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Mosaddad SA, Hussain A, Tebyaniyan H. Exploring the Use of Animal Models in Craniofacial Regenerative Medicine: A Narrative Review. TISSUE ENGINEERING. PART B, REVIEWS 2024; 30:29-59. [PMID: 37432898 DOI: 10.1089/ten.teb.2023.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
The craniofacial region contains skin, bones, cartilage, the temporomandibular joint (TMJ), teeth, periodontal tissues, mucosa, salivary glands, muscles, nerves, and blood vessels. Applying tissue engineering therapeutically helps replace lost tissues after trauma or cancer. Despite recent advances, it remains essential to standardize and validate the most appropriate animal models to effectively translate preclinical data to clinical situations. Therefore, this review focused on applying various animal models in craniofacial tissue engineering and regeneration. This research was based on PubMed, Scopus, and Google Scholar data available until January 2023. This study included only English-language publications describing animal models' application in craniofacial tissue engineering (in vivo and review studies). Study selection was based on evaluating titles, abstracts, and full texts. The total number of initial studies was 6454. Following the screening process, 295 articles remained on the final list. Numerous in vivo studies have shown that small and large animal models can benefit clinical conditions by assessing the efficacy and safety of new therapeutic interventions, devices, and biomaterials in animals with similar diseases/defects to humans. Different species' anatomical, physiologic, and biological features must be considered in developing innovative, reproducible, and discriminative experimental models to select an appropriate animal model for a specific tissue defect. As a result, understanding the parallels between human and veterinary medicine can benefit both fields.
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Affiliation(s)
- Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmed Hussain
- School of Dentistry, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Canada
| | - Hamid Tebyaniyan
- Department of Science and Research, Islimic Azade University, Tehran, Iran
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2
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Neves LMG, Wilgus TA, Bayat A. In Vitro, Ex Vivo, and In Vivo Approaches for Investigation of Skin Scarring: Human and Animal Models. Adv Wound Care (New Rochelle) 2023; 12:97-116. [PMID: 34915768 DOI: 10.1089/wound.2021.0139] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Significance: The cutaneous repair process naturally results in different types of scarring that are classified as normal or pathological. Affected individuals are often affected from an esthetic, physical (functional), and psychosocial perspective. The distinct nature of scarring in humans, particularly the formation of pathological scars, makes the study of skin scarring a challenge for researchers in this area. Several established experimental models exist for studying scar formation. However, the increasing development and validation of newly emerging models have made it possible to carry out studies focused on different variables that influence this unique process. Recent Advances: Experimental models such as in vitro, ex vivo, and in vivo models have obtained different degrees of success in the reproduction of the scar formation in its native milieu and true environment. These models also differ in their ability to elucidate the molecular, cellular, and structural mechanisms involved in scarring, as well as for testing new agents and approaches for therapies. The models reviewed here, including cells derived from human skin and in vivo animal models, have contributed to the advancement of skin scarring research. Critical Issues and Future Directions: The absence of experimental models that faithfully reproduce the typical characteristics of the different types of human skin scars makes the improvement of validated models and the establishment of new ones a critical unmet need. The fields of wound healing research combined with tissue engineering have offered newer alternatives for experimental studies with the potential to provide clinically useful knowledge about scar formation.
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Affiliation(s)
- Lia M G Neves
- Plastic & Reconstructive Surgery Research, Centre for Dermatology Research, Wound Healing Theme, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, England, United Kingdom
| | - Traci A Wilgus
- Department of Pathology, Ohio State University, Columbus, Ohio, USA
| | - Ardeshir Bayat
- Plastic & Reconstructive Surgery Research, Centre for Dermatology Research, Wound Healing Theme, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, England, United Kingdom.,Medical Research Council (MRC) Wound Healing Unit, Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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3
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Liu T, Qiu C, Lu H, Li H, Zhu S, Ma L. A novel recombinant human collagen hydrogel as minced split-thickness skin graft overlay to promote full-thickness skin defect reconstruction. Burns 2023; 49:169-181. [PMID: 35361497 DOI: 10.1016/j.burns.2022.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 01/06/2023]
Abstract
To overcome limited donor-site availability in patients with extensive burns, split-thickness skin grafts (STSGs) are sometimes minced into micrografts (MGs) to improve the expansion ratio of the grafts, but this may reduce wound healing. We aimed to produce a novel hydrogel as an overlay of minced STSGs to improve wound healing. The new hydrogel was produced using recombinant human collagen type III powder as a raw material. Morphological and physical characteristics (degradation and swelling rate), cytotoxicity, and cell viability of the hydrogel were evaluated in vitro. A full-thickness in vivo skin defect model was constructed with male Sprague-Dawley rats. The animals were randomly assigned to experimental and control groups in which the new hydrogel and Vaseline gauze, respectively, were overlaid on minced STSGs to repair and regenerate skin wound. The healing rates and recovery status were compared between the two groups. The hydrogels exhibited good water retention properties and a suitable degradation rate, which can promote the proliferation and migration of wound healing-related cells in vitro. Further, using the hydrogel as an overlay accelerated wound closure and angiogenesis, increased dermal tissue and basement membrane formation, enhanced collagen synthesis and wound healing-related growth factor expression, while reducing scar formation compared to the Vaseline gauze group. In conclusion, the novel, low-cost recombinant human collagen hydrogel can accelerate wound closure and improve wound healing when used as an overlay of minced STSGs. The new hydrogel could become a new treatment option for traumatic skin wounds caused by burns or injuries.
