúrcio FC, Ferreira RS, Barraviera B, Matheus SMM. Heterologous fibrin biopolymer as an emerging approach to peripheral nerve repair: a scoping review. J Venom Anim Toxins Incl Trop Dis 2024; 30:e20230060. [PMID: 38628622 PMCID: PMC11019597 DOI: 10.1590/1678-9199-jvatitd-2023-0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/29/2024] [Indexed: 04/19/2024] Open
Abstract
Nerve injuries present a substantial challenge within the medical domain due to their prevalent occurrence and significant impact. In nerve injuries, a range of physiopathological and metabolic responses come into play to stabilize and repair the resulting damage. A critical concern arises from the disruption of connections at neuromuscular junctions, leading to profound degeneration and substantial loss of muscle function, thereby hampering motor tasks. While end-to-end neurorrhaphy serves as the established technique for treating peripheral nerve injuries, achieving comprehensive morphofunctional recovery remains a formidable challenge. In pursuit of enhancing the repair process, alternative and supportive methods are being explored. A promising candidate is the utilization of heterologous fibrin biopolymer, a sealant devoid of human blood components. Notably, this biopolymer has showcased its prowess in establishing a stable and protective microenvironment at the site of use in multiple scenarios of regenerative medicine. Hence, this scoping review is directed towards assessing the effects of associating heterologous fibrin biopolymer with neurorrhaphy to treat nerve injuries, drawing upon findings from prior studies disseminated through PubMed/MEDLINE, Scopus, and Web of Science databases. Further discourse delves into the intricacies of the biology of neuromuscular junctions, nerve injury pathophysiology, and the broader utilization of fibrin sealants in conjunction with sutures for nerve reconstruction procedures. The association of the heterologous fibrin biopolymer with neurorrhaphy emerges as a potential avenue for surmounting the limitations associated with traditional sealants while also mitigating degeneration in nerves, muscles, and NMJs post-injury, thereby fostering a more conducive environment for subsequent regeneration. Indeed, queries arise regarding the long-term regenerative potential of this approach and its applicability in reconstructive surgeries for human nerve injuries.
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Affiliation(s)
- Kevin Silva Muller
- Department of Structural and Functional Biology, São Paulo State
University (UNESP), Botucatu Institute of Biosciences, Botucatu, SP, Brazil
- Botucatu Medical School, São Paulo State University (UNESP),
Botucatu, SP, Brazil
| | - Felipe Cantore Tibúrcio
- Department of Structural and Functional Biology, São Paulo State
University (UNESP), Botucatu Institute of Biosciences, Botucatu, SP, Brazil
- Botucatu Medical School, São Paulo State University (UNESP),
Botucatu, SP, Brazil
| | - Rui Seabra Ferreira
- Botucatu Medical School, São Paulo State University (UNESP),
Botucatu, SP, Brazil
- Center for the Study of Venoms and Venomous Animals (CEVAP), São
Paulo State University (UNESP), Botucatu, SP, Brazil
- Center for Translational Sciences and Biopharmaceuticals Development
(CTS), Center for the Study of Venoms and Venomous Animals (CEVAP), Botucatu, SP,
Brazil
| | - Benedito Barraviera
- Botucatu Medical School, São Paulo State University (UNESP),
Botucatu, SP, Brazil
- Center for the Study of Venoms and Venomous Animals (CEVAP), São
Paulo State University (UNESP), Botucatu, SP, Brazil
- Center for Translational Sciences and Biopharmaceuticals Development
(CTS), Center for the Study of Venoms and Venomous Animals (CEVAP), Botucatu, SP,
Brazil
| | - Selma Maria Michelin Matheus
- Department of Structural and Functional Biology, São Paulo State
University (UNESP), Botucatu Institute of Biosciences, Botucatu, SP, Brazil
- Botucatu Medical School, São Paulo State University (UNESP),
Botucatu, SP, Brazil
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Ortiz-Arrabal O, Irastorza-Lorenzo A, Campos F, Martín-Piedra MÁ, Carriel V, Garzón I, Ávila-Fernández P, de Frutos MJ, Esteban E, Fernández J, Janer A, Campos A, Chato-Astrain J, Alaminos M. Fibrin and Marine-Derived Agaroses for the Generation of Human Bioartificial Tissues: An Ex Vivo and In Vivo Study. Mar Drugs 2023; 21:md21030187. [PMID: 36976236 PMCID: PMC10058299 DOI: 10.3390/md21030187] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
Development of an ideal biomaterial for clinical use is one of the main objectives of current research in tissue engineering. Marine-origin polysaccharides, in particular agaroses, have been widely explored as scaffolds for tissue engineering. We previously developed a biomaterial based on a combination of agarose with fibrin, that was successfully translated to clinical practice. However, in search of novel biomaterials with improved physical and biological properties, we have now generated new fibrin-agarose (FA) biomaterials using 5 different types of agaroses at 4 different concentrations. First, we evaluated the cytotoxic effects and the biomechanical properties of these biomaterials. Then, each bioartificial tissue was grafted in vivo and histological, histochemical and immunohistochemical analyses were performed after 30 days. Ex vivo evaluation showed high biocompatibility and differences in their biomechanical properties. In vivo, FA tissues were biocompatible at the systemic and local levels, and histological analyses showed that biointegration was associated to a pro-regenerative process with M2-type CD206-positive macrophages. These results confirm the biocompatibility of FA biomaterials and support their clinical use for the generation of human tissues by tissue engineering, with the possibility of selecting specific agarose types and concentrations for applications requiring precise biomechanical properties and in vivo reabsorption times.
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Grants
- FIS PI20/0317 FIS PI20/0318 FIS PI21/0980 ICI19/00024 ICI21/00010 Spanish Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica (I+D+I) of the Spanish Ministry of Science and Innovation (Instituto de Salud Carlos III),
- PE-0395-2019 PI-0442-2019 Consejería de Salud y Familias, Junta de Andalucía, Spain
- IDI-20180052 Hispanagar SA, Burgos, Spain, through CDTI, Ministry of Science and Innovation, Spain, Pro-grama Operativo Plurirregional de Crecimiento Inteligente (CRIN)
- B-CTS-504-UGR20 B-CTS-450-UGR20 marco del Programa Operativo FEDER Andalucía 2014-2020, University of Granada and Conseje-ría de Transformación Económica, Industria, Conocimiento y Universidades
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Affiliation(s)
- Olimpia Ortiz-Arrabal
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, E18016 Granada, Spain
- Doctoral Program in Biochemistry and Molecular Biology, University of Granada, E18016 Granada, Spain
| | - Ainhoa Irastorza-Lorenzo
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, E18016 Granada, Spain
| | - Fernando Campos
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, E18016 Granada, Spain
| | - Miguel Ángel Martín-Piedra
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, E18016 Granada, Spain
| | - Víctor Carriel
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, E18016 Granada, Spain
| | - Ingrid Garzón
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, E18016 Granada, Spain
| | - Paula Ávila-Fernández
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, E18016 Granada, Spain
| | | | | | | | | | - Antonio Campos
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, E18016 Granada, Spain
| | - Jesús Chato-Astrain
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, E18016 Granada, Spain
| | - Miguel Alaminos
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, E18016 Granada, Spain
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Leite APS, Pinto CG, Tibúrcio FC, Muller KS, Padovani CR, Barraviera B, Junior RSF, Leal CV, Matsumura CY, Matheus SMM. Acetylcholine receptors of the neuromuscular junctions present normal distribution after peripheral nerve injury and repair through nerve guidance associated with fibrin biopolymer. Injury 2023; 54:345-361. [PMID: 36446670 DOI: 10.1016/j.injury.2022.11.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 10/26/2022] [Accepted: 11/20/2022] [Indexed: 11/25/2022]
Abstract
Peripheral nerve injuries (PNI) lead to alterations in the Agrin-LRP4-MuSK pathway. This results in disaggregation of AChRs and change from epsilon (mature, innervated) to gamma (immature, denervated) subunit. Tubulization technique has been shown to be effective for PNI repair and it also allows the use of adjuvants, such as fibrin biopolymer (FB). This study evaluated the effect of the association of tubulization with FB after PNI on AChRs and associated proteins. Fifty-two adults male Wistar rats were used, distributed in 4 experimental groups: Sham Control (S), Denervated Control (D); Tubulization (TB) and Tubulization + Fibrin Biopolymer (TB+FB). Catwalk was performed every 15 days. Ninety days after surgery the right soleus muscles and ischiatic nerves were submitted to the following analyses: (a) morphological and morphometric analysis of AChRs by confocal microscopy; (b) morphological and morphometric analysis of the ischiatic nerve; (c) protein quantification of AChRs: alpha, gama, and epsilon, of Schwann cells, agrin, LRP4, MuSK, rapsyn, MMP3, MyoD, myogenin, MURF1 and atrogin-1. The main results were about the NMJs that in the TB+FB group presented morphological and morphometric approximation (compactness index; area of the AChRs and motor plate) to the S group. In addition, there were also an increase of S100 and AChRε protein expression and a decrease of MyoD. These positive association resulted in AChRs stabilization that potentiate the neuromuscular regeneration, which strengthens the use of TB for severe injuries repair and the beneficial effect of FB, along with tubulization technique.
