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Carmichael SP, Chandra PK, Vaughan JW, Kline DM, Ip EH, Holcomb JB, Atala A. Prevention of post-operative adhesions: Model development and pilot outcomes of human placental stem cell-based interventions. Transfusion 2024; 64:1059-1067. [PMID: 38693056 PMCID: PMC11211869 DOI: 10.1111/trf.17859] [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: 01/17/2024] [Revised: 04/12/2024] [Accepted: 04/14/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Abdominal adhesions are the most common surgical complication and without reliable prophylactics. This study presents a novel rat model for abdominal adhesions and reports pilot results of human placental stem cell (hPSC)-based therapies. METHODS Forty-four (n = 44) male Sprague-Dawley rats (250-350 g) were used in the experiment. Of these, thirty-eight (n = 38) were included in a preliminary data set to determine a minimum treatment effect. Adhesions were created in a reproducible model to the abdominal wall and between organs. Experimental groups included the control group (Model No Treatment, MNT), Plasmalyte A (Media Alone, MA, 10 mL), hPSC (5 × 106 cells/10 mL Plasmalyte A), hPSC-CM (hPSC secretome, conditioned media) in 10 mL Plasmalyte A, Seprafilm™ (Baxter, Deerfield, IL), and sham animals (laparotomy only). Treatments were inserted intraperitoneally (IP) and the study period was 14 days post-operation. Results are reported as the difference between means of an index statistic (AIS, Animal Index Score) and compared by ANOVA with pairwise comparison. RESULTS The overall mean AIS was 23 (SD 6.16) for the MNT group with an average of 75% of ischemic buttons involved in abdominal adhesions. Treatment groups MA (mean overall AIS 17.33 SD 6.4), hPSC (mean overall AIS 13.86 SD 5.01), hPSC-CM (mean overall AIS 13.13 SD 6.15), and Seprafilm (mean overall AIS 13.43 SD 9.11) generated effect sizes of 5.67, 9.14, 9.87, and 9.57 decrease in mean overall AIS, respectively, versus the MNT. DISCUSSION The presented rat model and scoring system represent the clinical adhesion disease process. hPSC-based interventions significantly reduce abdominal adhesions in this pilot dataset.
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Affiliation(s)
- Samuel P. Carmichael
- Wake Forest School of Medicine, Department of Surgery, Medical Center Boulevard, Winston-Salem, NC 27157
- Wake Forest School of Medicine, Institute for Regenerative Medicine, 391 Technology Way NE, Winston-Salem, NC 27101
| | - Prafulla K. Chandra
- Wake Forest School of Medicine, Institute for Regenerative Medicine, 391 Technology Way NE, Winston-Salem, NC 27101
| | - John W. Vaughan
- Wake Forest School of Medicine, Institute for Regenerative Medicine, 391 Technology Way NE, Winston-Salem, NC 27101
| | - David M. Kline
- Wake Forest School of Medicine, Division of Public Health Sciences, Department of Biostatistics and Data Science, Medical Center Boulevard, Winston-Salem, NC 27157
| | - Edward H. Ip
- Wake Forest School of Medicine, Division of Public Health Sciences, Department of Biostatistics and Data Science, Medical Center Boulevard, Winston-Salem, NC 27157
| | - John B. Holcomb
- University of Alabama at Birmingham, Department of Surgery, 1808 7th Ave S, Birmingham, AL 35233
| | - Anthony Atala
- Wake Forest School of Medicine, Institute for Regenerative Medicine, 391 Technology Way NE, Winston-Salem, NC 27101
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2
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Xiang N, Lin Y, Su X, Hu Z, Zhou J, Wu Y, Du L, Huang J. Assessing the application of barbed sutures in comparison to conventional sutures for surgical applications: a global systematic review and meta-analysis of preclinical animal studies. Int J Surg 2024; 110:3060-3071. [PMID: 38445518 DOI: 10.1097/js9.0000000000001230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/14/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Following an initiative published by Lancet in 2002 and an IDEAL-D framework, the value of preclinical animal studies has garnered increasing attention in recent research. Numerous preclinical animal experiments tried to generate evidence to guide the development of barbed sutures. However, discernible drawbacks and incongruities in outcomes have emerged between clinical and preclinical animal studies. Therefore, this meta-analysis aimed to review the preclinical animal experiments comparing barbed sutures with conventional sutures. The authors hope to facilitate clinical translation of barbed sutures by evaluating effectiveness, safety, and physical properties/reliability. MATERIALS AND METHODS A systematic search of PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov was conducted to identify controlled preclinical animal experiments comparing barbed sutures with conventional sutures. The risk of bias was assessed using SYRCLE. GRADE approach was used to evaluate evidence quality. Revman was applied to analyze all the data. Subgroup, sensitivity, and meta-regression analyses were also performed. RESULTS A total of 62 articles were eligible with low to moderate quality, including 2158 samples from 10 different animal species across 27 surgical procedures. Barbed suture exhibited a significant reduction in suture time, limited change in Cross-Sectional Area (CSA), and decreased instances of tissue disruption (all P <0.05). Subgroup analyses, considering both clinical and research significance, indicated that barbed sutures might cause more specific adverse events and demonstrate suboptimal performance of physical properties/reliability. Meta-regression suggested that heterogeneity resulted from variations in studies and animal models. CONCLUSION Although barbed suture demonstrated superiority in numerous surgeries for time efficiency, its safety and physical properties/reliability might be influenced by diverse preclinical models, sutures' brand, surgeries, and anatomical sites. Further evaluation, based on standardized and well-designed animal experiments, is essential for medical device development and applications in human beings.
