1
|
Martínez-Navarrete M, Guillot AJ, Lobita MC, Recio MC, Giner R, Aparicio-Blanco J, Montesinos MC, Santos HA, Melero A. Cyclosporin A-loaded dissolving microneedles for dermatitis therapy: Development, characterisation and efficacy in a delayed-type hypersensitivity in vivo model. Drug Deliv Transl Res 2024:10.1007/s13346-024-01542-9. [PMID: 38472726 DOI: 10.1007/s13346-024-01542-9] [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] [Accepted: 02/07/2024] [Indexed: 03/14/2024]
Abstract
Several drugs can be used for treating inflammatory skin pathologies like dermatitis and psoriasis. However, for the management of chronic and long-term cases, topical administration is preferred over oral delivery since it prevents certain issues due to systemic side effects from occurring. Cyclosporin A (CsA) has been used for this purpose; however, its high molecular weight (1202 Da) restricts the diffusion through the skin structure. Here, we developed a nano-in-micro device combining lipid vesicles (LVs) and dissolving microneedle array patches (DMAPs) for targeted skin delivery. CsA-LVs allowed the effective incorporation of CsA in the hydrophilic DMAP matrix despite the hydrophobicity of the drug. Polymeric matrix composed of poly (vinyl alcohol) (5% w/v), poly (vinyl pyrrolidine) (15% w/v) and CsA-LV dispersion (10% v/v) led to the formation of CsA-LVs@DMAPs with adequate mechanical properties to penetrate the stratum corneum barrier. The safety and biocompatibility were ensured in an in vitro viability test using HaCaT keratinocytes and L929 fibroblast cell lines. Ex vivo permeability studies in a Franz-diffusion cell setup showed effective drug retention in the skin structure. Finally, CsA-LVs@DMAPs were challenged in an in vivo murine model of delayed-type hypersensitivity to corroborate their potential to ameliorate skin inflammatory conditions. Different findings like photon emission reduction in bioluminescence study, normalisation of histological damage and decrease of inflammatory cytokines point out the effectivity of CsA-LVs@DMAPs to treat these conditions. Overall, our study demonstrates that CsA-LVs@DMAPs can downregulate the skin inflammatory environment which paves the way for their clinical translation and their use as an alternative to corticosteroid-based therapies.
Collapse
Affiliation(s)
- Miquel Martínez-Navarrete
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Ave. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - Antonio José Guillot
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Ave. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain.
- Department of Biomaterials and Biomedical Technology, University Medical Center Groningen, University of Groningen, Ant. Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - Maria C Lobita
- Department of Biomaterials and Biomedical Technology, University Medical Center Groningen, University of Groningen, Ant. Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - María Carmen Recio
- Department of Pharmacology, University of Valencia, Ave. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - Rosa Giner
- Department of Pharmacology, University of Valencia, Ave. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - Juan Aparicio-Blanco
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040, Madrid, Spain
| | - María Carmen Montesinos
- Department of Pharmacology, University of Valencia, Ave. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
- Interuniversity Research Institute for Molecular Recognition and Technological Development (IDM), University of Valencia, Polytechnic University of Valencia, Valencia, Spain
| | - Hélder A Santos
- Department of Biomaterials and Biomedical Technology, University Medical Center Groningen, University of Groningen, Ant. Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, FI-00014, Helsinki, Finland
| | - Ana Melero
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Ave. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| |
Collapse
|
2
|
Flori E, Mosca S, Kovacs D, Briganti S, Ottaviani M, Mastrofrancesco A, Truglio M, Picardo M. Skin Anti-Inflammatory Potential with Reduced Side Effects of Novel Glucocorticoid Receptor Agonists. Int J Mol Sci 2023; 25:267. [PMID: 38203435 PMCID: PMC10778823 DOI: 10.3390/ijms25010267] [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: 11/21/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Glucocorticoids (GCs) are commonly used in the treatment of inflammatory skin diseases, although the balance between therapeutic benefits and side effects is still crucial in clinical practice. One of the major and well-known adverse effects of topical GCs is cutaneous atrophy, which seems to be related to the activation of the glucorticoid receptor (GR) genomic pathway. Dissociating anti-inflammatory activity from atrophogenicity represents an important goal to achieve, in order to avoid side effects on keratinocytes and fibroblasts, known target cells of GC action. To this end, we evaluated the biological activity and safety profile of two novel chemical compounds, DE.303 and KL.202, developed as non-transcriptionally acting GR ligands. In primary keratinocytes, both compounds demonstrated anti-inflammatory properties inhibiting NF-κB activity, downregulating inflammatory cytokine release and interfering with pivotal signaling pathways involved in the inflammatory process. Of note, these beneficial actions were not associated with GC-related atrophic effects: treatments of primary keratinocytes and fibroblasts with DE.303 and KL.202 did not induce, contrarily to dexamethasone-a known potent GC-alterations in extracellular matrix components and lipid synthesis, thus confirming their safety profile. These data provide the basis for evaluating these compounds as effective alternatives to the currently used GCs in managing inflammatory skin diseases.
Collapse
Affiliation(s)
- Enrica Flori
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (S.M.); (D.K.); (S.B.); (M.O.)
| | - Sarah Mosca
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (S.M.); (D.K.); (S.B.); (M.O.)
| | - Daniela Kovacs
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (S.M.); (D.K.); (S.B.); (M.O.)
| | - Stefania Briganti
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (S.M.); (D.K.); (S.B.); (M.O.)
| | - Monica Ottaviani
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (S.M.); (D.K.); (S.B.); (M.O.)
| | - Arianna Mastrofrancesco
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (A.M.); (M.T.)
| | - Mauro Truglio
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (A.M.); (M.T.)
| | - Mauro Picardo
- Istituto Dermopatico dell’Immacolata, IDI-IRCCS, 00167 Rome, Italy;
| |
Collapse
|
3
|
Radstake WE, Gautam K, Miranda S, Van Rompay C, Vermeesen R, Tabury K, Verslegers M, Dowson A, Gorissen J, van Loon JJWA, Savage NDL, Baatout S, Baselet B. Gravitational effects on fibroblasts' function in relation to wound healing. NPJ Microgravity 2023; 9:48. [PMID: 37344509 DOI: 10.1038/s41526-023-00286-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 05/25/2023] [Indexed: 06/23/2023] Open
Abstract
The spaceflight environment imposes risks for maintaining a healthy skin function as the observed delayed wound healing can contribute to increased risks of infection. To counteract delayed wound healing in space, a better understanding of the fibroblasts' reaction to altered gravity levels is needed. In this paper, we describe experiments that were carried out at the Large Diameter Centrifuge located in ESA-ESTEC as part of the ESA Academy 2021 Spin Your Thesis! Campaign. We exposed dermal fibroblasts to a set of altered gravity levels, including transitions between simulated microgravity and hypergravity. The addition of the stress hormone cortisol to the cell culture medium was done to account for possible interaction effects of gravity and cortisol exposure. Results show a main impact of cortisol on the secretion of pro-inflammatory cytokines as well as extracellular matrix proteins. Altered gravity mostly induced a delay in cellular migration and changes in mechanosensitive cell structures. Furthermore, 20 × g hypergravity transitions induced changes in nuclear morphology. These findings provide insights into the effect of gravity transitions on the fibroblasts' function related to wound healing, which may be useful for the development of countermeasures.
Collapse
Affiliation(s)
- Wilhelmina E Radstake
- Radiobiology Unit, SCK CEN, Belgian Nuclear Research Centre, 2400, Mol, Belgium
- Department of Molecular Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000, Ghent, Belgium
| | - Kiran Gautam
- Radiobiology Unit, SCK CEN, Belgian Nuclear Research Centre, 2400, Mol, Belgium
| | - Silvana Miranda
- Radiobiology Unit, SCK CEN, Belgian Nuclear Research Centre, 2400, Mol, Belgium
- Department of Molecular Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000, Ghent, Belgium
| | - Cynthia Van Rompay
- Radiobiology Unit, SCK CEN, Belgian Nuclear Research Centre, 2400, Mol, Belgium
| | - Randy Vermeesen
- Radiobiology Unit, SCK CEN, Belgian Nuclear Research Centre, 2400, Mol, Belgium
| | - Kevin Tabury
- Radiobiology Unit, SCK CEN, Belgian Nuclear Research Centre, 2400, Mol, Belgium
- Department of Biomedical Engineering, University of South Carolina, Columbia, SC, 29208, USA
| | - Mieke Verslegers
- Radiobiology Unit, SCK CEN, Belgian Nuclear Research Centre, 2400, Mol, Belgium
| | - Alan Dowson
- Serco Nederland for the European Space Agency (ESA), European Space Research and Technology Centre (ESTEC), TEC-MMG, Keplerlaan 1, 2201, AZ, Noordwijk, the Netherlands
| | | | - Jack J W A van Loon
- ESA/ESTEC, Keplerlaan 1, 2200, AZ, Noordwijk, The Netherlands
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam Movement Sciences & Amsterdam Bone Center (ABC), Amsterdam UMC location Vrije Universiteit Amsterdam & Academic Center for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, The Netherlands
| | - Nigel D L Savage
- HE Space Operations for the European Space Agency, ESA/ESTEC, Keplerlaan 1, 2200, AZ, Noordwijk, The Netherlands
| | - Sarah Baatout
- Radiobiology Unit, SCK CEN, Belgian Nuclear Research Centre, 2400, Mol, Belgium
- Department of Molecular Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000, Ghent, Belgium
| | - Bjorn Baselet
- Radiobiology Unit, SCK CEN, Belgian Nuclear Research Centre, 2400, Mol, Belgium.
| |
Collapse
|
4
|
Dexamethasone Is Not Sufficient to Facilitate Tenogenic Differentiation of Dermal Fibroblasts in a 3D Organoid Model. Biomedicines 2023; 11:biomedicines11030772. [PMID: 36979751 PMCID: PMC10044928 DOI: 10.3390/biomedicines11030772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/11/2023] [Accepted: 02/22/2023] [Indexed: 03/08/2023] Open
Abstract
Self-assembling three-dimensional organoids that do not rely on an exogenous scaffold but maintain their native cell-to-cell and cell-to-matrix interactions represent a promising model in the field of tendon tissue engineering. We have identified dermal fibroblasts (DFs) as a potential cell type for generating functional tendon-like tissue. The glucocorticoid dexamethasone (DEX) has been shown to regulate cell proliferation and facilitate differentiation towards other mesenchymal lineages. Therefore, we hypothesized that the administration of DEX could reduce excessive DF proliferation and thus, facilitate the tenogenic differentiation of DFs using a previously established 3D organoid model combined with dose-dependent application of DEX. Interestingly, the results demonstrated that DEX, in all tested concentrations, was not sufficient to notably induce the tenogenic differentiation of human DFs and DEX-treated organoids did not have clear advantages over untreated control organoids. Moreover, high concentrations of DEX exerted a negative impact on the organoid phenotype. Nevertheless, the expression profile of tendon-related genes of untreated and 10 nM DEX-treated DF organoids was largely comparable to organoids formed by tendon-derived cells, which is encouraging for further investigations on utilizing DFs for tendon tissue engineering.
