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Jacob G, Shimomura K, Nakamura N. Biologic Therapies in Stress Fractures: Current Concepts. J ISAKOS 2024:S2059-7754(24)00078-6. [PMID: 38631518 DOI: 10.1016/j.jisako.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024]
Abstract
Stress fractures, a common overuse injury in physically active individuals, present a significant challenge for athletes and military personnel. Patients who sustain stress fractures have demanding training regimes, where periods of rest and immobilisation have unacceptable negative consequences on sport goals and finances. Aside from being an overuse injury, there are various contributing risk factors that put certain individuals at risk of a stress fracture. The main two being nutritional deficiencies and hormonal variations which have significant effects on bone metabolism and turnover. Historically, treatment of stress fractures focused on conservative strategies such as rest and immobilisation. Calcium and vitamin D deficiencies have been closely linked to stress fractures and so over time supplementation has also played a role in treatment. With the introduction of biologics into orthopaedics, newer treatment strategies have been applied accelerate fracture healing and perhaps improve fracture callus quality. If such therapies can reduce, time spent away from sport and activity, it would be ideal for treating stress fractures. This article aims to offers insights into the evolving landscape of stress fracture management. It investigates the pre-clinical evidence and available published clinical applications. Though fracture healing is well understood, the role of biologics for fracture healing is still indeterminate. Available literature for the use of biologics therapies in stress fractures is restricted and most reports have used biologics as a supplement to surgical fixation in subjects in studies that lack control groups. Randomised control trials have been proposed and registered by a few groups with results awaited. Assessing individuals for risk factors, addressing hormonal imbalances and nutritional deficiencies seem an effective approach to addressing the burden of stress fractures. We await better designed trials and studies to accurately determine the clinical benefit of adding biologics to management of these injuries.
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Affiliation(s)
- George Jacob
- Department of Orthopaedic Surgery, Lakeshore Hospital, Cochin, India
| | - Kazunori Shimomura
- Department of Rehabilitation, Kansai University of Welfare Sciences, Osaka, Japan; Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norimasa Nakamura
- Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan; Global Centre for Medical Engineering and Informatics, Osaka University, Osaka, Japan.
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Strasser P, Fukumura S, Iwai R, Kanda S, Kawamura S, Kitaguchi M, Nishimura S, Seo S, Shimizu HM, Shimomura K, Tada H, Torii HA. Improved Measurements of Muonic Helium Ground-State Hyperfine Structure at a Near-Zero Magnetic Field. Phys Rev Lett 2023; 131:253003. [PMID: 38181354 DOI: 10.1103/physrevlett.131.253003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/12/2023] [Accepted: 11/15/2023] [Indexed: 01/07/2024]
Abstract
Muonic helium atom hyperfine structure (HFS) measurements are a sensitive tool to test the three-body atomic system and bound-state quantum electrodynamics theory, and determine fundamental constants of the negative muon magnetic moment and mass. The world's most intense pulsed negative muon beam at the Muon Science Facility of the Japan Proton Accelerator Research Complex allows improvement of previous measurements and testing further CPT invariance by comparing the magnetic moments and masses of positive and negative muons (second-generation leptons). We report new ground-state HFS measurements of muonic helium-4 atoms at a near-zero magnetic field, performed for the first time using a small admixture of CH_{4} as an electron donor to form neutral muonic helium atoms efficiently. Our analysis gives Δν=4464.980(20) MHz (4.5 ppm), which is more precise than both previous measurements at weak and high fields. The muonium ground-state HFS was also measured under the same conditions to investigate the isotopic effect on the frequency shift due to the gas density dependence in He with CH_{4} admixture and compared with previous studies. Muonium and muonic helium can be regarded as light and heavy hydrogen isotopes with an isotopic mass ratio of 36. No isotopic effect was observed within the current experimental precision.
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Affiliation(s)
- P Strasser
- Muon Science Laboratory, Institute of Materials Structure Science (IMSS), High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
- Muon Science Section, Materials and Life Science Division, J-PARC Center, 2-4 Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
- Materials Structure Science Program, Graduate Institute for Advanced Studies, SOKENDAI, 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - S Fukumura
- Department of Physics, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
| | - R Iwai
- Muon Science Laboratory, Institute of Materials Structure Science (IMSS), High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - S Kanda
- Muon Science Laboratory, Institute of Materials Structure Science (IMSS), High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
- Muon Science Section, Materials and Life Science Division, J-PARC Center, 2-4 Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
- Materials Structure Science Program, Graduate Institute for Advanced Studies, SOKENDAI, 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - S Kawamura
- Department of Physics, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
| | - M Kitaguchi
- Department of Physics, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
- Kobayashi-Maskawa Institute, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8602, Japan
| | - S Nishimura
- Muon Science Laboratory, Institute of Materials Structure Science (IMSS), High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
- Muon Science Section, Materials and Life Science Division, J-PARC Center, 2-4 Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
| | - S Seo
- Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro, Tokyo 153-8902, Japan
| | - H M Shimizu
- Department of Physics, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
| | - K Shimomura
- Muon Science Laboratory, Institute of Materials Structure Science (IMSS), High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
- Muon Science Section, Materials and Life Science Division, J-PARC Center, 2-4 Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
- Materials Structure Science Program, Graduate Institute for Advanced Studies, SOKENDAI, 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - H Tada
- Department of Physics, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
| | - H A Torii
- School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Ohtsuru T, Otsuji M, Nakanishi J, Nakamura N, Lyman S, Hanai H, Shimomura K, Ando W. Freeze-dried noncoagulating platelet-derived factor concentrate is a safe and effective treatment for early knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2023; 31:4716-4723. [PMID: 37380754 PMCID: PMC10598078 DOI: 10.1007/s00167-023-07414-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/02/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE While a wide variety of platelet-rich plasma (PRP) solutions has been developed, innovation continues. In this case, the freeze-dried platelet factor concentrate (PFC-FD) represents another step in PRP refinement. The preparation of PFC-FD at a central laboratory with freeze drying for shelf stabilization should provide additional quality improvements if clinical effectiveness can be demonstrated. Therefore, this study was undertaken to assess the safety and effectiveness of PFC-FD in a prospective open-label trial of patients suffering from knee osteoarthritis (OA). METHODS 312 consecutive knee OA patients (67% female, mean age 63 ± 10 years), were prospectively recruited in an outpatient knee clinic in Japan. Of these, 10 (3.2%) were lost to follow-up at < 12 months and 17 (5.5%) sought additional knee therapy during the follow-up period. The primary outcome of interest was achievement of the OMERACT-OARSI responder criteria with secondary outcomes of adverse events and PROMs scores 1, 3, 6, 12 months following a single PFC-FD injection. RESULTS 285 patients (91%) completed 12 month PROMs. The 17 who sought additional therapy were considered failures leaving an effective sample size of 302 for our primary outcome in which 62% of patients achieved OMERACT-OARSI responder status by 12 months. This varied by OA class with Kellgren-Lawrence grade 4 patients 3.6 times less likely to be responders than grade 1-2 patients. 6% of patients experienced a non-serious adverse event, primarily pain or swelling at the injection site. CONCLUSIONS PFC-FD provides an observable clinical improvement in 62% of knee OA patients at 12 months post-injection with very little risk of any clinically relevant adverse event. Of course, nearly 40% of patients did not experience an observable clinical improvement, primarily among those with worse KL grades. LEVEL OF EVIDENCE Therapeutic, Level II.
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Affiliation(s)
- Tadahiko Ohtsuru
- Omiya Knee Osteoarthritis Clinic, Saitama, Japan
- Department of Orthopedic Surgery, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Masaki Otsuji
- Yokohama Knee Osteoarthritis Clinic, Kanagawa, Japan
| | | | | | - Stephen Lyman
- Hospital for Special Surgery, New York, NY, USA
- Kyushu University School of Medicine, Fukuoka, Japan
| | - Hiroto Hanai
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazunori Shimomura
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Wataru Ando
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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Nakagawa S, Ando W, Shimomura K, Hart DA, Hanai H, Jacob G, Chijimatsu R, Yarimitu S, Fujie H, Okada S, Tsumaki N, Nakamura N. Repair of osteochondral defects: efficacy of a tissue-engineered hybrid implant containing both human MSC and human iPSC-cartilaginous particles. NPJ Regen Med 2023; 8:59. [PMID: 37857652 PMCID: PMC10587071 DOI: 10.1038/s41536-023-00335-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/09/2023] [Indexed: 10/21/2023] Open
Abstract
Both mesenchymal stromal cells (MSC) and induced pluripotent stem cells (iPSC) offer the potential for repair of damaged connective tissues. The use of hybrid implants containing both human MSC and iPSC was investigated to assess their combined potential to yield enhanced repair of osteochondral defects. Human iPSC-CP wrapped with tissue engineered constructs (TEC) containing human MSC attained secure defect filling with good integration to adjacent tissue in a rat osteochondral injury model. The presence of living MSC in the hybrid implants was required for effective biphasic osteochondral repair. Thus, the TEC component of such hybrid implants serves several critical functions including, adhesion to the defect site via the matrix and facilitation of the repair via live MSC, as well as enhanced angiogenesis and neovascularization. Based on these encouraging studies, such hybrid implants may offer an effective future intervention for repair of complex osteochondral defects.
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Affiliation(s)
- Shinichi Nakagawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - Wataru Ando
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan.
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, 660-8511, Japan.
| | - Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - David A Hart
- McCaig Institute for Bone and Joint Health, Department of Surgery and Faculty of Kinesiology, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Hiroto Hanai
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - George Jacob
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - Ryota Chijimatsu
- Department of Medical Data Science, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - Seido Yarimitu
- Department of Mechanical Systems Engineering, Faculty of Systems Design, Tokyo Metropolitan University, Hachioji, 192-0364, Japan
| | - Hiromichi Fujie
- Department of Mechanical Systems Engineering, Faculty of Systems Design, Tokyo Metropolitan University, Hachioji, 192-0364, Japan
| | - Seiji Okada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - Noriyuki Tsumaki
- Department of Clinical Application, Center for iPS Cell Research and Application, Kyoto University, Kyoto, 606-8507, Japan
- Department of Tissue Biochemistry, Graduate School of Medicine and Frontier Biosciences, Osaka University, Suita, 565-0871, Japan
| | - Norimasa Nakamura
- Institute for Medical Science in Sports, Osaka Health Science University, Osaka, 530-0043, Japan
- Center for Advanced Medical Engineering and Informatics, Osaka University, Suita, 565-0871, Japan
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Shimomura K, Ando W, Hart DA, Yonetani Y, Horibe S, Nakamura N. Five-Year Outcomes After Implantation of a Scaffold-Free Tissue-Engineered Construct Generated From Autologous Synovial Mesenchymal Stromal Cells for Repair of Knee Chondral Lesions. Orthop J Sports Med 2023; 11:23259671231189474. [PMID: 37564952 PMCID: PMC10411276 DOI: 10.1177/23259671231189474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/24/2023] [Indexed: 08/12/2023] Open
Abstract
Background In an earlier study, a scaffold-free tissue-engineered construct (TEC) derived from autologous synovial membrane mesenchymal stromal cells (MSCs) was developed and demonstrated to be safe and effective for cartilage repair at 2 years postoperatively. Purpose To investigate clinical outcomes and magnetic resonance imaging (MRI) findings at 5 years after implantation. Study Design Case series; Level of evidence, 4. Methods This was an observational first-in-human study limited to 5 patients (age, 28-46 years) with symptomatic knee chondral lesions (size, 1.5-3.0 cm2) on the medial femoral condyle, lateral femoral condyle, or femoral groove. Synovial MSCs were isolated from arthroscopic biopsy specimens and cultured to develop a TEC that matched the lesion size. The TECs were then implanted into chondral defects without fixation and assessed at up to 5 years postoperatively. The patients were clinically evaluated using the visual analog scale for pain, Lysholm score, Tegner score, and Knee injury and Osteoarthritis Outcome Score. An MRI scan evaluation was also performed for morphologic and compositional quality of the repair tissue at both 2 and 5 years of follow-up. Results All clinical scores were significantly improved from the preoperative evaluation to the 2- and 5-year follow-ups and the results were stable over time. The MRI scan evaluation showed cartilage defects filled with newly generated tissues with good tissue integration to adjacent host cartilage over time. The cartilage thickness and surface smoothness of the repair cartilage were maintained up to 5 years postoperatively. The MOCART (magnetic resonance observation of cartilage repair tissue) 2.0 Knee Scores remained high at 5 years, although the total points decreased slightly. Conclusion The results highlight the efficacy and feasibility of autologous scaffold-free TEC derived from synovial MSCs for regenerative cartilage repair via a sutureless and simple implantation procedure, showing good clinical outcomes and MRI findings with stable results at midterm follow-up. Further follow-up will be needed to assess the long-term quality of the repair tissue.
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Affiliation(s)
- Kazunori Shimomura
- Department of Rehabilitation, Kansai University of Welfare Sciences, Osaka, Japan
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Wataru Ando
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Hyogo, Japan
| | - David A. Hart
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
| | - Yasukazu Yonetani
- Department of Sports Orthopaedics, Hoshigaoka Medical Center, Osaka, Japan
| | - Shuji Horibe
- Department of Sports Orthopaedics, Seifu Hospital, Osaka, Japan
| | - Norimasa Nakamura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
- Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan
- Global Center for Medical Engineering and Informatics, Osaka University, Osaka, Japan
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Hanai H, Hart DA, Jacob G, Shimomura K, Ando W, Yoshioka Y, Ochiya T, Nakagawa S, Nakamura M, Okada S, Nakamura N. Small extracellular vesicles derived from human adipose-derived mesenchymal stromal cells cultured in a new chemically-defined contaminate-free media exhibit enhanced biological and therapeutic effects on human chondrocytes in vitro and in a mouse osteoarthritis model. J Extracell Vesicles 2023; 12:e12337. [PMID: 37367299 PMCID: PMC10295161 DOI: 10.1002/jev2.12337] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
Human small extracellular vesicles (sEVs) derived from adipose-derived mesenchymal stromal cells (ASC) have been reported to suppress the progression of osteoarthritis (OA) in animal studies and subsequently, translation of this potential to assess their clinical efficacy is anticipated. However, fabrication protocols for sEVs to eliminate potential contamination by culture medium-derived components need to be established prior to their clinical use. The purpose of the present studies was to elucidate the influence of medium-derived contaminants on the biological effects of sEVs, and to establish isolation methods for sEVs using a new clinical grade chemically-defined media (CDM). The quantity and purity of ASC-derived sEVs cultured in four different CDMs (CDM1, 2, 3 and 4) were evaluated. The concentrates of the four media incubated without cells were used as the background (BG) control for each set of sEVs. The biological effect of sEVs fabricated in the four different CDMs on normal human articular chondrocytes (hACs) were evaluated in vitro using a variety of methodological assessments. Finally, the sEVs with the highest purity were tested for their ability to suppress the progression of knee OA mouse model. Analysis of the BG controls revealed that CDM1-3 contained detectable particles, while there was no visible contamination of culture media-derived components detected with CDM4. Accordingly, the sEVs fabricated with CDM4 (CDM4-sEVs) exhibited the highest purity and yield. Notably, the CDM4-sEVs were the most efficient in promoting the cellular proliferation, migration, chondrogenic differentiation, and anti-apoptotic activity of hACs. Furthermore, CDM4-sEVs significantly suppressed the osteochondral degeneration in vivo model. Small EVs derived from ASCs cultured in a CDM without detectable contaminants demonstrated enhanced biological effects on hACs and the progression of OA. Thus, sEVs isolated with CDM4 most optimally meet the requirements of efficacy and safety for assessment in their future clinical applications.