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Affiliation(s)
- Ana Paula Silveira Leite
- Medical School, São Paulo State University (Unesp), Botucatu, SP, Brazil; Division of Anatomy, Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu, SP, Brazil.
| | - Carina Guidi Pinto
- Medical School, São Paulo State University (Unesp), Botucatu, SP, Brazil; Division of Anatomy, Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu, SP, Brazil
| | - Felipe Cantore Tibúrcio
- Medical School, São Paulo State University (Unesp), Botucatu, SP, Brazil; Division of Anatomy, Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu, SP, Brazil
| | - Kevin Silva Muller
- Medical School, São Paulo State University (Unesp), Botucatu, SP, Brazil; Division of Anatomy, Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu, SP, Brazil
| | - Carlos Roberto Padovani
- Division of Biostatistics, Department of Biostatistics, Vegetal Biology, Parasitology and Zoology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu, SP, Brazil
| | - Benedito Barraviera
- Medical School, São Paulo State University (Unesp), Botucatu, SP, Brazil; Center for the Study of Venoms and Venomous Animals (Cevap), São Paulo State University (Unesp), Botucatu, SP, Brazil
| | - Rui Seabra Ferreira Junior
- Center for the Study of Venoms and Venomous Animals (Cevap), São Paulo State University (Unesp), Botucatu, SP, Brazil
| | - Claudenete Vieira Leal
- School of Mechanical Engineering, University of Campinas (Unicamp), Campinas, SP, Brazil
| | - Cintia Yuri Matsumura
- Division of Anatomy, Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu, SP, Brazil
| | - Selma Maria Michelin Matheus
- Division of Anatomy, Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu, SP, Brazil
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Application of Hydrogels as Sustained-Release Drug Carriers in Bone Defect Repair. Polymers (Basel) 2022; 14:polym14224906. [PMID: 36433033 PMCID: PMC9695274 DOI: 10.3390/polym14224906] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
Large bone defects resulting from trauma, infection and tumors are usually difficult for the body's repair mechanisms to heal spontaneously. Generally, various types of bones and orthopedic implants are adopted to enhance bone repair and regeneration in the clinic. Due to the limitations of traditional treatments, bone defect repair is still a compelling challenge for orthopedic surgeons. In recent years, bone tissue engineering has become a potential option for bone repair and regeneration. Amidst the various scaffolds for bone tissue engineering applications, hydrogels are considered a new type of non-toxic, non-irritating and biocompatible materials, which are widely used in the biomedicine field currently. Some studies have demonstrated that hydrogels can provide a three-dimensional network structure similar to a natural extracellular matrix for tissue regeneration and can be used to transport cells, biofactors, nutrients and drugs. Therefore, hydrogels may have the potential to be multifunctional sustained-release drug carriers in the treatment of bone defects. The recent applications of different types of hydrogels in bone defect repair were briefly reviewed in this paper.
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Fixation of the Membrane during Matrix-Induced Autologous Chondrocyte Implantation in the Knee: A Systematic Review. Life (Basel) 2022; 12:life12111718. [PMID: 36362873 PMCID: PMC9698345 DOI: 10.3390/life12111718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: It is unclear whether the type of membrane used for matrix-assisted autologous chondrocyte implantation (mACI) influences results. A systematic review was conducted to investigate the midterm results of the three most common types of membrane fixation for mACI. Methods: This systematic review was conducted according to the 2020 PRISMA checklist. PubMed, Google Scholar, Embase, and Scopus online databases were accessed in August 2022. All the prospective clinical trials reporting outcomes of mACI in the knee were considered. Studies that describe the modality of membrane fixation (glued, glued, and sutured, no fixation) used for mACI were eligible. Studies that conducted a minimum of 12 months of follow-up were considered. The outcomes of interest were the Tegner Activity Scale and International Knee Documentation Committee (IKDC) score. The rate of failure and revisions were also collected. Results: Data from 26 studies (1539 procedures; 554 of 1539 (36%) were women) were retrieved. The mean follow-up was 42.6 (12 to 84) months. No difference between the groups was found in terms of mean duration of symptoms, age, BMI, gender, and defect size (P > 0.1). No difference was found in terms of the Tegner score (P = 0.3). When no fixation was used, a statistically significant higher IKDC compared to the other groups (P = 0.02) was evidenced. No difference was found in the rate of failure (P = 0.1). The no-fixation group evidenced a statistically significant lower rate of revisions (P = 0.02). Conclusions: No membrane fixation for mACI in the knee scored better than the fastening techniques at the midterm follow-up.
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Rojas-Murillo JA, Simental-Mendía MA, Moncada-Saucedo NK, Delgado-Gonzalez P, Islas JF, Roacho-Pérez JA, Garza-Treviño EN. Physical, Mechanical, and Biological Properties of Fibrin Scaffolds for Cartilage Repair. Int J Mol Sci 2022; 23:ijms23179879. [PMID: 36077276 PMCID: PMC9456199 DOI: 10.3390/ijms23179879] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/16/2022] Open
Abstract
Articular cartilage is a highly organized tissue that provides remarkable load-bearing and low friction properties, allowing for smooth movement of diarthrodial joints; however, due to the avascular, aneural, and non-lymphatic characteristics of cartilage, joint cartilage has self-regeneration and repair limitations. Cartilage tissue engineering is a promising alternative for chondral defect repair. It proposes models that mimic natural tissue structure through the use of cells, scaffolds, and signaling factors to repair, replace, maintain, or improve the specific function of the tissue. In chondral tissue engineering, fibrin is a biocompatible biomaterial suitable for cell growth and differentiation with adequate properties to regenerate damaged cartilage. Additionally, its mechanical, biological, and physical properties can be enhanced by combining it with other materials or biological components. This review addresses the biological, physical, and mechanical properties of fibrin as a biomaterial for cartilage tissue engineering and as an element to enhance the regeneration or repair of chondral lesions.
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Affiliation(s)
- Juan Antonio Rojas-Murillo
- Laboratorio de Terapia Celular, Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 64460, NL, Mexico
| | - Mario A. Simental-Mendía
- Servicio de Ortopedia y Traumatología, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey 64460, NL, Mexico
| | - Nidia K. Moncada-Saucedo
- Departamento de Hematología, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey 64460, NL, Mexico
| | - Paulina Delgado-Gonzalez
- Laboratorio de Terapia Celular, Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 64460, NL, Mexico
| | - José Francisco Islas
- Laboratorio de Terapia Celular, Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 64460, NL, Mexico
| | - Jorge A. Roacho-Pérez
- Laboratorio de Terapia Celular, Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 64460, NL, Mexico
| | - Elsa N. Garza-Treviño
- Laboratorio de Terapia Celular, Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 64460, NL, Mexico
- Correspondence: ; Tel.: +52-81-83294173
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Application of Fibrin Associated with Photobiomodulation as a Promising Strategy to Improve Regeneration in Tissue Engineering: A Systematic Review. Polymers (Basel) 2022; 14:polym14153150. [PMID: 35956667 PMCID: PMC9370794 DOI: 10.3390/polym14153150] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/19/2022] [Accepted: 07/28/2022] [Indexed: 12/11/2022] Open
Abstract
Fibrin, derived from proteins involved in blood clotting (fibrinogen and thrombin), is a biopolymer with different applications in the health area since it has hemostasis, biocompatible and three-dimensional physical structure properties, and can be used as scaffolds in tissue regeneration or drug delivery system for cells and/or growth factors. Fibrin alone or together with other biomaterials, has been indicated for use as a biological support to promote the regeneration of stem cells, bone, peripheral nerves, and other injured tissues. In its diversity of forms of application and constitution, there are platelet-rich fibrin (PRF), Leukocyte- and platelet-rich fibrin (L-PRF), fibrin glue or fibrin sealant, and hydrogels. In order to increase fibrin properties, adjuvant therapies can be combined to favor tissue repair, such as photobiomodulation (PBM), by low-level laser therapy (LLLT) or LEDs (Light Emitting Diode). Therefore, this systematic review aimed to evaluate the relationship between PBM and the use of fibrin compounds, referring to the results of previous studies published in PubMed/MEDLINE, Scopus and Web of Science databases. The descriptors “fibrin AND low-level laser therapy” and “fibrin AND photobiomodulation” were used, without restriction on publication time. The bibliographic search found 44 articles in PubMed/MEDLINE, of which 26 were excluded due to duplicity or being outside the eligibility criteria. We also found 40 articles in Web of Science and selected 1 article, 152 articles in Scopus and no article selected, totaling 19 articles for qualitative analysis. The fibrin type most used in combination with PBM was fibrin sealant, mainly heterologous, followed by PRF or L-PRF. In PBM, the gallium-aluminum-arsenide (GaAlAs) laser prevailed, with a wavelength of 830 nm, followed by 810 nm. Among the preclinical studies, the most researched association of fibrin and PBM was the use of fibrin sealants in bone or nerve injuries; in clinical studies, the association of PBM with medication-related treatments osteonecrosis of the jaw (MRONJ). Therefore, there is scientific evidence of the contribution of PBM on fibrin composites, constituting a supporting therapy that acts by stimulating cell activity, angiogenesis, osteoblast activation, axonal growth, anti-inflammatory and anti-edema action, increased collagen synthesis and its maturation, as well as biomolecules.
