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Sedmera D, Kvasilova A, Eckhardt A, Kacer P, Penicka M, Kocka M, Schindler D, Kaban R, Kockova R. Fibrosis and expression of extracellular matrix proteins in human interventricular septum in aortic valve stenosis and regurgitation. Histochem Cell Biol 2024; 161:367-379. [PMID: 38347221 PMCID: PMC11045568 DOI: 10.1007/s00418-024-02268-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 04/28/2024]
Abstract
Valvular heart disease leads to ventricular pressure and/or volume overload. Pressure overload leads to fibrosis, which might regress with its resolution, but the limits and details of this reverse remodeling are not known. To gain more insight into the extent and nature of cardiac fibrosis in valve disease, we analyzed needle biopsies taken from the interventricular septum of patients undergoing surgery for valve replacement focusing on the expression and distribution of major extracellular matrix protein involved in this process. Proteomic analysis performed using mass spectrometry revealed an excellent correlation between the expression of collagen type I and III, but there was little correlation with the immunohistochemical staining performed on sister sections, which included antibodies against collagen I, III, fibronectin, sarcomeric actin, and histochemistry for wheat germ agglutinin. Surprisingly, the immunofluorescence intensity did not correlate significantly with the gold standard for fibrosis quantification, which was performed using Picrosirius Red (PSR) staining, unless multiplexed on the same tissue section. There was also little correlation between the immunohistochemical markers and pressure gradient severity. It appears that at least in humans, the immunohistochemical pattern of fibrosis is not clearly correlated with standard Picrosirius Red staining on sister sections or quantitative proteomic data, possibly due to tissue heterogeneity at microscale, comorbidities, or other patient-specific factors. For precise correlation of different types of staining, multiplexing on the same section is the best approach.
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Affiliation(s)
- David Sedmera
- Institute of Anatomy, First Faculty of Medicine, Charles University, U Nemocnice 3, 128 00, Prague, Czech Republic.
- Institute of Physiology, The Czech Academy of Sciences, Videnska 1024, 142 00, Prague, Czech Republic.
| | - Alena Kvasilova
- Institute of Anatomy, First Faculty of Medicine, Charles University, U Nemocnice 3, 128 00, Prague, Czech Republic
| | - Adam Eckhardt
- Institute of Physiology, The Czech Academy of Sciences, Videnska 1024, 142 00, Prague, Czech Republic
| | - Petr Kacer
- Department of Cardiac Surgery, Third Faculty of Medicine, Charles University, Prague, Czech Republic
- University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Martin Penicka
- Cardiovascular Center Aalst, OLV Clinic, 9300, Aalst, Belgium
| | - Matej Kocka
- Institute of Anatomy, First Faculty of Medicine, Charles University, U Nemocnice 3, 128 00, Prague, Czech Republic
| | - Dana Schindler
- Institute of Anatomy, First Faculty of Medicine, Charles University, U Nemocnice 3, 128 00, Prague, Czech Republic
| | - Ron Kaban
- Institute of Anatomy, First Faculty of Medicine, Charles University, U Nemocnice 3, 128 00, Prague, Czech Republic
| | - Radka Kockova
- Na Homolce Hospital, Roentgenova 37/2, 150 30, Prague, Czech Republic
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Chiu KH, Karpat M, Hahn J, Chang KY, Weber M, Wolf M, Aveic S, Fischer H. Cyclic Stretching Triggers Cell Orientation and Extracellular Matrix Remodeling in a Periodontal Ligament 3D In Vitro Model. Adv Healthc Mater 2023; 12:e2301422. [PMID: 37703581 DOI: 10.1002/adhm.202301422] [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: 05/04/2023] [Revised: 08/07/2023] [Indexed: 09/15/2023]
Abstract
During orthodontic tooth movement (OTM), the periodontal ligament (PDL) plays a crucial role in regulating the tissue remodeling process. To decipher the cellular and molecular mechanisms underlying this process in vitro, suitable 3D models are needed that more closely approximate the situation in vivo. Here, a customized bioreactor is developed that allows dynamic loading of PDL-derived fibroblasts (PDLF). A collagen-based hydrogel mixture is optimized to maintain structural integrity and constant cell growth during stretching. Numerical simulations show a uniform stress distribution in the hydrogel construct under stretching. Compared to static conditions, controlled cyclic stretching results in directional alignment of collagen fibers and enhances proliferation and spreading ability of the embedded PDLF cells. Effective force transmission to the embedded cells is demonstrated by a more than threefold increase in Periostin protein expression. The cyclic stretch conditions also promote extensive remodeling of the extracellular matrix, as confirmed by increased glycosaminoglycan production. These results highlight the importance of dynamic loading over an extended period of time to determine the behavior of PDLF and to identify in vitro mechanobiological cues triggered during OTM-like stimulus. The introduced dynamic bioreactor is therefore a useful in vitro tool to study these mechanisms.
