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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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Gu R, Zhou H, Zhang Z, Lv Y, Pan Y, Li Q, Shi C, Wang Y, Wei L. Research progress related to thermosensitive hydrogel dressings in wound healing: a review. NANOSCALE ADVANCES 2023; 5:6017-6037. [PMID: 37941954 PMCID: PMC10629053 DOI: 10.1039/d3na00407d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 07/27/2023] [Indexed: 11/10/2023]
Abstract
Wound healing is a dynamic and complex process in which the microenvironment at the wound site plays an important role. As a common material for wound healing, dressings accelerate wound healing and prevent external wound infections. Hydrogels have become a hot topic in wound-dressing research because of their high water content, good biocompatibility, and adjustable physical and chemical properties. Intelligent hydrogel dressings have attracted considerable attention because of their excellent environmental responsiveness. As smart polymer hydrogels, thermosensitive hydrogels can respond to small temperature changes in the environment, and their special properties make them superior to other hydrogels. This review mainly focuses on the research progress in thermosensitive intelligent hydrogel dressings for wound healing. Polymers suitable for hydrogel formation and the appropriate molecular design of the hydrogel network to achieve thermosensitive hydrogel properties are discussed, followed by the application of thermosensitive hydrogels as wound dressings. We also discuss the future perspectives of thermosensitive hydrogels as wound dressings and provide systematic theoretical support for wound healing.
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Affiliation(s)
- Ruting Gu
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Haiqing Zhou
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Zirui Zhang
- Emergency Departments, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Yun Lv
- School of Nursing, Qingdao University Qingdao 266000 China
| | - Yueshuai Pan
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Qianqian Li
- Ophthalmology Department, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Changfang Shi
- Department of Spinal Surgery, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Yanhui Wang
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Lili Wei
- Office of the Dean, The Affiliated Hospital of Qingdao University Qingdao 266000 China
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Nakawaki M, Kenmoku T, Uchida K, Arendt-Nielsen L, Nagura N, Takaso M. Expression of Apelin in Rotator Cuff Tears and Examination of Its Regulatory Mechanism: A Translational Study. Cureus 2023; 15:e44347. [PMID: 37654901 PMCID: PMC10465352 DOI: 10.7759/cureus.44347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVES Inflammatory mediators play important roles in the pain associated with rotator cuff tears (RCTs), but their underlying mechanisms are unclear. Apelin, a neuropeptide, is upregulated under inflammatory conditions and possibly contributes to pain induced by rotator cuff tears. This translational study aimed to examine apelin expression and regulation by tumor necrosis factor alpha (TNF-α) in patients with RCT and in rat RCT models. METHODS Synovial tissues were harvested from the glenohumeral joints of the shoulders in 46 patients who underwent arthroscopic Bankart repair for recurrent shoulder dislocations (RSDs) or arthroscopic rotator cuff repair for RCTs. The harvested tissues were extracted and processed by reverse transcriptase-polymerase chain reaction (RT-PCR). Rats underwent sham or RCT surgery; the rotator cuff tissues were extracted 1, 7, 14, 28, and 56 days after surgery and analyzed for mRNA expression levels of the TNF-α and apelin using RT-PCR. The cultured rotator cuff cells (RCCs) were stimulated with TNF-α to examine their role in the regulation of apelin expression. RESULTS Apelin expression was higher in the RCT group than in the RSD group and significantly correlated with pain intensity. In rats, the expression was also higher in RCT. Apelin expression significantly increased during the acute and chronic phases in rats. CONCLUSIONS In cultured RCCs, apelin mRNA levels significantly increased after TNF-α stimulation. Apelin levels were regulated by TNF-α and were highly expressed in patients with RCT and rats in RCT models. Thus, apelin may be a new pain management target for RCTs.
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Affiliation(s)
- Mitsufumi Nakawaki
- Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, JPN
| | - Tomonori Kenmoku
- Orthopaedic Surgery, Kitasato University Hospital, Sagamihara, JPN
| | - Kentaro Uchida
- Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, JPN
| | - Lars Arendt-Nielsen
- Health Science and Technology, Center for Neuroplasticity and Pain (CNP), Faculty of Medicine, Aalborg University, Aalborg, DNK
- Health Science and Technology, Center for Sensory-Motor Interaction (SMI), Faculty of Medicine, Aalborg University, Aalborg, DNK
| | - Naoshige Nagura
- Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, JPN
| | - Masashi Takaso
- Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, JPN
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Carton F. The contribution of immunohistochemistry to the development of hydrogels for skin repair and regeneration. Eur J Histochem 2023; 67. [PMID: 36843501 DOI: 10.4081/ejh.2023.3679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
Hydrogels based on various polymeric materials have been successfully developed in recent years for a variety of skin applications. Several studies have shown that hydrogels with regenerative, antibacterial, and antiinflammatory properties can provide faster and better healing outcomes, particularly in chronic diseases where the normal physiological healing process is significantly hampered. Various experimental tests are typically performed to assess these materials' ability to promote angiogenesis, re-epithelialization, and the production and maturation of new extracellular matrix. Immunohistochemistry is important in this context because it allows for the visualization of in situ target tissue factors involved in the various stages of wound healing using antibodies labelled with specific markers detectable with different microscopy techniques. This review provides an overview of the various immunohistochemical techniques that have been used in recent years to investigate the efficacy of various types of hydrogels in assisting skin healing processes. The large number of scientific articles published demonstrates immunohistochemistry's significant contribution to the development of engineered biomaterials suitable for treating skin injuries.