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Affiliation(s)
- Tong Liu
- Department of Critical Care Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, People's Republic of China.
| | - Chao Qiu
- Department of Emergency Medicine, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China.
| | - Hao Lu
- Department of Burn Surgery, Institute of Burns, The First Affiliated Hospital, Naval Medical University, Shanghai 200433, People's Republic of China.
| | - Haihang Li
- Department of Burn Surgery, Institute of Burns, The First Affiliated Hospital, Naval Medical University, Shanghai 200433, People's Republic of China.
| | - Shihui Zhu
- Department of Burn Surgery, Institute of Burns, The First Affiliated Hospital, Naval Medical University, Shanghai 200433, People's Republic of China.
| | - Lijie Ma
- Department of Critical Care Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, People's Republic of China.
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4
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Bakhrushina EO, Shumkova MM, Sergienko FS, Novozhilova EV, Demina NB. Spray Film-Forming systems as promising topical in situ Systems: A review. Saudi Pharm J 2023; 31:154-169. [PMID: 36685308 PMCID: PMC9845128 DOI: 10.1016/j.jsps.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022] Open
Abstract
Spray film-forming systems (SFFSs) provide great potential for the treatment of various types of wounds. Such systems afford to prolong the action of active substances, to prevent cross-contamination, and to ensure accelerated wound healing. Spray films are known since the mid-20th century, and nowadays they are widely used to treat minor skin injuries, but numerous clinical cases describe their successful use in the treatment of burns, wounds, bedsores, etc. The current level of polymer development and composite synthesis has greatly expanded the possibilities of creating compositions of spray film-forming systems. Scattered information and lack of standardization of such delivery systems creates difficulties for pharmaceutical development. This review highlights most of the existing requirements and suggestions from studies to standardize the characteristics of SFFSs and classify them based on scientific sources and regulatory documentation, as well as the position of such systems in the pharmaceutical market. The search and evaluation of known characterization methods and their modifications, as well as the approval of their list (separately for development and for standardization) can potentially increase the research interest in the problem of spray film-forming systems development and contribute to the registration of new drugs and medical devices in this promising dosage form, including with its own pharmacological effect.
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5
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Tuca AC, Bernardelli de Mattos I, Funk M, Winter R, Palackic A, Groeber-Becker F, Kruse D, Kukla F, Lemarchand T, Kamolz LP. Orchestrating the Dermal/Epidermal Tissue Ratio during Wound Healing by Controlling the Moisture Content. Biomedicines 2022; 10:biomedicines10061286. [PMID: 35740308 PMCID: PMC9219632 DOI: 10.3390/biomedicines10061286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 01/13/2023] Open
Abstract
A balanced and moist wound environment and surface increases the effect of various growth factors, cytokines, and chemokines, stimulating cell growth and wound healing. Considering this fact, we tested in vitro and in vivo water evaporation rates from the cellulose dressing epicitehydro when combined with different secondary dressings as well as the resulting wound healing efficacy in a porcine donor site model. The aim of this study was to evaluate how the different rates of water evaporation affected wound healing efficacy. To this end, epicitehydro primary dressing, in combination with different secondary dressing materials (cotton gauze, JELONET◊, AQUACEL® Extra ™, and OPSITE◊ Flexifix), was placed on 3 × 3 cm-sized dermatome wounds with a depth of 1.2 mm on the flanks of domestic pigs. The healing process was analyzed histologically and quantified by morphometry. High water evaporation rates by using the correct secondary dressing, such as cotton gauze, favored a better re-epithelialization in comparison with the low water evaporation resulting from an occlusive secondary dressing, which favored the formation of a new and intact dermal tissue that nearly fully replaced all the dermis that was removed during wounding. This newly available evidence may be of great benefit to clinical wound management.
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Affiliation(s)
- Alexandru-Cristian Tuca
- Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University of Graz, 8036 Graz, Austria; (R.W.); (A.P.); (L.-P.K.)
- Correspondence: ; Tel.: +43-316-385-30742
| | - Ives Bernardelli de Mattos
- Department Tissue Engineering & Regenerative Medicine (TERM), University Hospital Würzburg, 97080 Würzburg, Germany; (I.B.d.M.); (F.G.-B.); (D.K.)
| | | | - Raimund Winter
- Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University of Graz, 8036 Graz, Austria; (R.W.); (A.P.); (L.-P.K.)
| | - Alen Palackic
- Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University of Graz, 8036 Graz, Austria; (R.W.); (A.P.); (L.-P.K.)
| | - Florian Groeber-Becker
- Department Tissue Engineering & Regenerative Medicine (TERM), University Hospital Würzburg, 97080 Würzburg, Germany; (I.B.d.M.); (F.G.-B.); (D.K.)
- Translational Center Regenerative Therapies, Fraunhofer Institute for Silicate Research ISC, 97080 Würzburg, Germany
| | - Daniel Kruse
- Department Tissue Engineering & Regenerative Medicine (TERM), University Hospital Würzburg, 97080 Würzburg, Germany; (I.B.d.M.); (F.G.-B.); (D.K.)
| | - Fabian Kukla
- TPL Path Labs GmbH, 79111 Freiburg, Germany; (F.K.); (T.L.)
| | | | - Lars-Peter Kamolz
- Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University of Graz, 8036 Graz, Austria; (R.W.); (A.P.); (L.-P.K.)