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Affiliation(s)
- Nanyan Xiang
- Department of Urology, Innovation Institute for Integration of Medicine and Engineering, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, Sichuan, People's Republic of China
| | - Yifei Lin
- Department of Urology, Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Chengdu, Sichuan, People's Republic of China
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Xiaoyi Su
- Department of Urology, Innovation Institute for Integration of Medicine and Engineering, Chinese Evidence-Based Medicine Center,West China Hospital, Chengdu, Sichuan, People's Republic of China
| | - Zifan Hu
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jinyu Zhou
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Yi Wu
- Peking Union Medical College, Beijing, People's Republic of China
| | - Liang Du
- Department of Urology, Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Chengdu, Sichuan, People's Republic of China
| | - Jin Huang
- Department of Urology, Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Chengdu, Sichuan, People's Republic of China
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Vélez-Pinto JF, Garcia-Arranz M, García-Bernal D, García Gómez-Heras S, Villarejo-Campos P, García-Hernández AM, Vega-Clemente L, Jiménez-Galanes S, Guadalajara H, Moraleda JM, García-Olmo D. Therapeutic effect of adipose-derived mesenchymal stem cells in a porcine model of abdominal sepsis. Stem Cell Res Ther 2023; 14:365. [PMID: 38087374 PMCID: PMC10717819 DOI: 10.1186/s13287-023-03588-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The term sepsis refers to a complex and heterogeneous syndrome. Although great progress has been made in improving the diagnosis and treatment of this condition, it continues to have a huge impact on morbidity and mortality worldwide. Mesenchymal stem cells are a population of multipotent cells that have immunomodulatory properties, anti-apoptotic effects, and antimicrobial activity. We studied these capacities in a porcine model of peritoneal sepsis. METHODS We infused human adipose-derived mesenchymal stem cells (ADSCs) into a porcine model of peritoneal sepsis. Twenty piglets were treated with antibiotics alone (control group) or antibiotics plus peritoneal infusion of ADSCs at a concentration of 2 × 106 cells/kg or 4 × 106 cells/kg (low- and high-dose experimental groups, respectively). The animals were evaluated at different time points to determine their clinical status, biochemical and hematologic parameters, presence of inflammatory cytokines and chemokines in blood and peritoneal fluid, and finally by histologic analysis of the organs of the peritoneal cavity. RESULTS One day after sepsis induction, all animals presented peritonitis with bacterial infection as well as elevated C-reactive protein, haptoglobin, IL-1Ra, IL-6, and IL-1b. Xenogeneic ADSC infusion did not elicit an immune response, and peritoneal administration of the treatment was safe and feasible. One day after infusion, the two experimental groups showed a superior physical condition (e.g., mobility, feeding) and a significant increase of IL-10 and TGF-β in blood and a decrease of IL-1Ra, IL-1b, and IL-6. After 7 days, all animals treated with ADSCs had better results concerning blood biomarkers, and histopathological analysis revealed a lower degree of inflammatory cell infiltration of the organs of the peritoneal cavity. CONCLUSIONS Intraperitoneal administration of ADSCs as an adjuvant therapy for sepsis improves the outcome and diminishes the effects of peritonitis and associated organ damage by regulating the immune system and reducing intra-abdominal adhesions in a clinically relevant porcine model of abdominal sepsis.
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Affiliation(s)
- J F Vélez-Pinto
- Surgery Department, Fundación Jiménez Díaz University Hospital, 28033, Madrid, Spain
| | - M Garcia-Arranz
- New Therapy Laboratory, Health Research Institute of the Jimenez Diaz Foundation (Instituto de Investigacion Sanitaria de la Fundacion Jimenez Diaz), Avda Reyes Católicos 2, 28040, Madrid, Spain.
- Department of Surgery, Faculty of Medicine, Universidad Autónoma de Madrid, 28029, Madrid, Spain.
