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Campbell SJ, Campbell SJ, Chegini S, Ahmed F, Heliotis M. 168. Comparison of manual positioning Vs wafer positioning for orthognathic surgery, a cohort study. Br J Oral Maxillofac Surg 2022. [DOI: 10.1016/j.bjoms.2022.11.242] [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: 12/24/2022]
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2
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Chegini S, Campbell SJ, Klontzas ME, Chopra R, Wright H, Exley R, Thusu S, McKenny E, Heliotis M. Development of a patient-reported outcomes and experience measure for Orthognathic surgery: validation of the Northwick Park Orthognathic Questionnaire (NOQ). Int J Oral Maxillofac Surg 2021; 51:659-664. [PMID: 34756661 DOI: 10.1016/j.ijom.2021.10.007] [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: 09/21/2020] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022]
Abstract
Orthognathic surgery aims to correct dentoskeletal and facial discrepancies. The expected benefits are functional, cosmetic, and psychological. In a previous publication, this group assessed the determinants of patient satisfaction to formulate the Northwick Park Orthognathic Questionnaire (NOQ). The aim of the present study was to validate this questionnaire. A total of 118 postoperative patients prospectively completed the NOQ, 30 of whom completed the questionnaire a second time. The mean completion rate was 87.6 ± 10%. Response reproducibility was high: 92% of patients gave identical responses (range 81-100%). The intra-class correlation coefficient (ICC) was 0.96 (0.96 ± 0.072). Average test-retest scores for each domain were as follows (range in parenthesis): reasons for treatment 93% (60-100%), preoperative experience 96% (81-100%), preparation for surgery 95% (81-100%), inpatient experience 89% (55-100%), post-discharge experience 83% (55-100%), benefits of treatment 92% (71-100%), overall patient education 91% (62-100%). Internal validity using Cronbach's alpha was 0.72 (standard deviation 0.23, range 0.5-1). The results confirm the consistency of responses and the reliability of the information collected with the NOQ. The NOQ is a novel questionnaire and a valid metric to quantify a patient's perception of their experience. Its adoption may aid in making targeted improvements to patient care.
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Affiliation(s)
- S Chegini
- Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, Harrow, Middlesex, UK.
| | - S-J Campbell
- Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, Harrow, Middlesex, UK
| | - M E Klontzas
- Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, Harrow, Middlesex, UK
| | - R Chopra
- Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, Harrow, Middlesex, UK
| | - H Wright
- Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, Harrow, Middlesex, UK
| | - R Exley
- Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, Harrow, Middlesex, UK
| | - S Thusu
- Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, Harrow, Middlesex, UK
| | - E McKenny
- Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, Harrow, Middlesex, UK
| | - M Heliotis
- Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, Harrow, Middlesex, UK
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Shah KS, Letafat M, Nightingale C, Ismail S, Klontzas M, Ferretti C, Stone IS, Messiha A, Heliotis M. Maxillomandibular Advancement (MMA) By Means of Bilateral Total TMJ Replacement and Le Fort 1 Advancement Osteotomy For Obstructive Sleep Apnoea (OSA). Br J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.bjoms.2019.10.213] [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: 11/28/2022]
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Campbell SJ, Chegini S, Heliotis M. Re: re: Condylectomy: treatment of recurrent unilateral dislocation of the temporomandibular joint in a patient with Ehlers-Danlos syndrome. Br J Oral Maxillofac Surg 2019; 57:484. [PMID: 30967294 DOI: 10.1016/j.bjoms.2019.03.018] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 03/21/2019] [Indexed: 11/29/2022]
Affiliation(s)
- S-J Campbell
- DCT2 OMFS Northwick Park hospital, 46 Acorn walk, SE16 5EP, London
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Klontzas ME, Reakasame S, Silva R, Morais JC, Vernardis S, MacFarlane RJ, Heliotis M, Tsiridis E, Panoskaltsis N, Boccaccini AR, Mantalaris A. Oxidized alginate hydrogels with the GHK peptide enhance cord blood mesenchymal stem cell osteogenesis: A paradigm for metabolomics-based evaluation of biomaterial design. Acta Biomater 2019; 88:224-240. [PMID: 30772514 DOI: 10.1016/j.actbio.2019.02.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/08/2019] [Accepted: 02/13/2019] [Indexed: 02/06/2023]
Abstract
Oxidized alginate hydrogels are appealing alternatives to natural alginate due to their favourable biodegradability profiles and capacity to self-crosslink with amine containing molecules facilitating functionalization with extracellular matrix cues, which enable modulation of stem cell fate, achieve highly viable 3-D cultures, and promote cell growth. Stem cell metabolism is at the core of cellular fate (proliferation, differentiation, death) and metabolomics provides global metabolic signatures representative of cellular status, being able to accurately identify the quality of stem cell differentiation. Herein, umbilical cord blood mesenchymal stem cells (UCB MSCs) were encapsulated in novel oxidized alginate hydrogels functionalized with the glycine-histidine-lysine (GHK) peptide and differentiated towards the osteoblastic lineage. The ADA-GHK hydrogels significantly improved osteogenic differentiation compared to gelatin-containing control hydrogels, as demonstrated by gene expression, alkaline phosphatase activity and bone extracellular matrix deposition. Metabolomics revealed the high degree of metabolic heterogeneity in the gelatin-containing control hydrogels, captured the enhanced osteogenic differentiation in the ADA-GHK hydrogels, confirmed the similar metabolism between differentiated cells and primary osteoblasts, and elucidated the metabolic mechanism responsible for the function of GHK. Our results suggest a novel paradigm for metabolomics-guided biomaterial design and robust stem cell bioprocessing. STATEMENT OF SIGNIFICANCE: Producing high quality engineered bone grafts is important for the treatment of critical sized bone defects. Robust and sensitive techniques are required for quality assessment of tissue-engineered constructs, which result to the selection of optimal biomaterials for bone graft development. Herein, we present a new use of metabolomics signatures in guiding the development of novel oxidised alginate-based hydrogels with umbilical cord blood mesenchymal stem cells and the glycine-histidine-lysine peptide, demonstrating that GHK induces stem cell osteogenic differentiation. Metabolomics signatures captured the enhanced osteogenesis in GHK hydrogels, confirmed the metabolic similarity between differentiated cells and primary osteoblasts, and elucidated the metabolic mechanism responsible for the function of GHK. In conclusion, our results suggest a new paradigm of metabolomics-driven design of biomaterials.