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Affiliation(s)
- Hiroto Hanai
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - David A Hart
- Department of Surgery and the McCaig Institute for Bone & Joint Health, University of Calgary, Calgary, Canada
| | - George Jacob
- Department of Orthopaedics, VPS Lakeshore Hospital, Kerala, India
| | - Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Wataru Ando
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Hyogo, Japan
| | - Yusuke Yoshioka
- Department of Molecular and Cellular Medicine, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
| | - Takahiro Ochiya
- Department of Molecular and Cellular Medicine, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
| | - Shinicihi Nakagawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masato Nakamura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Seiji Okada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norimasa Nakamura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
- Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan
- Global Center for Medical Engineering and Informatics, Osaka University, Osaka, Japan
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Okumura T, Azuma T, Bennett DA, Chiu I, Doriese WB, Durkin MS, Fowler JW, Gard JD, Hashimoto T, Hayakawa R, Hilton GC, Ichinohe Y, Indelicato P, Isobe T, Kanda S, Katsuragawa M, Kawamura N, Kino Y, Mine K, Miyake Y, Morgan KM, Ninomiya K, Noda H, O'Neil GC, Okada S, Okutsu K, Paul N, Reintsema CD, Schmidt DR, Shimomura K, Strasser P, Suda H, Swetz DS, Takahashi T, Takeda S, Takeshita S, Tampo M, Tatsuno H, Ueno Y, Ullom JN, Watanabe S, Yamada S. Proof-of-Principle Experiment for Testing Strong-Field Quantum Electrodynamics with Exotic Atoms: High Precision X-Ray Spectroscopy of Muonic Neon. Phys Rev Lett 2023; 130:173001. [PMID: 37172243 DOI: 10.1103/physrevlett.130.173001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/10/2023] [Accepted: 03/10/2023] [Indexed: 05/14/2023]
Abstract
To test bound-state quantum electrodynamics (BSQED) in the strong-field regime, we have performed high precision x-ray spectroscopy of the 5g-4f and 5f- 4d transitions (BSQED contribution of 2.4 and 5.2 eV, respectively) of muonic neon atoms in the low-pressure gas phase without bound electrons. Muonic atoms have been recently proposed as an alternative to few-electron high-Z ions for BSQED tests by focusing on circular Rydberg states where nuclear contributions are negligibly small. We determined the 5g_{9/2}- 4f_{7/2} transition energy to be 6297.08±0.04(stat)±0.13(syst) eV using superconducting transition-edge sensor microcalorimeters (5.2-5.5 eV FWHM resolution), which agrees well with the most advanced BSQED theoretical prediction of 6297.26 eV.
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Affiliation(s)
- T Okumura
- Atomic, Molecular, and Optical Physics Laboratory, RIKEN, Wako 351-0198, Japan
| | - T Azuma
- Atomic, Molecular, and Optical Physics Laboratory, RIKEN, Wako 351-0198, Japan
| | - D A Bennett
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - I Chiu
- Institute for Radiation Sciences, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - W B Doriese
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - M S Durkin
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - J W Fowler
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - J D Gard
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - T Hashimoto
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai 319-1184, Japan
| | - R Hayakawa
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - G C Hilton
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - Y Ichinohe
- Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - P Indelicato
- Laboratoire Kastler Brossel, Sorbonne Université, CNRS, ENS-PSL Research University, Collège de France, Case 74, 4, place Jussieu, 75005 Paris, France
| | - T Isobe
- RIKEN Nishina Center, RIKEN, Wako 351-0198, Japan
| | - S Kanda
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - M Katsuragawa
- Kavli IPMU (WPI), The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - N Kawamura
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - Y Kino
- Department of Chemistry, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - K Mine
- Kavli IPMU (WPI), The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Miyake
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - K M Morgan
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
- Department of Physics, University of Colorado Boulder, Boulder, Colorado 80309, USA
| | - K Ninomiya
- Institute for Radiation Sciences, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - H Noda
- Department of Earth and Space Science, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - G C O'Neil
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - S Okada
- Engineering Science Laboratory, Chubu University, Kasugai, Aichi 487-8501, Japan
| | - K Okutsu
- Department of Chemistry, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - N Paul
- Laboratoire Kastler Brossel, Sorbonne Université, CNRS, ENS-PSL Research University, Collège de France, Case 74, 4, place Jussieu, 75005 Paris, France
| | - C D Reintsema
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - D R Schmidt
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - K Shimomura
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - P Strasser
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - H Suda
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - D S Swetz
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - T Takahashi
- Kavli IPMU (WPI), The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Takeda
- Kavli IPMU (WPI), The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Takeshita
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - M Tampo
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - H Tatsuno
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - Y Ueno
- Atomic, Molecular, and Optical Physics Laboratory, RIKEN, Wako 351-0198, Japan
| | - J N Ullom
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - S Watanabe
- Department of Space Astronomy and Astrophysics, Institute of Space and Astronautical Science (ISAS), Japan Aerospace Exploration Agency (JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - S Yamada
- Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
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Jingliang M, Wang K, Murahari P, Yokoyama K, Lord JS, Pratt FL, He J, Schulz L, Willis M, Anthony JE, Morley NA, Nuccio L, Misquitta A, Dunstan DJ, Shimomura K, Watanabe I, Zhang S, Heathcote P, Drew AJ. Reply to: On the observation of photo-excitation effects in molecules using muon spin spectroscopy. Nat Mater 2022; 21:1110. [PMID: 33972763 DOI: 10.1038/s41563-021-01003-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/01/2021] [Indexed: 06/12/2023]
Affiliation(s)
- M Jingliang
- School of Physics and Astronomy, Queen Mary University of London, London, UK
| | - K Wang
- School of Physics and Astronomy, Queen Mary University of London, London, UK
- College of Physical Sciences and Technology, Sichuan University, Chengdu, People's Republic of China
| | - P Murahari
- School of Physics and Astronomy, Queen Mary University of London, London, UK
| | - K Yokoyama
- School of Physics and Astronomy, Queen Mary University of London, London, UK
- ISIS Muon Facility, Rutherford Appleton Laboratory, Didcot, UK
| | - J S Lord
- ISIS Muon Facility, Rutherford Appleton Laboratory, Didcot, UK
| | - F L Pratt
- ISIS Muon Facility, Rutherford Appleton Laboratory, Didcot, UK
| | - J He
- College of Physical Sciences and Technology, Sichuan University, Chengdu, People's Republic of China
| | - L Schulz
- College of Physical Sciences and Technology, Sichuan University, Chengdu, People's Republic of China
| | - M Willis
- College of Physical Sciences and Technology, Sichuan University, Chengdu, People's Republic of China
| | - J E Anthony
- Department of Chemistry, University of Kentucky, Lexington, KY, USA
| | - N A Morley
- Department of Materials Science and Engineering, University of Sheffield, Sheffield, UK
| | - L Nuccio
- Department of Physics, University of Fribourg, Fribourg, Switzerland
| | - A Misquitta
- School of Physics and Astronomy, Queen Mary University of London, London, UK
| | - D J Dunstan
- School of Physics and Astronomy, Queen Mary University of London, London, UK
| | - K Shimomura
- Materials and Life Science Division, J-PARC Center, Tokai, Japan
| | | | - S Zhang
- College of Physical Sciences and Technology, Sichuan University, Chengdu, People's Republic of China
| | - P Heathcote
- School of Biological and Chemical Sciences, Queen Mary University of London, London, UK.
| | - A J Drew
- School of Physics and Astronomy, Queen Mary University of London, London, UK.
- College of Physical Sciences and Technology, Sichuan University, Chengdu, People's Republic of China.
- ISIS Muon Facility, Rutherford Appleton Laboratory, Didcot, UK.
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9
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Yokota N, Lyman S, Hanai H, Shimomura K, Ando W, Nakamura N. Clinical Safety and Effectiveness of Adipose-Derived Stromal Cell vs Stromal Vascular Fraction Injection for Treatment of Knee Osteoarthritis: 2-Year Results of Parallel Single-Arm Trials. Am J Sports Med 2022; 50:2659-2668. [PMID: 35834970 DOI: 10.1177/03635465221107364] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND There are currently no disease-modifying treatments available for knee osteoarthritis (OA), although cultured adipose-derived stromal cells (ASCs) have shown promise in experimental models. However, given the regulatory limits on the use of cultured cells in humans, previous trials have focused primarily on the stromal vascular fraction (SVF) intra-articular injection. Therefore, the therapeutic value of ASCs for knee OA remains unknown. PURPOSE To study ASC versus SVF intra-articular injection in patients with Kellgren-Lawrence (KL) knee OA grades 2 to 4 in parallel single-arm trials. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS A total of 80 patients were enrolled, with 42 (72 knees) receiving ASC intra-articular injection and 38 (69 knees) receiving SVF. Patient-reported outcome measures were assessed at 1, 3, 6, 12, and 24 months using the Knee injury and Osteoarthritis Outcome Score 5 (KOOS5) and pain visual analog scale (VAS). The percentages of patients achieving the minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) were also calculated. Per protocol, a subset of the ASC group received an ASC booster injection after 6 months. A repeated-measures analysis of variance compared results between treatment arms and by KL grade over time. RESULTS Patient-reported outcome measures improved substantially after both treatments (P < .05 at all time points), with the ASC group more likely to achieve the MCID (50% vs 24%; P = .01) and PASS (45% vs 24%; P = .04) for the pain VAS and the MCID (43% vs 16%; P = .02) for the KOOS5 at 12 months, although not at 24 months. Knees treated with ASC for KL grade 2/3 OA had significantly superior outcomes compared with those with KL grade 4 OA for the KOOS5 (P = .01) and pain VAS (P = .03), but no such difference was observed in knees treated with SVF. Three patients receiving ASCs (7%; all KL grade 3) sought additional nonoperative treatment by 24 months versus 9 patients receiving SVF (24%; all KL grade 3) (P = .06). ASC booster injections conferred no additional benefit. Notably, patients in the ASC cohort reported more injection-site pain and swelling after the booster injection than after the initial injection (P < .01). CONCLUSION This represents the first head-to-head comparison of ASCs and SVF for the treatment of knee OA in humans. ASC and SVF injections both substantially improved knee pain and function at all follow-up time points, although ASC injections demonstrated significantly better improvements with regard to the MCID and PASS for the pain VAS and the MCID for the KOOS5 at 12 months. There appears to be no benefit to a booster ASC injection after initial treatment. Given less donor-site morbidity and equivalent superior outcomes at 2 years, the use of ASCs over SVF in the treatment of knee OA may be warranted.
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Affiliation(s)
| | - Stephen Lyman
- Hospital for Special Surgery, New York, New York, USA.,School of Medicine, Kyushu University, Fukuoka, Japan
| | - Hiroto Hanai
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kazunori Shimomura
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Wataru Ando
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
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10
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Morii Y, Senaha H, Matsui S, Okawa K, Tsubaki M, Matzno S, Shimomura K, Nishida S. [Efficacy of a Dexamethasone Dose Escalation Regimen with a Cumulative Dose for Preventing Oxaliplatin Hypersensitivity Reactions]. Gan To Kagaku Ryoho 2022; 49:769-773. [PMID: 35851348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Oxaliplatin is a platinum complex antineoplastic agent widely used for chemotherapy of colorectal cancer. However, one of its side effects is hypersensitivity reactions, the incidence of which increases with a cumulative dose, thereby posing a difficulty to continue oxaliplatin use. Our hospital changed the premedication of oxaliplatin in August 2009 and September 2012. We retrospectively investigated the usefulness of these premedication changes. The results showed no significant difference in the incidence of hypersensitivity between the control group(12.1%)and the group receiving H1 and H2-blockers (12.3%); however, the incidence of hypersensitivity was significantly reduced in the group receiving increased dexamethasone based on the number of courses(2.7%). Therefore, our regimen was found to be effective in preventing hypersensitivity reactions to oxaliplatin.
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11
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Tanaka A, Tsujii A, Shimomura K, Yonetani Y, Hamada M. Two Uncommon Complications Related to Suture Knots After Meniscal All-Inside Suture Repair: A Case Report. JBJS Case Connect 2022; 12:01709767-202209000-00028. [PMID: 36040073 DOI: 10.2106/jbjs.cc.22.00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CASE A 17-year-old male patient suffered a radial lateral meniscus tear and underwent an arthroscopic all-inside suture repair. After 7 months, the patient experienced catching. Magnetic resonance imaging and computed tomography revealed an intra-articular loose body without calcification, which was removed surgically. The excised specimen was histopathologically confirmed to be a necrotic meniscus fragment with a suture knot. In addition, cartilage damage because of suspected impingement by a residual suture knot was observed. After removing the loose body and knot, the patient's symptoms were relieved, and he returned to sports. CONCLUSION Suture knot-related complications should be considered while performing meniscal repairs.
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Affiliation(s)
- Ayaka Tanaka
- Department of Orthopaedic Surgery, Japan Community Health Care Organization Hoshigaoka Medical Center, Osaka, Japan
| | - Akira Tsujii
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazunori Shimomura
- Department of Orthopaedic Surgery, Japan Community Health Care Organization Hoshigaoka Medical Center, Osaka, Japan
| | - Yasukazu Yonetani
- Department of Orthopaedic Surgery, Japan Community Health Care Organization Hoshigaoka Medical Center, Osaka, Japan
| | - Masayuki Hamada
- Department of Orthopaedic Surgery, Japan Community Health Care Organization Hoshigaoka Medical Center, Osaka, Japan
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12
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Fernandes TL, Bueno DF, Shimomura K, Shao Z, Gomoll AH. Editorial: Tissue Engineering and Cell Therapy for Cartilage Restoration. Front Cell Dev Biol 2022; 10:947588. [PMID: 35846365 PMCID: PMC9284499 DOI: 10.3389/fcell.2022.947588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/06/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Tiago Lazzaretti Fernandes
- Sports Medicine Division, Institute of Orthopedics and Traumatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Hospital Sírio-Libanês, São Paulo, Brazil
- *Correspondence: Tiago Lazzaretti Fernandes,
| | | | - Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Zhenxing Shao
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Andreas H. Gomoll
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, United States
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13
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Kinugasa K, Shimomura K, Tachibana Y, Hiramatsu K, Horibe S, Shino K, Tanaka Y. Posterior Ankle Impingement Caused by Hyaline-Like Cartilage Generation in Ballet Dancers-A Report of 2 Cases. J Foot Ankle Surg 2022; 61:e9-e14. [PMID: 34801380 DOI: 10.1053/j.jfas.2021.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 04/03/2020] [Accepted: 10/11/2021] [Indexed: 02/03/2023]
Abstract
Posterior ankle impingement syndrome is mainly seen in ballet dancers and frequently associated with specific movements in ballet such as pointe and demi pointe in which the whole-body weight is applied to the maximally plantar flexed ankle. We performed arthroscopic debridement for 2 dedicated ballet dancers on the intervening soft tissue causing posterior ankle impingement syndrome (PAIS). In both cases, T2-weighted magnetic resonance imaging (MRI) revealed low-signal intensity of meniscus-like soft tissue without abnormal osseous findings, connecting from the posterior side of the talus to Kager's fat pad. To examine the intervening soft tissue in detail, we performed histological evaluation by hematoxylin and eosin staining, Safranin O fast green staining, and immunohistochemistry for type I collagen and type II collagen. Hematoxylin and eosin staining showed that there was cartilage-like tissue including chondrocyte-like cells in contact with fibrous tissue. The extracellular matrix in the cartilage zone was consistently stained by Safranin O staining and type II collagen without any staining with type I collagen. These findings suggested that the meniscus-like soft tissue appearing as low-signal intensity on MRI at the posterior side of talus included hyaline-like cartilage. To the extent of our knowledge, these were rare cases of hyaline-like cartilage generation causing PAIS in ballet dancers, which might be associated with ballet specific movements resulting in chondrogenesis.
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Affiliation(s)
- Kazutaka Kinugasa
- Department of Orthopaedic Sports Medicine, Osaka Rosai Hospital, Sakai, Osaka, Japan.
| | - Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yuta Tachibana
- Department of Orthopaedic Sports Medicine, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Kunihiko Hiramatsu
- Department of Orthopaedic Surgery, Tamai Orthopaedic Hospital, Hannan, Osaka, Japan
| | - Shuji Horibe
- Faculty of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino, Osaka, Japan
| | - Konsei Shino
- Department of Sports Orthopaedics, Yukioka Hospital, Kita-ku, Osaka, Osaka, Japan
| | - Yoshinari Tanaka
- Department of Orthopaedic Sports Medicine, Osaka Rosai Hospital, Sakai, Osaka, Japan
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14
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Morii Y, Fujimoto S, Nakahara R, Okawa K, Senaha H, Fujiwara K, Tsubaki M, Matzno S, Takegami M, Shimomura K, Nishida S. Effect of proton pump inhibitors on the development of hypomagnesemia induced by panitumumab. Pharmazie 2022; 77:81-84. [PMID: 35209968 DOI: 10.1691/ph.2022.1988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Panitumumab, a therapeutic agent for unresectable advanced/recurrent colorectal cancer, is a human IgG2 monoclonal antibody that binds to and inhibits the activity of the epidermal growth factor receptor (EGFR). The onset of hypomagnesemia is a known side effect of anti-EGFR inhibitors, including panitumumab, and it is thought that inhibition of reabsorption of Mg in renal tubules is one of the causes. In addition, recent reports have shown that long-term administration of proton pump inhibitors (PPIs) reduces serum magnesium levels. Therefore, in this study, 102 patients who received oral PPIs treated with panitumumab were classified into a PPI combination group and a PPI non-combination group, and the effect of PPIs on the development of grade 2 or higher hypomagnesemia was investigated. The incidence of hypomagnesemia in the PPI combination group (46.9%, 15/32) was higher than that in the PPI non-combination group (25.7%, 18/70). A comparison of the backgrounds of the two groups of patients showed a significant difference in serum albumin levels. PPI administration was significantly associated with panitumumab-induced hypomagnesemia development when adjusted for known risk factors, serum albumin level, renal function, and oral magnesium oxide tablets in Cox proportional hazards regression analysis (hazard ratio 2.09; 95% confidence interval 1.03-4.22; P =0.040). These results indicate that detailed monitoring of serum magnesium levels is recommended for patients treated with panitumumab and co-administration of PPIs.
