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He M, Li L, Liu Y, Wu Z, Xu Y, Xiao L, Luo K, Xu X. Decellularized extracellular matrix coupled with polycaprolactone/laponite to construct a biomimetic barrier membrane for bone defect repair. Int J Biol Macromol 2024; 276:133775. [PMID: 38986979 DOI: 10.1016/j.ijbiomac.2024.133775] [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: 12/26/2023] [Revised: 06/14/2024] [Accepted: 07/07/2024] [Indexed: 07/12/2024]
Abstract
Barrier membranes play a prominent role in guided bone regeneration (GBR), and polycaprolactone (PCL) is an attractive biomaterial for the fabrication of barrier membranes. However, these nanofiber membranes (NFMs) require modification to improve their biological activity. PCL-NFMs incorporating with laponite (LAP) achieve biofunctional modification. Decellularized extracellular matrix (dECM) could modulate cell behaviour. The present study combined dECM with PCL/LAP-NFMs to generate a promising strategy for bone tissue regeneration. Bone marrow mesenchymal stem cells (BMSCs) were cultured on NFMs and deposited with an abundant extracellular matrix (ECM), which was subsequently decellularized to obtain dECM-modified PCL/LAP-NFMs (PCL/LAP-dECM-NFMs). The biological functions of the membranes were evaluated by reseeding MC3T3-E1 cells in vitro and transplanting them into rat calvarial defects in vivo. These results indicate that PCL/LAP-dECM-NFMs were successfully constructed. The presence of dECM slightly improved the mechanical properties of the NFMs, which exhibited a Young's modulus of 0.269 MPa, ultimate tensile strength of 2.04 MPa and elongation at break of 51.62 %. In vitro, the PCL/LAP-dECM-NFMs had favourable cytocompatibility, and the enhanced hydrophilicity was conducive to cell adhesion, proliferation, and osteoblast differentiation. PCL/LAP-dECM-NFMs exhibited an excellent bone repair capacity in vivo. Overall, dECM-modified PCL/LAP-NFMs should be promising biomimetic barrier membranes for GBR.
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Affiliation(s)
- Mengjiao He
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Centre of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China; Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China
| | - Lisheng Li
- Shengli Clinical Medical College of Fujian Medical University, Department of Emergency, Fujian Provincial Hospital, Fuzhou 350001, China; Fujian Provincial Key Laboratory of Emergency Medicine, Fujian Provincial Institute of Emergency Medicine, Fujian Emergency Medical Centre, Fuzhou 350001, China
| | - Yijuan Liu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Centre of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China; Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China
| | - Zekai Wu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Centre of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China; Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China
| | - Yanmei Xu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Centre of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China; Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China
| | - Long Xiao
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Centre of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China; Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China
| | - Kai Luo
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Centre of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China; Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China.
| | - Xiongcheng Xu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Centre of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China; Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China.
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Rattanapinyopituk K, Chaweewannakorn C, Tangjit N, Dechkunakorn S, Anuwongnukroh N, Sritanaudomchai H. Osteogenic potency of dental stem cell-composite scaffolds in an animal cleft palate model. Heliyon 2024; 10:e36036. [PMID: 39224373 PMCID: PMC11367540 DOI: 10.1016/j.heliyon.2024.e36036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 08/07/2024] [Accepted: 08/08/2024] [Indexed: 09/04/2024] Open
Abstract
Objective To evaluate the osteogenic potency of stem cells isolated from human exfoliated deciduous teeth (SHED) in polycaprolactone with gelatin surface modification (PCL-GE) and poly (lactic-co-glycolic acid)-bioactive glass composite (PLGA-bioactive glass (BG)) scaffolds after implantation in a rat cleft model. Methods Cleft palate-like lesions were induced in Sprague-Dawley rats by extracting the right maxillary first molars and drilling the intact alveolar bone. Rats were then divided into five groups: Control, PCL-GE, PCL-GE-SHED, PLGA-BG, and PLGA-BG-SHED, and received corresponding composite scaffolds with/without SHED at the extraction site. Tissue samples were collected at 2, 3, and 6 months post-implantation (4 rats per group). Gross and histological analyses were conducted to assess osteoid or bone formation. Immunohistochemistry for osteocalcin and human mitochondria was performed to evaluate bone components and human stem cell viability in the tissue. Results Bone tissue formation was observed in the PCL-GE and PLGA-BG groups compared to the control, where no bone formation occurred. PLGA-BG scaffolds demonstrated greater bone regeneration potential than PCL-GE over 2-6 months. Additionally, scaffolds with SHED accelerated bone formation compared to scaffolds alone. Osteocalcin expression was detected in all rats, and positive immunoreactivity for human mitochondria was observed in the regenerated bone tissue with PCL-GE-SHED and PLGA-BG-SHED. Conclusion PCL-GE and PLGA-BG composite scaffolds effectively repaired and regenerated bone tissue in rat cleft palate defects. Moreover, scaffolds supplemented with SHED exhibited enhanced osteogenic potency. Clinical significance PCL-GE and PLGA-BG scaffolds, augmented with SHED, emerge as promising biomaterial candidates for addressing cleft repair and advancing bone tissue engineering endeavors.
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Affiliation(s)
- Kasem Rattanapinyopituk
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | | | - Nathaphon Tangjit
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Surachai Dechkunakorn
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Niwat Anuwongnukroh
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Kelly SS, Suarez CA, Mirsky NA, Slavin BV, Brochu B, Vivekanand Nayak V, El Shatanofy M, Witek L, Thaller SR, Coelho PG. Application of 3D Printing in Cleft Lip and Palate Repair. J Craniofac Surg 2024:00001665-990000000-01572. [PMID: 38738906 DOI: 10.1097/scs.0000000000010294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/03/2024] [Indexed: 05/14/2024] Open
Abstract
This manuscript reviews the transformative impact of 3-dimensional (3D) printing technologies in the treatment and management of cleft lip and palate (CLP), highlighting its application across presurgical planning, surgical training, implantable scaffolds, and postoperative care. By integrating patient-specific data through computer-aided design and manufacturing, 3D printing offers tailored solutions that improve surgical outcomes, reduce operation times, and enhance patient care. The review synthesizes current research findings, technical advancements, and clinical applications, illustrating the potential of 3D printing to revolutionize CLP treatment. Further, it discusses the future directions of combining 3D printing with other innovative technologies like artificial intelligence, 4D printing, and in situ bioprinting for more comprehensive care strategies. This paper underscores the necessity for multidisciplinary collaboration and further research to overcome existing challenges and fully utilize the capabilities of 3D printing in CLP repair.