Collapse
|
5
|
Li T, Zhou L, Fan M, Chen Z, Yan L, Lu H, Jia M, Wu H, Shan L. Human Umbilical Cord-Derived Mesenchymal Stem Cells Ameliorate Skin Aging of Nude Mice Through Autophagy-Mediated Anti-Senescent Mechanism. Stem Cell Rev Rep 2022; 18:2088-2103. [PMID: 35864432 DOI: 10.1007/s12015-022-10418-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 10/17/2022]
Abstract
Skin aging is a currently irreversible process, affected by increased oxidative stress, activated cellular senescence, and lacked regeneration of the dermal layer. Mesenchymal stem cells (MSCs), such as human umbilical cord-derived MSCs (hucMSCs), have pro-regeneration and anti-aging potencies. To explore whether hucMSCs can be used to treat skin aging, this study employed skin-aging model of nude mice to conduct in vivo assays, including biochemical analysis of superoxide dismutase (SOD) and malondialdehyde (MDA), gross observation, histopathological observation, and immunohistochemical analysis. To clarify how hucMSCs work on skin aging, this study employed skin-aging model of human dermal fibroblasts (HDFs) to conduct in vitro assays by applying conditional medium of hucMSCs (CMM), including wound healing assay, senescence staining, flow cytometric oxidative detection, real time PCR, and western blot analysis. The in vivo data demonstrated that hucMSCs dose-dependently removed wrinkles, smoothed skin texture, and increased dermal thickness and collagen production of aged skin by reversing SOD and MDA levels and up-regulating Col-1 and VEGF expressions, indicating anti-oxidative and pro-regenerative effects against skin aging. The in vitro data revealed that hucMSCs significantly reversed the senescence of HDFs by promoting cell migration, inhibiting ROS production, and restoring the overexpressions of oxidative and senescent markers through paracrine mode of action, and the paracrine mechanism was mediated by the inhibition of autophagy. This study provided novel knowledge regarding the anti-aging efficacy and paracrine mechanism of hucMSCs on skin, making hucMSCs-based therapy a promising regime for skin aging treatment.
Collapse
Affiliation(s)
- Ting Li
- The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Plastic and Aesthetic Center, The First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Li Zhou
- The First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Mengqiang Fan
- The First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zuxiang Chen
- The First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Li Yan
- Cell Resource Bank and Integrated Cell Preparation Center of Xiaoshan District, Hangzhou Regional Cell Preparation Center (Shangyu Biotechnology Co., Ltd), Hangzhou, China
| | - Haishan Lu
- Department of Dermatology, PLA 903 Hospital, Hangzhou, China
| | - Ming Jia
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Huiling Wu
- The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China. .,Department of Plastic and Aesthetic Center, The First Affiliated Hospital of Zhejiang University, Hangzhou, China.
| | - Letian Shan
- The First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China. .,Cell Resource Bank and Integrated Cell Preparation Center of Xiaoshan District, Hangzhou Regional Cell Preparation Center (Shangyu Biotechnology Co., Ltd), Hangzhou, China.
| |
Collapse
|
6
|
Radstake WE, Baselet B, Baatout S, Verslegers M. Spaceflight Stressors and Skin Health. Biomedicines 2022; 10:364. [PMID: 35203572 PMCID: PMC8962330 DOI: 10.3390/biomedicines10020364] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 02/06/2023] Open
Abstract
Traveling to space puts astronauts at risk of developing serious health problems. Of particular interest is the skin, which is vitally important in protecting the body from harmful environmental factors. Although data obtained from long-duration spaceflight studies are inconsistent, there have been indications of increased skin sensitivity and signs of dermal atrophy in astronauts. To better understand the effects of spaceflight stressors including microgravity, ionizing radiation and psychological stress on the skin, researchers have turned to in vitro and in vivo simulation models mimicking certain aspects of the spaceflight environment. In this review, we provide an overview of these simulation models and highlight studies that have improved our understanding on the effect of simulation spaceflight stressors on skin function. Data show that all aforementioned spaceflight stressors can affect skin health. Nevertheless, there remains a knowledge gap regarding how different spaceflight stressors in combination may interact and affect skin health. In future, efforts should be made to better simulate the spaceflight environment and reduce uncertainties related to long-duration spaceflight health effects.
Collapse
Affiliation(s)
- Wilhelmina E. Radstake
- Radiobiology Unit, SCK CEN, Belgian Nuclear Research Centre, 2400 Mol, Belgium; (W.E.R.); (S.B.); (M.V.)
- Department of Molecular Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium
| | - Bjorn Baselet
- Radiobiology Unit, SCK CEN, Belgian Nuclear Research Centre, 2400 Mol, Belgium; (W.E.R.); (S.B.); (M.V.)
| | - Sarah Baatout
- Radiobiology Unit, SCK CEN, Belgian Nuclear Research Centre, 2400 Mol, Belgium; (W.E.R.); (S.B.); (M.V.)
- Department of Molecular Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium
| | - Mieke Verslegers
- Radiobiology Unit, SCK CEN, Belgian Nuclear Research Centre, 2400 Mol, Belgium; (W.E.R.); (S.B.); (M.V.)
| |
Collapse
|
7
|
Lumintang L, Adnyana IMS, Hamid AR, Sanjaya H, Golden N, Astawa P, Darmajaya M, Sumadi IWJ. The Effect of Topical Corticosteroid Time of Application on Fibroblast and Type III Collagen Expression in Oryctolagus cuniculus with Deep Dermal Burn Wound (As an Indicator for the Best Time to Start Topical Corticosteroid Application in Preventing Hypertrophic Scar). Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Hypertrophic scar is an abnormal scar that causes physical deteriorations, psychological problems, and aesthetic issues. An excessive number of fibroblasts and collagen III expressions are histopathology indicators for the hypertrophic scar. The role of topical corticosteroids in suppressing inflammation and hypergranulation had widely demonstrated in previous studies. However, there is no study related to the application of topical corticosteroids as prevention of hypertrophic scars from burn wound found. Hence, this study aimed to examine the evidence of the effects of corticosteroid topical in decreasing the number of fibroblasts and type III collagen expression and the best time to start its application in preventing hypertrophic scars.
Methods: This randomized experimental post-test only study involved 54 deep dermal burn wounds on the ventral ear of female Oryctolagus cuniculus that distributed into three groups based on the healing phases. Each group consisted of treatments and controls. Corticosteroid topical application on the first treatment group (inflammatory phase group), the second group (proliferation phase group), and the third group (remodelling phase group) was started on day 3, on day 10, and day 21, respectively. Specimens taken on day 35. Haematoxylin-Eosin and Immunohistochemically staining performed to measure the number of fibroblasts and type III collagen and to observe the epithelization and inflammation process.
Results: The number of fibroblasts significantly decreased in the second treatment group (p =0.001) and followed by the first group (p = 0.016), but no significant decrease found in the third group (p = 0.430). The type III collagen decreased significantly in the second treatment group (p = 0.000) and followed by the third group (p = 0.019), but no significant decrease found in the first group. There was no statistically different number of fibroblast and type III collagen discovered between the controls. Complete epithelization found in all groups. Also, no ongoing inflammation found in all groups.
Conclusion
: Topical corticosteroids on deep dermal burn wound revealed to be effective in reducing the number of fibroblasts and type III collagen with no healing disruption. The proliferation phase found to be the best time to start the application of topical corticosteroids.
Collapse
|
8
|
Karaca Z, Taheri S, Firat ST, Borlu M, Zararsiz G, Mehmetbeyoglu E, Caglar AS, Hacioglu A, Tanriverdi F, Unluhizarci K, Kelestimur F. Molecular skin changes in Cushing syndrome and the effects of treatment. J Endocrinol Invest 2021; 44:153-163. [PMID: 32410187 DOI: 10.1007/s40618-020-01285-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 04/29/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We investigated newly diagnosed patients with endogenous CS for molecular changes in skin by biopsy before and a year after treatment of CS. PATIENTS AND METHODS 26 Patients with CS and 23 healthy controls were included. All the patients were evaluated before and a year after treatment. Skin biopsies were obtained from abdominal region before and a year after treatment in patients with CS and once from healthy volunteers. Total RNA was isolated from the skin biopsy samples and the real-time PCR system was used to determine the expression levels of 23 genes in the skin biopsy. RESULTS Skin expression levels of HAS 1, 2 and 3 mRNAs were lower and COL1A2, COL2A1, COL3A1 mRNAs were higher in patients with CS than in normal controls. MMP-9, TIMP-1 and elastin mRNA expression levels were similar in two groups. Skin IL-1β mRNA expression level was significantly higher in patients with CS. None of these parameters changed significantly 12 months after treatment. Patients with CS showed higher skin GH and HSD11B1 mRNA expressions and lower GHR and IGF-1R mRNA expression compared to control. Expression levels of IGF-1, GR and HSD11B2 mRNA were similar in two groups. None of these parameters changed significantly 12 months after treatment. CONCLUSION CS is associated with increased expression levels of skin COL1A2, COL2A1, COL3A1 mRNAs (which are correlated with increased expression level of skin GH mRNA). Decreased skin HAS may cause decreased synthesis of HA that contributes to thinning of skin in CS. Increased local inflammatory cytokine and HSD11B1 mRNAs may be related to the acne formation in CS. Treatment of CS was not able to reverse these changes and ongoing changes were detected after treatment.
Collapse
Affiliation(s)
- Z Karaca
- Department of Endocrinology, Erciyes University Medical School, Kayseri, Turkey
| | - S Taheri
- Erciyes University Genome and Stem Cell Institution, Kayseri, Turkey
| | - S T Firat
- Department of Endocrinology, Erciyes University Medical School, Kayseri, Turkey
| | - M Borlu
- Department of Dermatology, Erciyes University Medical School, Kayseri, Turkey
| | - G Zararsiz
- Department of Biostatistics, Erciyes University Medical School, Kayseri, Turkey
| | - E Mehmetbeyoglu
- Erciyes University Genome and Stem Cell Institution, Kayseri, Turkey
| | - A Sezgin Caglar
- Department of Endocrinology, Erciyes University Medical School, Kayseri, Turkey
| | - A Hacioglu
- Department of Endocrinology, Erciyes University Medical School, Kayseri, Turkey
| | - F Tanriverdi
- Department of Endocrinology, Erciyes University Medical School, Kayseri, Turkey
| | - K Unluhizarci
- Department of Endocrinology, Erciyes University Medical School, Kayseri, Turkey
| | - F Kelestimur
- Department of Endocrinology, Yeditepe University Medical School, Istanbul, Turkey.
| |
Collapse
|
9
|
Barklund S, Brown M. Treatment of steroid atrophy with hyaluronic acid filler. JAAD Case Rep 2020; 6:973-974. [PMID: 32995421 PMCID: PMC7508711 DOI: 10.1016/j.jdcr.2020.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Sigrid Barklund
- Department of Dermatology, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Mariah Brown
- Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado
- Correspondence to: Mariah Brown, MD, Department of Dermatology, University of Colorado, Mail Stop F703, 1665 N Aurora Ct, Aurora, CO 80045.
| |
Collapse
|
10
|
Wang WS, Guo CM, Sun K. Cortisol Regeneration in the Fetal Membranes, A Coincidental or Requisite Event in Human Parturition? Front Physiol 2020; 11:462. [PMID: 32523541 PMCID: PMC7261858 DOI: 10.3389/fphys.2020.00462] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 04/16/2020] [Indexed: 12/20/2022] Open
Abstract
The fetal membranes are equipped with high capacity of cortisol regeneration through the reductase activity of 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1). The expression of 11β-HSD1 in the fetal membranes is under the feedforward induction by cortisol, which is potentiated by proinflammatory cytokines. As a result, the abundance of 11β-HSD1 increases with gestational age and furthermore at parturition with an escalation of cortisol concentration in the fetal membranes. Accumulated cortisol takes parts in a number of crucial events pertinent to the onset of labor in the fetal membranes, including extracellular matrix (ECM) remodeling and stimulation of prostaglandin output. Cortisol remodels the ECM through multiple approaches including induction of collagen I, III, and IV degradation, as well as inhibition of their cross-linking. These effects of cortisol are executed through activation of the autophagy, proteasome, and matrix metalloprotease 7 pathways, as well as inhibition of the expression of cross-linking enzyme lysyl oxidase in mesenchymal cells of the membranes. With regard to prostaglandin output, cortisol not only increases prostaglandin E2 and F2α syntheses through induction of their synthesizing enzymes such as cytosolic phospholipase A2, cyclooxygenase 2, and carbonyl reductase 1 in the amnion, but also decreases their degradation through inhibition of their metabolizing enzyme 15-hydroxyprostaglandin dehydrogenase in the chorion. Taking all together, data accumulated so far denote that the feedforward cortisol regeneration by 11β-HSD1 in the fetal membranes is a requisite event in the onset of parturition, and the effects of cortisol on prostaglandin synthesis and ECM remodeling may be enhanced by proinflammatory cytokines in chorioamnionitis.