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Affiliation(s)
- Y Morii
- Department of Pharmacy, Ikeda City Hospital, Osaka, Japan; Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Osaka, Japan
| | - S Fujimoto
- Department of Pharmacy, Kindai University Hospital, Osaka, Japan
| | - R Nakahara
- Department of Pharmacy, Kindai University Hospital, Osaka, Japan
| | - K Okawa
- Department of Pharmacy, Ikeda City Hospital, Osaka, Japan
| | - H Senaha
- Department of Pharmacy, Ikeda City Hospital, Osaka, Japan
| | - K Fujiwara
- Department of Pharmacy, Kindai University Hospital, Osaka, Japan
| | - M Tsubaki
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Osaka, Japan
| | - S Matzno
- Division of Pharmaceutical Education, Kindai University Faculty of Pharmacy, Osaka, Japan
| | - M Takegami
- Department of Pharmacy, Kindai University Hospital, Osaka, Japan
| | - K Shimomura
- Department of Pharmacy, Ikeda City Hospital, Osaka, Japan
| | - S Nishida
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Osaka, Japan;,
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15
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Shimomura K, Hamada H, Hart DA, Ando W, Nishii T, Trattnig S, Nehrer S, Nakamura N. Histological Analysis of Cartilage Defects Repaired with an Autologous Human Stem Cell Construct 48 Weeks Postimplantation Reveals Structural Details Not Detected by T2-Mapping MRI. Cartilage 2021; 13:694S-706S. [PMID: 33511856 PMCID: PMC8808920 DOI: 10.1177/1947603521989423] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to elucidate the efficacy of T2-mapping MRI and correlation with histology for the evaluation of tissue repair quality following the first-in-human implantation of an autologous tissue engineered construct. DESIGN We directly compared the results of T2-mapping MRI of cartilage repair tissue with the histology of a biopsy specimen from the corresponding area at 48 weeks postoperatively in 5 patients who underwent the implantation of a scaffold-free tissue-engineered construct generated from autologous synovial mesenchymal stem cells to repair an isolated cartilage lesion. T2 values and histological scores were compared at each of 2 layers of equally divided halves of the repair tissue (upper and lower zones). RESULTS Histology showed that the repair tissue in the upper zone was dominated by fibrous tissue and the ratio of hyaline-like matrix increased with the depth of the repair tissue. There were significant differences between upper and lower zones in histological scores. Conversely, there were no detectable statistically significant differences in T2 value detected among zones of the repair tissue, but zonal differences were detected in corresponding healthy cartilage. Accordingly, there were no correlations detected between histological scores and T2 values for each repair cartilage zone. CONCLUSION Discrepancies in the findings between T2 mapping and histology suggest that T2 mapping was limited in ability to detect details in the architecture and composition of the repair cartilage.
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Affiliation(s)
- Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka
University Graduate School of Medicine, Osaka, Japan
| | - Hidetoshi Hamada
- Department of Orthopaedic Medical
Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - David A. Hart
- McCaig Institute for Bone & Joint
Health, University of Calgary, Calgary, Alberta, Canada
| | - Wataru Ando
- Department of Orthopaedic Medical
Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Nishii
- Department of Orthopaedic Surgery, Osaka
General Medical Center, Osaka, Japan
| | - Siegfried Trattnig
- High Field MR Center, Department of
Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna,
Austria,Christian Doppler Laboratory for
Clinical Molecular MR Imaging (MOLIMA), Department of Biomedical Imaging and
Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Stefan Nehrer
- Faculty of Health and Medicine,
Department for Health Sciences, Medicine and Research, Center for Regenerative
Medicine, Danube University Krems, Krems, Austria
| | - Norimasa Nakamura
- Department of Orthopaedic Surgery, Osaka
University Graduate School of Medicine, Osaka, Japan,Institute for Medical Science in Sports,
Osaka Health Science University, Osaka, Japan,Global Center for Medical Engineering
and Informatics, Osaka University, Osaka, Japan,Norimasa Nakamura, Institute for Medical
Science in Sports, Osaka Health Science University, 1-9-27, Tenma, Kita-ku,
Osaka City, Osaka, 530-0043, Japan.
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16
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Mae T, Shimomura K, Ohori T, Hirose T, Taketomi S, Suzuki T, Nakata K. Suture Slippage During Anterior Cruciate Ligament Graft Passage Is Significantly Lower Using a Krackow Suture. Arthrosc Sports Med Rehabil 2021; 3:e1337-e1341. [PMID: 34712971 PMCID: PMC8527264 DOI: 10.1016/j.asmr.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose To compare the suture slippage on a hamstring tendon graft prepared with a modified finger-trap device (SPEEDTRAP) with one prepared with Krackow stitch during graft passage through the tibial tunnel in ACL reconstruction. Methods Thirty-eight patients underwent anatomic triple-bundle anterior cruciate ligament reconstruction with 2 femoral and 3 tibial tunnels. After semitendinosus tendon was cut in half to make 2 grafts, the free ends of the proximal membranous portion (posterolateral [PL] graft) were prepared together with 2 sutures: (1) one SPEEDTRAP and one Krackow stitch for 20 cases (group A) and (2) double Krackow stitches on both sides for 18 cases (group B). Then, the PL graft was dye-marked at the proximal suture of SPEEDTRAP in group A and Krackow suture in group B and was inserted into the joint via tibial tunnel ahead of the loop side. The distance between the mark on the graft and the proximal suture of SPEEDTRAP or Krackow stitch was measured under arthroscopy after graft fixation at femur. Slippage was defined as 1 mm and more of distance between the mark and the proximal suture. Results Slippage was observed in 16 cases for SPEEDTRAP and in 2 for Krackow suture in group A, whereas one case showed slippage in group B. The slippage distance was 4.0 ± 2.9 mm for SPEEDTRAP and 0.2 ± 0.5 mm for Krackow stitch in group A (P < .001), whereas it was 0.1 ± 0.2 mm for double Krackow stitch in group B, showing a significant difference from SPEEDTRAP suture (P < .001). Conclusions At the time of PL graft passage through the tibial tunnel in anterior cruciate ligament reconstruction, there was significantly less slippage observed with the Krackow stitch compared with the SPEEDTRAP stitch. Level of Evidence Level IV, therapeutic case series.
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Affiliation(s)
- Tatsuo Mae
- Department of Sports Medical Biomechanics, Osaka University Graduate School of Medicine, Osaka
| | - Kazunori Shimomura
- Department of Orthopaedics Surgery, Osaka University Graduate School of Medicine, Osaka
| | - Tomoki Ohori
- Department of Orthopaedics Surgery, Osaka University Graduate School of Medicine, Osaka
| | - Takehiko Hirose
- Department of Orthopaedics Surgery, Osaka University Graduate School of Medicine, Osaka
| | - Shuji Taketomi
- Department of Orthopaedic Surgery, The University of Tokyo, Tokyo
| | - Tomoyuki Suzuki
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo
| | - Ken Nakata
- Department of Sports and Performing Arts, Osaka University Graduate School of Medicine, Osaka, Japan
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Katano S, Yano T, Ohori K, Kouzu H, Nagaoka R, Honma S, Shimomura K, Numazawa R, Koyama M, Nagano N, Fujito T, Nishikawa R, Hashimoto A, Katayose M, Miura T. Barthel Index score predicts mortality in elderly heart failure: a goal of comprehensive cardiac rehabilitation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Accurate prediction of mortality in heart failure (HF) patients is crucial for decision-making regarding HF therapies, but a strategy for the prediction of mortality in elderly HF patients has not been established. In addition, although favorable effects of comprehensive cardiac rehabilitation (CR) on clinical outcomes and functional status in HF patients have been demonstrated, a goal of comprehensive CR during hospitalization for reducing mortality remains unclear.
Aims
We examined whether assessment of basic activities of daily living (ADL) by the Barthel Index (BI), the most widely used tool for assessment of basic ADL, is useful for predicting all-cause mortality in elderly HF patients who received comprehensive CR.
Methods
This study was a single-center, retrospective and observational study. We retrospectively examined 413 HF patients aged ≥65 years (mean age, 78±7 years; 50% female) who were admitted to our institute for management of HF and received comprehensive CR during hospitalization. Functional status for performing basic ADL ability was assessed by the BI within 3 days before discharge. The clinical endpoint was all-cause death during the follow-up period.
Results
Of 413 HF patients, 116 patients (28%) died during a follow-up period of median 1.90-years (interquartile range, 1.20–3.23 years). Results of an adjusted dose-dependent association analysis showed that the hazard ratio (HR) of mortality increases in an almost linear fashion as the BI score decreases and that the BI score corresponding the hazard ratio of 1.0 is 85 (Figure A). To minimize the differences in potential confounding factors between patient with low BI (<85) and patients with high BI (≥85), inverse probability treatment weighting (IPTW) was calculated using propensity score. Kaplan-Meier survival curves, in which selection bias was minimized by use of IPTW for confounders, showed that patients with low BI (<85) had a higher mortality rate than did patients with high BI (≥85) (Figure B). In multivariate Cox regression analyses, low BI was independently associated with higher mortality after adjustment for predictors including brain natriuretic peptide and prior HF hospitalization (IPTW-adjusted HR, 1.75 [95% confidence interval, 1.03–2.98], p<0.001). Inclusion of the BI into the adjustment model improved the accuracy of prediction of mortality (continuous net reclassification improvement, 0.292, p=0.008; integrated discrimination improvement, 0.017, p=0.022).
Conclusion
A BI score of <85 at the time of discharge is associated with increased mortality independently of known prognostic markers, and achievement of functional status of a BI score ≥85 by comprehensive CR during hospitalization may contribute to a favorable outcome in elderly HF patients.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): the Japan Society for the Promotion of Science
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Affiliation(s)
- S Katano
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - T Yano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - K Ohori
- Hokkaido Cardiovascular Hospital, Department of Cardiology, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - R Nagaoka
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - S Honma
- Sapporo Cardiovascular Hospital, Department of Rehabilitation, Sapporo, Japan
| | - K Shimomura
- Hakodate Goryoukaku Hospital, Department of Rehabilitation, Hakodate, Japan
| | - R Numazawa
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - M Koyama
- Sapporo Medical University, Department of Public Health, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Fujito
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - R Nishikawa
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Hashimoto
- Sapporo Medical University, Division of Health Care Administration and Management, Sapporo, Japan
| | - M Katayose
- Sapporo Medical University, Second Division of Physical Therapy, Sapporo, Japan
| | - T Miura
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
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Shimomura K, Minatogawa H, Mashiko T, Arioka H, Iihara H, Sugawara M, Hida N, Akiyama K, Nawata S, Tsuboya A, Mishima K, Izawa N, Miyaji T, Honda K, Inada Y, Ohno Y, Katada C, Morita H, Yamaguchi T, Nakajima T. LBA63 Placebo-controlled, double-blinded phase Ⅲ study comparing dexamethasone on day 1 with dexamethasone on days 1 to 4, with combined neurokinin-1 receptor antagonist, palonosetron, and olanzapine in patients receiving cisplatin-containing highly emetogenic chemotherapy: SPARED trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Okumura T, Azuma T, Bennett DA, Caradonna P, Chiu I, Doriese WB, Durkin MS, Fowler JW, Gard JD, Hashimoto T, Hayakawa R, Hilton GC, Ichinohe Y, Indelicato P, Isobe T, Kanda S, Kato D, Katsuragawa M, Kawamura N, Kino Y, Kubo MK, Mine K, Miyake Y, Morgan KM, Ninomiya K, Noda H, O'Neil GC, Okada S, Okutsu K, Osawa T, Paul N, Reintsema CD, Schmidt DR, Shimomura K, Strasser P, Suda H, Swetz DS, Takahashi T, Takeda S, Takeshita S, Tampo M, Tatsuno H, Tong XM, Ueno Y, Ullom JN, Watanabe S, Yamada S. Deexcitation Dynamics of Muonic Atoms Revealed by High-Precision Spectroscopy of Electronic K X Rays. Phys Rev Lett 2021; 127:053001. [PMID: 34397250 DOI: 10.1103/physrevlett.127.053001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/11/2021] [Indexed: 06/13/2023]
Abstract
We observed electronic K x rays emitted from muonic iron atoms using superconducting transition-edge sensor microcalorimeters. The energy resolution of 5.2 eV in FWHM allowed us to observe the asymmetric broad profile of the electronic characteristic Kα and Kβ x rays together with the hypersatellite K^{h}α x rays around 6 keV. This signature reflects the time-dependent screening of the nuclear charge by the negative muon and the L-shell electrons, accompanied by electron side feeding. Assisted by a simulation, these data clearly reveal the electronic K- and L-shell hole production and their temporal evolution on the 10-20 fs scale during the muon cascade process.
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Affiliation(s)
- T Okumura
- Atomic, Molecular and Optical Physics Laboratory, RIKEN, Wako 351-0198, Japan
| | - T Azuma
- Atomic, Molecular and Optical Physics Laboratory, RIKEN, Wako 351-0198, Japan
| | - D A Bennett
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - P Caradonna
- Kavli IPMU (WPI), The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - I Chiu
- Department of Chemistry, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - W B Doriese
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - M S Durkin
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - J W Fowler
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - J D Gard
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - T Hashimoto
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai 319-1184, Japan
| | - R Hayakawa
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - G C Hilton
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - Y Ichinohe
- Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - P Indelicato
- Laboratoire Kastler Brossel, Sorbonne Université, CNRS, ENS-PSL Research University, Collège de France, Case 74, 4, place Jussieu, 75005 Paris, France
| | - T Isobe
- RIKEN Nishina Center, RIKEN, Wako 351-0198, Japan
| | - S Kanda
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - D Kato
- National Institute for Fusion Science (NIFS), Toki, Gifu 509-5292, Japan
| | - M Katsuragawa
- Kavli IPMU (WPI), The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - N Kawamura
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - Y Kino
- Department of Chemistry, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - M K Kubo
- Department of Natural Sciences, College of Liberal Arts, International Christian University, Mitaka, Tokyo 181-8585, Japan
| | - K Mine
- Kavli IPMU (WPI), The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Miyake
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - K M Morgan
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - K Ninomiya
- Department of Chemistry, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - H Noda
- Department of Earth and Space Science, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - G C O'Neil
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - S Okada
- Atomic, Molecular and Optical Physics Laboratory, RIKEN, Wako 351-0198, Japan
| | - K Okutsu
- Department of Chemistry, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - T Osawa
- Materials Sciences Research Center (MSRC), Japan Atomic Energy Agency (JAEA), Tokai 319-1184, Japan
| | - N Paul
- Laboratoire Kastler Brossel, Sorbonne Université, CNRS, ENS-PSL Research University, Collège de France, Case 74, 4, place Jussieu, 75005 Paris, France
| | - C D Reintsema
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - D R Schmidt
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - K Shimomura
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - P Strasser
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - H Suda
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - D S Swetz
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - T Takahashi
- Kavli IPMU (WPI), The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Takeda
- Kavli IPMU (WPI), The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Takeshita
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - M Tampo
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - H Tatsuno
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - X M Tong
- Center for Computational Sciences, University of Tsukuba, Tsukuba, Ibaraki 305-8573, Japan
| | - Y Ueno
- Atomic, Molecular and Optical Physics Laboratory, RIKEN, Wako 351-0198, Japan
| | - J N Ullom
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - S Watanabe
- Department of Space Astronomy and Astrophysics, Institute of Space and Astronautical Science (ISAS), Japan Aerospace Exploration Agency (JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - S Yamada
- Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
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20
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Morimoto S, Iseki T, Nakayama H, Shimomura K, Nishikawa T, Nakamura N, Tachibana T. Return to the original sport at only 3 months after an Achilles tendon rupture by a combination of intra-tissue injection of freeze-dried platelet-derived factor concentrate and excessively early rehabilitation after operative treatment in a male basketball player: A case report. Regen Ther 2021; 18:112-116. [PMID: 34141835 PMCID: PMC8178092 DOI: 10.1016/j.reth.2021.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/13/2021] [Accepted: 05/15/2021] [Indexed: 12/12/2022] Open
Abstract
Background Achilles tendon rupture is one of the most common serious injuries in athletes. Various studies to accelerate the healing process of the Achilles tendon have been performed as it takes a longer time to repair the tissue compared to other tendons. Here, we report a case of an acute Achilles tendon rupture in a male basketball player treated by a combination of an intra-tissue injection of freeze-dried platelet-derived factor concentrate, which included a platelet-derived growth factor with an early rehabilitation protocol after the operative treatment to facilitate the biological healing of the injured tendon tissue. To the best of our knowledge, this case is the first instance that enabled the athlete to return to original sport activity at only 3-months after the injury. Case report A 23-year-old male basketball player who belonged to a university basketball team sustained an Achilles tendon rupture during running in a training match. The remaining time period until the final tournament of the university league as a senior player was only 3 months. The patient received a combination of an intra-tissue injection of freeze-dried platelet-derived factor concentrate and early rehabilitation protocol after operative treatment. Surgery was performed 4 days after the injury and the early rehabilitation protocols were applied postoperatively. A freeze-dried platelet-derived factor concentrate was injected into the ruptured site of the Achilles tendon under ultrasound guide at 4 weeks postoperatively. The patient could return to play at the pre-injury level without any symptoms and disfunctions at 3 months after surgery. At two years postoperatively, the patient could play basketball without symptoms or rerupture. Conclusions We reported a case of an Achilles tendon rupture which was treated by a combination of intra-tissue injection of freeze-dried platelet-derived factor concentrate and an early rehabilitation protocol after the operative treatment. The patient could return to play basketball at the pre-injury activity level at only 3-months after the injury, suggesting that the role of applying excessively early rehabilitation of mechanical loading could facilitate tendon tissue healing when combined with an intra-tissue injection of freeze-dried platelet-derived factor concentrate. FD-PFC has rich growth factors such as PDGF-BB, which is a part of the PDGF growth family. An achilles tendon rupture was treated by a combination of injection of FD-PFC and excessively postoperative rehabilitation. The patient could return to play basketball at the pre-injury activity level at only 3-months after the injury.
