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Cheng N, Jeschke MG, Sheikholeslam M, Datu AK, Oh HH, Amini-Nik S. Promotion of dermal regeneration using pullulan/gelatin porous skin substitute. J Tissue Eng Regen Med 2019; 13:1965-1977. [PMID: 31350941 PMCID: PMC7020691 DOI: 10.1002/term.2946] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 07/11/2019] [Accepted: 07/15/2019] [Indexed: 12/18/2022]
Abstract
Tissue-engineered dermal substitutes represent a promising approach to improve wound healing and provide more sufficient regeneration, compared with current clinical standards on care of large wounds, early excision, and grafting of autografts. However, inadequate regenerative capacity, impaired regeneration/degradation profile, and high cost of current commercial tissue-engineered dermal regeneration templates hinder their utilization, and the development of an efficient and cost-effective tissue-engineered dermal substitute remains a challenge. Inspired from our previously reported data on a pullulan/gelatin scaffold, here we present a new generation of a porous pullulan/gelatin scaffold (PG2) served as a dermal substitute with enhanced chemical and structural characteristics. PG2 shows excellent biocompatibility (viability, migration, and proliferation), assessed by in vitro incorporation of human dermal fibroblasts in comparison with the Integra® dermal regeneration template (Control). When applied on a mouse full-thickness excisional wound, PG2 shows rapid scaffold degradation, more granulation tissue, more collagen deposition, and more cellularity in comparison with Control at 20 days post surgery. The faster degradation is likely due to the enhanced recruitment of inflammatory macrophages to the scaffold from the wound bed, and that leads to earlier maturation of granulation tissue with less myofibroblastic cells. Collectively, our data reveal PG2's characteristics as an applicable dermal substitute with excellent dermal regeneration, which may attenuate scar formation.
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Affiliation(s)
- Nan Cheng
- Sunnybrook Research Institute, University of Toronto, Toronto, ON M4N 3M5, Canada
| | - Marc G Jeschke
- Sunnybrook Research Institute, University of Toronto, Toronto, ON M4N 3M5, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
- Ross-Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
| | | | - Andrea-Kaye Datu
- Sunnybrook Research Institute, University of Toronto, Toronto, ON M4N 3M5, Canada
| | - Hwan Hee Oh
- Sunnybrook Research Institute, University of Toronto, Toronto, ON M4N 3M5, Canada
| | - Saeid Amini-Nik
- Sunnybrook Research Institute, University of Toronto, Toronto, ON M4N 3M5, Canada
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
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Feng Y, Sun ZL, Liu SY, Wu JJ, Zhao BH, Lv GZ, Du Y, Yu S, Yang ML, Yuan FL, Zhou XJ. Direct and Indirect Roles of Macrophages in Hypertrophic Scar Formation. Front Physiol 2019; 10:1101. [PMID: 31555142 PMCID: PMC6724447 DOI: 10.3389/fphys.2019.01101] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 08/08/2019] [Indexed: 12/12/2022] Open
Abstract
Hypertrophic scars are pathological scars that result from abnormal responses to trauma, and could cause serious functional and cosmetic disability. To date, no optimal treatment method has been established. A variety of cell types are involved in hypertrophic scar formation after wound healing, but the underlying molecular mechanisms and cellular origins of hypertrophic scars are not fully understood. Macrophages are major effector cells in the immune response after tissue injury that orchestrates the process of wound healing. Depending on the local microenvironment, macrophages undergo marked phenotypic and functional changes at different stages during scar pathogenesis. This review intends to summarize the direct and indirect roles of macrophages during hypertrophic scar formation. The in vivo depletion of macrophages or blocking their signaling reduces scar formation in experimental models, thereby establishing macrophages as positive regulatory cells in the skin scar formation. In the future, a significant amount of attention should be given to molecular and cellular mechanisms that cause the phenotypic switch of wound macrophages, which may provide novel therapeutic targets for hypertrophic scars.