Collapse
Affiliation(s)
- Wang-Sheng Wang
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Chun-Ming Guo
- School of Life Sciences, Yunnan University, Kunming, China
| | - Kang Sun
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| |
Collapse
|
11
|
Vallini V, Rinaldi E, Mangano L, Modesti L, Ghelardini P, Roberts AT, Grazi G. Multiple subcutaneous haematomas of the legs causing skin necrosis in an elderly patient affected by corticosteroid-induced skin atrophy: Case report and review of literature. Int Wound J 2020; 17:540-546. [PMID: 31972900 DOI: 10.1111/iwj.13312] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/16/2018] [Indexed: 12/19/2022] Open
Abstract
Corticosteroid-induced skin atrophy (CISA) consists of a thinning of the skin and subcutaneous tissues, representing the natural consequence of a prolonged glucocorticosteroids use, both systemic as well as topical. It is characterised by the loss of elasticity and skin thickness, associated with an increased skin fragility leading to ecchymoses, haematomas, and steroid purpura. The management of CISA is a challenge for physicians, as the pathology is reversible in a minimal percentage of cases and only after a short topical steroid or low-dose course therapy. Often wounds with large loss of substance represent the more common complication, after a surgical drainage which is often necessary. Skin necrosis with compartment syndrome of a leg is another potential risk for these patients. Here, we report a case of an elderly patient affected by multiple subcutaneous haematomas of the legs causing skin necrosis, arisen after the use of anticoagulants for a deep venous thrombosis. The patient was successfully treated with surgical drainage, negative pressure wound therapy (NPWT), and porcine xenograft with no complications. Finally, we discuss the evidence of the current literature on topic.
Collapse
Affiliation(s)
- Valerio Vallini
- Azienda USL Toscana nord ovest, U.O. Medicina Interna, Ospedale Santa Maria Maddalena, Pisa, Italy
| | - Elisabetta Rinaldi
- Azienda USL Toscana nord ovest, U.O. Medicina Interna, Ospedale Santa Maria Maddalena, Pisa, Italy
| | - Luciana Mangano
- Azienda USL Toscana nord ovest, U.O. Medicina Interna, Ospedale Santa Maria Maddalena, Pisa, Italy
| | - Luca Modesti
- Azienda USL Toscana nord ovest, U.O. Ortopedia, Ospedale Felice Lotti, Pisa, Italy
| | - Piero Ghelardini
- Azienda USL Toscana nord ovest, U.O. Medicina Interna, Ospedale Santa Maria Maddalena, Pisa, Italy
| | - Anna Theresa Roberts
- Azienda USL Toscana nord ovest, U.O. Medicina Interna, Ospedale Santa Maria Maddalena, Pisa, Italy
| | - Giovanni Grazi
- Azienda USL Toscana nord ovest, U.O. Medicina Interna, Ospedale Santa Maria Maddalena, Pisa, Italy
| |
Collapse
|
12
|
Arai K, Yamamoto KH, Suzuki T, Mitsukawa N, Ishii I. Risk factors affecting pressure ulcer healing: Impact of prescription medications. Wound Repair Regen 2020; 28:409-415. [PMID: 31916373 DOI: 10.1111/wrr.12791] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 11/20/2019] [Accepted: 12/16/2019] [Indexed: 12/18/2022]
Abstract
Treatment of pressure ulcers requires removing the cause as well as eliminating factors that interfere with healing. There are no reports on the effect of medications prescribed for underlying diseases on pressure ulcers. Accordingly, the aim of this study was to investigate whether medications prescribed to patients with pressure ulcers could be a factor that influences pressure ulcer healing. We retrospectively reviewed the records of patients with pressure ulcer who were admitted to Chiba University Hospital between June 2009 and June 2015. A total of 110 patients were included in this study. In univariate analysis, there were significant differences in corticosteroid use and total caloric intake. Logistic regression analysis was performed for four factors, including corticosteroid use and total caloric intake, which were significant at P < .05, plus the two factors malignancy and body mass index, which were previously reported as factors that may affect pressure ulcer healing. The results showed that corticosteroid use [odds ratio (OR) 0.205, 95% confidence interval (CI): 0.046 to 0.911, P = .037] and total caloric intake [OR 1.002, 95% CI: 1.000 to 1.003, P = .006] were significant risk factors influencing pressure ulcer healing. This study revealed that use of corticosteroids and total caloric intake could be risk factors affecting pressure ulcer healing. These findings provide useful information for the management of pressure ulcer.
Collapse
Affiliation(s)
- Kenichi Arai
- Department of Pharmacy, Chiba University Hospital, Chiba Prefecture, Chiba, Japan
| | - Ko-Hei Yamamoto
- Department of Pharmacy, Chiba University Hospital, Chiba Prefecture, Chiba, Japan
| | - Takaaki Suzuki
- Department of Pharmacy, Chiba University Hospital, Chiba Prefecture, Chiba, Japan
| | - Nobuyuki Mitsukawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Chiba University Hospital, Chiba Prefecture, Chiba, Japan, Chiba, Japan
| | - Itsuko Ishii
- Department of Pharmacy, Chiba University Hospital, Chiba Prefecture, Chiba, Japan
| |
Collapse
|
13
|
Hayashi R, Okuno Y, Mukai K, Kitamura T, Hayakawa T, Onodera T, Murata M, Fukuhara A, Imamura R, Miyagawa Y, Nonomura N, Otsuki M, Shimomura I. Adipocyte GR Inhibits Healthy Adipose Expansion Through Multiple Mechanisms in Cushing Syndrome. Endocrinology 2019; 160:504-521. [PMID: 30649271 DOI: 10.1210/en.2018-01029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 12/26/2018] [Indexed: 12/30/2022]
Abstract
In Cushing syndrome, excessive glucocorticoids lead to metabolic disturbances, such as insulin resistance, adipocyte hypertrophy, and liver steatosis. In vitro experiments have highlighted the importance of adipocyte glucocorticoid receptor (GR), but its metabolic roles in vivo have not been fully elucidated in Cushing syndrome. In this study, using clinical samples from patients with Cushing syndrome and adipocyte-specific GR knockout (AGRKO) mice, we investigated the roles of adipocyte GR and its clinical relevance in Cushing syndrome. Under chronic treatment with corticosterone, AGRKO mice underwent healthy adipose expansion with diminished ectopic lipid deposition and improved insulin sensitivity. These changes were associated with Atgl-mediated lipolysis through a novel intronic glucocorticoid-responsive element. Additionally, integrated analysis with RNA sequencing of AGRKO mice and clinical samples revealed that healthy adipose expansion was associated with dysregulation of tissue remodeling, preadipocyte proliferation, and expression of the circadian gene. Thus, our study revealed the roles of adipocyte GR on healthy adipose expansion and its multiple mechanisms in Cushing syndrome.
Collapse
Affiliation(s)
- Reiko Hayashi
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yosuke Okuno
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kosuke Mukai
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tetsuhiro Kitamura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tomoaki Hayakawa
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Toshiharu Onodera
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masahiko Murata
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Atsunori Fukuhara
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ryoichi Imamura
- Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasushi Miyagawa
- Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norio Nonomura
- Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Michio Otsuki
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
14
|
PI3K inhibitors protect against glucocorticoid-induced skin atrophy. EBioMedicine 2019; 41:526-537. [PMID: 30737086 PMCID: PMC6441871 DOI: 10.1016/j.ebiom.2019.01.055] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/20/2022] Open
Abstract
Background Skin atrophy is a major adverse effect of topical glucocorticoids. We recently reported that REDD1 (regulated in development and DNA damage 1) and FKBP51 (FK506 binding protein 5), negative regulators of mTOR/Akt signaling, are induced by glucocorticoids in mouse and human skin and are central drivers of steroid skin atrophy. Thus, we hypothesized that REDD1/FKBP51 inhibitors could protect skin against catabolic effects of glucocorticoids. Methods Using drug repurposing approach, we screened LINCS library (http://lincsproject.org/LINCS/) to identify repressors of REDD1/FKBP51 expression. Candidate compounds were tested for their ability to inhibit glucocorticoid-induced REDD1/FKBP51 expression in human primary/immortalized keratinocytes and in mouse skin. Reporter gene expression, microarray, and chromatin immunoprecipitation were employed to evaluate effect of these inhibitors on the glucocorticoid receptor (GR) signaling. Findings Bioinformatics analysis unexpectedly identified phosphoinositide-3-kinase (PI3K)/mTOR/Akt inhibitors as a pharmacological class of REDD1/FKBP51 repressors. Selected PI3K/mTOR/Akt inhibitors-Wortmannin (WM), LY294002, AZD8055, and two others indeed blocked REDD1/FKBP51expression in human keratinocytes. PI3K/mTOR/Akt inhibitors also modified global effect of glucocorticoids on trascriptome, shifting it towards therapeutically important transrepression; negatively impacted GR phosphorylation; nuclear translocation; and GR loading on REDD1/FKBP51 gene promoters. Further, topical application of LY294002 together with glucocorticoid fluocinolone acetonide (FA) protected mice against FA-induced proliferative block and skin atrophy but did not alter the anti-inflammatory activity of FA in ear edema test. Interpretation Our results built a strong foundation for development of safer GR-targeted therapies for inflammatory skin diseases using combination of glucocorticoids with PI3K/mTOR/Akt inhibitors. Fund Work is supported by NIH grants R01GM112945, R01AI125366, and HESI-THRIVE foundation.
Collapse
|
15
|
Sims SM, Kao AM, Spaniolas K, Celio AC, Sippey M, Heniford BT, Kasten KR. Chronic immunosuppressant use in colorectal cancer patients worsens postoperative morbidity and mortality through septic complications in a propensity-matched analysis. Colorectal Dis 2019; 21:156-163. [PMID: 30244521 DOI: 10.1111/codi.14432] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 09/17/2018] [Indexed: 12/27/2022]
Abstract
AIM Chronic immunosuppressant use increases the risk of septic complications after colectomy; however, adverse effects on other organ systems remain poorly understood. The aim of this study was to evaluate the multisystem organ effect(s) of chronic immunosuppressant(s) in colorectal cancer patients. METHODS This was a retrospective study. The American College of Surgeons National Surgical Quality Improvement database (2005-2012) was queried. The primary end-points were 30-day mortality and 30-day morbidity after colectomy in patients on chronic immunosuppressant(s) compared to a non-immunosuppressant cohort. RESULTS In total, 50 766 patients were identified, with 1203 (2.4%) taking chronic immunosuppressant(s). After propensity matching, 1197 patients in each cohort were evaluated with no differences seen in age, body mass index, male sex, wound classification, emergency case status, the presence of preoperative sepsis or operative time. On outcome analysis, 30-day mortality (5.7% vs 3.4%, P < 0.001) and 30-day overall morbidity (35.4% vs 29.0%, P = 0.001) were higher in patients on chronic immunosuppressant(s). Septic complications (10.6% vs 7.9%, P = 0.02) and surgical site infections (15.3% vs 12.3%, P = 0.03) were elevated with chronic immunosuppressant(s). There were no differences in cardiovascular, pulmonary, renal or neurological complications. Chronic immunosuppressant patients demonstrated longer total hospital stay (11.4 ± 11.7 vs 9.5 ± 9.4 days, P < 0.001) and postoperative length of stay (9.4 ± 9.2 vs 8.1 ± 7.6 days, P < 0.001). The limitation was that this was a retrospective study using a clinical dataset. CONCLUSION In this study, immunosuppressant use is associated with worsened infective complications, without contributing to organ-specific complications following colectomy. Significant thought should be given to anastomosis vs stoma creation to possibly prevent worsened morbidity and mortality. Future study is required to determine specific pathways for risk reduction.
