1
|
Girão L, Pinto P. Efficacy and Safety of an Autologous Micrografting Procedure for Management of Striae Distensae in Women. Dermatol Ther (Heidelb) 2024; 14:469-488. [PMID: 38321354 PMCID: PMC10891005 DOI: 10.1007/s13555-023-01096-7] [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: 11/29/2023] [Accepted: 12/22/2023] [Indexed: 02/08/2024] Open
Abstract
INTRODUCTION Striae distensae (SD), or stretch marks, are a common skin problem having a psychological impact and cosmetic concern, especially for women, in whom the prevalence is higher than in men. This study assessed the efficacy and safety of a single autologous micrografting treatment (AMT®) using Rigenera® technology for the management of SD. METHODS This single-centre study included 10 healthy women between 24 and 65 years of age, with Fitzpatrick-Goldman skin types I-IV, who had visible SD in glutes/thighs. Each subject acted as their own control. The treatment procedure (microneedling + AMT) and the control procedure (no treatment) were performed on contralateral sides of the glutes/thighs, targeting matched and paired SD. Microneedling was carried out using Dermapen®, equipped with 32 needle heads set at 1.5 mm needle length. The AMT procedure involved extracting biopsies from the mastoid hair zone with a 2.5-mm dermal punch, followed by disaggregation of the biopsies in a physiological saline solution using the Rigeneracons. The disaggregated micrografts were then intradermally injected using 30G 4-mm needles, maintaining a distance of 1 cm between injection points, covering the entire marked treatment region. RESULTS In the treated area, at 3 months post-procedure compared to pre-procedure, the following changes were observed, all with statistical significance (P ≤ 0.05): (a) significant reductions in skin roughness (Ra, - 15.9%; Rz, - 22.6%), skin luminance (- 2.0%), and blue-green color distribution (- 10.6%); (b) significant increases in skin microcirculation maximum value (+ 240.1%), skin hydration (+ 71.2%), skin elasticity (+ 216.5%), skin density (+ 34.3%), skin thickness (+ 26.0%), and hypodermis thickness (+ 29.9%). Furthermore, for each of the aforementioned parameters, there was a significantly greater improvement observed with the AMT procedure compared with microneedling at 3 months (all P ≤ 0.05). CONCLUSION The AMT procedure using Rigenera technology resulted in an noticeable improvement in the SD appearance after 3 months in healthy women.
Collapse
Affiliation(s)
- Leonor Girão
- Clínica Dermatologia do Areeiro, Avenida Afonso Costa 22 S/L dta, 1900-036, Lisbon, Portugal.
- PhD Trials, Avenida Afonso Costa 22 S/L dta, 1900-036, Lisbon, Portugal.
| | - Pedro Pinto
- PhD Trials, Avenida Afonso Costa 22 S/L dta, 1900-036, Lisbon, Portugal
| |
Collapse
|
2
|
Tsoukas D, Muntean I, Simos C, Sabido-Vera R. Prospective Observational Study of a Non-Arthroscopic Autologous Cartilage Micrografting Technology for Knee Osteoarthritis. Bioengineering (Basel) 2023; 10:1294. [PMID: 38002418 PMCID: PMC10669557 DOI: 10.3390/bioengineering10111294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Autologous micrografting technology (AMT®) involves the use of autologous micrografts to stimulate/enhance the repair of damaged tissue. This study assessed the efficacy and safety of the AMT® procedure in patients with early stages of knee osteoarthritis. Briefly, the AMT® procedure involved extraction of auricular cartilage, disaggregation using the Rigeneracons® SRT in 4.0 mL of saline solution, and injection of the disaggregated micrografts into the external femorotibial compartment area of the affected knee. Ten patients (4 men, 6 women; age range: 37-84 years) were included in the study. In all patients, there was a steady improvement in knee instability, pain, swelling, mechanical locking, stair climbing, and squatting at 1- and 6-months post-procedure. Improvement in mobility was observed as early as 3 weeks post-procedure in 2 patients. Significant improvements were seen in mean scores of all five subscales of Knee Injury and Osteoarthritis Outcome Score (KOOS [KOOS symptoms, KOOS pain, KOOS ADL, KOOS sport and recreation, and KOOS quality-of-life]) between pre-procedure and 1- and 6-months post-procedure (all p ≤ 0.05). Autologous auricular cartilage micrografts obtained by AMT® procedure (using Rigenera® technology) is an effective and safe protocol in the treatment of early stage knee osteoarthritis. These encouraging findings need to be validated in a larger patient population and in a randomized clinical trial (RCT).
Collapse
Affiliation(s)
- Dimitrios Tsoukas
- Orthopaedic Clinic for Advanced Arthroscopic Sports and Regenerative Surgery, MITERA General Maternity and Children’s Hospital, 15123 Athens, Greece;
| | - Ilie Muntean
- Hospital of Sant Joan Despi Moises Broggi, 08970 Barcelona, Spain;
| | - Christos Simos
- Orthopaedic Clinic for Advanced Arthroscopic Sports and Regenerative Surgery, MITERA General Maternity and Children’s Hospital, 15123 Athens, Greece;
| | | |
Collapse
|
3
|
De Francesco F, Zingaretti N, Parodi PC, Riccio M. The Evolution of Current Concept of the Reconstructive Ladder in Plastic Surgery: The Emerging Role of Translational Medicine. Cells 2023; 12:2567. [PMID: 37947645 PMCID: PMC10649097 DOI: 10.3390/cells12212567] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023] Open
Abstract
Plastic surgeons have used the reconstructive ladder for many decades as a standard directory for complex trauma reconstruction with the goal of repairing body structures and restoring functionality. This consists of different surgical maneuvers, such as secondary intention and direct tissue closure, as well as more complex methods such as local tissue transfer and free flap. The reconstructive ladder represents widely known options achievable for tissue reconstruction and wound closure that puts at the bottom rung the simplest methods of reconstruction and strengthens the complexity by moving upward. Regenerative medicine and surgery constitute a quickly spreading area of translational research that can be employed by minimally invasive surgical strategies, with the aim of regenerating cells and tissues in vivo in order to reestablish normal function through the intrinsic potential of cells, in combination with biomaterials and appropriate biochemical stimuli. These translational procedures have the aim of creating an appropriate microenvironment capable of supporting the physiological cellular function to generate the desired cells or tissues and to generate parenchymal, stromal, and vascular components on demand, and above all to produce intelligent materials capable of determining the fate of cells. Smart technologies have been grown that give extra "rungs" on the classic reconstructive ladder to integrate a more holistic, patient-based approach with improved outcomes. This commentary presents the evolution of the traditional concept of the reconstructive ladder in the field of plastic surgery into a new course with the aim of achieving excellent results for soft tissue reconstruction by applying innovative technologies and biologically active molecules for a wide range of surgical diseases.
