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Komulainen T, Daymond P, Hietanen KE, Kaartinen IS, Järvinen TAH. Myofibroblasts reside in the middle dermis of the keloids but do not predict the response to injection therapies: a double-blinded, randomized, controlled trial. Front Med (Lausanne) 2024; 11:1293028. [PMID: 38495113 PMCID: PMC10943694 DOI: 10.3389/fmed.2024.1293028] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/29/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction Keloids form as a pathological response to skin wound healing, and their etiopathology is poorly understood. Myofibroblasts, which are cells transformed from normal fibroblasts, are believed to contribute to pathological scar formation in wounds. Methods We carried out a double-blinded randomized controlled trial (RCT) comparing the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinolone (TAC) injections in treating keloids. A total of 43 patients with 50 keloids were treated with either intralesional TAC or 5-FU injections, and their clinical response was evaluated. Biopsies were collected before, during, and after injection therapy from the active border of a keloid. To understand the role of myofibroblasts in keloids, we conducted an immunohistochemical analysis to identify myofibroblasts [α-smooth muscle actin (αSMA)] from the biopsies. We first defined the three histologically distinct regions-superficial, middle, and deep dermis-in each keloid. Results We then demonstrated that myofibroblasts almost exclusively exist in the middle dermis of the keloids as 80% of the cells in the middle dermis were αSMA positive. However, both the percentage of myofibroblasts as well as the area covered by them was substantially lower in the superficial and deep dermis than in the middle dermis of the keloids. Myofibroblasts do not predict the clinical response to intralesional injection therapies. There is no difference in the myofibroblast numbers in keloids or in the induced change in myofibroblasts between the responders and non-responders after treatment. Discussion This study demonstrates that myofibroblasts reside almost exclusively in the middle dermis layer of the keloids, but their numbers do not predict the clinical response to intralesional injection therapies in the RCT.
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Affiliation(s)
- Tuomas Komulainen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland
| | - Patrik Daymond
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Kristiina E. Hietanen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Plastic Surgery, Hospital Nova, Wellbeing Services County of Central Finland, Jyväskylä, Finland
| | - Ilkka S. Kaartinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland
| | - Tero A. H. Järvinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland
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Maldonado H, Savage BD, Barker HR, May U, Vähätupa M, Badiani RK, Wolanska KI, Turner CMJ, Pemmari T, Ketomäki T, Prince S, Humphries MJ, Ruoslahti E, Morgan MR, Järvinen TAH. Author Correction: Systemically administered wound-homing peptide accelerates wound healing by modulating syndecan-4 function. Nat Commun 2024; 15:234. [PMID: 38172142 PMCID: PMC10764947 DOI: 10.1038/s41467-023-44574-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Affiliation(s)
- Horacio Maldonado
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Bryan D Savage
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Harlan R Barker
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland
| | - Ulrike May
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland
| | - Maria Vähätupa
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland
| | - Rahul K Badiani
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Katarzyna I Wolanska
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Craig M J Turner
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Toini Pemmari
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland
| | - Tuomo Ketomäki
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland
| | - Stuart Prince
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland
| | - Martin J Humphries
- Wellcome Trust Centre for Cell-Matrix Research, University of Manchester, Manchester, UK
| | - Erkki Ruoslahti
- Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA and Center for Nanomedicine, University of California (UCSB), Santa Barbara, CA, USA
| | - Mark R Morgan
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK.
| | - Tero A H Järvinen
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland.
- Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA and Center for Nanomedicine, University of California (UCSB), Santa Barbara, CA, USA.
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Maldonado H, Savage BD, Barker HR, May U, Vähätupa M, Badiani RK, Wolanska KI, Turner CMJ, Pemmari T, Ketomäki T, Prince S, Humphries MJ, Ruoslahti E, Morgan MR, Järvinen TAH. Systemically administered wound-homing peptide accelerates wound healing by modulating syndecan-4 function. Nat Commun 2023; 14:8069. [PMID: 38057316 PMCID: PMC10700342 DOI: 10.1038/s41467-023-43848-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/19/2023] [Indexed: 12/08/2023] Open
Abstract
CAR (CARSKNKDC) is a wound-homing peptide that recognises angiogenic neovessels. Here we discover that systemically administered CAR peptide has inherent ability to promote wound healing: wounds close and re-epithelialise faster in CAR-treated male mice. CAR promotes keratinocyte migration in vitro. The heparan sulfate proteoglycan syndecan-4 regulates cell migration and is crucial for wound healing. We report that syndecan-4 expression is restricted to epidermis and blood vessels in mice skin wounds. Syndecan-4 regulates binding and internalisation of CAR peptide and CAR-mediated cytoskeletal remodelling. CAR induces syndecan-4-dependent activation of the small GTPase ARF6, via the guanine nucleotide exchange factor cytohesin-2, and promotes syndecan-4-, ARF6- and Cytohesin-2-mediated keratinocyte migration. Finally, we show that genetic ablation of syndecan-4 in male mice eliminates CAR-induced wound re-epithelialisation following systemic administration. We propose that CAR peptide activates syndecan-4 functions to selectively promote re-epithelialisation. Thus, CAR peptide provides a therapeutic approach to enhance wound healing in mice; systemic, yet target organ- and cell-specific.
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Affiliation(s)
- Horacio Maldonado
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Bryan D Savage
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Harlan R Barker
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland
| | - Ulrike May
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland
| | - Maria Vähätupa
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland
| | - Rahul K Badiani
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Katarzyna I Wolanska
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Craig M J Turner
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Toini Pemmari
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland
| | - Tuomo Ketomäki
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland
| | - Stuart Prince
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland
| | - Martin J Humphries
- Wellcome Trust Centre for Cell-Matrix Research, University of Manchester, Manchester, UK
| | - Erkki Ruoslahti
- Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA and Center for Nanomedicine, University of California (UCSB), Santa Barbara, CA, USA
| | - Mark R Morgan
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK.
| | - Tero A H Järvinen
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, Tampere, Finland.
- Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA and Center for Nanomedicine, University of California (UCSB), Santa Barbara, CA, USA.
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Edouard P, Reurink G, Mackey AL, Lieber RL, Pizzari T, Järvinen TAH, Gronwald T, Hollander K. Traumatic muscle injury. Nat Rev Dis Primers 2023; 9:56. [PMID: 37857686 DOI: 10.1038/s41572-023-00469-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/21/2023]
Abstract
Traumatic muscle injury represents a collection of skeletal muscle pathologies caused by trauma to the muscle tissue and is defined as damage to the muscle tissue that can result in a functional deficit. Traumatic muscle injury can affect people across the lifespan and can result from high stresses and strains to skeletal muscle tissue, often due to muscle activation while the muscle is lengthening, resulting in indirect and non-contact muscle injuries (strains or ruptures), or from external impact, resulting in direct muscle injuries (contusion or laceration). At a microscopic level, muscle fibres can repair focal damage but must be completely regenerated after full myofibre necrosis. The diagnosis of muscle injury is based on patient history and physical examination. Imaging may be indicated to eliminate differential diagnoses. The management of muscle injury has changed within the past 5 years from initial rest, immobilization and (over)protection to early activation and progressive loading using an active approach. One challenge of muscle injury management is that numerous medical treatment options, such as medications and injections, are often used or proposed to try to accelerate muscle recovery despite very limited efficacy evidence. Another challenge is the prevention of muscle injury owing to the multifactorial and complex nature of this injury.
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Affiliation(s)
- Pascal Edouard
- Université Jean Monnet, Lyon 1, Université Savoie Mont-Blanc, Inter-university Laboratory of Human Movement Biology, Saint-Etienne, France.
- Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France.
| | - Gustaaf Reurink
- Department of Orthopedic Surgery and Sports Medicine, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Academic Medical Center, Amsterdam, Netherlands
- The Sports Physicians Group, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Abigail L Mackey
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Richard L Lieber
- Shirley Ryan AbilityLab, Chicago, IL, USA
- Departments of Physical Medicine and Rehabilitation and Biomedical Engineering, Northwestern University, Chicago, IL, USA
- Hines VA Medical Center, Maywood, IL, USA
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Tero A H Järvinen
- Tampere University and Tampere University Hospital, Tampere, Finland
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Salomaa T, Kummola L, González-Rodríguez MI, Hiihtola L, Järvinen TAH, Junttila IS. Low IL-13Rα1 Expression on Mast Cells Tunes Them Unresponsive to IL-13. J Leukoc Biol 2023:7177897. [PMID: 37224625 DOI: 10.1093/jleuko/qiad065] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 04/06/2023] [Accepted: 05/13/2023] [Indexed: 05/26/2023] Open
Abstract
Cytokine-mediated mast cell regulation enables precise optimization of their own pro-inflammatory cytokine production. During allergic inflammation, Interleukin(IL)-4 regulates mast cell functions, tissue-homing and proliferation, but the direct role of closely related IL-13 for mast cell activation remains unclear. Previous work has shown that mast cells are potent IL-13 producers, but here we show that mouse mast cells do not directly respond to IL-13 by Stat6 activation, as they do not express measurable amount of IL-13Rα1 mRNA. Consequently, IL-4 responses are mediated via type I IL-4R (IL-4/IL4Rα/γC) and IL-4-induced Stat6 activation is abolished in γC deficient mast cells. Type II IL-4R deficiency (IL-13Rα1 KO) has no effect on IL-4-induced Stat6 activation. In basophils, both IL-4 and IL-13 induce Stat6 activation in WT and γC deficient cells, while in type II IL-4R deficient basophils IL-4 signaling is impaired at low ligand concentration. Thus, mast cell and basophil sensitivity to IL-4/IL-13 is different and in mast cells, lack of IL-13Rα1 expression likely explains their unresponsiveness to IL-13.
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Affiliation(s)
- Tanja Salomaa
- Faculty of Medicine and Health Technology, Tampere University, 33014, Tampere, Finland
- Fimlab Laboratories, 33520, Tampere, Finland
- Northern Finland Laboratory Centre (NordLab), 90220, Oulu, Finland
| | - Laura Kummola
- Faculty of Medicine and Health Technology, Tampere University, 33014, Tampere, Finland
| | - Martín Ignacio González-Rodríguez
- Faculty of Medicine and Health Technology, Tampere University, 33014, Tampere, Finland
- Fimlab Laboratories, 33520, Tampere, Finland
- Northern Finland Laboratory Centre (NordLab), 90220, Oulu, Finland
| | - Lotta Hiihtola
- Faculty of Medicine and Health Technology, Tampere University, 33014, Tampere, Finland
- Fimlab Laboratories, 33520, Tampere, Finland
| | - Tero A H Järvinen
- Faculty of Medicine and Health Technology, Tampere University, 33014, Tampere, Finland
- Department of Orthopaedics and Traumatology, Tampere University Hospital, Tampere, Finland
| | - Ilkka S Junttila
- Faculty of Medicine and Health Technology, Tampere University, 33014, Tampere, Finland
- Fimlab Laboratories, 33520, Tampere, Finland
- Northern Finland Laboratory Centre (NordLab), 90220, Oulu, Finland
- Research Unit of Biomedicine, University of Oulu, 90570, Oulu, Finland
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6
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Vähätupa M, Nättinen J, Aapola U, Uusitalo-Järvinen H, Uusitalo H, Järvinen TAH. Proteomics Analysis of R-Ras Deficiency in Oxygen Induced Retinopathy. Int J Mol Sci 2023; 24:ijms24097914. [PMID: 37175621 PMCID: PMC10178533 DOI: 10.3390/ijms24097914] [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: 03/12/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Small GTPase R-Ras regulates vascular permeability in angiogenesis. In the eye, abnormal angiogenesis and hyperpermeability are the leading causes of vision loss in several ischemic retinal diseases such as proliferative diabetic retinopathy (PDR), retinal vein occlusion (RVO), and retinopathy of prematurity (ROP). Oxygen-induced retinopathy (OIR) is the most widely used experimental model for these ischemic retinopathies. To shed more light on how the R-Ras regulates vascular permeability in pathological angiogenesis, we performed a comprehensive (>2900 proteins) characterization of OIR in R-Ras knockout (KO) and wild-type (WT) mice by sequential window acquisition of all theoretical mass spectra (SWATH-MS) proteomics. OIR and age-matched normoxic control retinas were collected at P13, P17, and P42 from R-Ras KO and WT mice and were subjected to SWATH-MS and data analysis. The most significant difference between the R-Ras KO and WT retinas was an accumulation of plasma proteins. The pathological vascular hyperpermeability during OIR in the R-Ras KO retina took place very early, P13. This led to simultaneous hypoxic cell injury/death (ferroptosis), glycolytic metabolism as well compensatory mechanisms to counter the pathological leakage from angiogenic blood vessels in the OIR retina of R-Ras deficient mice.