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Migliorini F, Prinz J, Maffulli N, Eschweiler J, Weber C, Lecoutrier S, Hildebrand F, Greven J, Schenker H. Fibrin glue does not assist migration and proliferation of chondrocytes in collagenic membranes: an in vitro study. J Orthop Surg Res 2022; 17:311. [PMID: 35690862 PMCID: PMC9188690 DOI: 10.1186/s13018-022-03201-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background Some authors secured the membrane during matrix-induced autologous chondrocyte implantation (mACI) with fibrin glue or did not use a formal fixation. The real impact of fibrin glue addition on chondrocytes migration and proliferation has not yet been clarified. This study evaluated the impact of fibrin glue on a chondrocyte loaded collagenic membrane. Methods A resorbable collagen I/III porcine derived membrane commonly employed in AMIC was used for all experiments. Chondrocytes from three difference donors were used. At 1-, 2-, 3-, 4-, 6-, and at 8-week the membranes were embedded in Mounting Medium with Dapi (ABCAM, Cambridge, UK). The Dapi contained in the mounting medium ties the DNA of the cell nucleus and emits a blue fluorescence. In this way, the spreading of the cells in the membrane can be easily monitored. The outcomes of interest were to evaluate (1) cell migration and (2) cell proliferation within the porous membrane layer. DAPI/nuclei signals were analysed with fluorescence microscope under a magnification of 100-fold. Results The no-fibrin group demonstrated greater migration of the cells within the membrane. Although migration resulted higher in the no-fibrin group at every follow-up, this difference was significant only at week 1 (P < 0.001), 2 (P = 0.004), and 3 (P = 0.03). No difference was found at week 3, 6, and 8. The no-fibrin group demonstrated greater proliferation of the chondrocytes within the membrane. These differences were significant at week 4 (P < 0.0001), 6 (P < 0.0001), 8 (P < 0.0001). Conclusion The use of fibrin glue over a resorbable membrane leads to lower in vitro proliferation and migration of chondrocytes.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Julia Prinz
- Department of Ophthalmology, RWTH University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, SA, Italy. .,School of Pharmacy and Bioengineering, Faculty of Medicine, Keele University, ST4 7QB, Stoke on Trent, England. .,Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Queen Mary University of London, Mile End Hospital, 275 Bancroft Road, E1 4DG, London, England.
| | - Jörg Eschweiler
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Christian Weber
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Sophie Lecoutrier
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Frank Hildebrand
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Johannes Greven
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Hanno Schenker
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
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Tzagiollari A, McCarthy HO, Levingstone TJ, Dunne NJ. Biodegradable and Biocompatible Adhesives for the Effective Stabilisation, Repair and Regeneration of Bone. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9060250. [PMID: 35735493 PMCID: PMC9219717 DOI: 10.3390/bioengineering9060250] [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: 04/12/2022] [Revised: 05/11/2022] [Accepted: 06/06/2022] [Indexed: 11/19/2022]
Abstract
Bone defects and complex fractures present significant challenges for orthopaedic surgeons. Current surgical procedures involve the reconstruction and mechanical stabilisation of complex fractures using metal hardware (i.e., wires, plates and screws). However, these procedures often result in poor healing. An injectable, biocompatible, biodegradable bone adhesive that could glue bone fragments back together would present a highly attractive solution. A bone adhesive that meets the many clinical requirements for such an application has yet to be developed. While synthetic and biological polymer-based adhesives (e.g., cyanoacrylates, PMMA, fibrin, etc.) have been used effectively as bone void fillers, these materials lack biomechanical integrity and demonstrate poor injectability, which limits the clinical effectiveness and potential for minimally invasive delivery. This systematic review summarises conventional approaches and recent developments in the area of bone adhesives for orthopaedic applications. The required properties for successful bone repair adhesives, which include suitable injectability, setting characteristics, mechanical properties, biocompatibility and an ability to promote new bone formation, are highlighted. Finally, the potential to achieve repair of challenging bone voids and fractures as well as the potential of new bioinspired adhesives and the future directions relating to their clinical development are discussed.
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Affiliation(s)
- Antzela Tzagiollari
- School of Mechanical and Manufacturing Engineering, Dublin City University, D09 NA55 Dublin, Ireland; (A.T.); (T.J.L.)
- Centre for Medical Engineering Research, Dublin City University, D09 NA55 Dublin, Ireland
| | - Helen O. McCarthy
- School of Pharmacy, Queen’s University, Belfast BT9 7BL, UK;
- School of Chemical Sciences, Dublin City University, D09 NA55 Dublin, Ireland
- Biodesign Europe, Dublin City University, D09 NA55 Dublin, Ireland
| | - Tanya J. Levingstone
- School of Mechanical and Manufacturing Engineering, Dublin City University, D09 NA55 Dublin, Ireland; (A.T.); (T.J.L.)
- Centre for Medical Engineering Research, Dublin City University, D09 NA55 Dublin, Ireland
- Biodesign Europe, Dublin City University, D09 NA55 Dublin, Ireland
- Tissue, Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, D02 PN40 Dublin, Ireland
- Advanced Manufacturing Research Centre (I-Form), School of Mechanical and Manufacturing Engineering, Dublin City University, D09 NA55 Dublin, Ireland
- Advanced Processing Technology Research Centre, Dublin City University, D09 NA55 Dublin, Ireland
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Nicholas J. Dunne
- School of Mechanical and Manufacturing Engineering, Dublin City University, D09 NA55 Dublin, Ireland; (A.T.); (T.J.L.)
- Centre for Medical Engineering Research, Dublin City University, D09 NA55 Dublin, Ireland
- Biodesign Europe, Dublin City University, D09 NA55 Dublin, Ireland
- Advanced Manufacturing Research Centre (I-Form), School of Mechanical and Manufacturing Engineering, Dublin City University, D09 NA55 Dublin, Ireland
- Advanced Processing Technology Research Centre, Dublin City University, D09 NA55 Dublin, Ireland
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER), Trinity College Dublin, D02 PN40 Dublin, Ireland
- Department of Mechanical and Manufacturing Engineering, School of Engineering, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Correspondence: ; Tel.: +353-(0)1-7005712
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Migliorini F, Maffulli N, Baroncini A, Bell A, Hildebrand F, Schenker H. Autologous matrix-induced chondrogenesis is effective for focal chondral defects of the knee. Sci Rep 2022; 12:9328. [PMID: 35661147 PMCID: PMC9167289 DOI: 10.1038/s41598-022-13591-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 05/17/2022] [Indexed: 12/05/2022] Open
Abstract
Focal chondral defects of the knee are common and their management is challenging. This study investigated the efficacy and safety of Autologous Matrix-Induced Chondrogenesis (AMIC) for focal chondral defects of the knee. A systematic review and meta-analysis was conducted (according to the 2020 PRISMA statement) to investigate the efficacy of AMIC in improving symptoms and to compare AMIC versus microfracture (MFx). In January 2022, the following databases were accessed: Pubmed, Web of Science, Google Scholar, Embase. No time constrain was used for the search. All the clinical trials investigating AMIC and/or those comparing AMIC versus MFx for focal chondral defects of the knee were accessed. Only studies published in peer reviewed journals were considered. Studies which investigated other locations of the defects rather than knee were not eligible, nor those reporting data form mixed locations. Studies which reported data on revision settings, as well as those investigating efficacy on kissing lesions or multiple locations, were not suitable. The mean difference (MD) and odd ratio (OR) effect measure were used for continuous and binary data, respectively. Data from 18 studies (548 patients) were retrieved with a mean follow-up of 39.9 ± 26.5 months. The mean defect size was 3.2 ± 1.0 cm2. The visual analogue scale (VAS) decreased of − 3.9/10 (95% confidence interval (CI) − 4.0874 to -3.7126), the Tegner Activity Scale increased of + 0.8/10 (95% CI 0.6595 to 0.9405). The Lysholm Knee Scoring System increased of + 28.9/100 (95% CI 26.8716 to 29.1284), as did the International Knee Documentation Committee (IKDC) + 33.6/100 (95% CI 32.5800 to 34.6200). At last follow-up no patient showed signs of hypertrophy. 4.3% (9 of 210) of patients underwent revision procedures. The rate of failure was 3.8% (9 of 236). Compared to MFx, AMIC demonstrated lower VAS score (MD: − 1.01; 95% CI − 1.97 to 0.05), greater IKDC (MD: 11.80; 95% CI 6.65 to 16.94), and lower rate of revision (OR: 0.16; 95% CI 0.06 to 0.44). AMIC is effective for focal chondral defects of the knee. Furthermore, AMIC evidenced greater IKDC, along with a lower value of VAS and rate of revision compared to MFx.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, SA, Italy.,School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, ST4 7QB, Stoke on Trent, England.,Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, E1 4DG, London, England
| | - Alice Baroncini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Andreas Bell
- Department of Orthopaedic and Trauma Surgery, Eifelklinik St. Brigida, 52152, Simmerath, Germany
| | - Frank Hildebrand
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Hanno Schenker
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
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11
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de Freitas Dutra Júnior E, Hidd SMCM, Amaral MM, Filho ALMM, Assis L, Ferreira RS, Barraviera B, Martignago CCS, Figueredo-Silva J, de Oliveira RA, Tim CR. Treatment of partial injury of the calcaneus tendon with heterologous fibrin biopolymer and/or photobiomodulation in rats. Lasers Med Sci 2022; 37:971-981. [PMID: 34041619 DOI: 10.1007/s10103-021-03341-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 05/09/2021] [Indexed: 10/21/2022]
Abstract
The present study aimed to evaluate the new heterologous fibrin biopolymer associated, or not, with photobiomodulation therapy for application in tendon injuries, considered a serious and common orthopedic problem. Thus, 84 Rattus norvegicus had partial transection of the calcaneus tendon (PTCT) and were randomly divided into: control (CG); heterologous fibrin biopolymer (HFB); photobiomodulation (PBM); heterologous fibrin biopolymer + photobiomodulation (HFB + PBM). The animals received HFB immediately after PTCT, while PBM (660 nm, 40 mW, 0.23 J) started 24 h post injury and followed every 24 h for 7, 14, and 21 days. The results of the edema volume showed that after 24 h of PTCT, there was no statistical difference among the groups. After 7, 14, and 21 days, it was observed that the treatment groups were effective in reducing edema when compared to the control. The HFB had the highest edema volume reduction after 21 days of treatment. The treatment groups did not induce tissue necrosis or infections on the histopathological analysis. Tenocyte proliferation, granulation tissue, and collagen formation were observed in the PTCT area in the HFB and HFB + PBM groups, which culminated a better repair process when compared to the CG in the 3 experimental periods. Interestingly, the PBM group revealed, in histological analysis, major tendon injury after 7 days; however, in the periods of 14 and 21 days, the PBM had a better repair process compared to the CG. In the quantification of collagen, there was no statistical difference between the groups in the 3 experimental periods. The findings suggest that the HFB and PBM treatments, isolated or associated, were effective in reducing the volume of the edema, stimulating the repair process. However, the use of HFB alone was more effective in promoting the tendon repair process. Thus, the present study consolidates previous studies of tendon repair with this new HFB. Future clinical trials will be needed to validate this proposal.