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Affiliation(s)
- Flavia Carton
- Department of Health Sciences, University of Piemonte Orientale "A. Avogadro", Novara.
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Liu X, Wang J, Xu X, Zhu H, Man K, Zhang J. SDF-1 Functionalized Hydrogel Microcarriers for Skin Flap Repair. ACS Biomater Sci Eng 2022; 8:3576-3588. [PMID: 35899941 DOI: 10.1021/acsbiomaterials.2c00755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Critically sized skin flaps used to treat skin defects often suffer from necrosis due to insufficient blood supply. Hence there is an urgent need to improve the survival rate of skin flaps by promoting local angiogenesis. The delivery of growth factor loaded microcarriers have shown promise in enhancing defect repair, however, their rapid clearance from the defect site limits their regenerative potential. Thus, it is critical to develop microcarriers which can promote the sustained release of bioactive factors to effectively stimulate tissue repair. This study aimed to develop a stromal cell-derived factor 1 (SDF-1) loaded microcarrier coated with Matrigel (MC@SDF-1@Mat) to promote skin flap repair. SEM imaging showed that the surface of the microcarrier was coated by a porous Matrigel film. The drug release experiment showed that the Matrigel-coated microcarriers enhanced the sustained release of the model drug methylene blue when compared to uncoated group. MC@SDF-1@Mat significantly promoted the proliferation, migration, and angiogenesis of HUVECs via CCK-8, wound healing assay, and tube formation assay, respectively. Moreover, the murine random skin flap model was further established and treated. It was found that the flap necrosis area in the MC@SDF-1@Mat treated group was significantly reduced. H&E and Masson staining showed the histological structure and collagen organization exhibited a normal phenotype in the MC@SDF-1@Mat treated group. Additionally, CD31 immunohistochemical analysis showed that the MC@SDF-1@Mat treated group exhibited the greatest degree of neovascularization. In conclusion, our SDF-1 functionalized gelatin-based hydrogel microcarrier has potential clinical applications in promoting skin flap repair and drug delivery.
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Affiliation(s)
- Xiaochuan Liu
- Key Laboratory of 3D Printing Technology in Stomatology, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523710, P.R. China
| | - Jinsi Wang
- Key Laboratory of 3D Printing Technology in Stomatology, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523710, P.R. China
| | - Xiaoqin Xu
- Key Laboratory of 3D Printing Technology in Stomatology, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523710, P.R. China
| | - Hong Zhu
- Key Laboratory of 3D Printing Technology in Stomatology, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523710, P.R. China
| | - Kenny Man
- School of Chemical Engineering, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Jingying Zhang
- Key Laboratory of 3D Printing Technology in Stomatology, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523710, P.R. China
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Fan R, Cheng Y, Wang R, Zhang T, Zhang H, Li J, Song S, Zheng A. Thermosensitive Hydrogels and Advances in Their Application in Disease Therapy. Polymers (Basel) 2022; 14:polym14122379. [PMID: 35745954 PMCID: PMC9227257 DOI: 10.3390/polym14122379] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 01/27/2023] Open
Abstract
Thermosensitive hydrogels, having unique sol–gel transition properties, have recently received special research attention. These hydrogels exhibit a phase transition near body temperature. This feature is the key to their applications in human medicine. In addition, hydrogels can quickly gel at the application site with simple temperature stimulation and without additional organic solvents, cross-linking agents, or external equipment, and the loaded drugs can be retained locally to improve the local drug concentration and avoid unexpected toxicity or side effects caused by systemic administration. All of these features have led to thermosensitive hydrogels being some of the most promising and practical drug delivery systems. In this paper, we review thermosensitive hydrogel materials with biomedical application potential, including natural and synthetic materials. We describe their structural characteristics and gelation mechanism and briefly summarize the mechanism of drug release from thermosensitive hydrogels. Our focus in this review was to summarize the application of thermosensitive hydrogels in disease treatment, including the postoperative recurrence of tumors, the delivery of vaccines, the prevention of postoperative adhesions, the treatment of nervous system diseases via nasal brain targeting, wound healing, and osteoarthritis treatment.
