ABSTRACT
A periodontite é uma doença inflamatória crônica multifactorial caracterizada pela destruição progressiva do aparelho de suporte periodontal. Atualmente, as técnicas convencionais para regeneração desses tecidos periodontais perdidos tiveram sucesso limitado. A tecnologia de membranas de células usando células-tronco mesenquimais apareceu como uma estratégia promissora na medicina regenerativa periodontal. Embora estudos recentes tenham mostrado o papel das membranas de células-tronco mesenquimais (MSCSs) no aumento dos tecidos de suporte dentário e ósseo, não há uma revisão sistemática focada especificamente na avaliação da regeneração periodontal em modelos animais ortotópicos. Esta revisão tem como objetivo avaliar o potencial das MSCSs na regeneração periodontal em comparação ao controle, em modelos animais experimentais. Estudos pré-clínicos em defeitos periodontais de modelos animais foram considerados elegíveis. A busca eletrônica incluiu as bases de dados MEDLINE, Web of Science, EMBASE e LILACS. Além disso, uma busca manual avaliou as revistas científicas na área de periodontia/regeneração. A revisão sistemática foi conduzida de acordo com as diretrizes de Preferred Reporting Item for Systematic Reviews and Meta-Analyses statement guidelines. A ferramenta do Centro de Revisão Sistemática para Experimentação com Animais de Laboratório (SYRCLE) foi usada para avaliar o risco de viés. Dos 3989 estudos obtidos a partir da busca no banco de dados eletrônicos foram incluídos 17 artigos. Foram empregados MSCSs autólogos, alógenos e xenógenos para melhorar a regeneração periodontal. Estes incluíram MSCSs do folículo dentário (DF), MSCSs do ligamento periodontal (PDL), MSCSs da polpa dentária (DP), MSCSs da medula óssea (BM), MSCSs periosteais alveolares (AP) e MSCSs gengivais (G). Em relação ao protocolo de indução de células, a maioria dos estudos utilizou ácido ascórbico (52,94%), outros utilizaram placas de cultura com polímero termo responsivo (47,06%). Os efeitos adversos, em relação à utilização das MSCSs no sítio doador, não foram identificados na maioria dos estudos, mesmo com o uso adjunto de scaffolds, membranas ou ambos. Meta-análise não foi considerada devido a heterogeneidades metodológicas. PDL-MSCSs demonstrou ser superior para aumento da regeneração periodontal em comparação ao controle, mas em um microambiente inflamatório induzido, DF-MSCSs foram melhores. Os DF-MSCSs parecem estar relacionados à espessura do cemento e dimensão periodontal. Além disso, DP-MSCSs e BM-MSCSs mostraram resultados melhores em comparação com o controle. Em contraste, AP-MSCSs não foram associados a melhorias na regeneração periodontal. A avaliação do risco de viés com a ferramenta da SYRCLE revelou que 44,12% dos estudos apresentavam baixo risco de viés, 55,29% foram incertos e 0,59%, alto risco. A presente revisão sistemática mostrou que as MSCSs podem aumentar a regeneração periodontal em modelos animais de defeito periodontal, fornecendo uma estratégia promissora para aumentar a regeneração periodontal.
Subject(s)
Periodontitis , Tissue Engineering , Regenerative Medicine , Mesenchymal Stem Cells , Systematic Review , AnimalsABSTRACT
Se revisan los nuevos conocimientos sobre la matriz extracelular (MEC), que han permitido descubrir su importante rol en la cicatrización de las heridas cutáneas. Se describen sus características morfofisiológicas y cómo interviene en la curación de las heridas cutáneas. Se presentan cuatro casos clínicos en los que se aplicó este enfoque terapéutico: los sustitutos de piel y la "cura húmeda"
We review the new knowledge about the extracellular ma-trix (ECM) that has allowed us to discover its important role in the healing of cutaneous wounds. The morpho-physiological characteristics of ECM and its role in the healing of cutaneous wounds are described. Four clinical cases are presented where this therapeutic approach was applied: the skin substitutes and the "moist wound healing".
Subject(s)
Humans , Male , Female , Wound Healing , Burns/therapy , Skin, Artificial , Regenerative Medicine , Extracellular MatrixABSTRACT
Objetivo: Evaluar si el tratamiento con ácido hialurónico reticulado bifásico de lesiones osteocondrales promovería la regeneración del tejido cartilaginoso, favoreciendo así la reparación de la lesión. Materiales y métodos: Quince conejos hembra adultos fueron divididos aleatoriamente en tres grupos: grupo 1, de control; grupo 2 y grupo 3, sometidos a una estrategia quirúrgica de lesión osteocondral en la rodilla derecha (4 mm de diámetro, 5 mm de profundidad), el grupo 3 recibió tratamiento con 0,2 ml de ácido hialurónico por vía intrarticular después de la cirugía. Se realizaron controles clínicos, bioquímicos, histopatológicos y estudios por imágenes. Resultados: Se detectaron menos casos de dolor a la palpación en el grupo 3 que en el grupo 2 a partir de los 45 días. En la resonancia magnética, casi todas las muestras del grupo 3 tenían signos de regeneración del tejido cartilaginoso en el sitio de la lesión, sin edema óseo, ni derrame articular significativo. Los estudios histopatológicos de las muestras del grupo 3 indicaron un aumento de la matriz extracelular propia de tejido cartilaginoso, comparada con la del grupo 2, con hipercelularidad, dada por condrocitos, los que formaban grupos isogénicos axiales y coronales. Conclusiones: Este estudio brinda evidencias de que el tratamiento con ácido hialurónico reticulado bifásico en unidades experimentales de conejos con lesión osteocondral no tuvieron dolor en etapas tempranas después de la lesión, a diferencia de las unidades intervenidas y sin dicho tratamiento. A su vez, los estudios por imágenes e histopatológico mostraron la reparación del tejido dañado.
