Comparative examination of subcutaneous tissue reaction to high molecular materials in medical use

Influence of silver nanoparticles on the tissue reaction of polyacrylic acid-based gel

Purpose:

To study the influence of silver nanoparticles (AgNP) on tissue reaction when incorporated into a polymeric matrix of polyacrylic acid-based (Carbopol^®) gel as a proposal for a new low-cost type of biomaterial that is simple to manufacture for use as an antimicrobial and antioxidative dressing.

Methods:

In-vivo tests of implantation in the subcutaneous tissue of the back of rats were performed using polyethylene tubes in three situations: empty, only the gel, and gel incorporated with AgNP. Then, the tissue reaction was studied by counting inflammatory cells. Additionally, in-vitro tests of the antioxidative and antimicrobial activity of AgNP were performed. The radical 2,2 diphenyl-1 picrylhydrazyl (DPPH) was used to test the antioxidative activity of AgNP using electron spin resonance. The antimicrobial activity of AgNP was determined by minimum inhibitory concentration against the microorganisms: Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli.

Results:

The results indicated that AgNP presents antioxidative activity and was able to inhibit the growth of the microorganisms tested. The addition of AgNP in Carbopol^® did not alter the tissue inflammatory response (p>0.05, Kruskal-Wallis’s test).

Conclusions:

The new biomaterial is promising for future use as a dressing for its beneficial properties for regenerative processes.

Utilization of Nonabsorbable (Polyamide Black) Buried Subcutaneous Suture Material in Closure of Elliptical Excision in Various Indications for Better Aesthetic Outcome

The aim of this report was to study the effectiveness of nonabsorbable (polyamide black) subcutaneous buried suture (6-0) in elliptical excision of various indications for better outcome of the scar. Clinical data of 155 patients, who underwent nonabsorbable buried subcutaneous closure in elliptical excision for different indications, were collected randomly and analyzed retrospectively. By using a modified Vancouver Scar Scale, which includes an assessment of pliability, the height of scar, vascularity, and pigmentation, all postoperative scars were classified into five categories: excellent, good, moderate, hypertrophic scar, or keloid. A total of 155 patients of elliptical excision with different indications were included in the study. In this study, the male-to-female ratio was 1:2, and patients in the age-group between 10 and 70 years were involved. Of 155 patients, 72% of patients had excellent cosmetic outcome (0 score), 21.29% had good cosmetic outcome (1 score), and 2.58% had a moderate cosmetic outcome (2 score) without any hypertrophic scar or keloid by using a modified Vancouver Scar Scale. No complaints were reported during the study. Scar closure by nonabsorbable buried subcutaneous suture will reduce cutaneous tension, so there will be a better approximation of wound edges and thus better outcome of the scar.

Synthesis and fabrication of films including graphene oxide functionalized with chitosan for regenerative medicine applications

Graphene oxide (GO) has recently gained attention as a scaffold reinforcing agent for tissue engineering. Biomechanical and biological properties through a synergistic effect can be strengthened when combined with other materials such as chitosan (CS). For that reason, chitosan was used for Graphene Oxide (GO) functionalization through an amide group whose formation was evident by bands around 1600 cm⁻¹ in the FTIR analysis. Furthermore, bands located at 1348 cm⁻¹ (D band), 1593 cm⁻¹ (G band), and 2416 cm⁻¹ (2D band) in the RAMAN spectrum, and the displacement of the signal at 87.03 ppm (C5) in solid-state ¹³C-NMR confirmed the amide formation. Films including the CS-GO compound were prepared and characterized by thermogravimetric analysis (TGA), where CS-GO film presented a lighter mass loss (~10% less loosed) than CS due probably to the covalent functionalization with GO, providing film thermal resistance. The CS-GO films synthesized were implanted in Wistar rats' subdermal tissue as a first approximation to the biological response. In vivo tests showed a low inflammatory response, good cicatrization, and advanced resorption at 60 days of implantation, as indicated by histological images. It was evidenced that the covalent union between CS and GO increased biocompatibility and the degradation/resorption capacity, demonstrating tissue regeneration with typical characteristics and tiny remnants of implanted material surrounded by a type III collagen capsule. These results show the potential application of the new synthesized films, including the CS-GO compound, in tissue engineering.

Enhanced Mechanical Stability and Biodegradability of Ti-Infiltrated Polylactide

Biodegradable polymers have been often used in place of conventional nondegradable polymers for industrial and medical applications. In particular, polylactide (PLA) has been regarded as a popular ecofriendly plastic and has many advantages like good biocompatibility and processability. Yet, it still has some drawbacks in mechanical properties. Here, we prepared Ti-infiltrated PLA by mimicking the gelatinous jaw of a seaworm whose mechanical properties are toggled up and down by the tiny amount of metal ions, expecting to prepare a new type of alternative. Ti induced significant chemical and microstructural changes in the PLA, which led to a notable improvement in the mechanical properties as compared to the neat PLA. The Ti-infiltrated PLA exhibited high resistance to rapid degradation. More importantly, the toxicity assessment demonstrated that the resulting PLA is still biocompatible and nontoxic. Consequently, we proved that the Ti-infiltrated PLA has high mechanical properties comparable to conventional nondegradable polymers and good biocompatibility as well as delayed biodegradability. We anticipate the current Ti-infiltrated PLA to be an ecofriendly replacement of some conventional plastics, which helps preserve a green environment.