Collapse
Affiliation(s)
- Francesco De Francesco
- Department of Reconstructive Surgery and Hand Surgery, University Hospital (AOU Ospedali Riuniti di Ancona), Via Conca 71, Torrette di Ancona, 60123 Ancona, Italy;
| | - Nicola Zingaretti
- Department of Medical Area (DAME), Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, University of Udine, 33100 Udine, Italy; (N.Z.); (P.C.P.)
| | - Pier Camillo Parodi
- Department of Medical Area (DAME), Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, University of Udine, 33100 Udine, Italy; (N.Z.); (P.C.P.)
| | - Michele Riccio
- Department of Reconstructive Surgery and Hand Surgery, University Hospital (AOU Ospedali Riuniti di Ancona), Via Conca 71, Torrette di Ancona, 60123 Ancona, Italy;
| |
Collapse
|
4
|
First-in-Human Study to Investigate the Safety Assessment of Peri-Implant Soft Tissue Regeneration with Micronized-Gingival Connective Tissue: A Pilot Case Series Study. MEDICINES (BASEL, SWITZERLAND) 2023; 10:medicines10010009. [PMID: 36662493 PMCID: PMC9865433 DOI: 10.3390/medicines10010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023]
Abstract
Background: We have recently proposed an alternative strategy of free gingival graft (FGG) and connective tissue graft (CTG) using micronized-gingival connective tissues (MGCTs). The advantage of this strategy is that MGCTs from a small piece of maxillary tuberosity can regenerate the keratinized tissue band. However, safety and efficacy have not yet been established in patients. This clinical study was a pilot case series, and the objective was to assess the safety and the preliminary efficacy of MGCTs on peri-implant mucosa regeneration. Methods: This was a pilot interventional, single-center, first-in-human (FIH), open (no masking), uncontrolled, and single-assignment study. A total of 4 patients who needed peri-implant soft tissues reconstruction around dental implants received transplantation of atelocollagen-matrix with MGCTs micronized by the tissue disruptor technique. The duration of intervention was 4 weeks after surgery. Results: This first clinical study demonstrated that using MGCTs did not cause any irreversible adverse events, and it showed the preliminary efficacy for peri-implant soft tissues reconstruction in dental implant therapy. Conclusions: Though further studies are needed on an appropriate scale, as an alternative strategy of FGG or CTG, MGCTs might be promising for peri-implant mucosa reconstruction without requiring a high level of skills and morbidity to harvest graft tissues.
Collapse
|
5
|
Effects of Intra-Articular Autologous Adipose Micrograft for the Treatment of Osteoarthritis in Dogs: A Prospective, Randomized, Controlled Study. Animals (Basel) 2022; 12:ani12141844. [PMID: 35883392 PMCID: PMC9311928 DOI: 10.3390/ani12141844] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/14/2022] [Indexed: 12/12/2022] Open
Abstract
The purpose of this study was to estimate the safety, feasibility, and efficacy of the intra-articular treatment of autologous microfragmented adipose tissue in dogs with spontaneous osteoarthritis (OA) in comparison with hyaluronic acid (HA), the standard intra-articular treatment. Specifically, it clinically evaluated pain and lameness, the radiographic progression of osteoarthritis, and synovial fluid inflammation. This was a prospective, single-center, parallel-group, randomized, controlled, in vivo clinical study. Participants (n = 40) received either a single intra-articular injection of microfragmented adipose tissue or a single intra-articular injection of HA (1:1). Clinical outcomes were determined using a specialistic clinician assessment obtained by the completion of a specific clinical form based on the Vesseur modified lameness classification system, a pain evaluation using the Visual Analogue Scale (VAS), the measurement of the range of motion (ROM) of the affected joint, limb circumference, and the owners' score evaluation using the Canine Brief Pain Inventory (CBPI) for up to 6 months after the time of injection. Patients underwent a radiographic examination to establish the degree of OA in the affected joint, and synovial fluid samples were collected to assess the biochemical environment of the joint and evaluate and quantify the cellular population and the presence of three specific inflammation biomarkers for up to 60 days. The results of this study suggest that microfragmented autologous adipose tissue is safe and can effectively relieve pain and improve function in dogs with spontaneous articular OA. This one-step procedure is simple, timesaving, cost-effective, minimally invasive, and eliminates the need for complex and time-intensive cell culture processing. Furthermore, the clinical evidence and cytological results suggest better long-term pain control, resulting in an improvement in joint function, compared to HA treatment. The canine spontaneous OA model could play a key role in developing successful treatments for human medicine.
Collapse
|
6
|
Pavez Loriè E, Baatout S, Choukér A, Buchheim JI, Baselet B, Dello Russo C, Wotring V, Monici M, Morbidelli L, Gagliardi D, Stingl JC, Surdo L, Yip VLM. The Future of Personalized Medicine in Space: From Observations to Countermeasures. Front Bioeng Biotechnol 2021; 9:739747. [PMID: 34966726 PMCID: PMC8710508 DOI: 10.3389/fbioe.2021.739747] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 11/19/2021] [Indexed: 12/12/2022] Open
Abstract
The aim of personalized medicine is to detach from a “one-size fits all approach” and improve patient health by individualization to achieve the best outcomes in disease prevention, diagnosis and treatment. Technological advances in sequencing, improved knowledge of omics, integration with bioinformatics and new in vitro testing formats, have enabled personalized medicine to become a reality. Individual variation in response to environmental factors can affect susceptibility to disease and response to treatments. Space travel exposes humans to environmental stressors that lead to physiological adaptations, from altered cell behavior to abnormal tissue responses, including immune system impairment. In the context of human space flight research, human health studies have shown a significant inter-individual variability in response to space analogue conditions. A substantial degree of variability has been noticed in response to medications (from both an efficacy and toxicity perspective) as well as in susceptibility to damage from radiation exposure and in physiological changes such as loss of bone mineral density and muscle mass in response to deconditioning. At present, personalized medicine for astronauts is limited. With the advent of longer duration missions beyond low Earth orbit, it is imperative that space agencies adopt a personalized strategy for each astronaut, starting from pre-emptive personalized pre-clinical approaches through to individualized countermeasures to minimize harmful physiological changes and find targeted treatment for disease. Advances in space medicine can also be translated to terrestrial applications, and vice versa. This review places the astronaut at the center of personalized medicine, will appraise existing evidence and future preclinical tools as well as clinical, ethical and legal considerations for future space travel.