Objective: To demonstrate whether treatment with biphasic cross-linked hyaluronic acid in osteochondral lesions promotes the regeneration of cartilage tissue. Materials and methods: Fifteen adult female rabbits were randomly assigned to three groups. G1 was the control group, whereas G2 and G3 underwent surgery to treat an osteochondral injury in the right knee (4mm diameter, 5mm depth). G3 received treatment with 0.2 ml of hyaluronic acid intrarticularly after surgery. Clinical, biochemical, histopathological controls and imaging studies were performed. Results:Clinically, G3 exhibited less pain on palpation than G2 after 45 days. In G3, almost all samples showed evidence of cartilage tissue regeneration at the injury site, with neither bone edema or considerable joint effusion detected on MRI. The histological tests of G3 samples revealed an increase in the extracellular matrix of cartilaginous tissue when compared to G2, with hypercellularity caused by chondrocytes that formed axial and coronal isogenic groups. Conclusions: This study provides evidence that treatment with biphasic cross-linked hyaluronic acid in experimental units of rabbits with osteochondral injuries did not cause pain in the early stages of the injury. In turn, imaging and histopathological studies revealed that the injured tissue had been repaired.
Subject(s)
Osteochondritis , Cartilage, Articular , Regenerative Medicine , Hyaluronic AcidABSTRACT
La ortobiología está emergiendo como una nueva subespecialidad de la Ortopedia, con una aceptación gradual. Si bien el primer impulso del uso masivo de las terapias biológicas en Ortopedia vino de la mano del plasma rico en plaquetas y el concentrado de médula ósea por su elaboración y aplicación fáciles; en la última década, se han producido avances importantes y ha surgido numerosa evidencia clínica sobre los resultados de otras terapias biológicas prometedoras, como el lisado plaquetario, las células mesenquimales derivadas del tejido adiposo y los cultivos celulares. Este artículo tiene como objetivo describir las terapias biológicas más utilizadas actualmente en Ortopedia, con especial énfasis en su proceso de elaboración, su composición y mecanismo de acción. Nivel de Evidencia: V
Orthobiologics is emerging as a new subspecialty of orthopedics, with gradual acceptance. While platelet-rich plasma (PRP) and bone marrow concentrate (BMC) provided the initial catalyst for the widespread use of biological therapies in orthopedics due to their ease of preparation and application, there have been significant advances in the last decade, with numerous clinical evidence emerging on the outcomes of other promising biological therapies such as platelet lysate, adipose-derived stromal vascular fraction cells (SVF), and cell cultures. The following article aims to describe the most widely used biological therapies currently used in orthopedics, with special emphasis on their manufacturing process, composition, and mechanism of action. Level of Evidence: V
Subject(s)
Orthopedics , Bone Marrow Cells , Regenerative Medicine , Platelet-Rich Plasma , Mesenchymal Stem CellsABSTRACT
Elucidar o potencial terapêutico do uso de plasma rico em plaquetas (PRP). Foi realizado um levantamento de dados sobre o assunto em estudo nas bases de dados: PubMed, SciELO e Google Acadêmico, em língua portuguesa e inglesa, sendo considerado apenas trabalhos científicos publicados no período de 2011 a 2022. Foram consultados no total dezessete artigos para compor a presente revisão. Os estudos evidenciam que o plasma rico em plaquetas possui capacidade de atuar na síntese e liberação de fatores de crescimento e citocinas, que auxiliam na ação anti-inflamatória e antibacteriana promovendo a regeneração tecidual. Os fatores de crescimento derivados de plaquetas atuam como agentes reguladoras e estimuladoras dos processos celulares de mitogênese, quimiotaxia, diferenciação e metabolismo. Essas propriedades das plaquetas conferem ao plasma rico em plaquetas uma potencialidade em melhorar a integração de enxertos cutâneos, ósseos, cartilaginosos ou de gordura, proporcionando uma proteção natural contra processos infecciosos. Os resultados em conjunto sugerem que a aplicação do PRP é considerada uma técnica segura, eficaz e confiável por ser um procedimento autólogo, trazendo avanços promissores quanto ao tempo deregeneração tecidual. O uso dessa técnica pode trazer enormes benefícios aos pacientes, mas ainda há necessidade de maiores estudos científicos, objetivando sempre o aprimoramento da técnica.