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Affiliation(s)
- Sophie S Kelly
- Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL
| | | | | | | | | | | | - Muhammad El Shatanofy
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL
| | - Lukasz Witek
- Biomaterials Division, NYU Dentistry
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, Brooklyn, NY
| | - Seth R Thaller
- DeWitt Daughtry Family, Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine
- DeWitt Daughtry Family, Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL
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Sharif H, Ziaei H, Rezaei N. Stem Cell-Based Regenerative Approaches for the Treatment of Cleft Lip and Palate: A Comprehensive Review. Stem Cell Rev Rep 2024; 20:637-655. [PMID: 38270744 DOI: 10.1007/s12015-024-10676-9] [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] [Accepted: 01/08/2024] [Indexed: 01/26/2024]
Abstract
Cleft lip and/or palate (CLP) is a prevalent congenital craniofacial abnormality that can lead to difficulties in eating, speaking, hearing, and psychological distress. The traditional approach for treating CLP involves bone graft surgery, which has limitations, post-surgical complications, and donor site morbidity. However, regenerative medicine has emerged as a promising alternative, employing a combination of stem cells, growth factors, and scaffolds to promote tissue regeneration. This review aims to provide a comprehensive overview of stem cell-based regenerative approaches in the management of CLP. A thorough search was conducted in the Medline/PubMed and Scopus databases, including cohort studies, randomized controlled trials, case series, case controls, case reports, and animal studies. The identified studies were categorized into two main groups: clinical studies involving human subjects and in vivo studies using animal models. While there are only a limited number of studies investigating the combined use of stem cells and scaffolds for CLP treatment, they have shown promising results. Various types of stem cells have been utilized in conjunction with scaffolds. Importantly, regenerative methods have been successfully applied to patients across a broad range of age groups. The collective findings derived from the reviewed studies consistently support the notion that regenerative medicine holds potential advantages over conventional bone grafting and represents a promising therapeutic option for CLP. However, future well-designed clinical trials, encompassing diverse combinations of stem cells and scaffolds, are warranted to establish the clinical efficacy of these interventions with a larger number of patients.
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Affiliation(s)
- Helia Sharif
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Dental Society, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Heliya Ziaei
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, US
| | - Nima Rezaei
- Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
- Children's Medical Center Hospital, Dr. Qarib St, Keshavarz Blvd, Tehran, 14194, Iran.
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Zhou X, Xie D, He J, Jiang Y, Fang J, Wang H. Perinatal deaths from birth defects in Hunan Province, China, 2010-2020. BMC Pregnancy Childbirth 2023; 23:790. [PMID: 37957594 PMCID: PMC10644441 DOI: 10.1186/s12884-023-06092-5] [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: 07/21/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVE To describe the perinatal mortality rate (PMR) of birth defects and to define the relationship between birth defects (including a broad range of specific defects) and a broad range of factors. METHODS Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2010-2020. The prevalence rate (PR) of birth defects is the number of birth defects per 1000 fetuses (births and deaths at 28 weeks of gestation and beyond). PMR is the number of perinatal deaths per 100 fetuses. PR and PMR with 95% confidence intervals (CI) were calculated using the log-binomial method. Chi-square trend tests (χ2trend) were used to determine trends in PR and PMR by year, maternal age, income, education level, parity, and gestational age of termination. Crude odds ratios (ORs) were calculated to examine the association of each maternal characteristic with perinatal deaths attributable to birth defects. RESULTS Our study included 1,619,376 fetuses, a total of 30,596 birth defects, and 18,212 perinatal deaths (including 16,561 stillbirths and 1651 early neonatal deaths) were identified. The PR of birth defects was 18.89‰ (95%CI: 18.68-19.11), and the total PMR was 1.12%(95%CI: 1.11-1.14). Birth defects accounted for 42.0% (7657 cases) of perinatal deaths, and the PMR of birth defects was 25.03%. From 2010 to 2020, the PMR of birth defects decreased from 37.03% to 2010 to 21.00% in 2020, showing a downward trend (χ2trend = 373.65, P < 0.01). Congenital heart defects caused the most perinatal deaths (2264 cases); the PMR was 23.15%. PMR is highest for encephalocele (86.79%). Birth defects accounted for 45.01% (7454 cases) of stillbirths, and 96.16% (7168 cases) were selective termination of pregnancy. Perinatal deaths attributable to birth defects were more common in rural than urban areas (31.65% vs. 18.60%, OR = 2.03, 95% CI: 1.92-2.14) and in females than males (27.92% vs. 22.68%, OR = 1.32, 95% CI: 1.25-1.39). PMR of birth defects showed downward trends with rising maternal age (χ2trend = 200.86, P < 0.01), income (χ2trend = 54.39, P < 0.01), maternal education level (χ2trend = 405.66, P < 0.01), parity (χ2trend = 85.11, P < 0.01) and gestational age of termination (χ2trend = 15297.28, P < 0.01). CONCLUSION In summary, birth defects are an important cause of perinatal deaths. Rural areas, female fetuses, mothers with low maternal age, low income, low education level, low parity, and low gestational age of termination were risk factors for perinatal deaths attributable to birth defects. Future studies should examine the mechanisms. Our study is helpful for intervention programs to reduce the PMR of birth defects.
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Affiliation(s)
- Xu Zhou
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China.
| | - Donghua Xie
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China
| | - Jian He
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China
| | - Yurong Jiang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China.
| | - Junqun Fang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China.
| | - Hua Wang
- The Hunan Children's Hospital, Changsha, Hunan Province, China.
- National Health Commission Key Laboratory of Birth Defects Research, Prevention and Treatment, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China.
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Alavi SE, Gholami M, Shahmabadi HE, Reher P. Resorbable GBR Scaffolds in Oral and Maxillofacial Tissue Engineering: Design, Fabrication, and Applications. J Clin Med 2023; 12:6962. [PMID: 38002577 PMCID: PMC10672220 DOI: 10.3390/jcm12226962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/02/2023] [Accepted: 11/04/2023] [Indexed: 11/26/2023] Open
Abstract
Guided bone regeneration (GBR) is a promising technique in bone tissue engineering that aims to replace lost or injured bone using resorbable scaffolds. The promotion of osteoblast adhesion, migration, and proliferation is greatly aided by GBR materials, and surface changes are critical in imitating the natural bone structure to improve cellular responses. Moreover, the interactions between bioresponsive scaffolds, growth factors (GFs), immune cells, and stromal progenitor cells are essential in promoting bone regeneration. This literature review comprehensively discusses various aspects of resorbable scaffolds in bone tissue engineering, encompassing scaffold design, materials, fabrication techniques, and advanced manufacturing methods, including three-dimensional printing. In addition, this review explores surface modifications to replicate native bone structures and their impact on cellular responses. Moreover, the mechanisms of bone regeneration are described, providing information on how immune cells, GFs, and bioresponsive scaffolds orchestrate tissue healing. Practical applications in clinical settings are presented to underscore the importance of these principles in promoting tissue integration, healing, and regeneration. Furthermore, this literature review delves into emerging areas of metamaterials and artificial intelligence applications in tissue engineering and regenerative medicine. These interdisciplinary approaches hold immense promise for furthering bone tissue engineering and improving therapeutic outcomes, leading to enhanced patient well-being. The potential of combining material science, advanced manufacturing, and cellular biology is showcased as a pathway to advance bone tissue engineering, addressing a variety of clinical needs and challenges. By providing this comprehensive narrative, a detailed, up-to-date account of resorbable scaffolds' role in bone tissue engineering and their transformative potential is offered.
