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Liu SJ, Cao YL, Zhang C. Hirudin in the Treatment of Chronic Kidney Disease. Molecules 2024; 29:1029. [PMID: 38474541 DOI: 10.3390/molecules29051029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/13/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
Chronic kidney disease (CKD) is a common public health concern. The global burden of CKD is increasing due to the high morbidity and mortality associated with it, indicating the shortcomings of therapeutic drugs at present. Renal fibrosis is the common pathology of CKD, which is characterized by glomerulosclerosis, renal tubular atrophy, and renal interstitial fibrosis. Natural hirudin is an active ingredient extracted from Hirudo medicinalis, which has been found to be the strongest natural specific inhibitor of thrombin. Evidence based on pharmacological data has shown that hirudin has important protective effects in CKD against diabetic nephrology, nephrotic syndrome, and renal interstitial fibrosis. The mechanisms of hirudin in treating CKD are mainly related to inhibiting the inflammatory response, preventing apoptosis of intrinsic renal cells, and inhibiting the interactions between thrombin and protease-activated receptors. In this review, we summarize the function and beneficial properties of hirudin for the treatment of CKD, and its underlying mechanisms.
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Affiliation(s)
- Sai-Ji Liu
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yi-Ling Cao
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Chun Zhang
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Berry CE, Le T, An N, Griffin M, Januszyk M, Kendig CB, Fazilat AZ, Churukian AA, Pan PM, Wan DC. Pharmacological and cell-based treatments to increase local skin flap viability in animal models. J Transl Med 2024; 22:68. [PMID: 38233920 PMCID: PMC10792878 DOI: 10.1186/s12967-024-04882-9] [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: 11/15/2023] [Accepted: 01/10/2024] [Indexed: 01/19/2024] Open
Abstract
Local skin flaps are frequently employed for wound closure to address surgical, traumatic, congenital, or oncologic defects. (1) Despite their clinical utility, skin flaps may fail due to inadequate perfusion, ischemia/reperfusion injury (IRI), excessive cell death, and associated inflammatory response. (2) All of these factors contribute to skin flap necrosis in 10-15% of cases and represent a significant surgical challenge. (3, 4) Once flap necrosis occurs, it may require additional surgeries to remove the entire flap or repair the damage and secondary treatments for infection and disfiguration, which can be costly and painful. (5) In addition to employing appropriate surgical techniques and identifying healthy, well-vascularized tissue to mitigate the occurrence of these complications, there is growing interest in exploring cell-based and pharmacologic augmentation options. (6) These agents typically focus on preventing thrombosis and increasing vasodilation and angiogenesis while reducing inflammation and oxidative stress. Agents that modulate cell death pathways such as apoptosis and autophagy have also been investigated. (7) Implementation of drugs and cell lines with potentially beneficial properties have been proposed through various delivery techniques including systemic treatment, direct wound bed or flap injection, and topical application. This review summarizes pharmacologic- and cell-based interventions to augment skin flap viability in animal models, and discusses both translatability challenges facing these therapies and future directions in the field of skin flap augmentation.
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Affiliation(s)
- Charlotte E Berry
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 257 Campus Drive West, Stanford, CA, 94305, USA
| | - Thalia Le
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 257 Campus Drive West, Stanford, CA, 94305, USA
| | - Nicholas An
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 257 Campus Drive West, Stanford, CA, 94305, USA
| | - Michelle Griffin
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 257 Campus Drive West, Stanford, CA, 94305, USA
| | - Micheal Januszyk
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 257 Campus Drive West, Stanford, CA, 94305, USA
| | - Carter B Kendig
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 257 Campus Drive West, Stanford, CA, 94305, USA
| | - Alexander Z Fazilat
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 257 Campus Drive West, Stanford, CA, 94305, USA
| | - Andrew A Churukian
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 257 Campus Drive West, Stanford, CA, 94305, USA
| | - Phoebe M Pan
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 257 Campus Drive West, Stanford, CA, 94305, USA
| | - Derrick C Wan
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 257 Campus Drive West, Stanford, CA, 94305, USA.