Subject(s)
Humans , Adult , Wound Healing , Platelet-Rich Plasma , Intercellular Signaling Peptides and Proteins , Regenerative Medicine , Anti-Bacterial AgentsABSTRACT
In recent years, mesenchymal stem cell (MSCs)-derived exosomes have attracted much attention in the field of tissue regeneration. Mesenchymal stem cell-derived exosomes are signaling molecules for communication among cells. They are characterized by natural targeting and low immunogenicity, and are mostly absorbed by cells through the paracrine pathway of mesenchymal stem cells. Moreover, they participate in the regulation and promotion of cell or tissue regeneration. As a scaffold material in regenerative medicine, hydrogel has good biocompatibility and degradability. Combining the two compounds can not only improve the retention time of exosomes at the lesion site, but also improve the dose of exosomes reaching the lesion site by in situ injection, and the therapeutic effect in the lesion area is significant and continuous. This paper summarizes the research results of the interaction of exocrine and hydrogel composite materials to promote tissue repair and regeneration, in order to facilitate research in the field of tissue regeneration in the future.
Subject(s)
Hydrogels/metabolism , Exosomes/metabolism , Wound Healing , Regenerative Medicine , Mesenchymal Stem Cells/metabolismABSTRACT
Droplet microfluidics technology offers refined control over the flows of multiple fluids in micro/nano-scale, enabling fabrication of micro/nano-droplets with precisely adjustable structures and compositions in a high-throughput manner. With the combination of proper hydrogel materials and preparation methods, single or multiple cells can be efficiently encapsulated into hydrogels to produce cell-loaded hydrogel microspheres. The cell-loaded hydrogel microspheres can provide a three-dimensional, relatively independent and controllable microenvironment for cell proliferation and differentiation, which is of great value for three-dimensional cell culture, tissue engineering and regenerative medicine, stem cell research, single cell study and many other biological science fields. In this review, the preparation methods of cell-loaded hydrogel microspheres based on droplet microfluidics and its applications in biomedical field are summarized and future prospects are proposed.
Subject(s)
Hydrogels/chemistry , Microfluidics/methods , Microspheres , Regenerative Medicine , Tissue Engineering/methodsABSTRACT
In the field of plastic and reconstructive surgery, the loss of organs or tissues caused by diseases or injuries has resulted in challenges, such as donor shortage and immunosuppression. In recent years, with the development of regenerative medicine, the decellularization-recellularization strategy seems to be a promising and attractive method to resolve these difficulties. The decellularized extracellular matrix contains no cells and genetic materials, while retaining the complex ultrastructure, and it can be used as a scaffold for cell seeding and subsequent transplantation, thereby promoting the regeneration of diseased or damaged tissues and organs. This review provided an overview of decellularization-recellularization technique, and mainly concentrated on the application of decellularization-recellularization technique in the field of plastic and reconstructive surgery, including the remodeling of skin, nose, ears, face, and limbs. Finally, we proposed the challenges in and the direction of future development of decellularization-recellularization technique in plastic surgery.
Subject(s)
Tissue Engineering/methods , Tissue Scaffolds/chemistry , Surgery, Plastic , Regenerative Medicine/methods , Extracellular MatrixABSTRACT
Stem cells have been regarded with promising application potential in tissue engineering and regenerative medicine due to their self-renewal and multidirectional differentiation abilities. However, their fate is relied on their local microenvironment, or niche. Recent studied have demonstrated that biophysical factors, defined as physical microenvironment in which stem cells located play a vital role in regulating stem cell committed differentiation. In vitro, synthetic physical microenvironments can be used to precisely control a variety of biophysical properties. On this basis, the effect of biophysical properties such as matrix stiffness, matrix topography and mechanical force on the committed differentiation of stem cells was further investigated. This paper summarizes the approach of mechanical models of artificial physical microenvironment and reviews the effects of different biophysical characteristics on stem cell differentiation, in order to provide reference for future research and development in related fields.
Subject(s)
Cues , Stem Cells , Cell Differentiation , Regenerative Medicine , Tissue EngineeringABSTRACT
Introducción: En la reconstrucción de los defectos cutáneos nasales se han utilizado varias técnicas a nivel mundial. Novedosas prácticas utilizan los concentrados plaquetarios por sus propiedades moduladoras y favorecedoras de la regeneración tisular. Objetivo: Determinar los resultados estéticos asociados al uso de la membrana de fibrina autóloga rica en plaquetas y leucocitos, para la regeneración de defectos cutáneos nasales posquirúrgicos. Métodos: Se realizó un estudio cuasiexperimental, longitudinal y prospectivo en el Servicio de Cirugía Maxilofacial del Hospital Universitario "Arnaldo Milián Castro" de la ciudad de Santa Clara, Villa Clara, Cuba, desde septiembre de 2015 hasta junio de 2019. Se efectuó un muestreo intencional, no probabilístico, de 31 pacientes. A partir de una donación de sangre del paciente, se obtuvo una membrana de fibrina rica en plaquetas y leucocitos, la que fue suturada en el defecto nasal posquirúrgico. Se estudiaron variables como el resultado estético, evaluado sobre la base de parámetros como la elasticidad, el color, el volumen y la superficie. Resultados: La edad media fue 62,71 ± 11,09 años y el 61,29 por ciento de la muestra correspondió al sexo masculino. Mostraron un buen resultado estético el 90,32 por ciento de los pacientes, lo que se asoció de forma significativa al grado de epitelización. Conclusiones: Se obtuvo un buen resultado estético en los pacientes donde se utilizó la membrana de fibrina autóloga rica en plaquetas y leucocitos, con independencia de la presencia de diabetes mellitus y hábitos tóxicos. El resultado estético estuvo asociado significativamente al grado de epitelización y a la edad(AU)