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Key Words
- ATRs, Achilles tendon ruptures
- Achilles tendon rupture
- Early rehabilitation
- FD-PFC, Freeze-dried platelet-derived factor concentrate
- Freeze-dried platelet-derived factor concentrate
- IGF, Insulin growth factor
- MRI, Magnetic resonance imaging
- Operative treatment
- PDGF, Platelet-derived growth factor
- PRP, Plate-rich plasma
- Platelet-derived growth factor
- Platelet-rich plasma
- T2-STIR, T2 weighted short tau inversion recovery
- TGF-β, Transforming growth factor-β
- VEGF, Vascular endothelial growth factor
- b-FGF, Basic fibroblastic growth factor
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Affiliation(s)
- Shota Morimoto
- Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya City, Hyogo, 663-8501, Japan
| | - Tomoya Iseki
- Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya City, Hyogo, 663-8501, Japan
| | - Hiroshi Nakayama
- Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya City, Hyogo, 663-8501, Japan
| | - Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tetsuo Nishikawa
- Nishikawa Orthopaedics and Rehabilitation Clinic, 1-1-4, Souhon-machi, Amagasaki City, Hyogo, 661-0031, Japan
| | - Norimasa Nakamura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.,Institute for Medical Science in Sports, Osaka Health Science University, 1-9-27, Tenma, Kita-ku, Osaka City, Osaka, 530-0043, Japan.,Global Centre for Medical Engineering and Informatics, Osaka University, 2-2, Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Toshiya Tachibana
- Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya City, Hyogo, 663-8501, Japan
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21
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Morii Y, Tsubaki M, Takeda T, Otubo R, Seki S, Yamatomo Y, Imano M, Satou T, Shimomura K, Nishida S. Perifosine enhances the potential antitumor effect of 5-fluorourasil and oxaliplatin in colon cancer cells harboring the PIK3CA mutation. Eur J Pharmacol 2021; 898:173957. [PMID: 33662352 DOI: 10.1016/j.ejphar.2021.173957] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 02/13/2021] [Accepted: 02/15/2021] [Indexed: 12/25/2022]
Abstract
Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutation in colon cancer contributes to the poor prognosis of the disease and chemoresistance of tumors. New therapies are needed; however, the lack of knowledge of the mechanism of chemoresistance has hindered progress. In this study, we investigated the mechanism of the reduced sensitivity of colon cancer cells to 5-fluorouracil (5-FU) and oxaliplatin (L-OHP), and the effects of perifosine, an Akt inhibitor that enhances the cytotoxicity of 5-FU and L-OHP in colon cancer cells harboring the PIK3CA mutation. The use of 5-FU or L-OHP alone or in combination induced significant death of Caco-2 cells (PIK3CA wild type), but only weakly decreased the viability of DLD-1 and SW948 cells harboring the PIK3CA mutation. The use of 5-FU and L-OHP, either alone or in combination, strongly suppressed Akt activation, Survivin, Bcl-2, and Bcl-xL expression, and enhanced Puma, phospho-p53, and p53 expression in Caco-2 cells than in DLD-1 cells. In addition, perifosine enhanced the cytotoxicity of the 5-FU and L-OHP combination, inhibited Akt activation and the expression of Survivin, Bcl-2, and Bcl-xL, and increased the expression of Puma, phospho-p53, and p53 in DLD-1 cells. These results indicate that PIK3CA mutation contributes to reduced sensitivity to 5-FU and L-OHP via Akt activation in colon cancer cells. Perifosine increases the efficacy of 5-FU and L-OHP by suppressing Akt activation. Thus, the use of an Akt inhibitor in combination with 5-FU and L-OHP may be beneficial in colon cancer with cells harboring the PIK3CA mutation.
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Affiliation(s)
- Yusuke Morii
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka, Japan; Department of Phamacy, Municipal Ikeda Hospital, Japan
| | - Masanobu Tsubaki
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka, Japan
| | - Tomoya Takeda
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka, Japan
| | - Rie Otubo
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka, Japan
| | - Shiori Seki
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka, Japan
| | - Yuta Yamatomo
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka, Japan
| | - Motohiro Imano
- Department of Surgery, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
| | - Takao Satou
- Department of Phamacy, Municipal Ikeda Hospital, Japan; Department of Pathology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
| | | | - Shozo Nishida
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka, Japan.
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22
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Tsubaki M, Genno S, Takeda T, Matsuda T, Kimura N, Yamashita Y, Morii Y, Shimomura K, Nishida S. Rhosin Suppressed Tumor Cell Metastasis through Inhibition of Rho/YAP Pathway and Expression of RHAMM and CXCR4 in Melanoma and Breast Cancer Cells. Biomedicines 2021; 9:biomedicines9010035. [PMID: 33406809 PMCID: PMC7824767 DOI: 10.3390/biomedicines9010035] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/29/2020] [Indexed: 11/24/2022] Open
Abstract
The high mortality rate of cancer is strongly correlated with the development of distant metastases at secondary sites. Although Rho GTPases, such as RhoA, RhoB, RhoC, and RhoE, promote tumor metastasis, the main roles of Rho GTPases remain unidentified. It is also unclear whether rhosin, a Rho inhibitor, acts by suppressing metastasis by a downstream inhibition of Rho. In this study, we investigated this mechanism of metastasis in highly metastatic melanoma and breast cancer cells, and the mechanism of inhibition of metastasis by rhosin. We found that rhosin suppressed the RhoA and RhoC activation, the nuclear localization of YAP, but did not affect ERK1/2, Akt, or NF-κB activation in the highly metastatic cell lines B16BL6 and 4T1. High expression of YAP was associated with poor overall and recurrence-free survival in patients with breast cancer or melanoma. Treatment with rhosin inhibited lung metastasis in vivo. Moreover, rhosin inhibited tumor cell adhesion to the extracellular matrix via suppression of RHAMM expression, and inhibited SDF-1-induced cell migration and invasion by decreasing CXCR4 expression in B16BL6 and 4T1 cells. These results suggest that the inhibition of RhoA/C-YAP pathway by rhosin could be an extremely useful therapeutic approach in patients with melanoma and breast cancer.
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Affiliation(s)
- Masanobu Tsubaki
- Division of Pharmacotherapy, Faculty of Pharmacy, Kindai University, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.G.); (T.T.); (T.M.); (N.K.); (Y.Y.); (Y.M.)
| | - Shuuji Genno
- Division of Pharmacotherapy, Faculty of Pharmacy, Kindai University, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.G.); (T.T.); (T.M.); (N.K.); (Y.Y.); (Y.M.)
| | - Tomoya Takeda
- Division of Pharmacotherapy, Faculty of Pharmacy, Kindai University, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.G.); (T.T.); (T.M.); (N.K.); (Y.Y.); (Y.M.)
| | - Takuya Matsuda
- Division of Pharmacotherapy, Faculty of Pharmacy, Kindai University, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.G.); (T.T.); (T.M.); (N.K.); (Y.Y.); (Y.M.)
| | - Naoto Kimura
- Division of Pharmacotherapy, Faculty of Pharmacy, Kindai University, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.G.); (T.T.); (T.M.); (N.K.); (Y.Y.); (Y.M.)
| | - Yuuma Yamashita
- Division of Pharmacotherapy, Faculty of Pharmacy, Kindai University, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.G.); (T.T.); (T.M.); (N.K.); (Y.Y.); (Y.M.)
| | - Yuusuke Morii
- Division of Pharmacotherapy, Faculty of Pharmacy, Kindai University, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.G.); (T.T.); (T.M.); (N.K.); (Y.Y.); (Y.M.)
- Department of Phamacy, Municipal Ikeda Hospital, Ikeda, Osaka 563-0025, Japan;
| | - Kazunori Shimomura
- Department of Phamacy, Municipal Ikeda Hospital, Ikeda, Osaka 563-0025, Japan;
| | - Shozo Nishida
- Division of Pharmacotherapy, Faculty of Pharmacy, Kindai University, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.G.); (T.T.); (T.M.); (N.K.); (Y.Y.); (Y.M.)
- Correspondence: ; Tel.: +81-6-6721-2332
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23
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Hanai H, Jacob G, Nakagawa S, Tuan RS, Nakamura N, Shimomura K. Potential of Soluble Decellularized Extracellular Matrix for Musculoskeletal Tissue Engineering - Comparison of Various Mesenchymal Tissues. Front Cell Dev Biol 2020; 8:581972. [PMID: 33330460 PMCID: PMC7732506 DOI: 10.3389/fcell.2020.581972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/05/2020] [Indexed: 12/12/2022] Open
Abstract
Background It is well studied that preparations of decellularized extracellular matrix (ECM) obtained from mesenchymal tissues can function as biological scaffolds to regenerate injured musculoskeletal tissues. Previously, we reported that soluble decellularized ECMs derived from meniscal tissue demonstrated excellent biocompatibility and produced meniscal regenerate with native meniscal anatomy and biochemical characteristics. We therefore hypothesized that decellularized mesenchymal tissue ECMs from various mesenchymal tissues should exhibit tissue-specific bioactivity. The purpose of this study was to test this hypothesis using porcine tissues, for potential applications in musculoskeletal tissue engineering. Methods Nine types of porcine tissue, including cartilage, meniscus, ligament, tendon, muscle, synovium, fat pad, fat, and bone, were decellularized using established methods and solubilized. Although the current trend is to develop tissue specific decellularization protocols, we selected a simple standard protocol across all tissues using Triton X-100 and DNase/RNase after mincing to compare the outcome. The content of sulfated glycosaminoglycan (sGAG) and hydroxyproline were quantified to determine the biochemical composition of each tissue. Along with the concentration of several growth factors, known to be involved in tissue repair and/or maturation, including bFGF, IGF-1, VEGF, and TGF-β1. The effect of soluble ECMs on cell differentiation was explored by combining them with 3D collagen scaffold culturing human synovium derived mesenchymal stem cells (hSMSCs). Results The decellularization of each tissue was performed and confirmed both histologically [hematoxylin and eosin (H&E) and 4’,6-diamidino-2-phenylindole (DAPI) staining] and on the basis of dsDNA quantification. The content of hydroxyproline of each tissue was relatively unchanged during the decellularization process when comparing the native and decellularized tissue. Cartilage and meniscus exhibited a significant decrease in sGAG content. The content of hydroxyproline in meniscus-derived ECM was the highest when compared with other tissues, while sGAG content in cartilage was the highest. Interestingly, a tissue-specific composition of most of the growth factors was measured in each soluble decellularized ECM and specific differentiation potential was particularly evident in cartilage, ligament and bone derived ECMs. Conclusion In this study, soluble decellularized ECMs exhibited differences based on their tissue of origin and the present results are important going forward in the field of musculoskeletal regeneration therapy.
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Affiliation(s)
- Hiroto Hanai
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - George Jacob
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.,Department of Orthopaedics, Tejasvini Hospital, Mangalore, India
| | - Shinichi Nakagawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Rocky S Tuan
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, United States.,Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Norimasa Nakamura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.,Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan.,Global Center for Medical Engineering and Informatics, Osaka University, Suita, Japan
| | - Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
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24
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Kobayashi M, Chijimatsu R, Hart DA, Hamamoto S, Jacob G, Yano F, Saito T, Shimomura K, Ando W, Chung UI, Tanaka S, Yoshikawa H, Nakamura N. Evidence that TD-198946 enhances the chondrogenic potential of human synovium-derived stem cells through the NOTCH3 signaling pathway. J Tissue Eng Regen Med 2020; 15:103-115. [PMID: 33169924 DOI: 10.1002/term.3149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 11/10/2022]
Abstract
Human synovium-derived stem cells (hSSCs) are an attractive source of cells for cartilage repair. At present, the quality of tissue and techniques used for cartilage regeneration have scope for improvement. A small compound, TD-198946, was reported to enhance chondrogenic induction from hSSCs; however, other applications of TD-198946, such as priming the cell potential of hSSCs, remain unknown. Our study aimed to examine the effect of TD-198946 pretreatment on hSSCs. HSSCs were cultured with or without TD-198946 for 7 days during expansion culture and then converted into a three-dimensional pellet culture supplemented with bone morphogenetic protein-2 (BMP2) and/or transforming growth factor beta-3 (TGFβ3). Chondrogenesis in cultures was assessed based on the GAG content, histology, and expression levels of chondrogenic marker genes. Cell pellets derived from TD-198946-pretreated hSSCs showed enhanced chondrogenic potential when chondrogenesis was induced by both BMP2 and TGFβ3. Moreover, cartilaginous tissue was efficiently generated from TD-198946-pretreated hSSCs using a combination of BMP2 and TGFβ3. Microarray analysis revealed that NOTCH pathway-related genes and their target genes were significantly upregulated in TD-198946-treated hSSCs, although TD-198946 alone did not upregulate chondrogenesis related markers. The administration of the NOTCH signal inhibitor diminished the effect of TD-198946. Thus, TD-198946 enhances the chondrogenic potential of hSSCs via the NOTCH3 signaling pathway. This study is the first to demonstrate the gradual activation of NOTCH3 signaling during chondrogenesis in hSSCs. The priming of NOTCH3 using TD-198946 provides a novel insight regarding the regulation of the differentiation of hSSCs into chondrocytes.
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Affiliation(s)
- Masato Kobayashi
- Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Ryota Chijimatsu
- Bone and Cartilage Regenerative Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - David A Hart
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
| | - Shuichi Hamamoto
- Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - George Jacob
- Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Fumiko Yano
- Bone and Cartilage Regenerative Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Taku Saito
- Sensory and Motor System Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kazunori Shimomura
- Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Wataru Ando
- Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Ung-Il Chung
- Center for Disease Biology and Integrative Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Sakae Tanaka
- Sensory and Motor System Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hideki Yoshikawa
- Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Norimasa Nakamura
- Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan
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25
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Abstract
Osteochondral lesions (OL) are a common clinical problem for orthopedic surgeons worldwide and are associated with multiple clinical scenarios ranging from trauma to osteonecrosis. OL vary from chondral lesions in that they involve the subchondral bone and chondral surface, making their management more complex than an isolated chondral injury. Subchondral bone involvement allows for a natural healing response from the body as marrow elements are able to come into contact with the defect site. However, this repair is inadequate resulting in fibrous scar tissue. The second differentiating feature of OL is that damage to the subchondral bone has deleterious effects on the mechanical strength and nutritive capabilities to the chondral joint surface. The clinical solution must, therefore, address both the articular cartilage as well as the subchondral bone beneath it to restore and preserve joint health. Both cartilage and subchondral bone have distinctive functional requirements and therefore their physical and biological characteristics are very much dissimilar, yet they must work together as one unit for ideal joint functioning. In the past, the obvious solution was autologous graft transfer, where an osteochondral bone plug was harvested from a non-weight bearing portion of the joint and implanted into the defect site. Allografts have been utilized similarly to eliminate the donor site morbidity associated with autologous techniques and overall results have been good but both techniques have their drawbacks and limitations. Tissue engineering has thus been an attractive option to create multiphasic scaffolds and implants. Biphasic and triphasic implants have been under explored and have both a chondral and subchondral component with an interface between the two to deliver an implant which is biocompatible and emulates the osteochondral unit as a whole. It has been a challenge to develop such implants and many manufacturing techniques have been utilized to bring together two unalike materials and combine them with cellular therapies. We summarize the functions of the osteochondral unit and describe the currently available management techniques under study.
