1
|
Romeo DJ, Oral KT, Villavisanis DF, Ng JJ, Wu M, Massenburg BB, Taylor JA. The increasingly imporant role of genetics in plastic surgery. J Plast Reconstr Aesthet Surg 2024; 93:200-202. [PMID: 38703711 DOI: 10.1016/j.bjps.2024.04.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/14/2024] [Indexed: 05/06/2024]
Affiliation(s)
- Dominic J Romeo
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, USA
| | - Kaan T Oral
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, USA
| | - Dillan F Villavisanis
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, USA
| | - Jinggang J Ng
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, USA
| | - Meagan Wu
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, USA
| | - Benjamin B Massenburg
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, USA
| | - Jesse A Taylor
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, USA.
| |
Collapse
|
2
|
Hallock GG. The Reconstructive Toolbox. Arch Plast Surg 2023; 50:331-334. [PMID: 37564717 PMCID: PMC10411193 DOI: 10.1055/s-0043-1769619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/25/2023] [Indexed: 08/12/2023] Open
Abstract
Historically, the approach to any reconstructive challenge, whether intentionally or intuitively, can be seen to follow distinct guidelines that could aptly be called "reconstructive metaphors." These have been intended to inform us as to the "what, "when" and "where" this attempt can best be achieved. Yet the "how" or means to accomplish this goal, usually also intuitively well understood, in a similar vein can now be expressed to be within our "reconstructive toolbox." The latter will distinctly mirror our individuality and contain not only the various hardware that we deem essential, but also the means to access whatever technology we may be comfortable with. No toolbox, even if overflowing will ever be full, as potential options and the diversity they represent surely approaches infinity. But the truly excellent reconstructive surgeon will know when their toolbox is in any way lacking, and fears not remedying that deficiency even if the talents of another colleague must be sought, so as always to ensure that the patient will obtain the best appropriate treatment!
Collapse
Affiliation(s)
- Geoffrey G. Hallock
- Division of Plastic Surgery, Sacred Heart Campus, St. Luke's Hospital, Allentown, Pennsylvania
| |
Collapse
|
3
|
Khetpal S, Ghosh D, Roostaeian J. Innovations in Skin and Soft Tissue Aging-A Systematic Literature Review and Market Analysis of Therapeutics and Associated Outcomes. Aesthetic Plast Surg 2023:10.1007/s00266-023-03322-1. [PMID: 37154849 PMCID: PMC10390368 DOI: 10.1007/s00266-023-03322-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/13/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE Skin and soft tissue aging has been an important topic of discussion among plastic surgeons and their patients. While botulinum toxin, facial fillers, chemical peels, and surgical lifts preside as the mainstay of treatment to restore appearance of youth, emergent technologies, such as CRISPR-Cas9, proteostasis, flap biology, and stem cell therapies, have gained traction in addressing the aging process of skin and soft tissue. Several studies have introduced these advancements, but it remains unclear how safe and effective these therapeutics are in facial rejuvenation, and how they may fit in the existent treatment workflow for soft tissue aging. MATERIALS/METHODS A systematic literature review was conducted to identify and assess therapeutics utilized in addressing skin and soft tissue aging. Variables collected included year of publication, journal, article title, organization of study, patient sample, treatment modality, associated outcomes. In addition, we performed a market analysis of companies involved in promoting technologies and therapeutics within this space. PitchBook (Seattle, WA), a public market database, was utilized to classify companies, and record the amount of venture capital funding allocated to these categories. RESULTS Initial review yielded four hundred and two papers. Of these, thirty-five were extracted after applying inclusion and exclusion criteria. Though previous literature regards CRISPR-Cas9 technology as the most favorable anti-aging innovation, after reviewing the current literature, stem cell therapies utilizing recipient chimerism appeared to be the superior skin anti-aging technique when accounting for possible disadvantages of various techniques. The psychosocial and cosmetic outcomes from using cell therapy to modulate allograft survival and tolerance may confer more long-term proposed benefits than the technologies in CRISPR-Cas9, flap biology innovations, and autologous platelet-rich plasma use. Market analysis yielded a total of 87 companies, which promoted innovations in technology, biotechnology, biopharmaceuticals, cell-based therapies, and genetic therapy. CONCLUSION This review provides physicians and patients with relevant, usable information regarding how therapeutics can impact treatment regimen for facial aesthetics and skin rejuvenation. Furthermore, the goal of this research is to elucidate the varying therapeutics to restore appearance of youth, present associated outcomes, and in doing so, present plastic surgeons and their colleagues with greater insight on the role of these therapeutics and technologies in clinical practice. Future studies can further assess the safety and efficacy of these innovations and discuss how these may fit within surgical plans among patients seeking rejuvenation procedures. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Collapse
Affiliation(s)
- Sumun Khetpal
- Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, University of California Los Angeles, 200 Medical Plaza, Suite 460, Los Angeles, CA, 90095, USA
| | - Durga Ghosh
- Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, University of California Los Angeles, 200 Medical Plaza, Suite 460, Los Angeles, CA, 90095, USA
| | - Jason Roostaeian
- Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, University of California Los Angeles, 200 Medical Plaza, Suite 460, Los Angeles, CA, 90095, USA.