Collapse
Affiliation(s)
- S M Sims
- Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA
| | - A M Kao
- Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA
| | - K Spaniolas
- Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Health Sciences Center, Stony Brook Medicine, Stony Brook, New York, USA
| | - A C Celio
- Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
| | - M Sippey
- Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
| | - B T Heniford
- Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA
| | - K R Kasten
- Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA
| |
Collapse
|
16
|
Commentary on ATX-101 (Deoxycholic Acid Injection) Treatment in Men. Dermatol Surg 2017; 43 Suppl 2:S231-S234. [DOI: 10.1097/dss.0000000000001378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
17
|
ATX-101 (Deoxycholic Acid Injection) Treatment in Men: Insights From Our Clinical Experience. Dermatol Surg 2017; 43 Suppl 2:S225-S230. [DOI: 10.1097/dss.0000000000001306] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
18
|
Gastaldello A, Livingstone DEW, Abernethie AJ, Tsang N, Walker BR, Hadoke PWF, Andrew R. Safer topical treatment for inflammation using 5α-tetrahydrocorticosterone in mouse models. Biochem Pharmacol 2017; 129:73-84. [PMID: 28131845 PMCID: PMC5342892 DOI: 10.1016/j.bcp.2017.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 01/17/2017] [Indexed: 12/19/2022]
Abstract
Use of topical glucocorticoid for inflammatory skin conditions is limited by systemic and local side-effects. This investigation addressed the hypothesis that topical 5α-tetrahydrocorticosterone (5αTHB, a corticosterone metabolite) inhibits dermal inflammation without affecting processes responsible for skin thinning and impaired wound healing. The topical anti-inflammatory properties of 5αTHB were compared with those of corticosterone in C57Bl/6 male mice with irritant dermatitis induced by croton oil, whereas its effects on angiogenesis, inflammation, and collagen deposition were investigated by subcutaneous sponge implantation. 5αTHB decreased dermal swelling and total cell infiltration associated with dermatitis similarly to corticosterone after 24 h, although at a five fold higher dose, but in contrast did not have any effects after 6 h. Pre-treatment with the glucocorticoid receptor antagonist RU486 attenuated the effect of corticosterone on swelling at 24 h, but not that of 5αTHB. After 24 h 5αTHB reduced myeloperoxidase activity (representative of neutrophil infiltration) to a greater extent than corticosterone. At equipotent anti-inflammatory doses 5αTHB suppressed angiogenesis to a limited extent, unlike corticosterone which substantially decreased angiogenesis compared to vehicle. Furthermore, 5αTHB reduced only endothelial cell recruitment in sponges whereas corticosterone also inhibited smooth muscle cell recruitment and decreased transcripts of angiogenic and inflammatory genes. Strikingly, corticosterone, but not 5αTHB, reduced collagen deposition. However, both 5αTHB and corticosterone attenuated macrophage infiltration into sponges. In conclusion, 5αTHB displays the profile of a safer topical anti-inflammatory compound. With limited effects on angiogenesis and extracellular matrix, it is less likely to impair wound healing or cause skin thinning.
Collapse
Affiliation(s)
- Annalisa Gastaldello
- University/British Heart Foundation Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom.
| | - Dawn E W Livingstone
- University/British Heart Foundation Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom; Centre for Integrative Physiology, Hugh Robson Building, University of Edinburgh, 15 George Square, Edinburgh EH8 9XD, United Kingdom.
| | - Amber J Abernethie
- University/British Heart Foundation Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom.
| | - Nicola Tsang
- University/British Heart Foundation Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom.
| | - Brian R Walker
- University/British Heart Foundation Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom.
| | - Patrick W F Hadoke
- University/British Heart Foundation Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom.
| | - Ruth Andrew
- University/British Heart Foundation Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom.
| |
Collapse
|
19
|
Wegener JT, Kraal T, Stevens MF, Hollmann MW, Kerkhoffs GMMJ, Haverkamp D. Low-dose dexamethasone during arthroplasty: What do we know about the risks? EFORT Open Rev 2017; 1:303-309. [PMID: 28461961 PMCID: PMC5367537 DOI: 10.1302/2058-5241.1.000039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Dexamethasone is commonly applied during arthroplasty to control post-operative nausea and vomiting (PONV). However, conflicting views of orthopaedic surgeons and anaesthesiologists regarding the use of dexamethasone raise questions about risks of impaired wound healing and surgical site infections (SSI). The aim of this systematic review is to determine the level of evidence for the safety of a peri-operative single low dose of dexamethasone in hip and knee arthroplasty. We systematically reviewed literature in PubMed, EMBASE and Cochrane databases and cited references in articles found in the initial search from 1980 to 2013 based on predefined inclusion criteria. The review was completed with a ‘pro’ and ‘con’ discussion. After identifying 11 studies out of 104, only eight studies met the inclusion criteria. In total, 1335 patients were studied without any incidence of SSI. Causes of SSI are multifactorial. Therefore, 27 205 patients would be required (power = 90%, alpha = 0.05) to provide substantiated conclusions on safety of a single low dose of dexamethasone. Positively, many studies demonstrated showed convincing effects of low-dose dexamethasone on prevention of PONV and dose-dependent effects on post-operative pain and quality of recovery. Dexamethasone induces hyperglycaemia, but none of the studies demonstrated a concomitant SSI. Conversely, animal studies showed that high dose dexamethasone inhibits wound healing. A team approach of anaesthesiologists and orthopaedic surgeons is mandatory in order to balance the risk–benefit ratio of peri-operatively applied steroids for individual arthroplasty patients. We did not find evidence that a single low dose of dexamethasone contributes to SSI or wound healing impairment from the current studies.
Cite this article: Wegener JT, Kraal T, Stevens MF, Hollman MW, Kerkhoffs GMMJ, Haverkamp D. Low-dose dexamethasone during arthroplasty: what do we know about the risks? EFORT Open Rev 2016;1:303-309. DOI: 10.1302/2058-5241.1.000039.
Collapse
Affiliation(s)
- Jessica T Wegener
- Department of Anesthesiology, Academic Medical Center (AMC), University of Amsterdam, The Netherlands
| | - Tim Kraal
- Department of Orthopedic Surgery, Academic Medical Center and the Orthopedic Research Center Amsterdam, The Netherlands
| | - Markus F Stevens
- Department of Anesthesiology, Academic Medical Center (AMC), University of Amsterdam, The Netherlands
| | - Markus W Hollmann
- Department of Anesthesiology, Academic Medical Center (AMC), University of Amsterdam, The Netherlands
| | - Gino M M J Kerkhoffs
- Department of Orthopedic Surgery, Academic Medical Center and the Orthopedic Research Center Amsterdam, The Netherlands
| | - Daniël Haverkamp
- Department of Orthopedic Surgery, Slotervaart Ziekenhuis, Amsterdam, The Netherlands
| |
Collapse
|
20
|
Novel 11β-hydroxysteroid dehydrogenase 1 inhibitors reduce cortisol levels in keratinocytes and improve dermal collagen content in human ex vivo skin after exposure to cortisone and UV. PLoS One 2017; 12:e0171079. [PMID: 28152550 PMCID: PMC5289826 DOI: 10.1371/journal.pone.0171079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 01/17/2017] [Indexed: 01/03/2023] Open
Abstract
Activity and selectivity assessment of new bi-aryl amide 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) inhibitors, prepared in a modular manner via Suzuki cross-coupling, are described. Several compounds inhibiting 11β-HSD1 at nanomolar concentrations were identified. Compounds 2b, 3e, 7b and 12e were shown to selectively inhibit 11β-HSD1 over 11β-HSD2, 17β-HSD1 and 17β-HSD2. These inhibitors also potently inhibited 11β-HSD1 activity in intact HEK-293 cells expressing the recombinant enzyme and in intact primary human keratinocytes expressing endogenous 11β-HSD1. Moreover, compounds 2b, 3e and 12e were tested for their activity in human skin biopsies. They were able to prevent, at least in part, both the cortisone- and the UV-mediated decreases in collagen content. Thus, inhibition of 11β-HSD1 by these compounds can be further investigated to delay or prevent UV-mediated skin damage and skin aging.
Collapse
|
21
|
Shetty BS, Udupa SL, Udupa AL, Somayaji SN. Effect of Centella asiatica L (Umbelliferae) on Normal and Dexamethasone-Suppressed Wound Healing in Wistar Albino Rats. INT J LOW EXTR WOUND 2016; 5:137-43. [PMID: 16928669 DOI: 10.1177/1534734606291313] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Centella asiatica is a reputed medicinal plant used in the treatment of various skin diseases in the Indian system of medicine. The objective of the study presented in this article was to evaluate the wound-healing potential of the ethanolic extract of the plant in both normal and dexamethasone-suppressed wound healing. The study was done on Wistar albino rats using incision, excision, and dead space wounds models. The extract of C asiatica significantly increased the wound breaking strength in incision wound model compared to controls (P < .001). The extract-treated wounds were found to epithelize faster, and the rate of wound contraction was significantly increased as compared to control wounds (P < .001). Wet and dry granulation tissue weights, granulation tissue breaking strength, and hydroxyproline content in a dead space wound model also increased at statistically significant levels as shown. The extract of the leaves had the effect of attenuating the known effects of dexamethasone healing in all wound models (P < .001, P < .05). The results indicated that the leaf extract promotes wound healing significantly and is able to overcome the wound-healing suppressing action of dexamethasone in a rat model. These observations were supported by histology findings.
Collapse
|
22
|
Terao M, Katayama I. Local cortisol/corticosterone activation in skin physiology and pathology. J Dermatol Sci 2016; 84:11-16. [PMID: 27431412 DOI: 10.1016/j.jdermsci.2016.06.014] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 06/29/2016] [Indexed: 01/12/2023]
Abstract
Cortisol and corticosterone are the endogenous glucocorticoids (GCs) in humans and rodents, respectively. Systemic GC is released through the hypothalamic-pituitary-adrenal (HPA) axis in response to various stressors. Over the last decade, extra-adrenal production/activation of cortisol/corticosterone has been reported in many tissues. The enzyme that catalyzes the conversion of hormonally inactive cortisone/11-dehydrocorticosterone (11-DHC) into active cortisol/corticosterone in cells is 11β-hydroxysteroid dehydrogenase (11β-HSD). The 11β-HSD1 isoform is predominantly a reductase, which catalyzes nicotinamide adenine dinucleotide phosphate hydrogen-dependent conversion of cortisone/11-DHC to cortisol/corticosterone, and is widely expressed and present at the highest levels in the liver, lungs, adipose tissues, ovaries, and central nervous system. The 11β-HSD2 isoform, which catalyzes nicotinamide adenine dinucleotide+-dependent inactivation of cortisol/corticosterone to cortisone/11-DHC, is highly expressed in distal nephrons, the colon, sweat glands, and the placenta. In healthy skin, 11β-HSD1 is expressed in the epidermis and in dermal fibroblasts. On the other hand, 11β-HSD2 is expressed in sweat glands but not in the epidermis. The role of 11β-HSD in skin physiology and pathology has been reported recently. In this review, we summarize the recently reported role of 11β-HSD in the skin, focusing on its function in cell proliferation, wound healing, inflammation, and aging.