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Affiliation(s)
- Maria Vähätupa
- Faculty of Medicine and Health Technology, Tampere University, 33521 Tampere, Finland
| | - Janika Nättinen
- Faculty of Medicine and Health Technology, Tampere University, 33521 Tampere, Finland
- Tampere University Hospital, 33520 Tampere, Finland
| | - Ulla Aapola
- Faculty of Medicine and Health Technology, Tampere University, 33521 Tampere, Finland
- Tampere University Hospital, 33520 Tampere, Finland
| | - Hannele Uusitalo-Järvinen
- Faculty of Medicine and Health Technology, Tampere University, 33521 Tampere, Finland
- Tampere University Hospital, 33520 Tampere, Finland
| | - Hannu Uusitalo
- Faculty of Medicine and Health Technology, Tampere University, 33521 Tampere, Finland
- Tampere University Hospital, 33520 Tampere, Finland
| | - Tero A H Järvinen
- Faculty of Medicine and Health Technology, Tampere University, 33521 Tampere, Finland
- Tampere University Hospital, 33520 Tampere, Finland
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Ojanen MJT, Caro FM, Aittomäki S, Ploquin MJ, Ortutay Z, Pekkarinen M, Kesseli J, Vähätupa M, Määttä J, Nykter M, Junttila IS, Järvinen TAH, O Shea JJ, Biron CA, Pesu M. FURIN regulates cytotoxic T lymphocyte effector function and memory cell transition in mice. Eur J Immunol 2023:e2250246. [PMID: 37015057 DOI: 10.1002/eji.202250246] [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: 10/27/2022] [Revised: 03/16/2023] [Accepted: 04/03/2023] [Indexed: 04/06/2023]
Abstract
The proprotein convertase subtilisin/kexins (PCSKs) regulate biological actions by cleaving immature substrate proteins. The archetype PCSK, FURIN, promotes the pathogenicity of viruses by proteolytically processing viral proteins. FURIN has also important regulatory functions in both innate and adaptive immune responses but its role in the CD8+ CTLs remains enigmatic. We used a T cell specific FURIN deletion in vivo to demonstrate that FURIN promotes host response against the CTL-dependent lymphocytic choriomeningitis virus by virtue of restricting viral burden and augmenting IFNG production. We also characterized Furin KO CD8+ T cells ex vivo, including after their activation with FURIN regulating cytokines IL12 or TGFB1. Furin KO CD8+ T cells show an inherently activated phenotype characterized by the up-regulation of effector genes and increased frequencies of CD44+, TNF+ and IFNG+ cells. In the activated CTLs FURIN regulates the productions of IL2, TNF and GZMB and the genes associated with the TGFBR-signaling pathway. FURIN also controls the expression of Eomes, Foxo1 and Bcl6 and the levels of ITGAE and CD62L, which implies a role in the development of CTL memory. Collectively, our data suggest that the T cell expressed FURIN is important for host responses in viral infections, CTL homeostasis/activation and memory development. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Markus J T Ojanen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, FI-33014, Finland
| | - Fernanda Munoz Caro
- Faculty of Medicine and Health Technology, Tampere University, Tampere, FI-33014, Finland
| | - Saara Aittomäki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, FI-33014, Finland
| | - Mickaël J Ploquin
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, and The Warren Alpert Medical School, Brown University, Providence, RI, 02912, USA
| | - Zsuzsanna Ortutay
- Faculty of Medicine and Health Technology, Tampere University, Tampere, FI-33014, Finland
| | - Meeri Pekkarinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, FI-33014, Finland
| | - Juha Kesseli
- Faculty of Medicine and Health Technology, Tampere University, Tampere, FI-33014, Finland
| | - Maria Vähätupa
- Faculty of Medicine and Health Technology, Tampere University, Tampere, FI-33014, Finland
| | - Juuso Määttä
- Faculty of Medicine and Health Technology, Tampere University, Tampere, FI-33014, Finland
| | - Matti Nykter
- Faculty of Medicine and Health Technology, Tampere University, Tampere, FI-33014, Finland
| | - Ilkka S Junttila
- Faculty of Medicine and Health Technology, Tampere University, Tampere, FI-33014, Finland
- Fimlab Laboratories Ltd, Tampere, FI-33520, Finland
- Faculty of Medicine, University of Oulu, Oulu, FI-90570, Finland
- Department of Clinical Microbiology, Nordlab, Oulu University Hospital, Oulu, FI-90120, Finland
| | - Tero A H Järvinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, FI-33014, Finland
- Tampere University Hospital, Tampere, FI-33520, Finland
| | - John J O Shea
- Lymphocyte Cell Biology Section, Molecular Immunology and Inflammation Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Christine A Biron
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, and The Warren Alpert Medical School, Brown University, Providence, RI, 02912, USA
| | - Marko Pesu
- Faculty of Medicine and Health Technology, Tampere University, Tampere, FI-33014, Finland
- Fimlab Laboratories Ltd, Tampere, FI-33520, Finland
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Valle X, Mechó S, Alentorn-Geli E, Järvinen TAH, Lempainen L, Pruna R, Monllau JC, Rodas G, Isern-Kebschull J, Ghrairi M, Yanguas X, Balius R, la Torre AMD. Return to Play Prediction Accuracy of the MLG-R Classification System for Hamstring Injuries in Football Players: A Machine Learning Approach. Sports Med 2022; 52:2271-2282. [PMID: 35610405 DOI: 10.1007/s40279-022-01672-5] [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] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVE Muscle injuries are one of the main daily problems in sports medicine, football in particular. However, we do not have a reliable means to predict the outcome, i.e. return to play from severe injury. The aim of the present study was to evaluate the capability of the MLG-R classification system to grade hamstring muscle injuries by severity, offer a prognosis for the return to play, and identify injuries with a higher risk of re-injury. Furthermore, we aimed to assess the consistency of our proposed system by investigating its intra-observer and inter-observer reliability. METHODS All male professional football players from FC Barcelona, senior A and B and the two U-19 teams, with injuries that occurred between February 2010 and February 2020 were reviewed. Only players with a clinical presentation of a hamstring muscle injury, with complete clinic information and magnetic resonance images, were included. Three different statistical and machine learning approaches (linear regression, random forest, and eXtreme Gradient Boosting) were used to assess the importance of each factor of the MLG-R classification system in determining the return to play, as well as to offer a prediction of the expected return to play. We used the Cohen's kappa and the intra-class correlation coefficient to assess the intra-observer and inter-observer reliability. RESULTS Between 2010 and 2020, 76 hamstring injuries corresponding to 42 different players were identified, of which 50 (65.8%) were grade 3r, 54 (71.1%) affected the biceps femoris long head, and 33 of the 76 (43.4%) were located at the proximal myotendinous junction. The mean return to play for grades 2, 3, and 3r injuries were 14.3, 12.4, and 37 days, respectively. Injuries affecting the proximal myotendinous junction had a mean return to play of 31.7 days while those affecting the distal part of the myotendinous junction had a mean return to play of 23.9 days. The analysis of the grade 3r biceps femoris long head injuries located at the free tendon showed a median return to play time of 56 days while the injuries located at the central tendon had a shorter return to play of 24 days (p = 0.038). The statistical analysis showed an excellent predictive power of the MLG-R classification system with a mean absolute error of 9.8 days and an R-squared of 0.48. The most important factors to determine the return to play were if the injury was at the free tendon of the biceps femoris long head or if it was a grade 3r injury. For all the items of the MLG-R classification, the intra-observer and inter-observer reliability was excellent (k > 0.93) except for fibres blurring (κ = 0.68). CONCLUSIONS The main determinant for a long return to play after a hamstring injury is the injury affecting the connective tissue structures of the hamstring. We developed a reliable hamstring muscle injury classification system based on magnetic resonance imaging that showed excellent results in terms of reliability, prognosis capability and objectivity. It is easy to use in clinical daily practice, and can be further adapted to future knowledge. The adoption of this system by the medical community would allow a uniform diagnosis leading to better injury management.
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Affiliation(s)
- Xavier Valle
- FC Barcelona Medical Department, Barcelona, Spain. .,Hospital Universitari Dexeus (ICATME), Barcelona, Spain. .,PhD Student at the "Departament de Cirurgia i Ortopèdia", Universitat Autonoma de Barcelona, Barcelona, Spain.
| | - Sandra Mechó
- FC Barcelona Medical Department, Barcelona, Spain.,Department of Radiology, Hospital de Barcelona, SCIAS, Barcelona, Spain
| | - Eduard Alentorn-Geli
- Instituto Cugat, Barcelona, Spain.,Fundación García Cugat, Barcelona, Spain.,Mutualidad Española de Futbolistas, Delegación Cataluña, Federación Española de Fútbol, Barcelona, Spain
| | - Tero A H Järvinen
- Tampere University and Tampere University Hospital, Tampere, Finland
| | - Lasse Lempainen
- Sports Trauma Research Unit, Hospital Mehiläinen NEO, Turku, Finland
| | - Ricard Pruna
- FC Barcelona Medical Department, Barcelona, Spain
| | - Joan C Monllau
- Department of Orthopedic Surgery, Parc de Salut Mar, Hospital del Mar I L'Esperança, Barcelona, Spain.,ICATME, Hospital Universitari Dexeus, Bellaterra, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Gil Rodas
- FC Barcelona Medical Department, Barcelona, Spain
| | - Jaime Isern-Kebschull
- Musculoskeletal Imaging Specialist, Barcelona, Spain.,Department of Radiology at Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Mourad Ghrairi
- FIFA Medical Centre of Excellence, Dubai, United Arab Emirates
| | | | - Ramon Balius
- Catalan Sports Council, Generalitat de Catalunya, Barcelona, Spain.,Department of Sports Medicine, Clínica Diagonal, Barcelona, Spain
| | - Adrian Martinez-De la Torre
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
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9
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Coentro JQ, Di Nubila A, May U, Prince S, Zwaagstra J, Järvinen TAH, Zeugolis D. Dual drug delivery collagen vehicles for modulation of skin fibrosis in vitro. Biomed Mater 2022; 17. [PMID: 35176732 DOI: 10.1088/1748-605x/ac5673] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 09/28/2021] [Accepted: 02/17/2022] [Indexed: 11/11/2022]
Abstract
Single molecule drug delivery systems have failed to yield functional therapeutic outcomes, triggering investigations into multi-molecular drug delivery vehicles. In the context of skin fibrosis, although multi-drug systems have been assessed, no system has assessed molecular combinations that directly and specifically reduce cell proliferation, collagen synthesis and transforming growth factor β1 (TGFβ1) expression. Herein, a core-shell collagen type I hydrogel system was developed for the dual delivery of a TGFβ trap, a soluble recombinant protein that inhibits TGFβ signalling, and Trichostatin A (TSA), a small molecule inhibitor of histone deacetylases. The antifibrotic potential of the dual delivery system was assessed in an in vitro skin fibrosis model induced by macromolecular crowding (MMC) and TGFβ1. SDS-PAGE and HPLC analyses revealed that ~ 50 % of the TGFβ trap and ~ 30 % of the TSA were released from the core and shell compartments, respectively, of the hydrogel system after 10 days (longest time point assessed) in culture. As a direct consequence of this slow release, the core (TGFβ trap) / shell (TSA) hydrogel system induced significantly (p < 0.05) lower than the control group (MMC and TGFβ1) collagen type I deposition (assessed via SDS-PAGE and immunocytochemistry), α smooth muscle actin (αSMA) expression (assessed via immunocytochemistry) and cellular proliferation (assessed via DNA quantification) and viability (assessed via calcein AM and ethidium homodimer-I staining) after 10 days in culture. On the other hand, direct TSA-TGFβ supplementation induced the lowest (p < 0.05) collagen type I deposition, αSMA expression and cellular proliferation and viability after 10 days in culture. Our results illustrate the potential of core-shell collagen hydrogel systems for sustained delivery of antifibrotic molecules.
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Affiliation(s)
- João Q Coentro
- Regenerative, Modular & Developmental Engineering Laboratory (REMODEL) and Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), National University of Ireland Galway, Biomedical Sciences Building, Galway, Galway, IRELAND
| | - Alessia Di Nubila
- Regenerative, Modular & Developmental Engineering Laboratory (REMODEL) and Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), National University of Ireland Galway, Biomedical Sciences Building, Galway, Galway, IRELAND
| | - Ulrike May
- Faculty of Medicine & Health Technology, Tampere University, Kalevantie 4, Tampere, 33014, FINLAND
| | - Stuart Prince
- Faculty of Medicine & Health Technology, Tampere University, Kalevantie 4, Tampere, 33014, FINLAND
| | - John Zwaagstra
- Human Health Therapeutics Research Centre, National Research Council Canada, Human Health Therapeutics Research Centre, Montreal, Quebec, K1A 0R6, CANADA
| | - Tero A H Järvinen
- Faculty of Medicine & Health Technology, Tampere University, Faculty of Medicine & Health Technology, Tampere, 33014, FINLAND
| | - Dimitrios Zeugolis
- Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Charles Institute of Dermatology, University College Dublin, Conway Institute of Biomolecular & Biomedical Research and School of Mechanical & Materials Engineering, Dublin, 4, IRELAND
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10
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Salomaa T, Pemmari T, Määttä J, Kummola L, Salonen N, González-Rodríguez M, Parviainen L, Hiihtola L, Vähätupa M, Järvinen TAH, Junttila IS. IL-13Rα1 Suppresses Tumor Progression in Two-stage Skin Carcinogenesis Model by Regulating Regulatory T Cells. J Invest Dermatol 2021; 142:1565-1575.e17. [PMID: 34808240 DOI: 10.1016/j.jid.2021.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/24/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 12/19/2022]
Abstract
Type 2-inflammation-related cytokine Interleukin (IL)-13 plays a protective role in experimental papilloma induction in mice. To understand mechanisms by which IL-13 contributes to papilloma formation we utilized IL-13Rα1 knockout (KO) mice in widely used DMBA/TPA two-stage skin carcinogenesis protocol that mimics the development of Squamous Cell Carcinoma (SCC). KO mice developed more papillomas and significantly faster than wild-type (WT) mice. Papilloma development reduced Tregs in WT mice, but substantially less in KO mice. In line with this, IL-2 and IL-10 levels decreased in WT mice, but not in KO mice. Furthermore, systemic IL-5 and Thymic Stromal Lymphopoietin (TSLP) levels were elevated, while IL-22 was decreased during papilloma formation in the skin of KO mice. Polymorphonuclear Myeloid-derived suppressor cells (PMN-MDSCs) were decreased in the KO mice at the early phase of papilloma induction. We demonstrate that IL-13Rα1 protects from papilloma development in chemically induced skin carcinogenesis and our results provide further insights into the protective role of functional IL-4 and IL-13 signaling via type II IL-4R in tumor development.
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Affiliation(s)
- Tanja Salomaa
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Fimlab Laboratories, Tampere, Finland
| | - Toini Pemmari
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Juuso Määttä
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Laura Kummola
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Fimlab Laboratories, Tampere, Finland
| | - Niklas Salonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | - Liisa Parviainen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Lotta Hiihtola
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Maria Vähätupa
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Tero A H Järvinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Tampere University Hospital, Tampere, Finland
| | - Ilkka S Junttila
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Fimlab Laboratories, Tampere, Finland.
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11
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Vähätupa M, Salonen N, Uusitalo-Järvinen H, Järvinen TAH. Selective Targeting and Tissue Penetration to the Retina by a Systemically Administered Vascular Homing Peptide in Oxygen Induced Retinopathy (OIR). Pharmaceutics 2021; 13:pharmaceutics13111932. [PMID: 34834347 PMCID: PMC8618640 DOI: 10.3390/pharmaceutics13111932] [Citation(s) in RCA: 4] [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: 10/06/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 12/17/2022] Open
Abstract
Pathological angiogenesis is the hallmark of ischemic retinal diseases among them retinopathy of prematurity (ROP) and proliferative diabetic retinopathy (PDR). Oxygen-induced retinopathy (OIR) is a pure hypoxia-driven angiogenesis model and a widely used model for ischemic retinopathies. We explored whether the vascular homing peptide CAR (CARSKNKDC) which recognizes angiogenic blood vessels can be used to target the retina in OIR. We were able to demonstrate that the systemically administered CAR vascular homing peptide homed selectively to the preretinal neovessels in OIR. As a cell and tissue-penetrating peptide, CAR also penetrated into the retina. Hyperoxia used to induce OIR in the retina also causes bronchopulmonary dysplasia in the lungs. We showed that the CAR peptide is not targeted to the lungs in normal mice but is targeted to the lungs after hyperoxia-/hypoxia-treatment of the animals. The site-specific delivery of the CAR peptide to the pathologic retinal vasculature and the penetration of the retinal tissue may offer new opportunities for treating retinopathies more selectively and with less side effects.