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Affiliation(s)
- Kuo-Hui Chiu
- Department of Dental Materials and Biomaterials Research, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Mert Karpat
- Department of Dental Materials and Biomaterials Research, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Johannes Hahn
- Department of Dental Materials and Biomaterials Research, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Kao-Yuan Chang
- Department of Dental Materials and Biomaterials Research, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Michael Weber
- Department of Dental Materials and Biomaterials Research, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Michael Wolf
- Department of Orthodontics, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Sanja Aveic
- Department of Dental Materials and Biomaterials Research, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Horst Fischer
- Department of Dental Materials and Biomaterials Research, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany
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Nguyen PK, Hall K, Holt I, Kuo CK. Recombinant lysyl oxidase effects on embryonic tendon cell phenotype and behavior. J Orthop Res 2023; 41:2175-2185. [PMID: 37365857 DOI: 10.1002/jor.25655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/11/2023] [Accepted: 06/21/2023] [Indexed: 06/28/2023]
Abstract
Lysyl oxidase (LOX) plays an important role in the elaboration of tendon mechanical properties during embryonic development by mediating enzymatic collagen crosslinking. We previously showed recombinant LOX (rLOX) treatment of developing tendon significantly increased LOX-mediated collagen crosslink density to enhance tendon mechanical properties at different stages of tissue formation. Working toward the future development of rLOX-based therapeutic strategies to enhance mechanical properties of tendons that are compromised, such as after injury or due to abnormal development, this study characterized the direct effects of rLOX treatment on embryonic tendon cells from different stages of tissue formation. Tendon cell morphology, proliferation rate, proliferative capacity, and metabolic activity were not affected by rLOX treatment. Tenogenic phenotype was stable with rLOX treatment, reflected by no change in cell morphology or tendon marker messenger RNA (mRNA) levels assessed by reverse-transcription polymerase chain reaction. Collagen mRNA levels also remained constant. Matrix metalloproteinase-9 expression levels were downregulated in later stage tendon cells, but not in earlier stage cells, whereas enzyme activity levels were undetected. Bone morphogenetic protein-1 (BMP-1) expression was upregulated in earlier stage tendon cells, but not in later stage cells. Furthermore, BMP-1 activity was unchanged when intracellular LOX enzyme activity levels were upregulated in both stage cells, suggesting exogenous rLOX may have entered the cells. Based on our data, rLOX treatment had minimal effects on tendon cell phenotype and behaviors. These findings will inform future development of LOX-focused treatments to enhance tendon mechanical properties without adverse effects on tendon cell phenotype and behaviors.