| | - D García-Bernal
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria (IMIB) Pascual Parrilla, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
- Biochemistry, Molecular Biology and Immunology Department, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - S García Gómez-Heras
- Department of Basic Health Science, Faculty of Health Sciences, Rey Juan Carlos University, 28922, Alcorcón, Madrid, Spain
| | - P Villarejo-Campos
- Surgery Department, Fundación Jiménez Díaz University Hospital, 28033, Madrid, Spain
| | - A M García-Hernández
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria (IMIB) Pascual Parrilla, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - L Vega-Clemente
- New Therapy Laboratory, Health Research Institute of the Jimenez Diaz Foundation (Instituto de Investigacion Sanitaria de la Fundacion Jimenez Diaz), Avda Reyes Católicos 2, 28040, Madrid, Spain
| | - S Jiménez-Galanes
- Department of Surgery, Infanta Elena University Hospital, 28342, Valdemoro, Madrid, Spain
| | - H Guadalajara
- Surgery Department, Fundación Jiménez Díaz University Hospital, 28033, Madrid, Spain
- Department of Surgery, Faculty of Medicine, Universidad Autónoma de Madrid, 28029, Madrid, Spain
| | - J M Moraleda
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria (IMIB) Pascual Parrilla, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - D García-Olmo
- Surgery Department, Fundación Jiménez Díaz University Hospital, 28033, Madrid, Spain
- New Therapy Laboratory, Health Research Institute of the Jimenez Diaz Foundation (Instituto de Investigacion Sanitaria de la Fundacion Jimenez Diaz), Avda Reyes Católicos 2, 28040, Madrid, Spain
- Department of Surgery, Faculty of Medicine, Universidad Autónoma de Madrid, 28029, Madrid, Spain
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4
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Regenerative Medicine Therapies for Prevention of Abdominal Adhesions: A Scoping Review. J Surg Res 2022; 275:252-264. [DOI: 10.1016/j.jss.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/26/2021] [Accepted: 02/08/2022] [Indexed: 01/02/2023]
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Putra A, Widyatmoko A, Ibrahim S, Amansyah F, Amansyah F, Berlian MA, Retnaningsih R, Pasongka Z, Sari FE, Rachmad B. Case series of the first three severe COVID-19 patients treated with the secretome of hypoxia-mesenchymal stem cells in Indonesia. F1000Res 2022; 10:228. [PMID: 35350705 DOI: 10.12688/f1000research.51191.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 01/31/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the outbreak of coronavirus disease 2019 (COVID-19), which has been rapidly spreading. Several guideline therapies have been proposed as a possible treatment for SARS-CoV-2, however, these therapies are not sufficient to treat a severe condition of SARS-CoV-2 infection characterised by the increase of D-dimer and C-reactive protein (CRP) levels, and patchy ground-glass opacities (GGOs). Secretome-mesenchymal stem cells (S-MSCs) produced by MSCs under hypoxia could excessively release several anti-inflammatory cytokines and growth factors to control the COVID-19 cytokine storm and accelerate lung injury improvement. This is the first study investigating the clinical outcomes of three severe COVID-19 patients admitted to the intensive care unit of three different hospitals in Indonesia treated with S-MSCs. The decrease of D-dimer and CRP level was reported for all patients treated with S-MSCs. This was in line with improvement of pulmonary radiology, blood gas level, and hematologic assessment. In conclusion, these cases suggest that S-MSCs could effectively control D-dimer, CRP level and GGOs of severe COVID-19 patients associated with recovered pulmonary function.
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Affiliation(s)
- Agung Putra
- Stem Cell and Cancer Research (SCCR), Faculty of Medicine, Universitas Islam Sultan Agung (Unissula), Semarang, Central Java, Indonesia.,Department of Postgraduate Biomedical Science, Faculty of Medicine, Universitas Islam Sultan Agung (Unissula), Semarang, Central Java, Indonesia.,Department of Pathological Anatomy, Faculty of Medicine,, Universitas Islam Sultan Agung (Unissula), Semarang, Central Java, Indonesia
| | - Agus Widyatmoko
- Department of Internal Medicine, Faculty of Medicine, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Yogyakarta, Indonesia
| | - Sugeng Ibrahim
- Stem Cell and Cancer Research (SCCR), Faculty of Medicine, Universitas Islam Sultan Agung (Unissula), Semarang, Central Java, Indonesia.,Department of Molecular Biology, Faculty of Medicine, Universitas Katholik (Unika) Soegijapranata, Semarang, Central Java, Indonesia
| | - Fajar Amansyah
- Department of Internal Medicine, Bhayangkara Hospital, Makassar, South Sulawesi, Indonesia
| | - Farid Amansyah
- Department of Internal Medicine, Bhayangkara Hospital, Makassar, South Sulawesi, Indonesia
| | - Mukti Arja Berlian
- Department of Internal Medicine, Dr. Esnawan Antariksa Air Force Hospital, Jakarta, Jakarta, Indonesia
| | - Retnaningsih Retnaningsih
- Department of Neurology and Intensive Care Unit, Kariadi Hospital, Universitas Diponegoro, Semarang, Central Java, Indonesia
| | | | - Flora Eka Sari
- Department of Pulmonary Medicine, Dr. Esnawan Antariksa Air Force Hospital, Jakarta, Jakarta, Indonesia
| | - Basuki Rachmad
- Department of Intensive Care Unit, Gatot Soebroto Army Hospital, Jakarta, Jakarta, Indonesia
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6
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Putra A, Ibrahim S, Muhar AM, Kuntardjo N, Dirja BT, Pasongka Z, Tunru IS. Topical gel of mesenchymal stem cells-conditioned medium under TNF-α precondition accelerates wound closure healing in full-thickness skin defect animal model. J Med Life 2022; 15:214-221. [PMID: 35419097 PMCID: PMC8999092 DOI: 10.25122/jml-2019-0103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 09/13/2020] [Indexed: 02/02/2023] Open
Abstract
Mesenchymal Stem Cells (MSCs) under TNF-α stimulation (MSC-CM-T) can release numerous trophic and survival molecules that have a promising prospect in wound healing acceleration. However, the effective levels of MSC-CM-T in topical gel preparation to accelerate wound healing should be further explored. The aim of this study was to investigate the effects of MSC-CM-T in topical gel preparation in accelerating optimal wound healing through analyzing PDGF levels, wound closure rate percentages, and fibroblast density appearances. Twenty-four male Wistar rats were performed a full-thickness excision. The group studies were randomly assigned into four subgroups: control gel, control medium, and two treatment groups: MSC-CM-T topical gel at doses of 100 μL and 200 μL (T1 and T2, respectively). Wound closure rates were measured by standard caliper, platelet-derived growth factor (PDGF) levels were analyzed using ELISA on days 3 and 6, whereas the fibroblast density appearances were determined using hematoxylin-eosin staining. This study found a significant increase in PDGF levels in all treatment groups on days 3 and 6. These findings were in line with the increase of wound closure rates in all treatment groups on day 6, in which the high dose of MSC-CM-T was more effective in initiating the increase of wound closure rate. We also found the fibroblast density appearances on day 6 in the T2 group. We conclude that the topical gel of MSC-CM-T is more effective in accelerating wound closure healing through increasing PDGF levels and wound closure percentages and fibroblast density appearances in the skin defect animal models.