| |
Collapse
|
4
|
Aging, Skeletal Muscle, and Epigenetics. Plast Reconstr Surg 2022; 150:27S-33S. [DOI: 10.1097/prs.0000000000009670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
5
|
Infante-López DV, Céspedes-Galvis MF, Wilches-Flórez ÁM. CRISPR-Cas9: el debate bioético más allá de la línea germinal. PERSONA Y BIOÉTICA 2022. [DOI: 10.5294/pebi.2021.25.2.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
El sistema CRISPR-Cas9 es una tecnología de edición genética que, además de ampliar las posibilidades en investigación científica, despierta reflexiones asociadas a la dignidad humana, el control biológico, la terapia y la mejora genética. Se revisaron las discusiones bioéticas asociadas a los desafíos y las repercusiones que suscita su aplicación. Como resultado, los cuestionamientos bioéticos tienden a problematizar la aplicación en organismos no humanos, en la investigación básica y en la línea somática y germinal humana. Para concluir, falta incrementar los niveles de seguridad y efectividad para que los beneficios superen los riesgos y, de esta forma, sea posible disminuir las preocupaciones bioéticas y aumentar la credibilidad en el uso de la técnica.
Collapse
|
6
|
Goldenberg D, McLaughlin C, Koduru SV, Ravnic DJ. Regenerative Engineering: Current Applications and Future Perspectives. Front Surg 2021; 8:731031. [PMID: 34805257 PMCID: PMC8595140 DOI: 10.3389/fsurg.2021.731031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/13/2021] [Indexed: 12/12/2022] Open
Abstract
Many pathologies, congenital defects, and traumatic injuries are untreatable by conventional pharmacologic or surgical interventions. Regenerative engineering represents an ever-growing interdisciplinary field aimed at creating biological replacements for injured tissues and dysfunctional organs. The need for bioengineered replacement parts is ubiquitous among all surgical disciplines. However, to date, clinical translation has been limited to thin, small, and/or acellular structures. Development of thicker tissues continues to be limited by vascularization and other impediments. Nevertheless, currently available materials, methods, and technologies serve as robust platforms for more complex tissue fabrication in the future. This review article highlights the current methodologies, clinical achievements, tenacious barriers, and future perspectives of regenerative engineering.