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Campbell SJ, Chegini S, Heliotis M. Condylectomy: treatment of recurrent unilateral dislocation of the temporomandibular joint in a patient with Ehlers-Danlos syndrome. Br J Oral Maxillofac Surg 2019; 57:76-78. [PMID: 30598319 DOI: 10.1016/j.bjoms.2018.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 09/13/2018] [Indexed: 11/18/2022]
Abstract
We report the use of unilateral condylectomy to treat the recurrent dislocation of the temporomandibular joint (TMJ) in a 21-year-old woman with Ehlers-Danlos syndrome. Eighteen months after operation the patient had no further dislocation on full mouth opening, and no surgical complications.
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Affiliation(s)
- S-J Campbell
- Northwick park hospital, Watford Road, Harrow, Middlesex, HA1 3UJ.
| | - S Chegini
- Northwick park hospital, Watford Road, Harrow, Middlesex, HA1 3UJ
| | - M Heliotis
- Northwick park hospital, Watford Road, Harrow, Middlesex, HA1 3UJ
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Campbell SJ, Chegini S, Heliotis M. Unilateral condylectomy; treatment of recurrent temporomandibular joint dislocation in a patient with Ehlers Danlos Syndrome. Br J Oral Maxillofac Surg 2018. [DOI: 10.1016/j.bjoms.2018.10.149] [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: 10/27/2022]
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Al-Hadi N, Chegini S, Klontzas ME, McKenny J, Heliotis M. Patient expectations and satisfaction following orthognathic surgery. Int J Oral Maxillofac Surg 2018; 48:211-216. [PMID: 30143350 DOI: 10.1016/j.ijom.2018.07.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 12/01/2017] [Revised: 07/14/2018] [Accepted: 07/23/2018] [Indexed: 11/30/2022]
Abstract
Orthognathic surgery aims to correct dentoskeletal and facial discrepancies. Treatment usually requires a minimum of 18 months, necessitating that patients are adequately satisfied with the treatment provided. This study aimed to assess the determinants of patient satisfaction following treatment. One hundred and eighteen patients who had undergone orthognathic surgery were included prospectively. All participants completed a questionnaire regarding their reasons for undergoing treatment, treatment logistics, treatment outcomes, and satisfaction throughout their journey. Most patients were 'very satisfied' (71.2%) or 'satisfied' (19.5%) with the overall treatment. The majority wished to improve their smile (78.0%); post-treatment, 89.0% of patients reported an improved smile. Almost half of the patients (46.6%) stayed in hospital for only one night, and 41.5% took over 4 weeks off work or school post-surgery. People with postoperative breathing difficulties spent more days in hospital (P=0.021), but importantly, the duration of hospital stay did not differ between maxillary advancement, bilateral sagittal split osteotomy, and bimaxillary surgery (P=0.78). In conclusion, patient satisfaction was high following orthognathic treatment. The results highlight areas for improvement, such as information delivery to the patient throughout the treatment journey, and show that the presence of ongoing problems is an important predictor of patient satisfaction.
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Affiliation(s)
- N Al-Hadi
- Regional North West London Maxillofacial Unit, London North West University Healthcare NHS Trust, Northwick Park Hospital, Harrow, London, UK
| | - S Chegini
- Regional North West London Maxillofacial Unit, London North West University Healthcare NHS Trust, Northwick Park Hospital, Harrow, London, UK
| | - M E Klontzas
- Regional North West London Maxillofacial Unit, London North West University Healthcare NHS Trust, Northwick Park Hospital, Harrow, London, UK; Imperial College London, London, UK
| | - J McKenny
- Regional North West London Maxillofacial Unit, London North West University Healthcare NHS Trust, Northwick Park Hospital, Harrow, London, UK
| | - M Heliotis
- Regional North West London Maxillofacial Unit, London North West University Healthcare NHS Trust, Northwick Park Hospital, Harrow, London, UK; Imperial College London, London, UK.