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Affiliation(s)
- Agung Putra
- Stem Cell and Cancer Research (SCCR), Faculty of Medicine, Sultan Agung Islamic University, Semarang, Indonesia.,Department of Postgraduate Biomedical Science, Faculty of Medicine, Sultan Agung Islamic University, Semarang, Indonesia.,Department of Pathological Anatomy, Faculty of Medicine, Sultan Agung Islamic University, Semarang, Indonesia
| | - Sugeng Ibrahim
- Department of Molecular Biology and Biochemistry, Faculty of Medicine, Universitas Katolik Soegijapranata, Semarang, Indonesia.,Doctoral Program of Medical and Health Science, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Adi Muradi Muhar
- Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Novalia Kuntardjo
- Student of Postgraduate Biomedical Science Program, Faculty of Medicine, Sultan Agung Islamic University, Semarang, Indonesia
| | - Bayu Tirta Dirja
- Department of Microbiology, Faculty of Medicine, Mataram University, Mataram, Indonesia
| | - Zenitalia Pasongka
- Postgraduate Biomedical Science Program, Faculty of Medicine, Udayana University, Bukit Jimbaran, Indonesia
| | - Insan Sosiawan Tunru
- Department of Pathological Anatomy, Faculty of Medicine, YARSI University, Jakarta, Indonesia
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7
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Ekasaputra VM, Mughni A, Putra A, Riwanto I, Nugrahadi DE, Prasetya A, Putranto I, Alif I, Makarim FR. Combination of Sleeve Gastrectomy and Mesenchymal Stem Cells Improves Insulin Resistance by Modulating Pro-inflammatory Milieu in Obese Type 2 Diabetic Rat Model. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
ABSTRACT
Background: Obesity is a major risk factor for the onset of insulin resistance and type 2 diabetes mellitus (T2DM) caused by chronic inflammation of the islets of langerhans. Sleeve gastrectomy (SG) procedure increases particular hormone which stimulates insulin sensitivity. Mesenchymal stem cells (MSCs) can also exhibit potential immunomodulatory properties through their paracrine effects, however the mechanism regarding combination of them could not be adequately explained.
Aim: In this study, we explore the potential of sleeve gastrectomy followed by injection of MSCs in type 2 diabetic rats with obesity in improving insulin resistance.
Methods: This study used a pre and post control group design with 18 rats that divided into 3 groups: control (C), sleeve gastrectomy (SG), sleeve gastrectomy + MSCs (SG+M). On day 10, the level of IL-6, IL-10 and HOMA-IR were evaluated using ELISA.
Results: This study showed a significant decrease of IL-6 level in all treatment groups on day 10, in which SG+M group showed optimum inhibition. This result was in line with the optimum increase of IL-10 in SG+M group. Moreover, our study also revealed the optimum decrease of HOMA-IR in SG+M group on day 10.
Conclusion: Combination of SG and MSCs can optimally improve insulin resistance by modulating proinflammatory milieu though inhibiting IL-6 level and upregulating IL-10 level in obese type 2 diabetes mellitus rat model.
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8
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Putra A, Widyatmoko A, Ibrahim S, Amansyah F, Amansyah F, Berlian MA, Retnaningsih R, Pasongka Z, Sari FE, Rachmad B. Case series of the first three severe COVID-19 patients treated with the secretome of hypoxia-mesenchymal stem cells in Indonesia. F1000Res 2021; 10:228. [PMID: 35350705 PMCID: PMC8927740 DOI: 10.12688/f1000research.51191.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the outbreak of coronavirus disease 2019 (COVID-19), which has been rapidly spreading. Several guideline therapies have been proposed as a possible treatment for SARS-CoV-2, however, these therapies are not sufficient to treat a severe condition of SARS-CoV-2 infection characterised by the increase of D-dimer and C-reactive protein (CRP) levels, and patchy ground-glass opacities (GGOs). Secretome-mesenchymal stem cells (S-MSCs) produced by MSCs under hypoxia could excessively release several anti-inflammatory cytokines and growth factors to control the COVID-19 cytokine storm and accelerate lung injury improvement. This is the first study investigating the clinical outcomes of three severe COVID-19 patients admitted to the intensive care unit of three different hospitals in Indonesia treated with S-MSCs. The decrease of D-dimer and CRP level was reported for all patients treated with S-MSCs. This was in line with improvement of pulmonary radiology, blood gas level, and hematologic assessment. In conclusion, these cases suggest that S-MSCs could effectively control D-dimer, CRP level and GGOs of severe COVID-19 patients associated with recovered pulmonary function.