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Affiliation(s)
- Phong K Nguyen
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York, USA
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
| | - Kaitlyn Hall
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
| | - Iverson Holt
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
| | - Catherine K Kuo
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York, USA
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
- Department of Orthopaedics, University of Rochester Medical Center, Rochester, New York, USA
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Nguyen PK, Jana A, Huang C, Grafton A, Holt I, Giacomelli M, Kuo CK. Tendon mechanical properties are enhanced via recombinant lysyl oxidase treatment. Front Bioeng Biotechnol 2022; 10:945639. [PMID: 35992359 PMCID: PMC9389157 DOI: 10.3389/fbioe.2022.945639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Tendon mechanical properties are significantly compromised in adult tendon injuries, tendon-related birth defects, and connective tissue disorders. Unfortunately, there currently is no effective treatment to restore native tendon mechanical properties after postnatal tendon injury or abnormal fetal development. Approaches to promote crosslinking of extracellular matrix components in tendon have been proposed to enhance insufficient mechanical properties of fibrotic tendon after healing. However, these crosslinking agents, which are not naturally present in the body, are associated with toxicity and significant reductions in metabolic activity at concentrations that enhance tendon mechanical properties. In contrast, we propose that an effective method to restore tendon mechanical properties would be to promote lysyl oxidase (LOX)-mediated collagen crosslinking in tendon during adult tissue healing or fetal tissue development. LOX is naturally occurring in the body, and we previously demonstrated LOX-mediated collagen crosslinking to be a critical regulator of tendon mechanical properties during new tissue formation. In this study, we examined the effects of recombinant LOX treatment on tendon at different stages of development. We found that recombinant LOX treatment significantly enhanced tensile and nanoscale tendon mechanical properties without affecting cell viability or collagen content, density, and maturity. Interestingly, both tendon elastic modulus and LOX-mediated collagen crosslink density plateaued at higher recombinant LOX concentrations, which may have been due to limited availability of adjacent lysine residues that are near enough to be crosslinked together. The plateau in crosslink density at higher concentrations of recombinant LOX treatments may have implications for preventing over-stiffening of tendon, though this requires further investigation. These findings demonstrate the exciting potential for a LOX-based therapeutic to enhance tendon mechanical properties via a naturally occurring crosslinking mechanism, which could have tremendous implications for an estimated 32 million acute and chronic tendon and ligament injuries each year in the U.S.
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Affiliation(s)
- Phong K. Nguyen
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, United States
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, United States
| | - Aniket Jana
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, United States
| | - Chi Huang
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, United States
| | - Alison Grafton
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, United States
| | - Iverson Holt
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, United States
| | - Michael Giacomelli
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, United States
| | - Catherine K. Kuo
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, United States
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, United States
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, United States
- Department of Orthopaedics, University of Rochester Medical Center, Rochester, NY, United States
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, United States
- *Correspondence: Catherine K. Kuo,
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Xiong Z, Zhao Z, Deng H, Qiu X, Li W, Chen X, Tang Y, Han S, Zhao J, Cai T, Liu X, Zeng S, Tang S. Screening for musculoskeletal system malformations and birth injuries in newborns: Results of a screening program in two hospitals in Shenzen, China. Pediatr Investig 2022; 6:156-162. [PMID: 36203522 PMCID: PMC9523807 DOI: 10.1002/ped4.12334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022] Open
Abstract
Importance There are a variety of musculoskeletal malformations and injuries that can occur in newborns. These can be a significant cause of perinatal death or a reason for miscarriage and can lead to long‐term functional issues if not managed appropriately. There is no systematic and well‐established screening program for neonatal musculoskeletal malformations and injuries in China now. Objective To report the incidence and types of congenital musculoskeletal malformations in two hospitals in Shenzhen City, to explore and discuss the details of the screening procedure and improve future prevention and treatment. Methods From October 2013 to May 2014, 2564 one‐day‐old newborns were screened by a pediatric orthopedic physical examination, in combination with ultrasonography when required, and the incidence and variety of diseases were recorded statistically. Results Among 2564 screened newborns, the following musculoskeletal conditions were identified: congenital muscular torticollis (CMT) (seven cases, 0.27%), hip subluxation (four cases, 0.16%), hip dysplasia (47 cases, 1.83%), congenital talipes equinovarus (CTEV) (two cases, 0.08%), congenital talipes calcaneovalgus (15 cases, 0.58%), polydactyly (nine cases, 0.35%), syndactyly (one case, 0.04%), and spinal hemivertebra (one case, 0.04%). Additionally, there were five (0.19%) neonates with birth injuries. Interpretation It is feasible to carry out neonatal screening and identification of musculoskeletal malformations and birth injuries in China. This is helpful as timely detection and early intervention for many of these conditions can avoid permanent functional impairment in these children.