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Affiliation(s)
- Seyed Ebrahim Alavi
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4215, Australia; (S.E.A.); (M.G.)
| | - Max Gholami
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4215, Australia; (S.E.A.); (M.G.)
| | - Hasan Ebrahimi Shahmabadi
- Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan 7717933777, Iran;
| | - Peter Reher
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4215, Australia; (S.E.A.); (M.G.)
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Destrez A, Colin E, Testelin S, Devauchelle B, Dakpé S, Naudot M. Evaluation of a Granular Bone Substitute for Bone Regeneration Using an Optimized In Vivo Alveolar Cleft Model. Bioengineering (Basel) 2023; 10:1035. [PMID: 37760137 PMCID: PMC10525109 DOI: 10.3390/bioengineering10091035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Alveolar cleft is a common congenital deformity that requires surgical intervention, notably using autologous bone grafts in young children. Bone substitutes, in combination with mesenchymal stem cells (MSCs), have shown promise in the repair of these defects. This study aimed to evaluate the regenerative capabilities of a granular bone substitute using an optimized alveolar cleft model. Thirty-six rats underwent a surgical procedure for the creation of a defect filled with a fragment of silicone. After 5 weeks, the silicone was removed and the biomaterial, with or without Wharton's jelly MSCs, was put into the defect, except for the control group. The rats underwent μCT scans immediately and after 4 and 8 weeks. Analyses showed a statistically significant improvement in bone regeneration in the two treatment groups compared with control at weeks 4 and 8, both for bone volume (94.64% ± 10.71% and 91.33% ± 13.30%, vs. 76.09% ± 7.99%) and mineral density (96.13% ± 24.19% and 93.01% ± 27.04%, vs. 51.64% ± 16.51%), but without having fully healed. This study validates our optimized alveolar cleft model in rats, but further work is needed to allow for the use of this granular bone substitute in the treatment of bone defects.
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Affiliation(s)
- Alban Destrez
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France; (A.D.); (S.T.); (B.D.); (S.D.); (M.N.)
- Maxillofacial Surgery Department, Amiens University Hospital, Rond-point du Pr Christian Cabrol, 80054 Amiens, France
| | - Emilien Colin
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France; (A.D.); (S.T.); (B.D.); (S.D.); (M.N.)
- Maxillofacial Surgery Department, Amiens University Hospital, Rond-point du Pr Christian Cabrol, 80054 Amiens, France
- Institut Faire Faces, Rond-point du Pr Christian Cabrol, 80054 Amiens, France
| | - Sylvie Testelin
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France; (A.D.); (S.T.); (B.D.); (S.D.); (M.N.)
- Maxillofacial Surgery Department, Amiens University Hospital, Rond-point du Pr Christian Cabrol, 80054 Amiens, France
- Institut Faire Faces, Rond-point du Pr Christian Cabrol, 80054 Amiens, France
| | - Bernard Devauchelle
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France; (A.D.); (S.T.); (B.D.); (S.D.); (M.N.)
- Maxillofacial Surgery Department, Amiens University Hospital, Rond-point du Pr Christian Cabrol, 80054 Amiens, France
- Institut Faire Faces, Rond-point du Pr Christian Cabrol, 80054 Amiens, France
| | - Stéphanie Dakpé
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France; (A.D.); (S.T.); (B.D.); (S.D.); (M.N.)
- Maxillofacial Surgery Department, Amiens University Hospital, Rond-point du Pr Christian Cabrol, 80054 Amiens, France
- Institut Faire Faces, Rond-point du Pr Christian Cabrol, 80054 Amiens, France
| | - Marie Naudot
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France; (A.D.); (S.T.); (B.D.); (S.D.); (M.N.)
- Institut Faire Faces, Rond-point du Pr Christian Cabrol, 80054 Amiens, France
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Wang Z, Knight R, Stephens P, Ongkosuwito EM, Wagener FADTG, Von den Hoff JW. Stem cells and extracellular vesicles to improve preclinical orofacial soft tissue healing. Stem Cell Res Ther 2023; 14:203. [PMID: 37580820 PMCID: PMC10426149 DOI: 10.1186/s13287-023-03423-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 07/20/2023] [Indexed: 08/16/2023] Open
Abstract
Orofacial soft tissue wounds caused by surgery for congenital defects, trauma, or disease frequently occur leading to complications affecting patients' quality of life. Scarring and fibrosis prevent proper skin, mucosa and muscle regeneration during wound repair. This may hamper maxillofacial growth and speech development. To promote the regeneration of injured orofacial soft tissue and attenuate scarring and fibrosis, intraoral and extraoral stem cells have been studied for their properties of facilitating maintenance and repair processes. In addition, the administration of stem cell-derived extracellular vesicles (EVs) may prevent fibrosis and promote the regeneration of orofacial soft tissues. Applying stem cells and EVs to treat orofacial defects forms a challenging but promising strategy to optimize treatment. This review provides an overview of the putative pitfalls, promises and the future of stem cells and EV therapy, focused on orofacial soft tissue regeneration.
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Affiliation(s)
- Zhihao Wang
- Department of Dentistry, Orthodontics and Craniofacial Biology, Research Institute for Medical Innovation, Radboud University Medical Centre, 6525EX, Nijmegen, The Netherlands
| | - Rob Knight
- Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Phil Stephens
- Advanced Therapeutics Group, School of Dentistry, Cardiff University, Cardiff, Wales, UK
| | - E M Ongkosuwito
- Department of Dentistry, Orthodontics and Craniofacial Biology, Research Institute for Medical Innovation, Radboud University Medical Centre, 6525EX, Nijmegen, The Netherlands
| | - Frank A D T G Wagener
- Department of Dentistry, Orthodontics and Craniofacial Biology, Research Institute for Medical Innovation, Radboud University Medical Centre, 6525EX, Nijmegen, The Netherlands
| | - Johannes W Von den Hoff
- Department of Dentistry, Orthodontics and Craniofacial Biology, Research Institute for Medical Innovation, Radboud University Medical Centre, 6525EX, Nijmegen, The Netherlands.