Collapse
Affiliation(s)
| | - Sarah Baatout
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium.,Department of Biotechnology, Ghent University, Ghent, Belgium
| | - Alexander Choukér
- Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, Hospital of the Ludwig-Maximilians-University, Munich, Germany
| | - Judith-Irina Buchheim
- Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, Hospital of the Ludwig-Maximilians-University, Munich, Germany
| | - Bjorn Baselet
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium
| | - Cinzia Dello Russo
- Department of Healthcare Surveillance and Bioethics, Section of Pharmacology, Università Cattolica Del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,MRC Centre for Drug Safety Science and Wolfson Centre for Personalized Medicine, Institute of Systems, Molecular and Integrative Biology (ISMIB), University of Liverpool, Liverpool, United Kingdom
| | | | - Monica Monici
- ASA Campus Joint Laboratory, ASA Research Division, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | | | - Dimitri Gagliardi
- Manchester Institute of Innovation Research, Alliance Manchester Business School, The University of Manchester, Manchester, United Kingdom
| | - Julia Caroline Stingl
- Institute of Clinical Pharmacology, University Hospital of the RWTH Aachen, Aachen, Germany
| | - Leonardo Surdo
- Space Applications Services NV/SA for the European Space Agency, Noordwijk, Netherlands
| | - Vincent Lai Ming Yip
- MRC Centre for Drug Safety Science and Wolfson Centre for Personalized Medicine, Institute of Systems, Molecular and Integrative Biology (ISMIB), University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
7
|
Desando G, Grigolo B, Deangelles Pereira Florentino Á, Teixeira MW, Barbagallo F, Naro F, da Silva-Júnior VA, Soares AF. Preclinical Evidence of Intra-Articular Autologous Cartilage Micrograft for Osteochondral Repair: Evaluation in a Rat Model. Cartilage 2021; 13:1770S-1779S. [PMID: 34474579 PMCID: PMC8804823 DOI: 10.1177/19476035211042408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The search for an effective and long-lasting strategy to treat osteochondral defects (OCD) is a great challenge. Regenerative medicine launched a new era of research in orthopaedics for restoring normal tissue functions. The aim of this study was to test the healing potential of Rigenera micrografting technology in a rat model of OCD by investigating 2 cartilage donor sites. METHODS Full-thickness OCD was bilaterally created in the knee joints of rats. Animals were randomly divided into 2 groups based on the anatomical site used for micrograft collection: articular (TO) and xiphoid (XA). Micrograft was injected into the knee via an intra-articular approach. The contralateral joint served as the control. Euthanasia was performed 2 months after the set-up of OCD. Histological evaluations foresaw hematoxylin/eosin and safranin-O/fast green staining, the modified O'Driscoll score, and collagen 1A1 and 2A1 immunostaining. Kruskal-Wallis and the post hoc Dunn test were performed to evaluate differences among groups. RESULTS Histological results showed defect filling in both autologous micrografts. The TO group displayed tissue repair with more hyaline-like characteristics than its control (P < 0.01). A fibrocartilaginous aspect was instead noticed in the XA group. Immunohistochemical assessments on type 2A1 and type 1 collagens confirmed the best histological results in the TO group. CONCLUSIONS TO and XA groups contributed to a different extent to fill the OCD lesions. TO group provided the best histological and immunohistochemical results; therefore, it could be a promising method to treat OCD after the validation in a larger animal model.
Collapse
Affiliation(s)
- Giovanna Desando
- Laboratorio RAMSES, IRCCS Istituto
Ortopedico Rizzoli, Bologna, Italy
| | - Brunella Grigolo
- Laboratorio RAMSES, IRCCS Istituto
Ortopedico Rizzoli, Bologna, Italy,Brunella Grigolo, Laboratorio RAMSES, IRCCS
Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, Bologna, Emilia-Romagna
40136, Italy.
| | | | | | - Federica Barbagallo
- Department of Experimental Medicine,
Sapienza University of Rome, Rome, Italy
| | - Fabio Naro
- Department of Anatomical, Histological,
Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Anísio Francisco Soares
- Department of Animal Morphology and
Physiology, Federal Rural University of Pernambuco–UFRPE, Brazil
| |
Collapse
|
8
|
De Francesco F, Riccio V, Biswas R, Busato A, Di Bella C, Serri E, Sbarbati A, Zavan B, Riccio M, Palumbo Piccionello A. In Vitro Characterization of Canine Microfragmented Adipose Tissue Non-Enzymatically Extracted from the Thigh and Lumbar Regions. Animals (Basel) 2021; 11:ani11113231. [PMID: 34827964 PMCID: PMC8614580 DOI: 10.3390/ani11113231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/03/2021] [Accepted: 11/10/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Mesenchymal stem cells are located in bone marrow, adipose tissue, synovial membrane, and muscular tissue. They have an immunosuppressive, anti-inflammatory, and antifibrotic effect. Tissue engineering considers the usage of mesenchymal stem cells as a possible option for regenerating tissues, with respect to bone and cartilage, due to their ability to differentiate into multiple cytotypes (including chondrocytes and osteoblasts). Herein, we characterize a non-invasive solution based on Rigenera® technology, a mechanical disaggregation method able to produce autologous adipose tissue-derived micrografts which are analogous to adipose-derived stem cells. Abstract Within the adult canine population, disabilities and symptoms including joint pain and functional impairment are commonly observed in articular cartilage lesions and present a challenging feat in the operating room. Clinical settings require less invasive and more minimally manipulated measures facilitated by innovative and advanced technology. Mesenchymal stem cells have recently been proposed and, furthermore, autologous adipose tissue administration via injection has emerged as a new albeit somewhat controversial therapeutic tool. The purpose of this study is to characterize canine autologous micro-fragmented adipose tissue (micrografts) by mechanical approach without substantial manipulations. Adipose tissue samples collected from six dogs were processed by a Rigenera device and by enzymatic digestion from two different body regions (lumbar and thigh region). Interestingly, the immunophenotypic analysis attested that cells from Rigenera® were highly positive for the mesenchymal stem cells markers CD73 and CD90, less positive for hematopoietic CD45 and CD34, and negative for MHC class II antibodies (which play a role in immune responses). Finally, the Rigenera® technology obtained micrografts with a 35% higher expression of the IL10 gene with relevant anti-inflammatory activities compared to the enzymatic digestion protocol. This evidence suggests a potential improved clinical outcome capable of modulating inflammation and immune responses.