Introduction: In the reconstruction of nasal skin defects, several techniques have been used worldwide. Innovative practices use platelet concentrates for their modulating properties and favoring tissue regeneration. Objective: Determine the aesthetic results associated with the use of autologous fibrin rich in platelets and leukocytes, for the regeneration of post-surgical nasal skin defects. Methods: A quasi-experimental, longitudinal and prospective study was conducted in the Maxillofacial Surgery Service of "Arnaldo Milián Castro" University Hospital in the city of Santa Clara, Villa Clara province, Cuba, from September 2015 to June 2019. An intentional, non-probabilistic sampling of 31 patients was carried out. From a blood donation from the patient, a fibrin membrane rich in platelets and leukocytes was obtained, which was sutured in the post-surgical nasal defect. Variables such as the aesthetic result were studied, evaluated on the basis of parameters such as elasticity, color, volume and surface. Results: The mean age was 62.71 ± 11.09 years and 61.29 percent of the sample corresponded to the male sex. A good aesthetic result was shown by 90.32 percent of the patients, which was significantly associated with the degree of epithelialization. Conclusions: A good aesthetic result was obtained in patients where the fibrin membrane rich in leukocytes and autologous platelets was used, regardless of the presence of diabetes mellitus and toxic habits. The aesthetic result was significantly associated with the degree of epithelialization and age(AU)
Subject(s)
Humans , Male , Guided Tissue Regeneration/adverse effects , Nasal Surgical Procedures/methods , Platelet-Rich Fibrin , Longitudinal Studies , Plastic Surgery Procedures/methods , Regenerative Medicine/methodsABSTRACT
Introducción: La aplicación del lisado plaquetario alogénico en el tratamiento de la fisura anal crónica es uno de los temas más novedosos y excitantes dentro de las ciencias biomédicas hoy día. Objetivo: Exponer en forma resumida los avances y perspectivas de empleo del lisado plaquetario alogénico en la fisura anal. Métodos: La estrategia de búsqueda abarcó información en diferentes bases de datos como internet y en el buscador google académico, se utilizaron 42 bibliografías seleccionadas para realizar la revisión, 35 publicadas en los últimos cinco años como artículos originales de revisión, monografías y otros documentos científicos especializados en el tema. A partir de la búsqueda se elaboró el presente artículo. Desarrollo: Se hace alusión a la conceptualización de la enfermedad y los pilares terapéuticos, se sustenta la utilización del lisado plaquetario alogénico; los logros alcanzados con su aplicación en el Hospital General Docente Comandante Pinares; del municipio San Cristóbal en la provincia Artemisa en la especialidad; así como a las potencialidades de tan promisorio campo en el presente siglo. Conclusiones: El Lisado plaquetario alogénico en el tratamiento de la fisura anal crónica constituyó una nueva modalidad de tratamiento de la enfermedad(AU)
Introduction: The application of allogeneic platelet lysate in the treatment of chronic anal fissure is one of the most novel and exciting topics within biomedical sciences today. Objective: To summarize the advances and perspectives of the use of allogeneic platelet lysate in anal fissure. Methods: The search strategy included information in different databases such as the internet and the academic google search engine, 42 bibliographies selected for the review were used, 35 published in the last five years as original review articles, monographs and other scientific documents specialized in the subject. The present article was prepared on the basis of the search. Development: Allusion is made to the conceptualization of the disease and the therapeutic pillars, the use of allogeneic platelet lysate is sustained; the achievements reached with its application in the General Teaching Hospital Comandante Pinares; of San Cristóbal municipality in Artemisa province in the specialty; as well as to the potential of such promising field in the present century. Conclusions: Allogeneic platelet lysate in the treatment of chronic anal fissure constituted a new modality of treatment of the disease(AU)
Subject(s)
Humans , Male , Female , Regenerative Medicine/methods , Fissure in Ano/diagnosisABSTRACT
Abstract Objective Semiquantitative and automated measurement of nuclear material removal and cell infiltration in decellularized tendon scaffolds (DTSs). Method 16 pure New Zealand rabbits were used, and the gastrocnemius muscle tendon was collected bilaterally from half of these animals (16 tendons collected); 4 were kept as control and 12 were submitted to the decellularization protocol (DTS). Eight of the DTSs were used as an in vivo implant in the experimental rotator cuff tear (RCT) model, and the rest, as well as the controls, were used in the semiquantitative and automated evaluation of nuclear material removal. The eight additional rabbits were used to make the experimental model of RCT and subsequent evaluation of cellular infiltration after 2 or 8 weeks, within the DTS. Results The semiquantitative and automated analysis used demonstrated a removal of 79% of nuclear material (p< 0.001 and power > 99%) and a decrease of 88% (p < 0.001 and power >99%) in the area occupied by nuclear material after the decellularization protocol. On cell infiltration in DTS, an increase of 256% (p < 0.001 and power >99%) in the number of cells within the DTS was observed in the comparison between 2 and 8 weeks postoperatively. Conclusion The proposed semiquantitative and automated measurement method was able to objectively measure the removal of nuclear material and cell infiltration in DTS.
