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Vriend L, van Dongen J, Sinkunas V, Brouwer L, Buikema H, Moreira L, Gemperli R, Bongiovanni L, de Bruin A, van der Lei B, Camargo C, Harmsen MC. Limited efficacy of adipose stromal cell secretome-loaded skin-derived hydrogels to augment skin flap regeneration in rats. Stem Cells Dev 2022; 31:630-640. [PMID: 35583223 DOI: 10.1089/scd.2022.0003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Insufficient vascularization is a recurring cause of impaired pedicled skin flap healing. The administration of adipose tissue-derived stromal cells' (ASC) secretome is a novel approach to augment vascularization. Yet, the secretome comprised soluble factors that require a sustained release vehicle to increase residence time. We hypothesized that administration of a hydrogel derived from decellularized extracellular matrix (ECM) of porcine skin with bound trophic factors from ASCs, enhances skin flap viability and wound repair in a rat model. Porcine skin was decellularized and pepsin-digested to form a hydrogel at 37°C. Conditioned medium (CMe) of human ASC was collected, concentrated twentyfold and mixed with the hydrogel. Sixty Wistar rats were included. A dorsal skin flap (caudal based) of 3 x 10 cm was elevated for topical application of: DMEM medium (group I), a pre-hydrogel with or without ASC CMe (group II and III) or ASC CMe (group IV). After 7, 14 and 28 days, perfusion was measured and skin flaps were harvested for wound healing assessment and immunohistochemical analysis. Decellularized skin ECM hydrogel contained negligible amounts of DNA (11.6 ± 0.6 ng/mg), was noncytotoxic and well-tolerated by rats. Irrespective of ASC secretome, ECM hydrogel application resulted macroscopically and microscopically in similar dermal wound healing in terms of proliferation, immune response and matrix remodeling as the control group. However, ASC CMe alone increased vessel density after seven days. Concluding, porcine skin derived ECM hydrogels loaded with ASC secretome are non-cytotoxic but demand optimization to significantly augment wound healing of skin flaps.
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Affiliation(s)
- Linda Vriend
- University Medical Centre Groningen, 10173, Plastic Surgery, Groningen, Netherlands;
| | - Joris van Dongen
- University Medical Center Utrecht, Plastic Surgery, Netherlands;
| | - Viktor Sinkunas
- Universidade of Sao Paulo, Sao Paulo, Brazil, Department of Cardiovascular Surgery, Brazil;
| | - Linda Brouwer
- University of Groningen, University Medical Center Groningen, Department of Pathology & Medical Biology, Netherlands;
| | - Henk Buikema
- University and Medical Center Groningen, The Netherlands, Medical Biology and Pathology, Netherlands;
| | - Luiz Moreira
- Universidade of Sao Paulo, Sao Paulo, Brazil, Department of Cardiovascular Surgery, Brazil;
| | - Rolf Gemperli
- Universidade de São Paulo, São Paulo, Brazil, Department of Surgery, Discipline of Plastic Surgery, Brazil;
| | - Laura Bongiovanni
- University of Groningen, University Medical Center Groningen, Department of Pediatrics, Groningen, the Netherlands, Netherlands.,Utrecht University, Faculty of Veterinary Medicine, Department of Biomolecular Health Sciences, Utrecht, the Netherlands, Netherlands;
| | - Alain de Bruin
- Faculty of Veterinary Medicine, Pathobiology, Utrecht, Netherlands;
| | - Berend van der Lei
- University of Groningen, University Medical Center Groningen, Groningen, the Netherlands, Department of Plastic Surgery, Netherlands;
| | - Cristina Camargo
- Universidade of Sao Paulo, Department of Plastic Surgery Microsurgery and Plastic Surgery laboratory, Sao Paulo, Brazil, Brazil;
| | - Martin C Harmsen
- University of Groningen, Dept. Pathology and Medical Biology, University Medical Center Groningen, Groningen, Netherlands;
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Park DW, Lee HS, Shim MS, Yum KJ, Seo JT. Do Kimchi and Cheonggukjang Probiotics as a Functional Food Improve Androgenetic Alopecia? A Clinical Pilot Study. World J Mens Health 2019; 38:95-102. [PMID: 31385480 PMCID: PMC6920077 DOI: 10.5534/wjmh.180119] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 06/04/2019] [Accepted: 06/19/2019] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Probiotic supplementation demonstrates beneficial effects on serum lipid profiles. We hypothesized that probiotics could benefit patients presenting with alopecia, secondary to improved blood flow to the scalp. MATERIALS AND METHODS Our study included men with stage II to V patterns of hair loss based on the Hamilton-Norwood classification and women with stage I to III patterns of hair loss based on the Ludwig classification. All patients were administered 80 mL of Mogut® (a kimchi and cheonggukjang probiotic product) twice a day. Hair growth and numbers were measured using the Triple Scope System® (KC Technology, Korea) at baseline and after 1 and 4 months of administration of a kimchi and cheonggukjang probiotic product. RESULTS At baseline, the mean hair count was 85.98±20.54 hairs/cm² and the mean thickness was 0.062±0.011 mm in all patients (n=46). Hair count and thickness had significantly increased at 1 month (90.28±16.13 hairs/cm² and 0.068±0.008 mm, respectively) and at 4 months (91.54±16.29 hairs/cm² and 0.066±0.009 mm, respectively). In this study, we found that a kimchi and cheonggukjang probiotic product could promote hair growth and reverse hair loss without associated adverse effects such as diarrhea. CONCLUSIONS We suggest that the observed improvements in hair count and thickness resulted from initiation of the anagen phase in hair follicles in response to probiotics.