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Affiliation(s)
- Yi Feng
- Department of Burns and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, China.,Department of Pharmacy, Medical College, Yangzhou University, Yangzhou, China
| | - Zi-Li Sun
- Department of Burns and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, China.,Wuxi Clinical Medicine School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Wuxi, China
| | - Si-Yu Liu
- Department of Burns and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, China
| | - Jun-Jie Wu
- Department of Burns and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, China
| | - Bin-Hong Zhao
- Department of Burns and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, China.,Wuxi Clinical Medicine School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Wuxi, China
| | - Guo-Zhong Lv
- Department of Burns and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, China.,Wuxi Clinical Medicine School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Wuxi, China
| | - Yong Du
- Department of Burns and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, China
| | - Shun Yu
- Department of Burns and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, China
| | - Ming-Lie Yang
- Department of Burns and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, China.,Wuxi Clinical Medicine School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Wuxi, China
| | - Feng-Lai Yuan
- Department of Burns and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, China
| | - Xiao-Jin Zhou
- Department of Burns and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, China
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Sadiq A, Menchetti I, Shah A, Jeschke MG, Belo C, Carlos-Alcalde W, Hayat MQ, Amini-Nik S. 5-HT1A Receptor Function Makes Wound Healing a Happier Process. Front Pharmacol 2018; 9:1406. [PMID: 30618734 PMCID: PMC6297675 DOI: 10.3389/fphar.2018.01406] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/16/2018] [Indexed: 12/25/2022] Open
Abstract
Skin wound healing is a multistage phenomenon that is regulated by cell–cell interplay and various factors. Endogenous serotonin is an important neurotransmitter and cytokine. Its interaction with the serotonin 1A receptor (5-HTR1A) delivers downstream cellular effects. The role of serotonin (5-hydroxytryptamine, 5-HT) and the 5-HT1A receptor has been established in the regeneration of tissues such as the liver and spinal motor neurons, prompting the investigation of the role of 5-HT1A receptor in skin healing. This study assessed the role of 5-HT1A receptor in excisional wound healing by employing an excisional punch biopsy model on 5-Ht1a receptor knockout mice. Post-harvest analysis revealed 5-Ht1a receptor knockout mice showed impaired skin healing, accompanied by a greater number of F4/80 macrophages, which prolongs the inflammatory phase of wound healing. To further unravel this phenomenon, we employed the 5-HT1A receptor agonist [(R)-(+)-8-Hydroxy-DPAT hydrobromide] as a topical cream treatment in an excisional punch biopsy model. The 5-HT1A receptor agonist treated group showed a smaller wound area, scar size, and improved neovascularization, which contributed to improve healing outcomes as compared to the control. Collectively, these findings revealed that serotonin and 5-HT1A receptor play an important role during the healing process. These findings may open new lines of investigation for the potential treatment alternatives to improve skin healing with minimal scarring.
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Affiliation(s)
- Alia Sadiq
- Sunnybrook Research Institute, Toronto, ON, Canada.,Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology, Islamabad, Pakistan.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Ahmed Shah
- Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Marc G Jeschke
- Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.,Division of Plastic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.,Department of Immunology, University of Toronto, Toronto, ON, Canada.,Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Wendolyn Carlos-Alcalde
- Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Muhammad Qasim Hayat
- Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology, Islamabad, Pakistan
| | - Saeid Amini-Nik
- Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.,Division of Plastic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
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Amini-Nik S, Dolp R, Eylert G, Datu AK, Parousis A, Blakeley C, Jeschke MG. Stem cells derived from burned skin - The future of burn care. EBioMedicine 2018; 37:509-520. [PMID: 30409728 PMCID: PMC6284415 DOI: 10.1016/j.ebiom.2018.10.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Thermal injuries affect millions of adults and children worldwide and are associated with high morbidity and mortality. The key determinant for the survival of burns is rapid wound healing. Large wounds exceed intrinsic wound-healing capacities, and the currently available coverage materials are insufficient due to lack of cellularity, availability or immunological rejection. METHODS Using the surgically debrided tissue, we isolated viable cells from burned skin. The isolated cells cultured in tissue culture dishes and characterized. FINDINGS We report here that debrided burned skin, which is routinely excised from patients and otherwise considered medical waste and unconsciously discarded, contains viable, undamaged cells which show characteristics of mesenchymal skin stem cells. Those cells can be extracted, characterized, expanded, and incorporated into created epidermal-dermal substitutes to promote wound healing in immune-compromised mice and Yorkshire pigs without adverse side effects. INTERPRETATION These findings are of paramount importance and provide an ideal cell source for autologous skin regeneration. Furthermore, this study highlights that skin contains progenitor cells resistant to thermal stress. FUND: Canadian Institutes of Health Research # 123336. CFI Leader's Opportunity Fund: Project # 25407 National Institutes of Health 2R01GM087285-05A1. EMHSeed: Fund: 500463, A generous donation from Toronto Hydro. Integra© Life Science Company provided the meshed bilayer Integra© for porcine experiments.
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Affiliation(s)
- Saeid Amini-Nik
- Sunnybrook Research Institute, Canada; Department of Laboratory Medicine and Pathobiology (LMP), University of Toronto, Canada; Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Canada.
| | - Reinhard Dolp
- Sunnybrook Research Institute, Canada; Institute of Medical Science, University of Toronto, Canada
| | - Gertraud Eylert
- Sunnybrook Research Institute, Canada; Institute of Medical Science, University of Toronto, Canada
| | | | | | | | - Marc G Jeschke
- Sunnybrook Research Institute, Canada; Institute of Medical Science, University of Toronto, Canada; Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Canada; Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Canada.
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