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Abstract
Friction blisters on the feet commonly occur when individuals engage in active pursuits such as running, hiking, and military training. The high prevalence of blisters in active individuals underscores the fact that the pathomechanics of this condition are not fully understood. The traditional blister causation paradigm revolves around heat, moisture, and friction. In reality, foot friction blisters are caused by repetitive shear deformation. The 3 fundamental elements of blister-inducing shear deformation are (1) motion of bone, (2) high friction force, and (3) repetition of the resulting shear events. Rubbing at the skin surface is not a mechanism for friction blister formation. To that end, prevention of the friction blister continues to be an elusive quest for both the patient and the treating clinician. In this article, we aimed to highlight the limitations of the long-held blister-causation paradigm and offer a new explanation.
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Affiliation(s)
- Rebecca Rushton
- Esperance Podiatry and BlisterPod, Esperance, Western Australia, Australia
| | - Douglas Richie
- California School of Podiatric Medicine at Samuel Merritt University, Seal Beach
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2
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Zhang HM, Yang ML, Xi JZ, Yang GY, Wu QN. Mesenchymal stem cells-based drug delivery systems for diabetic foot ulcer: A review. World J Diabetes 2023; 14:1585-1602. [DOI: 10.4239/wjd.v14.i11.1585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 07/16/2023] [Accepted: 09/11/2023] [Indexed: 11/14/2023] Open
Abstract
The complication of diabetes, which is known as diabetic foot ulcer (DFU), is a significant concern due to its association with high rates of disability and mortality. It not only severely affects patients’ quality of life, but also imposes a substantial burden on the healthcare system. In spite of efforts made in clinical practice, treating DFU remains a challenging task. While mesenchymal stem cell (MSC) therapy has been extensively studied in treating DFU, the current efficacy of DFU healing using this method is still inadequate. However, in recent years, several MSCs-based drug delivery systems have emerged, which have shown to increase the efficacy of MSC therapy, especially in treating DFU. This review summarized the application of diverse MSCs-based drug delivery systems in treating DFU and suggested potential prospects for the future research.
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Affiliation(s)
- Hong-Min Zhang
- Department of Endocrinology, People’s Hospital of Chongqing Liangjiang New Area, Chongqing 400030, China
| | - Meng-Liu Yang
- Department of Endocrinology, The Second Affiliated Hospital of The Chongqing Medical University, Chongqing 400030, China
| | - Jia-Zhuang Xi
- Department of Endocrinology, Dazu Hospital of Chongqing Medical University, The People’s Hospital of Dazu, Chongqing 406230, China
| | - Gang-Yi Yang
- Department of Endocrinology, The Second Affiliated Hospital of The Chongqing Medical University, Chongqing 400030, China
| | - Qi-Nan Wu
- Department of Endocrinology, Dazu Hospital of Chongqing Medical University, The People’s Hospital of Dazu, Chongqing 406230, China
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3
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Abstract
The search for noninvasive methods to image and measure the mechanical properties of skin has been a frequent subject of research for many years. Although suction testing, elastography, and other testing can be noninvasive, these tests fail to yield comparable results to destructive tests such as uniaxial tensile testing. Accordingly, researchers have developed a technique to combine optical coherence tomography with vibrational analysis (vibrational optical coherence tomography) to image and analyze the biomechanical properties of tissues noninvasively and nondestructively. The result of this analysis is a "virtual biopsy" of skin, along with a physical analysis of the major components of the epidermis and dermis.In this study, the authors compare virtual biopsies of thermal and chemical burns to that of normal skin. They conclude that the enhanced optical coherence tomography images and measurements of the resonant frequency after thermal or chemical burns exhibit large differences when compared with the morphology and moduli of normal skin. Using vibrational optical coherence tomography, it is possible to follow changes in the morphology and physical properties of the epidermis and dermis associated with skin diseases and therapeutic treatments in situ.
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4
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Silver FH, Shah RG, Richard M, Benedetto D. Comparative "virtual biopsies" of normal skin and skin lesions using vibrational optical coherence tomography. Skin Res Technol 2019; 25:743-749. [PMID: 31127665 DOI: 10.1111/srt.12712] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 04/28/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Increased tissue stiffness (also termed modulus) has been shown to be a characteristic of potential tumor metastasis. Measured values of the stiffness of tumors and cancer cells are reported in the literature to increase compared to neighboring normal tissues. Yet the relationship between the mechanical properties of cells and the extracellular matrix has yet to be correlated with the histopathology of cancerous lesions. MATERIALS AND METHODS We have developed a technique to do virtual biopsies of skin lesions by combining images made using optical coherence tomography with stiffness measurements made simultaneously using vibrational analysis. The technique is termed vibrational optical coherence tomography (VOCT). RESULTS In this paper, we report that precancerous and cancerous lesions are characterized by changes in both the morphology and stiffness of the cellular components of the skin. The ratio of the peak heights that correspond to the epidermal (40-60Hz) and dermal (140-160 Hz) resonant frequencies appear to be different for benign and cancerous or precancerous lesions compared with normal skin and scar. CONCLUSIONS Cell-to-cell and epidermal-to-dermal interactions may be very important in evaluating the potential of skin lesions to become malignant. These interactions can be evaluated using VOCT, a new technique for performing "virtual biopsies" of skin lesions.