- Joanneum Research Forschungsgesellschaft mbH, COREMED, 8036 Graz, Austria
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6
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Nuutila K, Samandari M, Endo Y, Zhang Y, Quint J, Schmidt TA, Tamayol A, Sinha I. In vivo printing of growth factor-eluting adhesive scaffolds improves wound healing. Bioact Mater 2022; 8:296-308. [PMID: 34541402 PMCID: PMC8427093 DOI: 10.1016/j.bioactmat.2021.06.030] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/16/2021] [Accepted: 06/24/2021] [Indexed: 12/25/2022] Open
Abstract
Acute and chronic wounds affect millions of people around the world, imposing a growing financial burden on patients and hospitals. Despite the application of current wound management strategies, the physiological healing process is disrupted in many cases, resulting in impaired wound healing. Therefore, more efficient and easy-to-use treatment modalities are needed. In this study, we demonstrate the benefit of in vivo printed, growth factor-eluting adhesive scaffolds for the treatment of full-thickness wounds in a porcine model. A custom-made handheld printer is implemented to finely print gelatin-methacryloyl (GelMA) hydrogel containing vascular endothelial growth factor (VEGF) into the wounds. In vitro and in vivo results show that the in situ GelMA crosslinking induces a strong scaffold adhesion and enables printing on curved surfaces of wet tissues, without the need for any sutures. The scaffold is further shown to offer a sustained release of VEGF, enhancing the migration of endothelial cells in vitro. Histological analyses demonstrate that the administration of the VEGF-eluting GelMA scaffolds that remain adherent to the wound bed significantly improves the quality of healing in porcine wounds. The introduced in vivo printing strategy for wound healing applications is translational and convenient to use in any place, such as an operating room, and does not require expensive bioprinters or imaging modalities.
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Affiliation(s)
- Kristo Nuutila
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Mohamadmahdi Samandari
- Department of Biomedical Engineering, University of Connecticut, Farmington, CT, 06030, USA
| | - Yori Endo
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Yuteng Zhang
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Jacob Quint
- Department of Biomedical Engineering, University of Connecticut, Farmington, CT, 06030, USA
- Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, NE, 68588, USA
| | - Tannin A. Schmidt
- Department of Biomedical Engineering, University of Connecticut, Farmington, CT, 06030, USA
| | - Ali Tamayol
- Department of Biomedical Engineering, University of Connecticut, Farmington, CT, 06030, USA
- Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, NE, 68588, USA
| | - Indranil Sinha
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
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7
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Nuutila K, Eriksson E. Moist Wound Healing with Commonly Available Dressings. Adv Wound Care (New Rochelle) 2021; 10:685-698. [PMID: 32870777 DOI: 10.1089/wound.2020.1232] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Significance: A moist wound environment has several benefits that result in faster and better quality of healing. It facilitates autolytic debridement, reduces pain, reduces scarring, activates collagen synthesis, facilitates and promotes keratinocyte migration over the wound surface, and supports the presence and function of nutrients, growth factors, and other soluble mediators in the wound microenvironment. Recent Advances: Wound dressings can be utilized to create, maintain, and control a moist environment for healing. Moist wound dressings can be divided into films, foams, hydrocolloids, hydrogels, and alginates. We are also including negative pressure wound therapy systems in the moist dressings. Critical Issues: An optimal wound dressing should provide a moist environment and have an optimal water vapor transmission rate (WVTR) and absorptive capacity. It should also protect the wound against trauma and contamination and be easy to apply, painless to remove, and esthetically acceptable or even pleasing. Future Directions: Interventions, particularly dressing changes, by medical caregivers are labor intensive and expensive and there should be a continuous effort to reduce their number per week. Smart dressings with integrated microsensors and delivery capabilities that would allow wireless real-time monitoring and treatment of the wound would be very advantageous. This way the state of the wound as well as the wear time of the dressing could be assessed without dressing removal or visit to the wound care center. In addition, an ability to adjust the WVTRs to the exudate level of the wound (or having a large absorptive capacity without changing the WVTR) would be useful. This feature would guarantee an optimal level of hydration of the wound surface throughout the treatment.
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Affiliation(s)
- Kristo Nuutila
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Elof Eriksson
- Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
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8
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Hamilton DW, Walker JT, Tinney D, Grynyshyn M, El-Warrak A, Truscott E, Flynn LE. The pig as a model system for investigating the recruitment and contribution of myofibroblasts in skin healing. Wound Repair Regen 2021; 30:45-63. [PMID: 34708478 DOI: 10.1111/wrr.12981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/02/2021] [Accepted: 09/27/2021] [Indexed: 12/13/2022]
Abstract
In the skin-healing field, porcine models are regarded as a useful analogue for human skin due to their numerous anatomical and physiological similarities. Despite the widespread use of porcine models in skin healing studies, the initial origin, recruitment and transition of fibroblasts to matrix-secreting contractile myofibroblasts are not well defined for this model. In this review, we discuss the merit of the pig as an animal for studying myofibroblast origin, as well as the challenges associated with assessing their contributions to skin healing. Although a variety of wound types (incisional, partial thickness, full thickness, burns) have been investigated in pigs in attempts to mimic diverse injuries in humans, direct comparison of human healing profiles with regards to myofibroblasts shows evident differences. Following injury in porcine models, which often employ juvenile animals, myofibroblasts are described in the developing granulation tissue at 4 days, peaking at Days 7-14, and persisting at 60 days post-wounding, although variations are evident depending on the specific pig breed. In human wounds, the presence of myofibroblasts is variable and does not correlate with the age of the wound or clinical contraction. Our comparison of porcine myofibroblast-mediated healing processes with those in humans suggests that further validation of the pig model is essential. Moreover, we identify several limitations evident in experimental design that need to be better controlled, and standardisation of methodologies would be beneficial for the comparison and interpretation of results. In particular, we discuss anatomical location of the wounds, their size and depth, as well as the healing microenvironment (wet vs. moist vs. dry) in pigs and how this could influence myofibroblast recruitment. In summary, although a widespread model used in the skin healing field, further research is required to validate pigs as a useful analogue for human healing with regards to myofibroblasts.