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Zhou X, Jiang Y, Fang J, Wang H, Xie D, Kuang H, Li T, Liu Q, He J. Incidence of cleft lip and palate, and epidemiology of perinatal deaths related to cleft lip and palate in Hunan Province, China, 2016-2020. Sci Rep 2023; 13:10304. [PMID: 37365256 DOI: 10.1038/s41598-023-37436-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 06/21/2023] [Indexed: 06/28/2023] Open
Abstract
This study aimed to analyze the epidemiological characteristics of cleft lip and/or palate (CL/P) and CL/P-related perinatal deaths, provide some information for intervention programs to reduce the incidence of CL/P and provide clues for future researchers. Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2016-2020. Incidences of CL/P [number of cases per 1000 fetuses (births and deaths at 28 weeks of gestation and beyond)] with 95% confidence intervals (CI) were calculated by residence, gender, maternal age, year, and major types [cleft lip only (CL), cleft palate only (CP), and cleft lip with palate (CLP)]. Crude odds ratios (ORs) were calculated to examine the association of each maternal characteristic with CL/P. Pearson chi-square tests (χ2) were used to examine the association of each maternal characteristic with CL/P-related perinatal deaths. A total of 847,755 fetuses were registered, and 14,459 birth defects were identified, including 685 CL/P (accounted for 4.74% of all birth defects). CL, CP, and CLP accounted for 24.67% (169 cases), 36.79% (252 cases), and 38.54% (264 cases) of all CL/P, respectively. The incidence of CL/P was 0.81‰ (95%CI 0.75-0.87). The incidence of CL was 0.20‰ (95%CI 0.17-0.23) (169 cases), of CP was 0.30‰ (95%CI 0.26-0.33) (252 cases), and of CLP was 0.31‰ (95%CI 0.27-0.35) (264 cases). CL was more common in males than females (0.24‰ vs. 0.15‰, OR = 1.62, 95%CI 1.18-2.22). CP was more common in urban than rural (0.36‰ vs. 0.25‰, OR = 1.43, 95%CI 1.12-1.83), and less common in males than females (0.22‰ vs. 0.38‰, OR = 0.59, 95%CI 0.46-0.75). CLP was more common in males than females (0.35‰ vs. 0.26‰, OR = 1.36, 95%CI 1.06-1.74). Compared to mothers 25-29 years old, mothers < 20 years old were risk factors for CLP (OR = 3.62, 95%CI 2.07-6.33) and CL/P (OR = 1.80, 95%CI 1.13-2.86), and mothers ≥ 35 years old was a risk factor for CLP (OR = 1.43, 95%CI 1.01-2.02). CL/P-related perinatal deaths accounted for 24.96% (171/685) of all CL/P, of which 90.64% (155/171) were terminations of pregnancy. Rural residents, low income, low maternal age, and early prenatal diagnosis are risk factors for perinatal death. In conclusion, we found that CP was more common in urban areas and females, CL and CLP were more common in males, and CL/P was more common in mothers < 20 or ≥ 35 years old. In addition, most CL/P-related perinatal deaths were terminations of pregnancy. CL/P-related perinatal deaths were more common in rural areas, and the proportion of CL/P-related perinatal deaths decreased with the increase in maternal age, parity, and per-capita annual income. Several mechanisms have been proposed to explain these phenomena. Our study is the first systematic research on CL/P and CL/P-related perinatal deaths based on birth defects surveillance. It is significant for intervention programs to prevent CL/P and CL/P-related perinatal deaths. As well, more epidemiological characteristics of CL/P (such as the location of CL/P) and approaches to reduce CL/P-related perinatal deaths need to be studied in the future.
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Affiliation(s)
- Xu Zhou
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China.
| | - Yurong Jiang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China.
| | - Junqun Fang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China.
| | - Hua Wang
- The Hunan Children's Hospital, Changsha, 410000, Hunan Province, China.
- National Health Commission Key Laboratory of Birth Defects Research, Prevention and Treatment, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China.
| | - Donghua Xie
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China
| | - Haiyan Kuang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China
| | - Ting Li
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China
| | - Qin Liu
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China
| | - Jian He
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China
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10
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Kini U. Genetics and orofacial clefts: a clinical perspective. Br Dent J 2023; 234:947-952. [PMID: 37349452 PMCID: PMC10287552 DOI: 10.1038/s41415-023-5994-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/24/2023]
Abstract
Orofacial clefts (OFCs) are the most common congenital craniofacial anomaly seen in humans. Most OFCs are sporadic and isolated - these are thought to be multifactorial in origin. Chromosomal and monogenic variants account for the syndromic forms and for some of the non-syndromic inherited forms. This review discusses the importance of genetic testing and the current clinical strategy to deliver a genomics service that is of direct benefit to patients and their families.
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Affiliation(s)
- Usha Kini
- Oxford Centre for Genomic Medicine, Oxford University Hospitals, UK; Spires Cleft Service, Oxford University Hospitals, UK; NDCLS, Radcliffe Department of Medicine, University of Oxford, United Kingdom.
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11
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Tahmasebi E, Mohammadi M, Alam M, Abbasi K, Gharibian Bajestani S, Khanmohammad R, Haseli M, Yazdanian M, Esmaeili Fard Barzegar P, Tebyaniyan H. The current regenerative medicine approaches of craniofacial diseases: A narrative review. Front Cell Dev Biol 2023; 11:1112378. [PMID: 36926524 PMCID: PMC10011176 DOI: 10.3389/fcell.2023.1112378] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/08/2023] [Indexed: 03/08/2023] Open
Abstract
Craniofacial deformities (CFDs) develop following oncological resection, trauma, or congenital disorders. Trauma is one of the top five causes of death globally, with rates varying from country to country. They result in a non-healing composite tissue wound as they degenerate in soft or hard tissues. Approximately one-third of oral diseases are caused by gum disease. Due to the complexity of anatomical structures in the region and the variety of tissue-specific requirements, CFD treatments present many challenges. Many treatment methods for CFDs are available today, such as drugs, regenerative medicine (RM), surgery, and tissue engineering. Functional restoration of a tissue or an organ after trauma or other chronic diseases is the focus of this emerging field of science. The materials and methodologies used in craniofacial reconstruction have significantly improved in the last few years. A facial fracture requires bone preservation as much as possible, so tiny fragments are removed initially. It is possible to replace bone marrow stem cells with oral stem cells for CFDs due to their excellent potential for bone formation. This review article discusses regenerative approaches for different types of craniofacial diseases.
