ABSTRACT
PURPOSE: To evaluate the effect of 10% human serum (HS), 5% platelet-rich plasma (PRP), and 5% autologous conditioned plasma (ACP) on migration, proliferation, and extracellular matrix (ECM) synthesis of human meniscus cells. METHODS: Cell migration and proliferation on stimulation with HS, PRP, and ACP were assessed by chemotaxis assays and measurement of genomic DNA content. Meniscus cells were cultivated in pellets stimulated with 10% HS, 5% PRP, or 5% ACP. Meniscal ECM formation was evaluated by histochemical staining of collagen type I, type II, and proteoglycans and by analysis of fibrochondrocyte marker gene expression. RESULTS: Human meniscus cells were significantly attracted by all 3 blood-derived products (10% HS and 5% ACP: P = .0001, 5% PRP: P = .0002). Cell proliferation at day 9 was significantly increased on stimulation with 10% HS (P = .0001) and 5% PRP (P = .0002) compared with 5% ACP and controls. Meniscus cell pellet cultures showed the formation of a well-structured meniscal ECM with deposition of collagen type I, type II, and proteoglycans on stimulation with 10% HS, whereas 5% PRP or 5% ACP resulted in the formation of an inhomogeneous and more fibrous ECM. Stimulation with 10% HS and 5% ACP showed a significant induction of fibrochondrocyte marker genes such as aggrecan (HS: P = .0002, ACP: P = .0147), cartilage oligomeric matrix protein (HS: P = .0002, ACP: P = .0005), and biglycan (HS: P = .0002, ACP: P = .0003), whereas PRP showed no inducing effect. CONCLUSIONS: Among all tested blood-derived products, only stimulation with HS showed the formation of a meniscal ECM as well as positive cell proliferating and migrating effects in vitro. Regarding a potential biological repair of nonvascular meniscus lesions, our results may point toward the use of HS as a beneficial augment in regenerative meniscus repair approaches. CLINICAL RELEVANCE: Our findings may suggest that HS might be a beneficial augment for meniscus repair.
Subject(s)
Blood Platelets/physiology , Cell Movement , Cell Proliferation , Extracellular Matrix/metabolism , Menisci, Tibial/cytology , Platelet-Rich Plasma/physiology , Serum/physiology , Aged , Cells, Cultured , Chemotaxis , Collagen Type I/metabolism , Collagen Type II/metabolism , Female , Humans , Male , Menisci, Tibial/metabolism , Meniscus , Middle Aged , Proteoglycans/metabolismABSTRACT
On October 3, 2010, the Trinidad and Tobago Medical Association in association with the Trinidad and Tobago Heath Science Initiative and John Hopkins Cardiology sponsored a day-long symposium addressing the evaluation and management of patients with aortic stenosis and regurgitation in Trinidad and Tobago. The topic was chosen because aortic disease is the most common valve disorder, if not treated is associated with significant impairment of quality of life and mortality, and because its assessment and management is complex. There were three presentations reviewing some of the current international recommendation, guidelines and published literature, concerning the evaluation and medical management of aortic regurgitation, aortic stenosis, and the timing and type of surgical intervention. The group of approximately 70 health care providers then assembled in four workshops to address four critical issues in the management of this condition: (1) the initial diagnosis and evaluation, (2) medical management, (3) aortic valve surgery, and (4) post surgery follow-up and care. The workshop goals were to identify and prioritize targeted areas for improvement in each of these areas and were led by well-known and respected experts. The participants were asked to review a list of targets for improvement; to discuss, comment, add, and/or delete any; and to suggest how improvements might be implemented.