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He L, Sato JE, Sundar P, Azimi T, Beachy PA, Bekale LA, Pepper JP. Localized application of SAG21k-loaded fibrin hydrogels for targeted modulation of the hedgehog pathway in facial nerve injury. Int J Biol Macromol 2024; 269:131747. [PMID: 38670196 DOI: 10.1016/j.ijbiomac.2024.131747] [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: 12/05/2023] [Revised: 04/02/2024] [Accepted: 04/20/2024] [Indexed: 04/28/2024]
Abstract
Given the broad biological effects of the Hedgehog (Hh) pathway, there is potential clinical value in local application of Hh pathway modulators to restrict pathway activation of target tissues and avoid systemic pathway activation. One option to limit Hh pathway activation is using fibrin hydrogels to deliver pathway modulators directly to tissues of interest, bypassing systemic distribution of the drug. In this study, we loaded the potent Hh pathway agonist, SAG21k, into fibrin hydrogels. We describe the binding between fibrin and SAG21k and achieve sustained release of the drug in vitro. SAG21k-loaded fibrin hydrogels exhibit strong biological activity in vitro, using a pathway-specific reporter cell line. To test in vivo activity, we used a mouse model of facial nerve injury. Application of fibrin hydrogels is a common adjunct to surgical nerve repair, and the Hh pathway is known to play an important role in facial nerve injury and regeneration. Local application of the Hh pathway agonist SAG21k using a fibrin hydrogel applied to the site of facial nerve injury successfully activates the Hh pathway in treated nerve tissue. Importantly, this method appears to avoid systemic pathway activation when Hh-responsive organs are analyzed for transcriptional pathway activation. This method of local tissue Hh pathway agonist administration allows for effective pathway targeting surgically accessible tissues and may have translational value in situations where supranormal pathway activation is therapeutic.
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Affiliation(s)
- Lili He
- Department of Otolaryngology - Head & Neck Surgery, Stanford University School of Medicine; 300 Pasteur Drive, Stanford, CA 94305, United States
| | - Justine Esther Sato
- Department of Otolaryngology - Head & Neck Surgery, Stanford University School of Medicine; 300 Pasteur Drive, Stanford, CA 94305, United States
| | - Praveen Sundar
- Department of Otolaryngology - Head & Neck Surgery, Stanford University School of Medicine; 300 Pasteur Drive, Stanford, CA 94305, United States
| | - Tannaz Azimi
- Department of Otolaryngology - Head & Neck Surgery, Stanford University School of Medicine; 300 Pasteur Drive, Stanford, CA 94305, United States
| | - Philip Arden Beachy
- Departments of Urology, and Developmental Biology, Stanford University School of Medicine, Stanford, CA, United States; Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Laurent Adonis Bekale
- Department of Otolaryngology - Head & Neck Surgery, Stanford University School of Medicine; 300 Pasteur Drive, Stanford, CA 94305, United States.
| | - Jon-Paul Pepper
- Department of Otolaryngology - Head & Neck Surgery, Stanford University School of Medicine; 300 Pasteur Drive, Stanford, CA 94305, United States.
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Wu Y, Barrere V, Han A, Andre MP, Orozco E, Cheng X, Chang EY, Shah SB. Quantitative evaluation of rat sciatic nerve degeneration using high-frequency ultrasound. Sci Rep 2023; 13:20228. [PMID: 37980432 PMCID: PMC10657462 DOI: 10.1038/s41598-023-47264-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 11/11/2023] [Indexed: 11/20/2023] Open
Abstract
In this study, we evaluated the utility of using high-frequency ultrasound to non-invasively track the degenerative process in a rat model of peripheral nerve injury. Primary analyses explored spatial and temporal changes in quantitative backscatter coefficient (BSC) spectrum-based outcomes and B-mode textural outcomes, using gray level co-occurrence matrices (GLCMs), during the progressive transition from acute to chronic injury. As secondary analyses, correlations among GLCM and BSC spectrum-based parameters were evaluated, and immunohistochemistry were used to suggest a structural basis for ultrasound outcomes. Both mean BSC spectrum-based and mean GLCM-based measures exhibited significant spatial differences across presurgical and 1-month/2-month time points, distal stumps enclosed proximity to the injury site being particularly affected. The two sets of parameters sensitively detected peripheral nerve degeneration at 1-month and 2-month post-injury, with area under the receiver operating charactersitic curve > 0.8 for most parameters. The results also indicated that the many BSC spectrum-based and GLCM-based parameters significantly correlate with each other, and suggested a common structural basis for a diverse set of quantitative ultrasound parameters. The findings of this study suggest that BSC spectrum-based and GLCM-based analysis are promising non-invasive techniques for diagnosing peripheral nerve degeneration.