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Affiliation(s)
- Maria Vähätupa
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (M.V.); (N.S.); (H.U.-J.)
| | - Niklas Salonen
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (M.V.); (N.S.); (H.U.-J.)
| | - Hannele Uusitalo-Järvinen
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (M.V.); (N.S.); (H.U.-J.)
- Eye Centre & Department of Orthopedics & Traumatology, Tampere University Hospital, 33520 Tampere, Finland
| | - Tero A. H. Järvinen
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (M.V.); (N.S.); (H.U.-J.)
- Eye Centre & Department of Orthopedics & Traumatology, Tampere University Hospital, 33520 Tampere, Finland
- Correspondence:
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12
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Coentro JQ, May U, Prince S, Zwaagstra J, Ritvos O, Järvinen TAH, Zeugolis DI. Adapting the Scar-in-a-Jar to Skin Fibrosis and Screening Traditional and Contemporary Anti-Fibrotic Therapies. Front Bioeng Biotechnol 2021; 9:756399. [PMID: 34765594 PMCID: PMC8576412 DOI: 10.3389/fbioe.2021.756399] [Citation(s) in RCA: 4] [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: 08/10/2021] [Accepted: 10/11/2021] [Indexed: 12/14/2022] Open
Abstract
Skin fibrosis still constitutes an unmet clinical need. Although pharmacological strategies are at the forefront of scientific and technological research and innovation, their clinical translation is hindered by the poor predictive capacity of the currently available in vitro fibrosis models. Indeed, customarily utilised in vitro scarring models are conducted in a low extracellular matrix milieu, which constitutes an oxymoron for the in-hand pathophysiology. Herein, we coupled macromolecular crowding (enhances and accelerates extracellular matrix deposition) with transforming growth factor β1 (TGFβ1; induces trans-differentiation of fibroblasts to myofibroblasts) in human dermal fibroblast cultures to develop a skin fibrosis in vitro model and to screen a range of anti-fibrotic families (corticosteroids, inhibitors of histone deacetylases, inhibitors of collagen crosslinking, inhibitors of TGFβ1 and pleiotropic inhibitors of fibrotic activation). Data obtained demonstrated that macromolecular crowding combined with TGFβ1 significantly enhanced collagen deposition and myofibroblast transformation. Among the anti-fibrotic compounds assessed, trichostatin A (inhibitors of histone deacetylases); serelaxin and pirfenidone (pleiotropic inhibitors of fibrotic activation); and soluble TGFβ receptor trap (inhibitor of TGFβ signalling) resulted in the highest decrease of collagen type I deposition (even higher than triamcinolone acetonide, the gold standard in clinical practice). This study further advocates the potential of macromolecular crowding in the development of in vitro pathophysiology models.
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Affiliation(s)
- João Q Coentro
- Regenerative, Modular and Developmental Engineering Laboratory (REMODEL) and Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), National University of Ireland Galway (NUI Galway), Galway, Ireland
| | - Ulrike May
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Stuart Prince
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - John Zwaagstra
- Human Health Therapeutics Research Centre, National Research Council Canada, Montreal, QC, Canada
| | | | - Tero A H Järvinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Tampere University Hospital, Tampere, Finland
| | - Dimitrios I Zeugolis
- Regenerative, Modular and Developmental Engineering Laboratory (REMODEL) and Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), National University of Ireland Galway (NUI Galway), Galway, Ireland.,Regenerative, Modular and Developmental Engineering Laboratory (REMODEL), Charles Institute of Dermatology, Conway Institute of Biomolecular and Biomedical Research and School of Mechanical and Materials Engineering, University College Dublin (UCD), Dublin, Ireland
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13
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Contreras-Muñoz P, Torrella JR, Venegas V, Serres X, Vidal L, Vila I, Lahtinen I, Viscor G, Martínez-Ibáñez V, Peiró JL, Järvinen TAH, Rodas G, Marotta M. Muscle Precursor Cells Enhance Functional Muscle Recovery and Show Synergistic Effects With Postinjury Treadmill Exercise in a Muscle Injury Model in Rats. Am J Sports Med 2021; 49:1073-1085. [PMID: 33719605 DOI: 10.1177/0363546521989235] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Skeletal muscle injuries represent a major concern in sports medicine. Cell therapy has emerged as a promising therapeutic strategy for muscle injuries, although the preclinical data are still inconclusive and the potential clinical use of cell therapy has not yet been established. PURPOSE To evaluate the effects of muscle precursor cells (MPCs) on muscle healing in a small animal model. STUDY DESIGN Controlled laboratory study. METHODS A total of 27 rats were used in the study. MPCs were isolated from rat (n = 3) medial gastrocnemius muscles and expanded in primary culture. Skeletal muscle injury was induced in 24 rats, and the animals were assigned to 3 groups. At 36 hours after injury, animals received treatment based on a single ultrasound-guided MPC (105 cells) injection (Cells group) or MPC injection in combination with 2 weeks of daily exercise training (Cells+Exercise group). Animals receiving intramuscular vehicle injection were used as controls (Vehicle group). Muscle force was determined 2 weeks after muscle injury, and muscles were collected for histological and immunofluorescence evaluation. RESULTS Red fluorescence-labeled MPCs were successfully transplanted in the site of the injury by ultrasound-guided injection and were localized in the injured area after 2 weeks. Transplanted MPCs participated in the formation of regenerating muscle fibers as corroborated by the co-localization of red fluorescence with developmental myosin heavy chain (dMHC)-positive myofibers by immunofluorescence analysis. A strong beneficial effect on muscle force recovery was detected in the Cells and Cells+Exercise groups (102.6% ± 4.0% and 101.5% ± 8.5% of maximum tetanus force of the injured vs healthy contralateral muscle, respectively) compared with the Vehicle group (78.2% ± 5.1%). Both Cells and Cells+Exercise treatments stimulated the growth of newly formed regenerating muscles fibers, as determined by the increase in myofiber cross-sectional area (612.3 ± 21.4 µm2 and 686.0 ± 11.6 µm2, respectively) compared with the Vehicle group (247.5 ± 10.7 µm2), which was accompanied by a significant reduction of intramuscular fibrosis in Cells and Cells+Exercise treated animals (24.2% ± 1.3% and 26.0% ± 1.9% of collagen type I deposition, respectively) with respect to control animals (40.9% ± 4.1% in the Vehicle group). MPC treatment induced a robust acceleration of the muscle healing process as demonstrated by the decreased number of dMHC-positive regenerating myofibers (enhanced replacement of developmental myosin isoform by mature myosin isoforms) (4.3% ± 2.6% and 4.1% ± 1.5% in the Cells and Cells+Exercise groups, respectively) compared with the Vehicle group (14.8% ± 13.9%). CONCLUSION Single intramuscular administration of MPCs improved histological outcome and force recovery of the injured skeletal muscle in a rat injury model that imitates sports-related muscle injuries. Cell therapy showed a synergistic effect when combined with an early active rehabilitation protocol in rats, which suggests that a combination of treatments can generate novel therapeutic strategies for the treatment of human skeletal muscle injuries. CLINICAL RELEVANCE Our study demonstrates the strong beneficial effect of MPC transplant and the synergistic effect when the cell therapy is combined with an early active rehabilitation protocol for muscle recovery in rats; this finding opens new avenues for the development of effective therapeutic strategies for muscle healing and clinical trials in athletes undergoing MPC transplant and rehabilitation protocols.
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Affiliation(s)
- Paola Contreras-Muñoz
- Investigation performed at Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Joan Ramón Torrella
- Investigation performed at Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Vanessa Venegas
- Investigation performed at Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Xavier Serres
- Investigation performed at Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Laura Vidal
- Investigation performed at Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ingrid Vila
- Investigation performed at Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ilmari Lahtinen
- Investigation performed at Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ginés Viscor
- Investigation performed at Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Vicente Martínez-Ibáñez
- Investigation performed at Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - José Luis Peiró
- Investigation performed at Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Tero A H Järvinen
- Investigation performed at Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Gil Rodas
- Investigation performed at Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Mario Marotta
- Investigation performed at Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Pemmari T, Ivanova L, May U, Lingasamy P, Tobi A, Pasternack A, Prince S, Ritvos O, Makkapati S, Teesalu T, Cairo MS, Järvinen TAH, Liao Y. Exposed CendR Domain in Homing Peptide Yields Skin-Targeted Therapeutic in Epidermolysis Bullosa. Mol Ther 2020; 28:1833-1845. [PMID: 32497513 PMCID: PMC7403337 DOI: 10.1016/j.ymthe.2020.05.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 10/03/2019] [Revised: 02/05/2020] [Accepted: 05/14/2020] [Indexed: 01/12/2023] Open
Abstract
Systemic skin-selective therapeutics would be a major advancement in the treatment of diseases affecting the entire skin, such as recessive dystrophic epidermolysis bullosa (RDEB), which is caused by mutations in the COL7A1 gene and manifests in transforming growth factor-β (TGF-β)-driven fibrosis and malignant transformation. Homing peptides containing a C-terminal R/KXXR/K motif (C-end rule [CendR] sequence) activate an extravasation and tissue penetration pathway for tumor-specific drug delivery. We have previously described a homing peptide CRKDKC (CRK) that contains a cryptic CendR motif and homes to angiogenic blood vessels in wounds and tumors, but it cannot penetrate cells or tissues. In this study, we demonstrate that removal of the cysteine from CRK to expose the CendR sequence confers the peptide novel ability to home to normal skin. Fusion of the truncated CRK (tCRK) peptide to the C terminus of an extracellular matrix protein decorin (DCN), a natural TGF-β inhibitor, resulted in a skin-homing therapeutic molecule (DCN-tCRK). Systemic DCN-tCRK administration in RDEB mice led to inhibition of TGF-β signaling in the skin and significant improvement in the survival of RDEB mice. These results suggest that DCN-tCRK has the potential to be utilized as a novel therapeutic compound for the treatment of dermatological diseases such as RDEB.
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Affiliation(s)
- Toini Pemmari
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, 33520 Tampere, Finland
| | - Larisa Ivanova
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA
| | - Ulrike May
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, 33520 Tampere, Finland
| | - Prakash Lingasamy
- Laboratory of Cancer Biology, Institute of Biomedicine and Translational Medicine, University of Tartu, 50411 Tartu, Estonia
| | - Allan Tobi
- Laboratory of Cancer Biology, Institute of Biomedicine and Translational Medicine, University of Tartu, 50411 Tartu, Estonia
| | - Anja Pasternack
- Department of Physiology, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Stuart Prince
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, 33520 Tampere, Finland
| | - Olli Ritvos
- Department of Physiology, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Shreya Makkapati
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA
| | - Tambet Teesalu
- Laboratory of Cancer Biology, Institute of Biomedicine and Translational Medicine, University of Tartu, 50411 Tartu, Estonia; Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA; Center for Nanomedicine, University of California, Santa Barbara, CA 93106, USA
| | - Mitchell S Cairo
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA; Department of Microbiology and Immunology, New York Medical College, Valhalla, NY 10595, USA; Department of Pathology, New York Medical College, Valhalla, NY 10595, USA; Department of Medicine, New York Medical College, Valhalla, NY 10595, USA; Deparmtent of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 10595, USA
| | - Tero A H Järvinen
- Faculty of Medicine and Health Technology, Tampere University & Tampere University Hospital, 33520 Tampere, Finland.
| | - Yanling Liao
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA.
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15
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Pemmari T, Laakso J, Patrikainen MS, Parkkila S, Järvinen TAH. Carbonic Anhydrase VI in Skin Wound Healing Study on Car6 Knockout Mice. Int J Mol Sci 2020; 21:ijms21145092. [PMID: 32708518 PMCID: PMC7404312 DOI: 10.3390/ijms21145092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/29/2020] [Revised: 07/11/2020] [Accepted: 07/15/2020] [Indexed: 01/22/2023] Open
Abstract
Carbonic anhydrases (CAs) contribute to tumor cell migration by generating an acidic environment through the conversion of carbon dioxide to bicarbonate and a proton. CA VI is secreted to milk and saliva, and it could contribute to wound closure, as a potential trophic factor, in animals that typically lick their wounds. Our aim was to investigate whether human CA VI improves skin-wound healing in full-thickness skin-wound models. The effect was studied in Car6 -/- knockout mice and wild type littermates. Half of both mice strains were given topically administered, milk-derived CA VI after wounding and eight hours later. The amount of topically given CA VI exceeded the predicted amount of natural saliva-delivered CA VI. The healing was followed for seven days and studied from photographs and histological sections. Our results showed no significant differences between the treatment groups in wound closure, re-epithelization, or granulation tissue formation, nor did the Car6 genotype affect the healing. Our results demonstrate that CA VI does not play a major role in skin-wound healing and also suggest that saliva-derived CA VI is not responsible for the licking-associated improved wound healing in animals.
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Affiliation(s)
- Toini Pemmari
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
| | - Jaakko Laakso
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
| | - Maarit S Patrikainen
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
| | - Seppo Parkkila
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
- Fimlab Ltd., Tampere University Hospital, 33520 Tampere, Finland
| | - Tero A H Järvinen
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
- Department of Orthopedics and Traumatology, Tampere University Hospital, 33520 Tampere, Finland
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16
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Vähätupa M, Järvinen TAH, Uusitalo-Järvinen H. Exploration of Oxygen-Induced Retinopathy Model to Discover New Therapeutic Drug Targets in Retinopathies. Front Pharmacol 2020; 11:873. [PMID: 32595503 PMCID: PMC7300227 DOI: 10.3389/fphar.2020.00873] [Citation(s) in RCA: 13] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 05/27/2020] [Indexed: 12/11/2022] Open
Abstract
Oxygen-induced retinopathy (OIR) is a pure hypoxia-driven angiogenesis model and the most widely used model for ischemic retinopathies, such as retinopathy of prematurity (ROP), proliferative diabetic retinopathy (PDR), and retinal vein occlusion (RVO). OIR model has been used to test new potential anti-angiogenic factors for human diseases. We have recently performed the most comprehensive characterization of OIR by a relatively novel mass spectrometry (MS) technique, sequential window acquisition of all theoretical fragment ion mass spectra (SWATH-MS) proteomics and used genetically modified mice strains to identify novel molecular drug targets in angiogenic retinal diseases. We have confirmed the relevance of the identified molecular targets to human diseases by determining their expression pattern in neovascular membranes obtained from PDR and RVO patients. Based on our results, crystallins were the most prominent proteins induced by early hypoxic environment during the OIR, while actomyosin complex and Filamin A-R-Ras axis, that regulates vascular permeability of the angiogenic blood vessels, stood out at the peak of angiogenesis. Our results have revealed potential new therapeutic targets to address hypoxia-induced pathological angiogenesis and the associated vascular permeability in number of retinal diseases.