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Affiliation(s)
- Enéas de Freitas Dutra Júnior
- Department of Biomedical Engineering, Instituto Científico E Tecnológico, University Brazil, Carolina FonsecaSão Paulo, 235, Brazil
| | | | - Marcello Magri Amaral
- Department of Biomedical Engineering, Instituto Científico E Tecnológico, University Brazil, Carolina FonsecaSão Paulo, 235, Brazil
| | | | - Livia Assis
- Department of Biomedical Engineering, Instituto Científico E Tecnológico, University Brazil, Carolina FonsecaSão Paulo, 235, Brazil
| | - Rui Seabra Ferreira
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu, São Paulo, Brazil
| | - Benedito Barraviera
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu, São Paulo, Brazil
| | | | | | - Rauirys Alencar de Oliveira
- Department of Health Sciences, Piauí State University (UESPI), Teresina, PI, Brazil
- Department of Physiotherapy, Faculdade Uninovafapi, Teresina, PI, Brazil
| | - Carla Roberta Tim
- Department of Biomedical Engineering, Instituto Científico E Tecnológico, University Brazil, Carolina FonsecaSão Paulo, 235, Brazil.
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12
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Buchaim DV, Andreo JC, Pomini KT, Barraviera B, Ferreira Júnior RS, Duarte MAH, Alcalde MP, Reis CHB, Teixeira DDB, Bueno CRDS, Detregiachi CRP, Araujo AC, Buchaim RL. A biocomplex to repair experimental critical size defects associated with photobiomodulation therapy. J Venom Anim Toxins Incl Trop Dis 2022; 28:e20210056. [PMID: 35261617 PMCID: PMC8863337 DOI: 10.1590/1678-9199-jvatitd-2021-0056] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/16/2021] [Indexed: 02/14/2023] Open
Affiliation(s)
- Daniela Vieira Buchaim
- University of Marilia, Brazil; University Center of Adamantina, Brazil; São Paulo State University, Brazil
| | | | | | - Benedito Barraviera
- São Paulo State University, Brazil; São Paulo State University, Brazil; São Paulo State University, Brazil
| | - Rui Seabra Ferreira Júnior
- São Paulo State University, Brazil; São Paulo State University, Brazil; São Paulo State University, Brazil
| | | | | | | | | | | | | | | | - Rogério Leone Buchaim
- São Paulo State University, Brazil; University of São Paulo, Brazil; University of São Paulo, Brazil
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13
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Migliorini F, Eschweiler J, Goetze C, Tingart M, Maffulli N. Membrane scaffolds for matrix-induced autologous chondrocyte implantation in the knee: a systematic review. Br Med Bull 2021; 140:50-61. [PMID: 34553227 DOI: 10.1093/bmb/ldab024] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 08/30/2021] [Accepted: 09/05/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Chondral defects of the knee are common and their management is challenging. SOURCE OF DATA Current scientific literature published in PubMed, Google scholar, Embase and Scopus. AREAS OF AGREEMENT Membrane-induced autologous chondrocyte implantation (mACI) has been used to manage chondral defects of the knee. AREAS OF CONTROVERSY Hyaluronic acid membrane provides better outcomes than a collagenic membrane for mACI in the knee at midterm follow-up is controversial. GROWING POINTS To investigate whether hyaluronic acid membrane may provide comparable clinical outcomes than collagenic membranes for mACI in focal defects of the knee. AREAS TIMELY FOR DEVELOPING RESEARCH Hyaluronic acid membrane yields a lower rate of failures and revision surgeries for mACI in the management of focal articular cartilage defects of the knee compared with collagenic scaffolds at midterm follow-up. No difference was found in patient reported outcome measures (PROMs). Further comparative studies are required to validate these results in a clinical setting.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic and Trauma Surgery, RWTH University Hospital Aachen, 52074 Aachen, Germany
| | - Jörg Eschweiler
- Department of Orthopaedic and Trauma Surgery, RWTH University Hospital Aachen, 52074 Aachen, Germany
| | - Christian Goetze
- Department of Orthopaedic Surgery, Auguste-Viktoria Clinic, Ruhr University Bochum, 32545, Bad Oeynhausen, Germany
| | - Markus Tingart
- Department of Orthopaedic and Trauma Surgery, RWTH University Hospital Aachen, 52074 Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, SA, Italy.,Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK.,School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Thornburrow Drive, Stoke-on-Trent ST4 7QB, UK
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14
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The Impact of Nano-Crystal Hydroxyapatites on the Regeneration of Bone Defects. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2021. [DOI: 10.2478/sjecr-2021-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Calcium hydroxyapatite is a widely used material for replacing bone defects. However, the effectiveness of nano-crystalline calcium hydroxyapatite produced from eggshells in the replacement of bone defects has not been investigated yet. The study aimed to evaluate the effectiveness of using nano-crystalline calcium hydroxyapatite made from eggshell for the healing of bone defect of the femur in rats. Forty-eight (n=48) rats underwent a surgical procedure to simulate femoral defect. The animals were sub-divided into 4 groups (each with n=12) depending on the methods of bone defect replacement: I control group (CG) (without bone defect replacement); II intervention group (the bone defect was replaced by PRP (PRP); III intervention group (the bone defect was replaced by nano-crystalline hydroxyapatite obtained from eggshell) (HA) and IV interventional group (the bone defect was replaced by a combination of hydroxyapatite and PRP) (HA+PRP). The degree of effectiveness of studied methods was assessed using radiological (on the 14th day), histological (on the 61st day), and biomechanical analysis (on the 61st day). According to radiographic data, the CG group had the lowest level of bone regeneration after 14 days (4.2 ±1.7%). In the HA + PRP group, the level of bone regeneration was 22.1±7.1 %, which was higher in comparison with the rates of consolidation of bone defects in the HA group (20.7± 9.3) (p = 0.023). According to the histo-morphometry data, the rates of bone tissue regeneration in the PRP group (19.8 ±4.2%) were higher in comparison with the CG group (12.7 ± 7.3%), (p>0.05). In the HA+PRP group, bone regeneration rates (48.9±9.4 %) were significantly higher (p=0.001) than in the HA group (35.1±9.8%). According to the results of biomechanical assessment under the maximum stress (121.0722), the maximum bending deformation of the contralateral bone without defect was 0.028746, which was higher than the indicators of the HA+PRP group, where at the maximum stress (90.67979) the bending deformation was 0.024953 (p>0.05). Compared to CG, PRP, and HA, biomechanical bone strength was significantly higher in the HA + PRP group (p≤0.01). At the maximum stress (51.81391), the maximum bending strain in the CG group was 0.03869, which was lower than in the PRP group, where the maximum stress and bending strain were 59.45824 and 0.055171, respectively (p>0.05). However, the bone strength of the HA group was statistically significantly higher compared to the CG and PRP groups (p<0.01).
The results demonstrated the effectiveness of the use of nanocrystalline calcium hydroxyapatite obtained from eggshell in the healing of a bone defect. The best results were observed in the group of the combined use of nano-crystalline calcium hydroxyapatite and PRP.