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Aksamitiene E, Heffelfinger RN, Hoek JB, Pribitkin ED. Standardized Pre-clinical Surgical Animal Model Protocol to Investigate the Cellular and Molecular Mechanisms of Ischemic Flap Healing. Biol Proced Online 2024; 26:2. [PMID: 38229030 DOI: 10.1186/s12575-023-00227-w] [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: 06/13/2023] [Accepted: 12/14/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Some of the most complex surgical interventions to treat trauma and cancer include the use of locoregional pedicled and free autologous tissue transfer flaps. While the techniques used for these reconstructive surgery procedures have improved over time, flap complications and even failure remain a significant clinical challenge. Animal models are useful in studying the pathophysiology of ischemic flaps, but when repeatability is a primary focus of a study, conventional in-vivo designs, where one randomized subset of animals serves as a treatment group while a second subset serves as a control, are at a disadvantage instigated by greater subject-to-subject variability. Our goal was to provide a step-by-step methodological protocol for creating an alternative standardized, more economical, and transferable pre-clinical animal research model of excisional full-thickness wound healing following a simulated autologous tissue transfer which includes the primary ischemia, reperfusion, and secondary ischemia events with the latter mimicking flap salvage procedure. RESULTS Unlike in the most frequently used classical unilateral McFarlane's caudally based dorsal random pattern skin flap model, in the herein described bilateral epigastric fasciocutaneous advancement flap (BEFAF) model, one flap heals under normal and a contralateral flap-under perturbed conditions or both flaps heal under conditions that vary by one within-subjects factor. We discuss the advantages and limitations of the proposed experimental approach and, as a part of model validation, provide the examples of its use in laboratory rat (Rattus norvegicus) axial pattern flap healing studies. CONCLUSIONS This technically challenging but feasible reconstructive surgery model eliminates inter-subject variability, while concomitantly minimizing the number of animals needed to achieve adequate statistical power. BEFAFs may be used to investigate the spatiotemporal cellular and molecular responses to complex tissue injury, interventions simulating clinically relevant flap complications (e.g., vascular thrombosis) as well as prophylactic, therapeutic or surgical treatment (e.g., flap delay) strategies in the presence or absence of confounding risk factors (e.g., substance abuse, irradiation, diabetes) or favorable wound-healing promoting activities (e.g., exercise). Detailed visual instructions in BEFAF protocol may serve as an aid for teaching medical or academic researchers basic vascular microsurgery techniques that focus on precision, tremor management and magnification.
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Affiliation(s)
- Edita Aksamitiene
- Department of Otolaryngology - Head and Neck Surgery, Thomas Jefferson University, 925 Chestnut St., 6Th floor, Philadelphia, PA, 19107, USA
- Present address: Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Mathews Ave | M/C 251, Room 4357, Urbana, IL, 61801, USA
| | - Ryan N Heffelfinger
- Department of Otolaryngology - Head and Neck Surgery, Thomas Jefferson University, 925 Chestnut St., 6Th floor, Philadelphia, PA, 19107, USA
| | - Jan B Hoek
- Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, 1020 Locust St, Room 527, Philadelphia, PA, 19107, USA
| | - Edmund deAzevedo Pribitkin
- Department of Otolaryngology - Head and Neck Surgery, Thomas Jefferson University, 925 Chestnut St., 6Th floor, Philadelphia, PA, 19107, USA.
- Sidney Kimmel Medical College, 31st Floor, 1101 Market Street, Philadelphia, PA, 19107, USA.
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Experimental study of the effects of nitroglycerin, botulinum toxin A, and clopidogrel on bipedicled superficial inferior epigastric artery flap survival. Sci Rep 2022; 12:20891. [PMID: 36463303 PMCID: PMC9719547 DOI: 10.1038/s41598-022-24898-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 11/22/2022] [Indexed: 12/04/2022] Open
Abstract
Beneficial effects could be achieved by various agents such as nitroglycerin, botulinum toxin A (BoTA), and clopidogrel to improve skin flap ischaemia and venous congestion injuries. Eighty rats were subjected to either arterial ischaemia or venous congestion and applied to a bipedicled U-shaped superficial inferior epigastric artery (SIEA) flap with the administration of nitroglycerin, BoTA, or clopidogrel treatments. After 7 days, all rats were sacrificed for flap evaluation. Necrotic area percentage was significantly minimized in flaps treated with clopidogrel (24.49%) versus the ischemic flaps (34.78%); while nitroglycerin (19.22%) versus flaps with venous congestion (43.26%). With ischemia, light and electron microscopic assessments revealed that nitroglycerin produced degeneration of keratinocytes and disorganization of collagen fibers. At the same time, with clopidogrel administration, there was an improvement in the integrity of these structures. With venous congestion, nitroglycerin and BoTA treatments mitigated the epidermal and dermal injury; and clopidogrel caused coagulative necrosis. There was a significant increase in tissue gene expression and serum levels of vascular endothelial growth factor (VEGF) in ischemic flaps with BoTA and clopidogrel, nitroglycerin, and BoTA clopidogrel in flaps with venous congestion. With the 3 treatment agents, gene expression levels of tumor necrosis factor-α (TNF-α) were up-regulated in the flaps with ischemia and venous congestion. With all treatment modalities, its serum levels were significantly increased in flaps with venous congestion and significantly decreased in ischemic flaps. Our analyses suggest that the best treatment option for ischemic flaps is clopidogrel, while for flaps with venous congestion are nitroglycerin and BoTA.