Collapse
Affiliation(s)
- Dana Goldenberg
- Irvin S. Zubar Plastic Surgery Research Laboratory, Penn State College of Medicine, Hershey, PA, United States
- Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Caroline McLaughlin
- Irvin S. Zubar Plastic Surgery Research Laboratory, Penn State College of Medicine, Hershey, PA, United States
- Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Srinivas V. Koduru
- Irvin S. Zubar Plastic Surgery Research Laboratory, Penn State College of Medicine, Hershey, PA, United States
- Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Dino J. Ravnic
- Irvin S. Zubar Plastic Surgery Research Laboratory, Penn State College of Medicine, Hershey, PA, United States
- Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States
| |
Collapse
|
7
|
|
8
|
Discussion on Vascular Malformations: Current Progress Toward Drug Therapy. J Craniofac Surg 2021; 32:1215. [PMID: 33306651 DOI: 10.1097/scs.0000000000007336] [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] Open
|
9
|
Pang C, Fan KS, Wei L, Kolar MK. Gene therapy in wound healing using nanotechnology. Wound Repair Regen 2020; 29:225-239. [PMID: 33377593 DOI: 10.1111/wrr.12881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/11/2020] [Accepted: 12/02/2020] [Indexed: 12/20/2022]
Abstract
Wound healing is a complex and highly regulated process that is susceptible to a variety of failures leading to delayed wound healing or chronic wounds. This is becoming an increasingly global burden on the healthcare system. Treatment of wounds has evolved considerably to overcome barriers to wound healing especially within the field of regenerative medicine that focuses on the replacement of tissues or organs. Improved understanding of the pathophysiology of wound healing has enabled current advances in technology to allow better optimization of microenvironment within wounds. This approach may help tackle wounds that are difficult to treat and help reduce the global burden of the disease. This article provides an overview of the physiology in wound healing and the application of gene therapy using nanotechnology in the management of wounds.
Collapse
Affiliation(s)
- Calver Pang
- Department of Surgical Biotechnology, Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London, United Kingdom
| | - Ka Siu Fan
- Faculty of Medicine, St. George's, University of London, London, United Kingdom
| | - Lanxuan Wei
- Centre for Rheumatology and Connective Tissue Diseases, Division of Medicine, University College London, London, United Kingdom
| | - Mallappa K Kolar
- Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield, United Kingdom
| |
Collapse
|
10
|
Colazo JM, Evans BC, Farinas AF, Al-Kassis S, Duvall CL, Thayer WP. Applied Bioengineering in Tissue Reconstruction, Replacement, and Regeneration. TISSUE ENGINEERING PART B-REVIEWS 2020; 25:259-290. [PMID: 30896342 DOI: 10.1089/ten.teb.2018.0325] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPACT STATEMENT The use of autologous tissue in the reconstruction of tissue defects has been the gold standard. However, current standards still face many limitations and complications. Improving patient outcomes and quality of life by addressing these barriers remain imperative. This article provides historical perspective, covers the major limitations of current standards of care, and reviews recent advances and future prospects in applied bioengineering in the context of tissue reconstruction, replacement, and regeneration.
Collapse
Affiliation(s)
- Juan M Colazo
- 1Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.,2Medical Scientist Training Program, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Brian C Evans
- 3Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Angel F Farinas
- 4Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Salam Al-Kassis
- 4Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Craig L Duvall
- 3Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Wesley P Thayer
- 3Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,4Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| |
Collapse
|
11
|
Oliver JD, Duscher D, Hu MS. Engineering a Future with VCA: Applying Genetic Circuits to Engineer Tissues for Vascularized Composite Allotransplantation. J Plast Reconstr Aesthet Surg 2020; 74:223-243. [PMID: 32499184 DOI: 10.1016/j.bjps.2020.05.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/15/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Jeremie D Oliver
- Department of Biomedical Engineering, School of Medicine and School of Dentistry, University of Utah, Salt Lake City, UT
| | - Dominik Duscher
- Experimental Plastic Surgery, Plastic and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Michael S Hu
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA.
| |
Collapse
|
12
|
Ayanoğlu FB, Elçin AE, Elçin YM. Bioethical issues in genome editing by CRISPR-Cas9 technology. ACTA ACUST UNITED AC 2020; 44:110-120. [PMID: 32256147 PMCID: PMC7129066 DOI: 10.3906/biy-1912-52] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Genome editing technologies have led to fundamental changes in genetic science. Among them, CRISPR-Cas9 technology particularly stands out due to its advantages such as easy handling, high accuracy, and low cost. It has made a quick introduction in fields related to humans, animals, and the environment, while raising difficult questions, applications, concerns, and bioethical issues to be discussed. Most concerns stem from the use of CRISPR-Cas9 to genetically alter human germline cells and embryos (called germline genome editing). Germline genome editing leads to serial bioethical issues, such as the occurrence of undesirable changes in the genome, from whom and how informed consent is obtained, and the breeding of the human species (eugenics). However, the bioethical issues that CRISPR-Cas9 technology could cause in the environment, agriculture and livestock should also not be forgotten. In order for CRISPR-Cas9 to be used safely in all areas and to solve potential issues, worldwide legislation should be prepared, taking into account the opinions of both life and social scientists, policy makers, and all other stakeholders of the sectors, and CRISPR-Cas9 applications should be implemented according to such legislations. However, these controls should not restrict scientific freedom. Here, various applications of CRISPR-Cas9 technology, especially in medicine and agriculture, are described and ethical issues related to genome editing using CRISPR-Cas9 technology are discussed. The social and bioethical concerns in relation to human beings, other organisms, and the environment are addressed.