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Effects of Therapy with Fibrin Glue combined with Mesenchymal Stem Cells (MSCs) on Bone Regeneration: A Systematic Review. Cells 2021; 10:cells10092323. [PMID: 34571972 PMCID: PMC8468169 DOI: 10.3390/cells10092323] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 12/17/2022] Open
Abstract
Cell therapy strategies using mesenchymal stem cells (MSCs) carried in fibrin glue have shown promising results in regenerative medicine. MSCs are crucial for tissue healing because they have angiogenic, anti-apoptotic and immunomodulatory properties, in addition to the ability to differentiate into several specialized cell lines. Fibrin sealant or fibrin glue is a natural polymer involved in the coagulation process. Fibrin glue provides a temporary structure that favors angiogenesis, extracellular matrix deposition and cell-matrix interactions. Additionally, fibrin glue maintains the local and paracrine functions of MSCs, providing tissue regeneration through less invasive clinical procedures. Thus, the objective of this systematic review was to assess the potential of fibrin glue combined with MSCs in bone or cartilage regeneration. The bibliographic search was performed in the PubMed/MEDLINE, LILACS and Embase databases, using the descriptors (“fibrin sealant” OR “fibrin glue”) AND “stem cells” AND “bone regeneration”, considering articles published until 2021. In this case, 12 preclinical and five clinical studies were selected to compose this review, according to the eligibility criteria. In preclinical studies, fibrin glue loaded with MSCs, alone or associated with bone substitute, significantly favored bone defects regeneration compared to scaffold without cells. Similarly, fibrin glue loaded with MSCs presented considerable potential to regenerate joint cartilage injuries and multiple bone fractures, with significant improvement in clinical parameters and absence of postoperative complications. Therefore, there is clear evidence in the literature that fibrin glue loaded with MSCs, alone or combined with bone substitute, is a promising strategy for treating lesions in bone or cartilaginous tissue.
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Gao X, Cheng H, Sun X, Lu A, Ruzbarsky JJ, Wang B, Huard J. Comparison of Autologous Blood Clots with Fibrin Sealant as Scaffolds for Promoting Human Muscle-Derived Stem Cell-Mediated Bone Regeneration. Biomedicines 2021; 9:biomedicines9080983. [PMID: 34440188 PMCID: PMC8391974 DOI: 10.3390/biomedicines9080983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/23/2021] [Accepted: 08/05/2021] [Indexed: 01/01/2023] Open
Abstract
Background. Fibrin sealant has been used as a scaffold to deliver genetically modified human muscle-derived stem cells (hMDSCs) for bone regeneration. Alternatively, autologous blood clots are safe, economic scaffolds. This study compared autologous blood clot (BC) with fibrin sealant (FS) as a scaffold to deliver lenti-BMP2/GFP-transduced hMDSCs for bone regeneration. Methods. In vitro osteogenic differentiation was performed using 3D pellet culture and evaluated using microCT and Von Kossa staining. The lenti-GFP transduced cells were then mixed with human blood for evaluation of osteogenic differentiation. Furthermore, a murine critical- sized calvarial defect model was utilized to compare BC and FS scaffolds for lenti-BMP2/GFP-transduced hMDSCs mediated bone regeneration and evaluated with micro-CT and histology. Results. Lenti-BMP2/GFP transduced hMDSCs formed significantly larger mineralized pellets than non-transduced hMDSCs. hMDSCs within the human blood clot migrated out and differentiated into ALP+ osteoblasts. In vivo, BC resulted in significantly less new bone formation within a critical-sized calvarial bone defect than FS scaffold, despite no difference observed for GFP+ donor cells, osteoclasts, and osteoblasts in the newly formed bone. Conclusions. Human lenti-BMP2/GFP-transduced hMDSCs can efficiently undergo osteogenic differentiation in vitro. Unexpectedly, the newly regenerated bone in BC group was significantly less than the FS group. The autologous blood clot scaffold is less efficacious for delivering stem cells for bone regeneration than fibrin sealant.
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Affiliation(s)
- Xueqin Gao
- Center for Regenerative Sports Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA; (X.G.); (A.L.)
- Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77054, USA; (H.C.); (X.S.)
| | - Haizi Cheng
- Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77054, USA; (H.C.); (X.S.)
| | - Xuying Sun
- Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77054, USA; (H.C.); (X.S.)
| | - Aiping Lu
- Center for Regenerative Sports Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA; (X.G.); (A.L.)
- Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77054, USA; (H.C.); (X.S.)
| | | | - Bing Wang
- Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA 15140, USA;
- Department of Medicine, Division of Cardiology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15140, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15140, USA
| | - Johnny Huard
- Center for Regenerative Sports Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA; (X.G.); (A.L.)
- Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77054, USA; (H.C.); (X.S.)
- Correspondence:
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Hidd SMCM, Tim CR, Dutra EDF, Maia ALM, Assis L, Ferreira RS, Barraviera B, Silva JF, Amaral MM. Fibrin biopolymer sealant and aquatic exercise association for calcaneal tendon repair. Acta Cir Bras 2021; 36:e360407. [PMID: 34037082 PMCID: PMC8148814 DOI: 10.1590/acb360407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/21/2021] [Accepted: 03/19/2021] [Indexed: 01/19/2023] Open
Abstract
PURPOSE The aim of this work was to analyze the effect of fibrin biopolymer sealant (FS) associated or not to aquatic exercise (AE) on the calcaneal tendon repair. METHODS Forty-four female Wistar rats were randomly divided into four experimental groups: Lesion control (L), Lesion and FS (LS), Lesion and AE (LE) and Lesion and FS associated to AE (LSE). The edema volume (EV), collagen ratio, and histopathological analysis were evaluated after 7, 14, and 21 days of partial tendon transection. RESULTS The EV was statistically reduced for all treatment groups after 7 and 21 days when compared to L group. The LS and LSE had the highest EV reduction after 21 days of treatment. The FS group didn't induce tissue necrosis or infections on the histopathological analysis. It was observed tenocytes proliferation, granulation tissue and collagen formation in the tendon partial transection area in the FS group. The LSE demonstrated higher amount of granulation tissue and increased the collagen deposition at the injury site. CONCLUSIONS Our data suggests that the therapeutic potential of the association of heterologous fibrin biopolymer sealant with aquatic exercise program should be further explored as it may stimulate the regeneration phase and optimize calcaneal tendon recovery.
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Affiliation(s)
| | - Carla Roberta Tim
- PhD. Universidade Brasil – Scientific and Technological Institute –
Sao Paulo (SP), Brazil
| | - Eneas de Freitas Dutra
- PhD. Universidade Estadual do Piauí – Center for Research in
Biotechnology and Biodiversity – Teresina (PI), Brazil
| | - Antônio Luiz Martins Maia
- PhD. Universidade Estadual do Piauí – Center for Research in
Biotechnology and Biodiversity – Teresina (PI), Brazil
| | - Lívia Assis
- PhD. Universidade Brasil – Scientific and Technological Institute –
Sao Paulo (SP), Brazil
| | - Rui Seabra Ferreira
- PhD. Universidade Estadual Paulista – Center for the Study of Venoms
and Venomous Animals – Botucatu (SP), Brazil
| | - Benedito Barraviera
- PhD. Universidade Estadual Paulista – Botucatu Medical School –
Botucatu (SP), Brazil
| | - José Figueiredo Silva
- PhD. Universidade Estadual do Piauí – Center for Research in
Biotechnology and Biodiversity – Teresina (PI), Brazil
| | - Marcello Magri Amaral
- PhD. Universidade Brasil – Scientific and Technological Institute –
Sao Paulo (SP), Brazil
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Lana JFSD, da Fonseca LF, Macedo RDR, Mosaner T, Murrell W, Kumar A, Purita J, de Andrade MAP. Platelet-rich plasma vs bone marrow aspirate concentrate: An overview of mechanisms of action and orthobiologic synergistic effects. World J Stem Cells 2021; 13:155-167. [PMID: 33708344 PMCID: PMC7933989 DOI: 10.4252/wjsc.v13.i2.155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/15/2020] [Accepted: 01/15/2021] [Indexed: 02/06/2023] Open
Abstract
The use of orthobiologics as a novel therapy for the treatment of numerous musculoskeletal disorders has increased considerably over the past decade. Currently, there are multiple alternatives available as suitable treatments; however, the use of autologous blood-derived products such as platelet-rich plasma (PRP), bone marrow aspirate (BMA) and BMA concentrate (BMAC), specifically, is expanding. Although many investigations attempted to demonstrate the effectiveness of these therapies, even with positive results, the literature lacks standardized protocols and overall accuracy in study designs, which leads to variance and difficulty in reproducibility of protocols. The efficacy of PRP for the treatment of cartilage, bone and muscle tissues is well known. Although BMAC has generated optimistic results for the same purposes, its applicability in clinical trials is still relatively recent when compared to PRP. Both products demonstrate the potential to set forth reparative processes, each in their own distinct mechanism. The combination of these biological products has been previously proposed, yet little is known about their synergism. Evidence indicates that growth factor, cytokine, and chemokine profiles seen in both PRP and BMAC vary but are likely to work synergistically to enhance musculoskeletal healing. BMAC products seem to work well without PRP; however, the addition of PRP to BMAC has been shown to act as a rich and natural source of culture medium for stem cells located either peripherally or in the bone marrow itself. Nevertheless, additional variables associated with the use of BMAC and PRP in orthopedics must be further evaluated in order to consolidate the efficacy of this therapeutic strategy.