Resumo Objetivo Mensuração semiquantitativa e automatizada da remoção de material nuclear e da infiltração celular em scaffolds tendinosos descelularizados (STDs). Método Foram utilizados 16 coelhos Nova Zelândia puros, sendo o tendão do músculo gastrocnêmio coletado bilateralmente de metade destes animais (16 tendões coletados); 4 foram mantidos como controle e 12 foram submetidos ao protocolo de descelularização (STD). Dos STDs, 8 foram utilizados como implante in vivo no modelo experimental de lesão do manguito rotador (LMR) e os restantes, assim como os controles, foram utilizados na avaliação semiquantitativa e automatizada da remoção de material nuclear. Os oito coelhos adicionais foram utilizados na confecção do modelo experimental de LMR e posterior avaliação da infiltração celular após 2 ou 8 semanas, dentro do STD. Resultados A análise semiquantitativa e automatizada utilizada demonstrou uma remoção de 79% do material nuclear (p< 0,001 e poder > 99%) e uma diminuição de 88% (p< 0,001 e poder > 99%) na área ocupada por material nuclear após o protocolo de descelularização. Sobre a infiltração celular no STD, foi observado um aumento de 256% (p< 0,001 e poder > 99%) no número de células dentro do STD na comparação entre 2 e 8 semanas de pós-operatório. Conclusão O método de mensuração semiquantitativo e automatizado proposto foi capaz de mensurar objetivamente a remoção de material nuclear e a infiltração celular no STD.
Subject(s)
Animals , Rabbits , Tendons , Tissue Engineering , Regenerative Medicine , Extracellular Matrix , Tissue ScaffoldsABSTRACT
Abstract Objective Histological and macroscopic evaluation of the healing process of acute lesions of the femoral rectus muscle using stem cells derived from adipose tissue-derived stem cells (ADSCs). Method An experimental study was conducted with 18 hind legs of New Zealand rabbits, which were divided into three study groups according to the intervention to be performed. In group I, no surgical procedure was performed; in group II—SHAN, the experimental lesion was performed without any additional intervention protocol; in group III—Intervention, the addition of ADSCs was performed in the same topography of the experimental lesion. After the proposed period, 2 weeks, the material was collected and submitted to macroscopic and histological evaluation. Results The quantitative analysis showed that the addition of ADSCs is related to the reduction of inflammatory cells in the 2-week evaluation (164.2 cells in group II - SHAN to 89.62 cells in group III - ADSC). The qualitative analysis of the slides with Picrosirius red, noticed an increase in orange/yellow fibers in group III - ADSC, which evidences a final healing process. The macroscopic evaluation found no difference between the groups. Conclusion The use of ADSCs in the treatment of acute muscle injury presented histological advantages when compared to their non-use.
Resumo Objetivo Avaliação histológica e macroscópica do processo de cicatrização das lesões agudas do músculo reto femoral, com utilização de células-tronco derivadas de tecido adiposo (ADSCs, na sigla em inglês). Método Foi realizado um estudo experimental com 18 patas traseiras de coelhos Nova Zelândia, que foram divididos em três nos grupos de estudo de acordo com a intervenção a ser realizada. No grupo I não foi realizado procedimento cirúrgico; no grupo II - SHAN foi realizado a lesão experimental sem nenhum protocolo de intervenção adicional; e no grupo III - Intervenção foi realizado a adição de ADSCs na mesma topografia onde foi realizada a lesão experimental. Após o período proposto, 2 semanas, o material foi coletado, submetido a avaliação macroscópica e histológica. Resultados A análise quantitativa demonstrou que a adição de ADSCs está relacionada com a diminuição de células inflamatórias na avaliação com 2 semanas (164,2 células no grupo II - SHAN para 89,62 células no grupo III - ADSC). A análise qualitativa das lâminas coradas com Picrosírius red demonstrou um aumento das fibras de cor laranja/amarela no grupo III - ADSC, o que evidencia um processo final de cicatrização. A avaliação macroscópica não encontrou diferença entre os grupos. Conclusão A utilização de ADSCs no tratamento de lesão muscular aguda apresentou vantagens histológicas quando comparada a sua não utilização.
Subject(s)
Animals , Rabbits , Regeneration , Regenerative Medicine , Mesenchymal Stem Cells , Muscles , Muscular DiseasesABSTRACT
According to literature, certain microorganism productions mediate biological effects. However, their beneficial characteristics remain unclear. Nowadays, scientists concentrate on obtaining natural materials from live creatures as new sources to produce innovative smart biomaterials for increasing tissue reconstruction in tissue engineering and regenerative medicine. The present review aims to introduce microorganism-derived biological macromolecules, such as pullulan, alginate, dextran, curdlan, and hyaluronic acid, and their available sources for tissue engineering. Growing evidence indicates that these materials can be used as biological material in scaffolds to enhance regeneration in damaged tissues and contribute to cosmetic and dermatological applications. These natural-based materials are attractive in pharmaceutical, regenerative medicine, and biomedical applications. This study provides a detailed overview of natural-based biomaterials, their chemical and physical properties, and new directions for future research and therapeutic applications.