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Junren C, Xiaofang X, Huiqiong Z, Gangmin L, Yanpeng Y, Xiaoyu C, Yuqing G, Yanan L, Yue Z, Fu P, Cheng P. Pharmacological Activities and Mechanisms of Hirudin and Its Derivatives - A Review. Front Pharmacol 2021; 12:660757. [PMID: 33935784 PMCID: PMC8085555 DOI: 10.3389/fphar.2021.660757] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/22/2021] [Indexed: 12/13/2022] Open
Abstract
Hirudin, an acidic polypeptide secreted by the salivary glands of Hirudo medicinalis (also known as "Shuizhi" in traditional Chinese medicine), is the strongest natural specific inhibitor of thrombin found so far. Hirudin has been demonstrated to possess potent anti-thrombotic effect in previous studies. Recently, increasing researches have focused on the anti-thrombotic activity of the derivatives of hirudin, mainly because these derivatives have stronger antithrombotic activity and lower bleeding risk. Additionally, various bioactivities of hirudin have been reported as well, including wound repair effect, anti-fibrosis effect, effect on diabetic complications, anti-tumor effect, anti-hyperuricemia effect, effect on cerebral hemorrhage, and others. Therefore, by collecting and summarizing publications from the recent two decades, the pharmacological activities, pharmacokinetics, novel preparations and derivatives, as well as toxicity of hirudin were systematically reviewed in this paper. In addition, the clinical application, the underlying mechanisms of pharmacological effects, the dose-effect relationship, and the development potential in new drug research of hirudin were discussed on the purpose of providing new ideas for application of hirudin in treating related diseases.
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Affiliation(s)
- Chen Junren
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xie Xiaofang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhang Huiqiong
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Li Gangmin
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yin Yanpeng
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Cao Xiaoyu
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Gao Yuqing
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Li Yanan
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhang Yue
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Peng Fu
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China.,West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Peng Cheng
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Luo X, Zhao B, Chen B, Chen H, Han T, Bsoul NBN, Yan H. Trans-Cinnamaldehyde Increases Random Pattern Flap Survival Through Activation of the Nitric Oxide Pathway. Drug Des Devel Ther 2021; 15:679-688. [PMID: 33628013 PMCID: PMC7899309 DOI: 10.2147/dddt.s297458] [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: 12/15/2020] [Accepted: 01/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background The application of random pattern skin flaps is limited in plastic surgery reconstruction due to necrosis. Trans-cinnamaldehyde has antibacterial, anticancer, and antioxidant properties. In this study, we aimed to investigate the effect of trans-cinnamaldehyde on skin flap survival and its possible mechanism regarding nitric oxide. Materials and Methods One hundred forty male Sprague-Dawley rats were randomly divided into seven groups (n = 20 each group). After the dorsal flap was raised, different doses of trans-cinnamaldehyde (10, 20, and 30 mg/kg) were immediately given by oral gavage in the three different groups. To assess the possible involvement of the nitric oxide system, NG-nitro-L-arginine methyl ester (L-NAME, a nonselective nitric oxide synthase inhibitor) was used in this study. All flap samples were incised on postoperative day 7. Results Our results showed that flap survival was increased significantly in the 20 mg/kg (P < 0.001) trans-cinnamaldehyde (TC) group compared to the control group or 30 mg/kg TC group. This protective function was restrained by coadministration of L-NAME with 20 mg/kg TC. The results of histopathology, laser Doppler, arteriography mediated with oxide–gelatine, and fluorescent staining all showed a significant increase in capillary count, collagen deposition, angiogenesis, and flap perfusion. Immunohistochemistry results revealed a significant increase in the expression of CD34, eNOS, and VEGF. Conclusion Trans-cinnamaldehyde increased flap survival through the nitric oxide synthase pathway and contributed to angiogenesis. A concentration of 20 mg/kg trans-cinnamaldehyde was recommended in this study.