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Affiliation(s)
- Douglas W Hamilton
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - John T Walker
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Dylan Tinney
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Michael Grynyshyn
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Alexander El-Warrak
- Animal Care and Veterinary Services, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Emily Truscott
- Animal Care and Veterinary Services, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Lauren E Flynn
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.,Department of Chemical and Biochemical Engineering, Thompson Engineering Building, The University of Western Ontario, London, Ontario, Canada
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Alibardi L. Review. Limb regeneration in lizards under natural and experimental conditions with considerations on the induction of appendages regeneration in amniotes. Ann Anat 2021; 239:151844. [PMID: 34662737 DOI: 10.1016/j.aanat.2021.151844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Study on the failure of limb regeneration in lizards evidences the difficult problems met from amniotes to regenerate organs. Contrary to the tail, limb loss in terrestrial environment is generally fatal and no selection for its regeneration occurred during lizard evolution. METHODS Experimentally amputated limbs were fixed and embedded for microscopy. RESULTS After limb loss an intense inflammatory reaction occurs and immune cells are recruited underneath a wound epidermis, forming a vascularized granulation tissue. The regenerating epidermis takes 2-3 weeks to cover the limb stump since degenerating long bones must be excised first while a dense connective tissue is formed and no limb growth occurs. Cell proliferation occurs in granulation tissues and wound epidermis during the initial 2-3 weeks of wound healing but disappears later determining the arrest of growth. Transcriptome data indicates that the limb, contrary to the tail, activates numerous genes involved in inflammation, immunity and fibroplasia while down-regulates some proliferative and most myogenic genes. Attempts to stimulate limb regeneration, by implants of nervous tissues or growth factors such as FGFs only maintain proliferation for few weeks but eventually the scarring program prevails and only short outgrowths missing of autopodial elements are regenerated. CONCLUSIONS While lizard limbs show the typical scarring outcome of mammals, the comparison of genes activated in the regenerating tail has allowed identifying key genes implicated in organ regeneration in amniotes.
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Affiliation(s)
- Lorenzo Alibardi
- Comparative Histolab Padova and Department of Biology, University of Bologna, Italy.
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10
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Amer Y, Bridges C, Marathe K. Epidemiology, Pathophysiology, and Management Strategies of Neonatal Wound Care. Neoreviews 2021; 22:e452-e460. [PMID: 34210809 DOI: 10.1542/neo.22-7-e452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Guidelines for neonatal skin care are scarce, and there is no consensus on the best management practices for neonatal skin breakdown. This review presents the pathology and phases of wound healing, reasons for neonatal skin fragility, and approaches to recognition of commonly encountered neonatal wounds. This review also provides general strategies for neonatal wound prevention, care, dressing, and management to avoid further damage to the fragile neonatal skin. The importance and role of retaining moisture in expediting wound healing is discussed, as well as updated classifications on how to grade and assess pressure ulcers and the role of negative pressure wound therapy and silver dressings. Lastly, this review discusses prevention and treatment options for surgical wounds, intravenous extravasation wounds, congenital wounds, and thermal injuries, in addition to how to differentiate these wounds from the common diaper dermatitis and contact dermatitis.
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Affiliation(s)
- Yomna Amer
- School of Medicine, University of Louisville, Louisville, KY
| | - Catherine Bridges
- Department of Dermatology, University of Cincinnati, Cincinnati, OH.,Department of Dermatology, Cincinnati Children's Hospital, Cincinnati, OH
| | - Kalyani Marathe
- Department of Dermatology, Cincinnati Children's Hospital, Cincinnati, OH
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11
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Burtseva S, Khripunova L, Yashkin A, Pautova L, Chebakov S. Productive and biological features of breeding Irish pigs of various genotypes in Western Siberia. BIO WEB OF CONFERENCES 2021. [DOI: 10.1051/bioconf/20213700123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The present work studies the productive and biological characteristics of breeding Irish pigs of different genotypes in the conditions of Western Siberia. Pure-bred selection of Large White pigs (WP) was used in the first control group and intra-breed selection of Landrace pigs (LP) was used in the second control group. The following patterns of interbreeding were used in the experimental groups: ♀WP × ♂LP (third group), ♀LP × ♂WP (fourth group). In terms of reproductive qualities, the best combination should be considered the selection of ♀WP × ♂LP, in which 8.1% (p <0.05) more piglets were obtained at 30 days, with a 10.0% (p <0.05) higher weight of the nest at 30 days and 3.6% (p <0.05) greater safety than in the first control group. The combination of breeds according to the ♀LP × ♂WP scheme contributed to an increase in the average daily 13.7% (p <0.05) gain in live weight of the resulting offspring. At the age of 4 months, piglets of the LP × WP genotype had a 10.9% (p <0.05) higher content of total protein in the blood serum than in animals of the Large White breed. The muscle tissue of Large White pigs was characterized by a 5.2% (p <0.05) higher moisture binding capacity in relation to Landrace pigs. The melting point of fatty tissue was lower in Large White pigs by 14.3% (p <0.05). The fatty tissue of LP × WP hybrids has a 10.0% higher melting point (p <0.05) in contrast to Large White pigs.
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12
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Wilgus TA. Inflammation as an orchestrator of cutaneous scar formation: a review of the literature. PLASTIC AND AESTHETIC RESEARCH 2020; 7:54. [PMID: 33123623 PMCID: PMC7592345 DOI: 10.20517/2347-9264.2020.150] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Inflammation is a key phase in the cutaneous wound repair process. The activation of inflammatory cells is critical for preventing infection in contaminated wounds and results in the release of an array of mediators, some of which stimulate the activity of keratinocytes, endothelial cells, and fibroblasts to aid in the repair process. However, there is an abundance of data suggesting that the strength of the inflammatory response early in the healing process correlates directly with the amount of scar tissue that will eventually form. This review will summarize the literature related to inflammation and cutaneous scar formation, highlight recent discoveries, and discuss potential treatment modalities that target inflammation to minimize scarring.