Subject(s)
Humans , Biocompatible Materials/chemistry , Hyaluronic Acid , Regenerative Medicine , Tissue Engineering , Tissue Scaffolds/chemistryABSTRACT
Introdução: O uso de pericárdio bovino teve início em 1972 nas cirurgias cardiovasculares. A partir da evolução da engenharia de tecidos com os cuidados na preparação do material, minimizando os riscos de rejeição e facilitando a utilização para diversos tipos de cirurgias, o pericárdio bovino tornou-se ferramenta importante em procedimentos cirúrgicos reconstrutivos. Objetivos: Nessa casuística, o presente estudo propõe avaliar o atual cenário da utilização do pericárdio bovino em procedimentos cirúrgicos de diversas especialidades e os resultados pósoperatórios encontrados. Métodos: Assim, foi realizada uma revisão sistemática da literatura e a base de dados consultada foi a MEDLINE, utilizando a palavra-chave "bovine pericardium", elencando estudos publicados nos últimos cinco anos em inglês e português, e que não utilizavam outro tipo de "patch". Resultados: Foram selecionados 14 artigos que totalizam 507 pacientes, submetidos a cirurgias em diversas áreas, tais quais, cardiologia, neurologia, vascular, pediatria, urologia e oftalmologia. Conclusão: Depreende-se que o uso de pericárdio bovino como remendo cirúrgico é seguro, tendo em vista que existem poucos casos de rejeição do hospedeiro, além de fácil e rápido de ser manuseado, possuindo benefícios frente a próteses mecânicas. Faz-se relevante, portanto, ampliar o número de estudos sobre o tema, visando o grande potencial que esse tipo de material possui para a medicina regenerativa.
Introduction: The use of bovine pericardium started in 1972 in cardiovascular surgeries. From the evolution of tissue engineering with care in the preparation of the material, minimizing the risk of rejection and facilitating the use for various types of surgeries, the bovine pericardium has become an important tool in reconstructive surgical procedures. Purpose: In this series, the present study proposes to evaluate the current scenario of the use of bovine pericardium in surgical procedures of different specialties, and the postoperative results found. Methods: Thus, a systematic literature review was carried out and the database consulted was MEDLINE, using the keywords "bovine pericardium", listing studies published in the last five years in English and Portuguese and that did not use another type of patch. Results: 14 articles were selected, totaling 507 patients, who underwent surgery in several areas, such as cardiology, neurology, vascular, pediatrics, urology, and ophthalmology. Conclusion: It appears that the use of bovine pericardium as a surgical patch is safe, given that there are few cases of host rejection, in addition to being easy and quick to handle, with benefits compared to mechanical prostheses. It is relevant, therefore, to expand the number of studies on the subject, aiming at the great potential that this type of material has for regenerative medicine.
Subject(s)
Humans , Bioprosthesis , Plastic Surgery Procedures , Pericardium , Regenerative MedicineABSTRACT
Las arrugas son surcos o pliegues en la piel, que aparecen principalmente por efecto del envejecimiento. Este artículo describe el caso de un paciente masculino de 47 años de edad, piel blanca, que acudió a consulta de cirugía plástica ocular por inconformidad con el aspecto envejecido de su rostro a causa de las arrugas perioculares. Se le aplicó plasma rico en plaquetas intradérmico en el trayecto de las arrugas a razón de 3 dosis con intervalo promedio de 30 días entre cada una. Se logró la corrección total de las arrugas, con buenos resultados estéticos. No se encontró reacción adversa. Se reafirma el criterio planteado por estudios de que el plasma rico en plaquetas es una opción terapéutica de primera línea para rejuvenecer la región periocular(AU)
Wrinkles are a creases or folds which appear in the skin mainly as a result of aging. A case is described of a male 47-year-old patient of white skin color who attended ocular plastic surgery consultation for dissatisfaction with the periocular wrinkles on his face, which gave it an aged appearance. Intradermal platelet-rich plasma was applied along the course of the wrinkles at three doses with an average separation of 30 days between them. Total wrinkle correction was achieved, with good esthetic results. There was not any adverse reaction. The case confirms the criterion contained in previous studies that platelet-rich plasma is a first-line therapeutic option to rejuvenate the periocular region(AU)
Subject(s)
Humans , Male , Middle Aged , Skin Aging , Regenerative Medicine/methods , Platelet-Rich Plasma , Mesotherapy/methods , Surgery, PlasticABSTRACT
Introducción: La medicina regenerativa se basa en la sustitución o regeneración de células humanas, tejidos u órganos con la finalidad de restablecer una función normal. Es una terapia basada en el tratamiento con células madre. Las estrategias terapéuticas basadas en la terapia celular permiten su empleo en diferentes enfermedades que no resuelven o tardan más en resolver por tratamientos médicos convencionales. Objetivos: Analizar aspectos éticos de la investigación que contribuyen a la reflexión cognitiva y ética de la ciencia en el ámbito de la medicina regenerativa. Métodos: Se realizó una revisión que consideró artículos originales y de corte experimental publicados en la última década, en algunas bases de datos de la Biblioteca Virtual de Salud (BVS) de Cuba. Se emplearon los descriptores del Medical Subject Headings y de Ciencias de la Salud. Análisis y síntesis de la información: Se abordan las aplicaciones y generalidades relacionadas con las células madre y los avances en la medicina regenerativa, así como los procedimientos y tratamientos con células madre para diferentes enfermedades con la aplicación de los conocimientos destinados al beneficio social del ser humano. Conclusiones: Se señala la importancia de una postura ética en la medicina regenerativa para la valoración adecuada de los avances en el tratamiento de diversas enfermedades, el impacto de la adquisición de nuevos conocimientos, así como una actitud más responsable y el desarrollo de valores sociales que forman parte de la humanidad(AU)