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Affiliation(s)
- Elahe Tahmasebi
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohammadi
- School of Dentistry, Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Gharibian Bajestani
- Student Research Committee, Dentistry Research Center, Research Institute of Dental Sciences, Dental School, Shahid Behesti University of Medical Sciences, Tehran, Iran
| | - Rojin Khanmohammad
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohsen Haseli
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Hamid Tebyaniyan
- Department of Science and Research, Islimic Azade University, Tehran, Iran
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12
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Wang B, Feng C, Liu Y, Mi F, Dong J. Recent advances in biofunctional guided bone regeneration materials for repairing defective alveolar and maxillofacial bone: A review. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:233-248. [PMID: 36065207 PMCID: PMC9440077 DOI: 10.1016/j.jdsr.2022.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/23/2022] [Accepted: 07/28/2022] [Indexed: 11/28/2022] Open
Abstract
The anatomy of the oral and maxillofacial sites is complex, and bone defects caused by trauma, tumors, and inflammation in these zones are extremely difficult to repair. Among the most effective and reliable methods to attain osteogenesis, the guided bone regeneration (GBR) technique is extensively applied in defective oral and maxillofacial GBR. Furthermore, endowing biofunctions is crucial for GBR materials applied in repairing defective alveolar and maxillofacial bones. In this review, recent advances in designing and fabricating GBR materials applied in oral and maxillofacial sites are classified and discussed according to their biofunctions, including maintaining space for bone growth; facilitating the adhesion, migration, and proliferation of osteoblasts; facilitating the migration and differentiation of progenitor cells; promoting vascularization; providing immunoregulation to induce osteogenesis; suppressing infection; and effectively mimicking natural tissues using graded biomimetic materials. In addition, new processing strategies (e.g., 3D printing) and new design concepts (e.g., developing bone mimetic extracellular matrix niches and preparing scaffolds to suppress connective tissue to actively acquire space for bone regeneration), are particularly worthy of further study. In the future, GBR materials with richer biological functions are expected to be developed based on an in-depth understanding of the mechanism of bone-GBR-material interactions.
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Affiliation(s)
- Bing Wang
- Department of Chemistry, School of Pharmacy, North Sichuan Medical College, Nanchong, China
- Corresponding author at: Department of Chemistry, School of Pharmacy, North Sichuan Medical College, Nanchong, China.
| | - Chengmin Feng
- Department of Otorhinolaryngology & Head Neck Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yiming Liu
- Department of Stomatology, North Sichuan Medical College, Nanchong, China
| | - Fanglin Mi
- Department of Stomatology, North Sichuan Medical College, Nanchong, China
- Department of Stomatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Corresponding author at: Department of Stomatology, North Sichuan Medical College, Nanchong, China.
| | - Jun Dong
- Department of Chemistry, School of Pharmacy, North Sichuan Medical College, Nanchong, China
- Corresponding author.
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13
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Buile D, Pilmane M, Akota I. Evaluation of the Multiple Tissue Factors in the Cartilage of Primary and Secondary Rhinoplasty in Cleft Lip and Palate Patients. Pediatr Rep 2022; 14:419-433. [PMID: 36278554 PMCID: PMC9590111 DOI: 10.3390/pediatric14040050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Cleft lip and palate (CLP) is one of the craniofacial defects. The objective of this study was to identify the differences in appearance between the tissue factors in cartilage of CLP patients after primary and secondary rhinoplasty. Immunohistochemistry was performed with MMP-2, MMP-8, MMP-9, TIMP-2, IL-1α, IL-10, bFGF, and TGFβ1. The quantification of the structures was performed using a semi-quantitative census method. MMP-2, -9, IL-1a, and bFGF demonstrated higher number of positive cells in patients, while the number of MMP-8, IL-1a, -10 and TGFβ1 cells was higher or equal in the control subjects. The only statistically significant difference between CLP-operated patients was found in the TIMP-2 group, where the primary CLP patient group had a higher number of TIMP-2 positive chondrocytes than the secondary CLP patient group (U = 53.5; p = 0.021). The median value of the primary CLP group was ++ number of TIMP-2 positive chondrocytes compared to +++ in the secondary CLP group. No statistically significant difference was found between primary and secondary rhinoplasty patients for other tissue factors. Commonly, the rich expression of different tissue factors suggests a stimulation of higher elasticity in cleft affected cartilage. The statistically significant TIMP-2 elevation in primary operated cartilage indicates an impact of the selective tissue remodeling for hard tissue.
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Affiliation(s)
- Dace Buile
- Department of Morphology, Institute of Anatomy and Anthropology, Riga Stradiņš University, 9 Kronvalda Str., LV-1010 Riga, Latvia
- Correspondence: ; Tel.: +37-126-445-444
| | - Mara Pilmane
- Department of Morphology, Institute of Anatomy and Anthropology, Riga Stradiņš University, 9 Kronvalda Str., LV-1010 Riga, Latvia
| | - Ilze Akota
- Department of Maxillofacial Surgery, Institute of Stomatology, Riga Stradiņš University, 20 Dzirciema Str., LV-1007 Riga, Latvia
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14
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Chen J, Yao Y, Wang X, Wang Y, Li T, Du J. Chloroquine regulates the proliferation and apoptosis of palate development on mice embryo by activating P53 through blocking autophagy in vitro. In Vitro Cell Dev Biol Anim 2022; 58:558-570. [PMID: 35947289 DOI: 10.1007/s11626-022-00704-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 07/02/2022] [Indexed: 11/05/2022]
Abstract
Cleft lip and palate is one of the most frequent congenital developmental defects. Autophagy is a highly conserved process of cell self-degradation in eukaryotes, involving multiple biological processes in which chloroquine (CQ) is the most common inhibitor. However, whether CQ affects and how it affects palate development is unknown. Mouse embryonic palatal cells (MEPCs) were treated with CQ to observe cell viability, apoptosis, migration, osteogenic differentiation by cell proliferation assay, flow cytometric analysis, scratch assay, and alizarin red staining. PI staining was used to measure cell cycle distribution. Immunofluorescence (IF) assay and transmission electron microscopy were used to detect autophagosomes. The autophagy-related factors (LC3 and P62), apoptosis-related markers (P53, caspase-3 cleaved caspase-3, BAX, and BCL-2), and cell cycle-related proteins (P21, CDK2, CDK4, cyclin D1, and cyclin E) were all measured by western blot. CQ inhibited the proliferation of MEPCs by arresting the G0/G1 phase of the cell cycle in a concentration- and time-dependent manner with cell cycle-related proteins P21 upregulated and CDK2, CDK4, cyclin D1, and cyclin E downregulated. Then we detected CQ also induced cell apoptosis in a dose-dependent manner by decreasing the BCL-2/BAX ratio and increasing cleaved caspase-3. Next, it was investigated that migration and osteogenesis of MEPCs decreased with CQ treatment in a dose-dependent manner. Meanwhile, CQ blocked the autophagy pathway by upregulating LC3II and P62 expressions which activated the P53 pathway. CQ activates P53 which affects MEPC biological characteristics by changing the proliferation and apoptosis of MEPCs through inhibiting autophagy.