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Affiliation(s)
- Xiaobin Luo
- Department of Orthopedics (Division of Hand Surgery), The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Key Laboratory of Orthopedics of Zhejiang Province, The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Bin Zhao
- Department of Post Anaesthesia Care Unit, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, People's Republic of China
| | - Baoxia Chen
- Department of Post Anaesthesia Care Unit, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, People's Republic of China
| | - Hongyu Chen
- Department of Orthopedics (Division of Hand Surgery), The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Key Laboratory of Orthopedics of Zhejiang Province, The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Tao Han
- Department of Orthopedics (Division of Hand Surgery), The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Key Laboratory of Orthopedics of Zhejiang Province, The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Najeeb Bassam Najeeb Bsoul
- Department of Orthopedics (Division of Hand Surgery), The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Key Laboratory of Orthopedics of Zhejiang Province, The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Hede Yan
- Department of Orthopedics (Division of Hand Surgery), The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Key Laboratory of Orthopedics of Zhejiang Province, The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
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Effects of Hirudin on High Glucose-Induced Oxidative Stress and Inflammatory Pathway in Rat Dorsal Root Ganglion Neurons. Chin J Integr Med 2020; 26:197-204. [DOI: 10.1007/s11655-019-2712-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2018] [Indexed: 01/24/2023]
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Zhu J, Pan X, Lin B, Lin G, Pradhan R, Long F, Yin G. The effect of hirudin on antagonisting thrombin induced apoptosis of human microvascular endothelial cells1. Acta Cir Bras 2019; 34:e20190010000006. [PMID: 30785507 PMCID: PMC6585924 DOI: 10.1590/s0102-865020190010000006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 12/14/2018] [Indexed: 02/06/2023] Open
Abstract
Purpose To investigate whether hirudin exerts its antithrombin action to decrease the
ratio of Human Microvascular Endothelial Cells (HMVECs) apoptosis. Methods Human microvascular endothelial cells (HMVECs) cultured in the third and
fifth generations were used. HMVECs were divided into normal group, thrombin
group (T group), natrual hirudin group (H group), thrombin + natrual hirudin
group (T + H group), AG490 group, thrombin + AG490 group (T + AG490 group),
natrual hirudin + AG490 group (H + AG490 group), thrombin + natural hirudin
+ AG490 (T + H + AG490 group).Apart from the normal group, the other groups
were exposed to the relevant drugs for 24 hours.HMVEC apoptosis was assessed
by flow cytometric and double Immunofluorescence of phosphorylation of JAK
(P-JAK2) and TUNEL assay. Results Compared with the normal group, in thrombin group the HMVECs apoptosis rate
were significantly increased (P<0.05).The results indicated that the
index of apoptosis and the apoptosis rate were improved in cultures treated
by natural hirudin (T + H group), relative to cultures with thrombin only (T
group). We found that the index of apoptosis and the apoptosis rate in the
AG490 + thrombin group were higher than that in the hirudin + thrombin group
(P<0.05). Double Immunofluorescence of p-JAK2 and TUNEL assays showed
that cells were double positive for P-JAK2 uptake and TUNEL detection liquid
binding. Conclusion The natural hirudin and JAK2/STATs signal inhibitor AG490 could block the
effects of thrombin. Natural hirudin could attenuate HMVECs apoptosis via
antagonizing thrombin and it is suggested that this effect may occur by
blocking the JAK2/STATs signaling pathway and this signaling pathways
appears to be not the only pathway.