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Ferretti C, Reyneke J, Heliotis M, Ripamonti U. New technique for endoscopically-assisted particulate graft reconstruction of the mandible. Br J Oral Maxillofac Surg 2018; 56:430-432. [DOI: 10.1016/j.bjoms.2018.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/13/2018] [Indexed: 10/17/2022]
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Shah N, Chegini S, Heliotis M. A 12 year retrospective review of Outcomes in Orthognathic Surgery (2004-2016). Br J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.bjoms.2017.08.249] [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: 10/18/2022]
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12
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Ria S, Madattigowda R, Heliotis M. Combined Traumatic, Orthognathic and Implant Surgical Techniques to Correct Post Traumatic Dental and Facial Deformity- A Case Report. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.274] [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: 11/17/2022]
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13
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Klontzas ME, Vernardis SI, Heliotis M, Tsiridis E, Mantalaris A. Metabolomics Analysis of the Osteogenic Differentiation of Umbilical Cord Blood Mesenchymal Stem Cells Reveals Differential Sensitivity to Osteogenic Agents. Stem Cells Dev 2017; 26:723-733. [PMID: 28418785 PMCID: PMC5439454 DOI: 10.1089/scd.2016.0315] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [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: 01/08/2023] Open
Abstract
Mesenchymal stem cells (MSCs) of fetal origin, such as umbilical cord blood MSCs (UCB MSCs), have emerged as a promising cell source for musculoskeletal tissue regeneration because of their higher proliferation potential, lack of donor site morbidity, and their off-the-shelf potential. MSCs differentiated toward the osteogenic lineage exhibit a specific metabolic phenotype characterized by reliance to oxidative phosphorylation for energy production and reduced glycolytic rates. Currently, limited information exists on the metabolic transitions at different stages of the osteogenic process after osteoinduction with different agents. Herein, the osteoinduction efficiency of BMP-2 and dexamethasone on UCB MSCs was assessed using gas chromatography-mass spectrometry (GC-MS) metabolomics analysis, revealing metabolic discrepancies at 7, 14, and 21 days of induction. Whereas both agents when administered individually were able to induce collagen I, osteocalcin, and osteonectin expression, BMP-2 was less effective than dexamethasone in promoting alkaline phosphatase expression. The metabolomics analysis revealed that each agent induced distinct metabolic alterations, including changes in amino acid pools, glutaminolysis, one-carbon metabolism, glycolysis, and tricarboxylic acid cycle. Importantly, we showed that in vitro-differentiated UCB MSCs acquire a metabolic physiology similar to primary osteoblasts when induced with dexamethasone but not with BMP-2, highlighting the fact that metabolomics analysis is sensitive enough to reveal potential differences in the osteogenic efficiency and can be used as a quality control assay for evaluating the osteogenic process.
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Affiliation(s)
- Michail E Klontzas
- 1 Biological Systems Engineering Laboratory, Department of Chemical Engineering and Chemical Technology, Imperial College London , London, United Kingdom
| | - Spyros I Vernardis
- 1 Biological Systems Engineering Laboratory, Department of Chemical Engineering and Chemical Technology, Imperial College London , London, United Kingdom
| | - Manolis Heliotis
- 2 Department of Oral and Maxillofacial Surgery, London North West Healthcare NHS Trust, Northwick Park Hospital , London, United Kingdom
| | - Eleftherios Tsiridis
- 3 Academic Orthopaedic Unit, Aristotle University Medical School , Thessaloniki, Greece .,4 Department of Surgery and Cancer, Division of Surgery, Imperial College London , London, United Kingdom
| | - Athanasios Mantalaris
- 1 Biological Systems Engineering Laboratory, Department of Chemical Engineering and Chemical Technology, Imperial College London , London, United Kingdom
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Affiliation(s)
- Isabelle J Moran
- Oral and Maxillofacial Surgery, Northwick Park Hospital, London HA1 3UJ, UK
- Barts Health Dental Hospital, London E1 1BB, UK
| | | | - Manolis Heliotis
- Oral and Maxillofacial Surgery, Northwick Park Hospital, London HA1 3UJ, UK
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Sheikh O, Logan G, Azizi M, Vempaty S, Sheikh S, Rahim I, Hilmi S, Heliotis M. Surgical vision: enhancing training in oral and maxillofacial surgery. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.729] [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: 11/28/2022]
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16
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Chegini S, Heliotis M. Re: Cross-cover of oral and maxillofacial surgery out-of-hours: an audit of a new adult treatment clinic. Br J Oral Maxillofac Surg 2017; 55:565. [PMID: 28216307 DOI: 10.1016/j.bjoms.2016.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 12/12/2016] [Indexed: 11/25/2022]
Affiliation(s)
- S Chegini
- Northwick Park Hospital, Watford Rd, Harrow HA1 3UJ.
| | - M Heliotis
- Northwick Park Hospital, Watford Rd, Harrow HA1 3UJ
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E. Klontzas M, I. Kenanidis E, J. MacFarlane R, Michail T, E. Potoupnis M, Heliotis M, Mantalaris A, Tsiridis E. Investigational drugs for fracture healing: preclinical & clinical data. Expert Opin Investig Drugs 2016; 25:585-96. [DOI: 10.1517/13543784.2016.1161757] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Berridge N, Heliotis M. New technique to improve lower facial contour using a three-dimensional, custom-made, positional stent. Br J Oral Maxillofac Surg 2016; 54:1044-1045. [PMID: 26980474 DOI: 10.1016/j.bjoms.2016.02.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 02/26/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Natasha Berridge
- Department of Oral & Maxillofacial Surgery, Northwick Park Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ.