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Affiliation(s)
- Jing Chen
- Laboratory of Orofacial Development, Laboratory of Molecular Signaling and Stem Cells Therapy, Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Yaxia Yao
- Laboratory of Orofacial Development, Laboratory of Molecular Signaling and Stem Cells Therapy, Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Xiaotong Wang
- Laboratory of Orofacial Development, Laboratory of Molecular Signaling and Stem Cells Therapy, Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Yijia Wang
- Laboratory of Orofacial Development, Laboratory of Molecular Signaling and Stem Cells Therapy, Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Tianli Li
- Laboratory of Orofacial Development, Laboratory of Molecular Signaling and Stem Cells Therapy, Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Juan Du
- Laboratory of Orofacial Development, Laboratory of Molecular Signaling and Stem Cells Therapy, Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China.
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15
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Amiri MA, Lavaee F, Danesteh H. Use of stem cells in bone regeneration in cleft palate patients: review and recommendations. J Korean Assoc Oral Maxillofac Surg 2022; 48:71-78. [PMID: 35491137 PMCID: PMC9065639 DOI: 10.5125/jkaoms.2022.48.2.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 11/08/2022] Open
Abstract
This study was conducted to review the efficacy of different sources of stem cells in bone regeneration of cleft palate patients. The majority of previous studies focused on the transplantation of bone marrow mesenchymal stem cells. However, other sources of stem cells have also gained considerable attention, and dental stem cells have shown especially favorable outcomes. Additionally, approaches that apply the co-culture and co-transplantation of stem cells have shown promising results. The use of different types of stem cells, based on their accessibility and efficacy in bone regeneration, is a promising method in cleft palate bone regeneration. In this regard, dental stem cells may be an ideal choice due to their efficacy and accessibility. In conclusion, stem cells, despite the lengthy procedures required for culture and preparation, are a suitable alternative to conventional bone grafting techniques.
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Affiliation(s)
- Mohammad Amin Amiri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Lavaee
- Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Danesteh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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16
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Reyna-Urrutia VA, González-González AM, Rosales-Ibáñez R. Compositions and Structural Geometries of Scaffolds Used in the Regeneration of Cleft Palates: A Review of the Literature. Polymers (Basel) 2022; 14:polym14030547. [PMID: 35160534 PMCID: PMC8840587 DOI: 10.3390/polym14030547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 02/04/2023] Open
Abstract
Cleft palate (CP) is one of the most common birth defects, presenting a multitude of negative impacts on the health of the patient. It also leads to increased mortality at all stages of life, economic costs and psychosocial effects. The embryological development of CP has been outlined thanks to the advances made in recent years due to biomolecular successions. The etiology is broad and combines certain environmental and genetic factors. Currently, all surgical interventions work off the principle of restoring the area of the fissure and aesthetics of the patient, making use of bone substitutes. These can involve biological products, such as a demineralized bone matrix, as well as natural–synthetic polymers, and can be supplemented with nutrients or growth factors. For this reason, the following review analyzes different biomaterials in which nutrients or biomolecules have been added to improve the bioactive properties of the tissue construct to regenerate new bone, taking into account the greatest limitations of this approach, which are its use for bone substitutes for large areas exclusively and the lack of vascularity. Bone tissue engineering is a promising field, since it favors the development of porous synthetic substitutes with the ability to promote rapid and extensive vascularization within their structures for the regeneration of the CP area.
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17
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Almotawah FN, AlNamasy R, Alhamazani B, Almohsen S, AlNamasy RE. Alveolar Reconstruction Using Stem Cells in Patients with Cleft Lip and Palate: A Systematic Review. ARCHIVES OF PHARMACY PRACTICE 2022. [DOI: 10.51847/iobhdehrqo] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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18
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Alhussain BS, Bahamid AA, Turaif DTA, Alrifae EAA, Alkahtani JM, Alrejaie LM, Alomran RY. Adipocyte Stem Cells for the Treatment of Cleft Lip and Palate: A Systematic Review. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/xcyuyfdjsh] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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19
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Zhu Y, Miao H, Zeng Q, Li B, Wang D, Yu X, Wu H, Chen Y, Guo P, Liu F. Prevalence of cleft lip and/or cleft palate in Guangdong province, China, 2015-2018: a spatio-temporal descriptive analysis. BMJ Open 2021; 11:e046430. [PMID: 34341041 PMCID: PMC8330564 DOI: 10.1136/bmjopen-2020-046430] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 07/17/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the temporal and spatial characteristics of cleft lip and/or palate based on a large-scale birth defect monitoring database. METHODS Data on perinatal infants and children with cleft lip and/or palate defects from 1 January 2015 to 31 December 2018 in Guangdong province of China were collected. The variables including the demographic data, basic family information (address, education level, etc.), the infant's birth weight, gender and other basic parameters were collected and analysed. RESULTS During the study period, the prevalence of cleft lip and/or palate was 7.55 per 10 000 perinatal infants. The prevalence of cleft lip, cleft palate and cleft lip and palate were 2.34/10 000, 2.22/10 000 and 2.98/10 000, respectively. The prevalence of cleft lip and/or palate showed a pronounced downward trend, reducing from 8.47/10 000 in 2015 to 6.51/10 000 in 2018. We observed spatial heterogeneity of prevalence of cleft lip and/or palate across the study period in Guangdong. In the Pearl River Delta region, the overall prevalence of cleft lip and/or palate was 7.31/10 000, while the figure (7.86/10 000) was slightly higher in the non-Pearl River Delta region (p<0.05). Concerning infant gender, the prevalence was in general higher in boys than girls (p<0.05). In addition, the higher prevalence was more common in mothers older than 35 years old. For the birth season, infants born in spring tended to have a higher prevalence than those born in other seasons, regardless of the prevalence of cleft lip and palate calculated separately or jointly (p<0.05). The majority of newborns with cleft lip and palate were accompanied by other birth defects. CONCLUSION This study contributes a better understanding of the characteristics of spatio-temporal trends for birth defects of cleft lip and/or palate in south China.