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Affiliation(s)
- Jiangying Zhu
- MD, Department of Plastic and Aesthetic Surgery, The First Affiliated Hospital of Guangxi Medical University, China. Conception and design of the study, manuscript preparation, final approval
| | - Xinyuan Pan
- MD, Department of Plastic and Aesthetic Surgery, The First Affiliated Hospital of Guangxi Medical University, China. Acquisition, analysis and interpretation of data
| | - Bojie Lin
- MD, Department of Plastic and Aesthetic Surgery, The First Affiliated Hospital of Guangxi Medical University, China. Acquisition, analysis and interpretation of data
| | - Guanyu Lin
- IMM, Department of Plastic and Aesthetic Surgery, The First Affiliated Hospital of Guangxi Medical University, China. Technical procedures
| | - Rohan Pradhan
- IMM, Department of Plastic and Aesthetic Surgery, The First Affiliated Hospital of Guangxi Medical University, China. Technical procedures
| | - Feiwen Long
- MM, Department of Ultrasonic, Maternal and Child Health Hospital of Guangxi Zhuang Autonous Region, China. Acquisition of data
| | - Guoqian Yin
- MD, Department of Plastic and Aesthetic Surgery, The First Affiliated Hospital of Guangxi Medical University, China. Analysis and interpretation of data, critical revision
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Jin Z, Chen S, Wu H, Wang J, Wang L, Gao W. Inhibition of autophagy after perforator flap surgery increases flap survival and angiogenesis. J Surg Res 2018; 231:83-93. [PMID: 30278973 DOI: 10.1016/j.jss.2018.05.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 04/02/2018] [Accepted: 05/16/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND The survival ratio of multiterritory perforator flap is variable. Therefore, surviving mechanisms are increasingly explored to identify novel therapeutics. The condition of the choke zone is essential for perforator flap survival. In this study, we investigated autophagy in the choke zone after flap surgery. MATERIALS AND METHODS The flap model involved a perforator flap with three territories that was located on the right dorsal side of a rat. A total of 36 rats were divided into six groups, including the control, 0 d postoperative (PO), 1, 3, 5, and 7 d PO groups. In addition, 72 rats were divided into three groups, including a control group, a 3-methyladenine (3-MA) group, and a rapamycin group. Skin tissue of rats was used for measuring autophagy proteins, vascular endothelial growth factor (VEGF) expression, and histological examination. On day 7 after surgery, the survival ratio of each flap was determined. RESULTS The expression of autophagy and VEGF in the second choke zone (choke II) was increased after flap surgery. Among the three groups, the survival ratio of flaps in the 3-MA group was the highest. Furthermore, the angiogenesis level in the 3-MA group in choke II was the highest among the three groups. CONCLUSIONS Autophagy was initiated by surgery in choke II, and VEGF expression in choke II was increased after flap surgery. Inhibiting autophagy after perforator flap surgery is beneficial for flap survival and for promoting angiogenesis in choke II.
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Affiliation(s)
- Zhicheng Jin
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Shao Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Hongqiang Wu
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Jieke Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Long Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Weiyang Gao
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, The Second School of Medicine, Wenzhou Medical University, Wenzhou, China.
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Experimental Rat Skin Flap Model That Distinguishes between Venous Congestion and Arterial Ischemia. Plast Reconstr Surg 2017; 139:79e-84e. [DOI: 10.1097/prs.0000000000002900] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Zhou RB, Lu HM, Liu J, Shi JY, Zhu J, Lu QQ, Yin DC. A Systematic Analysis of the Structures of Heterologously Expressed Proteins and Those from Their Native Hosts in the RCSB PDB Archive. PLoS One 2016; 11:e0161254. [PMID: 27517583 PMCID: PMC4982684 DOI: 10.1371/journal.pone.0161254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 08/02/2016] [Indexed: 11/18/2022] Open
Abstract
Recombinant expression of proteins has become an indispensable tool in modern day research. The large yields of recombinantly expressed proteins accelerate the structural and functional characterization of proteins. Nevertheless, there are literature reported that the recombinant proteins show some differences in structure and function as compared with the native ones. Now there have been more than 100,000 structures (from both recombinant and native sources) publicly available in the Protein Data Bank (PDB) archive, which makes it possible to investigate if there exist any proteins in the RCSB PDB archive that have identical sequence but have some difference in structures. In this paper, we present the results of a systematic comparative study of the 3D structures of identical naturally purified versus recombinantly expressed proteins. The structural data and sequence information of the proteins were mined from the RCSB PDB archive. The combinatorial extension (CE), FATCAT-flexible and TM-Align methods were employed to align the protein structures. The root-mean-square distance (RMSD), TM-score, P-value, Z-score, secondary structural elements and hydrogen bonds were used to assess the structure similarity. A thorough analysis of the PDB archive generated five-hundred-seventeen pairs of native and recombinant proteins that have identical sequence. There were no pairs of proteins that had the same sequence and significantly different structural fold, which support the hypothesis that expression in a heterologous host usually could fold correctly into their native forms.