Collapse
Affiliation(s)
- Francesco De Francesco
- Hand Surgery Unit, Department of Plastic and Reconstructive Surgery, Azienda ‘Ospedali Riuniti di Ancona’, 60126 Ancona, Italy;
- Correspondence: ; Tel.: +39-071-5963945; Fax: +39-071-5965297
| | - Valentina Riccio
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Matelica, Italy; (V.R.); (C.D.B.); (E.S.); (A.P.P.)
| | - Reetuparna Biswas
- Department of Neuroscience, Biomedicine and Movement, Human Anatomy and Histology Section, University of Verona, 37179 Verona, Italy; (R.B.); (A.B.); (A.S.)
| | - Alice Busato
- Department of Neuroscience, Biomedicine and Movement, Human Anatomy and Histology Section, University of Verona, 37179 Verona, Italy; (R.B.); (A.B.); (A.S.)
| | - Caterina Di Bella
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Matelica, Italy; (V.R.); (C.D.B.); (E.S.); (A.P.P.)
| | - Evelina Serri
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Matelica, Italy; (V.R.); (C.D.B.); (E.S.); (A.P.P.)
| | - Andrea Sbarbati
- Department of Neuroscience, Biomedicine and Movement, Human Anatomy and Histology Section, University of Verona, 37179 Verona, Italy; (R.B.); (A.B.); (A.S.)
| | - Barbara Zavan
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, 44121 Ferrara, Italy;
| | - Michele Riccio
- Hand Surgery Unit, Department of Plastic and Reconstructive Surgery, Azienda ‘Ospedali Riuniti di Ancona’, 60126 Ancona, Italy;
| | - Angela Palumbo Piccionello
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Matelica, Italy; (V.R.); (C.D.B.); (E.S.); (A.P.P.)
| |
Collapse
|
9
|
Amsar RM, Barlian A, Judawisastra H, Wibowo UA, Karina K. Cell penetration and chondrogenic differentiation of human adipose derived stem cells on 3D scaffold. Future Sci OA 2021; 7:FSO734. [PMID: 34295538 PMCID: PMC8288224 DOI: 10.2144/fsoa-2021-0040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/19/2021] [Indexed: 11/25/2022] Open
Abstract
The ability of cells to penetrate the scaffold and differentiate into chondrocyte is important in cartilage engineering. The aim of this research was to evaluate the use of silk fibroin 3D scaffold in facilitating the growth of stem cell and to study the role of L-ascorbic acid and platelet rich plasma (PRP) in proliferation and differentiation genes. Cell penetration and type II collagen content in the silk fibroin scaffold was analyzed by confocal microscopy. Relative expressions of CDH2, CCND1, CTNNB1 and COL2A1 were analyzed by reverse transcription-quantitative PCR (RT-qPCR). The silk fibroin 3D scaffold could facilitate cell penetration. L-ascorbic acid and PRP increased the expression of CDH2 and COL2A1 on the 21st day of treatment while PRP inhibited CTNNB1 and CCND1.
Collapse
Affiliation(s)
- Rizka Musdalifah Amsar
- School of Life Science & Technology, Institute of Technology Bandung, Bandung, West Java, Indonesia
| | - Anggraini Barlian
- School of Life Science & Technology, Institute of Technology Bandung, Bandung, West Java, Indonesia
| | - Hermawan Judawisastra
- Faculty of Mechanical & Aerospace of Engineering, Institute of Technology Bandung, Bandung, West Java, Indonesia
| | - Untung Ari Wibowo
- Faculty of Mechanical & Aerospace of Engineering, Institute of Technology Bandung, Bandung, West Java, Indonesia
| | | |
Collapse
|
10
|
Gambaro FM, Ummarino A, Torres Andón F, Ronzoni F, Di Matteo B, Kon E. Drug Delivery Systems for the Treatment of Knee Osteoarthritis: A Systematic Review of In Vivo Studies. Int J Mol Sci 2021; 22:ijms22179137. [PMID: 34502046 PMCID: PMC8431358 DOI: 10.3390/ijms22179137] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/21/2021] [Accepted: 08/22/2021] [Indexed: 12/12/2022] Open
Abstract
Many efforts have been made in the field of nanotechnology to improve the local and sustained release of drugs, which may be helpful to overcome the present limitations in the treatment of knee OA. Nano-/microparticles and/or hydrogels can be now engineered to improve the administration and intra-articular delivery of specific drugs, targeting molecular pathways and pathogenic mechanisms involved in OA progression and remission. In order to summarize the current state of this field, a systematic review of the literature was performed and 45 relevant studies were identified involving both animal models and humans. We found that polymeric nanoparticles loaded with anti-inflammatory drugs (i.e., dexamethasone or celecoxib) are the most frequently investigated drug delivery systems, followed by microparticles and hydrogels. In particular, the nanosystem most frequently used in preclinical research consists of PLGA-nanoparticles loaded with corticosteroids and non-steroidal anti-inflammatory drugs. Overall, improvement in histological features, reduction in joint inflammation, and improvement in clinical scores in patients were observed. The last advances in the field of nanotechnology could offer new opportunities to treat patients affected by knee OA, including those with previous meniscectomy. New smart drug delivery approaches, based on nanoparticles, microparticles, and hydrogels, may enhance the therapeutic potential of intra-articular agents by increasing the permanence of selected drugs inside the joint and better targeting specific receptors and tissues.
Collapse
Affiliation(s)
- Francesco Manlio Gambaro
- Department of Biomedical Sciences, Humanitas University Pieve Emanuele, 20090 Milan, Italy; (A.U.); (F.T.A.); (F.R.); (E.K.)
- IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
- Correspondence:
| | - Aldo Ummarino
- Department of Biomedical Sciences, Humanitas University Pieve Emanuele, 20090 Milan, Italy; (A.U.); (F.T.A.); (F.R.); (E.K.)
- IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
| | - Fernando Torres Andón
- Department of Biomedical Sciences, Humanitas University Pieve Emanuele, 20090 Milan, Italy; (A.U.); (F.T.A.); (F.R.); (E.K.)
- Center for Research in Molecular Medicine & Chronic Diseases (CIMUS), Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain
| | - Flavio Ronzoni
- Department of Biomedical Sciences, Humanitas University Pieve Emanuele, 20090 Milan, Italy; (A.U.); (F.T.A.); (F.R.); (E.K.)
- Human Anatomy Unit, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Berardo Di Matteo
- IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
- Department of Traumatology, Orthopaedics and Disaster Surgery, First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Elizaveta Kon
- Department of Biomedical Sciences, Humanitas University Pieve Emanuele, 20090 Milan, Italy; (A.U.); (F.T.A.); (F.R.); (E.K.)
- IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
| |
Collapse
|
11
|
Astarita C, Arora CL, Trovato L. Tissue regeneration: an overview from stem cells to micrografts. J Int Med Res 2021; 48:300060520914794. [PMID: 32536230 PMCID: PMC7297485 DOI: 10.1177/0300060520914794] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Regenerative medicine represents a major challenge for the scientific community. The choice of the biological sources used, such as stem cells and grafts, is crucial. Stem cell therapy is mainly related to the use of mesenchymal stem cells; however, clinical trials are still needed to investigate their safety. The micrografting technique was conceived by Cicero Parker Meek in 1958. It is based on the principle that by increasing the superficial area of skin grafts and reducing the size of its particles, it is possible to cover an area larger than the original donor site. Stem cells are pluripotent cells that have the capacity to differentiate into all cell types and are self-renewing, whereas micrografts derive from a small fragment of an autologous tissue and exhibit limited differentiative potential compared with stem cells. Therefore, stem cells and micrografts cannot be considered equivalent, although in some cases they exhibit similar regenerative potential, which is the focus of this review. Last, stem cell therapies remain limited because of complex and costly processes, making them not very feasible in clinical practice, whereas obtaining micrografts is generally a one-step procedure that does not require any advanced tissue manipulation.
