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Janssen K, van Ruiten GW, Eijkelkamp N, Damaser MS, van der Vaart CH. Effects of mesenchymal stem cells and heparan sulfate mimetics on urethral function and vaginal wall biomechanics in a simulated rat childbirth injury model. Int Urogynecol J 2023; 34:1635-1644. [PMID: 36662271 PMCID: PMC10287815 DOI: 10.1007/s00192-022-05439-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 12/07/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION AND HYPOTHESIS New treatments are needed for pelvic floor disorders. ReGeneraTing Agent® (RGTA®) is a promising regenerative therapy. Therefore, the objective of this study was to compare regenerative abilities of mesenchymal stem cells (MSCs) and RGTA® on regeneration after simulated childbirth injury in rats. METHODS Rats underwent pudendal nerve crush and vaginal distension (PNC+VD) or sham injury. Rats that underwent PNC+VD were treated intravenously with vehicle, MSCs or RGTA® 1 h, 7 days, and 14 days after surgery. Sham rats received 1 ml vehicle at all time points. After 21 days, urethral function and pudendal nerve function were tested. Vaginal tissues were harvested for biomechanical testing and histology. Biaxial testing was performed to measure tissue stiffness. RESULTS PNC+VD decreased urethral and pudendal nerve function compared with sham. Vaginal wall stiffness was significantly decreased in longitudinal and transverse tissue axes after PNC+VD compared with sham. MSC or RGTA® did not restore urethral or pudendal nerve function. However, MSC treatment resolved loss in vaginal wall stiffness in both tissue axes and improved collagen content within the vaginal wall. RGTA® treatment increased vaginal wall anisotropy by increasing relative stiffness in the longitudinal direction. PNC+VD (with vehicle or MSCs) enhanced elastogenesis, which was not observed after RGTA® treatment. CONCLUSIONS Treatment with MSCs facilitated recovery of vaginal wall biomechanical properties and connective tissue composition after PNC+VD, whereas treatment with RGTA® resulted in anisotropic biomechanical changes. This indicates that MSCs and RGTA® promote different aspects of vaginal tissue regeneration after simulated childbirth injury.
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Affiliation(s)
- Kristine Janssen
- Division Woman and Baby, University Medical Center Utrecht, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands.
- Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.
- Biomedical Engineering Department, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Geertruida W van Ruiten
- Division Woman and Baby, University Medical Center Utrecht, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands
| | - Niels Eijkelkamp
- Center of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Margot S Damaser
- Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
- Biomedical Engineering Department, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Carl H van der Vaart
- Division Woman and Baby, University Medical Center Utrecht, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands
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Crosio A, Ronchi G, Fornasari BE, Odella S, Raimondo S, Tos P. Experimental Methods to Simulate and Evaluate Postsurgical Peripheral Nerve Scarring. J Clin Med 2021; 10:jcm10081613. [PMID: 33920209 PMCID: PMC8070420 DOI: 10.3390/jcm10081613] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/30/2021] [Accepted: 04/07/2021] [Indexed: 01/09/2023] Open
Abstract
As a consequence of trauma or surgical interventions on peripheral nerves, scar tissue can form, interfering with the capacity of the nerve to regenerate properly. Scar tissue may also lead to traction neuropathies, with functional dysfunction and pain for the patient. The search for effective antiadhesion products to prevent scar tissue formation has, therefore, become an important clinical challenge. In this review, we perform extensive research on the PubMed database, retrieving experimental papers on the prevention of peripheral nerve scarring. Different parameters have been considered and discussed, including the animal and nerve models used and the experimental methods employed to simulate and evaluate scar formation. An overview of the different types of antiadhesion devices and strategies investigated in experimental models is also provided. To successfully evaluate the efficacy of new antiscarring agents, it is necessary to have reliable animal models mimicking the complications of peripheral nerve scarring and also standard and quantitative parameters to evaluate perineural scars. So far, there are no standardized methods used in experimental research, and it is, therefore, difficult to compare the results of the different antiadhesion devices.