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Affiliation(s)
- Ren-Bin Zhou
- Institute for Special Environmental Biophysics, Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi’an, Shaanxi, PR China
| | - Hui-Meng Lu
- Institute for Special Environmental Biophysics, Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi’an, Shaanxi, PR China
| | - Jie Liu
- School of Computer Science and Technology, Xidian University, Xi’an, PR China
| | - Jian-Yu Shi
- Institute for Special Environmental Biophysics, Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi’an, Shaanxi, PR China
| | - Jing Zhu
- Institute for Special Environmental Biophysics, Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi’an, Shaanxi, PR China
| | - Qin-Qin Lu
- Institute for Special Environmental Biophysics, Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi’an, Shaanxi, PR China
| | - Da-Chuan Yin
- Institute for Special Environmental Biophysics, Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi’an, Shaanxi, PR China
- * E-mail:
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Lv QB, Gao X, Lin DS, Chen Y, Cao B, Zhou KL. Effects of diammonium glycyrrhizinate on random skin flap survival in rats: An experimental study. Biomed Rep 2016; 5:383-389. [PMID: 27588181 DOI: 10.3892/br.2016.733] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 07/15/2016] [Indexed: 12/21/2022] Open
Abstract
Partial necrosis of skin flaps continues to restrict the survival of local skin flaps following plastic and reconstructive surgeries. The aim of the present study was to investigate the effects of diammonium glycyrrhizinate (DG), a salt of glycyrrhetinic acid that has been widely used in the therapy of chronic hepatitis and human immunodeficiency virus infection, on random skin flap survival in rats. McFarlane flaps were established in 60 male Sprague-Dawley rats randomly divided into three groups. Group I served as the control group and was injected with saline (10 mg/kg) once per day. Group II and group III were the experimental groups, and were injected with 10 mg/kg DG once and twice per day, respectively. On day 7, the survival area of the flap was measured. Tissue samples were stained with hematoxylin and eosin and immunohistochemically evaluated. Tissue edema, neutrophil density, superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels were evaluated. The mean survival areas of the flaps of group II were significantly larger when compared with those of group I (P<0.05), and the rats of group III exhibited significantly higher survival areas than group II (P<0.05). Histologic and immunohistochemical evaluation showed that microvessel development and the expression level of vascular endothelial growth factor were higher in the two experimental groups than in the control group. Furthermore, SOD activity was significantly increased (P<0.05), while the neutrophil density and MDA level were significantly reduced (P<0.05) in group II when compared with group I. Significant differences between group II and group III with regard to SOD activity and MDA level were also observed (P<0.05). Thus, DG may have a dose-dependent effect on promoting the survival of random skin flaps.
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Affiliation(s)
- Qing-Bo Lv
- Department of Hand and Plastic Surgery, The Second Affiliated Hospital of Wenzhou Medical University, The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China
| | - Xiang Gao
- Department of Hand and Plastic Surgery, The Second Affiliated Hospital of Wenzhou Medical University, The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China
| | - Ding-Sheng Lin
- Department of Hand and Plastic Surgery, The Second Affiliated Hospital of Wenzhou Medical University, The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China
| | - Yun Chen
- Department of Hand and Plastic Surgery, The Second Affiliated Hospital of Wenzhou Medical University, The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China
| | - Bin Cao
- Department of Hand and Plastic Surgery, The Second Affiliated Hospital of Wenzhou Medical University, The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China
| | - Kai-Liang Zhou
- Department of Hand and Plastic Surgery, The Second Affiliated Hospital of Wenzhou Medical University, The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China
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Transplantation of adipose tissue-derived stromal cells promotes the survival of venous-congested skin flaps in rabbit ear. Cell Biochem Biophys 2016; 71:557-63. [PMID: 25190589 DOI: 10.1007/s12013-014-0234-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Venous congestion after skin flap transplantation usually slows blood flow velocity and induces skin flap necrosis and surgical failure. Adipose tissue-derived stromal cells (ADSCs) can promote neovascularization and have been extensively applied in cell transplantation therapy and tissue regeneration. However, their function has not been reported in venous-congested skin flaps. In this study, rabbit ADSCs were isolated and identified. We established a rabbit ear venous-congested skin flap model and injected ADSCs into points along the midlines of skin flaps. The survival conditions of venous-congested skin flaps on postoperative day 7 showed that there was obvious swelling, hemorrhage, or necrosis in skin flaps of the control group, while the skin flap survival rate in the ADSC treatment group significantly increased. Hematoxylin and eosin (HE) staining results indicated that compared with the control group, thrombosis was significantly relieved and neovascularization was observed in the ADSC treatment group. Immunofluorescence revealed that the CD34 expression level and the number of capillaries significantly increased in the ADSC treatment group. In summary, ADSC transplantation promotes neovascularization in venous-congested skin flaps and skin flap survival. Therefore, ADSC transplantation may be an effective measure for promoting the survival of venous-congested skin flaps.