Collapse
Affiliation(s)
- Mika Terao
- Department of Dermatology, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Ichiro Katayama
- Department of Dermatology, Osaka University Graduate School of Medicine, Suita, Japan
| |
Collapse
|
23
|
Vanella R, Callari R, Weston A, Heider H, Schwab MS, Kübler E. Yeast-based assays for screening 11β-HSD1 inhibitors. Microb Cell Fact 2016; 15:52. [PMID: 26980090 PMCID: PMC4791775 DOI: 10.1186/s12934-016-0450-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 03/07/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Intracellular metabolism of glucocorticoid hormones plays an important role in the pathogenesis of metabolic syndrome and regulates, among many physiological processes, collagen metabolism in skin. At the peripheral level the concentration of active glucocorticoids is mainly regulated by the 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) enzyme, involved in the conversion of cortisone into the biologically active hormone cortisol. Cortisol interacts with the glucocorticoid receptor and regulates the expression of different classes of genes within the nucleus. Due to its implication in glucocorticoid metabolism, the inhibition of 11β-HSD1 activity has become a dominant strategy for the treatment of metabolic syndrome. Moreover, inhibitors of this target enzyme can be used for development of formulations to counteract skin ageing. Here we present the construction of two yeast cell based assays that can be used for the screening of novel 11β-HSD1 inhibitors. RESULTS The yeast Saccharomyces cerevisiae is used as a host organism for the expression of human 11β-HSD1 as well as a genetically encoded assay system that allows intracellular screening of molecules with 11β-HSD1 inhibitory activity. As proof of concept the correlation between 11β-HSD1 inhibition and fluorescent output signals was successfully tested with increasing concentrations of carbenoxolone and tanshinone IIA, two known 11β-HSD1 inhibitors. The first assay detects a decrease in fluorescence upon 11β-HSD1 inhibition, whereas the second assay relies on stabilization of yEGFP upon inhibition of 11β-HSD1, resulting in a positive read-out and thus minimizing the rate of false positives sometimes associated with read-outs based on loss of signals. Specific inhibition of the ABC transporter Pdr5p improves the sensitivity of the assay strains to cortisone concentrations by up to 60 times. CONCLUSIONS Our yeast assay strains provide a cost-efficient and easy to handle alternative to other currently available assays for the screening of 11β-HSD1 inhibitors. These assays are designed for an initial fast screening of large numbers of compounds and enable the selection of cell permeable molecules with target inhibitory activity, before proceeding to more advanced selection processes. Moreover, they can be employed in yeast synthetic biology platforms to reconstitute heterologous biosynthetic pathways of drug-relevant scaffolds for simultaneous synthesis and screening of 11β-HSD1 inhibitors at intracellular level.
Collapse
Affiliation(s)
- Rosario Vanella
- />University of Applied Sciences Northwestern Switzerland, Gründenstrasse 40, 4132 Muttenz, Switzerland
| | - Roberta Callari
- />University of Applied Sciences Northwestern Switzerland, Gründenstrasse 40, 4132 Muttenz, Switzerland
- />Evolva SA, Duggingerstrasse 23, 4153 Reinach, Switzerland
| | - Anna Weston
- />University of Applied Sciences Northwestern Switzerland, Gründenstrasse 40, 4132 Muttenz, Switzerland
| | - Harald Heider
- />Evolva SA, Duggingerstrasse 23, 4153 Reinach, Switzerland
| | | | - Eric Kübler
- />University of Applied Sciences Northwestern Switzerland, Gründenstrasse 40, 4132 Muttenz, Switzerland
| |
Collapse
|
24
|
Freitas JOGD, Quieregatto PR, Hochman B, Lapin GAF, Mella SMB, Maximino JR, Chadi G, Ferreira LM. Does dexamethasone act in neuropeptides SP and CGRP in neurogenic inflammation of the skin? An experimental study. Acta Cir Bras 2015; 30:523-8. [PMID: 26352331 DOI: 10.1590/s0102-865020150080000002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To investigate the neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP) after subcutaneous injection of dexamethasone prior to skin incision in rats. METHODS Twenty seven Wistar-EPM-1 rats were randomly divided into three groups. The sham group (SG) of rats was injected with 0.9 % saline. The second group (Dexa) was injected with 1.0 mg/kg dexamethasone, and the third group (Dexa+) was injected with 10.0 mg/kg dexamethasone. In all groups, the three subcutaneous injections were performed 30 minutes prior to the surgical skin incision and tissue collection. SP and CGRP (15 kDa pro-CGRP and 5 kDa CGRP) were quantified by Western Blotting. RESULTS No statistically significant differences (p>0.05) were found in pro-CGRP, CGRP and SP values in all three groups. CONCLUSION The anti-inflammatory effect of dexamethasone did not occur when the substance P and calcitonin gene-related peptide levels were altered during the neurogenic inflammation process of skin wound healing in rats.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Gerson Chadi
- Neuroregeneration Center, School of Medicine, USP, São Paulo, SP, BR
| | | |
Collapse
|
25
|
Miedel EL, Brisson BK, Hamilton T, Gleason H, Swain GP, Lopas L, Dopkin D, Perosky JE, Kozloff KM, Hankenson KD, Volk SW. Type III collagen modulates fracture callus bone formation and early remodeling. J Orthop Res 2015; 33:675-84. [PMID: 25626998 PMCID: PMC4406871 DOI: 10.1002/jor.22838] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 01/19/2015] [Indexed: 02/04/2023]
Abstract
Type III collagen (Col3) has been proposed to play a key role in tissue repair based upon its temporospatial expression during the healing process of many tissues, including bone. Given our previous finding that Col3 regulates the quality of cutaneous repair, as well as our recent data supporting its role in regulating osteoblast differentiation and trabecular bone quantity, we hypothesized that mice with diminished Col3 expression would exhibit altered long-bone fracture healing. To determine the role of Col3 in bone repair, young adult wild-type (Col3+/+) and haploinsufficent (Col3+/-) mice underwent bilateral tibial fractures. Healing was assessed 7, 14, 21, and 28 days following fracture utilizing microcomputed tomography (microCT), immunohistochemistry, and histomorphometry. MicroCT analysis revealed a small but significant increase in bone volume fraction in Col3+/- mice at day 21. However, histological analysis revealed that Col3+/- mice have less bone within the callus at days 21 and 28, which is consistent with the established role for Col3 in osteogenesis. Finally, a reduction in fracture callus osteoclastic activity in Col3+/- mice suggests Col3 also modulates callus remodeling. Although Col3 haploinsufficiency affected biological aspects of bone repair, it did not affect the regain of mechanical function in the young mice that were evaluated in this study. These findings provide evidence for a modulatory role for Col3 in fracture repair and support further investigations into its role in impaired bone healing.
Collapse
Affiliation(s)
- Emily L. Miedel
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - Becky K. Brisson
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - Todd Hamilton
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - Hadley Gleason
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - Gary P. Swain
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - Luke Lopas
- Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Derek Dopkin
- Department of Small Animal Clinical Science and Department of Physiology, Michigan State University, East Lansing, MI
| | - Joseph E. Perosky
- Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI
| | - Kenneth M. Kozloff
- Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI
| | - Kurt D. Hankenson
- Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Small Animal Clinical Science and Department of Physiology, Michigan State University, East Lansing, MI
| | - Susan W. Volk
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
26
|
Ochandio BS, Bechara IJ, Parise-Maltempi PP. Dexamethasone action on caudal fin regeneration of carp Cyprinus carpio (Linnaeus, 1758). BRAZ J BIOL 2015; 75:442-50. [DOI: 10.1590/1519-6984.16813] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 12/13/2013] [Indexed: 11/22/2022] Open
Abstract
Studies have demonstrated that the prolonged use of corticoids can delay the healing process, affecting re-epithelialization, neovascularization and collagen synthesis. As the fins of teleost fish contain a large amount of collagen, the aim of the present study was to investigate the effect of dexamethasone (anti-inflammatory and glucocorticoid steroid widely used in the treatment of rheumatic diseases) during the regeneration process in the caudal fin of specimens of carp (Cyprinus carpio). For such, two glass aquaria were used – one for a group of fish treated with dexamethasone (Henrifarma) in a 20 mg/L concentration and the other for the control group. The caudal fins were amputated transversally and fish remained in their respective aquaria until regeneration occurred. Samples of regenerating fins were collected on days 1, 2, 4, 6, 8 and 10 after amputation. The fins in the control group regenerated normally and grew within the expected in time course. The fins in the group treated with dexamethasone were significantly smaller in comparison to the control group at every evaluation time. Thus, it was possible to verify that, at this concentration of dexamethasone, the regeneration of the caudal fins was delayed, but not completely inhibited. The results show that the caudal fin is a good model for histological studies on regeneration and the action of drug toxicity, but it’s also of great importance the interaction with further studies for a better knowledge and understanding of all the changes in all the phases.
Collapse
Affiliation(s)
- BS. Ochandio
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Brazil
| | | | | |
Collapse
|
27
|
Brisson BK, Mauldin EA, Lei W, Vogel LK, Power AM, Lo A, Dopkin D, Khanna C, Wells RG, Puré E, Volk SW. Type III Collagen Directs Stromal Organization and Limits Metastasis in a Murine Model of Breast Cancer. THE AMERICAN JOURNAL OF PATHOLOGY 2015; 185:1471-86. [PMID: 25795282 DOI: 10.1016/j.ajpath.2015.01.029] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/31/2014] [Accepted: 01/22/2015] [Indexed: 01/02/2023]
Abstract
Breast cancer metastasis is the leading cause of cancer-related deaths in women worldwide. Collagen in the tumor microenvironment plays a crucial role in regulating tumor progression. We have shown that type III collagen (Col3), a component of tumor stroma, regulates myofibroblast differentiation and scar formation after cutaneous injury. During the course of these wound-healing studies, we noted that tumors developed at a higher frequency in Col3(+/-) mice compared to wild-type littermate controls. We, therefore, examined the effect of Col3 deficiency on tumor behavior, using the murine mammary carcinoma cell line 4T1. Notably, tumor volume and pulmonary metastatic burden after orthotopic injection of 4T1 cells were increased in Col3(+/-) mice compared to Col3(+/+) littermates. By using murine (4T1) and human (MDA-MB-231) breast cancer cells grown in Col3-poor and Col3-enriched microenvironments in vitro, we found that several major events of the metastatic process were suppressed by Col3, including adhesion, invasion, and migration. In addition, Col3 deficiency increased proliferation and decreased apoptosis of 4T1 cells both in vitro and in primary tumors in vivo. Mechanistically, Col3 suppresses the procarcinogenic microenvironment by regulating stromal organization, including density and alignment of fibrillar collagen and myofibroblasts. We propose that Col3 plays an important role in the tumor microenvironment by suppressing metastasis-promoting characteristics of the tumor-associated stroma.
Collapse
Affiliation(s)
- Becky K Brisson
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Elizabeth A Mauldin
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Weiwei Lei
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laurie K Vogel
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ashley M Power
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Albert Lo
- Department of Animal Biology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Derek Dopkin
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Chand Khanna
- Tumor and Metastasis Biology Section, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Rebecca G Wells
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ellen Puré
- Department of Animal Biology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Susan W Volk
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| |
Collapse
|
28
|
Verkerk MM, Bhatia D, Rimmer J, Earls P, Sacks R, Harvey RJ. Intranasal Steroids and the Myth of Mucosal Atrophy: A Systematic Review of Original Histological Assessments. Am J Rhinol Allergy 2015; 29:3-18. [DOI: 10.2500/ajra.2015.29.4111] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Intranasal corticosteroids (INCSs) are well established in the treatment of allergic rhinitis, chronic rhinosinusitis, and nasal polyposis. Although reversible atrophy of keratinized skin is seen with corticosteroids, the respiratory mucosa is histologically very different and but concerns remain among patients and some health-care professionals over local side effects on nasal respiratory mucosa. A systematic review and meta-analysis were performed of the available evidence for nasal mucosal atrophy as an adverse effect of INCSs in patients with sinonasal disease. Methods A systematic search of Embase (1974-) and Medline (1946-) databases to September 27, 2013 was performed. Inclusion criteria selected any study where the histopathology of nasal mucosa was assessed in patients with sinonasal disease using intranasally administered corticosteroids with or without a control group. Results Twenty-three hundred sixty-four publications were retrieved with a subsequent full text review of 149 publications for 34 articles that met the selection criteria. These articles included 11 randomized controlled trials, 5 cohorts, and 20 case series. Duration of treatment varied from 5 days to 5.5 years. “Mucosal atrophy” as an outcome was reported in 17 studies. The definition of “mucosal atrophy” was highly variable with a definition given in only 10 studies. One hundred thirty-six patients were represented in controlled studies of atrophy with only one study reporting the event in both groups with an odds ratio of “mucosal atrophy” at 0.51 (95% CI, 0.09-3.11; p = 0.47). Conclusion The concept of nasal mucosal atrophy is poorly defined and there is no histological evidence for deleterious effects from INCS use on human nasal mucosa.