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Affiliation(s)
- Yuanshan Wu
- Department of Bioengineering, University of California, San Diego, 9500 Gilman Drive, MC 0863, La Jolla, CA, 92093-0683, USA
- Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Victor Barrere
- Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Aiguo Han
- Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Michael P Andre
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Elisabeth Orozco
- Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Xin Cheng
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Eric Y Chang
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Sameer B Shah
- Department of Bioengineering, University of California, San Diego, 9500 Gilman Drive, MC 0863, La Jolla, CA, 92093-0683, USA.
- Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, USA.
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
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Jiang L, Ouyang X, Zhang D, Wang G, Zhang Z, Wang W, Yan H. The role of Gel-Ppy-modified nerve conduit on the repair of sciatic nerve defect in rat model. FASEB J 2023; 37:e22921. [PMID: 37052612 DOI: 10.1096/fj.202201969r] [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] [Received: 11/24/2022] [Revised: 02/14/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023]
Abstract
The serious clinical challenge of peripheral nerve injury (PNI) is nerve regeneration. Nerve conduit represents a promising strategy to contribute to nerve regeneration by bridging injured nerve gaps. However, due to a unique microenvironment of nerve tissue, autologous nerves have not been substituted by nerve conduit. Nerve regeneration after nerve conduit implantation depends on many factors, such as conductivity and biocompatibility. Therefore, Gelatin (Gel) with biocompatibility and polypyrrole (Ppy) with conductivity is highly concerned. In this paper, Gel-Ppy modified nerve conduit was fabricated with great biocompatibility and conductivity to evaluate its properties of enhancing nerve regeneration in vivo and in vitro. The proliferation of Schwann cells on Gel-Ppy modified nerve conduit was remarkably increased. Consistent with in vitro results, the Gel-Ppy nerve conduit could contribute to the regeneration of Schwann cell in vivo. The axon diameters and myelin sheath thickness were also enhanced, resulting in the amelioration of muscle atrophy, nerve conduction, and motor function recovery. To explain this interesting phenomenon, western blot results indicated that the Gel-Ppy conduit facilitated nerve regeneration via upregulating the Rap1 pathway to induce neurite outgrowth. Therefore, the above results demonstrated that Gel-Ppy modified nerve conduit could provide an acceptable microenvironment for nerve regeneration and be popularized as a novel therapeutic strategy of PNI.