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Affiliation(s)
- George Jacob
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Orthopedics, Tejasvini Hospital, Mangalore, India
| | - Kazunori Shimomura
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norimasa Nakamura
- Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan
- Global Center for Medical Engineering and Informatics, Osaka University, Osaka, Japan
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Tsubaki M, Seki S, Takeda T, Chihara A, Arai Y, Morii Y, Imano M, Satou T, Shimomura K, Nishida S. The HGF/Met/NF-κB Pathway Regulates RANKL Expression in Osteoblasts and Bone Marrow Stromal Cells. Int J Mol Sci 2020; 21:ijms21217905. [PMID: 33114380 PMCID: PMC7663721 DOI: 10.3390/ijms21217905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/16/2020] [Accepted: 10/22/2020] [Indexed: 12/15/2022] Open
Abstract
Multiple myeloma (MM)-induced bone disease occurs through hyperactivation of osteoclasts by several factors secreted by MM cells. MM cell-secreted factors induce osteoclast differentiation and activation via direct and indirect actions including enhanced expression of receptor activator of nuclear factor κB ligand (RANKL) in osteoblasts and bone marrow stromal cells (BMSCs). Hepatocyte growth factor (HGF) is elevated in MM patients and is associated with MM-induced bone disease, although the mechanism by which HGF promotes bone disease remains unclear. In the present study, we demonstrated that HGF induces RANKL expression in osteoblasts and BMSCs, and investigated the mechanism of induction. We found that HGF and MM cell supernatants induced RANKL expression in ST2 cells, MC3T3-E1 cells, and mouse BMSCs. In addition, HGF increased phosphorylation of Met and nuclear factor κB (NF-κB) in ST2 cells, MC3T3-E1 cells, or mouse BMSCs. Moreover, Met and NF-κB inhibitors suppressed HGF-induced RANKL expression in ST2 cells, MC3T3-E1 cells, and mouse BMSCs. These results indicated that HGF promotes RANKL expression in osteoblasts and BMSCs via the Met/NF-κB signaling pathway, and Met and NF-κB inhibitors suppressed HGF-induced RANKL expression. Our findings suggest that Met and NF-κB inhibitors are potentially useful in mitigating MM-induced bone disease in patients expressing high levels of HGF.
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Affiliation(s)
- Masanobu Tsubaki
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.S.); (T.T.); (A.C.); (Y.A.); (Y.M.)
| | - Shiori Seki
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.S.); (T.T.); (A.C.); (Y.A.); (Y.M.)
| | - Tomoya Takeda
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.S.); (T.T.); (A.C.); (Y.A.); (Y.M.)
| | - Akiko Chihara
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.S.); (T.T.); (A.C.); (Y.A.); (Y.M.)
| | - Yuuko Arai
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.S.); (T.T.); (A.C.); (Y.A.); (Y.M.)
| | - Yuusuke Morii
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.S.); (T.T.); (A.C.); (Y.A.); (Y.M.)
- Department of Pharmacy, Municipal Ikeda Hospital, Ikeda 563-0025, Japan;
| | - Motohiro Imano
- Department of Surgery, Kindai University Faculty of Medicine, Osakasayama, Osaka 589-0014, Japan;
| | - Takao Satou
- Department of Pathology, Kindai University Faculty of Medicine, Osakasayama, Osaka 589-0014, Japan;
| | - Kazunori Shimomura
- Department of Pharmacy, Municipal Ikeda Hospital, Ikeda 563-0025, Japan;
| | - Shozo Nishida
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (S.S.); (T.T.); (A.C.); (Y.A.); (Y.M.)
- Correspondence: ; Tel.: +81-6-6721-2332
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Hevesi M, Jacob G, Shimomura K, Ando W, Nakamura N, Krych AJ. Current hip cartilage regeneration/repair modalities: a scoping review of biologics and surgery. Int Orthop 2020; 45:319-333. [PMID: 32910240 DOI: 10.1007/s00264-020-04789-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE The rapidly growing and emerging nature of biologics have made indications for regenerative and reparative hip therapies ever changing, with at times only early-stage evidence for their use. The purpose of this study was to review and summarize the currently available data on the management of hip cartilage injuries and osteoarthritis. METHODS A scoping review of the available scientific literature for hip biologics was performed, with available evidence for hyaluronic acid (HA), platelet rich plasma (PRP), stem/stromal cells, microfracture, mosaicplasty, osteochondral allograft, and cell-based therapies investigated. RESULTS To date, there exist better guidelines and further consensus concerning knee joint biologic treatments than the hip due to a greater number of studies as well as the more recent emergence of hip preservation approaches. However, increasing evidence is available for the selective implementation of biologics on an individualized basis with attention to lesion size and location. CONCLUSION Orthopedic surgeons are at an exciting crossroads in medicine, where hip biologic therapies are evolving and increasingly available. Timetested interventions such as arthroplasty have shown good results and still have a major role to play but newer, regenerative approaches have the potential to effectively delay or reduce the requirement for such invasive procedures.
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Affiliation(s)
- Mario Hevesi
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - George Jacob
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Wataru Ando
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norimasa Nakamura
- Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan
| | - Aaron J Krych
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
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Tsujii A, Hiramatsu K, Shimomura K, Kobayashi M, Mera H, Wakitani S, Nakamura N, Horibe S, Mitsuoka T. Long-term results of autologous bone marrow mesenchymal stem cell transplantation for cartilage defects in the patella: Two case reports with more than 18 years of follow-up. J Orthop Sci 2020; 25:920-925. [PMID: 29454547 DOI: 10.1016/j.jos.2018.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 12/22/2017] [Accepted: 01/24/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Akira Tsujii
- Department of Orthopedic Surgery, Yao Municipal Hospital, 1-3-1, Ryugecho, Yao, Osaka, 581-0069, Japan.
| | - Kunihiko Hiramatsu
- Department of Orthopedic Surgery, Yao Municipal Hospital, 1-3-1, Ryugecho, Yao, Osaka, 581-0069, Japan.
| | - Kazunori Shimomura
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
| | - Masato Kobayashi
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
| | - Hisashi Mera
- Department of Orthopedic Surgery, Uonuma Kikan Hospital, Niigata, Japan.
| | - Shigeyuki Wakitani
- Department of Health and Sports Sciences, Mukogawa Women's University, Hyogo, Japan.
| | - Norimasa Nakamura
- Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan.
| | - Shuji Horibe
- Faculty of Comprehensive Rehabilitation, Osaka Prefectural University, Osaka, Japan.
| | - Tomoki Mitsuoka
- Department of Orthopedic Surgery, Yao Municipal Hospital, 1-3-1, Ryugecho, Yao, Osaka, 581-0069, Japan.
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Fernandes TL, Kimura HA, Pinheiro CCG, Shimomura K, Nakamura N, Ferreira JR, Gomoll AH, Hernandez AJ, Bueno DF. Human Synovial Mesenchymal Stem Cells Good Manufacturing Practices for Articular Cartilage Regeneration. Tissue Eng Part C Methods 2020; 24:709-716. [PMID: 30412046 PMCID: PMC6306653 DOI: 10.1089/ten.tec.2018.0219] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Cartilage restoration is a desperately needed bridge for patients with symptomatic cartilage lesions. Chondral lesion is a pathology with high prevalence, reaching as much as 63% of general population and 36% among athletes. Despite autologous chondrocyte implantation versatility, it still fails to fully reproduce hyaline articular cartilage characteristics. Mesenchymal stem cells (MSCs) may be isolated from various known tissues, including discarded fragments at arthroscopy such as synovial membrane. Choice of harvesting site is motivated by MSCs' abilities to modulate immunologic and inflammatory response through paracrine communication. Synovial MSCs have a greater proliferation and strong chondrogenic potential than bone and adipose MSCs and a less hypertrophic differentiation than bone MSCs. Good manufacturing practice (GMP) laboratory techniques for human clinical trials are still novel. To our knowledge, there are only two clinical trials in humans published since today. Purpose: Therefore, this work aimed to isolate and characterize synovial MSCs and evaluated their differentiation properties according to GMP standards. Materials and Methods: One-gram tissue sample from three patients of synovia was harvested at the beginning of arthroscopy surgery. MSCs were isolated, expanded, and characterized by flow cytometry. Results: It was possible to isolate and expand MSCs cultures from synovia, characterize MSCs by flow cytometry using proper monoclonal antibodies, and differentiate MSCs by coloring technique after chondrogenic, adipogenic, and osteogenic differentiations. Cartilage treatment may benefit from these tissue engineering protocols since arthroscopic procedures are routinely performed for different purposes in a previous stage and a favorable chondronegic differentiation cell lineage may be collected and stored in a less invasive way. Conclusion: Laboratory protocols established according to presented GMP were able to isolate and characterize MSCs obtained from synovia. Impact Statement Articular cartilage restoration is a desperately needed bridge for patients with symptomatic cartilage lesions and it rises as a socioeconomic issue with a considerable economic burden. Synovial mesenchymal stem cells (MSCs) have a greater proliferation rate and strong chondrogenic potential than bone and adipose MSCs and a less hypertrophic differentiation than bone MSCs. To our knowledge, there are only two human clinical trials with good manufacturing practice laboratory techniques for synovial MSCs harvesting and differentiation. Cartilage treatment may benefit from these tissue engineering protocols since arthroscopic procedures are routinely performed for different purposes in a previous stage.
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Affiliation(s)
- Tiago Lazzaretti Fernandes
- Sports Medicine Group, Institute of Orthopedics and Traumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Heitor Akio Kimura
- Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, Brazil
| | | | - Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norimasa Nakamura
- Center for Advanced Medical Engineering and Informatics, Osaka University, Osaka, Japan
| | - José Ricardo Ferreira
- Department of Materials Science, Post Grad Programme on Materials Science, Military Institute of Engineering (IME), Rio de Janeiro, Brazil
| | - Andreas H Gomoll
- Orthopedic Surgery and Sports Medicine, Hospital for Special Surgery (HSS), New York, New York
| | - Arnaldo Jose Hernandez
- Sports Medicine Group, Institute of Orthopedics and Traumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, Brazil
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Shimomura K. 0103 Novel Prebiotic Enhances Sleep-Wake Cycle and Memory Consolidation in 5xFAD Mice. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Prior studies have shown that the gut microbiomes of Alzheimer’s Disease (AD) patients differ from unaffected individuals. Sleep and circadian rhythm disturbances are common in AD and often precede dementia symptoms. Gut microbiome alterations have also been observed in models of circadian disruption. Therefore, we hypothesized that altering the gut microbiome could improve sleep/circadian rhythms and cognition in an AD mouse model.
Methods
Mice were given a dietary polysaccharide, Modified Resistant Maltodextrin (MRM), as a 1% solution in the drinking water beginning at 2 months of age. 5xFAD and wild-type (WT) littermates were tested. Sleep-wake was recorded by EEG/EMG, memory consolidation was tested by the Object-Location Memory test, and beta amyloid deposition in the brain was assayed (dot blot). Composition of the gut microbiota was determined from amplicon sequencing of the 16s ribosomal RNA gene from fecal DNA.
Results
MRM treatment reduced dark (active)-phase sleep and the phase scattering of REM sleep in 5xFAD mice, indices of circadian consolidation. 6-month-old 5xFAD mice given plain water exhibited no 24hr retention of object location memory. However, MRM-treated 5xFAD mice demonstrated 24-hour memory, even at 12 months of age. Both improved memory and increased consolidation of sleep were also observed in WT mice. Two unclassified species of bacteria from the family Tannerellaceae were significantly increased in MRM-treated 5xFAD and WT mice. At 12 months of age, synaptic and neuronal loss become prominent in this AD model. However, the level of beta amyloid deposition in the brain was not significantly different between MRM and water control groups.
Conclusion
MRM treatment altered the gut microbiome, improved circadian timing of sleep and memory retention, but did not impact beta amyloid deposition in 5xFAD mice. Because these effects were also present in WT mice, MRM-induced microbiome changes may affect sleep and cognition independently from beta amyloid.
Support
Northwestern University Feinberg School of Medicine Center for Circadian and Sleep Medicine
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Hamamoto S, Chijimatsu R, Shimomura K, Kobayashi M, Jacob G, Yano F, Saito T, Chung UI, Tanaka S, Nakamura N. Enhancement of chondrogenic differentiation supplemented by a novel small compound for chondrocyte-based tissue engineering. J Exp Orthop 2020; 7:10. [PMID: 32146609 PMCID: PMC7060980 DOI: 10.1186/s40634-020-00228-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 02/26/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose Chondrocyte -based tissue engineering has been a promising option for the treatment of cartilage lesions. In previous literature, TD198946 has been shown to promote chondrogenic differentiation which could prove useful in cartilage regeneration therapies. Our study aimed to investigate the effects of TD198946 in generating engineered cartilage using dedifferentiated chondrocyte-seeded collagen scaffolds treated with TD198946. Methods Articular chondrocytes were isolated from mini pig knees and expanded in 2-dimensional cell culture and subsequently used in the experiments. 3-D pellets were then cultured for two weeks. Cells were also cultured in a type I collagen scaffolds for four weeks. Specimens were cultured with TD198946, BMP-2, or both in combination. Outcomes were determined by gene expression levels of RUNX1, SOX9, ACAN, COL1A1, COL2A1 and COL10A1, the glycosaminoglycan content, and characteristics of histology and immunohistochemistry. Furthermore, the maturity of the engineered cartilage cultured for two weeks was evaluated through subcutaneous implantation in nude mice for four weeks. Results Addition of TD198946 demonstrated the upregulation of gene expression level except for ACAN, type II collagen and glycosaminoglycan synthesis in both pellet and 3D scaffold cultures. TD198946 and BMP-2 combination cultures showed higher chondrogenic differentiation than TD198946 or BMP-2 alone. The engineered cartilage maintained its extracellular matrices for four weeks post implantation. In contrast, engineered cartilage treated with either TD198946 or BMP-2 alone was mostly absorbed. Conclusions Our results indicate that TD198946 could improve quality of engineered cartilage by redifferentiation of dedifferentiated chondrocytes pre-implantation and promoting collagen and glycosaminoglycan synthesis.
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Affiliation(s)
- Shuichi Hamamoto
- Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Ryota Chijimatsu
- Bone and Cartilage Regenerative Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazunori Shimomura
- Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masato Kobayashi
- Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - George Jacob
- Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Fumiko Yano
- Bone and Cartilage Regenerative Medicine, The University of Tokyo, Tokyo, Japan.,Center for Disease Biology and Integrative Medicine, The University of Tokyo, Tokyo, Japan
| | - Taku Saito
- Sensory and Motor System Medicine, The University of Tokyo, Tokyo, Japan
| | - Ung-Il Chung
- Center for Disease Biology and Integrative Medicine, The University of Tokyo, Tokyo, Japan
| | - Sakae Tanaka
- Sensory and Motor System Medicine, The University of Tokyo, Tokyo, Japan
| | - Norimasa Nakamura
- Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan. .,Global Center of Medical Engineering and Informatics, Osaka University, Suita, Japan. .,Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan.