Safety Assessment of Polyene Group as Used in Cosmetics

The Expert Panel for Cosmetic Ingredient Safety (Panel) reviewed the safety of polyenes, which are reported to function in cosmetics primarily as film formers and viscosity increasing agents. The Panel reviewed relevant data related to these ingredients, not inggaps in the available safety data for some of the polyenes in this safety assessment. The data available for many of the ingredients are sufficient and can be extrapolated to support the safety of the entire group because of the similarities in the chemical structures, chemical properties, use concentrations, and reported functions across the group. The Panel concluded that polyenes were safe in cosmetics in the present practices of use and concentration described in this safety assessment.

Polytetrafluoroethylene Ingestion as a Way to Increase Food Volume and Hence Satiety Without Increasing Calorie Content

Since satiety is largely due to stretch of the stomach and people tend to eat a consistent weight of food, increasing food volume and mass increases satiety. This can be achieved without increasing the calories of food by mixing food with a material that cannot be metabolized. Such a material should be inert, safe, resistant to stomach acid, lack taste, available in powder form, smooth, resistant to heat, and cost effective. Polytetrafluoroethylene (PTFE) is an ideal substance for this purpose. It is a soft plastic that is widely considered to be the most inert material known and is extremely stable. Animal feeding trials showed that rats fed a diet of 25% PTFE for 90 days had no signs of toxicity and that the rats lost weight. This article publishes the data from these subchronic animal feeding trials, reviews the relevant available literature, and hypothesizes that increasing the volume of food by mixing the food with PTFE powder at a ratio of 3 parts food to 1 part PTFE by volume will substantially improve satiety and reduce caloric consumption in people.

In vitro model to study the biomaterial-dependent reaction of macrophages in an inflammatory environment

Background

Macrophages play an important role in the reaction to biomaterials, which sometimes have to be used in a surgical field at risk of contamination. The macrophage phenotype in reaction to biomaterials in an inflammatory environment was evaluated in both an in vivo and in vitro setting.

Methods

In the in vivo setting, polypropylene (PP) biomaterial was implanted for 28 days in the contaminated abdominal wall of rats, and upon removal analysed by routine histology as well as immunohistochemistry for CD68 (marker for macrophages), inducible nitric oxide synthase (iNOS – a marker for proinflammatory M1 macrophages) and CD206 (marker for anti-inflammatory M2 macrophages). For the in vitro model, human peripheral blood monocytes were cultured for 3 days on biomaterials made from PP, collagen (COL), polyethylene terephthalate (PET) and PET coated with collagen (PET+COL). These experiments were performed both with and without lipopolysaccharide and interferon γ stimulation. Secretion of both M1- and M2-related proteins was measured, and a relative M1/M2 index was calculated.

Results

In vivo, iNOS- and CD206-positive cells were found around the fibres of the implanted PP biomaterial. In vitro, macrophages on both PP and COL biomaterial had a relatively low M1/M2 index. Macrophages on the PET biomaterial had a high M1/M2 index, with the highest increase of M1 cytokines in an inflammatory environment. Macrophages on the PET+COL biomaterial also had a high M1/M2 index.

Conclusion

Macrophages in an inflammatory environment in vitro still react in a biomaterial-dependent manner. This model can help to select biomaterials that are tolerated best in a surgical environment at risk of contamination.

Surgical relevance

Biomaterials in an environment at risk of contamination are often not tolerated owing to a high risk of postoperative infection, which may ultimately lead to removal of the biomaterial.

An in vitro model with primary human macrophages was used to provide insight into the acute reaction of macrophages to a biomaterial in an inflammatory environment simulated with lipopolysaccharide and interferon γ. The reaction of macrophages in such an inflammatory environment was still biomaterial-dependent.

This in vitro model can be used to study the reaction of macrophages to different biomaterials in an inflammatory environment in more detail, and thereby help to select biomaterials that are tolerated best in a surgical environment at risk of contamination.

Compressive properties of fibrous repair tissue compared to nucleus and annulus

The wound healing process includes filling the void between implant and tissue edges by collagenous connective repair tissue. This fibrous repair tissue may load share or stabilize implants such as spinal disc replacements. The objective of this study was the biomechanical characterization of human fibrous tissue compared to annulus fibrosus and nucleus pulposus. Human lumbar discs (10 nucleus and annulus) and 10 lumbar deep wound fibrous tissue specimens were sectioned into 12mm diameter×6mm high cylindrical samples. Confined compression testing, after 2h swelling at 0.11MPa, was performed at 5%, 10% and 15% strain over 3.5h. Unconfined dynamic testing (2-0.001Hz) was performed at 5-15% strain. Semi-quantitative histology estimated the proportion of proteoglycan to collagen. Fibrous tissue exhibited a decrease in height during the swelling period whereas annulus and nucleus tissues did not. The aggregate modulus was significantly less for fibrous tissue (p<0.002). Percent stress relaxation was greatest for the fibrous tissue and similar for annulus and nucleus. Dynamic testing found the storage modulus (E') was greater than the loss modulus (E″) for all tissues. Annulus were found to have greater E' and E″ than nucleus, whereas E' and E″ were similar between annulus and fibrous tissue. Fibrous tissue had the greatest increase in both moduli at greater frequencies, but had the lowest hydration and proteoglycan content. Fibrous tissue would not be a substitute for native tissue within the disc space but if adjacent to a disc prosthesis may impart some degree of intersegmental stability during acute loading activities.