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Affiliation(s)
- Yingxian Zhu
- Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Huazhang Miao
- Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Qinghui Zeng
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Bing Li
- Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Degang Wang
- Boai Hospital of Zhongshan, Zhongshan, China
| | - Xiaolin Yu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Haisheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Yuliang Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Fenghua Liu
- Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
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20
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Rizzo MI, Tomao L, Tedesco S, Cajozzo M, Esposito M, De Stefanis C, Ferranti AM, Mezzogori D, Palmieri A, Pozzato G, Algeri M, Locatelli F, Leone L, Zama M. Engineered mucoperiosteal scaffold for cleft palate regeneration towards the non-immunogenic transplantation. Sci Rep 2021; 11:14570. [PMID: 34272436 PMCID: PMC8285425 DOI: 10.1038/s41598-021-93951-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 05/25/2021] [Indexed: 12/15/2022] Open
Abstract
Cleft lip and palate (CL/P) is the most prevalent craniofacial birth defect in humans. None of the surgical procedures currently used for CL/P repair lead to definitive correction of hard palate bone interruption. Advances in tissue engineering and regenerative medicine aim to develop new strategies to restore palatal bone interruption by using tissue or organ-decellularized bioscaffolds seeded with host cells. Aim of this study was to set up a new natural scaffold deriving from a decellularized porcine mucoperiosteum, engineered by an innovative micro-perforation procedure based on Quantum Molecular Resonance (QMR) and then subjected to in vitro recellularization with human bone marrow-derived mesenchymal stem cells (hBM-MSCs). Our results demonstrated the efficiency of decellularization treatment gaining a natural, non-immunogenic scaffold with preserved collagen microenvironment that displays a favorable support to hMSC engraftment, spreading and differentiation. Ultrastructural analysis showed that the micro-perforation procedure preserved the collagen mesh, increasing the osteoinductive potential for mesenchymal precursor cells. In conclusion, we developed a novel tissue engineering protocol to obtain a non-immunogenic mucoperiosteal scaffold suitable for allogenic transplantation and CL/P repair. The innovative micro-perforation procedure improving hMSC osteogenic differentiation potentially impacts for enhanced palatal bone regeneration leading to future clinical applications in humans.
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Affiliation(s)
- M I Rizzo
- Plastic and Maxillofacial Surgery Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - L Tomao
- Department of Pediatric Onco-Hematology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - S Tedesco
- Telea Biotech e Telea Electronic Engineering, Sandrigo, VI, Italy
| | - M Cajozzo
- Plastic and Maxillofacial Surgery Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Esposito
- Plastic and Maxillofacial Surgery Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - C De Stefanis
- Research Laboratories, Histology Core Facility, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A M Ferranti
- Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - D Mezzogori
- Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - A Palmieri
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, National Institute of Health, Rome, Italy
| | - G Pozzato
- Telea Biotech e Telea Electronic Engineering, Sandrigo, VI, Italy
| | - M Algeri
- Department of Pediatric Onco-Hematology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - F Locatelli
- Department of Pediatric Onco-Hematology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Department of Gynecology/Obstetrics & Pediatrics, Sapienza University of Rome, Rome, Italy
| | - L Leone
- Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168, Rome, Italy. .,Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy.
| | - M Zama
- Plastic and Maxillofacial Surgery Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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21
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Antibacterial Bio-Based Polymers for Cranio-Maxillofacial Regeneration Applications. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10238371] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Cranio-maxillofacial structure is a region of particular interest in the field of regenerative medicine due to both its anatomical complexity and the numerous abnormalities affecting this area. However, this anatomical complexity is what makes possible the coexistence of different microbial ecosystems in the oral cavity and the maxillofacial region, contributing to the increased risk of bacterial infections. In this regard, different materials have been used for their application in this field. These materials can be obtained from natural and renewable feedstocks, or by synthetic routes with desired mechanical properties, biocompatibility and antimicrobial activity. Hence, in this review, we have focused on bio-based polymers which, by their own nature, by chemical modifications of their structure, or by their combination with other elements, provide a useful antibacterial activity as well as the suitable conditions for cranio-maxillofacial tissue regeneration. This approach has not been reviewed previously, and we have specifically arranged the content of this article according to the resulting material and its corresponding application; we review guided bone regeneration membranes, bone cements and devices and scaffolds for both soft and hard maxillofacial tissue regeneration, including hybrid scaffolds, dental implants, hydrogels and composites.
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22
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Oliver JD, Jia S, Halpern LR, Graham EM, Turner EC, Colombo JS, Grainger DW, D'Souza RN. Innovative Molecular and Cellular Therapeutics in Cleft Palate Tissue Engineering. TISSUE ENGINEERING PART B-REVIEWS 2020; 27:215-237. [PMID: 32873216 DOI: 10.1089/ten.teb.2020.0181] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Clefts of the lip and/or palate are the most prevalent orofacial birth defects occurring in about 1:700 live human births worldwide. Early postnatal surgical interventions are extensive and staged to bring about optimal growth and fusion of palatal shelves. Severe cleft defects pose a challenge to correct with surgery alone, resulting in complications and sequelae requiring life-long, multidisciplinary care. Advances made in materials science innovation, including scaffold-based delivery systems for precision tissue engineering, now offer new avenues for stimulating bone formation at the site of surgical correction for palatal clefts. In this study, we review the present scientific literature on key developmental events that can go awry in palate development and the common surgical practices and challenges faced in correcting cleft defects. How key osteoinductive pathways implicated in palatogenesis inform the design and optimization of constructs for cleft palate correction is discussed within the context of translation to humans. Finally, we highlight new osteogenic agents and innovative delivery systems with the potential to be adopted in engineering-based therapeutic approaches for the correction of palatal defects. Impact statement Tissue-engineered scaffolds supplemented with osteogenic growth factors have attractive, largely unexplored possibilities to modulate molecular signaling networks relevant to driving palatogenesis in the context of congenital anomalies (e.g., cleft palate). Constructs that address this need may obviate current use of autologous bone grafts, thereby avoiding donor-site morbidity and other regenerative challenges in patients afflicted with palatal clefts. Combinations of biomaterials and drug delivery of diverse regenerative cues and biologics are currently transforming strategies exploited by engineers, scientists, and clinicians for palatal cleft repair.