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Affiliation(s)
- Maria Vähätupa
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Tero A. H. Järvinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland
| | - Hannele Uusitalo-Järvinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Eye Centre, Tampere University Hospital, Tampere, Finland
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17
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Hietanen KE, Järvinen TAH, Huhtala H, Tolonen TT, Kaartinen IS. Histopathology and immunohistochemical analysis of 5-fluorouracil and triamcinolone treated keloids in double-blinded randomized controlled trial. Wound Repair Regen 2020; 28:385-399. [PMID: 32112591 DOI: 10.1111/wrr.12803] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/03/2020] [Accepted: 02/05/2020] [Indexed: 12/11/2022]
Abstract
Keloids are a major complication related to surgical wound healing and very challenging condition to treat. Many treatment options are available, but the efficacy of the treatment is poor in most of cases and some keloids do not respond to the treatment at all. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinolone (TAC) injections in a double-blind randomized controlled trial (RCT). Forty-three patients with 50 keloid scars were treated with either intralesional TAC or 5-FU-injections over 6 months. We wanted to find out whether biological features (cell density, cell proliferation rate, vascular density, myofibroblast numbers, steroid hormone receptor expression) in keloids could be used to predict the response to therapy and define the biological changes that take place in patients receiving a response. As there was no statistically significant difference in the remission rate between TAC and 5-FU treatments, all patients were combined and analyzed as responders and nonresponders. Although responders have slightly more myofibroblasts than the nonresponders in their keloids in the pretreatment biopsy samples, we could not identify a single predictive factor that could identify those patients that respond to drug injections. The good clinical response to therapy is associated with the simultaneous reduction of myofibroblasts in the keloid. This study demonstrates that myofibroblasts are reduced in number in those keloids that were responsive to therapy, and that both 5-FU and TAC injections are useful for keloid treatment.
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Affiliation(s)
- Kriistiina E Hietanen
- Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland.,Central Finland Health Care District, Jyväskylä, Finland
| | - Tero A H Järvinen
- Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Teemu T Tolonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Pathology, Fimlab Laboratories, Tampere University Hospital, Tampere, Finland
| | - Ilkka S Kaartinen
- Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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18
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Vähätupa M, Pemmari T, Junttila I, Pesu M, Järvinen TAH. Chemical-Induced Skin Carcinogenesis Model Using Dimethylbenz[a]Anthracene and 12-O-Tetradecanoyl Phorbol-13-Acetate (DMBA-TPA). J Vis Exp 2019. [PMID: 31904021 DOI: 10.3791/60445] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Cancer is one of the most devastating human diseases. Experimental cancer models are important to gain insight into the complex interplay of different cell types and genes in promoting tumor progression and to provide a platform for testing the efficacy of different therapeutic approaches. One of the most commonly used experimental inflammatory cancer models is the DMBA-TPA two-stage skin carcinogenesis model. Tumor formation is induced in this model by the topical application of two different chemicals, 7,12-dimethylbenz[a]anthracene (DMBA) and 12-O-tetradecanoyl phorbol-13-acetate (TPA), that together cause papilloma formation in the skin. As the primary outcome is papilloma formation in the skin, the model is an ideal, reliable, and reproducible way to address both tumor initiation (tumor-free survival) and tumor progression (number and size of visible tumors). The effects of the DMBA-TPA treatment are transmitted via an inflammatory mechanism, which makes this model especially suitable for studying the role of the immune system in tumor formation. However, this model is restricted to the skin and other surfaces where the chemicals can be applied on. A detailed protocol is provided in this article to use the model successfully.
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Affiliation(s)
- Maria Vähätupa
- Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital
| | - Toini Pemmari
- Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital
| | - Ilkka Junttila
- Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital; Department of Clinical Microbiology, Fimlab Laboratories
| | - Marko Pesu
- Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital; Department of Clinical Microbiology, Fimlab Laboratories
| | - Tero A H Järvinen
- Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital;
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19
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Vähätupa M, Nättinen J, Jylhä A, Aapola U, Kataja M, Kööbi P, Järvinen TAH, Uusitalo H, Uusitalo-Järvinen H. SWATH-MS Proteomic Analysis of Oxygen-Induced Retinopathy Reveals Novel Potential Therapeutic Targets. Invest Ophthalmol Vis Sci 2019; 59:3294-3306. [PMID: 30025079 DOI: 10.1167/iovs.18-23831] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Oxygen-induced retinopathy (OIR) is the most widely used model for ischemic retinopathies such as retinopathy of prematurity (ROP), proliferative diabetic retinopathy (PDR), and retinal vein occlusion (RVO). The purpose of this study was to perform the most comprehensive characterization of OIR by a recently developed technique, sequential window acquisition of all theoretical mass spectra (SWATH-MS) proteomics. Methods Control and OIR retina samples collected from various time points were subjected to SWATH-MS and detailed data analysis. Immunohistochemistry from mouse retinas as well as neovascular membranes from human PDR and RVO patients were used for the detection of the localization of the proteins showing altered expression in the retina and to address their relevance to human ischemic retinopathies. Results We report the most extensive proteomic profiling of OIR to date by quantifying almost 3000 unique proteins and their expression differences between control and OIR retinas. Crystallins were the most prominent proteins induced by hypoxia in the retina, while angiogenesis related proteins such as Filamin A and nonmuscle myosin IIA stand out at the peak of angiogenesis. Majority of the changes in protein expression return to normal at P42, but there is evidence to suggest that proteins involved in neurotransmission remain at reduced level. Conclusions The results reveal new potential therapeutic targets to address hypoxia-induced pathological angiogenesis taking place in number of retinal diseases. The extensive proteomic profiling combined with pathway analysis also identifies novel molecular networks that could contribute to the pathogenesis of retinal diseases.
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Affiliation(s)
- Maria Vähätupa
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland
| | - Janika Nättinen
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland.,The Center for Proteomics and Personalized Medicine, Tampere, Finland
| | - Antti Jylhä
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland.,The Center for Proteomics and Personalized Medicine, Tampere, Finland
| | - Ulla Aapola
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland.,The Center for Proteomics and Personalized Medicine, Tampere, Finland
| | - Marko Kataja
- Eye Centre, Tampere University Hospital, Tampere, Finland
| | - Peeter Kööbi
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland.,Eye Centre, Tampere University Hospital, Tampere, Finland
| | - Tero A H Järvinen
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland.,Department of Musculoskeletal Disorders, Tampere University Hospital, Tampere, Finland
| | - Hannu Uusitalo
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland.,The Center for Proteomics and Personalized Medicine, Tampere, Finland.,Eye Centre, Tampere University Hospital, Tampere, Finland
| | - Hannele Uusitalo-Järvinen
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland.,Eye Centre, Tampere University Hospital, Tampere, Finland
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20
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Järvinen TAH, Ruoslahti E. Generation of a multi-functional, target organ-specific, anti-fibrotic molecule by molecular engineering of the extracellular matrix protein, decorin. Br J Pharmacol 2019; 176:16-25. [PMID: 29847688 PMCID: PMC6284330 DOI: 10.1111/bph.14374] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/04/2018] [Accepted: 05/10/2018] [Indexed: 02/06/2023] Open
Abstract
Extracellular matrix (ECM) molecules play important roles in regulating processes such as cell proliferation, migration, differentiation and survival. Decorin is a proteoglycan that binds to ('decorates') collagen fibrils in the ECM. Decorin also interacts with many growth factors and their receptors, the most notable of these interactions being its inhibitory activity on TGF-β, the growth factor responsible for fibrosis formation. We have generated a recombinant, multi-functional, fusion-protein consisting of decorin as a therapeutic domain and a vascular homing and cell-penetrating peptide as a targeting vehicle. This recombinant decorin (CAR-DCN) accumulates at the sites of the targeted disease at higher levels and, as a result, has substantially enhanced biological activity over native decorin. CAR-DCN is an example of how molecular engineering can give a compound the ability to seek out sites of disease and enhance its therapeutic potential. CAR-DCN will hopefully be used to treat severe human diseases. LINKED ARTICLES: This article is part of a themed section on Translating the Matrix. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.1/issuetoc.
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Affiliation(s)
- Tero A H Järvinen
- Faculty of Medicine and Life SciencesUniversity of TampereTampereFinland
- Department of Orthopedics and TraumatologyTampere University HospitalTampereFinland
| | - Erkki Ruoslahti
- Cancer CenterSanford Burnham Prebys Medical Discovery InstituteLa JollaCAUSA
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21
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Ketomäki T, Vähätupa M, May U, Pemmari T, Ruikka E, Hietamo J, Kaipiainen P, Barker H, Parkkila S, Uusitalo-Järvinen H, Järvinen TAH. R-Ras regulates vascular permeability, but not overall healing in skin wounds. Exp Dermatol 2018; 28:202-206. [PMID: 30489650 DOI: 10.1111/exd.13851] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 11/07/2018] [Accepted: 11/20/2018] [Indexed: 12/12/2022]
Abstract
Wounds close by keratinocytes migrating from the edge of the wound and re-epithelializing the epidermis. It has been proposed that the major stimuli for wound closure are blood-derived growth factors, chemokines and cytokines. The small GTPase R-Ras, a known integrin activator, also regulates vascular permeability during angiogenesis, and blood vessels lacking R-Ras leak plasma proteins constantly. We explored whether the access to blood-derived proteins influences skin wound healing in R-Ras knockout (KO) mice. In skin wounds, R-Ras expression was mostly restricted to the vasculature in the granulation tissue. Angiogenic blood vessels in the R-Ras KO mice were significantly more permeable than in wild-type (WT) controls. Although the distances between epidermal tongues, and the panniculus carnosus muscles, were significantly longer in R-Ras KO than WT controls before the granulation tissue formation took place, there were no differences in the wound closure or re-epithelialization rates or granulation tissue formation. These findings were also corroborated in a special splint excision wound model. Our study shows that although R-Ras does not influence the skin wound healing itself, the blood vessels lacking R-Ras are leaky and thus could facilitate the access of blood-derived proteins to the wound.
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Affiliation(s)
- Tuomo Ketomäki
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Maria Vähätupa
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Ulrike May
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Toini Pemmari
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Ella Ruikka
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Jussi Hietamo
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Pirkka Kaipiainen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Harlan Barker
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Seppo Parkkila
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Fimlab laboratories, Eye Centre & Department of Orthopedics & Traumatology, Tampere University Hospital, Tampere, Finland
| | - Hannele Uusitalo-Järvinen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Fimlab laboratories, Eye Centre & Department of Orthopedics & Traumatology, Tampere University Hospital, Tampere, Finland
| | - Tero A H Järvinen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Fimlab laboratories, Eye Centre & Department of Orthopedics & Traumatology, Tampere University Hospital, Tampere, Finland
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22
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Sihvonen R, Paavola M, Malmivaara A, Itälä A, Joukainen A, Nurmi H, Kalske J, Ikonen A, Järvelä T, Järvinen TAH, Kanto K, Karhunen J, Knifsund J, Kröger H, Kääriäinen T, Lehtinen J, Nyrhinen J, Paloneva J, Päiväniemi O, Raivio M, Sahlman J, Sarvilinna R, Tukiainen S, Välimäki VV, Äärimaa V, Toivonen P, Järvinen TLN. Arthroscopic partial meniscectomy versus placebo surgery for a degenerative meniscus tear: a 2-year follow-up of the randomised controlled trial. Ann Rheum Dis 2018; 77:188-195. [PMID: 28522452 PMCID: PMC5867417 DOI: 10.1136/annrheumdis-2017-211172] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/03/2017] [Accepted: 04/13/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess if arthroscopic partial meniscectomy (APM) is superior to placebo surgery in the treatment of patients with degenerative tear of the medial meniscus. METHODS In this multicentre, randomised, participant-blinded and outcome assessor-blinded, placebo-surgery controlled trial, 146 adults, aged 35-65 years, with knee symptoms consistent with degenerative medial meniscus tear and no knee osteoarthritis were randomised to APM or placebo surgery. The primary outcome was the between-group difference in the change from baseline in the Western Ontario Meniscal Evaluation Tool (WOMET) and Lysholm knee scores and knee pain after exercise at 24 months after surgery. Secondary outcomes included the frequency of unblinding of the treatment-group allocation, participants' satisfaction, impression of change, return to normal activities, the incidence of serious adverse events and the presence of meniscal symptoms in clinical examination. Two subgroup analyses, assessing the outcome on those with mechanical symptoms and those with unstable meniscus tears, were also carried out. RESULTS In the intention-to-treat analysis, there were no significant between-group differences in the mean changes from baseline to 24 months in WOMET score: 27.3 in the APM group as compared with 31.6 in the placebo-surgery group (between-group difference, -4.3; 95% CI, -11.3 to 2.6); Lysholm knee score: 23.1 and 26.3, respectively (-3.2; -8.9 to 2.4) or knee pain after exercise, 3.5 and 3.9, respectively (-0.4; -1.3 to 0.5). There were no statistically significant differences between the two groups in any of the secondary outcomes or within the analysed subgroups. CONCLUSIONS In this 2-year follow-up of patients without knee osteoarthritis but with symptoms of a degenerative medial meniscus tear, the outcomes after APM were no better than those after placebo surgery. No evidence could be found to support the prevailing ideas that patients with presence of mechanical symptoms or certain meniscus tear characteristics or those who have failed initial conservative treatment are more likely to benefit from APM.