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Yokoi H, Take Y, Uchida R, Magome T, Shimomura K, Mae T, Okamoto T, Hanai T, Chong Y, Sato S, Hikida M, Nakata K. Vibration acceleration promotes endochondral formation during fracture healing through cellular chondrogenic differentiation. PLoS One 2020; 15:e0229127. [PMID: 32134943 PMCID: PMC7058294 DOI: 10.1371/journal.pone.0229127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 01/30/2020] [Indexed: 02/07/2023] Open
Abstract
Vibration acceleration through whole body vibration has been reported to promote fracture healing. However, the mechanism responsible for this effect remains unclear. Purpose of this study was to determine whether vibration acceleration directly affects cells around the fracture site and promotes endochondral ossification. Four-week-old female Wistar Hannover rats were divided into two groups (vibration [V group] and control [C group]). The eighth ribs on both sides were cut vertically using scissors. From postoperative day 3 to 11, vibration acceleration using Power Plate® (30 Hz, low amplitude [30-Low], 10 min/day) was applied in the V group. Mature calluses appeared earlier in the V group than in the C group by histological analysis. The GAG content in the fracture callus on day 6 was significantly higher in the V group than in the C group. The mRNA expressions of SOX-9, aggrecan, and Col-II in the fracture callus on day 6 and Col-X on day 9 were significantly higher in the V group than in the C group. For in vitro analysis, four different conditions of vibration acceleration (30 or 50 Hz with low or high amplitude [30-Low, 30-High, 50-Low, and 50-High], 10 min/day) were applied to a prechondrogenic cell (ATDC5) and an undifferentiated cell (C3H10T1/2). There was no significant difference in cell proliferation between the control and any of the four vibration conditions for both cell lines. For both cell lines, alcian blue staining was greater under 30-Low and 50-Low conditions than under control as well as 30-High and 50-High conditions on days 7 and 14. Vibration acceleration under 30-L condition upregulated chondrogenic gene expressions of SOX-9, aggrecan, Col-II, and Col-X. Low-amplitude vibration acceleration can promote endochondral ossification in the fracture healing in vivo and chondrogenic differentiation in vitro.
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Affiliation(s)
- Hiroyuki Yokoi
- Medicine for Sports and Performing Arts, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yasuhiro Take
- Medicine for Sports and Performing Arts, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ryohei Uchida
- Department of Sports Medicine, Yukioka Hospital, Osaka, Japan
| | - Takuya Magome
- Medicine for Sports and Performing Arts, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kazunori Shimomura
- Medicine for Sports and Performing Arts, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Tatsuo Mae
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Tomoko Okamoto
- Medicine for Sports and Performing Arts, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Tatsuhiro Hanai
- Medicine for Sports and Performing Arts, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yang Chong
- Medicine for Sports and Performing Arts, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Seira Sato
- Medicine for Sports and Performing Arts, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Minami Hikida
- Medicine for Sports and Performing Arts, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ken Nakata
- Medicine for Sports and Performing Arts, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
- * E-mail:
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Nakamura N, Yokota N, Hattori M, Ohtsuru T, Otsuji M, Lyman S, Shimomura K. Comparative Clinical Outcomes After Intra-articular Injection With Adipose-Derived Cultured Stem Cells or Noncultured Stromal Vascular Fraction for the Treatment of Knee Osteoarthritis: Response. Am J Sports Med 2020; 48:NP19-NP20. [PMID: 32003633 DOI: 10.1177/0363546519895242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Abstract
Meniscal injuries have posed a challenging problem for many years, especially considering that historically the meniscus was considered to be a structure with no important role in the knee joint. This led to earlier treatments aiming at the removal of the entire structure in a procedure known as a meniscectomy. However, with the current understanding of the function and roles of the meniscus, meniscectomy has been identified to accelerate joint degradation significantly and is no longer a preferred treatment option in meniscal tears. Current therapies are now focused to regenerate, repair, or replace the injured meniscus to restore its native function. Repairs have improved in technique and materials over time, with various implant devices being utilized and developed. More recently, strategies have applied stem cells, tissue engineering, and their combination to potentiate healing to achieve superior quality repair tissue and retard the joint degeneration associated with an injured or inadequately functioning meniscus. Accordingly, the purpose of this current review is to summarize the current available pre-clinical and clinical literature using stem cells and tissue engineering for meniscal repair and regeneration.
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Affiliation(s)
- George Jacob
- Department and Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan; (G.J.); (K.S.)
| | - Kazunori Shimomura
- Department and Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan; (G.J.); (K.S.)
| | - Aaron J. Krych
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Norimasa Nakamura
- Institute for Medical Science in Sports, Osaka Health Science University, Osaka 530-0043, Japan
- Global Centre for Medical Engineering and Informatics, Osaka University, Osaka 565-0871, Japan
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Tsubaki M, Takeda T, Noguchi M, Jinushi M, Seki S, Morii Y, Shimomura K, Imano M, Satou T, Nishida S. Overactivation of Akt Contributes to MEK Inhibitor Primary and Acquired Resistance in Colorectal Cancer Cells. Cancers (Basel) 2019; 11:cancers11121866. [PMID: 31769426 PMCID: PMC6966459 DOI: 10.3390/cancers11121866] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/21/2019] [Accepted: 11/21/2019] [Indexed: 12/21/2022] Open
Abstract
RAS and BRAF-mutated colorectal cancers are associated with resistance to chemotherapy and poor prognosis, highlighting the need for new therapeutic strategies. Although these cancers sometimes respond to mitogen activated protein kinase kinase (MEK) inhibitor treatment, they often acquire resistance via mechanisms, which are poorly understood. Here, we investigated the mechanism of MEK inhibitor resistance in primary- and acquired-resistant cells. Cell viability was examined using the trypan blue dye exclusion assay. Protein expression was analyzed by western blotting. Somatic mutations in colorectal cancer cells were investigated using the polymerase chain reaction array. PD0325901 and trametinib induced cell death in LoVo and Colo-205 cells but not in DLD-1 and HT-29 cells, which have a PIK3CA mutation constitutively activating Akt and NF-κB. Treatment with PD0325901 and trametinib suppressed ERK1/2 activation in all four cell lines but only induced Akt and NF-κB activation in DLD-1 and HT-29 cells. Inhibition of Akt but not NF-κB, overcame MEK inhibitor resistance in DLD-1 and HT-29 cells. Acquired-resistant LoVo/PR, Colo-205/PR and LoVo/TR cells have constitutively active Akt due to a M1043V mutation in the kinase activation loop of PIK3CA and Akt inhibitor resensitized these cells to MEK inhibitor. These results demonstrate that the overactivation of Akt plays a critical role in MEK inhibitor primary and acquired resistance and implicate combined Akt/MEK inhibition as a potentially useful treatment for RAS/BRAF-mutated colorectal cancer.
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Affiliation(s)
- Masanobu Tsubaki
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (T.T.); (M.N.); (M.J.); (S.S.); (Y.M.)
| | - Tomoya Takeda
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (T.T.); (M.N.); (M.J.); (S.S.); (Y.M.)
| | - Masaki Noguchi
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (T.T.); (M.N.); (M.J.); (S.S.); (Y.M.)
| | - Minami Jinushi
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (T.T.); (M.N.); (M.J.); (S.S.); (Y.M.)
| | - Shiori Seki
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (T.T.); (M.N.); (M.J.); (S.S.); (Y.M.)
| | - Yuusuke Morii
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (T.T.); (M.N.); (M.J.); (S.S.); (Y.M.)
- Department of Phamacy, Municipal Ikeda Hospital, Ikeda, Osaka 563-8510, Japan;
| | - Kazunori Shimomura
- Department of Phamacy, Municipal Ikeda Hospital, Ikeda, Osaka 563-8510, Japan;
| | - Motohiro Imano
- Department of Surgery, Kindai University Faculty of Medicine, Osakasayama, Osaka 589-0014, Japan;
| | - Takao Satou
- Department of Pathology, Kindai University Faculty of Medicine, Osakasayama, Osaka 589-0014, Japan.;
| | - Shozo Nishida
- Division of Pharmacotherapy, Kindai University Faculty of Pharmacy, Kowakae, Higashi-Osaka 577-8502, Japan; (M.T.); (T.T.); (M.N.); (M.J.); (S.S.); (Y.M.)
- Correspondence:
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Ohori K, Yano T, Katano S, Honma S, Shimomura K, Watanabe A, Ishigo T, Fujito T, Nagano N, Koyama M, Kouzu H, Hashimoto A, Miura T. P4537Impact of body composition analysis on prediction of short-term readmission events in heart failure: muscle wasting vs. obesity. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Obesity, defined as higher body mass index (BMI), is associated with better prognosis in patients with chronic heart failure (CHF), though the presence of obesity is a risk factor of development of CHF (Obesity paradox). On the other hand, muscle wasting, i.e. reduction in skeletal muscle mass, is frequently observed in CHF, leading to lower exercise capacity and poor cardiovascular outcome.
Purpose
The aim of this study was to examine whether analysis of body composition improves prediction of short-term readmission rates in patients with CHF.
Methods
We retrospectively analyzed data for 167 consecutive HF patients who were admitted to our institute for management of HF and received a Dual-energy X-ray absorptiometry (DEXA) scan. Muscle wasting was defined as DEXA-measured appendicular skeletal muscle mass index <7.0 kg/m2 in male and <5.4 kg/m2 in female according to the Asian Working Group for Sarcopenia criteria. Obesity was defined according to the criteria by the use of DEXA-measured percent body fat mass: >25% in male, >30% in female. The primary endpoint was readmission due to cardiac events including worsening heart failure, arrhythmia, and cardiopulmonary arrest during a 180-days follow-up period after discharge.
Results
The mean age of the patients was 74±13 years and 46% of them were male. The mean BMI was 21.8±3.8 kg/m2. Forty-seven percent of the patients were classified as NYHA functional class III. The most frequent etiology of HF was cardiomyopathy (30%), followed by ischemic heart disease (27%) and valvular heart disease (27%). The prevalence of muscle wasting and that of obesity were 69% and 59%, respectively. Patients with muscle wasting had lower BMI level, higher prevalence of NYHA functional class III and diabetes mellitus compared with those without muscle wasting. On the other hand, patients with obesity had higher prevalence of hypertension and dyslipidemia, higher level of BMI, fasting plasma insulin and triglyceride, and lower level of HDL-cholesterol compared with those without obesity. During the follow-up period, 34 patients (19%) were re-hospitalized due to cardiac events. Kaplan-Meier survival curves showed that patients with obesity had a significantly lower readmission rate during a 180-days follow-up period than did the patients without obesity (14.3% vs. 29.0%, Log-Rank test, p<0.01). There was no difference in readmission rates between patients with and without muscle wasting (20.0% vs. 21.2%, p=0.88). In multivariate Cox regression analyses adjusted for age, sex, diabetes, and renal function, obesity was independently associated with lower readmission rates (hazard ratio 0.45, 95% confidence interval 0.22–0.93). However, the association between obesity and readmission rate was lost after the adjustment for NT-proBNP levels.
Conclusion
Body composition analysis by DEXA enables to find CHF patients with increased fat mass who have lower risk of short-term readmission.
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Affiliation(s)
- K Ohori
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Yano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - S Katano
- Sapporo Medical University, Division of Rehabilitation, Sapporo, Japan
| | - S Honma
- Sapporo Medical University, Division of Rehabilitation, Sapporo, Japan
| | - K Shimomura
- Sapporo Medical University, Division of Rehabilitation, Sapporo, Japan
| | - A Watanabe
- Sapporo Medical University, Division of Nursing, Sapporo, Japan
| | - T Ishigo
- Sapporo Medical University, Division of Hospital Pharmacy, Sapporo, Japan
| | - T Fujito
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - M Koyama
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Hashimoto
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Miura
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
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Shimomura K, Katano S, Yano T, Ohori K, Honma S, Watanabe A, Ishigo T, Fujito T, Nagano N, Koyama M, Kouzu H, Hashimoto A, Miura T. P1538Low energy intake predicts readmission of elderly heart failure patients independently of nutritional status. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Malnutrition is frequently present and closely associated with poor clinical outcomes in elderly heart failure (HF) patients. Our previous study showed that low energy intake (EI) is associated with worse functional status in elderly HF inpatients after cardiac rehabilitation, but significance of EI in prediction of hospital readmission has not been elucidated fully.
Purpose
We examined whether low EI is a predictor of readmission for cardiac events in elderly HF patients.
Methods
We retrospectively retrieved data for 298 HF patients aged ≥65 years (median age of 77 years, interquartile range [IQR]: 71 - 82, female: 53%) who admitted to our institute for diagnosis and treatment of HF. Medical records were reviewed with regard to demography, medical history, comorbidities, medications, laboratory data, echocardiograms, functional status, nutritional status and total energy intake. Nutritional status was assessed using the Mini Nutritional Assessment Short Form (MNA-SF) and total EI per day were calculated at discharge by a registered dietitian and a trained physical therapist. The primary endpoint was readmission due to cardiovascular events including worsening HF, arrhythmia, angina pectoris and myocardial infarction during a 1-year follow-up period.
Results
The median period of follow-up was 235 days (IQR: 78–365 days). The 1-year readmission rate for cardiovascular events was 54.4%. The cutoff values of MNA-SF score and EI, calculated by ROC curve analysis to predict the primary endpoint, were 7 points (area under the curve [AUC]: 0.59, sensitivity: 0.65, specificity: 0.50) and 31.8 kcal/kg/day (AUC: 0.59, sensitivity: 0.83, specificity: 0.35), respectively. Patients with low MNF-SF score (≤7) or low EI (≤31.8 kcal/kg/day) had significantly higher readmission rate during a 1-year follow-up period than did the patients with high MNF-SF score or EI (MNA-SF: 60.7% vs. 45.6%, p<0.01, EI: 60.4% vs. 36.8%, p<0.01), respectively. When patients were classified into four groups using cutoff values of MNA-SF score and EI, 1-year readmission rate was significantly higher in patients with low EI than in those with high EI regardless of MNF-SF scores. In multivariate Cox proportional hazard analyses adjusted for known prognostic factors in addition to age and gender, hazard ratios (HR) were significantly higher in patients with high MNA-SF score and low EI (adjusted HR: 2.81, 95% confidential interval [CI]: 1.15 - 9.32, p=0.02) and low MNA-SF score (≤7) and low EI (adjusted HR: 4.16, 95% CI: 1.72 - 13.72, p<0.01) than those with high MNA-SF score and high EI.
Kaplan-Meier curves of readmission rates
Conclusions
Low energy intake is a nutritional status-independent predictor of 1-year readmission rate in elderly HF patients.
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Affiliation(s)
- K Shimomura
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - S Katano
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - T Yano
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - K Ohori
- Hokkaido Cardiovascular Hospital, Department of Cardiology, Sapporo, Japan
| | - S Honma
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - A Watanabe
- Sapporo Medical University Hospital, Division of Nursing, Sapporo, Japan
| | - T Ishigo
- Sapporo Medical University Hospital, Department of Hospital Pharmacy, Sapporo, Japan
| | - T Fujito
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - M Koyama
- Sapporo Medical University School of Medicine, Department of Public Health, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Hashimoto
- Sapporo Medical University School of Medicine, Division of Health Care Administration and Management, Sapporo, Japan
| | - T Miura
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
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Yokota N, Hattori M, Ohtsuru T, Otsuji M, Lyman S, Shimomura K, Nakamura N. Comparative Clinical Outcomes After Intra-articular Injection With Adipose-Derived Cultured Stem Cells or Noncultured Stromal Vascular Fraction for the Treatment of Knee Osteoarthritis. Am J Sports Med 2019; 47:2577-2583. [PMID: 31373830 DOI: 10.1177/0363546519864359] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Intra-articular injection of adipose-derived stem cells (ASCs) has shown promise for improving symptoms and cartilage quality in the treatment of osteoarthritis (OA). However, while most preclinical studies have been performed with plastic-adherent ASCs, most clinical trials are being conducted with the stromal vascular fraction (SVF), prepared from adipose tissue without prior culture. PURPOSE To directly compare clinical outcomes of intra-articular injection with ASCs or SVF in patients with knee OA. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS The authors retrospectively compared 6-month outcomes in 42 patients (59 knees) receiving intra-articular injection with 12.75 million ASCs and 38 patients (69 knees) receiving a 5-mL preparation of SVF. All patients had Kellgren-Lawrence grade 2, 3, or 4 knee OA and had failed standard medical therapy. The visual analog scale (VAS) pain score and Knee injury and Osteoarthritis Outcome Score (KOOS) at baseline and 1, 3, and 6 months after injection were considered as outcomes. Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) criteria were also used to assess positive response. A repeated measures analysis of variance was used for comparison between the treatment groups. RESULTS No major complications occurred in either group. The SVF group had a higher frequency of knee effusion (SVF 8%, ASC 2%) and minor complications related to the fat harvest site (SVF 34%, ASC 5%). Both groups reported improvements in pain VAS and KOOS domains. Specifically, in the ASC group, symptoms improved earlier (by 3 months; P < .05) and pain VAS decreased to a greater degree (55%; P < .05) compared with the SVF group (44%). The proportion of OMERACT-OARSI responders in the ASC group was slightly higher (ASCs, 61%; SVF, 55%; P = .25). CONCLUSION It was observed that both ASCs and SVF resulted in clinical improvement in patients with knee OA, but that ASCs outperform SVF in the early reduction of symptoms and pain with less comorbidity.