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Affiliation(s)
- Traci A Wilgus
- Department of Pathology, Ohio State University, Columbus, OH 43210, USA
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13
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Hasegawa M, Inoue Y, Kaneko S, Kanoh H, Shintani Y, Tsujita J, Fujita H, Motegi SI, Le Pavoux A, Asai J, Asano Y, Abe M, Amano M, Ikegami R, Ishii T, Isei T, Isogai Z, Ito T, Irisawa R, Iwata Y, Otsuka M, Omoto Y, Kato H, Kadono T, Kawakami T, Kawaguchi M, Kukino R, Kono T, Koga M, Kodera M, Sakai K, Sakurai E, Sarayama Y, Tanioka M, Tanizaki H, Doi N, Nakanishi T, Hashimoto A, Hayashi M, Hirosaki K, Fujimoto M, Fujiwara H, Maekawa T, Matsuo K, Madokoro N, Yatsushiro H, Yamasaki O, Yoshino Y, Tachibana T, Ihn H. Wound, pressure ulcer and burn guidelines - 1: Guidelines for wounds in general, second edition. J Dermatol 2020; 47:807-833. [PMID: 32614097 DOI: 10.1111/1346-8138.15401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/19/2020] [Indexed: 01/22/2023]
Abstract
The Japanese Dermatological Association prepared the clinical guidelines for the "Wound, pressure ulcer and burn guidelines", second edition, focusing on treatments. Among them, "Guidelines for wounds in general" is intended to provide the knowledge necessary to heal wounds, without focusing on particular disorders. It informs the basic principles of wound treatment, before explanations are provided in individual chapters of the guidelines. We updated all sections by collecting references published since the publication of the first edition. In particular, we included new wound dressings and topical medications. Additionally, we added "Question 6: How should wound-related pain be considered, and what should be done to control it?" as a new section addressing wound pain, which was not included in the first edition.
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Affiliation(s)
- Minoru Hasegawa
- Department of Dermatology, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Japan
| | - Yuji Inoue
- Suizenji Dermatology Clinic, Kumamoto, Japan
| | - Sakae Kaneko
- Department of Dermatology, School of Medicine, Shimane University, Izumo, Japan
| | - Hiroyuki Kanoh
- Department of Dermatology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | | | - Jun Tsujita
- Department of Dermatology, Social Insurance Inatsuki Hospital, Fukuoka Prefecture Social Insurance Hospital Association, Fukuoka, Japan
| | - Hideki Fujita
- Department of Dermatology, School of Medicine, Nihon University, Tokyo, Japan
| | - Sei-Ichiro Motegi
- Department of Dermatology, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | | | - Jun Asai
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshihide Asano
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | | | - Masahiro Amano
- Department of Dermatology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Ryuta Ikegami
- Department of Dermatology, JCHO Osaka Hospital, Osaka, Japan
| | - Takayuki Ishii
- Division of Dermatology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Taiki Isei
- Department of Dermatology, Osaka National Hospital, Osaka, Japan
| | - Zenzo Isogai
- Division of Dermatology and Connective Tissue Medicine, Department of Advanced Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takaaki Ito
- Department of Dermatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Ryokichi Irisawa
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Yohei Iwata
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Masaki Otsuka
- Division of Dermatology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yoichi Omoto
- Department of Dermatology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Hiroshi Kato
- Department of Geriatric and Environmental Dermatology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Takafumi Kadono
- Department of Dermatology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Tamihiro Kawakami
- Department of Dermatology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masakazu Kawaguchi
- Department of Dermatology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | | | - Takeshi Kono
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzei, Japan
| | - Monji Koga
- Department of Dermatology, School of Medicine, Fukuoka University, Fukuoka, Japan
| | - Masanari Kodera
- Department of Dermatology, JCHO Chukyo Hospital, Nagoya, Japan
| | - Keisuke Sakai
- Department of Dermatology, Minamata City General Hospital & Medical Center, Minamata, Japan
| | | | | | | | - Hideaki Tanizaki
- Department of Dermatology, Osaka Medical College, Takatsuki, Japan
| | - Naotaka Doi
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Takeshi Nakanishi
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masahiro Hayashi
- Department of Dermatology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Kuninori Hirosaki
- Department of Dermatology, Hokkaido Medical Care Center, Sapporo, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroshi Fujiwara
- Department of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Dermatology, Uonuma Kikan Hospital, Minamiuonuma, Japan
| | - Takeo Maekawa
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | | | - Naoki Madokoro
- Department of Dermatology, MAZDA Hospital, Aki-gun, Japan
| | | | - Osamu Yamasaki
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Yuichiro Yoshino
- Department of Dermatology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | - Takao Tachibana
- Department of Dermatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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14
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Daristotle JL, Lau LW, Erdi M, Hunter J, Djoum A, Srinivasan P, Wu X, Basu M, Ayyub OB, Sandler AD, Kofinas P. Sprayable and biodegradable, intrinsically adhesive wound dressing with antimicrobial properties. Bioeng Transl Med 2020; 5:e10149. [PMID: 31989038 PMCID: PMC6971445 DOI: 10.1002/btm2.10149] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/04/2019] [Accepted: 12/03/2019] [Indexed: 01/29/2023] Open
Abstract
Conventional wound dressings are difficult to apply to large total body surface area (TBSA) wounds, as they typically are prefabricated, require a layer of adhesive coating for fixation, and need frequent replacement for entrapped exudate. Large TBSA wounds as well as orthopedic trauma and low-resource surgery also have a high risk of infection. In this report, a sprayable and intrinsically adhesive wound dressing loaded with antimicrobial silver is investigated that provides personalized fabrication with minimal patient contact. The dressing is composed of adhesive and biodegradable poly(lactic-co-glycolic acid) and poly(ethylene glycol) (PLGA/PEG) blend fibers with or without silver salt (AgNO3). in vitro studies demonstrate that the PLGA/PEG/Ag dressing has antimicrobial properties and low cytotoxicity, with antimicrobial silver controllably released over 7-14 days. In a porcine partial-thickness wound model, the wounds treated with both antimicrobial and nonantimicrobial PLGA/PEG dressings heal at rates similar to those of the clinical, thin film polyurethane wound dressing, with similar scarring. However, PLGA/PEG adds a number of features beneficial for wound healing: greater exudate absorption, integration into the wound, a 25% reduction in dressing changes, and tissue regeneration with greater vascularization. There is also modest improvement in epidermis thickness compared to the control wound dressing.