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Affiliation(s)
- Alessandro Crosio
- UO Microchirurgia e Chirurgia della Mano, Ospedale Gaetano Pini, Piazza Andrea Ferrari 1, 20122 Milano, Italy; (A.C.); (S.O.); (P.T.)
| | - Giulia Ronchi
- Department of Clinical and Biological Sciences, Neuroscience Institute of the “Cavalieri Ottolenghi” Foundation (NICO), University of Turin, Regione Gonzole 10, 10043 Orbassano, Italy; (G.R.); (B.E.F.)
| | - Benedetta Elena Fornasari
- Department of Clinical and Biological Sciences, Neuroscience Institute of the “Cavalieri Ottolenghi” Foundation (NICO), University of Turin, Regione Gonzole 10, 10043 Orbassano, Italy; (G.R.); (B.E.F.)
| | - Simonetta Odella
- UO Microchirurgia e Chirurgia della Mano, Ospedale Gaetano Pini, Piazza Andrea Ferrari 1, 20122 Milano, Italy; (A.C.); (S.O.); (P.T.)
| | - Stefania Raimondo
- Department of Clinical and Biological Sciences, Neuroscience Institute of the “Cavalieri Ottolenghi” Foundation (NICO), University of Turin, Regione Gonzole 10, 10043 Orbassano, Italy; (G.R.); (B.E.F.)
- Correspondence: ; Tel.: +39-011-670-5433
| | - Pierluigi Tos
- UO Microchirurgia e Chirurgia della Mano, Ospedale Gaetano Pini, Piazza Andrea Ferrari 1, 20122 Milano, Italy; (A.C.); (S.O.); (P.T.)
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Alvites R, Rita Caseiro A, Santos Pedrosa S, Vieira Branquinho M, Ronchi G, Geuna S, Varejão AS, Colette Maurício A. Peripheral nerve injury and axonotmesis: State of the art and recent advances. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1466404] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Rui Alvites
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
| | - Ana Rita Caseiro
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
- Departamento de Engenharia Metalúrgica e Materiais, Faculdade de Engenharia, Universidade do Porto (REQUIMTE/LAQV), R. Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Sílvia Santos Pedrosa
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
| | - Mariana Vieira Branquinho
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
| | - Giulia Ronchi
- Departamento de Ciências Veterinárias, Universidade de Trás-os-Montes e Alto Douro, UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Stefano Geuna
- Departamento de Ciências Veterinárias, Universidade de Trás-os-Montes e Alto Douro, UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Artur S.P. Varejão
- CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
- Department of Clinical and Biological Sciences, and Cavalieri Ottolenghi Neuroscience Institute, University of Turin, Ospedale San Luigi, 10043 Orbassano, Turin, Italy
| | - Ana Colette Maurício
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
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Lemke A, Penzenstadler C, Ferguson J, Lidinsky D, Hopf R, Bradl M, Redl H, Wolbank S, Hausner T. A novel experimental rat model of peripheral nerve scarring that reliably mimics post-surgical complications and recurring adhesions. Dis Model Mech 2017; 10:1015-1025. [PMID: 28550101 PMCID: PMC5560061 DOI: 10.1242/dmm.028852] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 05/24/2017] [Indexed: 01/25/2023] Open
Abstract
Inflammation, fibrosis and perineural adhesions with the surrounding tissue are common pathological processes following nerve injury and surgical interventions on peripheral nerves in human patients. These features can reoccur following external neurolysis, currently the most common surgical treatment for peripheral nerve scarring, thus leading to renewed nerve function impairment and chronic pain. To enable a successful evaluation of new therapeutic approaches, it is crucial to use a reproducible animal model that mimics the main clinical symptoms occurring in human patients. However, a clinically relevant model combining both histological and functional alterations has not been published to date. We therefore developed a reliable rat model that exhibits the essential pathological processes of peripheral nerve scarring. In our study, we present a novel method for the induction of nerve scarring by applying glutaraldehyde-containing glue that is known to cause nerve injury in humans. After a 3-week contact period with the sciatic nerve in female Sprague Dawley rats, we could