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Affiliation(s)
- Raine Sihvonen
- Department of Orthopedics and Traumatology, Hatanpää Hospital, Tampere, Finland
| | - Mika Paavola
- Department of Orthopedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
| | - Antti Malmivaara
- Center for Health and Social Economics, National Institute for Health and Welfare, Helsinki, Finland
| | - Ari Itälä
- Department of Orthopedics and Traumatology, Turku University Hospital, Turku, Finland
| | - Antti Joukainen
- Department of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland
| | - Heikki Nurmi
- Department of Orthopedics and Traumatology, Central Finland Central Hospital, Jyväskylä, Finland
| | - Juha Kalske
- Department of Orthopedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
| | - Anna Ikonen
- Department of Orthopedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
| | - Timo Järvelä
- Arthroscopic and Sports Medicine Center Pohjola Sairaala, Helsinki, Finland
| | - Tero A H Järvinen
- Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland
| | - Kari Kanto
- Department of Orthopedics and Traumatology, Hatanpää Hospital, Tampere, Finland
| | - Janne Karhunen
- Department of Orthopedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
| | - Jani Knifsund
- Department of Orthopedics and Traumatology, Turku University Hospital, Turku, Finland
| | - Heikki Kröger
- Department of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland
| | - Tommi Kääriäinen
- Department of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland
| | - Janne Lehtinen
- Department of Orthopedics and Traumatology, Hatanpää Hospital, Tampere, Finland
| | - Jukka Nyrhinen
- Department of Orthopedics and Traumatology, Central Finland Central Hospital, Jyväskylä, Finland
| | - Juha Paloneva
- Department of Orthopedics and Traumatology, Central Finland Central Hospital, Jyväskylä, Finland
| | - Outi Päiväniemi
- Department of Orthopedics and Traumatology, Hatanpää Hospital, Tampere, Finland
| | - Marko Raivio
- Department of Orthopedics and Traumatology, Hatanpää Hospital, Tampere, Finland
| | - Janne Sahlman
- Department of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland
| | - Roope Sarvilinna
- Department of Orthopedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
| | - Sikri Tukiainen
- Department of Orthopedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
| | | | - Ville Äärimaa
- Department of Orthopedics and Traumatology, Turku University Hospital, Turku, Finland
| | - Pirjo Toivonen
- Department of Orthopaedics and Traumatology, Helsinki University, Töölö Hospital, Helsinki, Finland
| | - Teppo L N Järvinen
- Department of Orthopaedics and Traumatology, Helsinki University, Töölö Hospital, Helsinki, Finland
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23
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Shen Y, Russo V, Zeglinski MR, Sellers SL, Wu Z, Oram C, Santacruz S, Merkulova Y, Turner C, Tauh K, Zhao H, Bozin T, Bohunek L, Zeng H, Seidman MA, Bleackley RC, McManus BM, Ruoslahti E, Järvinen TAH, Granville DJ. Recombinant Decorin Fusion Protein Attenuates Murine Abdominal Aortic Aneurysm Formation and Rupture. Sci Rep 2017; 7:15857. [PMID: 29158532 PMCID: PMC5696466 DOI: 10.1038/s41598-017-16194-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 09/07/2017] [Accepted: 11/02/2017] [Indexed: 01/23/2023] Open
Abstract
Decorin (DCN) is a small-leucine rich proteoglycan that mediates collagen fibrillogenesis, organization, and tensile strength. Adventitial DCN is reduced in abdominal aortic aneurysm (AAA) resulting in vessel wall instability thereby predisposing the vessel to rupture. Recombinant DCN fusion protein CAR-DCN was engineered with an extended C-terminus comprised of CAR homing peptide that recognizes inflamed blood vessels and penetrates deep into the vessel wall. In the present study, the role of systemically-administered CAR-DCN in AAA progression and rupture was assessed in a murine model. Apolipoprotein E knockout (ApoE-KO) mice were infused with angiotensin II (AngII) for 28 days to induce AAA formation. CAR-DCN or vehicle was administrated systemically until day 15. Mortality due to AAA rupture was significantly reduced in CAR-DCN-treated mice compared to controls. Although the prevalence of AAA was similar between vehicle and CAR-DCN groups, the severity of AAA in the CAR-DCN group was significantly reduced. Histological analysis revealed that CAR-DCN treatment significantly increased DCN and collagen levels within the aortic wall as compared to vehicle controls. Taken together, these results suggest that CAR-DCN treatment attenuates the formation and rupture of Ang II-induced AAA in mice by reinforcing the aortic wall.
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Affiliation(s)
- Yue Shen
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute and Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Valerio Russo
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute and Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Matthew R Zeglinski
- International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute and Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Stephanie L Sellers
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- Department of Radiology, University of British Columbia & St. Paul's Hospital, Vancouver, BC, Canada
| | - Zhengguo Wu
- Imaging Unit, Integrative Oncology Department, BC Cancer Agency Research Centre, Vancouver, BC, Canada
- Photomedicine Institute, Department of Dermatology and Skin Science, University of British Columbia & Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Cameron Oram
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute and Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Stephanie Santacruz
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute and Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Yulia Merkulova
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute and Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Christopher Turner
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute and Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Keerit Tauh
- International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute and Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hongyan Zhao
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute and Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tatjana Bozin
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Lubos Bohunek
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Haishan Zeng
- Imaging Unit, Integrative Oncology Department, BC Cancer Agency Research Centre, Vancouver, BC, Canada
- Photomedicine Institute, Department of Dermatology and Skin Science, University of British Columbia & Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Michael A Seidman
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - R Chris Bleackley
- Department of Biochemistry, University of Alberta, Edmonton, AB, Canada
| | - Bruce M McManus
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- PROOF Centre of Excellence, University of British Columbia & Providence Health Care, Vancouver, BC, Canada
| | - Erkki Ruoslahti
- Cancer Research Center, Sanford-Burnham Prebys Medical Discovery Institute, La Jolla, CA, 92037, USA
- Center for Nanomedicine and Department of Molecular Cellular and Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA, 93106-9610, USA
| | - Tero A H Järvinen
- Faculty of Medicine & Life Sciences, University of Tampere & Department of Orthopedics & Traumatology, Tampere University Hospital, Tampere, Finland
| | - David J Granville
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
- International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute and Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
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24
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Vähätupa M, Cordova ZM, Barker H, Aittomäki S, Uusitalo H, Järvinen TAH, Pesu M, Uusitalo-Järvinen H. Furin deficiency in myeloid cells leads to attenuated revascularization in a mouse-model of oxygen-induced retinopathy. Exp Eye Res 2017; 166:160-167. [PMID: 29031855 DOI: 10.1016/j.exer.2017.10.013] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 09/01/2017] [Accepted: 10/11/2017] [Indexed: 12/12/2022]
Abstract
Ischemic retinopathy is a vision-threatening disease associated with chronic retinal inflammation and hypoxia leading to abnormal angiogenesis. Furin, a member of the proprotein convertase family of proteins, has been implicated in the regulation of angiogenesis due to its essential role in the activation of several angiogenic growth factors, including vascular endothelial growth factor-C (VEGF-C), VEGF-D and transforming growth factor - β (TGF- β). In the present study, we evaluated expression of furin in the retina and its role in retinal angiogenesis. As both inflammation and hypoxia contribute to angiogenesis, the role of furin was evaluated using myeloid-cell specific furin knockout (KO) mice (designated LysMCre-fur(fl/fl)) both in developmental retinal angiogenesis as well as in hypoxia-driven angiogenesis using the oxygen-induced retinopathy (OIR) model. In the retina, furin expression was detected in endothelial cells, macrophages and, to some extent, in neurons. The rate of angiogenesis was not different in LysMCre-fur(fl/fl) mice when compared to their wild-type littermates during development. In the OIR model, the revascularization of retina was significantly delayed in LysMCre-fur(fl/fl) mice compared to their wild-type littermates, while there was no compensatory increase in the preretinal neovascularization in LysMCre-fur(fl/fl) mice. These results demonstrate that furin expression in myeloid cells plays a significant role in hypoxia-induced angiogenesis in retina.
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Affiliation(s)
- Maria Vähätupa
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland
| | - Zuzet Martinez Cordova
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland; Immunoregulation, Institute of Biosciences and Medical Technology (BioMediTech), University of Tampere, Tampere, Finland
| | - Harlan Barker
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland
| | - Saara Aittomäki
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland; Immunoregulation, Institute of Biosciences and Medical Technology (BioMediTech), University of Tampere, Tampere, Finland
| | - Hannu Uusitalo
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland; Eye Centre, Tampere University Hospital, Tampere, Finland
| | - Tero A H Järvinen
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland; Departments of Musculoskeletal Disorders, Tampere University Hospital, Tampere, Finland
| | - Marko Pesu
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland; Immunoregulation, Institute of Biosciences and Medical Technology (BioMediTech), University of Tampere, Tampere, Finland; Departments of Dermatology, Tampere University Hospital, Tampere, Finland
| | - Hannele Uusitalo-Järvinen
- Faculty of Medicine & Life Sciences, University of Tampere, Tampere, Finland; Eye Centre, Tampere University Hospital, Tampere, Finland.
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25
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Contreras-Muñoz P, Torrella JR, Serres X, Rizo-Roca D, De la Varga M, Viscor G, Martínez-Ibáñez V, Peiró JL, Järvinen TAH, Rodas G, Marotta M. Postinjury Exercise and Platelet-Rich Plasma Therapies Improve Skeletal Muscle Healing in Rats But Are Not Synergistic When Combined. Am J Sports Med 2017; 45:2131-2141. [PMID: 28453295 DOI: 10.1177/0363546517702864] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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 Skeletal muscle injuries are the most common sports-related injury and a major concern in sports medicine. The effect of platelet-rich plasma (PRP) injections on muscle healing is still poorly understood, and current data are inconclusive. PURPOSE To evaluate the effects of an ultrasound-guided intramuscular PRP injection, administered 24 hours after injury, and/or posttraumatic daily exercise training for 2 weeks on skeletal muscle healing in a recently established rat model of skeletal muscle injury that highly mimics the muscle trauma seen in human athletes. STUDY DESIGN Controlled laboratory study. METHODS A total of 40 rats were assigned to 5 groups. Injured rats (medial gastrocnemius injury) received a single PRP injection (PRP group), daily exercise training (Exer group), or a combination of a single PRP injection and daily exercise training (PRP-Exer group). Untreated and intramuscular saline-injected animals were used as controls. Muscle force was determined 2 weeks after muscle injury, and muscles were harvested and evaluated by means of histological assessment and immunofluorescence microscopy. RESULTS Both PRP (exhibiting 4.8-fold higher platelet concentration than whole blood) and exercise training improved muscle strength (maximum tetanus force, TetF) in approximately 18%, 20%, and 30% of rats in the PRP, PRP-Exer, and Exer groups, respectively. Specific markers of muscle regeneration (developmental myosin heavy chain, dMHC) and scar formation (collagen I) demonstrated the beneficial effect of the tested therapies in accelerating the muscle healing process in rats. PRP and exercise treatments stimulated the growth of newly formed regenerating muscle fibers (1.5-, 2-, and 2.5-fold increase in myofiber cross-sectional area in PRP, PRP-Exer, and Exer groups, respectively) and reduced scar formation in injured skeletal muscle (20%, 34%, and 41% of reduction in PRP, PRP-Exer, and Exer groups, respectively). Exercise-treated muscles (PRP-Exer and Exer groups) had significantly reduced percentage of dMHC-positive regenerating fibers (35% and 47% decrease in dMHC expression, respectively), indicating that exercise therapies accelerated the muscle healing process witnessed by the more rapid replacement of the embryonic-developmental myosin isoform by mature muscle myosin isoforms. CONCLUSION Intramuscular PRP injection and, especially, treadmill exercise improve histological outcome and force recovery of the injured skeletal muscle in a rat injury model that imitates sports-related muscle injuries in athletes. However, there was not a synergistic effect when both treatments were combined, suggesting that PRP does not add any beneficial effect to exercise-based therapy in the treatment of injured skeletal muscle. CLINICAL RELEVANCE This study demonstrates the efficacy of an early active rehabilitation protocol or single intramuscular PRP injection on muscle recovery. The data also reveal that the outcome of the early active rehabilitation is adversely affected by the PRP injection when the two therapies are combined, and this could explain why PRP therapies have failed in randomized clinical trials where the athletes have adhered to postinjection rehabilitation protocols based on the principle of early, active mobilization.
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Affiliation(s)
- Paola Contreras-Muñoz
- Leitat Foundation, Leitat Technological Center, Barcelona, Spain.,Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Ramon Torrella
- Departament de Biologia Cellular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Xavier Serres
- Ultrasound Unit, Department of Radiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - David Rizo-Roca
- Departament de Biologia Cellular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | | | - Ginés Viscor
- Departament de Biologia Cellular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Vicente Martínez-Ibáñez
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Luis Peiró
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain.,Translational Research in Fetal Surgery for Congenital Malformations Laboratory, Center for Fetal, Cellular and Molecular Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Tero A H Järvinen
- Medical School, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Gil Rodas
- Leitat Foundation, Leitat Technological Center, Barcelona, Spain.,Medical Services, Futbol Club Barcelona, Ciutat Esportiva Futbol Club Barcelona, Barcelona, Spain
| | - Mario Marotta
- Leitat Foundation, Leitat Technological Center, Barcelona, Spain.,Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain
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Kummola L, Ortutay Z, Vähätupa M, Prince S, Uusitalo-Järvinen H, Järvinen TAH, Junttila IS. R-Ras deficiency does not affect papain-induced IgE production in mice. Immun Inflamm Dis 2017; 5:280-288. [PMID: 28497586 PMCID: PMC5569372 DOI: 10.1002/iid3.168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/29/2017] [Accepted: 04/13/2017] [Indexed: 01/12/2023]
Abstract
Introduction R‐Ras GTPase has recently been implicated in the regulation of immune functions, particularly in dendritic cell (DC) maturation, immune synapse formation, and subsequent T cell responses. Methods Here, we investigated the role of R‐Ras in allergen‐induced immune response (type 2 immune response) in Rras deficient (R‐Ras KO) and wild type (WT) mice. Results Initially, we found that the number of conventional DC's in the lymph nodes (LNs) was reduced in R‐Ras KO mice. The expression of co‐stimulatory CD80 and CD86 molecules on these cells was also reduced on DC's from the R‐Ras KO mice. However, there was no difference in papain‐induced immune response between the R‐Ras WT and KO as measured by serum IgE levels after the immunization. Interestingly, neither the DC number nor co‐stimulatory molecule expression was different between WT and R‐Ras KO animals after the immunization. Conclusions Taken together, despite having reduced number of conventional DC's in the R‐Ras KO mice and low expression of CD80 on DC's, the R‐Ras KO mice are capable of mounting papain‐induced IgE responses comparable to that of the WT mice. To our knowledge, this is the first report addressing potential differences in in vivo allergen responses regulated by the R‐Ras GTPase.