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Affiliation(s)
| | | | - Rafael da Rocha Macedo
- Department of Orthopedics, Rede D’Or Unit IFOR Hospital, São Bernardo do Campo 09715-021, SP, Brazil
| | - Tomas Mosaner
- Department of Orthopedics, The Bone and Cartilage Institute, Indaiatuba 13334-170, SP, Brazil
| | - William Murrell
- Department of Orthopaedics, Healthpoint UAE, Abu Dhabi 00000, United Arab Emirates
| | - Ashok Kumar
- Department of Orthopaedics, My Doc Specialist Medical Centre, Dubai 00000, United Arab Emirates
| | - Joseph Purita
- Department of Orthopedics, Institute of Regenerative Medicine, Boca Raton, FL 33432, United States
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Abbade LPF, Barraviera SRCS, Silvares MRC, Lima ABBDCO, Haddad GR, Gatti MAN, Medolago NB, Rigotto Carneiro MT, dos Santos LD, Ferreira RS, Barraviera B. Treatment of Chronic Venous Ulcers With Heterologous Fibrin Sealant: A Phase I/II Clinical Trial. Front Immunol 2021; 12:627541. [PMID: 33708219 PMCID: PMC7940668 DOI: 10.3389/fimmu.2021.627541] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background Heterologous fibrin sealant (HFS) consists of a fibrinogen-rich cryoprecipitate extracted from Bubalus bubalis buffalo blood and a thrombin-like enzyme purified from Crotalus durissus terrificus snake venom. This study evaluated the safety and immunogenicity of HFS, estimated the best dose, and assessed its preliminary efficacy in the treatment of chronic venous ulcers (CVU). Methods A phase I/II non-randomized, single-arm clinical trial was performed on 31 participants, accounting for a total of 69 active CVUs. All ulcers were treated with HFS, essential fatty acid, and Unna boot for 12 weeks. The outcomes assessed were: (1) primary safety, immunogenicity analyses, and confirmation of the lowest safe dose; (2) secondary promising efficacy by analyzing the healing process. Immunogenicity was evaluated using the serum-neutralizing (IgM and IgG) and non-neutralizing (IgA and IgE) antibody techniques against the product. The immuno-detection of IgE class antibodies was assessed using dot-blot assay before and at the end of treatment. Positive samples on dot-blot assays were subsequently analyzed by western blotting to verify the results. Results No severe systemic adverse events related to the use of HFS were observed. Local adverse events potentially related to treatment include ulcer pain (52%), peri-ulcer maceration (16%), peri-ulcer pruritus (12%), critical colonization (8%), peri-ulcer eczema (4%), the opening of new ulcers (4%), and increased ulcerated area 4%). Neutralizing and non-neutralizing antibodies did not show significant deviations at any of the evaluated time points. Blot assays showed that all patients presented negative immunological reactions, either before or after treatment, with the thrombin-like enzyme component. In addition, two participants showed a positive immunological reaction to the cryoprecipitate component, while another two were positive before and during treatment. Regarding the secondary outcomes of preliminary efficacy, a total healing and significant reduction of the area was observed in 47.5 and 22%, respectively. A qualitative improvement was observed in the wound beds of unhealed ulcers. Conclusions The investigational HFS bioproduct proved to be safe and non-immunogenic with a good preliminary efficacy for the treatment of CVU, according to the protocol and doses proposed. A multicentric phase III clinical trial will be necessary to verify these findings.
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Affiliation(s)
- Luciana P. F. Abbade
- Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
- Graduate Program in Nursing, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
- Graduate Program in Clinical Research, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
| | - Silvia Regina Catharino Sartori Barraviera
- Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
| | - Maria Regina Cavariani Silvares
- Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
| | - Ana Beatriz B. de C. O. Lima
- Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
| | - Gabriela R. Haddad
- Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
| | - Márcia A. N. Gatti
- Nursing School of Sagrado Coração University (UNISAGRADO), Bauru, Brazil
| | - Natália Bronzatto Medolago
- Clinical Research Unit (UPECLIN), Botucatu Medical School, São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
| | - Márcia Tonin Rigotto Carneiro
- Clinical Research Unit (UPECLIN), Botucatu Medical School, São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
| | - Lucilene Delazari dos Santos
- Graduate Program in Clinical Research, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
| | - Rui Seabra Ferreira
- Graduate Program in Clinical Research, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
| | - Benedito Barraviera
- Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
- Graduate Program in Clinical Research, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu, Brazil
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20
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Della Coletta BB, Jacob TB, Moreira LADC, Pomini KT, Buchaim DV, Eleutério RG, Pereira EDSBM, Roque DD, Rosso MPDO, Shindo JVTC, Duarte MAH, Alcalde MP, Júnior RSF, Barraviera B, Dias JA, Andreo JC, Buchaim RL. Photobiomodulation Therapy on the Guided Bone Regeneration Process in Defects Filled by Biphasic Calcium Phosphate Associated with Fibrin Biopolymer. Molecules 2021; 26:847. [PMID: 33562825 PMCID: PMC7914843 DOI: 10.3390/molecules26040847] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 12/13/2022] Open
Abstract
The aim is to evaluate the effects of photobiomodulation therapy (PBMT) on the guided bone regeneration process (GBR) in defects in the calvaria of rats filled with biphasic calcium phosphate associated with fibrin biopolymer. Thirty male Wistar rats were randomly separated: BMG (n = 10), defects filled with biomaterial and covered by membrane; BFMG (n = 10), biomaterial and fibrin biopolymer covered by membrane; and BFMLG (n = 10), biomaterial and fibrin biopolymer covered by membrane and biostimulated with PBMT. The animals were euthanized at 14 and 42 days postoperatively. Microtomographically, in 42 days, there was more evident bone growth in the BFMLG, limited to the margins of the defect with permanence of the particles. Histomorphologically, an inflammatory infiltrate was observed, which regressed with the formation of mineralized bone tissue. In the quantification of bone tissue, all groups had a progressive increase in new bone tissue with a significant difference in which the BFMLG showed greater bone formation in both periods (10.12 ± 0.67 and 13.85 ± 0.54), followed by BFMG (7.35 ± 0.66 and 9.41 ± 0.84) and BMG (4.51 ± 0.44 and 7.11 ± 0.44). Picrosirius-red staining showed greater birefringence of collagen fibers in yellow-green color in the BFMLG, showing more advanced bone maturation. PBMT showed positive effects capable of improving and accelerating the guided bone regeneration process when associated with biphasic calcium phosphate and fibrin biopolymer.
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Affiliation(s)
- Bruna Botteon Della Coletta
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru 17012-901, São Paulo, Brazil; (B.B.D.C.); (K.T.P.); (M.P.d.O.R.); (J.V.T.C.S.); (J.C.A.)
| | - Thiago Borges Jacob
- Medical and Dentistry School, University of Marilia (UNIMAR), Marília 17525-902, São Paulo, Brazil; (T.B.J.); (L.A.d.C.M.); (D.V.B.); (R.G.E.); (E.d.S.B.M.P.); (D.D.R.)
| | - Luana Aparecida de Carvalho Moreira
- Medical and Dentistry School, University of Marilia (UNIMAR), Marília 17525-902, São Paulo, Brazil; (T.B.J.); (L.A.d.C.M.); (D.V.B.); (R.G.E.); (E.d.S.B.M.P.); (D.D.R.)
| | - Karina Torres Pomini
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru 17012-901, São Paulo, Brazil; (B.B.D.C.); (K.T.P.); (M.P.d.O.R.); (J.V.T.C.S.); (J.C.A.)
- Medical and Dentistry School, University of Marilia (UNIMAR), Marília 17525-902, São Paulo, Brazil; (T.B.J.); (L.A.d.C.M.); (D.V.B.); (R.G.E.); (E.d.S.B.M.P.); (D.D.R.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília 17525-902, São Paulo, Brazil;
| | - Daniela Vieira Buchaim
- Medical and Dentistry School, University of Marilia (UNIMAR), Marília 17525-902, São Paulo, Brazil; (T.B.J.); (L.A.d.C.M.); (D.V.B.); (R.G.E.); (E.d.S.B.M.P.); (D.D.R.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília 17525-902, São Paulo, Brazil;
- Medical School, University Center of Adamantina (UniFAI), Adamantina 17800-000, São Paulo, Brazil
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (Univ Estadual Paulista, UNESP), Botucatu 18610-307, São Paulo, Brazil; (R.S.F.J.); (B.B.)
| | - Rachel Gomes Eleutério
- Medical and Dentistry School, University of Marilia (UNIMAR), Marília 17525-902, São Paulo, Brazil; (T.B.J.); (L.A.d.C.M.); (D.V.B.); (R.G.E.); (E.d.S.B.M.P.); (D.D.R.)
| | - Eliana de Souza Bastos Mazuqueli Pereira
- Medical and Dentistry School, University of Marilia (UNIMAR), Marília 17525-902, São Paulo, Brazil; (T.B.J.); (L.A.d.C.M.); (D.V.B.); (R.G.E.); (E.d.S.B.M.P.); (D.D.R.)
| | - Domingos Donizeti Roque
- Medical and Dentistry School, University of Marilia (UNIMAR), Marília 17525-902, São Paulo, Brazil; (T.B.J.); (L.A.d.C.M.); (D.V.B.); (R.G.E.); (E.d.S.B.M.P.); (D.D.R.)
| | - Marcelie Priscila de Oliveira Rosso
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru 17012-901, São Paulo, Brazil; (B.B.D.C.); (K.T.P.); (M.P.d.O.R.); (J.V.T.C.S.); (J.C.A.)
| | - João Vitor Tadashi Cosin Shindo
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru 17012-901, São Paulo, Brazil; (B.B.D.C.); (K.T.P.); (M.P.d.O.R.); (J.V.T.C.S.); (J.C.A.)
| | - Marco Antônio Húngaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo (USP), Bauru 17012-901, São Paulo, Brazil;
| | - Murilo Priori Alcalde
- Department of Health Science, Unisagrado University Center, Bauru 17011-160, São Paulo, Brazil;
| | - Rui Seabra Ferreira Júnior
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (Univ Estadual Paulista, UNESP), Botucatu 18610-307, São Paulo, Brazil; (R.S.F.J.); (B.B.)
