In vitro effect of platelet-derived growth factor-BB on collagen synthesis and proliferation of human periodontal ligament cells

Hormesis mediates platelet-rich plasma and wound healing

Platelet-rich plasma (PRP) has become an accepted and general wound healing approach with an extremely wide range of applications. Despite considerable diversity in the composition of platelet-rich plasma products that are applied in specific wound healing usage, it is widely recognised that such diverse platelet-rich plasma complex mixtures routinely display hormetic-like biphasic concentrations that are independent of the tissue treated and endpoints measured. The present paper is the first to place the area of platelet-rich plasma-biomedical research and applications within an hormetic framework. The platelet-rich plasma area is also unique as it represents the application of the hormetic concept to the issue of complex biological mixtures.

A Promising Candidate in Tendon Healing Events—PDGF-BB

Tendon injuries are one of the most common musculoskeletal disorders for which patients seek medical aid, reducing not only the quality of life of the patient but also imposing a significant economic burden on society. The administration of growth factors at the wound site is a feasible solution for enhancing tendon healing. Platelet-derived growth factor-BB (PDGF-BB) has a well-defined safety profile compared to other growth factors and has been approved by the Food and Drug Administration (FDA). The purpose of this review is to summarize the role of PDGF-BB in tendon healing through a comprehensive review of the published literature. Experimental studies suggest that PDGF-BB has a positive effect on tendon healing by enhancing inflammatory responses, speeding up angiogenesis, stimulating tendon cell proliferation, increasing collagen synthesis and increasing the biomechanics of the repaired tendon. PDGF-BB is regarded as a promising candidate in tendon healing. However, in order to realize its full potential, we still need to carefully consider and study key issues such as dose and application time in the future, so as to explore further applications of PDGF-BB in the tendon healing process.

Extracellular Matrix-Oriented Proteomic Analysis of Periodontal Ligament Under Mechanical Stress

The periodontal ligament (PDL) is a specialized connective tissue that provides structural support to the tooth and is crucial for oral functions. The mechanical properties of the PDL are mainly derived from the tissue-specific composition and structural characteristics of the extracellular matrix (ECM). The ECM also plays key roles in determining cell fate in the cellular microenvironment thus crucial in the PDL tissue homeostasis. In the present study, we determined the comprehensive ECM profile of mouse molar PDL using laser microdissection and mass spectrometry-based proteomic analysis with ECM-oriented data curation. Additionally, we evaluated changes in the ECM proteome under mechanical loading using a mouse orthodontic tooth movement (OTM) model and analyzed potential regulatory networks using a bioinformatics approach. Proteomic changes were evaluated in reference to the novel second harmonic generation (SHG)-based fiber characterization. Our ECM-oriented proteomics approach succeeded in illustrating the comprehensive ECM profile of the mouse molar PDL. We revealed the presence of type II collagen in PDL, possibly associated with the load-bearing function upon occlusal force. Mechanical loading induced unique architectural changes in collagen fibers along with dynamic compositional changes in the matrisome profile, particularly involving ECM glycoproteins and matrisome-associated proteins. We identified several unique matrisome proteins which responded to the different modes of mechanical loading in PDL. Notably, the proportion of type VI collagen significantly increased at the mesial side, contributing to collagen fibrogenesis. On the other hand, type XII collagen increased at the PDL-cementum boundary of the distal side. Furthermore, a multifaceted bioinformatics approach illustrated the potential molecular cues, including PDGF signaling, that maintain ECM homeostasis under mechanical loading. Our findings provide fundamental insights into the molecular network underlying ECM homeostasis in PDL, which is vital for clinical diagnosis and development of biomimetic tissue-regeneration strategies.