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Affiliation(s)
- Laura Kummola
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Zsuzsanna Ortutay
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Maria Vähätupa
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Stuart Prince
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Hannele Uusitalo-Järvinen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Departments of Ophthalmology and Orthopaedics & Traumatology, Tampere University Hospital, Tampere, Finland
| | - Tero A H Järvinen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Departments of Ophthalmology and Orthopaedics & Traumatology, Tampere University Hospital, Tampere, Finland
| | - Ilkka S Junttila
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Fimlab Laboratories, Tampere, Finland
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Järvinen TAH, Rashid J, Valmari T, May U, Ahsan F. Systemically Administered, Target-Specific Therapeutic Recombinant Proteins and Nanoparticles for Regenerative Medicine. ACS Biomater Sci Eng 2017; 3:1273-1282. [DOI: 10.1021/acsbiomaterials.6b00746] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Tero A. H. Järvinen
- Faculty
of Medicine and Life Sciences, University of Tampere, Lääkärinkatu
1, 33014 Tampere, Finland
- Department of Orthopedics & Traumatology, Tampere University Hospital, Teiskontie 35, 33520 Tampere, Finland
| | - Jahidur Rashid
- Department
of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, 1300 Coulter Street, Amarillo, Texas 79106, United States
| | - Toini Valmari
- Faculty
of Medicine and Life Sciences, University of Tampere, Lääkärinkatu
1, 33014 Tampere, Finland
| | - Ulrike May
- Faculty
of Medicine and Life Sciences, University of Tampere, Lääkärinkatu
1, 33014 Tampere, Finland
| | - Fakhrul Ahsan
- Department
of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, 1300 Coulter Street, Amarillo, Texas 79106, United States
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Vähätupa M, Prince S, Vataja S, Mertimo T, Kataja M, Kinnunen K, Marjomäki V, Uusitalo H, Komatsu M, Järvinen TAH, Uusitalo-Järvinen H. Lack of R-Ras Leads to Increased Vascular Permeability in Ischemic Retinopathy. Invest Ophthalmol Vis Sci 2016; 57:4898-4909. [PMID: 27654416 PMCID: PMC5032915 DOI: 10.1167/iovs.16-19212] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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] [Indexed: 01/07/2023] Open
Abstract
Purpose The role of R-Ras in retinal angiogenesis and vascular permeability was evaluated in an oxygen-induced retinopathy (OIR) model using R-Ras knockout (KO) mice and in human diabetic neovascular membranes. Methods Mice deficient for R-Ras and their wild-type (WT) littermates were subjected to 75% oxygen from postnatal day 7 (P7) to P12 and then returned to room air. At P17 retinal vascularization was examined from whole mounts, and retinal vascular permeability was studied using Miles assay. Real-time RT-PCR, Western blotting, and immunohistochemistry were used to assess the expression of R-Ras in retina during development or in the OIR model. The degree of pericyte coverage and vascular endothelial (VE)-cadherin expression on WT and R-Ras KO retinal blood vessels was quantified using confocal microscopy. The correlation of R-Ras with vascular endothelial growth factor receptor 2 (VEGFR2) and human serum albumin on human proliferative diabetic retinopathy membranes was assessed using immunohistochemistry. Results In retina, R-Ras expression was mostly restricted to the vasculature. Retinal vessels in the R-Ras KO mice were significantly more permeable than WT controls in the OIR model. A significant reduction in the direct physical contact between pericytes and blood vessel endothelium as well as reduced VE-cadherin immunostaining was found in R-Ras–deficient mice. In human proliferative diabetic retinopathy neovascular membranes, R-Ras expression negatively correlated with increased vascular leakage and expression of VEGFR2, a marker of blood vessel immaturity. Conclusions Our results suggest that R-Ras has a role in controlling retinal vessel maturation and stabilization in ischemic retinopathy and provides a potential target for pharmacologic manipulation to treat diabetic retinopathy.
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Affiliation(s)
- Maria Vähätupa
- Department of Ophthalmology, University of Tampere, Tampere, Finland 2Department of Anatomy, University of Tampere, Tampere, Finland
| | - Stuart Prince
- Department of Anatomy, University of Tampere, Tampere, Finland
| | - Suvi Vataja
- Department of Ophthalmology, University of Tampere, Tampere, Finland
| | - Teija Mertimo
- Department of Ophthalmology, University of Tampere, Tampere, Finland
| | - Marko Kataja
- Eye Centre, Tampere University Hospital, Tampere, Finland
| | - Kati Kinnunen
- Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland
| | - Varpu Marjomäki
- Department of Biological and Environmental Science/Nanoscience Center, University of Jyväskylä, Jyväskylä, Finland
| | - Hannu Uusitalo
- Department of Ophthalmology, University of Tampere, Tampere, Finland 3Eye Centre, Tampere University Hospital, Tampere, Finland
| | - Masanobu Komatsu
- Sanford Burnham Prebys Medical Discovery Institute at Lake Nona, Orlando, Florida, United States
| | - Tero A H Järvinen
- Department of Anatomy, University of Tampere, Tampere, Finland 7Department of Musculoskeletal Disorders, Tampere University Hospital, Tampere, Finland
| | - Hannele Uusitalo-Järvinen
- Department of Ophthalmology, University of Tampere, Tampere, Finland 3Eye Centre, Tampere University Hospital, Tampere, Finland
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Contreras-Muñoz P, Fernández-Martín A, Torrella R, Serres X, De la Varga M, Viscor G, Järvinen TAH, Martínez-Ibáñez V, Peiró JL, Rodas G, Marotta M. A New Surgical Model of Skeletal Muscle Injuries in Rats Reproduces Human Sports Lesions. Int J Sports Med 2015; 37:183-90. [PMID: 26669249 DOI: 10.1055/s-0035-1555933] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Skeletal muscle injuries are the most common sports-related injuries in sports medicine. In this work, we have generated a new surgically-induced skeletal muscle injury in rats, by using a biopsy needle, which could be easily reproduced and highly mimics skeletal muscle lesions detected in human athletes. By means of histology, immunofluorescence and MRI imaging, we corroborated that our model reproduced the necrosis, inflammation and regeneration processes observed in dystrophic mdx-mice, a model of spontaneous muscle injury, and realistically mimicked the muscle lesions observed in professional athletes. Surgically-injured rat skeletal muscles demonstrated the longitudinal process of muscle regeneration and fibrogenesis as stated by Myosin Heavy Chain developmental (MHCd) and collagen-I protein expression. MRI imaging analysis demonstrated that our muscle injury model reproduces the grade I-II type lesions detected in professional soccer players, including edema around the central tendon and the typically high signal feather shape along muscle fibers. A significant reduction of 30% in maximum tetanus force was also registered after 2 weeks of muscle injury. This new model represents an excellent approach to the study of the mechanisms of muscle injury and repair, and could open new avenues for developing innovative therapeutic approaches to skeletal muscle regeneration in sports medicine.
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Affiliation(s)
- P Contreras-Muñoz
- Leitat Foundation, Leitat Technological Center, Carrer de la Innovació 2, Terrassa, Barcelona, Spain
| | - A Fernández-Martín
- Bioengineering, Orthopedics and Pediatric Surgery Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - R Torrella
- Physiology Department, Universitat de Barcelona, Barcelona, Spain
| | - X Serres
- Ultrasound Unit, Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M De la Varga
- Leitat Foundation, Leitat Technological Center, Carrer de la Innovació 2, Terrassa, Barcelona, Spain
| | - G Viscor
- Physiology Department, Universitat de Barcelona, Barcelona, Spain
| | - T A H Järvinen
- School of Medicine, University of Tampere, Tampere, Finland
| | - V Martínez-Ibáñez
- Bioengineering, Orthopedics and Pediatric Surgery Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - J L Peiró
- Bioengineering, Orthopedics and Pediatric Surgery Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - G Rodas
- Leitat Foundation, Leitat Technological Center, Carrer de la Innovació 2, Terrassa, Barcelona, Spain
| | - M Marotta
- Leitat Foundation, Leitat Technological Center, Carrer de la Innovació 2, Terrassa, Barcelona, Spain
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Järvinen TAH, May U, Prince S. Systemically Administered, Target Organ-Specific Therapies for Regenerative Medicine. Int J Mol Sci 2015; 16:23556-71. [PMID: 26437400 PMCID: PMC4632713 DOI: 10.3390/ijms161023556] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 07/31/2015] [Revised: 09/17/2015] [Accepted: 09/22/2015] [Indexed: 12/12/2022] Open
Abstract
Growth factors and other agents that could potentially enhance tissue regeneration have been identified, but their therapeutic value in clinical medicine has been limited for reasons such as difficulty to maintain bioactivity of locally applied therapeutics in the protease-rich environment of regenerating tissues. Although human diseases are treated with systemically administered drugs in general, all current efforts aimed at enhancing tissue repair with biological drugs have been based on their local application. The systemic administration of growth factors has been ruled out due to concerns about their safety. These concerns are warranted. In addition, only a small proportion of systemically administered drugs reach their intended target. Selective delivery of the drug to the target tissue and use of functional protein domains capable of penetrating cells and tissues could alleviate these problems in certain circumstances. We will present in this review a novel approach utilizing unique molecular fingerprints (“Zip/postal codes”) in the vasculature of regenerating tissues that allows target organ-specific delivery of systemically administered therapeutic molecules by affinity-based physical targeting (using peptides or antibodies as an “address tag”) to injured tissues undergoing repair. The desired outcome of targeted therapies is increased local accumulation and lower systemic concentration of the therapeutic payload. We believe that the physical targeting of systemically administered therapeutic molecules could be rapidly adapted in the field of regenerative medicine.
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Affiliation(s)
- Tero A H Järvinen
- School of Medicine, University of Tampere, 33520 Tampere, Finland.
- Department of Orthopedics & Traumatology, Tampere University Hospital, 33520 Tampere, Finland.
| | - Ulrike May
- School of Medicine, University of Tampere, 33520 Tampere, Finland.
| | - Stuart Prince
- School of Medicine, University of Tampere, 33520 Tampere, Finland.
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31
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Yanez CO, Morales AR, Yue X, Urakami T, Komatsu M, Järvinen TAH, Belfield KD. Correction: Deep Vascular Imaging in Wounds by Two-Photon Fluorescence Microscopy. PLoS One 2014; 9. [PMID: 29220845 PMCID: PMC5730225 DOI: 10.1371/annotation/59bcbe81-eddd-46a4-90dc-88c1ea70df72] [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: 12/03/2022] Open
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32
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Toba M, Alzoubi A, O'Neill K, Abe K, Urakami T, Komatsu M, Alvarez D, Järvinen TAH, Mann D, Ruoslahti E, McMurtry IF, Oka M. A novel vascular homing peptide strategy to selectively enhance pulmonary drug efficacy in pulmonary arterial hypertension. Am J Pathol 2014; 184:369-75. [PMID: 24401613 DOI: 10.1016/j.ajpath.2013.10.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 09/10/2013] [Accepted: 10/17/2013] [Indexed: 01/09/2023]
Abstract
A major limitation in the pharmacological treatment of pulmonary arterial hypertension (PAH) is the lack of pulmonary vascular selectivity. Recent studies have identified a tissue-penetrating homing peptide, CARSKNKDC (CAR), which specifically homes to hypertensive pulmonary arteries but not to normal pulmonary vessels or other tissues. Some tissue-penetrating vascular homing peptides have a unique ability to facilitate transport of co-administered drugs into the targeted cells/tissues without requiring physical conjugation of the drug to the peptide (bystander effect). We tested the hypothesis that co-administered CAR would selectively enhance the pulmonary vascular effects of i.v. vasodilators in Sugen5416/hypoxia/normoxia-exposed PAH rats. Systemically administered CAR was predominantly detected in cells of remodeled pulmonary arteries. Intravenously co-administered CAR enhanced pulmonary, but not systemic, effects of the vasodilators, fasudil and imatinib, in PAH rats. CAR increased lung tissue imatinib concentration in isolated PAH lungs without increasing pulmonary vascular permeability. Sublingual CAR was also effective in selectively enhancing the pulmonary vasodilation by imatinib and sildenafil. Our results suggest a new paradigm in the treatment of PAH, using an i.v./sublingual tissue-penetrating homing peptide to selectively augment pulmonary vascular effects of nonselective drugs without the potentially problematic conjugation process. CAR may be particularly useful as an add-on therapy to selectively enhance the pulmonary vascular efficacy of any ongoing drug treatment in patients with PAH.
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Affiliation(s)
- Michie Toba
- Departments of Pharmacology and Internal Medicine, Center for Lung Biology, University of South Alabama, College of Medicine, Mobile, Alabama
| | - Abdallah Alzoubi
- Departments of Pharmacology and Internal Medicine, Center for Lung Biology, University of South Alabama, College of Medicine, Mobile, Alabama
| | - Kealan O'Neill
- Departments of Pharmacology and Internal Medicine, Center for Lung Biology, University of South Alabama, College of Medicine, Mobile, Alabama
| | - Kohtaro Abe
- Departments of Pharmacology and Internal Medicine, Center for Lung Biology, University of South Alabama, College of Medicine, Mobile, Alabama
| | - Takeo Urakami
- Sanford-Burnham Medical Research Institute at Lake Nona, Orlando, Florida
| | - Masanobu Komatsu
- Sanford-Burnham Medical Research Institute at Lake Nona, Orlando, Florida
| | - Diego Alvarez
- Departments of Pharmacology and Internal Medicine, Center for Lung Biology, University of South Alabama, College of Medicine, Mobile, Alabama
| | - Tero A H Järvinen
- Medical School, University and University Hospital of Tampere, Tampere, Finland
| | - David Mann
- VBS Pharmaceuticals Division, Vascular BioSciences, Goleta, California
| | - Erkki Ruoslahti
- Cancer Center, Sanford-Burnham Medical Research Institute, La Jolla, California
| | - Ivan F McMurtry
- Departments of Pharmacology and Internal Medicine, Center for Lung Biology, University of South Alabama, College of Medicine, Mobile, Alabama
| | - Masahiko Oka
- Departments of Pharmacology and Internal Medicine, Center for Lung Biology, University of South Alabama, College of Medicine, Mobile, Alabama.
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Yanez CO, Morales AR, Yue X, Urakami T, Komatsu M, Järvinen TAH, Belfield KD. Deep vascular imaging in wounds by two-photon fluorescence microscopy. PLoS One 2013; 8:e67559. [PMID: 23844028 PMCID: PMC3699647 DOI: 10.1371/journal.pone.0067559] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [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: 03/16/2013] [Accepted: 05/20/2013] [Indexed: 01/22/2023] Open
Abstract
Deep imaging within tissue (over 300 μm) at micrometer resolution has become possible with the advent of two-photon fluorescence microscopy (2PFM). The advantages of 2PFM have been used to interrogate endogenous and exogenous fluorophores in the skin. Herein, we employed the integrin (cell-adhesion proteins expressed by invading angiogenic blood vessels) targeting characteristics of a two-photon absorbing fluorescent probe to image new vasculature and fibroblasts up to ≈ 1600 μm within wound (neodermis)/granulation tissue in lesions made on the skin of mice. Reconstruction revealed three dimensional (3D) architecture of the vascular plexus forming at the regenerating wound tissue and the presence of a fibroblast bed surrounding the capillaries. Biologically crucial events, such as angiogenesis for wound healing, may be illustrated and analyzed in 3D on the whole organ level, providing novel tools for biomedical applications.