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu 18618-687, São Paulo, Brazil
- Graduate Program in Clinical Research, Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP–Univ Estadual Paulista), Botucatu 18610-307, São Paulo, Brazil
| | - Benedito Barraviera
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (Univ Estadual Paulista, UNESP), Botucatu 18610-307, São Paulo, Brazil; (R.S.F.J.); (B.B.)
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP – Univ Estadual Paulista), Botucatu 18618-687, São Paulo, Brazil
- Graduate Program in Clinical Research, Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP–Univ Estadual Paulista), Botucatu 18610-307, São Paulo, Brazil
| | - Jefferson Aparecido Dias
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília 17525-902, São Paulo, Brazil;
- Postgraduate Program in Law, University of Marilia (UNIMAR), Marília 17525-902, São Paulo, Brazil
| | - Jesus Carlos Andreo
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru 17012-901, São Paulo, Brazil; (B.B.D.C.); (K.T.P.); (M.P.d.O.R.); (J.V.T.C.S.); (J.C.A.)
| | - Rogério Leone Buchaim
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru 17012-901, São Paulo, Brazil; (B.B.D.C.); (K.T.P.); (M.P.d.O.R.); (J.V.T.C.S.); (J.C.A.)
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (Univ Estadual Paulista, UNESP), Botucatu 18610-307, São Paulo, Brazil; (R.S.F.J.); (B.B.)
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21
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Abstract
Compared with non-degradable materials, biodegradable biomaterials play an increasingly important role in the repairing of severe bone defects, and have attracted extensive attention from researchers. In the treatment of bone defects, scaffolds made of biodegradable materials can provide a crawling bridge for new bone tissue in the gap and a platform for cells and growth factors to play a physiological role, which will eventually be degraded and absorbed in the body and be replaced by the new bone tissue. Traditional biodegradable materials include polymers, ceramics and metals, which have been used in bone defect repairing for many years. Although these materials have more or fewer shortcomings, they are still the cornerstone of our development of a new generation of degradable materials. With the rapid development of modern science and technology, in the twenty-first century, more and more kinds of new biodegradable materials emerge in endlessly, such as new intelligent micro-nano materials and cell-based products. At the same time, there are many new fabrication technologies of improving biodegradable materials, such as modular fabrication, 3D and 4D printing, interface reinforcement and nanotechnology. This review will introduce various kinds of biodegradable materials commonly used in bone defect repairing, especially the newly emerging materials and their fabrication technology in recent years, and look forward to the future research direction, hoping to provide researchers in the field with some inspiration and reference.
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Affiliation(s)
- Shuai Wei
- Tianjin Hospital, Tianjin University, No. 406 Jiefang South Road, Tianjin, 300211 China
| | - Jian-Xiong Ma
- Tianjin Hospital, Tianjin University, No. 406 Jiefang South Road, Tianjin, 300211 China
| | - Lai Xu
- Jiangsu Clinical Medicine Center of Tissue Engineering and Nerve Injury Repair, Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, No. 19 Qixiu Road, Chongchuan District, Nantong, 226001 China
| | - Xiao-Song Gu
- Jiangsu Clinical Medicine Center of Tissue Engineering and Nerve Injury Repair, Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, No. 19 Qixiu Road, Chongchuan District, Nantong, 226001 China
| | - Xin-Long Ma
- Tianjin Hospital, Tianjin University, No. 406 Jiefang South Road, Tianjin, 300211 China
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22
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Abbade LPF, Ferreira RS, Dos Santos LD, Barraviera B. Chronic venous ulcers: a review on treatment with fibrin sealant and prognostic advances using proteomic strategies. J Venom Anim Toxins Incl Trop Dis 2020; 26:e20190101. [PMID: 32636876 PMCID: PMC7315627 DOI: 10.1590/1678-9199-jvatitd-2019-0101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Venous ulcers are the main causes of chronic lower-limb ulcers. The healing difficulties encourage the research and development of new products in order to achieve better therapeutic results. Fibrin sealant is one of these alternatives. Besides being a validated scaffold and drug delivery system, it possesses excellent healing properties. This review covered the last 25 years of the literature and showed that the fibrin sealant is used in various clinical situations to promote the healing of different types of ulcers, especially chronic ones. These are mostly venous in origin and usually does not respond to conventional treatment. Commercially, only the homologous fibrin sealants obtained from human blood are available, which are highly efficient but very expensive. The heterologous fibrin sealant is a non-commercial experimental low-cost product and easily produced due to the abundance of raw material. The phase I/II clinical trial is already completed and showed that the product is safe and promisingly efficacious for the treatment of chronic venous ulcers. In addition, clinical proteomic strategies to assess disease prognosis have been increasingly used. By analyzing liquid samples from the wounds through proteomic strategies, it is possible to predict before treatment which ulcers will evolve favorably and which ones will be difficult to heal. This prognosis is only possible by evaluating the expression of isolated proteins in exudates and analysis using label-free strategies for shotgun. Multicentric clinical trials will be required to evaluate the efficacy of fibrin sealant to treat chronic ulcers, as well as to validate the proteomic strategies to assess prognosis.
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Affiliation(s)
- Luciana Patricia Fernandes Abbade
- Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil.,Graduate Program in Clinical Research, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Rui Seabra Ferreira
- Graduate Program in Clinical Research, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil.,Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil.,Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Lucilene Delazari Dos Santos
- Graduate Program in Clinical Research, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil.,Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil.,Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Benedito Barraviera
- Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil.,Graduate Program in Clinical Research, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil.,Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil.,Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP), Botucatu, SP, Brazil
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23
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Creste CFZ, Orsi PR, Landim-Alvarenga FC, Justulin LA, Golim MDA, Barraviera B, Ferreira RS. Highly effective fibrin biopolymer scaffold for stem cells upgrading bone regeneration. MATERIALS 2020; 13:ma13122747. [PMID: 32560388 PMCID: PMC7344939 DOI: 10.3390/ma13122747] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/29/2020] [Accepted: 06/05/2020] [Indexed: 12/19/2022]
Abstract
Fibrin scaffold fits as a provisional platform promoting cell migration and proliferation, angiogenesis, connective tissue formation and growth factors stimulation. We evaluated a unique heterologous fibrin biopolymer as scaffold to mesenchymal stem cells (MSCs) to treat a critical-size bone defect. Femurs of 27 rats were treated with fibrin biopolymer (FBP); FBP + MSCs; and FBP + MSC differentiated in bone lineage (MSC-D). Bone repair was evaluated 03, 21 and 42 days later by radiographic, histological and scanning electron microscopy (SEM) imaging. The FBP + MSC-D association was the most effective treatment, since newly formed Bone was more abundant and early matured in just 21 days. We concluded that FBP is an excellent scaffold for MSCs and also use of differentiated cells should be encouraged in regenerative therapy researches. The FBP ability to maintain viable MSCs at Bone defect site has modified inflammatory environment and accelerating their regeneration.
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Affiliation(s)
- Camila Fernanda Zorzella Creste
- Center for the Study of Venoms and Venomous Animals (CEVAP), UNESP—São Paulo State University, Botucatu 18610-307, Brazil; (C.F.Z.C.); (P.R.O.); (B.B.)
- Botucatu Medical School, UNESP—São Paulo State University, Botucatu 18618-687, Brazil;
| | - Patrícia Rodrigues Orsi
- Center for the Study of Venoms and Venomous Animals (CEVAP), UNESP—São Paulo State University, Botucatu 18610-307, Brazil; (C.F.Z.C.); (P.R.O.); (B.B.)
| | - Fernanda Cruz Landim-Alvarenga
- College of Veterinary Medicine and Animal Husbandry (FMVZ), UNESP—São Paulo State University, Botucatu 18618-681, Brazil;
| | - Luis Antônio Justulin
- Botucatu Biosciences Institute, UNESP—São Paulo State University, Botucatu 18618-689, Brazil;
| | | | - Benedito Barraviera
- Center for the Study of Venoms and Venomous Animals (CEVAP), UNESP—São Paulo State University, Botucatu 18610-307, Brazil; (C.F.Z.C.); (P.R.O.); (B.B.)
- Botucatu Medical School, UNESP—São Paulo State University, Botucatu 18618-687, Brazil;
| | - Rui Seabra Ferreira
- Center for the Study of Venoms and Venomous Animals (CEVAP), UNESP—São Paulo State University, Botucatu 18610-307, Brazil; (C.F.Z.C.); (P.R.O.); (B.B.)