Platelet-derived growth factor-BB regenerates functional periodontal ligament in the tooth replantation

Tooth ankylosis is a pathological condition of periodontal ligament (PDL) restoration after tooth replantation. Platelet-derived growth factor-BB (PDGF-BB) has been proposed as a promising factor for preventing tooth ankylosis. Using rat tooth replantation model, we investigated whether PDGF-BB accelerates the repair of PDL after tooth replantation without ankylosis, and its molecular mechanisms. In PDGF-BB pretreated replanted teeth (PDGF-BB group), ankylosis was markedly reduced and functionally organized PDL collagen fibers were restored; the mechanical strength of the healing PDL was restored to an average of 76% of that in non-replanted normal teeth at 21 days. The numbers of PDGF-Rβ- and BrdU-positive cells in the periodontal tissues of the PDGF-BB group were greater than those of atelocollagen pretreated replanted teeth (AC group). Moreover, in the PDGF-BB group, the periodontal tissues had fewer osteocalcin-positive cells and decreased number of nuclear β-catenin-positive cells compared to those in the AC group. In vitro analyses showed that PDGF-BB increased the proliferation and migration of human periodontal fibroblasts. PDGF-BB downregulated mRNA expressions of RUNX2 and ALP, and inhibited upregulatory effects of Wnt3a on β-catenin, AXIN2, RUNX2, COL1A1, and ALP mRNA expressions. These findings indicate that in tooth replantation, topical PDGF-BB treatment enhances cell proliferation and migration, and inhibits canonical Wnt signaling activation in bone-tooth ankylosis, leading to occlusal loading of the PDL tissues and subsequent functional restoration of the healing PDL. This suggests a possible clinical application of PDGF-BB to reduce ankylosis after tooth replantation and promote proper regeneration of PDL.

Commercial Bone Grafts Claimed as an Alternative to Autografts: Current Trends for Clinical Applications in Orthopaedics

In the last twenty years, due to an increasing medical and market demand for orthopaedic implants, several grafting options have been developed. However, when alternative bone augmentation materials mimicking autografts are searched on the market, commercially available products may be grouped into three main categories: cellular bone matrices, growth factor enhanced bone grafts, and peptide enhanced xeno-hybrid bone grafts. Firstly, to obtain data for this review, the search engines Google and Bing were employed to acquire information from reports or website portfolios of important competitors in the global bone graft market. Secondly, bibliographic databases such as Medline/PubMed, Web of Science, and Scopus were also employed to analyse data from preclinical/clinical studies performed to evaluate the safety and efficacy of each product released on the market. Here, we discuss several products in terms of osteogenic/osteoinductive/osteoconductive properties, safety, efficacy, and side effects, as well as regulatory issues and costs. Although both positive and negative results were reported in clinical applications for each class of products, to date, peptide enhanced xeno-hybrid bone grafts may represent the best choice in terms of risk/benefit ratio. Nevertheless, more prospective and controlled studies are needed before approval for routine clinical use.

RhPDGF – Basic Characteristics and Potential Application in the Oral Surgery – An Overview

Growth factors (GFs) are bioactive molecules participating in organ development, tissue regeneration and repair. They are protein molecules with a relatively low molecular weight and are released by activated platelets. Platelet-derived growth factor (PDGF) is one of the GFs of highest amount in human platelets. It is known to stimulate cell proliferation and extracellular matrix synthesis, as well as angiogenesis in healthy tissues and neoplasms. However, most of the studies in the literature demonstrate the influence of PDGF on tissue regeneration without revealing its intimate mechanisms of action on different cell types. In the current review we emphasis on the effects of PDGF in order to stimulate various biological processes in wide number of pre-clinical and clinical studies.

Platelet-Derived Growth Factor Receptor-α and β are Involved in Fluid Shear Stress Regulated Cell Migration in Human Periodontal Ligament Cells

Introduction

Fluid shear stress (FSS) is the most common stress produced by mastication, speech, or tooth movement. However, how FSS regulates human periodontal ligament (PDL) cell proliferation and migration as well as the underlying mechanism remains unknown.

Methods

FSS (6 dyn/cm²) was produced in a flow chamber. Cell proliferation was tested by the 5-ethynyl-2'-deoxyuridine assay. Cell migration was tested by the wound healing assay. Gene and protein expression of platelet-derived growth factors (PDGFs) and matrix metalloproteinase (MMP)-2 were measured by reverse transcription-polymerase chain reaction and western blot analyses.