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Affiliation(s)
- Ciceron O. Yanez
- Department of Chemistry, University of Central Florida, Orlando, Florida, United States of America
| | - Alma R. Morales
- Department of Chemistry, University of Central Florida, Orlando, Florida, United States of America
| | - Xiling Yue
- Department of Chemistry, University of Central Florida, Orlando, Florida, United States of America
| | - Takeo Urakami
- Sanford-Burnham Medical Research Institute at Lake Nona, Orlando, Florida, United States of America
| | - Masanobu Komatsu
- Sanford-Burnham Medical Research Institute at Lake Nona, Orlando, Florida, United States of America
| | - Tero A. H. Järvinen
- Department of Orthopaedic Surgery, Tampere City Hospital and Medical School, University of Tampere, Tampere, Finland
| | - Kevin D. Belfield
- Department of Chemistry, University of Central Florida, Orlando, Florida, United States of America
- The College of Optics and Photonics, University of Central Florida, Orlando, Florida, United States of America
- * E-mail:
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Abstract
Selective delivery of drugs and biotherapeutics to the site of disease (synaphic targeting) has a number of advantages. First, the enhanced accumulation of the therapeutic compound at the target tissue increases drug efficacy without increasing side effects. Alternatively, the dose of the drug can be lowered to reduce the side effects. On the practical level, when a drug is difficult or expensive to make, being able to lower the dose may be the key to commercial viability. Certain targeting systems can change the distribution of the drug in a beneficial way. Examples include wider distribution and deeper penetration of the drug in the target tissue, active intracellular targeting when desirable, and even targeting to a particular subcellular organelle. In this chapter, we illustrate these principles by describing the development of a targeting system for an antifibrotic biotherapeutic, decorin. The system is based on vascular homing peptide (sequence: CARSKNKDC; referred to as CAR) that specifically recognizes angiogenic blood vessels in injured (regenerating) and inflammatory tissues and can deliver a payload to such tissues with high selectivity. So far, the CAR-targeted decorin has been shown to promote tissue repair with reduced scarring in a skin wound model, but this biotherapeutic can potentially be used in other injuries and in various fibrotic diseases.
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Affiliation(s)
- Tero A H Järvinen
- Vascular Mapping Laboratory, Center for Nanomedicine, Sanford-Burnham Medical Research Institute at UCSB, University of California, Santa Barbara, California, USA
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35
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Urakami T, Järvinen TAH, Toba M, Sawada J, Ambalavanan N, Mann D, McMurtry I, Oka M, Ruoslahti E, Komatsu M. Peptide-directed highly selective targeting of pulmonary arterial hypertension. Am J Pathol 2011; 178:2489-95. [PMID: 21549345 DOI: 10.1016/j.ajpath.2011.02.032] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 01/19/2011] [Accepted: 02/28/2011] [Indexed: 10/18/2022]
Abstract
Pulmonary arterial hypertension (PAH) is a disorder of the pulmonary vasculature associated with elevated pulmonary vascular resistance. Despite recent advances in the treatment of PAH, with eight approved clinical therapies and additional therapies undergoing clinical trials, PAH remains a serious life-threatening condition. The lack of pulmonary vascular selectivity and associated systemic adverse effects of these therapies remain the main obstacles to successful treatment. Peptide-mediated drug delivery that specifically targets the vasculature of PAH lungs may offer a solution to the lack of drug selectivity. Herein, we show highly selective targeting of rat PAH lesions by a novel cyclic peptide, CARSKNKDC (CAR). Intravenous administration of CAR peptide resulted in intense accumulation of the peptide in monocrotaline-induced and SU5416/hypoxia-induced hypertensive lungs but not in healthy lungs or other organs of PAH rats. CAR homed to all layers of remodeled pulmonary arteries, ie, endothelium, neointima, medial smooth muscle, and adventitia, in the hypertensive lungs. CAR also homed to capillary vessels and accumulated in the interstitial space of the PAH lungs, manifesting its extravasation activity. These results demonstrated the remarkable ability of CAR to selectively target PAH lung vasculature and effectively penetrate and spread throughout the diseased lung tissue. These results suggest the clinical utility of CAR in the targeted delivery of therapeutic compounds and imaging probes to PAH lungs.
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Affiliation(s)
- Takeo Urakami
- Sanford-Burnham Medical Research Institute (formerly the Burnham Institute for Medical Research) at Lake Nona, Orlando, Florida, USA
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Abstract
Muscle injuries are one of the most common traumas occurring in sports. Despite their clinical importance, there are only a few clinical studies on the treatment of muscle injuries. Lack of clinical studies is most probably attributable to the fact that there is not only a high heterogeneity in the severity of injuries, but also the injuries take place in different muscles, making it very demanding to carry out clinical trials. Accordingly, the current treatment principles of muscle injuries have either been derived from experimental studies or been tested empirically only. Clinically, first aid for muscle injuries follows the RICE (Rest, Ice, Compression and Elevation) principle. The objective of RICE is to stop the injury-induced bleeding into the muscle tissue and thereby minimise the extent of the injury. Clinical examination should be carried out immediately after the injury and 5-7 days after the initial trauma, at which point the severity of the injury can be assessed more reliably. At that time, a more detailed characterisation of the injury can be made using imaging diagnostic modalities (ultrasound or MRI) if desired. The treatment of injured skeletal muscle should be carried out by immediate immobilisation of the injured muscle (clinically, relative immobility/avoidance of muscle contractions). However, the duration of immobilisation should be limited to a period sufficient to produce a scar of sufficient strength to bear the forces induced by remobilisation without re-rupture and the return to activity (mobilisation) should then be started gradually within the limits of pain. Early return to activity is needed to optimise the regeneration of healing muscle and recovery of the flexibility and strength of the injured skeletal muscle to pre-injury levels. The rehabilitation programme should be built around progressive agility and trunk stabilisation exercises, as these exercises seem to yield better outcome for injured skeletal muscle than programmes based exclusively on stretching and strengthening of the injured muscle.
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Affiliation(s)
- Tero A H Järvinen
- Institute of Medical Technology and Medical School, University of Tampere, Tampere, Finland.
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37
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Abstract
We have explored molecular specialization of the vasculature of regenerating wound tissue in the skin and tendons to identify a different repertoire of markers from that obtained by studying tumor vasculature. We screened a phage-displayed peptide library for peptides that home to wounds in mice and identified two peptides that selectively target phage to skin and tendon wounds: CARSKNKDC (CAR) and CRKDKC (CRK). CAR is homologous to heparin-binding sites in various proteins and binds to cell surface heparan sulfate and heparin. CRK is similar to a segment in thrombospondin type 1 repeat. Intravenously injected CAR and CRK phage, as well as fluorescein-labeled CAR and CRK peptides, selectively accumulated at wound sites, where they partially co-localized with blood vessels. The CAR peptide showed a preference for early stages of wound healing, whereas the CRK favored wounds at later stages of healing. The CAR peptide was internalized into the target cells and delivered the fluorescent label into the cell nuclei. These results identify new molecular markers in wound tissues and show that the expression of these markers in wound vasculature changes as healing progresses. The peptides recognizing these markers may be useful in delivering treatments into regenerating tissues.
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Affiliation(s)
- Tero A H Järvinen
- Cancer Research Center, Burnham Institute for Medical Research, La Jolla, CA, USA
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38
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Järvinen TAH, Liu ET. Simultaneous amplification of HER-2 (ERBB2) and topoisomerase IIalpha (TOP2A) genes--molecular basis for combination chemotherapy in cancer. Curr Cancer Drug Targets 2006; 6:579-602. [PMID: 17100565 DOI: 10.2174/156800906778742497] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [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: 11/22/2022]
Abstract
The HER-2 (also known as ERBB2/ErbB2/c-erbB2/HER-2/neu) oncogene is the most frequently amplified oncogene in breast cancer and is also amplified in other forms of cancer. Beside its important role in tumor induction, growth and progression, HER-2 is also a target for new therapeutic approaches such as Herceptin (trastuzumab), a recombinant antibody designed to block signaling through the HER-2 receptor. In addition to Herceptin, which is in a wide clinical use for HER-2 amplified breast cancer, a number of various HER-2 directed immunological and genetic strategies, either targeting the HER-2 receptor, its signaling pathways or both HER-2 and epidermal growth factor receptor (EGFR) simultaneously, have demonstrated promising pre-clinical activity in HER-2 amplified carcinomas. Moreover, the HER-2 amplicon is known to contain more than 30 genes with altered copy numbers that could be therapeutic targets for chemotherapy. The topoisomerase IIalpha gene, TOP2A, is located adjacent to the HER-2 oncogene at the chromosome location 17q12-q21 and is either amplified or deleted (with equal frequency) in a great majority of HER-2 amplified primary breast tumors and also in tumors without HER-2 amplification. Recent experimental as well as numerous, large, multi-center trials suggest that amplification (and/or deletion) of TOP2A may account for both sensitivity or resistance to commonly used cytotoxic drugs, i.e. topoII-inhibitors (anthracyclines etc.), depending on the specific genetic defect at the TOP2A locus. The understanding of HER-2 amplification and its role in the pathogenesis of cancer is expanding, and a number of therapeutic strategies targeting either the HER-2 or its signaling pathways in cancer therapy are being investigated. Combining HER-2 targeting therapies with conventional forms of cytotoxic chemotherapy, where additional diagnostic tests such as those ascertaining TOP2A status, may be helpful for the ideal selection of patients for the combination therapy of an HER-2 targeting drug together with a cytotoxic drug such as topoII-inhibitor especially in the case of TOP2A amplification.
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MESH Headings
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antigens, Neoplasm/genetics
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- DNA Topoisomerases, Type II/genetics
- DNA-Binding Proteins/antagonists & inhibitors
- DNA-Binding Proteins/genetics
- Enzyme Inhibitors/therapeutic use
- ErbB Receptors/antagonists & inhibitors
- Gene Amplification
- Genes, erbB-2
- Genetic Therapy
- Humans
- Neoplasms/drug therapy
- Poly-ADP-Ribose Binding Proteins
- RNA, Small Interfering/therapeutic use
- Receptor, ErbB-2/antagonists & inhibitors
- Receptor, ErbB-2/immunology
- Signal Transduction
- Topoisomerase II Inhibitors
- Trastuzumab
- Vaccines, DNA/therapeutic use
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Pilch J, Brown DM, Komatsu M, Järvinen TAH, Yang M, Peters D, Hoffman RM, Ruoslahti E. Peptides selected for binding to clotted plasma accumulate in tumor stroma and wounds. Proc Natl Acad Sci U S A 2006; 103:2800-4. [PMID: 16476999 PMCID: PMC1413849 DOI: 10.1073/pnas.0511219103] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Screening of a phage library for peptides that bind to clotted plasma in the presence of liquid plasma yielded two cyclic decapeptides, CGLIIQKNEC (CLT1) and CNAGESSKNC (CLT2). When injected intravenously into mice bearing various types of tumors, fluorescein-conjugated CLT peptides accumulated in a fibrillar meshwork in the extracellular compartment of the tumors, but were not detectable in other tissues of the tumor-bearing mice. The tumor homing of both peptides was strongly reduced after coinjection with unlabeled CLT2, indicating that the two peptides recognize the same binding site. The CLT peptide fluorescence colocalized with staining for fibrin(ogen) present in the extravascular compartment of tumors, but not in other tissues. The CLT peptides did not home to tumors grown in fibrinogen-null mice or in mice that lack plasma fibronectin. The CLT peptides also accumulated at the sites of injury in arteries, skeletal muscle, and skin. We conclude that the CLT peptides recognize fibrin-fibronectin complexes formed by clotting of plasma proteins that have leaked into the extravascular space in tumors and other lesions. These peptides may be useful in targeting diagnostic and therapeutic materials into tumors and injured tissues.
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Affiliation(s)
- Jan Pilch
- *Burnham Institute for Medical Research, 10901 North Torrey Pines Road, La Jolla, CA 92037
| | - Darren M. Brown
- *Burnham Institute for Medical Research, 10901 North Torrey Pines Road, La Jolla, CA 92037
| | - Masanobu Komatsu
- *Burnham Institute for Medical Research, 10901 North Torrey Pines Road, La Jolla, CA 92037
| | - Tero A. H. Järvinen
- *Burnham Institute for Medical Research, 10901 North Torrey Pines Road, La Jolla, CA 92037
| | - Meng Yang
- AntiCancer, Inc., 7917 Ostrow Street, San Diego, CA 92111; and
| | - David Peters
- *Burnham Institute for Medical Research, 10901 North Torrey Pines Road, La Jolla, CA 92037
| | - Robert M. Hoffman
- AntiCancer, Inc., 7917 Ostrow Street, San Diego, CA 92111; and
- Department of Surgery, University of California, 200 West Arbor Drive, San Diego, CA 92103-8220
| | - Erkki Ruoslahti
- *Burnham Institute for Medical Research, 10901 North Torrey Pines Road, La Jolla, CA 92037
- **To whom correspondence should be addressed. E-mail:
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40
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Abstract
Because most Achilles tendon injuries take place in sports and there has been a general increase in the popularity of sporting activities, the number and incidence of Achilles tendon overuse injuries have increased in the industrialized countries during the last few decades. The term "Achilles paratendinopathy" is used in clinical practice to describe activity-related Achilles pain combined with tenderness on palpation, providing that there is no suspicion of intratendinous pathology on the basis of patient history, clinical examination, or imaging examinations. This article discusses Achilles paratendinopathy.
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Affiliation(s)
- Mika Paavola
- Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Töölö Hospital, Helsinki, Finland.
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41
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Abstract
The Achilles tendon is the strongest tendon in the human body. Because most Achilles tendon injuries take place in sports and there has been a general increase in popularity of sporting activities, the number and incidence of the Achilles tendon overuse injuries and complete, spontaneous ruptures has increased in the industrialized countries during the last decades. The most common clinical diagnosis of Achilles overuse injuries is tendinopathy. The basic etiology of the Achilles tendinopathy is known to be multi-factorial. Although histopathologic studies have shown that ruptured Achilles tendons have clear degenerative changes before the rupture, many Achilles tendon ruptures take place suddenly without any preceding signs or symptoms.
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Affiliation(s)
- Tero A H Järvinen
- Department of Orthopaedic Surgery, Tampere University Hospital, Tampere, Finland.