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Affiliation(s)
- Agung Putra
- Stem Cell and Cancer Research (SCCR), Faculty of Medicine, Universitas Islam Sultan Agung (Unissula), Semarang, Central Java, Indonesia
- Department of Postgraduate Biomedical Science, Faculty of Medicine, Universitas Islam Sultan Agung (Unissula), Semarang, Central Java, Indonesia
- Department of Pathological Anatomy, Faculty of Medicine,, Universitas Islam Sultan Agung (Unissula), Semarang, Central Java, Indonesia
| | - Agus Widyatmoko
- Department of Internal Medicine, Faculty of Medicine, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Yogyakarta, Indonesia
| | - Sugeng Ibrahim
- Stem Cell and Cancer Research (SCCR), Faculty of Medicine, Universitas Islam Sultan Agung (Unissula), Semarang, Central Java, Indonesia
- Department of Molecular Biology, Faculty of Medicine, Universitas Katholik (Unika) Soegijapranata, Semarang, Central Java, Indonesia
| | - Fajar Amansyah
- Department of Internal Medicine, Bhayangkara Hospital, Makassar, South Sulawesi, Indonesia
| | - Farid Amansyah
- Department of Internal Medicine, Bhayangkara Hospital, Makassar, South Sulawesi, Indonesia
| | - Mukti Arja Berlian
- Department of Internal Medicine, Dr. Esnawan Antariksa Air Force Hospital, Jakarta, Jakarta, Indonesia
| | - Retnaningsih Retnaningsih
- Department of Neurology and Intensive Care Unit, Kariadi Hospital, Universitas Diponegoro, Semarang, Central Java, Indonesia
| | | | - Flora Eka Sari
- Department of Pulmonary Medicine, Dr. Esnawan Antariksa Air Force Hospital, Jakarta, Jakarta, Indonesia
| | - Basuki Rachmad
- Department of Intensive Care Unit, Gatot Soebroto Army Hospital, Jakarta, Jakarta, Indonesia
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9
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Awonuga AO, Chatzicharalampous C, Thakur M, Rambhatla A, Qadri F, Awonuga M, Saed G, Diamond MP. Genetic and Epidemiological Similarities, and Differences Between Postoperative Intraperitoneal Adhesion Development and Other Benign Fibro-proliferative Disorders. Reprod Sci 2021; 29:3055-3077. [PMID: 34515982 DOI: 10.1007/s43032-021-00726-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/22/2021] [Indexed: 12/11/2022]
Abstract
Intraperitoneal adhesions complicate over half of abdominal-pelvic surgeries with immediate, short, and long-term sequelae of major healthcare concern. The pathogenesis of adhesion development is similar to the pathogenesis of wound healing in all tissues, which if unchecked result in production of fibrotic conditions. Given the similarities, we explore the published literature to highlight the similarities in the pathogenesis of intra-abdominal adhesion development (IPAD) and other fibrotic diseases such as keloids, endometriosis, uterine fibroids, bronchopulmonary dysplasia, and pulmonary, intraperitoneal, and retroperitoneal fibrosis. Following a literature search using PubMed database for all relevant English language articles up to November 2020, we reviewed relevant articles addressing the genetic and epidemiological similarities and differences in the pathogenesis and pathobiology of fibrotic diseases. We found genetic and epidemiological similarities and differences between the pathobiology of postoperative IPAD and other diseases that involve altered fibroblast-derived cells. We also found several genes and single nucleotide polymorphisms that are up- or downregulated and whose products directly or indirectly increase the propensity for postoperative adhesion development and other fibrotic diseases. An understanding of the similarities in pathophysiology of adhesion development and other fibrotic diseases contributes to a greater understanding of IPAD and these disease processes. At a very fundamental level, blocking changes in the expression or function of genes necessary for the transformation of normal to altered fibroblasts may curtail adhesion formation and other fibrotic disease since this is a prerequisite for their development. Similarly, applying measures to induce apoptosis of altered fibroblast may do the same; however, apoptosis should be at a desired level to simultaneously ameliorate development of fibrotic diseases while allowing for normal healing. Scientists may use such information to develop pharmacologic interventions for those most at risk for developing these fibrotic conditions.