| | - Manolis Heliotis
- Department of Oral & Maxillofacial Surgery, Northwick Park Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ
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Kang Y, Georgiou AI, MacFarlane RJ, Klontzas ME, Heliotis M, Tsiridis E, Mantalaris A. Fibronectin stimulates the osteogenic differentiation of murine embryonic stem cells. J Tissue Eng Regen Med 2015; 11:1929-1940. [PMID: 26449737 DOI: 10.1002/term.2090] [Citation(s) in RCA: 18] [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] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 06/12/2015] [Accepted: 09/04/2015] [Indexed: 12/24/2022]
Abstract
Conditioned medium from human hepatocarcinoma cells (HepG2-CM) has been shown to stimulate the osteogenic/chondrogenic differentiation of murine embryonic stem cells (mESCs). HepG2-CM is considered to contain visceral endoderm (VE)-like signals and attempts have recently been made to characterize it, using proteomic profiling, with fibronectin being identified as one promising candidate. Herein, we investigated whether fibronectin is able to mimic the activities of HepG2-CM during the osteogenic differentiation of mESCs. Specifically, the addition of RGD peptides and heparin in HepG2-CM significantly reduced the growth- and adhesion-promoting effects of HepG2-CM, in addition to suppressing its osteogenic-inductive activity. Furthermore, direct addition of fibronectin to basal medium was able to reproduce, at least partially, the function of HepG2-CM. In particular, fibronectin induced the early onset of osteogenic differentiation in mESCs, as confirmed by gene expression of osteogenic markers, and resulted in the three-fold higher calcium deposition at day 11 of osteogenic culture compared to the control group. These data clearly suggest that fibronectin contributes to the biological activities of HepG2-CM and plays a stimulatory role during the process of osteogenesis in mESCs. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Yunyi Kang
- Biological Systems Engineering Laboratory, Department of Chemical Engineering, Imperial College London, UK
| | - Anastasia I Georgiou
- Biological Systems Engineering Laboratory, Department of Chemical Engineering, Imperial College London, UK
| | - Robert J MacFarlane
- Biological Systems Engineering Laboratory, Department of Chemical Engineering, Imperial College London, UK
| | - Michail E Klontzas
- Biological Systems Engineering Laboratory, Department of Chemical Engineering, Imperial College London, UK
| | | | | | - Athanasios Mantalaris
- Biological Systems Engineering Laboratory, Department of Chemical Engineering, Imperial College London, UK
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Rahim I, Salt S, Heliotis M. Successful long-term mandibular reconstruction and rehabilitation using non-vascularised autologous bone graft and recombinant human BMP-7 with subsequent endosseous implant in a patient with bisphosphonate-related osteonecrosis of the jaw. Br J Oral Maxillofac Surg 2015; 53:870-4. [PMID: 26392134 DOI: 10.1016/j.bjoms.2015.08.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [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: 08/11/2014] [Accepted: 08/06/2015] [Indexed: 10/23/2022]
Abstract
We describe a case of extensive osteonecrosis of the mandible after a dental extraction in a 71-year-old woman who was taking alendronic acid (Fosamax(®), Merck) for osteoporosis. Bone damaged by bisphosphonate-related osteonecrosis of the jaw (BRONJ), also now known as medication-related osteonecrosis of the jaw (MRONJ), can be regenerated and filled with endosseous implants using non-vascularised autologous grafts.
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Affiliation(s)
- Ishrat Rahim
- Regional North West London Maxillofacial Unit, Northwick Park Hospital, London, United Kingdom.
| | - Stephen Salt
- Regional North West London Maxillofacial Unit, Northwick Park Hospital, London, United Kingdom.
| | - Manolis Heliotis
- Regional North West London Maxillofacial Unit, Northwick Park Hospital, London, United Kingdom.
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Klontzas ME, Kenanidis EI, Heliotis M, Tsiridis E, Mantalaris A. Bone and cartilage regeneration with the use of umbilical cord mesenchymal stem cells. Expert Opin Biol Ther 2015; 15:1541-52. [PMID: 26176327 DOI: 10.1517/14712598.2015.1068755] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The production of functional alternatives to bone autografts and the development new treatment strategies for cartilage defects are great challenges that could be addressed by the field of tissue engineering. Umbilical cord mesenchymal stem cells (MSCs) can be used to produce cost-effective, atraumatic and possibly autologous bone and cartilage grafts. AREAS COVERED MSCs can be isolated from umbilical cord Wharton's jelly, perivascular tissue and blood using various techniques. Those cells have been characterized and phenotypic similarities with bone marrow-derived MSCs (BM-MSCs) and embryonic stem cells have been found. Findings on their differentiation into the osteogenic and chondrogenic lineage differ between studies and are not as consistent as for BM-MSCs. EXPERT OPINION MSCs from umbilical cords have to be more extensively studied and the mechanisms underlying their differentiation have to be clarified. To date, they seem to be an attractive alternative to BM-MSCs. However, further research with suitable scaffolds and growth factors as well as with novel scaffold fabrication and culture technology should be conducted before they are introduced to clinical practice and replace BM-MSCs.