demonstrate severe intra- and perineural scarring that resulted in grade 3 adhesions and major impairments in the electrophysiological peak amplitude compared with sham control (P=0.0478). Immunohistochemical analysis of the nerve structure revealed vigorous nerve inflammation and recruitment of T cells and macrophages. Also, distinct nerve degeneration was determined by immunostaining. These pathological alterations were further reflected in significant functional deficiencies, as determined by the analysis of relevant gait parameters as well as the quantification of the sciatic functional index starting at week 1 post-operation (P<0.01). Moreover, with this model we could, for the first time, demonstrate not only the primary formation, but also the recurrence, of severe adhesions 1 week after glue removal, imitating a major clinical challenge. As a comparison, we tested a published model for generating perineural fibrotic adhesions, which did not result in significant pathological changes. Taken together, we established an easily reproducible and reliable rat model for peripheral nerve scarring that allows for the effective testing of new therapeutic strategies.
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Affiliation(s)
- Angela Lemke
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, Vienna 1200, Austria .,Austrian Cluster for Tissue Regeneration, Austria
| | - Carina Penzenstadler
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, Vienna 1200, Austria
| | - James Ferguson
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, Vienna 1200, Austria.,Austrian Cluster for Tissue Regeneration, Austria
| | - Dominika Lidinsky
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, Vienna 1200, Austria
| | - Rudolf Hopf
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, Vienna 1200, Austria
| | - Monika Bradl
- Department for Neuroimmunology, Center for Brain Research, Medical University Vienna, Spitalgasse 4, Vienna 1090, Austria
| | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, Vienna 1200, Austria.,Austrian Cluster for Tissue Regeneration, Austria
| | - Susanne Wolbank
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, Vienna 1200, Austria.,Austrian Cluster for Tissue Regeneration, Austria
| | - Thomas Hausner
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center, Donaueschingenstraße 13, Vienna 1200, Austria.,Department of Traumatology, Lorenz Böhler Hospital, Donaueschingenstraße 13, Vienna 1200, Austria.,Department for Trauma Surgery and Sports Traumatology, Paracelsus Medical University, Strubergasse 21, Salzburg 5020, Austria
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5
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Barritault D, Gilbert-Sirieix M, Rice KL, Siñeriz F, Papy-Garcia D, Baudouin C, Desgranges P, Zakine G, Saffar JL, van Neck J. RGTA ® or ReGeneraTing Agents mimic heparan sulfate in regenerative medicine: from concept to curing patients. Glycoconj J 2016; 34:325-338. [PMID: 27924424 PMCID: PMC5487810 DOI: 10.1007/s10719-016-9744-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 10/18/2016] [Accepted: 10/20/2016] [Indexed: 01/12/2023]
Abstract
The importance of extracellular matrix (ECM) integrity in maintaining normal tissue function is highlighted by numerous pathologies and situations of acute and chronic injury associated with dysregulation or destruction of ECM components. Heparan sulfate (HS) is a key component of the ECM, where it fulfils important functions associated with tissue homeostasis. Its degradation following tissue injury disrupts this delicate equilibrium and may impair the wound healing process. ReGeneraTing Agents (RGTA®s) are polysaccharides specifically designed to replace degraded HS in injured tissues. The unique properties of RGTA® (resistance to degradation, binding and protection of ECM structural and signaling proteins, like HS) permit the reconstruction of the ECM, restoring both structural and biochemical functions to this essential substrate, and facilitating the processes of tissue repair and regeneration. Here, we review 25 years of research surrounding this HS mimic, supporting the mode of action, pre-clinical studies and therapeutic efficacy of RGTA® in the clinic, and discuss the potential of RGTA® in new branches of regenerative medicine.