Results

We investigated the effect of 4 h of 6 dyn/cm² FSS on proliferation and migration of PDL cells. FSS promoted PDL cell proliferation but inhibited migration. The gene and protein expression of PDGF receptor (PDGFR)-α and β both decreased in response to FSS. Activating and inhibiting the PDGFRs did not affect the FSS-induced increase in cell proliferation. However, activating PDGFRs with PDGF-BB, which bound both PDGFR-α and β, and PDGF-CC and DD, which had high affinities for PDGFR-α and PDGFR-β, individually rescued FSS-inhibited migration. FSS also inhibited MMP-2 gene expression, which was the most important factor for matrix turnover and migration of PDLs. PDGF-BB, CC, and DD increased the FSS-induced decline in MMP-2 expression. These results indicate that MMP-2 is regulated by FSS and contributes to the FSS-induced decrease in cell migration.

Conclusions

Our study suggests a role for PDGFR-α and β in short-term FSS-regulated cell proliferation and migration. These results will help provide the scientific foundation for revealing the mechanisms clinical tooth movement and PDL regeneration.

Growth factor delivery strategies for rotator cuff repair and regeneration

The high incidence of degenerative tears and prevalence of retears (20-95%) after surgical repair makes rotator cuff injuries a significant health problem. This high retear rate is attributed to the failure of the repaired tissue to regenerate the native tendon-to-bone insertion (enthesis). Biological augmentation of surgical repair such as autografts, allografts, and xenografts are confounded by donor site morbidity, immunogenicity, and disease transmission, respectively. In contrast, these risks may be alleviated via growth factor therapy, which can actively influence the healing environment to promote functional repair. Several challenges have to be overcome before growth factor delivery can translate into clinical practice such as the selection of optimal growth factor(s) or combination, identification of the most efficient stage and duration of delivery, and the design considerations for the delivery device. Emerging insight into the injury-repair microenvironment and our understanding of growth factor mechanisms in healing are informing the design of advanced delivery scaffolds to effectively treat rotator cuff tears. Here, we review potential growth factor candidates, design parameters and material selection for growth factor delivery, innovative and dynamic delivery scaffolds, and novel therapeutic targets from tendon and developmental biology for the structural and functional healing of rotator cuff repair.

Growth factors and beta-tricalcium phosphate in the treatment of periodontal intraosseous defects: A systematic review and meta-analysis of randomised controlled trials

OBJECTIVE

To evaluate the effectiveness at different points in time, of recombinant human platelet-derived growth factor-BB (rhPDGF-BB) coated onto a beta-tricalcium phosphate (β-TCP) carrier compared to β-TCP alone, or to recombinant human growth/differentiation factor-5 (rhGDF-5) adsorbed onto a β-TCP scaffold in intraosseous periodontal defects.

DESIGN

A digital search for randomised controlled trials (RCTs) was conducted on MEDLINE/PubMed. The quality of reporting and the risk of bias of the included RCTs were assessed using the CONSORT guidelines and the Cochrane risk of bias tool. The difference between the means of the outcomes at baseline and at follow-up for each group was tested using the Student's t-test for paired samples. The difference between the means of the outcome changes at follow-up between groups was analysed using the Student's t-test for two independent samples. Prior to each analysis a test of homogeneity of variances (Ansari-Bradley) was performed.

RESULTS

From 11 articles assessed for eligibility, 5 RCTs were included in this review. The risk of bias was considered to be low in 2 articles, medium in 1 study and high in 2 studies.

CONCLUSIONS

In the treatment of periodontal intraosseous defects the application of rhPDGF-BB/β-TCP improved all outcomes when compared to β-TCP at 6 months follow-up. Either rhPDGF-BB/β-TCP or rhGDF-5/β-TCP seemed to provide similar results in terms of probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain. The application of rhGDF-5/β-TCP resulted in a more pronounced reduction in gingival recession (GR) depth at 6 months follow-up compared to rhPDGF-BB/β-TCP.