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Affiliation(s)
- Michail E Klontzas
- a 1 Imperial College London, Department of Chemical Engineering and Chemical Technology , South Kensington Campus, London, UK
| | - Eustathios I Kenanidis
- b 2 Aristotle University Medical School, Academic Orthopaedic Unit , University Campus 54 124, Thessaloniki, Greece.,c 3 Aristotle University Medical School, "PapaGeorgiou" General Hospital, Academic Orthopaedic Unit , Thessaloniki, Greece
| | | | - Eleftherios Tsiridis
- b 2 Aristotle University Medical School, Academic Orthopaedic Unit , University Campus 54 124, Thessaloniki, Greece.,e 5 Imperial College London, Department of Surgery and Cancer, Division of Surgery , B-block, Hammersmith, Du-Cane Road, London, UK
| | - Athanasios Mantalaris
- f 6 Imperial College London, Department of Chemical Engineering , South Kensington Campus, London, UK
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Thavarajah M, Szamocki S, Komath D, Cascarini L, Heliotis M. Comparing disciplines: outcomes of non melanoma cutaneous malignant lesions in oral and maxillofacial surgery and dermatology. Eur J Surg Oncol 2014; 41:169-73. [PMID: 25468744 DOI: 10.1016/j.ejso.2014.10.054] [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: 09/07/2014] [Revised: 10/09/2014] [Accepted: 10/24/2014] [Indexed: 10/24/2022] Open
Abstract
300 cases of non-melanoma cutaneous lesion procedures carried out by the Oral and Maxillofacial Surgery and Dermatology departments in a North West London hospital over a 6 month period between September 2011 and February 2012 were included in a retrospective case control study. The results from each speciality were compared. The mean age of the OMFS group was 75.8 years compared to 69.9 years in the dermatology group. There was no statistically significant difference in gender between the 2 groups. The OMFS group treated a higher proportion of atypical (17%) and malignant (64.9%) cases compared to the dermatology group (11.3% and 50.5% respectively). This could also account for the fact that the OMFS group carried out a higher number of full excisions compared to dermatology. Both groups had a similar number of false positives (a benign lesion initially diagnosed as malignant) and a similar proportion of false negatives (a malignant lesion initially diagnosed as benign). Overall, the results show that both specialities had similar outcomes when managing non-melanoma cutaneous lesions. Both groups adhere to the guidelines set out by the British Association of Dermatologists and the National Institute of Clinical Excellence when managing such lesions.
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Affiliation(s)
- M Thavarajah
- Northwick Park Hospital, North West London Hospital Trust, Watford Rd, Harrow, Middlesex HA1 3UJ, UK
| | - S Szamocki
- Northwick Park Hospital, North West London Hospital Trust, Watford Rd, Harrow, Middlesex HA1 3UJ, UK.
| | - D Komath
- Northwick Park Hospital, North West London Hospital Trust, Watford Rd, Harrow, Middlesex HA1 3UJ, UK
| | - L Cascarini
- Northwick Park Hospital, North West London Hospital Trust, Watford Rd, Harrow, Middlesex HA1 3UJ, UK
| | - M Heliotis
- Northwick Park Hospital, North West London Hospital Trust, Watford Rd, Harrow, Middlesex HA1 3UJ, UK
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Berridge N, Magopoulos C, Heliotis M. Bilateral Labiomental Fan Flap. Plast Reconstr Surg 2014. [DOI: 10.1097/01.prs.0000455482.94711.b1] [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: 11/25/2022]
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Berridge N, Heliotis M. The ‘Downsliding’ Osteotomy. Plast Reconstr Surg 2014. [DOI: 10.1097/01.prs.0000455384.97389.98] [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: 11/25/2022]
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Berridge N, Heliotis M. The ‘Downsliding’ Osteotomy; Highlighting an Underused Surgical Technique to Manage Vertical Maxillary Deficiency. J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.joms.2014.06.082] [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: 11/27/2022]
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Vig N, Heliotis M, Rathod N. Patient-centred evaluation of satisfaction levels following orthognathic surgery: results over a 4-year period, and implications for the futures. Int J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.ijom.2013.07.592] [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: 10/26/2022]
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Komath D, Szamocki S, Thavarajah M, Nigar E, Cascarini L, Heliotis M. OP219. Oral Oncol 2013. [DOI: 10.1016/j.oraloncology.2013.03.228] [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: 11/25/2022]
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MacFarlane RJ, Graham SM, Davies PSE, Korres N, Tsouchnica H, Heliotis M, Mantalaris A, Tsiridis E. Anti-inflammatory role and immunomodulation of mesenchymal stem cells in systemic joint diseases: potential for treatment. Expert Opin Ther Targets 2013; 17:243-54. [PMID: 23293906 DOI: 10.1517/14728222.2013.746954] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Mesenchymal stem cells (MSCs) are multipotent stromal cells characterized by their ability to differentiate into adipocytes, chondrocytes, osteocytes and a number of other lineages. Investigation into their use has increased in recent years as characterization of their immunomodulatory properties has developed, and their role in the pathophysiology of joint disease has been suggested. AREAS COVERED MSCs demonstrate immunosuppressive functionality by suppressing T- and B-cell responses following activation by cytokines such as IL-6 and IL-1α. They also can be induced to exert pro-inflammatory effects in the presence of acute inflammatory environment due to the actions of TNF-α and IFN-γ. In inflammatory joint diseases such as rheumatoid arthritis, MSCs in bone marrow migrate to joints by a TNF-α-dependent mechanism and may be in part responsible for the disease process. MSCs have also been demonstrated in increased numbers in periarticular tissues in osteoarthritis, which may reflect an attempt at joint regeneration. EXPERT OPINION Clinical applications for MSCs have shown promise in a number of inflammatory and autoimmune disorders. Future work is likely to further reveal the immunosuppressive characteristics of MSCs, their role in the pathophysiology of joint diseases and provide the basis for new avenues for treatment.