Collapse
Affiliation(s)
- Misha M. Verkerk
- Department of Otolaryngology, Head and Neck Surgery, and Freeman Hospital, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Daman Bhatia
- Department of Otolaryngology, Hornsby Ku-ring-gai Hospital, Sydney, New South Wales, Australia
| | - Janet Rimmer
- Department of Thoracic Medicine, St. Vincent's Hospital, Sydney, New South Wales, Australia
| | - Peter Earls
- Department of Pathology, St. Vincent's Hospital, Sydney, New South Wales, Australia
| | - Raymond Sacks
- Department of Otolaryngology, Head and Neck Surgery, Concord General Hospital, University of Sydney, and Macquarie University, Sydney, New South Wales, Australia
| | - Richard J. Harvey
- Department of Otolaryngology, Head and Neck Surgery, St. Vincent's Hospital, University of New South Wales, and Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
29
|
Trevizan Pera D, Freitas Planello J, Cancino J, Polikarpov I, Zucolotto V, Retto da Silva de Avó L, Maria Ramos Germano C, Gusmão Melo D. Effects of 3,5,3′-Triiodothyroacetic Acid, Nanoencapsulated or Not, on Intact and Atrophic Skin in Rats. J Nanotechnol Eng Med 2014. [DOI: 10.1115/1.4028695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We aimed to investigate 3,5,3′-triiodothyroacetic acid (TRIAC) effects on intact and atrophic skin induced by glucocorticoids (GCs) in rats and the effects induced by nanoencapsulation. The effects of TRIAC and nanoencapsulated TRIAC were evaluated on intact and atrophic skin in TRIAC experiment and nanoencapsulated TRIAC experiment, respectively. Both experiments had two phases: phase I, cutaneous atrophy was induced; phase II, TRIAC or nanoencapsulated TRIAC was administrated. Our results showed that topical use of TRIAC with or without nanoencapsulation was able to reverse cutaneous atrophy. Nanoencapsulated TRIAC showed less systemic changes than TRIAC; therefore, it is possibly a safer drug for topical administration.
Collapse
Affiliation(s)
- Daniele Trevizan Pera
- Postgraduate Program in Biotechnology (PPGBiotec), Federal University of São Carlos (UFSCar), São Carlos, São Paulo CEP 13565-905, Brazil e-mail:
| | - Jéssica Freitas Planello
- Department of Medicine (DMed), Federal University of São Carlos (UFSCar), São Carlos, São Paulo CEP 13565-905, Brazil e-mail:
| | - Juliana Cancino
- Physics Institute of São Carlos (IFSC), University of São Paulo (USP), São Carlos, São Paulo CEP 13566-590, Brazil e-mail:
| | - Igor Polikarpov
- Physics Institute of São Carlos (IFSC), University of São Paulo (USP), São Carlos, São Paulo CEP 13566-590, Brazil e-mail:
| | - Valtencir Zucolotto
- Physics Institute of São Carlos (IFSC), University of São Paulo (USP), São Carlos, São Paulo CEP 13566-590, Brazil e-mail:
| | - Lucimar Retto da Silva de Avó
- Department of Medicine (DMed), Federal University of São Carlos (UFSCar), São Carlos, São Paulo CEP 13565-905, Brazil e-mail:
| | - Carla Maria Ramos Germano
- Department of Medicine (DMed), Federal University of São Carlos (UFSCar), São Carlos, São Paulo CEP 13565-905, Brazil e-mail:
| | - Débora Gusmão Melo
- Department of Medicine (DMed), Federal University of São Carlos (UFSCar), São Carlos, São Paulo CEP 13565-905, Brazil e-mail:
| |
Collapse
|
30
|
Accelerating Effect of Soy Peptides Containing Collagen Peptides on Type I and III Collagen Levels in Rat Skin. Biosci Biotechnol Biochem 2014; 76:1549-51. [DOI: 10.1271/bbb.120088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
31
|
Terao M, Tani M, Itoi S, Yoshimura T, Hamasaki T, Murota H, Katayama I. 11β-hydroxysteroid dehydrogenase 1 specific inhibitor increased dermal collagen content and promotes fibroblast proliferation. PLoS One 2014; 9:e93051. [PMID: 24667799 PMCID: PMC3965512 DOI: 10.1371/journal.pone.0093051] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Accepted: 02/28/2014] [Indexed: 01/07/2023] Open
Abstract
Glucocorticoids (GCs) are one of the most effective anti-inflammatory drugs for treating acute and chronic inflammatory diseases. However, several studies have shown that GCs alter collagen metabolism in the skin and induce skin atrophy. Cortisol is the endogenous GC that is released in response to various stressors. Over the last decade, extraadrenal cortisol production in various tissues has been reported. Skin also synthesizes cortisol through a de novo pathway and through an activating enzyme. 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) is the enzyme that catalyzes the conversion of hormonally inactive cortisone to active cortisol in cells. We previously found that 11β-HSD1 negatively regulates proliferation of keratinocytes. To determine the function of 11β-HSD1 in dermal fibroblasts and collagen metabolism, the effect of a selective 11β-HSD1 inhibitor was studied in mouse tissues and dermal fibroblasts. The expression of 11β-HSD1 increased with age in mouse skin. Subcutaneous injection of a selective 11β-HSD1 inhibitor increased dermal thickness and collagen content in the mouse skin. In vitro, proliferation of dermal fibroblasts derived from 11β-HSD1 null mice (Hsd11b1−/− mice) was significantly increased compared with fibroblasts from wild-type mice. However, in vivo, dermal thickness of Hsd11b1−/− mice was not altered in 3-month-old and 1-year-old mouse skin compared with wild-type mouse skin. These in vivo findings suggest the presence of compensatory mechanisms in Hsd11b1−/− mice. Our findings suggest that 11β-HSD1 inhibition may reverse the decreased collagen content observed in intrinsically and extrinsically aged skin and in skin atrophy that is induced by GC treatment.
Collapse
Affiliation(s)
- Mika Terao
- Department of Dermatology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- * E-mail:
| | - Mamori Tani
- Department of Dermatology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Saori Itoi
- Department of Dermatology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Takuji Yoshimura
- Laboratory of Reproductive Engineering, The Institute of Experimental Animal Sciences, Osaka University Medical School, Suita, Osaka, Japan
| | - Toshimitsu Hamasaki
- Department of Biomedical Statistics, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Hiroyuki Murota
- Department of Dermatology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Ichiro Katayama
- Department of Dermatology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| |
Collapse
|
32
|
Comparative effects of biodynes, tocotrienol-rich fraction, and tocopherol in enhancing collagen synthesis and inhibiting collagen degradation in stress-induced premature senescence model of human diploid fibroblasts. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2013; 2013:298574. [PMID: 24396567 PMCID: PMC3874949 DOI: 10.1155/2013/298574] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 11/01/2013] [Indexed: 12/20/2022]
Abstract
Biodynes, tocotrienol-rich fraction (TRF), and tocopherol have shown antiaging properties. However, the combined effects of these compounds on skin aging are yet to be investigated. This study aimed to elucidate the skin aging effects of biodynes, TRF, and tocopherol on stress-induced premature senescence (SIPS) model of human diploid fibroblasts (HDFs) by determining the expression of collagen and MMPs at gene and protein levels. Primary HDFs were treated with biodynes, TRF, and tocopherol prior to hydrogen peroxide (H2O2) exposure. The expression of COL1A1, COL3A1, MMP1, MMP2, MMP3, and MMP9 genes was determined by qRT-PCR. Type I and type III procollagen proteins were measured by Western blotting while the activities of MMPs were quantified by fluorometric Sensolyte MMP Kit. Our results showed that biodynes, TRF, and tocopherol upregulated collagen genes and downregulated MMP genes (P < 0.05). Type I procollagen and type III procollagen protein levels were significantly increased in response to biodynes, TRF, and tocopherol treatment (P < 0.05) with reduction in MMP-1, MMP-2, MMP-3, and MMP-9 activities (P < 0.05). These findings indicated that biodynes, TRF, and tocopherol effectively enhanced collagen synthesis and inhibited collagen degradation and therefore may protect the skin from aging.
Collapse
|
33
|
Grotheer V, Goergens M, Fuchs PC, Dunda S, Pallua N, Windolf J, Suschek CV. The performance of an orthosilicic acid-releasing silica gel fiber fleece in wound healing. Biomaterials 2013; 34:7314-27. [DOI: 10.1016/j.biomaterials.2013.06.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 06/09/2013] [Indexed: 12/30/2022]
|
34
|
Hydrolyzed collagen intake increases bone mass of growing rats trained with running exercise. J Int Soc Sports Nutr 2013; 10:35. [PMID: 23914839 PMCID: PMC3750261 DOI: 10.1186/1550-2783-10-35] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 08/01/2013] [Indexed: 01/22/2023] Open
Abstract
Background Some studies have shown that dietary hydrolyzed collagen peptides (HC) effectively prevent age-related bone loss. However, it is not known whether the intake of HC also has positive effect on bone mass or strength when combined with exercise during growth phase. Methods We examined the effects of 11 weeks of HC intake and running exercise on bone mass and strength in growing rats. Rats were randomized into four groups, the 20% casein group (Casein20), the 40% casein group (Casein40), the 20% HC group (HC20), and the 40% HC group (HC40). Each group was further divided into exercise groups (Casein20 + Ex, Casein40 + Ex, HC20 + Ex, HC40 + Ex) and non-exercise group (Casein20, Casein40, HC20, HC40). In the HC intake groups, 30% of casein protein was replaced with HC. Exercise group rats were trained 6 days per week on a treadmill (25–30 m/min, 60 min) for 60 days. After being sacrificed, their bone mineral content (BMC) and bone strength were evaluated. Results Exercise and dietary HC effects were observed in the adjusted BMC of lumbar spine and tibia among the 20% protein groups (p < 0.001 for exercise; p < 0.05 for dietary HC, respectively). These effects were also noted in the adjusted wet weight and dry weight of femur among the 20% protein groups (p < 0.001, p < 0.01 for exercise; p < 0.01, p < 0.001 for dietary HC, respectively). On the other hand, in adjusted bone breaking force and energy, dietary HC effect was not significant. Among the 40% protein groups, similar results were obtained in the adjusted BMC, femoral weight, bone breaking force, and energy. There were no differences between the 20% protein groups and the 40% protein groups. Conclusions The present study demonstrated that moderate HC intake (where the diet contains 20% protein, of which 30% is HC) increased bone mass during growth period and further promoted the effect of running exercise. On the other hand, a higher HC intake (where the diet contains 40% protein, of which 30% is HC) had no more beneficial effect on bone mass than the moderate HC intake.
Collapse
|
35
|
Wang AS, Armstrong EJ, Armstrong AW. Corticosteroids and wound healing: clinical considerations in the perioperative period. Am J Surg 2013; 206:410-7. [PMID: 23759697 DOI: 10.1016/j.amjsurg.2012.11.018] [Citation(s) in RCA: 217] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 11/01/2012] [Accepted: 11/06/2012] [Indexed: 12/21/2022]
Abstract
BACKGROUND Determining whether systemic corticosteroids impair wound healing is a clinically relevant topic that has important management implications. METHODS We reviewed literature on the effects of corticosteroids on wound healing from animal and human studies searching MEDLINE from 1949 to 2011. RESULTS Some animal studies show a 30% reduction in wound tensile strength with perioperative corticosteroids at 15 to 40 mg/kg/day. The preponderance of human literature found that high-dose corticosteroid administration for <10 days has no clinically important effect on wound healing. In patients taking chronic corticosteroids for at least 30 days before surgery, their rates of wound complications may be increased 2 to 5 times compared with those not taking corticosteroids. Complication rates may vary depending on dose and duration of steroid use, comorbidities, and types of surgery. CONCLUSIONS Acute, high-dose systemic corticosteroid use likely has no clinically significant effect on wound healing, whereas chronic systemic steroids may impair wound healing in susceptible individuals.