Introduction: regenerative medicine is based on the replacement or regeneration of human cells, tissues or organs in order to restore normal function; it is a therapy based on stem cell treatment. Therapeutic strategies based on cell therapy allow their use in different diseases that do not resolve or take longer to resolve by conventional medical treatments. Objectives: to address ethical aspects of research those contribute to cognitive and ethical reflection of science in the field of regenerative medicine research. Methods: A review was carried out that considered original and experimental articles published in the last decade, in some databases of the Virtual Health Library (VHL) of Cuba. The descriptors of the Medical Subject Headings and Descriptors in Health Sciences were used. Analysis and synthesis of the information: Applications and generalities related to stem cells and advances in regenerative medicine are summarized, as well as procedures and treatments with stem cells for different diseases with the application of knowledge aimed at the social benefit of the human being. Conclusions: the importance of an ethical posture in regenerative medicine was pointed out for the adequate assessment of the advances in the treatment of various diseases, the impact of the acquisition of new knowledge, as well as a more responsible attitude and the development of social values that they are part of humanity(AU)
Subject(s)
Humans , Male , Female , Health Strategies , Regenerative Medicine , Libraries, Digital , Health Sciences , Cell- and Tissue-Based TherapyABSTRACT
Resumen Introducción El uso de concentrados plaquetarios para el tratamiento de heridas complejas y regeneración tisular está siendo ampliamente utilizado a nivel mundial. Durante el último tiempo, la segunda generación de concentrados plaquetarios, particularmente el L-PRF, ha permitido tratar de manera efectiva a pacientes con esta patología. Debido a su bajo costo y versatilidad, ha sido posible aplicar esta técnica en variadas situaciones clínicas con buenos resultados. El objetivo de este trabajo es presentar nuestra experiencia utilizando L-PRF para la curación de heridas complejas (CHC) como una alternativa al uso de injertos de distinto grado de complejidad. Materiales y Método: Se realizó un análisis prospectivo de una serie de casos de pacientes que fueron sometidos a tratamiento quirúrgico de heridas complejas mediante el uso de L-PRF en el Hospital Santiago Oriente - Luis Tisné Brousse, entre los meses de enero de 2017 y diciembre de 2018. Mediante examen clínico y parámetros de inclusión, de éxito y de fracaso definidos previamente, se evaluó un total de 11 pacientes con heridas complejas a los cuales se les realizó un tratamiento local con injerto de L-PRF. Resultados: _La etiología de las heridas fue variada. 8 (72%) de los casos lograron una epitelización del 100% y 3 (28%) fracasaron. Se identificaron factores predisponentes para el fracaso de la técnica, y también fue posible establecer una relación de predicción de éxito en donde se relaciona una probabilidad alta de epitelización cuando la granulación de la herida ocurre durante los primeros 10 días sobre el injerto de L-PRF. Conclusión: El tratamiento de heridas complejas mediante L-PRF es una alternativa factible, de bajo costo y requerimientos (comparada con el uso de injertos, colgajos y sustitutos dérmicos), es segura en la resolución de heridas complejas, permitiendo disminuir la morbilidad, los costos asociados al tratamiento y estadía hospitalaria.
Introduction: The use of platelet concentrates for the treatment of complex wounds and tissue regenera-tion is being widely used worldwide. During the last time, the second generation of platelet concentrates, particularly L-PRF, has made it possible to effectively treat patients with this pathology. Due to its low cost and versatility, it has been possible to apply this technique in various clinical situations with good results. The objective of this work is to present our experience using L-PRF for the healing of complex wounds (HCC) as an alternative to the use of grafts of different degrees of complexity. Materials and Method: A prospective analysis was carried out with a series of cases who underwent surgical treatment of complex wounds using L-PRF at Santiago Oriente - Luis Tisné Brousse Hospital, between the months of January 2017 and December 2018. Through clinical examination and previously defined inclusion, success, and failure parameters, a total of 11 patients with complex wounds were evaluated who underwent local treatment with an L-PRF graft. Results: The etiology of the wounds was varied. 8 (72%) of the cases achieved 100% epithelialization and 3 (28%) failed. Predisposing factors for the failure of the technique were identified, and it was also possible to establish a predictive relationship of success where a high probability of epithelialization is related when the granulation of the wound occurs during the first 10 days on the L-PRF graft. Conclusion: The treatment of complex wounds using L-PRF is a feasible alternative, with low cost and requirements (compared to the use of grafts, flaps and dermal substitutes) and safe in the resolution of complex wounds, allowing to reduce morbidity, the costs associated with treatment and hospital stay.
Subject(s)
Humans , Male , Female , Middle Aged , Regenerative Medicine/methods , Platelet-Rich Fibrin/metabolism , Leg Ulcer/therapy , Leukocytes/metabolism , Prospective Studies , Risk Factors , Leg Ulcer/pathologyABSTRACT
A cooperação científica internacional tornou-se um fator essencial para que os países emergentes alcancem novos patamares de pesquisa, publicações e financiamento. No contexto de uma discussão analítica sobre a cooperação científica global, foram analisadas as publicações brasileiras indexadas na Web of Science e a coautoria entre pesquisadores locais e estrangeiros, com o objetivo de ilustrar as mudanças ocorridas na medicina regenerativa nas duas últimas décadas. O artigo conclui que, na última década, expandiu-se a coautoria entre autores brasileiros e destes com autores de países desenvolvidos, especialmente com aqueles dos Estados Unidos, mas também, em menor grau, com os de outros países emergentes e da América Latina. Pesquisadores brasileiros também publicaram artigos de impacto global, indicando a qualidade atingida, no país, pela pesquisa científica na área. A análise mostra que a colaboração abriu portas, no âmbito global, para a pesquisa local, mas também que as assimetrias científicas se mantiveram ao longo do tempo.