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Affiliation(s)
- Naomasa Yokota
- Tokyo Knee Osteoarthritis Clinic Ginza, Tokyo, Japan.,Tokyo Knee Osteoarthritis Clinic Shinjuku, Tokyo, Japan
| | - Mari Hattori
- Tokyo Knee Osteoarthritis Clinic Ginza, Tokyo, Japan
| | | | - Masaki Otsuji
- Tokyo Knee Osteoarthritis Clinic Ginza, Tokyo, Japan
| | - Stephen Lyman
- Hospital for Special Surgery, New York, New York, USA
| | - Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Norimasa Nakamura
- Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan.,Global Center for Medical Engineering and Informatics, Osaka University, Suita, Osaka, Japan
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Lin H, Beck AM, Shimomura K, Sohn J, Fritch MR, Deng Y, Kilroy EJ, Tang Y, Alexander PG, Tuan RS. Optimization of photocrosslinked gelatin/hyaluronic acid hybrid scaffold for the repair of cartilage defect. J Tissue Eng Regen Med 2019; 13:1418-1429. [PMID: 31066519 PMCID: PMC6739828 DOI: 10.1002/term.2883] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 04/05/2019] [Accepted: 04/29/2019] [Indexed: 01/07/2023]
Abstract
There is no therapy currently available for fully repairing articular cartilage lesions. Our laboratory has recently developed a visible light-activatable methacrylated gelatin (mGL) hydrogel, with the potential for cartilage regeneration. In this study, we further optimized mGL scaffolds by supplementing methacrylated hyaluronic acid (mHA), which has been shown to stimulate chondrogenesis via activation of critical cellular signalling pathways. We hypothesized that the introduction of an optimal ratio of mHA would enhance the biological properties of mGL scaffolds and augment chondrogenesis of human bone marrow-derived mesenchymal stem cells (hBMSCs). To test this hypothesis, hybrid scaffolds consisting of mGL and mHA at different weight ratios were fabricated with hBMSCs encapsulated at 20 × 106 cells/ml and maintained in a chondrogenesis-promoting medium. The chondrogenenic differentiation of hBMSCs, within different scaffolds, was estimated after 8 weeks of culture. Our results showed that mGL/mHA at a 9:1 (%, w/v) ratio resulted in the lowest hBMSC hypertrophy and highest glycosaminoglycan production, with a slightly increased volume of the entire construct. The applicability of this optimally designed mGL/mHA hybrid scaffold for cartilage repair was then examined in vivo. A full-thickness cylindrical osteochondral defect was surgically created in the rabbit femoral condyle, and a three-dimensional cell-biomaterial construct was fabricated by in situ photocrosslinking to fully fill the lesion site. The results showed that implantation of the mGL/mHA (9:1) construct resulted in both cartilage and subchondral bone regeneration after 12 weeks, supporting its use as a promising scaffold for repair and resurfacing of articular cartilage defects, in the clinical setting.
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Affiliation(s)
- Hang Lin
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pittsburgh, Pennsylvania
| | - Angela M. Beck
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kazunori Shimomura
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jihee Sohn
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Madalyn R. Fritch
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Yuhao Deng
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Evan J. Kilroy
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ying Tang
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Peter G. Alexander
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Rocky S. Tuan
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
- McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pittsburgh, Pennsylvania
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Strasser P, Abe M, Aoki M, Choi S, Fukao Y, Higashi Y, Higuchi T, Iinuma H, Ikedo Y, Ishida K, Ito T, Ito TU, Iwasaki M, Kadono R, Kamigaito O, Kanda S, Kawagoe K, Kawall D, Kawamura N, Kitaguchi M, Koda A, Kojima KM, Kubo K, Matama M, Matsuda Y, Matsudate Y, Mibe T, Miyake Y, Mizutani T, Nagamine K, Nishimura S, Ogitsu T, Saito N, Sasaki K, Seo S, Shimizu HM, Shimomura K, Suehara T, Tajima M, Tanaka KS, Tanaka T, Tojo J, Tomono D, Torii HA, Torikai E, Toyoda A, Tsutsumi Y, Ueno K, Ueno Y, Yagi D, Yamamoto A, Yamanaka T, Yamazaki T, Yasuda H, Yoshida M, Yoshioka T. New precise measurements of muonium hyperfine structure at J-PARC MUSE. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201919800003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
High precision measurements of the ground state hyperfine structure (HFS) of muonium is a stringent tool for testing bound-state quantum electrodynamics (QED) theory, determining fundamental constants of the muon magnetic moment and mass, and searches for new physics. Muonium is the most suitable system to test QED because both theoretical and experimental values can be precisely determined. Previous measurements were performed decades ago at LAMPF with uncertainties mostly dominated by statistical errors. At the J-PARC Muon Science Facility (MUSE), the MuSEUM collaboration is planning complementary measurements of muonium HFS both at zero and high magnetic field. The new high-intensity muon beam that will soon be available at H-Line will provide an opportunity to improve the precision of these measurements by one order of magnitude. An overview of the different aspects of these new muonium HFS measurements, the current status of the preparation for high-field measurements, and the latest results at zero field are presented.
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Fernandes TL, Shimomura K, Asperti A, Pinheiro CCG, Caetano HVA, Oliveira CRGCM, Nakamura N, Hernandez AJ, Bueno DF. Development of a Novel Large Animal Model to Evaluate Human Dental Pulp Stem Cells for Articular Cartilage Treatment. Stem Cell Rev Rep 2018; 14:734-743. [PMID: 29728886 PMCID: PMC6132738 DOI: 10.1007/s12015-018-9820-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose Chondral lesion is a pathology with high prevalence, reaching as much as 63% of general population and 36% among athletes. The ability of human Dental Pulp Stem Cells (DPSCs) to differentiate into chondroblasts in vitro suggests that this stem cell type may be useful for tissue bioengineering. However, we have yet to identify a study of large animal models in which DPSCs were used to repair articular cartilage. Therefore, this study aimed to describe a novel treatment for cartilage lesion with DPSCs on a large animal model. Methods Mesenchymal stem cells (MSC) were obtained from deciduous teeth and characterized by flow cytometry. DPSCs were cultured and added to a collagen type I/III biomaterial composite scaffold. Brazilian miniature pig (BR-1) was used. A 6-mm diameter, full-thickness chondral defect was created in each posterior medial condyle. The defects were covered with scaffold alone or scaffold + DPSCs on the contralateral side. Animals were euthanized 6 weeks post-surgery. Cartilage defects were analyzed macroscopically and histology according to modified O’Driscoll scoring system. Results Flow cytometry confirmed characterization of DPSCs as MSCs. Macroscopic and histological findings suggested that this time period was reasonable for evaluating cartilage repair. To our knowledge, this study provides the first description of an animal model using DPSCs to study the differentiation of hyaline articular cartilage in vivo. Conclusion The animals tolerated the procedure well and did not show clinical or histological rejection of the DPSCs, reinforcing the feasibility of this descriptive miniature pig model for pre-clinical studies.
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Affiliation(s)
- Tiago Lazzaretti Fernandes
- Institute of Orthopedics and Traumatology, Hospital das Clínicas, School of Medicine, University of São Paulo, 333 Dr. Ovídio Pires de Campos, São Paulo, 05403-010, Brazil. .,Hospital Sírio-Libanês, 115 Rua Dona Adma Jafet, Bela Vista, São Paulo / SP, 01308-050, Brazil.
| | - Kazunori Shimomura
- Department of Orthopedics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Andre Asperti
- Institute of Orthopedics and Traumatology, Hospital das Clínicas, School of Medicine, University of São Paulo, 333 Dr. Ovídio Pires de Campos, São Paulo, 05403-010, Brazil
| | | | | | - Claudia Regina G C M Oliveira
- Institute of Orthopedics and Traumatology, Hospital das Clínicas, School of Medicine, University of São Paulo, 333 Dr. Ovídio Pires de Campos, São Paulo, 05403-010, Brazil
| | - Norimasa Nakamura
- Center for Advanced Medical Engineering and Informatics, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Arnaldo José Hernandez
- Institute of Orthopedics and Traumatology, Hospital das Clínicas, School of Medicine, University of São Paulo, 333 Dr. Ovídio Pires de Campos, São Paulo, 05403-010, Brazil
| | - Daniela Franco Bueno
- Hospital Sírio-Libanês, 115 Rua Dona Adma Jafet, Bela Vista, São Paulo / SP, 01308-050, Brazil
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Shimomura K, Rothrauff BB, Hart DA, Hamamoto S, Kobayashi M, Yoshikawa H, Tuan RS, Nakamura N. Enhanced repair of meniscal hoop structure injuries using an aligned electrospun nanofibrous scaffold combined with a mesenchymal stem cell-derived tissue engineered construct. Biomaterials 2018; 192:346-354. [PMID: 30471629 DOI: 10.1016/j.biomaterials.2018.11.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 11/02/2018] [Accepted: 11/08/2018] [Indexed: 02/07/2023]
Abstract
Damage to the meniscal hoop structure results in loss of biomechanical function, which potentially leads to the extrusion of the meniscus from the weight bearing area. However, there have been no established, effective treatments for such injuries. The purpose of this study was to investigate the applicability of cell-seeded nanofibrous scaffolds to repair the damaged meniscal hoop structure along with the prevention of subsequent cartilage degeneration using a rabbit model. Meniscal radial defects (5 mm width) in the medial meniscus were treated by wrapping and suturing with either an aligned electrospun nanofibrous scaffold alone or a scaffold combined with a tissue engineered construct (TEC) derived from synovial mesenchymal stem cells (MSCs), with the scaffold fiber direction matching that of the meniscal circumferential fibers. The MSC-based TEC-combined nanofibrous scaffolds contributed significantly to the prevention of meniscal extrusion and exerted a chondroprotective effect, compared with either scaffold alone or the untreated control groups. Also, meniscal defects treated with such TEC-combined nanofibrous scaffolds were consistently repaired with a fibrocartilaginous tissue. In this study, we have demonstrated the feasibility of a combined TEC-nanofibrous scaffold to repair the meniscal hoop structure, and prevent the progression to cartilage degeneration, as a potential tissue engineering method.
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Affiliation(s)
- Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
| | - Benjamin B Rothrauff
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Suite 221, Pittsburgh, PA, 15219-3143, USA.
| | - David A Hart
- McCaig Institute for Bone & Joint Health, University of Calgary, 3330 Hospital Drive Northwest, Calgary, Alberta, T2N 4N1, Canada.
| | - Shuichi Hamamoto
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
| | - Masato Kobayashi
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
| | - Hideki Yoshikawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
| | - Rocky S Tuan
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Suite 221, Pittsburgh, PA, 15219-3143, USA.
| | - Norimasa Nakamura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan; Institute for Medical Science in Sports, Osaka Health Science University, 1-9-27 Tenma, Kita-ku, Osaka City, Osaka, 530-0043, Japan; Center for Advanced Medical Engineering and Informatics, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
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Shimomura K, Yasui Y, Koizumi K, Chijimatsu R, Hart DA, Yonetani Y, Ando W, Nishii T, Kanamoto T, Horibe S, Yoshikawa H, Nakamura N, Sakaue M, Sugita N, Moriguchi Y. First-in-Human Pilot Study of Implantation of a Scaffold-Free Tissue-Engineered Construct Generated From Autologous Synovial Mesenchymal Stem Cells for Repair of Knee Chondral Lesions. Am J Sports Med 2018; 46:2384-2393. [PMID: 29969043 DOI: 10.1177/0363546518781825] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Articular cartilage has limited healing capacity, owing in part to poor vascularity and innervation. Once injured, it cannot be repaired, typically leading to high risk for developing osteoarthritis. Thus, cell-based and/or tissue-engineered approaches have been investigated; however, no approach has yet achieved safety and regenerative repair capacity via a simple implantation procedure. PURPOSE To assess the safety and efficacy of using a scaffold-free tissue-engineered construct (TEC) derived from autologous synovial membrane mesenchymal stem cells (MSCs) for effective cartilage repair. STUDY DESIGN Case series; Level of evidence, 4. METHODS Five patients with symptomatic knee chondral lesions (1.5-3.0 cm2) on the medial femoral condyle, lateral femoral condyle, or femoral groove were included. Synovial MSCs were isolated from arthroscopic biopsy specimens and cultured to develop a TEC that matched the lesion size. The TECs were then implanted into chondral defects without fixation and assessed up to 24 months postoperatively. The primary outcome was the safety of the procedure. Secondary outcomes were self-assessed clinical scores, arthroscopy, tissue biopsy, and magnetic resonance image-based estimation of morphologic and compositional quality of the repair tissue. RESULTS No adverse events were recorded, and self-assessed clinical scores for pain, symptoms, activities of daily living, sports activity, and quality of life were significantly improved at 24 months after surgery. Secure defect filling was confirmed by second-look arthroscopy and magnetic resonance imaging in all cases. Histology of biopsy specimens indicated repair tissue approaching the composition and structure of hyaline cartilage. CONCLUSION Autologous scaffold-free TEC derived from synovial MSCs may be used for regenerative cartilage repair via a sutureless and simple implantation procedure. Registration: 000008266 (UMIN Clinical Trials Registry number).
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Affiliation(s)
- Kazunori Shimomura
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yukihiko Yasui
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kota Koizumi
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ryota Chijimatsu
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - David A Hart
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasukazu Yonetani
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Wataru Ando
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Nishii
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Kanamoto
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shuji Horibe
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hideki Yoshikawa
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norimasa Nakamura
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Morito Sakaue
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norihiko Sugita
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yu Moriguchi
- Investigation performed at the Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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Yasui Y, Hart DA, Sugita N, Chijimatsu R, Koizumi K, Ando W, Moriguchi Y, Shimomura K, Myoui A, Yoshikawa H, Nakamura N. Time-Dependent Recovery of Human Synovial Membrane Mesenchymal Stem Cell Function After High-Dose Steroid Therapy: Case Report and Laboratory Study. Am J Sports Med 2018; 46:695-701. [PMID: 29227146 DOI: 10.1177/0363546517741307] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The use of mesenchymal stem cells from various tissue sources to repair injured tissues has been explored over the past decade in large preclinical models and is now moving into the clinic. PURPOSE To report the case of a patient who exhibited compromised mesenchymal stem cell (MSC) function shortly after use of high-dose steroid to treat Bell's palsy, who recovered 7 weeks after therapy. STUDY DESIGN Case report and controlled laboratory study. METHODS A patient enrolled in a first-in-human clinical trial for autologous implantation of a scaffold-free tissue engineered construct (TEC) derived from synovial MSCs for chondral lesion repair had a week of high-dose steroid therapy for Bell's palsy. Synovial tissue was harvested for MSC preparation after a 3-week recovery period and again at 7 weeks after therapy. RESULTS The MSC proliferation rates and cell surface marker expression profiles from the 3-week sample met conditions for further processing. However, the cells failed to generate a functional TEC. In contrast, MSCs harvested at 7 weeks after steroid therapy were functional in this regard. Further in vitro studies with MSCs and steroids indicated that the effect of in vivo steroids was likely a direct effect of the drug on the MSCs. CONCLUSION This case suggests that MSCs are transiently compromised after high-dose steroid therapy and that careful consideration regarding timing of MSC harvest is critical. CLINICAL RELEVANCE The drug profiles of MSC donors and recipients must be carefully monitored to optimize opportunities to successfully repair damaged tissues.
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Affiliation(s)
- Yukihiko Yasui
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - David A Hart
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
| | - Norihiko Sugita
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Ryota Chijimatsu
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kota Koizumi
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Wataru Ando
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yu Moriguchi
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Akira Myoui
- Medical Center for Translational and Clinical Research, Department of Medical Innovation, Osaka University Hospital, Suita, Osaka, Japan
| | - Hideki Yoshikawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Norimasa Nakamura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.,Center for Advanced Medical Engineering and Informatics, Osaka University, Suita, Osaka, Japan.,Institute for Medical Science in Sports, Osaka Health Science University, Osaka City, Osaka, Japan
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45
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Shimomura K, Ando W, Fujie H, Hart DA, Yoshikawa H, Nakamura N. Scaffold-free tissue engineering for injured joint surface restoration. J Exp Orthop 2018; 5:2. [PMID: 29330730 PMCID: PMC5768574 DOI: 10.1186/s40634-017-0118-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 12/20/2017] [Indexed: 12/31/2022] Open
Abstract
Articular cartilage does not heal spontaneously due to its limited healing capacity, and thus effective treatments for cartilage injuries has remained challenging. Since the first report by Brittberg et al. in 1994, autologous chondrocyte implantation (ACI) has been introduced into the clinic. Recently, as an alternative for chondrocyte-based therapy, mesenchymal stem cell (MSC)-based therapy has received considerable research attention because of the relative ease in handling for tissue harvest, and subsequent cell expansion and differentiation. In this review, we discuss the latest developments regarding stem cell-based therapies for cartilage repair, with special focus on recent scaffold-free approaches.