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Affiliation(s)
- Zhu Xiong
- Department of Pediatric Orthopedics Shenzhen Children's Hospital of China Medical University Shenzhen Guangdong China
| | - Zhenhui Zhao
- Department of Pediatric Orthopedics Shenzhen Children's Hospital of China Medical University Shenzhen Guangdong China
| | - Hansheng Deng
- Department of Pediatric Orthopedics Shenzhen Children's Hospital of China Medical University Shenzhen Guangdong China
| | - Xin Qiu
- Department of Pediatric Orthopedics Shenzhen Children's Hospital of China Medical University Shenzhen Guangdong China
| | - Weiqing Li
- Department of Pediatric Orthopedics Shenzhen Children's Hospital of China Medical University Shenzhen Guangdong China
| | - Xiaodi Chen
- Department of Pediatric Orthopedics Shenzhen Children's Hospital of China Medical University Shenzhen Guangdong China
| | - Yu Tang
- Department of Pediatric Orthopedics Shenzhen Children's Hospital of China Medical University Shenzhen Guangdong China
| | - Shuai Han
- Department of Pediatric Orthopedics Shenzhen Children's Hospital of China Medical University Shenzhen Guangdong China
| | - Jiaxin Zhao
- Guangxi Medical University Nanning Guangxi China
| | - Ting Cai
- Department of Pediatric Orthopedics Shenzhen Children's Hospital of China Medical University Shenzhen Guangdong China
| | - Xian Liu
- Department of Pediatric Orthopedics Shenzhen Children's Hospital of China Medical University Shenzhen Guangdong China
| | - Shuaidan Zeng
- Department of Pediatric Orthopedics Shenzhen Children's Hospital of China Medical University Shenzhen Guangdong China
| | - Shengping Tang
- Department of Pediatric Orthopedics Shenzhen Children's Hospital of China Medical University Shenzhen Guangdong China
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Novotny T, Eckhardt A, Doubkova M, Knitlova J, Vondrasek D, Vanaskova E, Ostadal M, Uhlik J, Bacakova L, Musilkova J. The possible role of hypoxia in the affected tissue of relapsed clubfoot. Sci Rep 2022; 12:4462. [PMID: 35292718 PMCID: PMC8924187 DOI: 10.1038/s41598-022-08519-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 03/07/2022] [Indexed: 02/07/2023] Open
Abstract
Our aim was to study the expression of hypoxia-related proteins as a possible regulatory pathway in the contracted side tissue of relapsed clubfoot. We compared the expression of hypoxia-related proteins in the tissue of the contracted (medial) side of relapsed clubfoot, and in the tissue of the non-contracted (lateral) side of relapsed clubfoot. Tissue samples from ten patients were analyzed by immunohistochemistry and image analysis, Real-time PCR and Mass Spectrometry to evaluate the differences in protein composition and gene expression. We found a significant increase in the levels of smooth muscle actin, transforming growth factor-beta, hypoxia-inducible factor 1 alpha, lysyl oxidase, lysyl oxidase-like 2, tenascin C, matrix metalloproteinase-2, matrix metalloproteinase-9, fibronectin, collagen types III and VI, hemoglobin subunit alpha and hemoglobin subunit beta, and an overexpression of ACTA2, FN1, TGFB1, HIF1A and MMP2 genes in the contracted medial side tissue of clubfoot. In the affected tissue, we have identified an increase in the level of hypoxia-related proteins, together with an overexpression of corresponding genes. Our results suggest that the hypoxia-associated pathway is potentially a factor contributing to the etiology of clubfoot relapses, as it stimulates both angioproliferation and fibroproliferation, which are considered to be key factors in the progression and development of relapses.
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Affiliation(s)
- Tomas Novotny
- Department of Orthopaedics, University J.E. Purkinje and Masaryk Hospital, Usti nad Labem, Czech Republic.,Department of Histology and Embryology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Adam Eckhardt
- Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic.
| | - Martina Doubkova
- Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic. .,Second Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Jarmila Knitlova
- Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - David Vondrasek
- Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic.,Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Eliska Vanaskova
- Department of Orthopaedics, University J.E. Purkinje and Masaryk Hospital, Usti nad Labem, Czech Republic
| | - Martin Ostadal
- Department of Orthopaedics, University Hospital Bulovka, Charles University, Prague, Czech Republic
| | - Jiri Uhlik
- Department of Histology and Embryology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lucie Bacakova
- Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Jana Musilkova
- Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
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