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42
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Abstract
Muscle injuries are one of the most common traumas occurring in sports. Despite their clinical importance, few clinical studies exist on the treatment of these traumas. Thus, the current treatment principles of muscle injuries have either been derived from experimental studies or been tested only empirically. Although nonoperative treatment results in good functional outcomes in the majority of athletes with muscle injuries, the consequences of failed treatment can be very dramatic, possibly postponing an athlete's return to sports for weeks or even months. Moreover, the recognition of some basic principles of skeletal muscle regeneration and healing processes can considerably help in both avoiding the imminent dangers and accelerating the return to competition. Accordingly, in this review, the authors have summarized the prevailing understanding on the biology of muscle regeneration. Furthermore, they have reviewed the existing data on the different treatment modalities (such as medication, therapeutic ultrasound, physical therapy) thought to influence the healing of injured skeletal muscle. In the end, they extend these findings to clinical practice in an attempt to propose an evidence-based approach for the diagnosis and optimal treatment of skeletal muscle injuries.
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Affiliation(s)
- Tero A H Järvinen
- Department of Orthopaedics, Tampere University Hospital and University of Tampere, PO Box 2000, FIN-33521 Tampere, Finland
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43
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Järvinen TAH, Järvinen TLN, Kannus P, Józsa L, Järvinen M. Collagen fibres of the spontaneously ruptured human tendons display decreased thickness and crimp angle. J Orthop Res 2004; 22:1303-9. [PMID: 15475213 DOI: 10.1016/j.orthres.2004.04.003] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.5] [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] [Received: 02/05/2004] [Accepted: 04/08/2004] [Indexed: 02/04/2023]
Abstract
PURPOSE To study collagen fibre thickness and crimp formation in healthy and ruptured human tendons. METHODS The thickness, crimp angle and wavelength of the collagen fibres were analyzed by interference and polarization microscopy and the samples were studied by transmission and scanning electron microscopy in four different healthy human tendons (Achilles, Quadriceps, Biceps brachii and Extensor pollicis longus) and in 66 spontaneously ruptured tendons. RESULTS In the normal (healthy) tendons, the diameter and crimp angle of the collagen fibres varied greatly between the four different tendons, the thickest fibres with the largest crimp angle being in the Achilles and Quadriceps tendons, whereas the Biceps brachii and Extensor pollicis longus, tendons that bear lighter strains but carry functions of high specificity, were found to have substantially smaller collagen fibres with lower crimp angle. Ruptured tendons had significantly smaller collagen fibre diameter than the normal tendons, the fibre diameter being -36% in comparison to their healthy counterparts in the Achilles tendons (P < 0.0001), -24% in the Quadriceps tendons (P < 0.0001), -37% in the Biceps brachii (P < 0.0001) and -14% in the Extensor pollicis longus (P = 0.10), respectively. Similarly, the crimp angle of the collagen fibres was also found to be lower in the ruptured tendons than in healthy, normal tendons. Further, the collagen fibres in the ruptured human tendons showed great variation in the crimp angle between the adjacent fibres and in the successive crimps of the same fibre. CONCLUSION Our results show that spontaneously ruptured tendons display focal regions with decreased collagen fibre thickness, decreased crimp angle and disrupted crimp continuity, microscopic alterations that possibly result in reduced strength of the tendons being less resistant to tensile forces, and thus, place them at increased risk of ruptures.
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Affiliation(s)
- Tero A H Järvinen
- The Burnham Institute, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA.
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44
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Abstract
In solid tumours the predominant genetic mechanism for oncogene activation is through amplification of genes. The HER-2 (also known as ErbB2/c-erbB2/HER-2/neu) oncogene is the most frequently amplified oncogene in breast cancer and is also commonly amplified in other forms of cancer. The HER-2 amplicon also contains other biologically relevant genes with altered copy numbers, among these genes is the topoisomerase IIalpha (TOP2A). TOP2A gene is located adjacent to the HER-2 oncogene at the chromosome location 17q12-q21 and is either amplified or deleted, with equal frequency, in almost 90% of HER-2 amplified primary breast tumours. Recent data suggest that amplification and deletion of TOP2A may account for both sensitivity and resistance to topoII-inhibitor-chemotherapy, depending on the specific genetic defect at the TOP2A locus. In this issue of the Cytopathology, Bofin et al. present preliminary evidence for high prevalance of TOP2A amplification and deletion not only in the HER-2 amplified breast tumours, but also in the primary breast tumours without the HER-2 amplification. This finding together with the concept that TOP2A gene amplification and deletion seem to account for both relative chemosensitivity and resistance to topoII-inhibitor therapy further highlights the importance of screening for TOP2A gene copy number aberrations when topoII-inhibitors are considered either alone or in combination of other chemotherapeutic drugs for the treatment of cancer patients.
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45
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46
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Abstract
In solid tumors the predominant genetic mechanism for oncogene activation is through amplification of genes. The HER-2 (also known as ErbB2/c-erbB2/HER-2/neu) oncogene is the most frequently amplified oncogene in breast cancer and is also commonly amplified in other forms of cancer. Alongside its important role in tumor induction, growth and progression, HER-2 is also a target for a new form of chemotherapy. Since 1998, breast cancer patients have been treated with considerable success with Herceptin (trastuzumab), a recombinant antibody designed to block signaling through the HER-2 receptor. In addition to Herceptin, a large number of various HER-2 directed immunological and genetic approaches, either targeting the HER-2 receptor, its signaling pathways or both HER-2 and epidermal growth factor receptor (EGFR) together, have demonstrated promising pre-clinical potential towards HER-2 amplified carcinomas. Moreover, the HER-2 amplicon contains other genes with altered copy numbers that could be used as targets for chemotherapy. The topoisomerase IIalpha (topoIIalpha) gene (TOP2A) is located adjacent to the HER-2 oncogene at the chromosome location 17q12-q21 and is either amplified or deleted, with equal frequency, in almost 90% of HER-2 amplified primary breast tumors. Recent data suggest that amplification or deletion of TOP2A may account for both sensitivity or resistance to topoII-inhibitor-chemotherapy, depending on the specific genetic defect at the TOP2A locus. The understanding of HER-2 amplification and its role in the pathogenesis of cancer is expanding. The number of therapeutic strategies targeting HER-2 signaling pathways will most probably be introduced in the treatment of HER-2 amplified tumors within the next few years. Combining HER-2 targeting therapies with conventional forms of cytotoxic chemotherapy, where additional diagnostics tests such as those ascertaining topoIIalpha status, may be helpful for the ideal selection of patients for the combination therapy of a HER-2 targeting drug together with a cytotoxic drug. The clinical and therapeutic importance of the HER-2 and TOPO2A status of tumor cells in cancer management will only increase within the next few years.
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Affiliation(s)
- Tero A H Järvinen
- Institute of Medical Technology, University of Tampere and Tampere University Hosptial, Finland.
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47
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Kannus P, Parkkari J, Järvinen TLN, Järvinen TAH, Järvinen M. Basic science and clinical studies coincide: active treatment approach is needed after a sports injury. Scand J Med Sci Sports 2003; 13:150-4. [PMID: 12753486 DOI: 10.1034/j.1600-0838.2003.02225.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [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: 12/26/2022]
Abstract
The basic response to injury at the tissue level is well known and consists of acute inflammatory phase, proliferative phase, and maturation and remodeling phase. Knowing these phases, the treatment and rehabilitation program of athletes' acute musculoskeletal injuries should use a short period of immobilization followed by controlled and progressive mobilization. Both experimental and clinical trials have given systematic and convincing evidence that this program is superior to immobilization - a good example where basic science and clinical studies do coincide - and therefore active approach is needed in the treatment of these injuries.
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Affiliation(s)
- P Kannus
- Accident and Trauma Research Center and Research Center of Sports Medicine, UKK Institute, Tampere, Finland
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48
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Järvinen TAH, Józsa L, Kannus P, Järvinen TLN, Järvinen M. Organization and distribution of intramuscular connective tissue in normal and immobilized skeletal muscles. An immunohistochemical, polarization and scanning electron microscopic study. J Muscle Res Cell Motil 2003; 23:245-54. [PMID: 12500904 DOI: 10.1023/a:1020904518336] [Citation(s) in RCA: 145] [Impact Index Per Article: 6.9] [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: 11/12/2022]
Abstract
Collagen fiber network is a major contributor to the coherence and tensile strength of normal skeletal muscle. Despite the well-recognized importance of the intramuscular connective tissue to the normal integrity and function of the skeletal muscle, the specific architecture including the location and three-dimensional orientation of the intramuscular connective tissue within the muscle tissue is poorly described. The structure of the intramuscular connective tissue was studied by immunohistochemistry, polarization microscopy (the crimp length and angle of the collagen fibers) and scanning electron microscope (SEM) in rat skeletal muscles (gastrocnemius, soleus and tibialis anterior) in normal situation and after 3 weeks of disuse (immobilization). Three separate networks of collagen fibers were distinguished by SEM in the normal endomysium; fibers running longitudinally on the surface of the muscle fibers (the main collagen orientation), fibers running perpendicularly to the long axis of the muscle fibers and having contacts with adjacent muscle fibers, and fibers attached to the intramuscular nerves and arteries. Similarly, the SEM analysis also disclosed three distinct collagen fiber networks running in different directions in the perimysium, but, contrary to the endomysium, the main fiber orientation could not be established. Immobilization resulted in a marked increase in the endo- and perimysial connective tissue, the majority of the increased endomysial collagen being deposited directly on the sarcolemma of the muscle cells. Immobilization also resulted in substantial increase in the number of perpendicularly oriented collagen fibers with contacts to two adjacent muscle fibers in the endomysium. Further, immobilization clearly disturbed the normal structure of the endomysium making it impossible to distinguish the various networks of fibers from each other. In the perimysium, immobilization-induced changes were similar, the number of longitudinally oriented collagen fibers was increased, the connective tissue was very dense, the number of irregularly oriented collagen fibers was markedly increased, and consequently, the different networks of collagen fibers could not be distinguished from each other. Of the three studied intact muscles, the crimp angle of the collagen fibers was lowest in the soleus and highest in the gastrocnemius muscle, and the crimp angle decreased over 10% in all muscles after the immobilization-period. Altogether, the above described quantitative and qualitative changes in the intramuscular connective tissue are likely to contribute to the deteriorated function and biomechanical properties of the immobilized skeletal muscle.
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Affiliation(s)
- Tero A H Järvinen
- Department of Surgery, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland.
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49
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Torvinen S, Kannus P, Sievänen H, Järvinen TAH, Pasanen M, Kontulainen S, Nenonen A, Järvinen TLN, Paakkala T, Järvinen M, Vuori I. Effect of 8-month vertical whole body vibration on bone, muscle performance, and body balance: a randomized controlled study. J Bone Miner Res 2003; 18:876-84. [PMID: 12733727 DOI: 10.1359/jbmr.2003.18.5.876] [Citation(s) in RCA: 170] [Impact Index Per Article: 8.1] [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: 12/30/2022]
Abstract
Recent animal studies have given evidence that vibration loading may be an efficient and safe way to improve mass and mechanical competence of bone, thus providing great potential for preventing and treating osteoporosis. Randomized controlled trials on the safety and efficacy of the vibration on human skeleton are, however, lacking. This randomized controlled intervention trial was designed to assess the effects of an 8-month whole body vibration intervention on bone, muscular performance, and body balance in young and healthy adults. Fifty-six volunteers (21 men and 35 women; age, 19-38 years) were randomly assigned to the vibration group or control group. The vibration intervention consisted of an 8-month whole body vibration (4 min/day, 3-5 times per week). During the 4-minute vibration program, the platform oscillated in an ascending order from 25 to 45 Hz, corresponding to estimated maximum vertical accelerations from 2 g to 8 g. Mass, structure, and estimated strength of bone at the distal tibia and tibial shaft were assessed by peripheral quantitative computed tomography (pQCT) at baseline and at 8 months. Bone mineral content was measured at the lumbar spine, femoral neck, trochanter, calcaneus, and distal radius using DXA at baseline and after the 8-month intervention. Serum markers of bone turnover were determined at baseline and 3, 6, and 8 months. Five performance tests (vertical jump, isometric extension strength of the lower extremities, grip strength, shuttle run, and postural sway) were performed at baseline and after the 8-month intervention. The 8-month vibration intervention succeeded well and was safe to perform but had no effect on mass, structure, or estimated strength of bone at any skeletal site. Serum markers of bone turnover did not change during the vibration intervention. However, at 8 months, a 7.8% net benefit in the vertical jump height was observed in the vibration group (95% CI, 2.8-13.1%; p = 0.003). On the other performance and balance tests, the vibration intervention had no effect. In conclusion, the studied whole body vibration program had no effect on bones of young, healthy adults, but instead, increased vertical jump height. Future human studies are needed before clinical recommendations for vibration exercise.
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50
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Abstract
In breast cancer, the predominant genetic mechanism for oncogene activation is through an amplification of a gene. The HER-2 (also known as ErbB2/c-erbB2/HER-2/neu) oncogene is the most frequently amplified oncogene in breast cancer, and its overexpression is associated with poor clinical outcome. In addition to its important role in breast cancer growth and progression, HER-2 is also a target for a new form of chemotherapy. Breast cancer patients have been treated with considerable success since 1998 with trastuzumab, a recombinant antibody designed to block signaling through HER-2 receptor. HER-2 has also been implicated in altering the chemosensitivity of breast cancer cells to different forms of conventional cytotoxic chemotherapy, particularly of topoII-inhibitors (e.g., anthracyclines). Topoisomerase IIalpha gene is located just by the HER-2 oncogene at the chromosome 17q12-q21 and is amplified or deleted in almost 90% of the HER-2 amplified primary breast tumors. Recent data suggests that amplification and deletion of topoisomerase IIalpha may account for both relative chemosensitivity and resistance to anthracycline therapy, depending on the specific genetic defect at the topoIIalpha locus. Expanding our understanding of HER-2 amplification also changes its role in the pathogenesis of breast cancer. HER-2 is an oncogene that clearly can drive tumor induction and growth and is also a target for a new kind of chemotherapy, but its function as a marker for chemoselection may be due to associated genetic changes, of which topoisomerase IIalpha is a good example. Moreover, despite potential evidence that genes other than HER-2, such as topoisomerase IIalpha, may be more important predictors of therapeutic response in breast cancer, HER-2 status still has a very significant role in therapeutic selection, mainly as the major criterion for administering trastuzumab in treating breast cancer. Thus, the clinical and therapeutic importance of the HER-2 and topoisomerase IIalpha status to breast cancer management should only increase in the next few years.
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Affiliation(s)
- Tero A H Järvinen
- Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland.
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