Root surface modifiers and subepithelial connective tissue graft for treatment of gingival recessions: a systematic review

BACKGROUND AND OBJECTIVE

Many techniques and flap designs have been used to treat gingival recession by root coverage, but subepithelial connective tissue graft (SCTG) seems to be the gold standard procedure. In an attempt to improve the healing process and increase the success rate of root coverage, some authors have used root modifiers, including different root conditioners, lasers, EMD, recombinant human growth factors and platelet-rich plasma (PRP). The aim of this systematic review was to evaluate the effects of root biomodification in clinical outcomes of gingival recessions treated with SCTG.

MATERIAL AND METHODS

Studies reporting SCTG associated with any form of root surface biomodification for root coverage of gingival recessions (Miller Class I and Class II) were considered as eligible for inclusion. Studies needed to have data of clinical outcomes in a follow up of at least 6 months. Screening of the articles, data extraction and quality assessment were conducted independently and in duplicate.

RESULTS

None of the products evaluated (citric acid, EDTA, PRP, lasers and EMD) showed evident benefits in clinical outcomes. Test and control groups presented similar outcomes related to root coverage and periodontal parameters, with no statistical differences between them. The exception was root biomodification with the neodymium-doped yttrium aluminium garnet (Nd:YAG) laser, which impaired root coverage and had a detrimental effect on clinical outcomes.

CONCLUSION

Based on the present clinical data, the use of root surface modifiers to improve clinical outcomes in gingival recessions treated with SCTG is not justified. More in vivo studies, and randomized clinical trials with larger sample sizes and extended follow up, are necessary.

Enamel matrix proteins exhibit growth factor activity: A review of evidence at the cellular and molecular levels

Enamel matrix derivative (EMD) is a commercially available protein extract, mainly comprising amelogenins. A number of other polypeptides have been identified in EMD, mostly growth factors, which promote cementogenesis and osteogenesis during the regeneration processes through the regulation of cell proliferation, differentiation and activity; however, not all of their functions are clear. Enamel extracts have been proposed to have numerous activities such as bone morphogenetic protein- and transforming growth factor β (TGF-β)-like activity, and activities similar to those of insulin-like growth factor, fibroblast growth factor, platelet-derived growth factor, vascular endothelial growth factor and epidermal growth factor. These activities have been observed at the molecular and cellular levels and in numerous animal models. Furthermore, it has been suggested that EMD contains an unidentified biologically active factor that acts in combination with TGF-β1, and several studies have reported functional similarities between growth factors and TGF-β in cellular processes. The effects of enamel extracts on the cell cycle and biology are summarized and discussed in this review.

Efficacy of Platelet-Rich-Plasma (PRP) and Highly Purified Bovine Xenograft (Laddec(®)) Combination in Bone Regeneration after Cyst Enucleation: Radiological and Histological Evaluation

Objectives

The purpose of the present study was to evaluate the efficacy of adding platelet-rich plasma (PRP) to a new highly purified bovine allograft (Laddec^®) in the bone regeneration of cystic bony defects augmented following cystectomy.

Material and Methods

Study sample included 20 patients undergoing cystectomy in which the bone defect was filled with PRP and Laddec^®. All patients were examined with periapical radiographs before operation and at follow-up. After 3 months, at re-entry surgery for implant placement, bone core was taken for histological and histomorphometric analysis.

Results

The postoperative successive radiographs showed a good regeneration of bone in the height of bony defects with application of PRP to bone graft. By the first postoperative month, about 48% of the defect was filled, which gradually increased in each month and showed about 90% of defect-fill by 6 months. Histological and histomorphometric analysis, showed a significant presence of bone tissue and vessels, with newly formed bone in contact with anorganic bone particles. The mean volume of vital bone was 68 ± 1.6% and the mean percentage of vital bone was 48 ± 2.4%. The mean percentage of inorganic particles in tissues was 20 ± 1.2% of the total volume. All the samples analyzed did not evidence the presence of inflammatory cells.