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Affiliation(s)
- Robert J MacFarlane
- The Royal Liverpool University Hospital, Department of Trauma and Orthopaedics, Prescot Street, Liverpool, Merseyside L7 8XP, UK
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Pagkalos J, Leonidou A, As-Sultany M, Heliotis M, Mantalaris A, Tsiridis E. Prostaglandin E2 Receptors as Potential Bone Anabolic Targets – Selective EP4 Receptor Agonists. Curr Mol Pharmacol 2012; 5:174-81. [DOI: 10.2174/1874467211205020174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2010] [Revised: 12/29/2010] [Accepted: 03/03/2011] [Indexed: 11/22/2022]
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Gamie Z, Tran GT, Vyzas G, Korres N, Heliotis M, Mantalaris A, Tsiridis E. Stem cells combined with bone graft substitutes in skeletal tissue engineering. Expert Opin Biol Ther 2012; 12:713-29. [DOI: 10.1517/14712598.2012.679652] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Kallala R, Graham SM, Nikkhah D, Kyrkos M, Heliotis M, Mantalaris A, Tsiridis E. In vitroandin vivoeffects of antibiotics on bone cell metabolism and fracture healing. Expert Opin Drug Saf 2011; 11:15-32. [DOI: 10.1517/14740338.2012.643867] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Borumandi F, Heliotis M, Kerawala C, Bisase B, Cascarini L. Role of robotic surgery in oral and maxillofacial, and head and neck surgery. Br J Oral Maxillofac Surg 2011; 50:389-93. [PMID: 21802802 DOI: 10.1016/j.bjoms.2011.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Accepted: 06/29/2011] [Indexed: 10/18/2022]
Abstract
We review the current status of robotic surgery in the head and neck region and its role in oral and maxillofacial surgery.
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Affiliation(s)
- Farzad Borumandi
- Department of Oral and Maxillofacial Surgery, North West London Hospitals NHS Trust, Northwick Park Hospital, Watford Road, Harrow, London HA1 3UJ, United Kingdom.
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Shakib K, Navai A, Heliotis M. The pattern of mandibular third molar impactions in presence or absence of lower first molars. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.213] [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: 11/26/2022]
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Graham SM, Howgate D, Anderson W, Howes C, Heliotis M, Mantalaris A, Tsiridis E, Tsapakis E. Risk of osteoporosis and fracture incidence in patients on antipsychotic medication. Expert Opin Drug Saf 2011; 10:575-602. [PMID: 21385106 DOI: 10.1517/14740338.2011.560112] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION In patients suffering from schizophrenia and bipolar disorder, antipsychotics are the mainstay of treatment worldwide. By blocking D(2) brain mesolimbic receptors, antipsychotics are believed to reduce and control psychotic experiences, but recent evidence has suggested that they may also have adverse effects on bone mineral architecture and fracture incidence. AREAS COVERED This study reviews current literature surrounding the use of antipsychotics and their effects on bone homeostasis. The primary medical search engines used for the study are Ovid MEDLINE (1950 - April 2010), EMBASE (1988 - April 2010) and PsychINFO (1987 - April 2010) databases. EXPERT OPINION Typical antipsychotics, in addition to the atypical antipsychotics risperidone and amisulpride, have been shown to increase serum prolactin levels in in vivo human studies. Results from animal and human in vitro and in vivo studies have demonstrated that high concentrations of prolactin have been shown to adversely affect bone cell metabolism and accelerate the rate bone mineral density loss, thereby increasing fracture risk. Increasing awareness of the side effect profile of antipsychotic medications on bone metabolism may prompt clinicians to screen patients at high risk of antipsychotic-induced osteoporosis and provide treatment, which may reduce the incidence of potentially avoidable fractures.
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Affiliation(s)
- Simon Matthew Graham
- Leeds University, Leeds School of Medicine, Academic Orthopaedic Department, Leeds General Infirmary, LS1 3EX, UK
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Abstract
Statins are potent inhibitors of cholesterol synthesis. Several statins are available with different molecular and pharmacokinetic properties. Simvastatin is more lipophilic than pravastatin and has a higher affinity to phospholipid membranes than atorvastatin, allowing its passive diffusion through the cell membrane. In vitro studies on bone marrow stromal cells, osteoblast-like cells, and embryonic stem cells have shown statins to have cholesterol-independent anabolic effects on bone metabolism; alas, statins were supplemented in osteogenic medium, which does not facilitate elucidation of their potential osteoinductive properties. Embryonic stem cells (ESCs), derived from the inner cell mass of the blastocyst, are unique in that they enjoy perpetual self-proliferation, are pluripotent, and are able to differentiate toward all the cellular lineages composing the body, including the osteogenic lineage. Consequently, ESCs represent a potentially potent cell source for future clinical cellular therapies of various bone diseases, even though there are several hurdles that still need to be overcome. Herein we demonstrate, for the first time to our knowledge, that simvastatin induces murine ESC (mESC) differentiation toward the osteogenic lineage in the absence of osteoinductive supplements. Specifically, we found that a simvastatin concentration in the micromolar range and higher was toxic to the cells and that an effective concentration for osteoinduction is 0.1 nM, as shown by increased alizarin red staining as well as increased osteocalcin and osetrix gene expression. These results suggest that in the future, lipophilic simvastatin may provide a novel pharmacologic agent for bone tissue engineering applications.