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Natural Hirudin Increases Rat Flap Viability by Anti-Inflammation via PARs/p38/NF-κB Pathway. BIOMED RESEARCH INTERNATIONAL 2015; 2015:597264. [PMID: 26770977 PMCID: PMC4685076 DOI: 10.1155/2015/597264] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 11/24/2015] [Indexed: 12/30/2022]
Abstract
The present study aimed to evaluate the effect of natural hirudin on rat random skin flap viability and to determine the mechanism. Forty-eight rats were randomly divided into 2 groups. After the dorsal skin flap operation (3 cm × 10 cm in size), subcutaneous injections of 6 ATU hirudin were administered to group H (n = 24) every 12 h, while group C (n = 24) received an equal volume of 0.9% normal saline. Six rats from each group were euthanized 1, 2, 4, and 7 days after the operation. A full skin sample was collected from these rats to measure the p38-mitogen-activated protein kinase (p38-MAPK), phospho-p38- (Pp38-) MAPK, nuclear factor-κB (NF-κB) p65, phosphor-NF-κB (pNF-κB) p65, tumour necrosis factor- (TNF-) α, interleukin- (IL-) 6, and intercellular adhesion molecule- (ICAM-) 1 levels via western blot (WB) assays. The results showed that flap viability was significantly higher in the hirudin-treated group, which showed a reduced inflammatory response compared with the control group. The Pp38/p38, pNF-κB p65/NF-κB p65, TNF-α, IL-6, and ICAM-1 levels in the hirudin-treated group were lower than those in the control group. The results demonstrated that hirudin could improve random skin flap viability and suggested that this effect maybe occurs by blocking the thrombin/proteinase-activated receptors (PARs)/p38/NF-κB signalling pathway, thus decreasing the inflammatory response.
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Pan XY, Peng L, Han ZQ, Yin GQ, Song YK, Huang J. Hirudin promotes angiogenesis by modulating the cross-talk between p38 MAPK and ERK in rat ischemic skin flap tissue. Tissue Cell 2015; 47:301-10. [DOI: 10.1016/j.tice.2015.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/24/2015] [Accepted: 04/03/2015] [Indexed: 02/03/2023]
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Moosavian HR, Mirghazanfari SM, Moghaddam KG. Effect of ischemia preconditioning and leech therapy on cutaneous pedicle flaps subjected to prolonged ischemia in a mouse model. Aesthetic Plast Surg 2014; 38:1024-9. [PMID: 25189297 DOI: 10.1007/s00266-014-0399-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 08/13/2014] [Indexed: 12/20/2022]
Abstract
We sought to determine the effect of ischemic preconditioning (IPC) and hirudotherapy (leech therapy) on cutaneous pedicle flaps after they underwent prolonged ischemia (global ischemia) in a mouse model. Twenty cutaneous pedicle flaps were elevated in 20 mice, and the animals were randomized into four groups: sham, control, IPC and leech (5 flaps in each group). Except in the sham group, all flaps were subjected to global ischemia for 5 h via pedicle clamping. The control group did not receive any treatment before or after global ischemia. In the IPC group, global ischemia was preceded by three 10-min episodes of ischemia, each followed by 10 min of reperfusion. In the leech therapy group, after global ischemia, hirudotherapy was performed. Flap survival area and histopathological changes were evaluated on the 10th day after surgery. Flap survival areas were significantly higher in both the IPC and leech groups than in the control group and were significantly higher in the leech group than in the IPC group (p < 0.05). In conclusion IPC and hirudotherapy had definite effects on the survival area of cutaneous pedicle flaps that underwent prolonged ischemia in a mouse model.
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