Conclusions

The results of this study showed how the use of Laddec^® in association with platelet-rich plasma allows bone regeneration and has a potential for routine clinical use for regeneration of cystic bony defects.

Advanced reconstructive technologies for periodontal tissue repair

Reconstructive therapies to promote the regeneration of lost periodontal support have been investigated through both preclinical and clinical studies. Advanced regenerative technologies using new barrier-membrane techniques, cell-growth-stimulating proteins or gene-delivery applications have entered the clinical arena. Wound-healing approaches using growth factors to target the restoration of tooth-supporting bone, periodontal ligament and cementum are shown to significantly advance the field of periodontal-regenerative medicine. Topical delivery of growth factors, such as platelet-derived growth factor, fibroblast growth factor or bone morphogenetic proteins, to periodontal wounds has demonstrated promising results. Future directions in the delivery of growth factors or other signaling models involve the development of innovative scaffolding matrices, cell therapy and gene transfer, and these issues are discussed in this paper.

Significance of the platelet-derived growth factor in periodontal tissue regeneration

AIM

The aim was to review the significance of the platelet derived growth factor (PGDF) in periodontal tissue regeneration.

METHODS AND RESULTS

Databases were searched using the following terms in different combinations: "growth factors", "guided bone regeneration", "guided tissue regeneration", "periodontal", "platelet rich plasma" and "platelet derived growth factor". Titles and abstracts of articles obtained using the above-described criteria were then screened by the authors and checked for agreement. The next step was to hand-search the reference lists of original and review studies that were found to be relevant in the previous step. PDGF has a stimulatory effect on the DNA replication and chemotaxis of osteoblasts, fibroblasts, leukocytes, monocytes, neutrophils periodontal and alveolar bone cells. Proliferation of mesenchymal stem cells is also promoted by supplement treatment with PDGF. PDGF in combination with other growth factors enhances periodontal tissue repair.

CONCLUSIONS

The PDGF plays a significant role in periodontal bone and tissue regeneration.

Periodontal regeneration: focus on growth and differentiation factors

Several growth and differentiation factors have shown potential as therapeutic agents to support periodontal wound healing/regeneration, although optimal dosage, release kinetics, and suitable delivery systems are still unknown. Experimental variables, including delivery systems, dose, and the common use of poorly characterized preclinical models, make it difficult to discern the genuine efficacy of each of these factors. Only a few growth and differentiation factors have reached clinical evaluation. It appears that well-defined discriminating preclinical models followed by well-designed clinical trials are needed to further investigate the true potential of these and other candidate factors. Thus, current research is focused on finding relevant growth and differentiation factors, optimal dosages, and the best approaches for delivery to develop clinically meaningful therapies in patient-centered settings.

A Role for α11β1 Integrin in the Human Periodontal Ligament

We previously demonstrated a role for α11β1 integrin in periodontal ligament (PDL)-driven tooth eruption in the mouse. To explore a possible role for α11β1 in the human periodontium, we have characterized the expression and function of α11 in human PDL tissue, in human PDL fibroblasts (hPDLF), and in human gingival fibroblasts (hGF). α11 expression was detected in PDL tissue, in hPDLF, and in hGF cells. Platelet-derived growth factor-BB and insulin-like growth factor II stimulated contraction of collagen lattices by both types of fibroblasts. α2 integrin blocking antibodies and the use of α11 siRNA demonstrated a role for both α2β1 and α11β1 in collagen lattice remodeling. Analysis of the proximal ITGA11 promoter from persons with chronic periodontal disease failed to reveal any polymorphism. Analysis of our data shows that α11β1 is a major collagen receptor on cultured human PDL cells and implies that it is also functionally important in the PDL in vivo.

Contrary effects of cytokines on mRNAs of cell cycle- and ECM-related proteins in hRPE cells in vitro

PURPOSE

Retinal pigment epithelial (RPE) cells play a pivotal role in the pathogenesis of proliferative vitreoretinopathy (PVR). As a result of a breakdown of the blood-retina barrier, growth factors obtain access to the subretinal space and stimulate several retinal cell types. The aim of the present study was to analyze the effect of several growth factors on the proliferation of human (h)RPE cells, and on the mRNA expression of transcription factors, cell cycle proteins, and extracellular matrix (ECM) proteins.