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Affiliation(s)
- Joseph Pagkalos
- Biological Systems Engineering Laboratory, Department of Chemical Engineering, Imperial College London, London, United Kingdom
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Graham SM, Leonidou A, Aslam-Pervez N, Hamza A, Panteliadis P, Heliotis M, Mantalaris A, Tsiridis E. Biological therapy of bone defects: the immunology of bone allo-transplantation. Expert Opin Biol Ther 2010; 10:885-901. [PMID: 20415596 DOI: 10.1517/14712598.2010.481669] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
IMPORTANCE OF THE FIELD Bone is one of the most transplanted tissues worldwide. Autograft is the ideal bone graft but is not widely used because of donor site morbidity and restricted availability. Allograft is easily accessible but can transmit infections and elicit an immune response. AREAS COVERED IN THIS REVIEW This review identifies all in vitro and in vivo evidence of immune responses following bone transplantation and highlights methods of improving host tolerance to bone allotransplantation. WHAT THE READER WILL GAIN In humans, the presence of anti-HLA specific antibodies against freeze-dried and fresh-frozen bone allografts has been demonstrated. Fresh-frozen bone allograft can still generate immune reactions whilst freeze-dried bone allografts present with less immunogenicity but have less structural integrity. This immune response can have an adverse effect on the graft's incorporation and increase the incidence of rejection. Decreasing the immune reaction against the allograft by lowering the immunogenic load of the graft or lowering the host immune response, would result in improved bone incorporation. TAKE HOME MESSAGE It is essential that the complex biological processes related to bone immunogenicity are understood, since this may allow the development of safer and more successful ways of controlling the outcome of bone allografting.
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Affiliation(s)
- Simon M Graham
- Academic Department of Trauma and Orthopaedics, University of Leeds, School of Medicine, Clarendon Wing A, Leeds General Infirmary Teaching Hospitals NHS Trust, Great George Street, Leeds LS1 3EX, UK
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Ferretti C, Ripamonti U, Tsiridis E, Kerawala CJ, Mantalaris A, Heliotis M. Osteoinduction: translating preclinical promise into clinical reality. Br J Oral Maxillofac Surg 2010; 49:507-9. [PMID: 20430492 DOI: 10.1016/j.bjoms.2010.07.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2010] [Accepted: 07/17/2010] [Indexed: 12/24/2022]
Abstract
This review, the second in a series of three editorials, focuses on the problems of translating basic scientific research on induction of bone into reliable clinical applications.
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Affiliation(s)
- Carlo Ferretti
- Division of Maxillofacial and Oral Surgery, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa.
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Ferretti C, Ripamonti U, Tsiridis E, Kerawala CJ, Mantalaris A, Heliotis M. Osteoinduction: translating preclinical promise into clinical reality. Br J Oral Maxillofac Surg 2010; 48:536-9. [PMID: 20430492 DOI: 10.1016/j.bjoms.2009.08.043] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Accepted: 08/21/2009] [Indexed: 11/29/2022]
Abstract
This review, the second in a series of three editorials, focuses on the problems of translating basic scientific research on induction of bone into reliable clinical applications.
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Affiliation(s)
- Carlo Ferretti
- Division of Maxillofacial and Oral Surgery, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa.
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Tran GT, Pagkalos J, Tsiridis E, Narvani AA, Heliotis M, Mantalaris A, Tsiridis E. Growth hormone: does it have a therapeutic role in fracture healing? Expert Opin Investig Drugs 2010; 18:887-911. [PMID: 19480608 DOI: 10.1517/13543780902893069] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The role of growth hormone (GH) in augmenting fracture healing has been postulated for over half a century. GH has been shown to play a role in bone metabolism and this can be mediated directly or indirectly through IGF-I. OBJECTIVES The use of GH was evaluated as a possible therapeutic agent in augmenting fracture healing. METHOD A literature search was undertaken on GH and its effect on bone fracture healing primarily using MEDLINE/OVID (1950 to January 2009). Key words and phrases including 'growth hormone', 'insulin like growth factor', 'insulin like growth factor binding protein', 'insulin like growth factor receptor', 'fracture repair', 'bone healing', 'bone fracture', 'bone metabolism', 'osteoblast' and 'osteoclast' were used in different combinations. Manual searches of the bibliography of key papers were also undertaken. RESULTS Current evidence suggests a positive role of GH on fracture healing as demonstrated by in vitro studies on osteoblasts, osteoclasts and the crosstalk between the two. Animal studies have demonstrated a number of factors influencing the effect of GH in vivo such as dose, timing and method of administration. Application of this knowledge in humans is limited but clearly demonstrates a positive effect on fracture healing. Concern has been raised in the past regarding the safety profile of the pharmacological use of GH when used in critically ill patients. CONCLUSION The optimal dose and method of administration is still to be determined, and the safety profile of this novel use of GH needs to be investigated prior to establishing its widespread use as a fracture-healing agent.
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Affiliation(s)
- Gui Tong Tran
- University of Leeds School of Medicine, Academic Department of Trauma and Orthopaedics, Leeds General Infirmary, Great George Street, Leeds, UK
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Abbas S, Asher S, Shakib K, Heliotis M. Bone morphogenetic protein (BMP-7) used in the reconstruction of a non-healing, atrophic edentulous mandible—a case report. Br J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.bjoms.2009.06.221] [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: 12/01/2022]
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Abbas S, Heliotis M, Kalsi H, Mills C. Correction of lower lip ptosis using Mitek anchorage screws—a report of three cases. Br J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.bjoms.2009.06.116] [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]
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Heliotis M, Ripamonti U, Ferretti C, Kerawala C, Mantalaris A, Tsiridis E. The basic science of bone induction. Br J Oral Maxillofac Surg 2009; 47:511-4. [DOI: 10.1016/j.bjoms.2009.01.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2009] [Indexed: 10/21/2022]
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Graham S, Leonidou A, Lester M, Heliotis M, Mantalaris A, Tsiridis E. Investigating the role of PDGF as a potential drug therapy in bone formation and fracture healing. Expert Opin Investig Drugs 2009; 18:1633-54. [DOI: 10.1517/13543780903241607] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Tang QO, Shakib K, Heliotis M, Tsiridis E, Mantalaris A, Ripamonti U, Tsiridis E. TGF-beta3: A potential biological therapy for enhancing chondrogenesis. Expert Opin Biol Ther 2009; 9:689-701. [PMID: 19426117 DOI: 10.1517/14712590902936823] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND TGF-beta has been proposed to stimulate chondrogenesis through intracellular pathways involving small mothers against decapentaplegic proteins (Smads). OBJECTIVE To examine the use of exogenous TGF-beta3 to promote new hyaline cartilage formation. METHODS An overview of in vitro and in vivo evidence on the effects of TGF-beta3 on cartilage regeneration. RESULTS/CONCLUSION There is robust in vitro evidence suggesting a positive dose- and time-dependent effect of TGF-beta3 on anabolic chondrogenic gene markers such as alpha1-collagen type II and cartilage oligomeric matrix protein in human mesenchymal stem cells. TGF-beta3 cultured with silk elastin-like polymer scaffold carrier exhibits significantly increased glycosaminoglycan and collagen content. In vivo data showed that TGF-beta3 cultured with ovine mesenchymal stem cells in a chitosan scaffold stimulated the growth of hyaline cartilage that was fully integrated into host cartilage tissue of sheep. We highlight the potential for the clinical enhancement of cartilage formation through the use of TGF-beta3 with a suitable dose and scaffold carrier.