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Affiliation(s)
- Denis Barritault
- OTR3, 4 rue Française, 75001 Paris, France
- Laboratory Cell Growth and Tissue Repair (CRRET), UPEC 4397/ERL CNRS 9215, Université Paris Est Cretéil, Université Paris Est, F-94000 Créteil, France
| | | | | | | | - Dulce Papy-Garcia
- Laboratory Cell Growth and Tissue Repair (CRRET), UPEC 4397/ERL CNRS 9215, Université Paris Est Cretéil, Université Paris Est, F-94000 Créteil, France
| | - Christophe Baudouin
- Institut de la Vision, 17 rue Moreau, 75012 Paris, France
- Universite Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), 55 Avenue de Paris, 78000 Versailles, France
- Centre Hospitalier National d’Opthalmologie des Quinze Vingts, 28 rue de Charenton, 75012 Paris, France
| | - Pascal Desgranges
- Department of Vascular Surgery, Hopital Henri Mondor, Université Paris-Est Créteil, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Gilbert Zakine
- Service de Chirurgie Plastique et Reconstructrice, 33 rue de la Tour, Paris, 75016 France
| | - Jean-Louis Saffar
- EA2496 Laboratoire Pathologies, Imagerie et Biothérapies Oro-Faciales, Faculté de Chirurgie Dentaire, Université Paris Descartes, Sorbonne Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Johan van Neck
- Department of Plastic and Reconstructive Surgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
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Hayek S, Atiyeh B, Zgheib E. Stewart-Bluefarb syndrome: review of the literature and case report of chronic ulcer treatment with heparan sulphate (Cacipliq20®). Int Wound J 2015; 12:169-72. [PMID: 23556996 PMCID: PMC7950802 DOI: 10.1111/iwj.12074] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 02/25/2013] [Accepted: 02/27/2013] [Indexed: 11/29/2022] Open
Abstract
Stewart-Bluefarb syndrome (SBS), also known as acroangiodermatitis or pseudo-Kaposi, is a condition rarely encountered. It involves skin lesions that are clinically similar to Kaposi sarcoma but are histologically different, and are usually secondary to an underlying arteriovenous fistula. Treatment of this disease usually involves the correction of the underlying vascular abnormality, with the mainstay of therapy ranging from compression devices for venous stasis, limited oral medications (dapsone and erythromycin) and local wound care including topical steroids. Different methods of treatment showed varied success but none is ideal. We report a case of a lower extremity ulcer in a 22-year-old male recently diagnosed with SBS successfully treated with heparan sulphate (Cacipliq20®).
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Affiliation(s)
- Shady Hayek
- Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon
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8
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Crosio A, Valdatta L, Cherubino M, Izzo M, Pellegatta I, Pascal D, Geuna S, Tos P. A simple and reliable method to perform biomechanical evaluation of postoperative nerve adhesions. J Neurosci Methods 2014; 233:73-7. [PMID: 24932965 DOI: 10.1016/j.jneumeth.2014.06.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 06/04/2014] [Accepted: 06/06/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Perineural fibrotic adhesions are among the major complications of peripheral nerve surgery. While different experimental models have been used for the pre-clinical testing of anti-adherential strategies, the methods used so far to induce scar tissue appear to be poorly standardized and reproducible. NEW METHOD Thirty adult mice were used. Two methods were tested: the first one is based on burning the perineural muscular bed with a diathermocoagulator, while the second is based on direct scratching of the nerve surface with a cotton swab. After 3 weeks, the fibrotic reaction was assessed by measuring the peak pull out force of the nerve from muscular bed by means of a new tool specifically devised for biomechanical assessment of scar tissue formation. Moreover, histological analysis with specific collagen stain was also carried out. RESULTS Both methods produced fibrotic reaction. Statistical analysis of biomechanical data showed a significant difference between burning and scratching group compared to the control sham operated group. No significant differences were detected between burning and scratching group. Histological analysis showed the presence of perineural scar tissue in both groups, though with a different distribution pattern. COMPARISON WITH OTHER METHODS This protocol is easier to perform. The tool used for biomechanical evaluation is reliable and cheap. CONCLUSIONS Both methods for perineural scar formation are effective and simple. They represent reproducible models for the study of the anti-adherential strategies. Yet, biomechanical testing with the device that we have developed proved to be a reliable and simple method for the quantitative assessment of the degree of perineural adhesion formation.