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Affiliation(s)
- Awoniyi O Awonuga
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, 48201, USA.
| | - Charalampos Chatzicharalampous
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Mili Thakur
- Reproductive Genomics Program, The Fertility Center, Grand Rapids, MI, USA.,Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Anupama Rambhatla
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Farnoosh Qadri
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Modupe Awonuga
- Division of Neonatology, Department of Pediatrics and Human Development, Michigan State University, 1355 Bogue Street, East Lansing, MI, USA
| | - Ghassan Saed
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Augusta University, 1120 15th Street, CJ-1036, Augusta, GA, 30912, USA
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Hermansyah D, Putra A, Munir D, Lelo A, Amalina ND, Alif I. Synergistic Effect of Curcuma longa Extract in Combination with Phyllanthus niruri Extract in Regulating Annexin A2, Epidermal Growth Factor Receptor, Matrix Metalloproteinases, and Pyruvate Kinase M1/2 Signaling Pathway on Breast Cancer Stem Cell. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AIM: This study aimed to investigate the synergistic effects of the combination between Curcuma longa extract (CL) and Phyllanthus niruri extract (PN) in inhibiting optimally the MDA-MB-231 breast cancer stem cells (BCSCs) growth and metastatic by exploring the target and molecular mechanism using integrative bioinformatics approaches and in vitro.
METHODS: CL and PN extracts were prepared by maceration method using ethanol 70%. The antiproliferative effect of CL and PN single and combination treatment was examined by 3-[4,5-dimethyl-2-thiazolyl]-2,5-diphenyl-2H-tetrazolium bromide assay. The bioinformatic approach was performed to identify molecular targets, key proteins, and molecular mechanism of curcumin and phyllanthin as CL and PN secondary metabolite, respectively, targeted at stemness and migration pathway of BCSCs.
RESULTS: The in vitro study showed that CL and PN possess cytotoxic activity in time- and dose-dependent manner. The combination of CL and PN has a synergistic effect by modulating the sensitivity of cells. Using a bioinformatics approach, the annexin A2 (ANXA2), epidermal growth factor receptor (EGFR), matrix metalloproteinases (MMPs), and pyruvate kinase M1/2 (PKM) as potential targets of curcumin and phyllanthin correlated with metastatic inhibition of BC. In addition, molecular docking showed that curcumin and phyllanthin performed similar or better interaction to stemness differentiation regulator pathway particularly histone deacetylase 1, EGFR, Heat Shock Protein 90 Alpha Family Class B Member 1, Hypoxia Inducible Factor 1 Subunit Alpha, and MMP9.
CONCLUSION: Combination of CL and PN has potential for the treatment of metastatic BCSCs by targeting ANXA2, EGFR, MMPs, and PKM to resolve stemness and inhibit of BCSCs.
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Putra A, Widyatmoko A, Ibrahim S, Amansyah F, Amansyah F, Berlian MA, Retnaningsih R, Pasongka Z, Sari FE, Rachmad B. Case series of the first three severe COVID-19 patients treated with the secretome of hypoxia-mesenchymal stem cells in Indonesia. F1000Res 2021; 10:228. [PMID: 35350705 PMCID: PMC8927740 DOI: 10.12688/f1000research.51191.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 01/21/2024] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the outbreak of coronavirus disease 2019 (COVID-19), which has been rapidly spreading. Several guideline therapies have been proposed as a possible treatment for SARS-CoV-2, however, these therapies are not sufficient to treat a severe condition of SARS-CoV-2 infection characterised by the increase of D-dimer and C-reactive protein (CRP) levels, and patchy ground-glass opacities (GGOs). Secretome-mesenchymal stem cells (S-MSCs) produced by MSCs under hypoxia could excessively release several anti-inflammatory cytokines and growth factors to control the COVID-19 cytokine storm and accelerate lung injury improvement. This is the first study investigating the clinical outcomes of three severe COVID-19 patients admitted to the intensive care unit of three different hospitals in Indonesia treated with S-MSCs. The decrease of D-dimer and CRP level was reported for all patients treated with S-MSCs. This was in line with improvement of pulmonary radiology, blood gas level, and hematologic assessment. In conclusion, these cases suggest that S-MSCs could effectively control D-dimer, CRP level and GGOs of severe COVID-19 patients associated with recovered pulmonary function.
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Affiliation(s)
- Agung Putra
- Stem Cell and Cancer Research (SCCR), Faculty of Medicine, Universitas Islam Sultan Agung (Unissula), Semarang, Central Java, Indonesia
- Department of Postgraduate Biomedical Science, Faculty of Medicine, Universitas Islam Sultan Agung (Unissula), Semarang, Central Java, Indonesia
- Department of Pathological Anatomy, Faculty of Medicine,, Universitas Islam Sultan Agung (Unissula), Semarang, Central Java, Indonesia
| | - Agus Widyatmoko
- Department of Internal Medicine, Faculty of Medicine, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Yogyakarta, Indonesia
| | - Sugeng Ibrahim
- Stem Cell and Cancer Research (SCCR), Faculty of Medicine, Universitas Islam Sultan Agung (Unissula), Semarang, Central Java, Indonesia
- Department of Molecular Biology, Faculty of Medicine, Universitas Katholik (Unika) Soegijapranata, Semarang, Central Java, Indonesia
| | - Fajar Amansyah
- Department of Internal Medicine, Bhayangkara Hospital, Makassar, South Sulawesi, Indonesia
| | - Farid Amansyah
- Department of Internal Medicine, Bhayangkara Hospital, Makassar, South Sulawesi, Indonesia
| | - Mukti Arja Berlian
- Department of Internal Medicine, Dr. Esnawan Antariksa Air Force Hospital, Jakarta, Jakarta, Indonesia
| | - Retnaningsih Retnaningsih
- Department of Neurology and Intensive Care Unit, Kariadi Hospital, Universitas Diponegoro, Semarang, Central Java, Indonesia
| | | | - Flora Eka Sari
- Department of Pulmonary Medicine, Dr. Esnawan Antariksa Air Force Hospital, Jakarta, Jakarta, Indonesia
| | - Basuki Rachmad
- Department of Intensive Care Unit, Gatot Soebroto Army Hospital, Jakarta, Jakarta, Indonesia
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Hamra NF, Putra A, Tjipta A, Amalina ND, Nasihun T. Hypoxia Mesenchymal Stem Cells Accelerate Wound Closure Improvement by Controlling α-smooth Muscle actin Expression in the Full-thickness Animal Model. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND: The active myofibroblast producing extracellular matrix deposition regarding wound closure is characterized by alpha-smooth muscle actin (α-SMA) expression. However, the persistence of α-SMA expression due to prolonged inflammation may trigger scar formation. A new strategy to control α-SMA expression in line with wound closure improvement uses hypoxic mesenchymal stem cells (HMSCs) due to their ability to firmly control inflammation for early initiating cell proliferation, including the regulation of α-SMA expression associated with wound closure acceleration.