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Affiliation(s)
- Jeremie D Oliver
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA.,Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA
| | - Shihai Jia
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Leslie R Halpern
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Emily M Graham
- School of Medicine, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Emma C Turner
- University of Western Australia Dental School, Perth, Western Australia
| | - John S Colombo
- University of Las Vegas at Nevada School of Dental Medicine, Las Vegas, Nevada, USA
| | - David W Grainger
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Rena N D'Souza
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA.,Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.,School of Medicine, University of Utah Health Sciences, Salt Lake City, Utah, USA
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23
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Reprogramming and transdifferentiation - two key processes for regenerative medicine. Eur J Pharmacol 2020; 882:173202. [PMID: 32562801 DOI: 10.1016/j.ejphar.2020.173202] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 04/22/2020] [Accepted: 05/13/2020] [Indexed: 12/11/2022]
Abstract
Regenerative medicine based on transplants obtained from donors or foetal and new-born mesenchymal stem cells, encounter important obstacles such as limited availability of organs, ethical issues and immune rejection. The growing demand for therapeutic methods for patients being treated after serious accidents, severe organ dysfunction and an increasing number of cancer surgeries, exceeds the possibilities of the therapies that are currently available. Reprogramming and transdifferentiation provide powerful bioengineering tools. Both procedures are based on the somatic differentiated cells, which are easily and unlimitedly available, like for example: fibroblasts. During the reprogramming procedure mature cells are converted into pluripotent cells - which are capable to differentiate into almost any kind of desired cells. Transdifferentiation directly converts differentiated cells of one type into another differentiated cells type. Both procedures allow to obtained patient's dedicated cells for therapeutic purpose in regenerative medicine. In combination with biomaterials, it is possible to obtain even whole anatomical structures. Those patient's dedicated structures may serve for them upon serious accidents with massive tissue damage but also upon cancer surgeries as a replacement of damaged organ. Detailed information about reprogramming and transdifferentiation procedures as well as the current state of the art are presented in our review.
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24
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Korn P, Ahlfeld T, Lahmeyer F, Kilian D, Sembdner P, Stelzer R, Pradel W, Franke A, Rauner M, Range U, Stadlinger B, Lode A, Lauer G, Gelinsky M. 3D Printing of Bone Grafts for Cleft Alveolar Osteoplasty - In vivo Evaluation in a Preclinical Model. Front Bioeng Biotechnol 2020; 8:217. [PMID: 32269989 PMCID: PMC7109264 DOI: 10.3389/fbioe.2020.00217] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/04/2020] [Indexed: 12/12/2022] Open
Abstract
One of the most common hereditary craniofacial anomalies in humans are cleft lip and cleft alveolar bone with or without cleft palate. Current clinical practice, the augmentation of the persisting alveolar bone defect by using autologous bone grafts, has considerable disadvantages motivating to an intensive search for alternatives. We developed a novel therapy concept based on 3D printing of biodegradable calcium phosphate-based materials and integration of osteogenic cells allowing fabrication of patient-specific, tissue-engineered bone grafts. Objective of the present study was the in vivo evaluation of implants in a rat alveolar cleft model. Scaffolds were designed according to the defect's geometry with two different pore designs (60° and 30° rotated layer orientation) and produced by extrusion-based 3D plotting of a pasty calcium phosphate cement. The scaffolds filled into the artificial bone defect in the palate of adult Lewis rats, showing a good support. Half of the scaffolds were colonized with rat mesenchymal stromal cells (rMSC) prior to implantation. After 6 and 12 weeks, remaining defect width and bone formation were quantified histologically and by microCT. The results revealed excellent osteoconductive properties of the scaffolds, a significant influence of the pore geometry (60° > 30°), but no enhanced defect healing by pre-colonization with rMSC.
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Affiliation(s)
- Paula Korn
- Department of Oral and Maxillofacial Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tilman Ahlfeld
- Centre for Translational Bone, Joint and Soft Tissue Research, University Hospital “Carl Gustav Carus”, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Franziska Lahmeyer
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
| | - David Kilian
- Centre for Translational Bone, Joint and Soft Tissue Research, University Hospital “Carl Gustav Carus”, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Philipp Sembdner
- Institute of Machine Elements and Machine Design, Technische Universität Dresden, Dresden, Germany
| | - Ralph Stelzer
- Institute of Machine Elements and Machine Design, Technische Universität Dresden, Dresden, Germany
| | - Winnie Pradel
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
| | - Adrian Franke
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
| | - Martina Rauner
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III and Center for Healthy Aging, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
| | - Ursula Range
- Institute for Medical Informatics and Biometry, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Anja Lode
- Centre for Translational Bone, Joint and Soft Tissue Research, University Hospital “Carl Gustav Carus”, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Günter Lauer
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
| | - Michael Gelinsky
- Centre for Translational Bone, Joint and Soft Tissue Research, University Hospital “Carl Gustav Carus”, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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25
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Paiva KBS, Maas CS, dos Santos PM, Granjeiro JM, Letra A. Extracellular Matrix Composition and Remodeling: Current Perspectives on Secondary Palate Formation, Cleft Lip/Palate, and Palatal Reconstruction. Front Cell Dev Biol 2019; 7:340. [PMID: 31921852 PMCID: PMC6923686 DOI: 10.3389/fcell.2019.00340] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 11/29/2019] [Indexed: 12/13/2022] Open
Abstract
Craniofacial development comprises a complex process in humans in which failures or disturbances frequently lead to congenital anomalies. Cleft lip with/without palate (CL/P) is a common congenital anomaly that occurs due to variations in craniofacial development genes, and may occur as part of a syndrome, or more commonly in isolated forms (non-syndromic). The etiology of CL/P is multifactorial with genes, environmental factors, and their potential interactions contributing to the condition. Rehabilitation of CL/P patients requires a multidisciplinary team to perform the multiple surgical, dental, and psychological interventions required throughout the patient's life. Despite progress, lip/palatal reconstruction is still a major treatment challenge. Genetic mutations and polymorphisms in several genes, including extracellular matrix (ECM) genes, soluble factors, and enzymes responsible for ECM remodeling (e.g., metalloproteinases), have been suggested to play a role in the etiology of CL/P; hence, these may be considered likely targets for the development of new preventive and/or therapeutic strategies. In this context, investigations are being conducted on new therapeutic approaches based on tissue bioengineering, associating stem cells with biomaterials, signaling molecules, and innovative technologies. In this review, we discuss the role of genes involved in ECM composition and remodeling during secondary palate formation and pathogenesis and genetic etiology of CL/P. We also discuss potential therapeutic approaches using bioactive molecules and principles of tissue bioengineering for state-of-the-art CL/P repair and palatal reconstruction.
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Affiliation(s)
- Katiúcia Batista Silva Paiva
- Laboratory of Extracellular Matrix Biology and Cellular Interaction, Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Clara Soeiro Maas
- Laboratory of Extracellular Matrix Biology and Cellular Interaction, Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Pâmella Monique dos Santos
- Laboratory of Extracellular Matrix Biology and Cellular Interaction, Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - José Mauro Granjeiro
- Clinical Research Laboratory in Dentistry, Federal Fluminense University, Niterói, Brazil
- Directory of Life Sciences Applied Metrology, National Institute of Metrology, Quality and Technology, Duque de Caxias, Brazil
| | - Ariadne Letra
- Center for Craniofacial Research, UTHealth School of Dentistry at Houston, Houston, TX, United States
- Pediatric Research Center, UTHealth McGovern Medical School, Houston, TX, United States
- Department of Diagnostic and Biomedical Sciences, UTHealth School of Dentistry at Houston, Houston, TX, United States
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