Collapse
Affiliation(s)
- Audrey S Wang
- Department of Dermatology, University of California, Davis, Sacramento, 95816, USA.
| | | | | |
Collapse
|
36
|
Tiganescu A, Tahrani AA, Morgan SA, Otranto M, Desmoulière A, Abrahams L, Hassan-Smith Z, Walker EA, Rabbitt EH, Cooper MS, Amrein K, Lavery GG, Stewart PM. 11β-Hydroxysteroid dehydrogenase blockade prevents age-induced skin structure and function defects. J Clin Invest 2013; 123:3051-60. [PMID: 23722901 DOI: 10.1172/jci64162] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 03/28/2013] [Indexed: 12/31/2022] Open
Abstract
Glucocorticoid (GC) excess adversely affects skin integrity, inducing thinning and impaired wound healing. Aged skin, particularly that which has been photo-exposed, shares a similar phenotype. Previously, we demonstrated age-induced expression of the GC-activating enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) in cultured human dermal fibroblasts (HDFs). Here, we determined 11β-HSD1 levels in human skin biopsies from young and older volunteers and examined the aged 11β-HSD1 KO mouse skin phenotype. 11β-HSD1 activity was elevated in aged human and mouse skin and in PE compared with donor-matched photo-protected human biopsies. Age-induced dermal atrophy with deranged collagen structural organization was prevented in 11β-HSD1 KO mice, which also exhibited increased collagen density. We found that treatment of HDFs with physiological concentrations of cortisol inhibited rate-limiting steps in collagen biosynthesis and processing. Furthermore, topical 11β-HSD1 inhibitor treatment accelerated healing of full-thickness mouse dorsal wounds, with improved healing also observed in aged 11β-HSD1 KO mice. These findings suggest that elevated 11β-HSD1 activity in aging skin leads to increased local GC generation, which may account for adverse changes occurring in the elderly, and 11β-HSD1 inhibitors may be useful in the treatment of age-associated impairments in dermal integrity and wound healing.
Collapse
Affiliation(s)
- Ana Tiganescu
- Centre for Endocrinology, Diabetes and Metabolism, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Kim JK, Yuan H, Nie J, Yang YT, Leggas M, Potter PM, Rinehart J, Jay M, Lu X. High payload dual therapeutic-imaging nanocarriers for triggered tumor delivery. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2012; 8:2895-2903. [PMID: 22777758 PMCID: PMC3817621 DOI: 10.1002/smll.201200437] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 04/17/2012] [Indexed: 05/29/2023]
Abstract
The in vitro and in vivo characterization of an optimized formulation of nanoparticles (NPs) loaded with a high content of dexamethasone palmitate (DEX-P), a chemotherapeutic adjuvant that decreases interstitial fluid pressure in tumors, and (111) In, a signaling agent, is described. These NPs are uniform in size and composition. Single photon emission computed tomography imaging demonstrates significant tumor uptake of (111) In-labeled DEX-P NPs in tumor-bearing mice. As with many nanoparticle-based drug delivery systems, significant liver accumulation is observed. Assessment of liver histology and blood tests show no apparent hepatic or renal toxicity of the DEX-P NPs. Conversion of DEX-P to DEX occurs when DEX-P NPs are incubated with mouse plasma, human tumor homogenate and ascites from tumor bearing mice, but not with human plasma. This conversion is slower in plasma from Es1(e) ((-/-)) /SCID mice, a potential alternative animal model that better mimics humans; however, plasma from these mice are not completely devoid of esterase activity. The difference between blood and tumor esterase activity in humans facilitates the delivery of DEX-P NPs to tumors and the release of dexamethasone by an esterase trigger.
Collapse
Affiliation(s)
- Jin-Ki Kim
- Division of Molecular Pharmaceutics Center for Nanotechnology in Drug Delivery Eshelman School of Pharmacy and Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 (USA)
- College of Pharmacy Hanyang University, Ansan, Gyeonggi, 426-791 (Republic of Korea)
| | - Hong Yuan
- Department of Radiology University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 (USA)
| | - Jingxin Nie
- Department of Radiology University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 (USA)
| | - Yu-Tsai Yang
- Division of Molecular Pharmaceutics Center for Nanotechnology in Drug Delivery Eshelman School of Pharmacy and Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 (USA)
| | - Markos Leggas
- Department of Pharmaceutical Sciences College of Pharmacy University of Kentucky, Lexington, Kentucky 40506 (USA)
| | - Philip M. Potter
- Department of Chemical Biology and Therapeutics St. Jude Children’s Research Hospital, Memphis, Tennessee 38105 (USA)
| | - John Rinehart
- Department of Medicine University of Kentucky, Lexington, Kentucky 40506 (USA)
| | - Michael Jay
- Division of Molecular Pharmaceutics Center for Nanotechnology in Drug Delivery Eshelman School of Pharmacy and Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 (USA)
- Joint Department of Biomedical Engineering University of North Carolina at Chapel Hill/North Carolina State University, Chapel Hill, North Carolina 27599 (USA)
| | | |
Collapse
|
38
|
Andrew R, Luecke G, Dozier S, Diven DG. A pilot study to investigate the efficacy of tobramycin-dexamethasone ointment in promoting wound healing. Dermatol Ther (Heidelb) 2012. [PMID: 23205334 PMCID: PMC3510414 DOI: 10.1007/s13555-012-0012-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The standard postsurgical treatment of wounds after dermatologic procedures is currently limited. Topical corticosteroids have been used successfully in postoperative management of ophthalmologic surgeries that involve the skin of the eyelid. In particular, tobramycin 0.3%/dexamethasone 0.1% ophthalmic ointment is considered the "gold standard" of steroid-antibiotic fixed combinations and is marketed worldwide as an agent used to control postsurgical inflammation and prevent postsurgical infection. The purpose of this study is to evaluate both the efficacy and safety of tobramycin-dexamethasone ointment for the postsurgical management of Mohs or dermatologic surgery in comparison to white petrolatum. METHODS The authors employed a half-scar study in which patients who underwent skin cancer removal surgery were given tobramycin-dexamethasone ointment and white petrolatum to apply to each half of their wound for 2 weeks. The study was double blinded, and physicians and the patients independently evaluated the scars for cosmetic appearance at 2 and 6 weeks postoperatively. The evaluation criteria included judging which side of the wound looked better based on color, thickness, and discomfort. RESULTS Eighteen patients were enrolled, of which 13 patients completed the three phases of the study. After 6 weeks the wounds did not show a statistically significant difference in color, thickness, or discomfort on either side. CONCLUSION Results obtained to date suggest that the application of tobramycin-dexamethasone ointment to wounds after dermatologic surgery does not promote better wound healing than white petrolatum. These findings indicate that a topical steroid and antibiotic ointment may not be an effective intervention in improving postoperative outcomes in dermatologic surgeries.
Collapse
Affiliation(s)
- Rachel Andrew
- University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Gwendolyn Luecke
- University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Susan Dozier
- Department of Dermatology, University of Texas Southwestern Austin Program, Dallas, TX 75390 USA
| | - Dayna G. Diven
- Department of Dermatology, University of Texas Southwestern Austin Program, Dallas, TX 75390 USA
| |
Collapse
|
39
|
Wheeler H, Black J, Webb S, Shen H. Dehiscence of corticosteroid-induced abdominal striae in a 14-year-old boy treated with bevacizumab for recurrent glioblastoma. J Child Neurol 2012; 27:927-9. [PMID: 22190499 DOI: 10.1177/0883073811428007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Corticosteroids have been the mainstay for management of cerebral edema caused by leaky angiogenic vessels associated with high-grade brain tumors since the early 1960s. Chronic corticosteroid use can cause iatrogenic Cushing syndrome, which is associated with weight gain and abdominal striae (striae distensae). The anti-vascular endothelial growth factor therapy, bevacizumab, has recently been introduced for the management of recurrent glioblastoma. Vascular endothelial growth factor plays multiple roles in wound healing, including promoting angiogenesis, acting as a chemo-attractant for inflammatory cells, and stimulating collagen production. We report the first pediatric case of a 14-year-old boy with corticosteroid-induced abdominal striae who developed ulceration and dehiscence of the striae following the introduction of bevacizumab therapy. The combination of high-dose corticosteroids and anti-vascular endothelial growth factor therapy may cause significant complications, especially in children who are susceptible to abdominal striae and therefore should be avoided.
Collapse
Affiliation(s)
- Helen Wheeler
- Department of Medical Oncology, Royal North Shore Hospital, New South Wales, Australia.
| | | | | | | |
Collapse
|
40
|
Abreu AM, Douglas de Oliveira DW, Marinho SA, Lima NL, de Miranda JL, Verli FD. Effect of topical application of different substances on fibroplasia in cutaneous surgical wounds. ISRN DERMATOLOGY 2012; 2012:282973. [PMID: 22536526 PMCID: PMC3321440 DOI: 10.5402/2012/282973] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Accepted: 01/09/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Fibroblasts on the edges of a surgical wound are induced to synthesize collagen during the healing process which is known as fibroplasia. OBJECTIVE The aim of this study was to determine the effect of the application of different substances on fibroplasia of cutaneous surgical wounds on rats. MATERIALS AND METHODS Forty-eight Wistar rats were divided into three groups. A surgical wound 1 cm in diameter and 1 mm in depth was created on the dorsum of each animal. The surgical wounds were submitted to the topical application of an alcoholic extract of 30% propolis, 70% alcohol, or 0.001% dexamethasone in a cream base every 12 hours. The animals were sacrificed three, seven, 14, and 28 days postoperatively. The specimens were histologically processed and stained with Masson's trichome. The assessment of fibroplasia was performed using a scoring system: (1) 5 to 25% collagen deposition; (2) 26 to 50% collagen deposition; (3) 51 to 75% collagen deposition; and (4) more than 75% collagen deposition. RESULTS There were statistically significant differences in collagen deposition between the substances at all postoperative evaluation times. CONCLUSION Propolis and alcohol promoted greater collagen deposition in surgical wounds than dexamethasone.
Collapse
Affiliation(s)
- Andreza Miranda Abreu
- Nursing Course, Federal University of Jequitinhonha and Mucuri Valleys, 39100-000 Diamantina, MG, Brazil
| | | | | | | | | | | |
Collapse
|
41
|
Stokes RB. Treatment of Steroid Induced Lipoatrophy with Structural Fat Grafting. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/mps.2012.21002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
42
|
Lambole V, Kumar U. Effect of Moringa oleifera Lam. on normal and dexamethasone suppressed wound healing. Asian Pac J Trop Biomed 2012. [DOI: 10.1016/s2221-1691(12)60163-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
43
|
Uva L, Miguel D, Pinheiro C, Antunes J, Cruz D, Ferreira J, Filipe P. Mechanisms of action of topical corticosteroids in psoriasis. Int J Endocrinol 2012; 2012:561018. [PMID: 23213332 PMCID: PMC3508578 DOI: 10.1155/2012/561018] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 10/14/2012] [Accepted: 10/20/2012] [Indexed: 11/17/2022] Open
Abstract
Psoriasis is a lifelong, chronic, and immune-mediated systemic disease, which affects approximately 1-3% of the Caucasian population. The different presentations of psoriasis require different approaches to treatment and appropriate prescriptions according to disease severity. The use of topical therapy remains a key component of the management of almost all psoriasis patients, and while mild disease is commonly treated only with topical agents, the use of topical therapy as adjuvant therapy in moderate-to-severe disease may also be helpful. This paper focuses on the cutaneous mechanisms of action of corticosteroids and on the currently available topical treatments, taking into account adverse effects, bioavailability, new combination treatments, and strategies to improve the safety of corticosteroids. It is established that the treatment choice should be tailored to match the individual patient's needs and his/her expectations, prescribing to each patient the most suitable vehicle.