Collapse
Affiliation(s)
- Carlo Astarita
- Sbarro Institute for Cancer Research and Molecular Medicine, Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA, USA.,Human Brain Wave, corso Galileo Ferraris 63, 10128 Turin, Italy
| | - Camilla L Arora
- Human Brain Wave, corso Galileo Ferraris 63, 10128 Turin, Italy
| | - Letizia Trovato
- Human Brain Wave, corso Galileo Ferraris 63, 10128 Turin, Italy
| |
Collapse
|
12
|
Marcarelli M, Zappia M, Rissolio L, Baroni C, Astarita C, Trovato L, Graziano A. Cartilage Micrografts as a Novel Non-Invasive and Non-Arthroscopic Autograft Procedure for Knee Chondropathy: Three-Year Follow-Up Study. J Clin Med 2021; 10:jcm10020322. [PMID: 33477260 PMCID: PMC7830188 DOI: 10.3390/jcm10020322] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 12/19/2022] Open
Abstract
(1) Background: Focal chondral defects of the knee can significantly impair patient quality of life. Although different options are available, they are still not conclusive and have several limitations. The aim of this study was to evaluate the role of autologous cartilage micrografts in the treatment of knee chondropathy. (2) Methods: Eight patients affected by knee chondropathy were evaluated before and after 6 months and 3 years following autologous cartilage micrografts by magnetic resonance imaging (MRI) for cartilage measurement and clinical assessment. (3) Results: All patients recovered daily activities, reporting pain reduction without the need for analgesic therapy; Oxford Knee Score (OKS) was 28.4 ± 6 and 40.8 ± 6.2 and visual analogue scale (VAS) was 5.5 ± 1.6 and 1.8 ± 0.7 before and after 6 months following treatment, respectively. Both scores remained stable after 3 years. Lastly, a significant improvement of the cartilage thickness was observed using MRI after 3 years. (4) Conclusions: Autologous cartilage micrografts can promote the formation of new cartilage, and could be a valid approach for the treatment of knee chondropathy.
Collapse
Affiliation(s)
- Marco Marcarelli
- Unit of Orthopedics and Traumatology of Chieri and Moncalieri, Santa Croce Hospital, 10024 Turin, Italy; (M.M.); (L.R.); (C.B.)
| | - Marcello Zappia
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy;
| | - Lorenzo Rissolio
- Unit of Orthopedics and Traumatology of Chieri and Moncalieri, Santa Croce Hospital, 10024 Turin, Italy; (M.M.); (L.R.); (C.B.)
| | - Chiara Baroni
- Unit of Orthopedics and Traumatology of Chieri and Moncalieri, Santa Croce Hospital, 10024 Turin, Italy; (M.M.); (L.R.); (C.B.)
| | - Carlo Astarita
- Human Brain Wave, Corso Galileo Ferraris, 63, 10128 Turin, Italy;
- Sbarro Institute for Cancer Research and Molecular Medicine, Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19126, USA;
- Correspondence:
| | - Letizia Trovato
- Sbarro Institute for Cancer Research and Molecular Medicine, Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19126, USA;
| | - Antonio Graziano
- Human Brain Wave, Corso Galileo Ferraris, 63, 10128 Turin, Italy;
- Sbarro Institute for Cancer Research and Molecular Medicine, Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19126, USA;
| |
Collapse
|
13
|
Miotti G, Zingaretti N, Guarneri GF, Manfrè V, Errichetti E, Stinco G, Parodi PC. Autologous micrografts and methotrexate in plantar erosive lichen planus: healing and pain control. A case report. CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY 2020; 7:134-138. [PMID: 33457454 PMCID: PMC7782279 DOI: 10.1080/23320885.2020.1848434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Erosive lichen planus is an uncommon variant of lichen planus. We report a case of longstanding and refractory plantar ELPs causing disabling and opiate-resistant pain treated with ‘classic’ meshed skin graft combined with Rigenera® micrografts. After approximately 9 months follow-up, no clinical recurrence or pain were observed. Erosive lichen planus (ELP) is an uncommon variant of lichen planus, involving oral cavity and genitalia and, less often plantar areas, where it usually presents with chronic erosions of the soles, along with intense, disabling pain and progressive loss of toenails. An abnormal immune cellular response (CD8+ lymphocytes and macrophages) and the consequent altered production of multiple mediators (interleukin-12, interferon-γ, tumor necrosis factor-α, RANTES and MMP-9), seem to play a crucial role in the pathogenesis, although the etiology remains uncertain. From a histological point of view, ELP shows keratinocyte apoptosis, intense inflammatory response and basal epithelial keratinocytes TNF-α overexpression. Several therapies have been proposed, with variable and controversial results. While topical corticosteroids and topical calcineurin inhibitors are the treatments of choice for localized forms, short pulses of systemic glucocorticoids, phototherapy, and systemic immunosuppressants are recommended for generalized cases. Surgery has been reported as a possible therapeutic option in refractory and stable cases with localized lesions, either alone or with cyclosporine. Herein, we report a case of longstanding and refractory plantar ELPS causing disabling and opiate-resistant pain treated with ‘classic’ meshed skin graft combined with Rigenera® micrografts.