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Affiliation(s)
- John L. Daristotle
- Fischell Department of BioengineeringUniversity of MarylandCollege ParkMaryland
| | - Lung W. Lau
- Sheikh Zayed Institute for Pediatric Surgical InnovationJoseph E. Robert Jr. Center for Surgical Care, Children's National Medical CenterWashingtonDistrict of Columbia
| | - Metecan Erdi
- Department of Chemical and Biomolecular EngineeringUniversity of MarylandCollege ParkMaryland
| | - Joseph Hunter
- Fischell Department of BioengineeringUniversity of MarylandCollege ParkMaryland
| | - Albert Djoum
- Department of Chemistry and BiochemistryUniversity of MarylandCollege ParkMaryland
| | - Priya Srinivasan
- Sheikh Zayed Institute for Pediatric Surgical InnovationJoseph E. Robert Jr. Center for Surgical Care, Children's National Medical CenterWashingtonDistrict of Columbia
| | - Xiaofang Wu
- Sheikh Zayed Institute for Pediatric Surgical InnovationJoseph E. Robert Jr. Center for Surgical Care, Children's National Medical CenterWashingtonDistrict of Columbia
| | - Mousumi Basu
- Sheikh Zayed Institute for Pediatric Surgical InnovationJoseph E. Robert Jr. Center for Surgical Care, Children's National Medical CenterWashingtonDistrict of Columbia
| | - Omar B. Ayyub
- Department of Chemical and Biomolecular EngineeringUniversity of MarylandCollege ParkMaryland
| | - Anthony D. Sandler
- Sheikh Zayed Institute for Pediatric Surgical InnovationJoseph E. Robert Jr. Center for Surgical Care, Children's National Medical CenterWashingtonDistrict of Columbia
| | - Peter Kofinas
- Department of Chemical and Biomolecular EngineeringUniversity of MarylandCollege ParkMaryland
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15
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Holt AW, McDaniel JS, Bramblett GT, Eriksson E, Johnson AJ, Griffith GL. Use of an ocular wound chamber for the prevention of exposure keratopathy in a guinea pig model. Wound Repair Regen 2018; 26:351-358. [DOI: 10.1111/wrr.12644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 05/16/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Andrew W. Holt
- Department of Sensory Trauma United States Army Institute of Surgical Research San Antonio Texas
| | - Jennifer S. McDaniel
- Laulima Government Solutions, LLC, c/o Sensory Trauma, United States Army Institute of Surgical Research San Antonio Texas
| | - Gregory T. Bramblett
- Oak Ridge Institute for Science and Education, c/o Sensory Trauma, United States Army Institute of Surgical Research San Antonio Texas
| | | | - Anthony J. Johnson
- Department of Sensory Trauma United States Army Institute of Surgical Research San Antonio Texas
| | - Gina L. Griffith
- Department of Sensory Trauma United States Army Institute of Surgical Research San Antonio Texas
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16
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van den Akker PC, Pasmooij AMG, Joenje H, Hofstra RMW, te Meerman GJ, Jonkman MF. A "late-but-fitter revertant cell" explains the high frequency of revertant mosaicism in epidermolysis bullosa. PLoS One 2018; 13:e0192994. [PMID: 29470523 PMCID: PMC5823395 DOI: 10.1371/journal.pone.0192994] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 02/03/2018] [Indexed: 12/20/2022] Open
Abstract
Revertant mosaicism, or "natural gene therapy", is the phenomenon in which germline mutations are corrected by somatic events. In recent years, revertant mosaicism has been identified in all major types of epidermolysis bullosa, the group of heritable blistering disorders caused by mutations in the genes encoding epidermal adhesion proteins. Moreover, revertant mosaicism appears to be present in all patients with a specific subtype of recessive epidermolysis bullosa. We therefore hypothesized that revertant mosaicism should be expected at least in all patients with recessive forms of epidermolysis bullosa. Naturally corrected, patient-own cells are of extreme interest for their promising therapeutic potential, and their presence in all patients would open exciting, new treatment perspectives to those patients. To test our hypothesis, we determined the probability that single nucleotide reversions occur in patients' skin using a mathematical developmental model. According to our model, reverse mutations are expected to occur frequently (estimated 216x) in each patient's skin. Reverse mutations should, however, occur early in embryogenesis to be able to drive the emergence of recognizable revertant patches, which is expected to occur in only one per ~10,000 patients. This underestimate, compared to our clinical observations, can be explained by the "late-but-fitter revertant cell" hypothesis: reverse mutations arise at later stages of development, but provide revertant cells with a selective growth advantage in vivo that drives the development of recognizable healthy skin patches. Our results can be extrapolated to any other organ with stem cell division numbers comparable to skin, which may offer novel future therapeutic options for other genetic conditions if these revertant cells can be identified and isolated.