METHODS

hRPE cells were incubated in the presence of TGF-beta1, TGF-beta2, PDGF, VEGF, or bFGF for 24-72 h. Cell proliferation was assessed by determinating BrdU incorporation. Changes in mRNA expression of c-fos, c-myc, PCNA, FEN1, Ki67, collagen III, and collagen IV were investigated by ribonuclease protection assay (RPA).

RESULTS

RPE cell proliferation was significantly increased by exposure to PDGF and bFGF for 48 h, and was decreased by application of TGF-beta1 and TGF-beta2 for 48 and 72 h. All the tested growth factors significantly elevated the amounts of c-fos mRNA (after 1 h) and of c-myc mRNA (after 24 h). PDGF and bFGF up-regulated the expression of Ki67 mRNA, and down-regulated that of collagen III and collagen IV mRNA after 24 h. TGF-beta1 and TGF-beta2 decreased the expression of Ki67 mRNA, and increased that of collagen III and collagen IV mRNA.

CONCLUSION

Our results show that distinct cytokines may induce contrary effects with respect to proliferation of, and ECM formation by, hRPE cells in vitro. This knowledge may be useful for the development of improved therapeutic approaches.

Use of platelet gel with connective tissue grafts for root coverage: a randomized-controlled trial

BACKGROUND

Platelet-rich plasma (PRP) was speculated to be a promoter of periodontal regeneration. There are only a few clinical comparative studies using PRP in the treatment of gingival recession.

AIM

The aim of the present study was to compare connective tissue graft (CTG)+PRP with CTG alone in the treatment of gingival recession.

MATERIAL AND METHODS

Forty patients with Miller I/II recessions were included. Each recession was randomly treated with either CTG+PRP or CTG. Clinical variables were recorded at baseline and at 6 weeks, 6 and 12 months. Root coverage (RC) and attachment gain (AG) were also calculated.

RESULTS

Probing depth, recession depth, clinical attachment level, keratinized tissue width and recession width (RW) were improved in both study groups. However, no difference was observed between groups, except RW. RW in the control group was statistically lower than the test group at all follow-up periods.

CONCLUSION

Treatment of recession with CTG or a CTG-PRP combination resulted in favourable clinical outcomes. However, no difference could be found between CTG and CTG+PRP. Whether much longer follow-up studies with higher statistical power may change these results remains questionable.

Temporal expression of 8 growth factors in tendon-to-bone healing in a rat supraspinatus model

Growth factors play an important role in supraspinatus tendon-to-bone healing. The objective of this study was to evaluate the temporal expression of 8 different growth factors in tendon-to-bone healing in an animal model. We hypothesize that growth factors exhibit unique temporal profiles that correlate to specific stages in the acute process of the supraspinatus tendon. To test this hypothesis, rats underwent bilateral supraspinatus tendon detachment and repair. Animals were euthanized at 1, 2, 4, 8, and 16 weeks. Immunohistochemical staining was done using antibodies for basic fibroblast growth factor (bFGF), bone morphogenetic protein 12 (BMP-12), BMP-13, BMP-14, cartilage oligomeric matrix protein (COMP), connective tissue growth factor (CTGF), platelet-derived growth factor-B (PDGF-B), and transforming growth factor-beta1 (TGF-beta1). Immunoassays showed an increase in the expression of all growth factors at 1 week, followed by a return to control or undetectable levels by 16 weeks in both the insertion and midsubstance. Future studies will investigate the different impacts of growth factor expression in tendon to bone healing.

Surgical Treatment of Infrabony Defects With Autologous Platelet Concentrate or Bioabsorbable Barrier Membrane: A Prospective Case Series

BACKGROUND

Autologous platelet concentrate (APC) contains concentrated platelet-derived growth factors that promote wound healing and tissue regeneration. The purpose of this prospective case series was to compare the treatment effects of an intralesional graft of APC to guided periodontal regeneration (GPR) using a bioabsorbable barrier membrane (MEM) over a 52-week period.