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Affiliation(s)
- Dong Wook Park
- Laboratory of Reproductive Medicine, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Hyo Serk Lee
- Department of Urology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | | | | | - Ju Tae Seo
- Department of Urology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
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Farrokhi M, Gashti MZ, Hoormand M, Bakhtiarian A, Habibi R. Combination therapy profoundly improved skin flap survival by modulating KATP channels and nitric oxide. Adv Med Sci 2019; 64:117-123. [PMID: 30640077 DOI: 10.1016/j.advms.2018.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 07/20/2018] [Accepted: 08/31/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE A potential therapeutic approach on skin flap necrosis is to target parallel pathways involved in necrosis. Azelaic Acid, Minoxidil and Caffeine combination was tried on skin flap survival by their possible interaction with ATP sensitive potassium (KATP) channels and nitric oxide pathway. MATERIAL AND METHODS Sprauge-Dawley rats were divided into 8 groups for skin flap surgery. Azelaic acid, minoxidil, caffeine, or their combination were applied topically in different groups. Two additional groups were treated with L-NAME or glibenclamide in addition to the combination therapy. Percentage of flap necrosis was calculated and flap samples were removed to measure tissue malondialdehyde (MDA) and nitric oxide (NO) and expression of inducible nitric oxide synthase (iNOS), Bcl-2 and Bax proteins. RESULTS Combination therapy profoundly decreased skin flap necrosis, tissue MDA contents, and expression of the pro-apoptotic protein Bax (p < 0.05 vs. single treatments). These effects were reversed by L-NAME and glibenclamide pre-treatments. Further evaluations showed combination therapy increases flap tissue NO content and iNOS expression (p < 0.05 vs. single treatments). CONCLUSION Beneficial effect of the combination therapy with azelaic acid, minoxidil and caffeine therapy on rescuing the flap from necrosis by targeting parallel signaling pathways suggested potential applications in clinical practice.
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Affiliation(s)
- Mahtab Farrokhi
- Department of Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mahmood Hoormand
- Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Azam Bakhtiarian
- Department of Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Rohalah Habibi
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Koolen PGL, Nguyen JT, Ibrahim AMS, Ganor O, Chuang DJ, Lin SJ, Lee BT. Effects of statins on ischemia-reperfusion complications in breast free flaps. J Surg Res 2014; 190:378-84. [PMID: 24636099 DOI: 10.1016/j.jss.2014.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 02/01/2014] [Accepted: 02/11/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Administration of statins or other cardiovascular medications (CVMs) could potentially protect against the development of ischemia-reperfusion (I/R) injury in free flap reconstruction. The aim of this study was to examine whether the use of statins and other CVMs decreased the rate of I/R injury in autologous free flap breast reconstruction. METHODS Retrospective chart review was performed on women who had undergone mastectomy and autologous free flap breast reconstruction between 2004 and 2010. Patient characteristics, use of statin and/or CVMs, and I/R-related complications were ascertained. Multivariable logistic regression was used to identify associations between independent risk factors and specific complications. RESULTS There were 702 free flap breast reconstructions included in this study; 45 performed in patients on statins, 70 in patients on CVMs, and 38 in patients on both. Overall complication rate in patients on statins and patients on CVMs was significantly higher than those not on any medication (46.7% versus 31.5%, P=0.037 and 45.7% versus 31.5%, P=0.017, respectively). When I/R complications were pooled, there were no significant differences between patients not on any medications and those on statins (P=0.26), CVMs (P=0.18), and both (P=0.83.) CONCLUSIONS Although there may be theoretical pharmacologic benefits of statins and/or CVMs to reduce the incidence of IR injury in autologous free flap breast reconstruction, the results of this study showed no clear advantages when these drugs were used.
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Affiliation(s)
- Pieter G L Koolen
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - John T Nguyen
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Ahmed M S Ibrahim
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Oren Ganor
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Danielle J Chuang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Samuel J Lin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Bernard T Lee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
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Vasilenko T, Slezák M, Novotný M, Kováč I, Durkáč J, Tomková I, Torma N, Vrzgula A, Lenhardt L, Levkut M, Gál P. Pre- and/or postsurgical administration of estradiol benzoate increases skin flap viability in female rats. Aesthetic Plast Surg 2013; 37:1003-9. [PMID: 23722351 DOI: 10.1007/s00266-013-0151-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 05/08/2013] [Indexed: 01/10/2023]
Abstract
BACKGROUND It has been shown that estrogens have a protective effect with regard to tissue ischemia. Therefore, in this macroscopic and histological investigation, the effect of estradiol benzoate on skin flap viability was studied in sham-operated and ovariectomized Sprague-Dawley rats. METHODS Three months prior to flap surgery a group of rats underwent ovariectomy, while the remaining animals underwent a sham operation. Subsequently, all rats had a 2 × 8-cm skin flap created on the dorsum. Rats were randomly divided into estradiol- or saline-treated groups. Treatment started either on the day of flap excision or 3 days prior to the surgery. RESULTS Our results showed that administration of estradiol benzoate prior to and after flap surgery significantly decreases skin flap necrosis in both sham-operated and ovariectomized rats, with the highest survival rate in animals where treatment started 3 days prior to flap surgery. CONCLUSION In conclusion, the observed protective effect of estradiol on skin flap viability could potentially be applied to plastic and reconstructive surgery in postmenopausal women. Nevertheless, further research is needed to explain the exact underlying mechanism and to find the optimal treatment protocol for human clinical practice.
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Affiliation(s)
- Tomáš Vasilenko
- Department of Pathological Anatomy, University of Veterinary Medicine and Pharmacy, Košice, Slovak Republic
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