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Affiliation(s)
- Alessandro Crosio
- Reconstructive Microsurgery Unit, Traumatology Department, CTO Hospital, Via Zuretti 29, 10100 Turin, Italy
| | - Luigi Valdatta
- Plastic Surgery Unit, Department of Biotechnologies and Sciences of Life, University of Insubria/Varese, Via JH Dunant 3, 21100 Varese, Italy
| | - Mario Cherubino
- Plastic Surgery Unit, Department of Biotechnologies and Sciences of Life, University of Insubria/Varese, Via JH Dunant 3, 21100 Varese, Italy
| | - Matteo Izzo
- Plastic Surgery Unit, Department of Biotechnologies and Sciences of Life, University of Insubria/Varese, Via JH Dunant 3, 21100 Varese, Italy
| | - Igor Pellegatta
- Plastic Surgery Unit, Department of Biotechnologies and Sciences of Life, University of Insubria/Varese, Via JH Dunant 3, 21100 Varese, Italy
| | - Davide Pascal
- Human Anatomy Laboratory, Clinical and Biological Sciences Department, University of Turin, AOU San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy
| | - Stefano Geuna
- Human Anatomy Laboratory, Clinical and Biological Sciences Department, University of Turin, AOU San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy.
| | - Pierluigi Tos
- Reconstructive Microsurgery Unit, Traumatology Department, CTO Hospital, Via Zuretti 29, 10100 Turin, Italy
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Hayek S, Dibo S, Baroud J, Ibrahim A, Barritault D. Refractory sickle cell leg ulcer: is heparan sulphate a new hope? Int Wound J 2014; 13:35-8. [PMID: 24618185 DOI: 10.1111/iwj.12217] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 12/16/2013] [Accepted: 12/19/2013] [Indexed: 11/26/2022] Open
Abstract
Patients with sickle cell disease are known to have recurrent lower extremity ulcers that have a high pain score and are resistant to conventional means of wound therapy. This study reports the successful use of synthetic heparan sulphate (Cacipliq20(®) , OTR3, Paris, France) in the treatment of a sickle cell ulcer that had failed to respond to several other means of treatment. Therapeutic success was assessed by complete wound coverage and vast improvement in pain score. This is the first study to report use of heparan sulphate in sickle cell ulcers.