- Botucatu Medical School, UNESP—São Paulo State University, Botucatu 18618-687, Brazil;
- Correspondence: ; Tel.: +55-(014)-3880-7241
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24
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Rosso MPDO, Oyadomari AT, Pomini KT, Della Coletta BB, Shindo JVTC, Ferreira Júnior RS, Barraviera B, Cassaro CV, Buchaim DV, Teixeira DDB, Barbalho SM, Alcalde MP, Duarte MAH, Andreo JC, Buchaim RL. Photobiomodulation Therapy Associated with Heterologous Fibrin Biopolymer and Bovine Bone Matrix Helps to Reconstruct Long Bones. Biomolecules 2020; 10:biom10030383. [PMID: 32121647 PMCID: PMC7175234 DOI: 10.3390/biom10030383] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/18/2020] [Accepted: 02/25/2020] [Indexed: 12/16/2022] Open
Abstract
Bone defects cause aesthetic and functional changes that affect the social, economic and especially the emotional life of human beings. This complication stimulates the scientific community to investigate strategies aimed at improving bone reconstruction processes using complementary therapies. Photobiomodulation therapy (PBMT) and the use of new biomaterials, including heterologous fibrin biopolymer (HFB), are included in this challenge. The objective of the present study was to evaluate the influence of photobiomodulation therapy on bone tibial reconstruction of rats with biomaterial consisting of lyophilized bovine bone matrix (BM) associated or not with heterologous fibrin biopolymer. Thirty male rats were randomly separated into three groups of 10 animals. In all animals, after the anesthetic procedure, a noncritical tibial defect of 2 mm was performed. The groups received the following treatments: Group 1: BM + PBMT, Group 2: BM + HFB and Group 3: BM + HFB + PBMT. The animals from Groups 1 and 3 were submitted to PBMT in the immediate postoperative period and every 48 h until the day of euthanasia that occurred at 14 and 42 days. Analyses by computed microtomography (µCT) and histomorphometry showed statistical difference in the percentage of bone formation between Groups 3 (BM + HB + PBMT) and 2 (BM + HFB) (26.4% ± 1.03% and 20.0% ± 1.87%, respectively) at 14 days and at 42 days (38.2% ± 1.59% and 31.6% ± 1.33%, respectively), and at 42 days there was presence of bone with mature characteristics and organized connective tissue. The µCT demonstrated BM particles filling the defect and the deposition of new bone in the superficial region, especially in the ruptured cortical. It was concluded that the association of PBMT with HFB and BM has the potential to assist in the process of reconstructing bone defects in the tibia of rats.
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Affiliation(s)
- Marcelie Priscila de Oliveira Rosso
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Alameda Dr. Octávio Pinheiro Brisolla, 9-75-Vila Universitaria, Bauru 17012-901, São Paulo, Brazil; (M.P.d.O.R.); (A.T.O.); (K.T.P.); (B.B.D.C.); (J.V.T.C.S.); (J.C.A.)
| | - Aline Tiemi Oyadomari
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Alameda Dr. Octávio Pinheiro Brisolla, 9-75-Vila Universitaria, Bauru 17012-901, São Paulo, Brazil; (M.P.d.O.R.); (A.T.O.); (K.T.P.); (B.B.D.C.); (J.V.T.C.S.); (J.C.A.)
| | - Karina Torres Pomini
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Alameda Dr. Octávio Pinheiro Brisolla, 9-75-Vila Universitaria, Bauru 17012-901, São Paulo, Brazil; (M.P.d.O.R.); (A.T.O.); (K.T.P.); (B.B.D.C.); (J.V.T.C.S.); (J.C.A.)
| | - Bruna Botteon Della Coletta
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Alameda Dr. Octávio Pinheiro Brisolla, 9-75-Vila Universitaria, Bauru 17012-901, São Paulo, Brazil; (M.P.d.O.R.); (A.T.O.); (K.T.P.); (B.B.D.C.); (J.V.T.C.S.); (J.C.A.)
| | - João Vitor Tadashi Cosin Shindo
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Alameda Dr. Octávio Pinheiro Brisolla, 9-75-Vila Universitaria, Bauru 17012-901, São Paulo, Brazil; (M.P.d.O.R.); (A.T.O.); (K.T.P.); (B.B.D.C.); (J.V.T.C.S.); (J.C.A.)
| | - Rui Seabra Ferreira Júnior
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (Univ. Estadual Paulista, UNESP), Botucatu 18610-307, São Paulo, Brazil or (R.S.F.J.); (B.B.); (C.V.C.)
| | - Benedito Barraviera
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (Univ. Estadual Paulista, UNESP), Botucatu 18610-307, São Paulo, Brazil or (R.S.F.J.); (B.B.); (C.V.C.)
| | - Claudia Vilalva Cassaro
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (Univ. Estadual Paulista, UNESP), Botucatu 18610-307, São Paulo, Brazil or (R.S.F.J.); (B.B.); (C.V.C.)
| | - Daniela Vieira Buchaim
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Avenue Hygino Muzzy Filho, 1001, Marília 17525-902, São Paulo, Brazil; (D.V.B.); (D.d.B.T.); (S.M.B.)
- Medical School, University Center of Adamantina (UniFAI), Nove de Julho Street, 730-Centro, Adamantina 17800-000, São Paulo, Brazil
| | - Daniel de Bortoli Teixeira
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Avenue Hygino Muzzy Filho, 1001, Marília 17525-902, São Paulo, Brazil; (D.V.B.); (D.d.B.T.); (S.M.B.)
| | - Sandra Maria Barbalho
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Avenue Hygino Muzzy Filho, 1001, Marília 17525-902, São Paulo, Brazil; (D.V.B.); (D.d.B.T.); (S.M.B.)
| | - Murilo Priori Alcalde
- Department of Health Science, University of the Sacred Heart (USC), Bauru 17011-160, São Paulo, Brazil;
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo (USP), Bauru 17012-901, São Paulo, Brazil;
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo (USP), Bauru 17012-901, São Paulo, Brazil;
| | - Jesus Carlos Andreo
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Alameda Dr. Octávio Pinheiro Brisolla, 9-75-Vila Universitaria, Bauru 17012-901, São Paulo, Brazil; (M.P.d.O.R.); (A.T.O.); (K.T.P.); (B.B.D.C.); (J.V.T.C.S.); (J.C.A.)
| | - Rogério Leone Buchaim
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Alameda Dr. Octávio Pinheiro Brisolla, 9-75-Vila Universitaria, Bauru 17012-901, São Paulo, Brazil; (M.P.d.O.R.); (A.T.O.); (K.T.P.); (B.B.D.C.); (J.V.T.C.S.); (J.C.A.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Avenue Hygino Muzzy Filho, 1001, Marília 17525-902, São Paulo, Brazil; (D.V.B.); (D.d.B.T.); (S.M.B.)
- Correspondence: ; Tel.: +55-14-3235-8226
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25
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Buchaim DV, Cassaro CV, Shindo JVTC, Coletta BBD, Pomini KT, Rosso MPDO, Campos LMG, Ferreira RS, Barraviera B, Buchaim RL. Unique heterologous fibrin biopolymer with hemostatic, adhesive, sealant, scaffold and drug delivery properties: a systematic review. J Venom Anim Toxins Incl Trop Dis 2019; 25:e20190038. [PMID: 31839802 PMCID: PMC6894437 DOI: 10.1590/1678-9199-jvatitd-2019-0038] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/16/2019] [Indexed: 12/19/2022] Open
Abstract
Fibrin biopolymers, previously referred as "fibrin glue" or "fibrin sealants", are natural biomaterials with diverse applications on health. They have hemostatic, adhesive, sealant, scaffold and drug delivery properties and have become widely used in medical and dental procedures. Historically, these biomaterials are produced from human fibrinogen and human or animal thrombin, and the possibility of transmission of infectious diseases by human blood is not ruled out. In the 1990s, to overcome this problem, a new heterologous biomaterial composed of a thrombin-like enzyme purified from Crotalus durissus terrificus venom and a cryoprecipitate rich in fibrinogen extracted from buffaloes Bubalus bubalis blood has been proposed. Therefore, a systematic review of studies on exclusively heterologous fibrin sealants published between 1989 and 2018 was carried out using the following databases: PubMed, SciELO and Google Scholar. The keyword used was "heterologous fibrin sealant". The search resulted in 35 scientific papers in PubMed, four in SciELO and 674 in Google Scholar. After applying the inclusion/exclusion criteria and complete reading of the articles, 30 studies were selected, which formed the basis of this systematic review. It has been observed that the only completely heterologous sealant is the one produced by CEVAP/UNESP. This heterologous biopolymer is proven effective by several studies published in refereed scientific journals. In addition, clinical trials phase I/II for the treatment of chronic venous ulcers authorized by the Brazilian Health Regulatory Agency (ANVISA) were completed. Preliminary results have indicated a safe and promising effective product. Phase III clinical trials will be proposed and required to validate these preliminary findings.
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Affiliation(s)
- Daniela Vieira Buchaim
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru, SP, Brazil.,Medical and Dentistry School, University of Marilia (UNIMAR), Marília, SP, Brazil.,Medical School, University Center of Adamantina (UNIFAI), Adamantina, SP, Brazil
| | - Claudia Vilalva Cassaro
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP), Botucatu, SP, Brazil.,Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil
| | | | - Bruna Botteon Della Coletta
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru, SP, Brazil
| | - Karina Torres Pomini
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru, SP, Brazil
| | | | | | - Rui Seabra Ferreira
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP), Botucatu, SP, Brazil.,Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Benedito Barraviera
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP), Botucatu, SP, Brazil.,Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Rogério Leone Buchaim
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru, SP, Brazil.,Medical and Dentistry School, University of Marilia (UNIMAR), Marília, SP, Brazil
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