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Affiliation(s)
- Quen Oak Tang
- Leeds School of Medicine, Academic Orthopaedic Unit, Leeds General Infirmary, Leeds LS1 3EX , UK
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Graham S, Gamie Z, Polyzois I, Narvani AA, Tzafetta K, Tsiridis E, Heliotis M, Mantalaris A, Tsiridis E. Prostaglandin EP2 and EP4 receptor agonists in bone formation and bone healing:In vivoandin vitroevidence. Expert Opin Investig Drugs 2009; 18:746-66. [DOI: 10.1517/13543780902893051] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Tsialogiannis E, Polyzois I, Tang QO, Pavlou G, Tsiridis E, Heliotis M, Tsiridis E. Targeting bone morphogenetic protein antagonists:in vitroandin vivoevidence of their role in bone metabolism. Expert Opin Ther Targets 2008; 13:123-37. [DOI: 10.1517/14728220802637725] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Tsiridis E, Ali Z, Bhalla A, Gamie Z, Heliotis M, Gurav N, Deb S, DiSilvio L. In vitroproliferation and differentiation of human mesenchymal stem cells on hydroxyapatite versus human demineralised bone matrix with and without osteogenic protein-1. Expert Opin Biol Ther 2008; 9:9-19. [DOI: 10.1517/14712590802622473] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Chadha A, Messiha A, Al-Hadad I, Hussain Z, Heliotis M. Analysis of surgical competencies of oral surgery registrants with respect to training and qualifications. Br J Oral Maxillofac Surg 2008. [DOI: 10.1016/j.bjoms.2008.07.086] [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: 10/21/2022]
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Heliotis M, Tsiridis E. Suppression of bone morphogenetic protein inhibitors promotes osteogenic differentiation: therapeutic implications. Arthritis Res Ther 2008; 10:115. [PMID: 18710600 PMCID: PMC2575635 DOI: 10.1186/ar2467] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Bone morphogenetic proteins (BMPs) are expressed during osteogenesis and their action is regulated by corresponding BMP inhibitors. Chordin (a well recognized BMP inhibitor) and BMP-2 are expressed during osteogenic differentiation of human mesenchymal stem cells. Chordin inhibition induces human mesenchymal stem cell differentiation and reduces their proliferation by increasing BMP-2 bioavailability. The potential of suppressing BMP inhibitors is emerging as a biological therapeutic target in bone tissue engineering, because it results in an unopposed synergy between the various growth factors that are involved in osteogenesis, within their physiological milieu.
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Tsiridis E, Ali Z, Bhalla A, Heliotis M, Gurav N, Deb S, DiSilvio L. In vitro and in vivo optimization of impaction allografting by demineralization and addition of rh-OP-1. J Orthop Res 2007; 25:1425-37. [PMID: 17557338 DOI: 10.1002/jor.20387] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Impaction allografting is a bone tissue engineering technique currently used in lower limb reconstruction orthopedic surgery. Our hypothesis was that biological optimization can be achieved by demineralization and addition of osteogenic protein-1 (OP-1) to the allograft. The objective of our in vitro study was to evaluate human mesenchymal stem cell (MSC) proliferation (Alamar Blue assay, titrated thymidine assay, total DNA Hoechst 33258, and scanning electron microscopy) and osteogenic differentiation (alkaline phosphatase assay) in two types of impacted carrier, namely, demineralized bone matrix (DBM) and insoluble collagenous bone matrix (ICBM), with or without OP-1. The objective in vivo was to compare the osteogenic potential of impacted DBM with or without OP-1, with that of impacted fresh frozen allograft (FFA), again with or without OP-1. DBM + OP-1 optimized osteoinduction and significantly improved (p < 0.05) proliferation and differentiation in comparison to the majority of all other graft preparation in vitro. In addition, DBM + OP-1 was significantly superior, with regard to osteogenesis, compared to the impacted FFA alone (p < 0.001), FFA + OP-1 (p = 0.01) and DBM alone (p = 0.02) in vivo. We propose that partial demineralization and addition of OP-1 provides a good method for improving the osteoinductive properties of fresh allograft currently used in the impaction grafting technique.
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Affiliation(s)
- Eleftherios Tsiridis
- Biomaterials and Biomimetics Group, King's College London, University of London, Guy's Hospital, London SE1 9RT, United Kingdom.
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