AIM: This study aimed to explore the role of HMSCs in accelerating the optimum wound closure percentages through controlling the α-SMA expression.
MATERIALS AND METHODS: Twenty-four full-thickness rats wound model were randomly divided into four groups: Sham (Sh), Control (C) by NaCl administration only, and two treatment groups by HMSCs at doses of 1.5×106 cells (T1) and HMSCs at doses of 3×106 cells (T2). HMSCs were incubated under hypoxic conditions. The α-SMA expression was analyzed under immunohistochemistry staining assay, and the wound closure percentage was analyzed by ImageJ software.
RESULTS: This study showed a significant increase in wound closure percentage in all treatment groups that gradually initiated on days 6 and 9 (p < 0.05). In line with the increase of wound closure percentages on day 9, there was also a significant decrease in α-SMA expression in all treatment groups (p < 0.05), indicating the optimum wound healing has preceded.
CONCLUSION: HMSCs have a robust ability to accelerated wound closure improvement to the optimum wound healing by controlling α-SMA expression depending on wound healing phases.
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Hermansyah D, Putra A, Muhar AM, Retnaningsih, Wirastuti K, Dirja BT. Mesenchymal Stem Cells Suppress TGF-β Release to Decrease α-SMA Expression in Ameliorating CCl4-Induced Liver Fibrosis. Med Arch 2021; 75:16-22. [PMID: 34012193 PMCID: PMC8116080 DOI: 10.5455/medarh.2021.75.16-22] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction: Liver fibrosis (LF) is the excessive deposition of extracellular matrix (ECM), produced by overactivated hepatic stellate cells, following prolonged transforming growth factor-β (TGF-β) stimulation. The ability of mesenchymal stem cells (MSCs) to improve LF has been reported. However, the mechanisms of MSCs to ameliorate LF through suppressing TGF-β and α-smooth muscle actin (α-SMA) remains unclear. Aim: To investigate the effects of MSCs treatment on suppressing TGF-β levels and decreasing α-SMA expression in an LF model. Methods: In this study, wenty-four male Wistar rats were injected intraperitoneal (IP) with carbon tetrachloride (CCL4), twice weekly, for eight weeks, to induce LF. Rats were randomly assigned to six groups: Sham, Control, Sham-lo, Sham-hi, and MSC-treated groups, at doses of 1 x 106 (T1) and 2x106 (T2) cells. TGF-β levels were analyzed by enzyme-linked immunosorbent assay (ELISA), whereas α-SMA expression was determined by immunohistochemistry staining. Results: MSCs decreased the expression of TGF-β in T1 and T2 groups on day 3 and 14. The T2 group showed lower TGF-β levels than that in the T1 group. This finding was in line with the observed decrease in α-SMA expression and the number of collagen. Conclusion: MSCs treatment ameliorated LF by suppressing TGF-β production, leading to decreased α-SMA expression in a CCL4-induced LF animal model.