Collapse
Affiliation(s)
- G Miotti
- Department of Plastic and Recostructive Surgery, "Santa Maria della Misericordia" University Hospital, Udine, Italy
| | - N Zingaretti
- Department of Plastic and Recostructive Surgery, "Santa Maria della Misericordia" University Hospital, Udine, Italy
| | - G F Guarneri
- Department of Plastic and Recostructive Surgery, "Santa Maria della Misericordia" University Hospital, Udine, Italy
| | - V Manfrè
- Department of Plastic and Recostructive Surgery, "Santa Maria della Misericordia" University Hospital, Udine, Italy
| | - E Errichetti
- Institute of Dermatology, Department of Medicine, "Santa Maria della Misericordia" University Hospital, Udine, Italy
| | - G Stinco
- Institute of Dermatology, Department of Medicine, "Santa Maria della Misericordia" University Hospital, Udine, Italy
| | - P C Parodi
- Department of Plastic and Recostructive Surgery, "Santa Maria della Misericordia" University Hospital, Udine, Italy
| |
Collapse
|
14
|
Niermeyer WL, Rodman C, Li MM, Chiang T. Tissue engineering applications in otolaryngology-The state of translation. Laryngoscope Investig Otolaryngol 2020; 5:630-648. [PMID: 32864434 PMCID: PMC7444782 DOI: 10.1002/lio2.416] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/06/2020] [Accepted: 05/11/2020] [Indexed: 12/14/2022] Open
Abstract
While tissue engineering holds significant potential to address current limitations in reconstructive surgery of the head and neck, few constructs have made their way into routine clinical use. In this review, we aim to appraise the state of head and neck tissue engineering over the past five years, with a specific focus on otologic, nasal, craniofacial bone, and laryngotracheal applications. A comprehensive scoping search of the PubMed database was performed and over 2000 article hits were returned with 290 articles included in the final review. These publications have addressed the hallmark characteristics of tissue engineering (cellular source, scaffold, and growth signaling) for head and neck anatomical sites. While there have been promising reports of effective tissue engineered interventions in small groups of human patients, the majority of research remains constrained to in vitro and in vivo studies aimed at furthering the understanding of the biological processes involved in tissue engineering. Further, differences in functional and cosmetic properties of the ear, nose, airway, and craniofacial bone affect the emphasis of investigation at each site. While otolaryngologists currently play a role in tissue engineering translational research, continued multidisciplinary efforts will likely be required to push the state of translation towards tissue-engineered constructs available for routine clinical use. LEVEL OF EVIDENCE NA.
Collapse
Affiliation(s)
| | - Cole Rodman
- The Ohio State University College of MedicineColumbusOhioUSA
| | - Michael M. Li
- Department of Otolaryngology—Head and Neck SurgeryThe Ohio State University Wexner Medical CenterColumbusOhioUSA
| | - Tendy Chiang
- Department of OtolaryngologyNationwide Children's HospitalColumbusOhioUSA
- Department of Otolaryngology—Head and Neck SurgeryThe Ohio State University Wexner Medical CenterColumbusOhioUSA
| |
Collapse
|
15
|
Marcarelli M, Fiammengo M, Trovato L, Lancione V, Novarese E, Indelli PF, Risitano S. Autologous grafts in the treatment of avascular osteonecrosis of the femoral head. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:342-349. [PMID: 32420971 PMCID: PMC7569645 DOI: 10.23750/abm.v91i2.8188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 08/24/2019] [Indexed: 11/23/2022]
Abstract
Background: Osteonecrosis of the femoral head (ONFH) is a frequent orthopedic disease leading to destruction of the hip joint and disabling arthritis. Several procedures have been developed to treat the joint deterioration in case of osteonecrosis, trying to avoid or delay an intervention of total hip replacement, especially in young patients. The aim of this study was to analyze the use of autologous bone micrografts derived from cancellous bone in the management of avascular ONFH. The treatment described was implemented using the Rigenera® protocol to obtain autologous micrografts: small fragments of cancellous bone collected by femoral neck, disaggregated and injected in the necrotic area using an empty screw. Materials and methods: Twenty adult patients affected by avascular ONFH were enrolled in this study; all patients reported a preoperative intermittent coxo-arthrosis and limited function of intra and extra rotation of the hip. Inclusion criteria were an Oxford Hip Score between (OHS) 20 and 39, a Harris hip score (HHS) showing pre-operative poor results (lower than 70 points) and a stage II-IIIA and IIIB according with the classification proposed by the Association Research Circulation Osseous (ARCO). Results: Using an MRI evaluation, after six months, the authors observed a complete regression of necrotic area and the restoration of osseous structure. Clinical outcome has been evaluated at 6-12 and 24 months follow-up. At the final F.U. the HHS rised from poor to good results (mean value at final F.U of 84) while the OHS improved significantly already after 21 days from micrografts injection (mean 35.4 ± 7.5) with an increasing trend until to two-year final FU (mean 37.4 ± 9.5). The full recovery of daily and mild sport activities was reached after 20 and 90 days from intervention, respectively. Conclusion: The results of this study are suggestive for a new approach in the treatment of avascular ONFH assuming a process of bone regeneration based on a dual mechanism of action, biological and mechanical, induced by micrografts and injected using an empty screw as vehicle. (www.actabiomedica.it)
Collapse
Affiliation(s)
- Marco Marcarelli
- Department of Orthopaedic Surgery and Traumatology. "Maggiore" Hospital of Chieri. Turin. ITA.
| | - Marco Fiammengo
- Department of Orthopaedic Surgery and Traumatology. "Maggiore" Hospital of Chieri. Turin. ITA.
| | - Letizia Trovato
- Department of nephrology and dialysis, "Regina Margherita" Hospital Turin. ITA.
| | - Vincenzo Lancione
- Department of Orthopaedic Surgery and Traumatology. "Maggiore" Hospital of Chieri. Turin. ITA.
| | - Elvio Novarese
- Department of Orthopaedic Surgery and Traumatology. "Maggiore" Hospital of Chieri. Turin. ITA.
| | - Pier Francesco Indelli
- Department of Orthopaedic Surgery and Bioengineering, Stanford University School of Medicine and the Palo Alto Veterans Affairs Health Care System(PAVAHCS), Palo Alto, CA, USA.
| | | |
Collapse
|
16
|
Dai Prè E, Busato A, Mannucci S, Vurro F, De Francesco F, Riccio V, Solito S, Biswas R, Bernardi P, Riccio M, Sbarbati A. In Vitro Characterization of Adipose Stem Cells Non-Enzymatically Extracted from the Thigh and Abdomen. Int J Mol Sci 2020; 21:ijms21093081. [PMID: 32349299 PMCID: PMC7247667 DOI: 10.3390/ijms21093081] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 12/11/2022] Open
Abstract
Autologous fat grafting is a surgical technique in which adipose tissue is transferred from one area of the body to another, in order to reconstruct or regenerate damaged or injured tissues. Before reinjection, adipose tissue needs to be purified from blood and cellular debris to avoid inflammation and preserve the graft viability. To perform this purification, different enzymatic and mechanical methods can be used. In this study, we characterized in vitro the product of a closed automatic device based on mechanical disaggregation, named Rigenera®, focusing on two sites of adipose tissue harvesting. At first, we optimized the Rigenera® operating timing, demonstrating that 60 s of treatment allows a higher cellular yield, in terms of the cell number and growth rate. This result optimizes the mechanical disaggregation and it can increase the clinical efficiency of the final product. When comparing the extracted adipose samples from the thigh and abdomen, our results showed that the thigh provides a higher number of mesenchymal-like cells, with a faster replication rate and a higher ability to form colonies. We can conclude that by collecting adipose tissue from the thigh and treating it with the Rigenera® device for 60 s, it is possible to obtain the most efficient product.