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Affiliation(s)
- Liangfu Jiang
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics (Division of Wound Repair), The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Xingyu Ouyang
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Dupiao Zhang
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics (Division of Hand Surgery), The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Gang Wang
- College of Fisheries and Life Science, Shanghai Ocean University, Shanghai, China
| | - Zhe Zhang
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics (Division of Hand Surgery), The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Wei Wang
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hede Yan
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics (Division of Hand Surgery), The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
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Suresh V, Schaefer EJ, Calotta NA, Giladi AM, Tuffaha SH. Use of Vascularized, Denervated Muscle Targets for Prevention and Treatment of Upper-Extremity Neuromas. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2022; 5:92-96. [PMID: 36704382 PMCID: PMC9870797 DOI: 10.1016/j.jhsg.2022.06.001] [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: 02/14/2022] [Accepted: 06/01/2022] [Indexed: 01/29/2023] Open
Abstract
Purpose Neuroma formation following upper-extremity peripheral nerve injury often results in persistent, debilitating neuropathic pain with a limited response to medical management. Vascularized, denervated muscle targets (VDMTs) offer a newly described surgical approach to address this challenging problem. Like targeted muscle reinnervation and regenerative peripheral nerve targets, VDMTs are used to redirect regenerating axons from an injured nerve into denervated muscle to prevent neuroma formation. By providing a vascularized muscle target that is reinnervated via direct neurotization, VDMTs offer some theoretical advantages in comparison with the other contemporary surgical options. In this study, we followed the short-term pain outcomes of patients who underwent VDMT surgery for neuroma prevention or treatment. Methods We performed a retrospective chart review of 9 patients (2 pediatric and 7 adult) who underwent VDMTs either for symptomatic upper-extremity neuromas or as a prophylactic measure to prevent primary neuroma formation. In-person and/or telephone interviews were conducted to assess their postoperative clinical outcomes, including the visual analog pain scale simple pain score. Results Of the 9 patients included in this study, 7 underwent VDMT surgery as a prophylactic measure against neuroma formation, and 2 presented with symptomatic neuromas that were treated with VDMTs. The average follow-up was 5.6 ± 4.1 months (range, 0.5-13.2 months). The average postoperative pain score of the 7 adult patients was 1.1 (range, 0-8). Conclusions This study demonstrated favorable short-term outcomes in a small cohort of patients treated with VDMTs in the upper extremity. Larger, prospective, and comparative studies with validated patient-reported and objective outcome measures and longer-term follow-ups are needed to further evaluate the benefits of VDMTs in upper-extremity neuroma management and prevention. Type of study/level of evidence Therapeutic III.
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Affiliation(s)
- Visakha Suresh
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Eliana J. Schaefer
- The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD,Department of Orthopedics, Georgetown University School of Medicine, Washington, DC
| | - Nicholas A. Calotta
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Aviram M. Giladi
- The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD,Corresponding author: Sami H. Tuffaha, MD, and Aviram M.Giladi, MD, MS, The Curtis National Hand Center, MedStar Union Memorial Hospital, 3333 North Calvert Street, JPB #200, Baltimore, MD 21218.
| | - Sami H. Tuffaha
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD,The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD,Corresponding author: Sami H. Tuffaha, MD, and Aviram M.Giladi, MD, MS, The Curtis National Hand Center, MedStar Union Memorial Hospital, 3333 North Calvert Street, JPB #200, Baltimore, MD 21218.
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Zhang M, Li L, An H, Zhang P, Liu P. Repair of Peripheral Nerve Injury Using Hydrogels Based on Self-Assembled Peptides. Gels 2021; 7:152. [PMID: 34698159 PMCID: PMC8544532 DOI: 10.3390/gels7040152] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 12/15/2022] Open
Abstract
Peripheral nerve injury often occurs in young adults and is characterized by complex regeneration mechanisms, poor prognosis, and slow recovery, which not only creates psychological obstacles for the patients but also causes a significant burden on society, making it a fundamental problem in clinical medicine. Various steps are needed to promote regeneration of the peripheral nerve. As a bioremediation material, self-assembled peptide (SAP) hydrogels have attracted international attention. They can not only be designed with different characteristics but also be applied in the repair of peripheral nerve injury by promoting cell proliferation or drug-loaded sustained release. SAP hydrogels are widely used in tissue engineering and have become the focus of research. They have extensive application prospects and are of great potential biological value. In this paper, the application of SAP hydrogel in peripheral nerve injury repair is reviewed, and the latest progress in peptide composites and fabrication techniques are discussed.
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Affiliation(s)
- Meng Zhang
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing 100044, China;
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Center for Trauma Medicine, Beijing 100044, China
| | - Lei Li
- Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan 250012, China;
| | - Heng An
- Beijing Key Laboratory for Bioengineering and Sensing Technology, Daxing Research Institute, School of Chemistry & Biological Engineering, University of Science & Technology Beijing, Beijing 100044, China;
| | - Peixun Zhang
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing 100044, China;
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Center for Trauma Medicine, Beijing 100044, China
| | - Peilai Liu
- Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan 250012, China;
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