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Affiliation(s)
- Ranran Fan
- School of Pharmacy, Bengbu Medical College, Anhui 233030, China;
| | - Yi Cheng
- College of Pharmacy, Yanbian University, Jilin 133002, China;
| | - Rongrong Wang
- School of Pharmacy, North China University of Science and Technology, Hebei 063210, China;
| | - Ting Zhang
- School of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450001, China;
| | - Hui Zhang
- Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, China;
- Correspondence: (H.Z.); (J.L.); (S.S.)
| | - Jianchun Li
- School of Pharmacy, Bengbu Medical College, Anhui 233030, China;
- Correspondence: (H.Z.); (J.L.); (S.S.)
| | - Shenghan Song
- Department of Vascular Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
- Correspondence: (H.Z.); (J.L.); (S.S.)
| | - Aiping Zheng
- Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, China;
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Wu L, Gao S, Zhao T, Tian K, Zheng T, Zhang X, Xiao L, Ding Z, Lu Q, Kaplan DL. Pressure-driven spreadable deferoxamine-laden hydrogels for vascularized skin flaps. Biomater Sci 2021; 9:3162-3170. [PMID: 33881061 PMCID: PMC8096535 DOI: 10.1039/d1bm00053e] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The development of hydrogels that support vascularization to improve the survival of skin flaps, yet establishing homogeneous angiogenic niches without compromising the ease of use in surgical settings remains a challenge. Here, pressure-driven spreadable hydrogels were developed utilizing beta-sheet rich silk nanofiber materials. These silk nanofiber-based hydrogels exhibited excellent spreading under mild pressure to form a thin coating to cover all the regions of the skin flaps. Deferoxamine (DFO) was loaded onto the silk nanofibers to support vascularization and these DFO-laden hydrogels were implanted under skin flaps in rats to fill the interface between the wound bed and the flap using the applied pressure. The thickness of the spread hydrogels was below 200 μm, minimizing the physical barrier effects from the hydrogels. The distribution of the hydrogels provided homogeneous angiogenic stimulation, accelerating rapid blood vessel network formation and significantly improving the survival of the skin flaps. The hydrogels also modulated the immune reactions, further facilitating the regeneration of the skin flaps. Considering the homogeneous distribution at the wound sites, improved vascularization, reduced barrier effects and low inflammation, these hydrogels appear to be promising candidates for use in tissue repair where a high blood supply is in demand. The pressure-driven spreading properties should simplify the use of the hydrogels in surgical settings to facilitate clinical translation.
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Affiliation(s)
- Lijun Wu
- National Engineering Laboratory for Modern Silk & Collaborative Innovation Center of Suzhou Nano Science and Technology, Soochow University, Suzhou 215123, People's Republic of China. and Department of Plastic and Cosmetic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, P. R. China
| | - Suyue Gao
- Department of Plastic and Cosmetic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, P. R. China and Department of Dermatology and Cosmetic Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215002, Jiangsu, China
| | - Tianlan Zhao
- Department of Plastic and Cosmetic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, P. R. China
| | - Kai Tian
- Department of Plastic and Cosmetic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, P. R. China
| | - Tingyu Zheng
- Department of Plastic and Cosmetic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, P. R. China
| | - Xiaoyi Zhang
- National Engineering Laboratory for Modern Silk & Collaborative Innovation Center of Suzhou Nano Science and Technology, Soochow University, Suzhou 215123, People's Republic of China.
| | - Liying Xiao
- National Engineering Laboratory for Modern Silk & Collaborative Innovation Center of Suzhou Nano Science and Technology, Soochow University, Suzhou 215123, People's Republic of China.
| | - Zhaozhao Ding
- National Engineering Laboratory for Modern Silk & Collaborative Innovation Center of Suzhou Nano Science and Technology, Soochow University, Suzhou 215123, People's Republic of China.
| | - Qiang Lu
- National Engineering Laboratory for Modern Silk & Collaborative Innovation Center of Suzhou Nano Science and Technology, Soochow University, Suzhou 215123, People's Republic of China.
| | - David L Kaplan
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts 02155, USA
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Injectable thermosensitive hydrogel-based drug delivery system for local cancer therapy. Colloids Surf B Biointerfaces 2021; 200:111581. [DOI: 10.1016/j.colsurfb.2021.111581] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 12/17/2020] [Accepted: 01/11/2021] [Indexed: 12/16/2022]
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Relationship between Apelin/APJ Signaling, Oxidative Stress, and Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021. [DOI: 10.1155/2021/8866725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Apelin, a peptide hormone, is an endogenous ligand for G protein-coupled receptor and has been shown to be widely expressed in human and animal tissues, such as the central nervous system and adipose tissue. Recent studies indicate that the apelin/APJ system is involved in the regulation of multiple physiological and pathological processes, and it is associated with cardiovascular diseases, metabolic disorders, neurological diseases, ischemia-reperfusion injury, aging, eclampsia, deafness, and tumors. The occurrence and development of these diseases are closely related to the local inflammatory response. Oxidative stress is that the balance between oxidation and antioxidant is broken, and reactive oxygen species are produced in large quantities, causing cell or molecular damage, which leads to vascular damage and a series of inflammatory reactions. Hence, this article reviewed recent advances in the relationship between apelin/APJ and oxidative stress, and inflammation-related diseases, and highlights them as potential therapeutic targets for oxidative stress-related inflammatory diseases.
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