Collapse
Affiliation(s)
- Elena Dai Prè
- Department of Neuroscience, Biomedicine and Movement, Human Anatomy and Histology Section, University of Verona, 37129 Verona, Italy; (E.D.P.); (A.B.); (S.M.); (F.V.); (R.B.); (P.B.); (A.S.)
| | - Alice Busato
- Department of Neuroscience, Biomedicine and Movement, Human Anatomy and Histology Section, University of Verona, 37129 Verona, Italy; (E.D.P.); (A.B.); (S.M.); (F.V.); (R.B.); (P.B.); (A.S.)
- Department of Computer Sciences, University of Verona, 37135 Verona, Italy
| | - Silvia Mannucci
- Department of Neuroscience, Biomedicine and Movement, Human Anatomy and Histology Section, University of Verona, 37129 Verona, Italy; (E.D.P.); (A.B.); (S.M.); (F.V.); (R.B.); (P.B.); (A.S.)
- Accademia del Lipofilling, Research and Training Center in Regenerative Surgery, 61025 Montelabbate (PU), Italy;
| | - Federica Vurro
- Department of Neuroscience, Biomedicine and Movement, Human Anatomy and Histology Section, University of Verona, 37129 Verona, Italy; (E.D.P.); (A.B.); (S.M.); (F.V.); (R.B.); (P.B.); (A.S.)
| | - Francesco De Francesco
- Accademia del Lipofilling, Research and Training Center in Regenerative Surgery, 61025 Montelabbate (PU), Italy;
- Department of Reconstructive Surgery and Hand Surgery, AOU “Ospedali Riuniti”, 60020 Ancona, Italy
- Correspondence: ; Tel.: +39-0715963945
| | - Valentina Riccio
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Matelica, MC, Italy;
| | - Samantha Solito
- Centro Piattaforme Tecnologiche, University of Verona, 37135 Verona, Italy;
| | - Reetuparna Biswas
- Department of Neuroscience, Biomedicine and Movement, Human Anatomy and Histology Section, University of Verona, 37129 Verona, Italy; (E.D.P.); (A.B.); (S.M.); (F.V.); (R.B.); (P.B.); (A.S.)
| | - Paolo Bernardi
- Department of Neuroscience, Biomedicine and Movement, Human Anatomy and Histology Section, University of Verona, 37129 Verona, Italy; (E.D.P.); (A.B.); (S.M.); (F.V.); (R.B.); (P.B.); (A.S.)
| | - Michele Riccio
- Accademia del Lipofilling, Research and Training Center in Regenerative Surgery, 61025 Montelabbate (PU), Italy;
- Department of Reconstructive Surgery and Hand Surgery, AOU “Ospedali Riuniti”, 60020 Ancona, Italy
| | - Andrea Sbarbati
- Department of Neuroscience, Biomedicine and Movement, Human Anatomy and Histology Section, University of Verona, 37129 Verona, Italy; (E.D.P.); (A.B.); (S.M.); (F.V.); (R.B.); (P.B.); (A.S.)
- Accademia del Lipofilling, Research and Training Center in Regenerative Surgery, 61025 Montelabbate (PU), Italy;
| |
Collapse
|
17
|
Trovato L, Astarita C, Graziano A. Comment on the article by Dr. Toshima about alopecia areata multiplex following autologous dermal micrograft injection. J Eur Acad Dermatol Venereol 2020; 34:e219-e221. [DOI: 10.1111/jdv.16176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
18
|
A Multicentre Study: The Use of Micrografts in the Reconstruction of Full-Thickness Posttraumatic Skin Defects of the Limbs-A Whole Innovative Concept in Regenerative Surgery. Stem Cells Int 2019; 2019:5043518. [PMID: 31885613 PMCID: PMC6915006 DOI: 10.1155/2019/5043518] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 09/06/2019] [Accepted: 10/03/2019] [Indexed: 12/25/2022] Open
Abstract
The skin graft is a surgical technique commonly used in the reconstructive surgery of the limbs, in order to repair skin loss, as well as to repair the donor area of the flaps and cover the dermal substitutes after engraftment. The unavoidable side effect of this technique consists of unaesthetic scars. In order to achieve the healing of posttraumatic ulcers by means of tissue regeneration and to avoid excessive scarring, a new innovative technology based on the application of autologous micrografts, obtained by Rigenera technology, was reported. This technology was able to induce tissue repair by highly viable skin micrografts of 80 micron size achieved by a mechanical disaggregation method. The specific cell population of these micrografts includes progenitor cells, which in association with the fragment of the Extracellular Matrix (ECM) and growth factors derived by patients' own tissue initiate biological processes of regeneration enhancing the wound healing process. We have used this technique in 70 cases of traumatic wounds of the lower and upper limbs, characterized by extensive loss of skin substance and soft tissue. In all cases, we have applied the Rigenera protocol using skin micrografts, achieving in 69 cases the complete healing of wounds in a period between 35 and 84 days. For each patient, the reconstructive outcome was evaluated weekly to assess the efficacy of this technique and any arising complication. A visual analogue scale (VAS) was administered to assess the amount of pain felt after the micrografts' application, whereas we evaluated the scars according to the Vancouver scale and the wound prognosis according to Wound Bed Score. We have thus been able to demonstrate that Rigenera procedure is very effective in stimulating skin regeneration, while reducing the outcome scar.
Collapse
|
19
|
Ruiz RG, Rosell JMC, Ceccarelli G, De Sio C, De Angelis GC, Pinto H, Astarita C, Graziano A. Progenitor-cell-enriched micrografts as a novel option for the management of androgenetic alopecia. J Cell Physiol 2019; 235:4587-4593. [PMID: 31643084 DOI: 10.1002/jcp.29335] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 09/30/2019] [Indexed: 01/25/2023]
Abstract
Regenerative medicine is a multidisciplinary field that combines engineering and life science principles to promote regeneration, potentially restoring the physiological condition in diseased tissues. Specifically, the developments of complex grafts enhance the intrinsic regenerative capacity of the host by altering its environment. Autologous micrografts obtained through Rigenera® micrografting technology are able to promote derma and bone regeneration. Androgenetic alopecia (AGA) leads to a progressive thinning of scalp hair affecting 60-70% of the adult population worldwide. Pharmacological treatment offers moderate results and hair transplantation represents the only permanent treatment option. The aim of this study was to demonstrate the role of dermis micrografting in the treatment of AGA by clinical and histological evaluations after 4, 6, and 12 months. Hair growth and density were improved at all indicated times. Those outcomes were also confirmed by the TrichoScan® analysis, reporting an increase of total hair count and density with an increase and reduction of anagen and telogen phases, respectively. Scalp dermoscopic analysis showed an improvement of hair density and histological analysis indicated a clear amelioration of the scalp, development of hair follicles, and a beginning of cuticle formation. Collectively, those results suggest a possible use of the micrografts as a novel therapeutic option in the management of AGA.