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Affiliation(s)
- Frederick H Silver
- Department of Pathology and Laboratory Medicine, Robert Wood Johnson Medical School, Rutgers, the State University of New Jersey, Piscataway, New Jersey.,OptoVibronex, LLC., Mt. Bethel, Pennsylvania
| | - Ruchit G Shah
- Graduate Program in Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Michael Richard
- Neigel Center for Cosmetic and Laser Surgery, Florham Park, New Jersey
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Vela-Romera A, Carriel V, Martín-Piedra MA, Aneiros-Fernández J, Campos F, Chato-Astrain J, Prados-Olleta N, Campos A, Alaminos M, Garzón I. Characterization of the human ridged and non-ridged skin: a comprehensive histological, histochemical and immunohistochemical analysis. Histochem Cell Biol 2018; 151:57-73. [PMID: 30099600 PMCID: PMC6328512 DOI: 10.1007/s00418-018-1701-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2018] [Indexed: 01/12/2023]
Abstract
The structure of the human skin is directly dependent on its location and the mechanical forces to which it is subjected. In the present work, we have performed a comprehensive analysis of the human ridged and non-ridged skin to identify the differences and similarities between both skin types. For this purpose, human skin samples were obtained from dorsal hand skin (DHS), palmar hand skin (PHS), dorsal foot skin (DFS) and plantar foot skin (PFS) from the same cadaveric donors. Histological, histochemical and semiquantitative and quantitative immunohistochemical analyses were carried out to evaluate the epidermis, dermis and basement membrane. Results show that the epithelial layer of ridged skin had larger cell number and size than non-ridged skin for most strata. Melanocytes and Langerhans cells were more abundant in non-ridged skin, whereas Merkel cells were preferentially found in ridged skin. The expression pattern of CK5/6 was slightly differed between non-ridged and ridged skin. Involucrin expression was slightly more intense in non-ridged skin than in ridged skin. Collagen was more abundant in foot skin dermis than in hand skin, and in ridged skin as compared to non-ridged skin. Elastic fibers were more abundant in DHS. Biglycan was more abundant in foot skin than in hand skin. No differences were found for blood and lymphatic vessels. The basement membrane laminin was preferentially found in foot skin. These results revealed important differences at the epithelial, dermal and basement membrane levels that could contribute to a better knowledge of the human skin histology.
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Affiliation(s)
- A Vela-Romera
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Avenida de la Investigación 11, Torre A, Planta 5, 18016, Granada, Spain.,PhD Program in Biomedicine, Escuela de Posgrado, University of Granada, Granada, Spain
| | - V Carriel
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Avenida de la Investigación 11, Torre A, Planta 5, 18016, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - M A Martín-Piedra
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Avenida de la Investigación 11, Torre A, Planta 5, 18016, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | | | - F Campos
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Avenida de la Investigación 11, Torre A, Planta 5, 18016, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - J Chato-Astrain
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Avenida de la Investigación 11, Torre A, Planta 5, 18016, Granada, Spain
| | - N Prados-Olleta
- Orthopedic Surgery Department, Virgen de las Nieves University Hospital, Granada, Spain.,Department of Surgery, University of Granada, Granada, Spain
| | - A Campos
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Avenida de la Investigación 11, Torre A, Planta 5, 18016, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - M Alaminos
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Avenida de la Investigación 11, Torre A, Planta 5, 18016, Granada, Spain. .,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - I Garzón
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Avenida de la Investigación 11, Torre A, Planta 5, 18016, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
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Shah RG, DeVore D, Silver FH. Biomechanical analysis of decellularized dermis and skin: Initial in vivo observations using optical cohesion tomography and vibrational analysis. J Biomed Mater Res A 2018; 106:1421-1427. [PMID: 29356381 DOI: 10.1002/jbm.a.36344] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 10/27/2017] [Accepted: 01/10/2018] [Indexed: 11/09/2022]
Abstract
Measurement of the mechanical properties of skin in vivo has been complicated by the lack of methods that can accurately measure the viscoelastic properties without assuming values of Poisson's ratio and tissue density. In this paper, we present the results of preliminary studies comparing the mechanical properties of skin and scar tissue measured using a technique involving optical cohesion tomography (OCT) and vibrational analysis. This technique has been reported to give values of the modulus that correlate with those obtained from tensile measurements made on decellularized dermis (Shah et al., Skin Res Technol 2016;23:399-406; Shah et al., J Biomed Mater Res Part 2017;105:15-22). The high correlation between moduli measured using vibrational studies and uniaxial tensile tests suggest that the modulus can be determined by measuring the natural frequency that occurs when a tissue is vibrated in tension. The results of studies on glutaric anhydride treated decellularized dermis suggest that vibrational analysis is a useful technique to look at changes in the properties of skin that occur after cosmetic and surgical treatments are used. Preliminary results suggest that the resonant frequency of scar tissue is much higher than that of adjacent normal skin reflecting the higher collagen content of scar. OCT in concert with vibrational analysis appears to be a useful tool to evaluate processes that alter skin properties in animals and humans as well to study the onset and pathogenesis of skin diseases such as cancer. This technique may be useful to evaluate the extent of wound healing in skin diabetic ulcers and other chronic skin conditions, scar tissue formation in response to implants, and other therapeutic treatments that alter skin properties. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1421-1427, 2018.
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Affiliation(s)
- Ruchit G Shah
- Graduate Program in Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey, 08854
| | - Dale DeVore
- DV Consulting Services, Chelmsford, Massachusetts, 01824
| | - Frederick H Silver
- Department of Pathology and Laboratory Medicine, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, New Jersey, 08854
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