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Affiliation(s)
- Shady Hayek
- Plastic and Reconstructive Surgery, Private Practice, American University of Beirut - Medical Center, Beirut, Lebanon
| | - Saad Dibo
- Plastic and Reconstructive Surgery, Private Practice, American University of Beirut - Medical Center, Beirut, Lebanon
| | - Joe Baroud
- Plastic and Reconstructive Surgery, Private Practice, American University of Beirut - Medical Center, Beirut, Lebanon
| | - Amir Ibrahim
- Plastic and Reconstructive Surgery, Private Practice, American University of Beirut - Medical Center, Beirut, Lebanon
| | - Denis Barritault
- Laboratoire CRRET CNRS, University Paris Est Creteil, Paris, France
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Tong M, Tuk B, Shang P, Hekking IM, Fijneman EMG, Guijt M, Hovius SER, van Neck JW. Diabetes-impaired wound healing is improved by matrix therapy with heparan sulfate glycosaminoglycan mimetic OTR4120 in rats. Diabetes 2012; 61:2633-41. [PMID: 22721969 PMCID: PMC3447910 DOI: 10.2337/db11-1329] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Wound healing in diabetes is frequently impaired, and its treatment remains a challenge. We tested a therapeutic strategy of potentiating intrinsic tissue regeneration by restoring the wound cellular environment using a heparan sulfate glycosaminoglycan mimetic, OTR4120. The effect of OTR4120 on healing of diabetic ulcers was investigated. Experimental diabetes was induced by intraperitoneal injection of streptozotocin. Seven weeks after induction of diabetes, rats were ulcerated by clamping a pair of magnet disks on the dorsal skin for 16 h. After magnet removal, OTR4120 was administered via an intramuscular injection weekly for up to 4 weeks. To examine the effect of OTR4120 treatment on wound heal-ing, the degree of ulceration, inflammation, angiogenesis, and collagen synthesis were evaluated. We found that OTR4120 treatment significantly reduced the degree of ulceration and the time of healing. These effects were associated with reduced neutrophil infiltration and macrophage accumulation and enhanced angiogenesis. OTR4120 treatment also increased the collagen content with an increase of collagen type I biosynthesis and reduction of collagen type III biosynthesis. Moreover, restoration of the ulcer biomechanical strength was significantly enhanced after OTR4120 treatment. This study shows that matrix therapy with OTR4120 improves diabetes-impaired wound healing.
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Affiliation(s)
- Miao Tong
- Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
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Martínez de Albornoz P, Delgado PJ, Forriol F, Maffulli N. Non-surgical therapies for peripheral nerve injury. Br Med Bull 2011; 100:73-100. [PMID: 21429947 DOI: 10.1093/bmb/ldr005] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Non-surgical approaches have been developed to enhance nerve recovery, which are complementary to surgery and are an adjunct to the reinnervation process. SOURCES OF DATA A search of PubMed, Medline, CINAHL, DH data and Embase databases was performed using the keywords 'peripheral nerve injury' and 'treatment'. AREAS OF CONTROVERSY Most of the conservative therapies are focused to control neuropathic pain after nerve tissue damage. Only physical therapy modalities have been studied in humans and their effectiveness is not proved. GROWING POINTS Many modalities have been experimented with to promote nerve healing and restore function in animal models and in vitro studies. Despite this, none have been actually translated into clinical practice. AREAS TIMELY FOR DEVELOPING RESEARCH The hypotheses proved in animals and in vitro should be translated to human clinical practice.
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Affiliation(s)
- Pilar Martínez de Albornoz
- Department of Trauma and Orthopaedic Surgery, FREMAP Hospital, Ctra de Pozuelo 61, 28220 Majadahonda, Madrid, Spain
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12
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Tong M, Tuk B, Hekking IM, Vermeij M, Barritault D, van Neck JW. Stimulated neovascularization, inflammation resolution and collagen maturation in healing rat cutaneous wounds by a heparan sulfate glycosaminoglycan mimetic, OTR4120. Wound Repair Regen 2010; 17:840-52. [PMID: 19903305 DOI: 10.1111/j.1524-475x.2009.00548.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Heparan sulfate glycosaminoglycans (HS-GAGs) are not only the structural elements of tissue architecture but also regulate the bioavailability and transduction pathways of heparan sulfate-bound polypeptides released by cells or the extracellular matrix. Heparan sulfate-bound polypeptides include inflammatory mediators, chemokines, angiogenic factors, morphogens, and growth-promoting factors that induce cell migration, proliferation, and differentiation in wound healing. OTR4120, a polymer engineered to mimic the properties of HS-GAGs, is used to replace the natural HS-GAGs that are degraded during wound repair, and enhance the tissue regeneration by preserving the cellular microenvironment and the endogenous signals needed for tissue regeneration. We previously demonstrated that OTR4120 treatment had a long-term effect on increasing breaking strength and vasodilation in healing rat full-thickness excisional wounds. The present study investigates the underlying mechanisms of the effects of OTR4120 treatment in improving the quality of cutaneous wound repair. We found that OTR4120 treatment stimulated inflammation resolution and increased neovascularization. OTR4120 treatment also promoted epidermal migration and proliferation during reepithelialization. Moreover, the granulation tissue formation and collagen maturation were improved in OTR4120-treated wounds. Three months after wounding, the effects of OTR4120 treatment on vascularization and inflammation resolution were normalized, except for an improved neodermis. We conclude that OTR4120 is a potential matrix therapeutic agent that ensures the quality of normal cutaneous wound repair and may restore impaired wound healing characterized by deficient angiogenesis and prolonged inflammation.