METHODS

Five patients were recruited for the study from two private periodontal practices. There were four females and one male having a mean age of 33 +/- 10.23 years. The five selected contralateral teeth had similar, but not identical, combinations of 1-, 2-, and 3-wall infrabony defects not involving furcations. Probing depths (PDs) of the defects were > or = 6 mm and had radiographic angular infrabony defects > or = 4 mm in depth. The patients had no local or systemic contraindications to minor oral surgical procedures and had not taken systemic antibiotics for > or = 6 months before the commencement of the study. All patients had completed cause-related periodontal therapy up to 6 months previously and had achieved a satisfactory level of oral hygiene. The selected teeth did not have purulent discharge from the pockets and responded normally to pulp sensibility testing. Patients were excluded if they smoked, were pregnant or lactating, or were allergic to any of the materials to be used in the treatment. At baseline and 8, 26, and 52 weeks after surgery, PDs, recession (REC), presence of plaque, and bleeding on probing were recorded, and standardized periapical radiographs were taken. At the time of surgery, the vertical distance to the deepest point of the infrabony defect was measured from the cemento-enamel junction (CEJ) to the buccal and lingual bone crests. The vertical distance to the base of the defect from the CEJ and defect angles were obtained from radiographs. The paired contralateral infrabony defects were treated with a graft APC or MEM after debridement and EDTA root surface conditioning. Surgical flaps were prepared and closed according to the papilla preservation method. Post-surgical care was provided at 1, 2, 8, 26, and 52 weeks after surgery. A mouthwash of 0.2% chlorhexidine gluconate was used twice daily for the first 3 weeks after surgery. Mean PD, REC, clinical attachment level (CAL), radiographic bone loss, and defect angle were computed and compared for each data collection point.

RESULTS

From baseline to 52 weeks, a mean PD reduction of 3 +/- 1.41 mm (APC) and 3.6 +/- 1.67 mm (MEM), mean REC increase of 0.8 +/- 1.01 mm (APC) and 0.6 +/- 1.14 mm (MEM), mean CAL gain of 2.2 +/- 1.79 mm (APC) and 3 +/- 1 mm (MEM), mean radiographic bone fill of 3.24 +/- 2.85 mm (APC) and 2.7 +/- 1.9 mm (MEM), and mean defect-angle increase of 15.25 degrees +/- 18.21 degrees (APC) and 22.4 degrees +/- 27.3 degrees (MEM) were calculated. CAL gain was not related clearly to defect angle at baseline, although radiographic bone fill was slightly greater for defect angles <39.4 degrees +/- 7.88 degrees.

CONCLUSIONS

This case series of five similar, but not identical, bilateral paired infrabony defects suggests that an APC graft achieves a similar CAL gain and PD reduction to GPR using an MEM over a 52-week period. A larger, controlled clinical trial is needed to evaluate further the efficacy of autologous platelet-rich plasma for the treatment of infrabony defects.

Role of growth factors on periodontal repair

Regeneration of periodontal structures lost during periodontal diseases constitutes a complex biological process regulated among others by interactions between cells and growth factors. Growth factors are biologically active polypeptides affecting the proliferation, chemotaxis and differentiation of cells from epithelium, bone and connective tissue. They express their action by binding to specific cell-surface receptors present on various target cells including osteoblasts, cementoblasts and periodontal ligament fibroblasts. The observation that growth factors participate in all cell functions led to exogenous application during periodontal tissue repair aiming to their use as an alternative therapeutic approach to periodontal therapy. Cell types and cultures conditions, dose, carrier materials, application requirements are of critical importance in the outcome of periodontal repair. The purpose of this article is to review the literature with respect to the biological actions of PDGF, TGF, FGF, IGF and EGF on periodontal cells and tissues, which are involved in periodontal regeneration.