Collapse
Affiliation(s)
| | | | - Gabriele Ceccarelli
- Department of Public Health, Experimental Medicine and Forensics, Center for Health Technologies, University of Pavia, Pavia, Italy
| | - Ciro De Sio
- Private practice of Plastic Surgeon, Rome, Italy
| | - Gabriella C De Angelis
- Department of Public Health, Experimental Medicine and Forensics, Center for Health Technologies, University of Pavia, Pavia, Italy
| | - Hernan Pinto
- Biomedical Research Institute i2e3, Barcelona, Spain
| | - Carlo Astarita
- Department of R&D, Human Brain Wave, Turin, Italy.,Department of Biology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, Pennsylvania
| | - Antonio Graziano
- Department of R&D, Human Brain Wave, Turin, Italy.,Department of Biology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, Pennsylvania
| |
Collapse
|
20
|
Viganò M, Tessaro I, Trovato L, Colombini A, Scala M, Magi A, Toto A, Peretti G, de Girolamo L. Rationale and pre-clinical evidences for the use of autologous cartilage micrografts in cartilage repair. J Orthop Surg Res 2018; 13:279. [PMID: 30400946 PMCID: PMC6218996 DOI: 10.1186/s13018-018-0983-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 10/19/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The management of cartilage lesions is an open issue in clinical practice, and regenerative medicine represents a promising approach, including the use of autologous micrografts whose efficacy was already tested in different clinical settings. The aim of this study was to characterize in vitro the effect of autologous cartilage micrografts on chondrocyte viability and differentiation and perform an evaluation of their application in racehorses affected by joint diseases. MATERIALS AND METHODS Matched human chondrocytes and micrografts were obtained from articular cartilage using Rigenera® procedure. Chondrocytes were cultured in the presence or absence of micrografts and chondrogenic medium to assess cell viability and cell differentiation. For the pre-clinical evaluation, three racehorses affected by joint diseases were treated with a suspension of autologous micrografts and PRP in arthroscopy interventions. Clinical and radiographic follow-ups were performed up to 4 months after the procedure. RESULTS Autologous micrografts support the formation of chondrogenic micromasses thanks to their content of matrix and growth factors, such as transforming growth factor β (TGFβ) and insulin-like growth factor 1 (IGF-1). On the other hand, no significant differences were observed on the gene expression of type II collagen, aggrecan, and SOX9. Preliminary data in the treatment of racehorses are suggestive of a potential in vivo use of micrografts to treat cartilage lesions. CONCLUSION The results reported in this study showed the role of articular micrografts in the promoting chondrocyte differentiation suggesting their potential use in the clinical practice to treat articular lesions.
Collapse
Affiliation(s)
- Marco Viganò
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Irene Tessaro
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Letizia Trovato
- Human Brain Wave, corso Galileo Ferraris 63, 10128 Turin, Italy
| | | | - Marco Scala
- Primus Gel srl, Via Casaregis, 30, 16129 Genoa, Italy
| | - Alberto Magi
- Clinica Veterinaria San Rossore, via delle cascine 149, 56100 Pisa, Italy
| | - Andrea Toto
- Clinica Veterinaria San Rossore, via delle cascine 149, 56100 Pisa, Italy
| | - Giuseppe Peretti
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161 Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, via Mangiagalli 31, 20133 Milan, Italy
| | - Laura de Girolamo
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161 Milan, Italy
| |
Collapse
|
21
|
Rodriguez Y Baena R, D'Aquino R, Graziano A, Trovato L, Aloise AC, Ceccarelli G, Cusella G, Pelegrine AA, Lupi SM. Autologous Periosteum-Derived Micrografts and PLGA/HA Enhance the Bone Formation in Sinus Lift Augmentation. Front Cell Dev Biol 2017; 5:87. [PMID: 29021982 PMCID: PMC5623661 DOI: 10.3389/fcell.2017.00087] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/12/2017] [Indexed: 12/30/2022] Open
Abstract
Sinus lift augmentation is a procedure required for the placement of a dental implant, whose success can be limited by the quantity or quality of available bone. To this purpose, the first aim of the current study was to evaluate the ability of autologous periosteum-derived micrografts and Poly(lactic-co-glycolic acid) (PLGA) supplemented with hydroxyl apatite (HA) to induce bone augmentation in the sinus lift procedure. Secondly, we compared the micrograft's behavior with respect to biomaterial alone, including Bio-Oss® and PLGA/HA, commercially named Alos. Sinus lift procedure was performed on 24 patients who required dental implants and who, according to the study design and procedure performed, were divided into three groups: group A (Alos + periosteum-derived micrografts); group B (Alos alone); and group C (Bio-Oss® alone). Briefly, in group A, a small piece of periosteum was collected from each patient and mechanically disaggregated by Rigenera® protocol using the Rigeneracons medical device. This protocol allowed for the obtainment of autologous micrografts, which in turn were used to soak the Alos scaffold. At 6 months after the sinus lift procedure and before the installation of dental implants, histological and radiographic evaluations in all three groups were performed. In group A, where sinus lift augmentation was performed using periosteum-derived micrografts and Alos, the bone regeneration was much faster than in the control groups where it was performed with Alos or Bio-Oss® alone (groups B and C, respectively). In addition, the radiographic evaluation in the patients of group A showed a radio-opacity after 4 months, while after 6 months, the prosthetic rehabilitation was improved and was maintained after 2 years post-surgery. In summary, we report on the efficacy of periosteum-derived micrografts and Alos to augment sinus lift in patients requiring dental implants. This efficacy is supported by an increased percentage of vital mineralized tisssue in the group treated with both periosteum-derived micrografts and Alos, with respect to the control group of Alos or Bio-Oss® alone, as confirmed by histological analysis and radiographic evaluations at 6 months from treatment.
Collapse
Affiliation(s)
- Ruggero Rodriguez Y Baena
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Riccardo D'Aquino
- Private Practice, Turin, Italy.,Human Brain Wave S.r.L., Turin, Italy
| | - Antonio Graziano
- Human Brain Wave S.r.L., Turin, Italy.,Sbarro Health Research Organization (SHRO), Temple University of Philadelphia, Philadelphia, PA, United States
| | | | - Antonio C Aloise
- Department of Implantology, São Leopoldo Mandic Institute and Research Center, Campinas, Brazil
| | - Gabriele Ceccarelli
- Department of Public Health, Experimental Medicine and Forensics, University of Pavia, Pavia, Italy.,Centre for Health Technologies, University of Pavia, Pavia, Italy
| | - Gabriella Cusella
- Department of Public Health, Experimental Medicine and Forensics, University of Pavia, Pavia, Italy.,Centre for Health Technologies, University of Pavia, Pavia, Italy
| | - André A Pelegrine
- Department of Implantology, São Leopoldo Mandic Institute and Research Center, Campinas, Brazil
| | - Saturnino M Lupi
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| |
Collapse
|