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Affiliation(s)
- Peter C. van den Akker
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, the Netherlands
- University of Groningen, University Medical Center Groningen, Department of Dermatology, Groningen, the Netherlands
| | - Anna M. G. Pasmooij
- University of Groningen, University Medical Center Groningen, Department of Dermatology, Groningen, the Netherlands
| | - Hans Joenje
- Department of Clinical Genetics and the Cancer Center Amsterdam/VUmc Institute for Cancer and Immunology, VU University Medical Center, Amsterdam, the Netherlands
| | - Robert M. W. Hofstra
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Gerard J. te Meerman
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, the Netherlands
| | - Marcel F. Jonkman
- University of Groningen, University Medical Center Groningen, Department of Dermatology, Groningen, the Netherlands
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17
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Yang L, Broomhead M, Nuutila K, Proppe K, Eriksson E. Topically Delivered Minocycline Penetrates a Full-Thickness Burn Eschar and Reduces Tissue Bacterial Counts. J Burn Care Res 2017; 39:790-797. [DOI: 10.1093/jbcr/irx051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Lu Yang
- Applied Tissue Technologies LLC, Hingham, MA
| | | | | | - Karl Proppe
- Applied Tissue Technologies LLC, Hingham, MA
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18
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Zhang J, Chai J, Luo Z, He H, Chen L, Liu X, Zhou Q. Meat and nutritional quality comparison of purebred and crossbred pigs. Anim Sci J 2017; 89:202-210. [PMID: 28856768 DOI: 10.1111/asj.12878] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 06/15/2017] [Indexed: 11/30/2022]
Abstract
Crossbreeding is an effective method of improving the efficiency and profit of production in commercial pig operations. To understand the effect of crossbreeding on meat and nutrient quality, a combination including three purebred (Duroc, D; Landrace, L; Yorkshire, Y) and two crossbred pig lines (Landrace × Yorkshire, LY; Duroc × (Landrace × Yorkshire), DLY) frequently used internationally were studied. The results showed that meat from the LY and DLY crosses had lower values for lightness L24h∗, shear force and epinephrine and higher values for drip loss, C18:1, insulin, glucagon and monounsaturated fatty acids than D, L and Y pigs. Moreover, LY had higher values for post mortem pH and lower values for a* and b* than the purebreds. In contrast, DLY had lower values for pH and higher values for a* and b* than the purebreds. Meat quality-related gene analysis showed that the CAST, IGF2 and MC4R gene expression levels in the LY and DLY pigs were significantly higher than those in the D, L and Y pigs. These results indicate that crossbreeding can alter the meat quality, nutritive value, energy metabolism and gene expression of pigs. Future research should focus on microRNA expression and DNA methylation that regulate gene expression and thus affect the meat quality.
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Affiliation(s)
- Jie Zhang
- College of Animal Science, Southwest University, Rongchang, Chongqing, China
| | - Jie Chai
- Chongqing Academy of Animal Science, Rongchang, Chongqing, China
| | - Zonggang Luo
- College of Animal Science, Southwest University, Rongchang, Chongqing, China
| | - Hang He
- College of Animal Science, Southwest University, Rongchang, Chongqing, China
| | - Lei Chen
- Chongqing Academy of Animal Science, Rongchang, Chongqing, China
| | - Xueqin Liu
- Chongqing Academy of Animal Science, Rongchang, Chongqing, China
| | - Qinfei Zhou
- College of Animal Science, Southwest University, Rongchang, Chongqing, China
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19
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Han YS, Song S, Sung TJ, Chun J. Successful Management of Severe Peripheral Tissue Ischemia after Arterial Catheterization in Micro Preemies using Humidification & Topical Nitroglycerin. NEONATAL MEDICINE 2017. [DOI: 10.5385/nm.2017.24.4.197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Yea-Seul Han
- Department of Pediatrics, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea
| | - Songyi Song
- Department of Pediatrics, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea
| | - Tae-Jung Sung
- Department of Pediatrics, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea
| | - Jiyoung Chun
- Department of Pediatrics, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea
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20
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Tsai DM, Tracy LE, Lee CCY, Hackl F, Kiwanuka E, Minasian RA, Onderdonk A, Junker JPE, Eriksson E, Caterson EJ. Full-thickness porcine burns infected with Staphylococcus aureus or Pseudomonas aeruginosa can be effectively treated with topical antibiotics. Wound Repair Regen 2016; 24:356-65. [PMID: 26800421 DOI: 10.1111/wrr.12409] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 01/17/2016] [Indexed: 11/30/2022]
Abstract
Burn and blast injuries are frequently complicated by invasive infections, which lead to poor wound healing, delay in treatment, disability, or death. Traditional approach centers on early debridement, fluid resuscitation, and adjunct intravenous antibiotics. These modalities often prove inadequate in burns, where compromised local vasculature limits the tissue penetration of systemic antibiotics. Here, we demonstrate the treatment of infected burns with topical delivery of ultrahigh concentrations of antibiotics. Standardized burns were inoculated with Staphylococcus aureus or Pseudomonas aeruginosa. After debridement, burns were treated with either gentamicin (2 mg/mL) or minocycline (1 mg/mL) at concentrations greater than 1,000 times the minimum inhibitory concentration. Amount of bacteria was quantified in tissue biopsies and wound fluid following treatment. After six days of gentamicin or minocycline treatment, S. aureus counts decreased from 4.2 to 0.31 and 0.72 log CFU/g in tissue, respectively. Similarly, P. aeruginosa counts decreased from 2.5 to 0.0 and 1.5 log CFU/g in tissue, respectively. Counts of both S. aureus and P. aeruginosa remained at a baseline of 0.0 log CFU/mL in wound fluid for both treatment groups. The findings here demonstrate that super-therapeutic concentrations of antibiotics delivered topically can rapidly reduce bacterial counts in infected full-thickness porcine burns. This treatment approach may aid wound bed preparation and accelerate time to grafting.