Collapse
Affiliation(s)
- Fatma Betül Ayanoğlu
- Tissue Engineering, Biomaterials and Nanobiotechnology Laboratory, Ankara University Faculty of Science,Ankara University Biotechnology Institute, Ankara University Stem Cell Institute, Ankara Turkey
| | - Ayşe Eser Elçin
- Tissue Engineering, Biomaterials and Nanobiotechnology Laboratory, Ankara University Faculty of Science,Ankara University Biotechnology Institute, Ankara University Stem Cell Institute, Ankara Turkey
| | - Yaşar Murat Elçin
- Tissue Engineering, Biomaterials and Nanobiotechnology Laboratory, Ankara University Faculty of Science,Ankara University Biotechnology Institute, Ankara University Stem Cell Institute, Ankara Turkey.,Biovalda Health Technologies, Inc., Ankara Turkey
| |
Collapse
|
13
|
|
14
|
Reply: CRISPR Craft: DNA Editing the Reconstructive Ladder. Plast Reconstr Surg 2019; 144:715e-716e. [PMID: 31568337 DOI: 10.1097/prs.0000000000006052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Affiliation(s)
- Ryan C. DeCoster
- Lucille P. Markey Cancer Center, University of Kentucky, Lexington, KY
- Division of Plastic Surgery, Department of Surgery University of Kentucky, Lexington, KY
| | - Henry C. Vasconez
- Division of Plastic Surgery, Department of Surgery University of Kentucky, Lexington, KY
| | | |
Collapse
|
16
|
Raghuram A, Singh A, Chang DK, Nunez M, Reece EM, Schultz BE. The Evolving Landscape of Gene Therapy in Plastic Surgery. Semin Plast Surg 2019; 33:167-172. [PMID: 31384232 DOI: 10.1055/s-0039-1693131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
With the rapid rise of personalized genomic sequencing and clustered regularly interspaced short palindromic repeat (CRISPR) technology, previous gaps in gene therapy are beginning to be bridged, paving the way for increasing clinical applicability. This article aims to provide an overview of the fundamentals of gene therapy and discuss future potential interventions relevant to plastic surgeons. These interventions include enhancing tissue regeneration and healing, as well as modifying disease processes in congenital anomalies. Though clinical applications are still on the horizon, a deeper understanding of these new advances will help plastic surgeons understand the current landscape of gene therapy and stay abreast of future opportunities.
Collapse
Affiliation(s)
| | - Aspinder Singh
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Daniel K Chang
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Mervin Nunez
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Edward M Reece
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | | |
Collapse
|
17
|
Singh P, Vijayan R, Singh E, Mosahebi A. Genetic Editing in Plastic Surgery. Aesthet Surg J 2019; 39:NP225-NP226. [PMID: 31095308 DOI: 10.1093/asj/sjz064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Prateush Singh
- Royal London Hospital, Department of Plastic Surgery, Hampstead, London, UK
| | - Roshan Vijayan
- Department of Plastic Surgery, Royal Free Hospital, Hampstead, London, UK
| | - Esha Singh
- Department of Plastic Surgery, Royal Free Hospital, Hampstead, London, UK
| | - Afshin Mosahebi
- Department of Plastic Surgery, Royal Free Hospital, Hampstead, London, UK
| |
Collapse
|
18
|
|