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Affiliation(s)
- Miao Tong
- Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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13
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Scar less: a review of methods of scar reduction at sites of peripheral nerve repair. ACTA ACUST UNITED AC 2010; 109:357-66. [DOI: 10.1016/j.tripleo.2009.06.030] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Revised: 06/30/2009] [Accepted: 06/30/2009] [Indexed: 12/30/2022]
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14
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Albayrak BS, Ismailoglu O, Ilbay K, Yaka U, Tanriover G, Gorgulu A, Demir N. Doxorubicin for prevention of epineurial fibrosis in a rat sciatic nerve model: outcome based on gross postsurgical, histopathological, and ultrastructural findings. J Neurosurg Spine 2010; 12:327-33. [DOI: 10.3171/2009.9.spine09407] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
Epineural fibrosis may complicate peripheral nerve surgeries and currently is considered as one of the main factors responsible for failed surgeries. The authors investigated the postoperative antiscarring effects of topically applied doxorubicin (DXR) on rat sciatic nerves.
Methods
The sciatic nerves were dissected from the surrounding tissue and exposed bilaterally in 20 Wistar albino adult male rats. Abrasion trauma was produced on the exposed surface of the biceps femoris muscle in the vicinity of the sciatic nerves and their main branches in all animals. In the DXR Group, cottonoid pads soaked with DXR (0.5 mg/ml) were placed around the nerves for 5 minutes, whereas cotton pads soaked with saline (0.9% NaCl) were applied to nerves of animals in the Control Group for the same duration. Twelve weeks after the procedure, all of the rats were killed and the sciatic nerves were examined. Epineural adhesions were evaluated histopathologically and ultrastructurally. Additionally, quantitative histological parameters, the scar tissue formation index and the scar density, were calculated in histological evaluation.
Results
Gross postsurgical evaluation as well as histopathological and electron microscopic examination of involved nerve segments showed significantly less epineurial adhesions in the DXR Group than in the Control Group. Quantitative analysis of the epineurium revealed a statistically significant reduction in the density and amount of epineural scarring in specimens from the DXR Group than in those from the Control Group.
Conlusions
The results of gross postsurgical anatomical evaluation and histopathological and ultrastructural studies suggested that topical application of DXR effectively reduced epineural scar formation on rat sciatic nerves. These promising findings merit further experimental and clinical studies to determine the efficacy and safe applicability of DXR in human subjects.
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Affiliation(s)
- Baki S. Albayrak
- 1Department of Neurosurgery, Suleyman Demirel University Hospital, Cunur, Isparta
| | - Ozgur Ismailoglu
- 1Department of Neurosurgery, Suleyman Demirel University Hospital, Cunur, Isparta
| | - Konuralp Ilbay
- 2Department of Neurosurgery, Kocaeli University Hospital, Kocaeli
| | - Umut Yaka
- 3Department of Neurosurgery, Istanbul University Hospital, Istanbul; and
| | - Gamze Tanriover
- 4Department of Histology and Embryology, Akdeniz University Hospital, Antalya, Turkey
| | - Askin Gorgulu
- 1Department of Neurosurgery, Suleyman Demirel University Hospital, Cunur, Isparta
| | - Necdet Demir
- 4Department of Histology and Embryology, Akdeniz University Hospital, Antalya, Turkey
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