International scientific cooperation has become a key factor for emerging countries to improve research advancement, publication and funding. An analysis of local publications indexed in the Web of Science and co-authored between Brazilian researchers and non-residents was carried out, in the context of an analytical discussion on global scientific cooperation and with the aim of illustrating changes in the last two decades in regenerative medicine regarding this topic. The article concluded that in the last decade Brazil increased scientific co-authorships significantly domestically and with advanced country authors, especially with American authors, but also to a lesser degree with those of other emerging economies in and beyond Latin American. Local researchers have also published on their own several articles of global impact, revealing the academic quality attained in local sciences related to the area. Collaboration has undoubtedly opened doors for Brazilian regenerative medicine globally, but historical scientific inequalities remain.
La cooperación científica internacional se ha transformado en un factor sustancial para que los países emergentes progresen en investigación, publicación y financiación. Se desarrolló un análisis de publicaciones locales indexadas en la Web of Science y coautorías entre investigadores brasileños y extranjeros en el contexto de una reflexión sobre cooperación científica global y con el fin de ilustrar las modificaciones producidas en la medicina molecular regenerativa durante los dos últimos decenios. El artículo concluye que, en el último decenio, Brasil aumentó significativamente las coautorías domésticas y con autores de países avanzados, especialmente de los Estados Unidos, y en menor medida con aquellos de otras economías emergentes dentro y fuera de América Latina. Los investigadores locales han publicado varios artículos propios de impacto global, lo cual revela la calidad académica lograda, en Brasil, en el área. La colaboración ha abierto puertas en el mundo para la medicina regenerativa brasileña, pero las asimetrías científicas históricas persisten.
Subject(s)
Humans , Brazil , Regenerative Medicine , Scientific and Technical Publications , Authorship in Scientific Publications , Technical Cooperation , Empirical Research , Science and Technology Information Networks , Cell- and Tissue-Based TherapyABSTRACT
Introducción: En el tejido adiposo se han identificado células madre mesenquimales con capacidad autorrenovadora y multipotencial. Mediante digestión enzimática y centrifugado del lipoaspirado se libera una población heterogénea de células denominada fracción vascular estromal, con innumerables potencialidades terapéuticas en el campo de la medicina regenerativa. Objetivo: Actualizar el alcance de las células madre derivadas de tejido adiposo en la terapia regenerativa. Método: Se revisaron 38 artículos entre los años 2000 y 2019 en las bases de datos Scielo, ScienceDirect, Medline y Pubmed. Desarrollo: Las células de la fracción vascular estromal se caracterizan por su capacidad de generar tejido adiposo y vasos sanguíneos, y por la producción de factores de crecimiento que ayudan en la supervivencia de los adipocitos y la formación de una red vascular. El principal mecanismo de acción de las células madre derivadas de tejido adiposo parece deberse a su acción paracrina y a la sinergia con células endoteliales. En el campo de la medicina regenerativa se han utilizado en el tratamiento de cicatrices patológicas y de fibrosis deformantes con impotencia funcional, en las reconstrucciones de secuelas por cáncer y en el cierre precoz de zonas cruentas. Conclusiones: La lipotransferencia es un procedimiento con un mínimo de complicaciones que constituye una de las opciones terapéuticas más empleadas para corregir defectos en los tejidos, debido a que no solo es un medio de relleno, sino que también permite la regeneración y restauración tisular. La presencia de células madre en el tejido adiposo, unido a su accesibilidad, disponibilidad e histocompatibilidad, ha motivado su aplicación cada vez más expandida en la medicina estética, reconstructiva y regenerativa(AU)
Introduction: Mesenchymal stem cells with self-renewing and multipotential capacity have been identified in adipose tissue. By means of enzymatic digestion and centrifugation of the lipoaspirate a heterogeneous population of cells called vascular stromal fraction is released. It has innumerable therapeutic potentialities in the field of regenerative medicine. Objective: To update the scope of stem cells derived from adipose tissue in regenerative therapy. Method: 38 articles published between 2000 and 2019 in the Scielo, ScienceDirect, Medline and Pubmed databases were reviewed. Development: The cells of the vascular stromal fraction are characterized by generating adipose tissue and blood vessels and by the production of growth factors that help in the survival of adipocytes and the formation of a vascular network. The main mechanism of action of stem cells derived from adipose tissue appears to be due to their paracrine action and synergy with endothelial cells. Stem cells derived from adipose tissue have been used in regenerative medicine for the treatment of pathological scars and deforming fibrosis with functional impotence, in the reconstruction of cancer sequelae and in the early closure of bloody areas. Conclusions: Lipotransfer is a procedure with a minimum of complications that constitutes one of the most widely used therapeutic options to correct tissue defects, since it is not only a filling medium, but also allows tissue regeneration and restoration. The presence of stem cells in adipose tissue, together with their accessibility, availability and histocompatibility, has motivated their increasingly widespread application in aesthetic, reconstructive and regenerative medicine(AU)