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Affiliation(s)
- David M Tsai
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lauren E Tracy
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cameron C Y Lee
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Florian Hackl
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elizabeth Kiwanuka
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Raquel A Minasian
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andrew Onderdonk
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Johan P E Junker
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elof Eriksson
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - E J Caterson
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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21
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22
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Curbing Inflammation in Skin Wound Healing: A Review. Int J Inflam 2015; 2015:316235. [PMID: 26356299 PMCID: PMC4556061 DOI: 10.1155/2015/316235] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 07/24/2015] [Accepted: 07/27/2015] [Indexed: 12/15/2022] Open
Abstract
Wound healing is a complex regulated process that results in skin scar formation in postnatal mammals. Chronic wounds are major medical problems that can confer devastating consequences. Currently, there are no treatments to prevent scarring. In the early fetus wounds heal without scarring and the healing process is characterized by relatively less inflammation compared to adults; therefore, research aimed at reducing the inflammatory process related to wound healing might speed healing and improve the final scar appearance.
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23
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Kruse CR, Nuutila K, Lee CCY, Kiwanuka E, Singh M, Caterson EJ, Eriksson E, Sørensen JA. The external microenvironment of healing skin wounds. Wound Repair Regen 2015; 23:456-64. [PMID: 25857996 DOI: 10.1111/wrr.12303] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 04/02/2015] [Indexed: 11/28/2022]
Abstract
The skin wound microenvironment can be divided into two main components that influence healing: the external wound microenvironment, which is outside the wound surface; and the internal wound microenvironment, underneath the surface, to which the cells within the wound are exposed. Treatment methods that directly alter the features of the external wound microenvironment indirectly affect the internal wound microenvironment due to the exchange between the two compartments. In this review, we focus on the effects of temperature, pressure (positive and negative), hydration, gases (oxygen and carbon dioxide), pH, and anti-microbial treatment on the wound. These factors are well described in the literature and can be modified with treatment methods available in the clinic. Understanding the roles of these factors in wound pathophysiology is of central importance in wound treatment.
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Affiliation(s)
- Carla R Kruse
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Plastic and Reconstructive Surgery, Odense University Hospital, Odense, Denmark
| | - Kristo Nuutila
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cameron C Y Lee
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elizabeth Kiwanuka
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mansher Singh
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Edward J Caterson
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elof Eriksson
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jens A Sørensen
- Department of Plastic and Reconstructive Surgery, Odense University Hospital, Odense, Denmark
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24
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Topical delivery of ultrahigh concentrations of gentamicin is highly effective in reducing bacterial levels in infected porcine full-thickness wounds. Plast Reconstr Surg 2015; 135:151-159. [PMID: 25539303 DOI: 10.1097/prs.0000000000000801] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Injury to the skin can predispose individuals to invasive infection. The standard of care for infected wounds is treatment with intravenous antibiotics. However, antibiotics delivered intravenously may have poor tissue penetration and be dose limited by systemic side effects. Topical delivery of antibiotics reduces systemic complications and delivers increased drug concentrations directly to the wound. METHODS Porcine full-thickness wounds infected with Staphylococcus aureus were treated with ultrahigh concentrations (over 1000 times the minimum inhibitory concentration) of gentamicin using an incubator-like wound healing platform. The aim of the present study was to evaluate clearance of infection and reduction in inflammation following treatment. Gentamicin cytotoxicity was evaluated by in vitro assays. RESULTS Application of 2000 μg/ml gentamicin decreased bacterial counts in wound tissue from 7.2 ± 0.3 log colony-forming units/g to 2.6 ± 0.6 log colony-forming units/g in 6 hours, with no reduction observed in saline controls (p < 0.005). Bacterial counts in wound fluid decreased from 5.7 ± 0.9 log colony-forming units/ml to 0.0 ± 0 log colony-forming units/ml in 1 hour, with no reduction observed in saline controls (p < 0.005). Levels of interleukin-1β were significantly reduced in gentamicin-treated wounds compared with saline controls (p < 0.005). In vitro, keratinocyte migration and proliferation were reduced at gentamicin concentrations between 100 and 1000 μg/ml. CONCLUSIONS Topical delivery of ultrahigh concentrations of gentamicin rapidly decontaminates acutely infected wounds and maintains safe systemic levels. Treatment of infected wounds using the proposed methodology protects the wound and establishes a favorable baseline for subsequent treatment.
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25
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Junker JP, Kamel RA, Caterson E, Eriksson E. Clinical Impact Upon Wound Healing and Inflammation in Moist, Wet, and Dry Environments. Adv Wound Care (New Rochelle) 2013; 2:348-356. [PMID: 24587972 DOI: 10.1089/wound.2012.0412] [Citation(s) in RCA: 235] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Indexed: 11/12/2022] Open
Abstract
SIGNIFICANCE Successful treatment of wounds relies on precise control and continuous monitoring of the wound-healing process. Wet or moist treatment of wounds has been shown to promote re-epithelialization and result in reduced scar formation, as compared to treatment in a dry environment. RECENT ADVANCES By treating wounds in a controlled wet environment, delivery of antimicrobials, analgesics, other bioactive molecules such as growth factors, as well as cells and micrografts, is allowed. The addition of growth factors or transplantation of cells yields the possibility of creating a regenerative wound microenvironment that favors healing, as opposed to excessive scar formation. CRITICAL ISSUES Although several manufacturers have conceived products implementing the concept of moist wound healing, there remains a lack of commercial translation of wet wound-healing principles into clinically available products. This can only be mitigated by further research on the topic. FUTURE DIRECTIONS The strong evidence pointing to the favorable healing of wounds in a wet or moist environment compared to dry treatment will extend the clinical indications for this treatment. Further advances are required to elucidate by which means this microenvironment can be optimized to improve the healing outcome.
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Affiliation(s)
- Johan P.E. Junker
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Rami A. Kamel
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - E.J. Caterson
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elof Eriksson
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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26
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Häkkinen L, Larjava H, Koivisto L. Granulation tissue formation and remodeling. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/etp.12008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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27
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Kim SC, ChoLee AR. Preparation of Reproducible and Responsive Scar Model and Histology Analysis. ACTA ACUST UNITED AC 2010. [DOI: 10.4333/kps.2010.40.1.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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