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Affiliation(s)
- Kazunori Shimomura
- Medicine for Sports and Performing Arts, Department of Health and Sport Sciences, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan.,Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Wataru Ando
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Hiromichi Fujie
- Division of Human Mechatronics Systems, Faculty of System Design, Tokyo Metropolitan University, 6-6 Asahigaoka, Hino City, Tokyo, 191-0065, Japan
| | - David A Hart
- McCaig Institute for Bone & Joint Health, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada
| | - Hideki Yoshikawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Norimasa Nakamura
- Institute for Medical Science in Sports, Osaka Health Science University, 1-9-27 Tenma, Kita-ku, Osaka City, Osaka, 530-0043, Japan. .,Center for Advanced Medical Engineering and Informatics, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
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46
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Shimomura K, Hamamoto S, Hart DA, Yoshikawa H, Nakamura N. Meniscal repair and regeneration: Current strategies and future perspectives. J Clin Orthop Trauma 2018; 9:247-253. [PMID: 30202157 PMCID: PMC6128795 DOI: 10.1016/j.jcot.2018.07.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 06/30/2018] [Accepted: 07/14/2018] [Indexed: 01/01/2023] Open
Abstract
The management of meniscal injuries remains difficult and challenging. Although several clinical options exist for the treatment of such injuries, complete regeneration of the damaged meniscus has proved difficult due to the limited healing capacity of the tissue. With the advancements in tissue engineering and cell-based technologies, new therapeutic options for patients with currently incurable meniscal lesions now potentially exist. This review will discuss basic anatomy, current repair techniques and treatment options for loss of meniscal integrity. Specifically, we focus on the possibility and feasibility of the latest tissue engineering approaches, including 3D printing technologies. Therefore, this discussion will facilitate a better understanding of the latest trends in meniscal repair and regeneration, and contribute to the future application of such clinical therapies for patients with meniscal injuries.
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Affiliation(s)
- Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Shuichi Hamamoto
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - David A. Hart
- McCaig Institute for Bone & Joint Health, University of Calgary, 3330 Hospital Drive Northwest, Calgary, Alberta, T2N 4N1, Canada
| | - Hideki Yoshikawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Norimasa Nakamura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan,Institute for Medical Science in Sports, Osaka Health Science University, 1-9-27 Tenma, Kita-ku, Osaka City, Osaka, 530-0043, Japan,Center for Advanced Medical Engineering and Informatics, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan,Corresponding author. Institute for Medical Science in Sports, Osaka Health Science University, 1-9-27, Tenma, Kita-ku, Osaka City, Osaka, 530-0043, Japan.
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47
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Yokoi H, Mae T, Iuchi R, Take Y, Tachibana Y, Shimomura K, Ohori T, Shino K, Yoshikawa H, Nakata K. Novel flat and wide meniscal repair material improves the ultimate load of knot breakage in a porcine trans-capsular meniscal repair model. J Exp Orthop 2017; 4:41. [PMID: 29260438 PMCID: PMC5736508 DOI: 10.1186/s40634-017-0114-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 11/30/2017] [Indexed: 11/10/2022] Open
Abstract
Background In the meniscal repair procedures, a high ultimate load capacity and low cyclic creep at the repair site are favorable and lead to good biological incorporation of the tear site after surgery. Previous biomechanical tensile tests of the meniscal sutures have identified the suture knot as the weakest point. We hypothesized that the strength of a suture knot depends on the suture shape, and therefore, we compared three differently shaped suture materials composed of the same material and quantity per length. The purpose of this study was to determine whether a novel flat and wide repair material (FWRM), which consists of braided multi-threads that are cross-sectionally flat and wide, improves the ultimate load of knot breakage in a biomechanical experiment using a porcine trans-capsular meniscal repair model. Methods Eighteen fresh-frozen porcine knees (n = 6 in each group) were used. A longitudinal tear in the middle segment of the medial meniscus was created and repaired with a trans-capsular inside-out method using the following suture materials: No. 2–0 braided polyester conventional suture, hollow suture, and FWRM. After the separation of the inner segment of the meniscus with leaving, the suture stability of the repaired menisci was biomechanically analyzed with a video camera system for widening after a cyclic load between 5 and 20 N was applied 300 times. Ultimate failure load and stiffness at 5 mm/ min were also analyzed. Results We found no significant difference in suture widening after cyclic load tests [conventional suture, mean 0.51 mm (S.D. 0.39 mm); hollow suture, mean 0.23 mm (S.D. 0.11 mm); and FWRM, mean 0.54 mm (S.D. 0.08 mm)]. The failure mode in all specimens was knot breakage. Compared with those of the other groups, the ultimate failure load of FWRM was statistically significantly higher in the load-to-failure tests (conventional suture, mean 58.8 N [S.D. 8.25 N]; hollow suture, mean 79.4 N [S.D. 10.2 N]; and FWRM, mean 97.4 N [S.D. 3.65 N]; p < 0.05). Conclusion FWRM improves the ultimate load of knot breakage without altering stability. This material may contribute to safe and stable meniscus repair.
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Affiliation(s)
- Hiroyuki Yokoi
- Medicine for Sports and Performing Arts, Department of Health and Sports Science, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Tatsuo Mae
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Ryo Iuchi
- Sports Orthopaedic Surgery Center, Yukioka Hospital, 2-2-3, Ukita, Kita-ku, Osaka, Osaka, 530-0021, Japan
| | - Yasuhiro Take
- Medicine for Sports and Performing Arts, Department of Health and Sports Science, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Yuta Tachibana
- Sports Orthopaedic Surgery Center, Yukioka Hospital, 2-2-3, Ukita, Kita-ku, Osaka, Osaka, 530-0021, Japan
| | - Kazunori Shimomura
- Medicine for Sports and Performing Arts, Department of Health and Sports Science, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Tomoki Ohori
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Konsei Shino
- Sports Orthopaedic Surgery Center, Yukioka Hospital, 2-2-3, Ukita, Kita-ku, Osaka, Osaka, 530-0021, Japan
| | - Hideki Yoshikawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Ken Nakata
- Medicine for Sports and Performing Arts, Department of Health and Sports Science, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan.
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48
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Wang K, Murahari P, Yokoyama K, Lord JS, Pratt FL, He J, Schulz L, Willis M, Anthony JE, Morley NA, Nuccio L, Misquitta A, Dunstan DJ, Shimomura K, Watanabe I, Zhang S, Heathcote P, Drew AJ. Temporal mapping of photochemical reactions and molecular excited states with carbon specificity. Nat Mater 2017; 16:467-473. [PMID: 27941808 DOI: 10.1038/nmat4816] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/31/2016] [Indexed: 06/06/2023]
Abstract
Photochemical reactions are essential to a large number of important industrial and biological processes. A method for monitoring photochemical reaction kinetics and the dynamics of molecular excitations with spatial resolution within the active molecule would allow a rigorous exploration of the pathway and mechanism of photophysical and photochemical processes. Here we demonstrate that laser-excited muon pump-probe spin spectroscopy (photo-μSR) can temporally and spatially map these processes with a spatial resolution at the single-carbon level in a molecule with a pentacene backbone. The observed time-dependent light-induced changes of an avoided level crossing resonance demonstrate that the photochemical reactivity of a specific carbon atom is modified as a result of the presence of the excited state wavefunction. This demonstrates the sensitivity and potential of this technique in probing molecular excitations and photochemistry.
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Affiliation(s)
- K Wang
- College of Physical Sciences and Technology, Sichuan University, Chengdu, Sichuan 610064, China
- School of Physics and Astronomy, Queen Mary University of London, Mile End, London E1 4NS, UK
| | - P Murahari
- School of Physics and Astronomy, Queen Mary University of London, Mile End, London E1 4NS, UK
| | - K Yokoyama
- School of Physics and Astronomy, Queen Mary University of London, Mile End, London E1 4NS, UK
- ISIS Muon Facility, Rutherford Appleton Laboratory, Didcot OX11 0QX, UK
| | - J S Lord
- ISIS Muon Facility, Rutherford Appleton Laboratory, Didcot OX11 0QX, UK
| | - F L Pratt
- ISIS Muon Facility, Rutherford Appleton Laboratory, Didcot OX11 0QX, UK
| | - J He
- College of Physical Sciences and Technology, Sichuan University, Chengdu, Sichuan 610064, China
| | - L Schulz
- College of Physical Sciences and Technology, Sichuan University, Chengdu, Sichuan 610064, China
| | - M Willis
- College of Physical Sciences and Technology, Sichuan University, Chengdu, Sichuan 610064, China
| | - J E Anthony
- Department of Chemistry, University of Kentucky, Lexington, Kentucky 40506, USA
| | - N A Morley
- Department of Materials Science and Engineering, University of Sheffield, Sheffield S1 3JD, UK
| | - L Nuccio
- University of Fribourg, Department of Physics and Fribourg Centre for Nanomaterials, Chemin du Museé 3, CH-1700 Fribourg, Switzerland
| | - A Misquitta
- School of Physics and Astronomy, Queen Mary University of London, Mile End, London E1 4NS, UK
| | - D J Dunstan
- School of Physics and Astronomy, Queen Mary University of London, Mile End, London E1 4NS, UK
| | - K Shimomura
- Materials and Life Science Division, J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - I Watanabe
- RIKEN-RAL, Nishina Centre, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - S Zhang
- College of Physical Sciences and Technology, Sichuan University, Chengdu, Sichuan 610064, China
| | - P Heathcote
- School of Biological and Chemical Sciences, Queen Mary University of London, Mile End, London E1 4NS, UK
| | - A J Drew
- College of Physical Sciences and Technology, Sichuan University, Chengdu, Sichuan 610064, China
- School of Physics and Astronomy, Queen Mary University of London, Mile End, London E1 4NS, UK
- ISIS Muon Facility, Rutherford Appleton Laboratory, Didcot OX11 0QX, UK
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Shimomura K, Moriguchi Y, Nansai R, Fujie H, Ando W, Horibe S, Hart DA, Gobbi A, Yoshikawa H, Nakamura N. Comparison of 2 Different Formulations of Artificial Bone for a Hybrid Implant With a Tissue-Engineered Construct Derived From Synovial Mesenchymal Stem Cells: A Study Using a Rabbit Osteochondral Defect Model. Am J Sports Med 2017; 45:666-675. [PMID: 28272938 DOI: 10.1177/0363546516668835] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Previously, we developed a hybrid implant composed of hydroxyapatite (HA)-based artificial bone coupled with a mesenchymal stem cell (MSC)-based scaffold-free tissue-engineered construct (TEC) and demonstrated its feasibility for osteochondral repair. Beta-tricalcium phosphate (βTCP) may be a promising alternative to HA, as it is a highly biocompatible material and is resorbed more rapidly than HA in vivo. HYPOTHESIS A βTCP-based hybrid TEC implant will exhibit superior osteochondral repair when directly compared with an HA-based hybrid implant, as tested using a rabbit osteochondral defect model. STUDY DESIGN Controlled laboratory study. METHODS Osteochondral defects were created in the femoral groove of skeletally mature rabbits. The TEC and artificial bone, using either HA or βTCP with the same porosities and similar mechanical properties, were hybridized and then implanted in the defects. A histological evaluation and microindentation testing were performed for the assessment of repair tissue. RESULTS Osteochondral defects treated with the TEC/βTCP implants showed more rapid subchondral bone repair at 1 month, but the cartilaginous tissue deteriorated over time out to 6 months after implantation. Osteochondral defects treated with the TEC/HA implants maintained good histological quality out to 6 months after implantation and also exhibited better biomechanical properties at 6 months as compared with the TEC/βTCP implants. CONCLUSION Contrary to our hypothesis, the TEC/HA hybrid implant facilitated better osteochondral repair than did the TEC/βTCP implant. The results of the present study suggest the importance of a stable restoration of subchondral bone for long-term effective osteochondral repair rather than rapid remodeling of subchondral bone. CLINICAL RELEVANCE This study contributes to the future selection of suitable materials for patients with osteochondral lesions.
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Affiliation(s)
- Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yu Moriguchi
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ryosuke Nansai
- Biomechanics Laboratory, Department of Mechanical Engineering, Kogakuin University, Tokyo, Japan
| | - Hiromichi Fujie
- Biomechanics Laboratory, Department of Mechanical Engineering, Kogakuin University, Tokyo, Japan.,Division of Human Mechatronics Systems, Faculty of System Design, Tokyo Metropolitan University, Tokyo, Japan
| | - Wataru Ando
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Japan
| | - Shuji Horibe
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Osaka, Japan
| | - David A Hart
- McCaig Institute for Bone & Joint Health, University of Calgary, Calgary, Alberta, Canada
| | - Alberto Gobbi
- Orthopaedic Arthroscopic Surgery International, Milan, Italy
| | - Hideki Yoshikawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norimasa Nakamura
- Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan.,Center for Advanced Medical Engineering and Informatics, Osaka University, Osaka, Japan
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50
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Shimomura K, Rothrauff BB, Tuan RS. Region-Specific Effect of the Decellularized Meniscus Extracellular Matrix on Mesenchymal Stem Cell-Based Meniscus Tissue Engineering. Am J Sports Med 2017; 45:604-611. [PMID: 27895039 DOI: 10.1177/0363546516674184] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The meniscus is the most commonly injured knee structure, and surgical repair is often ineffective. Tissue engineering-based repair or regeneration may provide a needed solution. Decellularized, tissue-derived extracellular matrices (ECMs) have received attention for their potential use as tissue-engineered scaffolds. In considering meniscus-derived ECMs (mECMs) for meniscus tissue engineering, it is noteworthy that the inner and outer regions of the meniscus have different structural and biochemical features, potentially directing the differentiation of cells toward region-specific phenotypes. PURPOSE To investigate the applicability of mECMs for meniscus tissue engineering by specifically comparing region-dependent effects of mECMs on 3-dimensional constructs seeded with human bone marrow mesenchymal stem cells (hBMSCs). STUDY DESIGN Controlled laboratory study. METHODS Bovine menisci were divided into inner and outer halves and were minced, treated with Triton X-100 and DNase, and extracted with urea. Then, hBMSCs (1 × 106 cells/mL) were encapsulated in a photo-cross-linked 10% polyethylene glycol diacrylate scaffold containing mECMs (60 μg/mL) derived from either the inner or outer meniscus, with an ECM-free scaffold as a control. The cell-seeded constructs were cultured with chondrogenic medium containing recombinant human transforming growth factor β3 (TGF-β3) and were analyzed for expression of meniscus-associated genes as well as for the collagen (hydroxyproline) and glycosaminoglycan content as a function of time. RESULTS Decellularization was verified by the absence of 4',6-diamidino-2-phenylindole (DAPI)-stained cell nuclei and a reduction in the DNA content. Quantitative real-time polymerase chain reaction showed that collagen type I expression was significantly higher in the outer mECM group than in the other groups, while collagen type II and aggrecan expression was highest in the inner mECM group. The collagen (hydroxyproline) content was highest in the outer mECM group, while the glycosaminoglycan content was higher in both the inner and outer mECM groups compared with the control group. CONCLUSION These results showed that the inner mECM enhances the fibrocartilaginous differentiation of hBMSCs, while the outer mECM promotes a more fibroblastic phenotype. Our findings support the feasibility of fabricating bioactive scaffolds using region-specific mECM preparations for meniscus tissue engineering. CLINICAL RELEVANCE This is the first report to demonstrate the feasibility of applying region-specific mECMs for the engineering of meniscus implants capable of reproducing the biphasic, anatomic, and biochemical characteristics of the meniscus, features that should contribute to the feasibility of their clinical application.
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Affiliation(s)
- Kazunori Shimomura
- Medicine for Sports and Performing Arts, Department of Health and Sport Sciences, Osaka University Graduate School of Medicine, Osaka, Japan.,Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Benjamin B Rothrauff
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rocky S Tuan
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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