Optimisation of biochemical condition and substrates in vitro for tissue engineering of ligament

In this work, we analysed the effect of growth factors on in vitro cell proliferation and collagens synthesis by fibroblasts cultured for 72 h on different substrates (silicon sheet with or without 1% gelatin, and glass as control surface) for ligament tissue engineering. A human fibroblast cell line (CRL-2703) was used. The synthesis of type I and type III collagens were evaluated qualitatively and quantitatively by RT-PCR and confocal microscopy, respectively. Cell proliferation was evaluated by two methods: (1) MTT assay (2) cell cycle analysis. It was found that PDGF-AB stimulate the proliferation of fibroblast cultured on gelatin coated silicon sheet in dose dependant manner with a maximum effect at 10 ng ml(-1). The exogenous TGF-beta1 induced the expression of type I and type III collagens in a dose and substrate-dependant manner. We deduce from this work that biochemical conditions and substrates have an important impact for optimisation of the tissue neo synthesis.

Liver fibrosis induced by hepatic overexpression of PDGF-B in transgenic mice

BACKGROUND/AIMS

In hepatic fibrogenesis, stellate cells are activated leading to production and deposition of extracellular matrix. To clarify the role of PDGF-B in liver fibrogenesis, we overexpressed PDGF-B in the liver of transgenic mice.

METHODS

Transgenic mice for the conditional overexpression of PDGF-B in the liver under control of an albumin promoter were generated utilising the Cre/loxP system. Constitutive PDGF-B expression was achieved after breeding with mice expressing Cre-recombinase under actin promoter control. Tamoxifen inducible expression was achieved after breeding with mice expressing Cre under transthyretin receptor promoter control. Levels of fibrosis were assessed and the expression of regulators of matrix remodelling was measured.

RESULTS

PDGF-B expression caused hepatic stellate cell and myofibroblast activation marked by alpha-smooth muscle actin and PDGFR-beta expression. Liver fibrosis was verified macroscopically, histologically and by collagen I mRNA quantification in 4-6 week-old animals. MMP-2, MMP-9 and TIMP-1 were upregulated whereas TGF-beta expression was unchanged.

CONCLUSIONS

We identified PDGF-B as a proliferative and profibrogenic stimulus and potential inducer of stellate cell transdifferentiation in vivo. PDGF-B overexpression causes liver fibrosis without significantly upregulating TGF-beta1, suggesting a TGF-beta-independent mechanism. The established model provides a tool for testing anti-PDGF-B therapeutic strategies in liver fibrosis in vivo.

Growth factor delivery for oral and periodontal tissue engineering

The treatment of oral and periodontal diseases and associated anomalies accounts for a significant proportion of the healthcare burden, with the manifestations of these conditions being functionally and psychologically debilitating. Growth factors are critical to the development, maturation, maintenance and repair of craniofacial tissues, as they establish an extracellular environment that is conducive to cell and tissue growth. Tissue-engineering principles aim to exploit these properties in the development of biomimetic materials that can provide an appropriate microenvironment for tissue development. These materials have been constructed into devices that can be used as vehicles for delivery of cells, growth factors and DNA. In this review, different mechanisms of drug delivery are addressed in the context of novel approaches to reconstruct and engineer oral- and tooth-supporting structures, namely the periodontium and alveolar bone.

Gene therapeutics for periodontal regenerative medicine

There has been significant advancement in the field of periodontal tissue engineering over the past decade for the repair of tooth-supporting structures. Although encouraging results for periodontal tissue regeneration have been found in numerous clinical investigations using recombinant growth factors, limitations exist with topical protein delivery. Newer approaches seek to develop methodologies that optimize growth factor targeting to maximize the therapeutic outcome of periodontal regenerative procedures. Genetic approaches in periodontal tissue engineering show early progress in achieving delivery of growth factor genes, such as platelet-derived growth factor or bone morphogenetic protein, to periodontal lesions. Ongoing investigations in ex vivo and in vivo gene transfer to periodontia seek to examine the extent of the potential effects in stimulating periodontal tissue engineering.