Collapse
Affiliation(s)
- Luís Uva
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
- *Luís Uva:
| | - Diana Miguel
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - Catarina Pinheiro
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - Joana Antunes
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - Diogo Cruz
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - João Ferreira
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - Paulo Filipe
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| |
Collapse
|
44
|
Effect of propolis on mast cells in wound healing. Inflammopharmacology 2011; 20:289-94. [PMID: 22179947 DOI: 10.1007/s10787-011-0105-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Accepted: 11/29/2011] [Indexed: 01/28/2023]
Abstract
Wound healing is divided into three phases: inflammatory, proliferative and remodeling. Mast cells participate in all these phases. The aim of the present study was to determine the effects of propolis on the population of mast cells in oral surgical wounds in comparison to the results obtained with dexamethasone. This study was prospective, in vivo, randomized, semiexperimental, quantitative and comparative animal. A circular surgical wound was made on the dorsum of the tongue of 90 hamsters divided into three experimental groups: topical application of 30% propolis alcoholic extract (Group 1); 0.1% dexamethasone in orabase cream (Group 2); and orabase cream alone (Group 3). Applications were performed every 12 h throughout the experiment. The postoperative times for killing of the animals were 1, 3, 7, 14 and 28 days. The Student's t test for independent samples was employed in the statistical analysis. In the inflammatory phase of healing, propolis caused a greater reduction in the number of mast cells on the edge and in the central region of the surgical wound in comparison to dexamethasone. Moreover, the number of mast cells on day 1 was lower in the central region of the wounds treated with the orabase cream alone in comparison to dexamethasone. In conclusion, the anti-inflammatory action of propolis mediated by mast cells was more effective than dexamethasone in the inflammatory phase of healing.
Collapse
|
45
|
Weindl G, Castello F, Schäfer-Korting M. Evaluation of anti-inflammatory and atrophogenic effects of glucocorticoids on reconstructed human skin. Altern Lab Anim 2011; 39:173-87. [PMID: 21639680 DOI: 10.1177/026119291103900212] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Topical glucocorticoids (GCs) are extensively used in the treatment of inflammatory skin diseases. However, their long-term use is often accompanied by severe and eventually irreversible adverse effects, with atrophy being the most important limitation. Currently, most non-clinical studies involve animal testing, so the results are not always representative of the situation in humans. The aim of this project was to establish an in vitro test protocol for the evaluation of the anti-inflammatory and atrophic potential of topically applied GCs in reconstructed human skin. Initial studies with fibroblasts and keratinocytes confirmed the anti-inflammatory and atrophogenic effects of GCs, as evidenced by decreased cytokine production and collagen mRNA expression. In non-pretreated reconstructed human skin (EpiDermFT™), the topical application of GCs for seven days strongly reduced the secretion of interleukin (IL)-6. GC-induced skin atrophy, known to appear only after prolonged treatment, was not detected by the analysis of epidermal thickness and collagen mRNA expression. However, reproducible epidermal inflammation was established for the first time in reconstructed human skin. Topical treatment with tumour necrosis factor (TNF) increased IL-6 release and strongly reduced epidermal thickness accompanied by severe parakeratosis. GC treatment of reconstructed human skin reduced IL-6 levels and completely resolved parakeratosis, leading to the normalisation of epidermal thickness. These induced inflammatory conditions mimic more closely the clinical situations in which GCs are used, and therefore appear to be more suitable for future investigations for the establishment of a human-based in vitro test protocol for evaluating wanted and unwanted GC effects.
Collapse
Affiliation(s)
- Günther Weindl
- Institut für Pharmazie (Pharmakologie und Toxikologie), Freie Universität Berlin, Berlin, Germany
| | | | | |
Collapse
|
46
|
Abstract
Corticosteroids are widely used as treatment for excessive scarring by intralesional injection with variable success rates. It is conceivable that systemically administered corticosteroids affect a wider range of inflammatory processes that influence wound healing and may be more successful in preventing hypertrophic scar formation. To study this presumption, we have used a standardized model of presternal scars caused by cardiothoracic surgery through a median sternotomy incision. During cardiac surgery with cardiopulmonary bypass, 1 mg/kg dexamethasone was administered preoperatively, and 0.5 mg/kg 8 hours postoperatively. The presternal scars were evaluated prospectively 2, 4, 6, 12, and 52 weeks postoperatively at standardized measuring points. The height and width of the scars were measured 12 and 52 weeks postoperatively using both a slide caliper and a 7.5-MHz ultrasound probe. Cardiopulmonary bypass was used in 31 of the 43 participants. Eleven patients (35%) in the dexamethasone group developed clinical hypertrophic scars compared with 4 patients (33%) in the control group. These differences were not statistically significant. However, cranial scars became significantly wider in the dexamethasone group compared with the control group (P = 0.04). Twelve weeks postoperatively scars were significantly higher in the dexamethasone group, both cranial (P = 0.05) and caudal (P = 0.03). The differences in scar width and height were mainly present in patients that developed hypertrophic scars. The present results suggest that administration of high-dose perioperative dexamethasone does not prevent hypertrophic scar formation. Its use together with the cardiopulmonary bypass, however, did affect scar dimensions negatively up to 52 weeks after surgery. These findings contribute to the concept of the involvement of perioperative immunologic responses in the etiology of hypertrophic scar formation.
Collapse
|
47
|
Yamane T, Kobayashi-Hattori K, Oishi Y, Takita T. High-fat diet reduces levels of type I tropocollagen and hyaluronan in rat skin. Mol Nutr Food Res 2010; 54 Suppl 1:S53-61. [PMID: 20397200 DOI: 10.1002/mnfr.201000022] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Although it is known that nutritional conditions affect the skin function, little information is available on the effect of a high-fat (HF) diet on skin. In this study, Sprague-Dawley rats were fed HF diets for 28 days, and we investigated the effect of this diet on type I tropocollagen and hyaluronan in rat skin. The HF diets reduced the levels of type I tropocollagen, COL1A1 mRNA, hyaluronan, and rat hyaluronan synthase (rhas)2 mRNA, which play a primary role in hyaluronan synthase in the dermis. However, rhas3 mRNA level in the skin was increased. The HF diets also decreased the skin mRNA expression of transforming growth factor (TGF)-beta1, which enhances the expression of COL1A1 and rhas2 mRNA and decreases rhas3 mRNA expression, and decreased the hepatic mRNA expression of insulin-like growth factor (IGF)-I, which enhances COL1A1, rhas2, and TGF-beta1 mRNA expression. The serum level of adiponectin, which promotes the syntheses of type I collagen and hyaluronan, was decreased in the HF diet groups. These findings suggest that an HF diet reduces the levels of type I tropocollagen and hyaluronan in the skin by suppressing the action of TGF-beta1, IGF-I and adiponectin, and these effects are deleterious for skin function.
Collapse
Affiliation(s)
- Takumi Yamane
- Department of Nutritional Sciences, Faculty of Applied Bioscience, Tokyo University of Agriculture, Setagaya-ku, Tokyo, Japan
| | | | | | | |
Collapse
|
48
|
Rosensteel SM, Wilson RP, White SL, Ehrlich HP. COL1A1 oligodeoxynucleotides decoy: biochemical and morphologic effects in an acute wound repair model. Exp Mol Pathol 2010; 89:307-13. [PMID: 20647009 DOI: 10.1016/j.yexmp.2010.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Revised: 06/29/2010] [Accepted: 07/09/2010] [Indexed: 11/15/2022]
Abstract
Type I collagen is an integral component of granulation tissue and scar, that is highly dependent on TGFβ1, a member of a pro-fibrotic family of cytokines, for its promotion and deposition. Blocking COL1A1 gene transcription obstructs type I collagen synthesis, hindering the progress of granulation tissue deposition and fibrosis. Local injections of a double stranded oligodeoxynucleotide (dsODN) decoy, containing the TGFβ1 regulatory element that is located in the distal promoter of the COL1A1 gene, were investigated in a rat polyvinyl alcohol (PVA) sponge granulation tissue implant model. The effects on the granulation tissue deposition by dsODN decoy therapy were evaluated by the synthesis of types I and III collagens as well as ED-A (cellular) fibronectin. Fluorescently labeled dsODN was used to identify the distribution of the decoy molecules in the sponge implant relative to the observed histological effects. Morphological alterations in cells and changes in the organization of connective tissue were documented and evaluated. Collagen levels were reduced by half in implants treated with 10 nM dsODN decoy compared to scrambled dsODN-treated implants. Histologically, dsODN decoy treated implants had an increased cellular density without a corresponding increase in deposited connective tissue. Polarized light birefringence pattern of Sirius red-stained sections showed less collagen fibers accumulating between fibroblasts. The highest concentration of fluorescently labeled dsODN was identified within the interior margin of sponge implants, correlating to increased cellular density and an altered birefringence patterns. In conclusion, 10 nM dsODN decoy therapy reduced collagen deposition and altered the organization of granulation tissue, supporting its potential as a localized anti-fibrotic therapy for limiting fibrotic conditions.
Collapse
Affiliation(s)
- Shawn M Rosensteel
- Department of Comparative Medicine, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.
| | | | | | | |
Collapse
|
49
|
Ulceration of Striae distensae in high-grade glioma patients on concurrent systemic corticosteroid and bevacizumab therapy. J Neurooncol 2010; 101:155-9. [PMID: 20524043 DOI: 10.1007/s11060-010-0239-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Accepted: 05/16/2010] [Indexed: 12/14/2022]
Abstract
Striae distensae (stretch marks) are a common complication seen in patients on chronic corticosteroid therapy. Under certain circumstances, primary brain tumor patients require chronic corticosteroid therapy and can suffer from striae distensae. Bevacizumab, a humanized monoclonal antibody to vascular endothelial growth factor-A (VEGF-A) is now more widely used for the treatment of primary brain tumors. In this paper, we present four cases of ulcerated striae distensae in primary brain tumor patients on concurrent corticosteroid and bevacizumab therapy. Because of bevacizumab's effects on wound healing and its recent accelerated approval for recurrent glioblastoma multiforme (GBM), the most common malignant primary brain tumor in adults, this novel skin complication should be considered in patients on concurrent corticosteroid and bevacizumab therapy.
Collapse
|
50
|
Norton LW, Park J, Babensee JE. Biomaterial adjuvant effect is attenuated by anti-inflammatory drug delivery or material selection. J Control Release 2010; 146:341-8. [PMID: 20595029 DOI: 10.1016/j.jconrel.2010.05.032] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 05/19/2010] [Accepted: 05/27/2010] [Indexed: 11/25/2022]
Abstract
Biomaterials have been shown to differentially support dendritic cell (DC) maturation, a prerequisite for an adjuvant effect. Treatment of DCs with poly(D,L-lactic-co-glycolic acid) (PLGA) films resulted in DC maturation but agarose films did not. In these studies, the biomaterial adjuvant effect was attenuated by material selection (PLGA or agarose scaffolds) or local delivery of an anti-inflammatory/immunosuppressive glucocorticoid, dexamethasone (DX), from PLGA scaffolds. Porous scaffolds (SCs) of PLGA or agarose were produced to deliver equivalent amounts of model antigen, ovalbumin (OVA). Alternatively, PLGA SCs with incorporated OVA were produced with or without DX. These SCs were implanted individually, subcutaneously, and dorsally in C57BL/6 mice. Blood was collected from mice at specific times over a 12-week duration for measurement of antibody production against OVA. Scaffolds were explanted at 12 weeks for histological examination of foreign body response. Scaffolds of PLGA, but not of agarose, were found to elicit higher antibody production against co-delivered OVA, than negative controls. Short-term delivery of DX from PLGA SCs delivering OVA temporarily delayed onset of anti-OVA antibody production. More sustained release of DX at an effective dose and with an appropriate time course is expected to extend the effect of DX on the biomaterial adjuvant effect. The immunomodulatory ability of biomaterials to affect the immune response to co-delivered antigen is demonstrated wherein this immunomodulatory ability correlates with the observed in vitro differential effects of biomaterials on DC maturation.
Collapse
Affiliation(s)
- Lori W Norton
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive Atlanta, GA 30332, USA
| | | | | |
Collapse
|