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Affiliation(s)
- Dedy Hermansyah
- Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
| | - Agung Putra
- Stem Cell and Cancer Research (SCCR), Faculty of Medicine, Sultan Agung Islamic University (UNISSULA), Semarang, Central Java, Indonesia.,Department of Postgraduate Biomedical Science, Faculty of Medicine, Sultan Agung Islamic University (UNISSULA), Semarang, Central Java, Indonesia.,Department of Pathological Anatomy, Faculty of Medicine, Sultan Agung Islamic University (UNISSULA), Semarang, Central Java, Indonesia
| | - Adi Muradi Muhar
- Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
| | - Retnaningsih
- Department of Neurology and Intensive Care Unit, Kariadi Hospital, Diponegoro University, Semarang, Central Java, Indonesia
| | - Ken Wirastuti
- Department of Neurology, Faculty of Medicine, Sultan Agung Islamic University (UNISSULA), Semarang, Central Java, Indonesia
| | - Bayu Tirta Dirja
- Biomedical Science Doctoral Program, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
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14
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Putra A, Alif I, Hamra N, Santosa O, Kustiyah AR, Muhar AM, Lukman K. MSC-released TGF-β regulate α-SMA expression of myofibroblast during wound healing. J Stem Cells Regen Med 2020; 16:73-79. [PMID: 33414583 DOI: 10.46582/jsrm.1602011] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 10/14/2020] [Indexed: 12/27/2022]
Abstract
Objective: Wound healing without fibrosis remains a clinical challenge and a new strategy to promote the optimal wound healing is needed. Mesenchymal stem cells (MSCs) can completely regenerate tissue injury due to the robust MSCs ability in controlling inflammation niche leading to granulation tissue formation, particularly through a release of various growth factors including transforming growth factor-β (TGF-β). In response to TGF-β stimulation, fibroblasts differentiate into myofibroblast, marked by alpha-smooth muscle actin (α-SMA) that leads to wound healing acceleration. On the other hand, sustained activation of TGF-β in wound areas may contribute to fibrosis-associated scar formation. The aim of this study was to evaluate the α-SMA expression of myofibroblast induced by MSC-released TGF-β during wound healing process. Materials and Methods: Twenty-four full-thickness excisional rat wound models were randomly divided into four groups: sham (Sh), Control (C), and MSCs treatment groups; topically treated by the MSCs at doses 2x106 cells (T1) and 1x106 cells (T2), respectively. While the control group was treated with NaCl. TGF-β level was determined using ELISA assay, α-SMA expression of myofibroblast was analyzed by immunofluorescence staining, and wound size measurement was calculated using a standard caliper. Results: This study showed a significant increase in TGF-β levels in all treatment groups on days 3 and 6. This finding was consistent with a significant increase of α-SMA expression of myofibroblast at day 6 and wound closure percentage, indicating that MSCs might promote an increase of wound closure. Conclusion: MSCs regulated the release of TGF-β to induce α-SMA expression of myofibroblast for accelerating an optimal wound healing.
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Affiliation(s)
- Agung Putra
- Stem Cell And Cancer Research (SCCR), Medical Faculty, Universitas Islam Sultan Agung (UNISSULA), Semarang, Central Java, Indonesia.,Department of Postgraduate Biomedical Science, Medical Faculty, Universitas Islam Sultan Agung (UNISSULA), Semarang, Central Java, Indonesia.,Department of Pathological Anatomy, Medical Faculty, Universitas Islam Sultan Agung (UNISSULA), Semarang, Central Java, Indonesia
| | - Iffan Alif
- Stem Cell And Cancer Research (SCCR), Medical Faculty, Universitas Islam Sultan Agung (UNISSULA), Semarang, Central Java, Indonesia
| | - Nurfitriani Hamra
- Postgraduate Biomedical Student, Medical Faculty, Universitas Islam Sultan Agung (UNISSULA), Semarang, Central Java, Indonesia
| | - Octyana Santosa
- Medical Student, Medical Faculty, Universitas Islam Sultan Agung (UNISSULA), Semarang, Central Java, Indonesia
| | - Azizah Retno Kustiyah
- Department of Pediatric, Medical Faculty, Universitas Islam Sultan Agung (UNISSULA), Semarang, Central Java, Indonesia
| | - Adi Muradi Muhar
- Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara (USU), Medan, Indonesia
| | - Kiki Lukman
- Department of Surgery, Faculty of Medicine, Universitas Padjadjaran (UNPAD), Bandung,West Java, Indonesia
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Ekasaputra VM, Putra A, Muhar AM, Varessa J, Cikita RB, Wijaya SAP, Nazar MA. Mesenchymal Stem Cell-injected Omental Patch More Effective Promoting Wound Healing in Bowel Perforation Animal Model. Med Arch 2020; 74:332-336. [PMID: 33424084 PMCID: PMC7780763 DOI: 10.5455/medarh.2020.74.332-336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction: Bowel perforation (BP) occurs as the complication of many gastrointestinal problems. Omental patch (OP) is one of the methods to place omentum flaps in the perforated area. Mesenchymal stem cells (MSCs) may increase regeneration process in all tissues. Aim: to demonstrate the role of MSC in accelerating of wound healing process by analyzing fibroblast and collagen appearance in perforated bowel conditions. Methods: Using a BP rabbit model, 18 rabbit were randomly assigned into three groups: combination of umbilical cord (UC)-MSCs injection and OP (T1), OP only (T2) and vehicle control (Veh). Hematoxylin-eosin staining and Masson’s trichrome staining were performed to analyze the level of fibroblast and collagen. Wound length were measured using standardized caliper. Results: The study showed a significant (P<0.05) increase of fibroblast and collagen amount on T1 and T2, in which T1 was higher than T2. This result was also followed by the decrease of wound length. Conclusion: The combination of MSCs and OP-sutured in perforated bowel are better to accelerate wound healing than OP only in BP cases.
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Affiliation(s)
| | - Agung Putra
- Stem Cell and Cancer Research, Sultan Agung Islamic University, Semarang, Indonesia.,Department of Pathological Anatomy, Sultan Agung Islamic University, Semarang, Indonesia.,Department of Postgraduate Biomedical Science, Sultan Agung Islamic University, Semarang, Indonesia
| | - Adi Muradi Muhar
- Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | | | | | | | - Mohammad Ariq Nazar
- Stem Cell and Cancer Research, Sultan Agung Islamic University, Semarang, Indonesia
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