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1.
BMC Womens Health ; 22(1): 381, 2022 09 19.
Artículo en Inglés | MEDLINE | ID: mdl-36123682

RESUMEN

BACKGROUND: The objective of the present trial was to assess the difference in pharmacokinetics (PK) of an oral test preparation containing 4 mg drospirenone (DRSP) under fasting conditions compared to PK upon food intake after single dose administration. METHODS: Open label, single centre, two-treatment, two-sequence, crossover study in 24 healthy female volunteers, with duration of 1 day per sequence and with a real wash-out period of 14 days to investigate the relative bioavailability of DRSP with both forms of administration. The 90% confidence intervals (CI) were calculated for the intra-individual ratio (test with food vs. without food) of the PK endpoints Area under the curve; 0-72 h [AUC(0-72 h)] and maximal plasma concentration [Cmax] of DRSP. RESULTS: The 90% CI calculated by analysis of variance using logistic transformation (ANOVA-log) for the endpoint, intra-individual ratio (Test 'A' = with food intake) vs. Test 'B' = without food intake) of AUC(0-72 h) of drospirenone was between 104.72 and 111.36%. The 90% CI calculated by means of ANOVA- log for the endpoint intra-individual ratio (Test 'A' vs. Test 'B') of Cmax of DRSP was between 118.58 and 141.10%. The mean relative bioavailability of the test with food 'A' compared to the Test without food 'B' after single dose administration based on the endpoints AUC(0-72 h) was 107.99%; for the endpoint Cmax it was 129.35%. CONCLUSIONS: The rate of absorption, based on the endpoint Cmax of DRSP was increased by about 30% under fed conditions. With respect to consumer habits, this may represent a relevant benefit for contraceptive safety, as the time span between food consumption and pill intake does not play a role. IMPLICATIONS: Our results suggest that the food intake has no impact on the absorption of 4 mg DRSP in the management of contraception. This increases the contraceptive efficacy as no interference with food is expected when consuming the oral formulation under real life conditions. TRAIL REGISTRATION: Trial registration number: EudraCT-No: 2012-004,309-28.


Asunto(s)
Androstenos , Desayuno , Anticonceptivos , Grasas de la Dieta , Androstenos/farmacocinética , Desayuno/efectos de los fármacos , Anticonceptivos/farmacocinética , Estudios Cruzados , Grasas de la Dieta/administración & dosificación , Femenino , Humanos
2.
J Appl Microbiol ; 128(4): 1050-1059, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31782200

RESUMEN

AIMS: The purpose of this study was to evaluate the effects of altered environmental conditions on the persistence of Francisella tularensis bacteria and Venezuelan equine encephalitis virus (VEEV), on two material types. METHODS AND RESULTS: Francisella tularensis (F.t.) and VEEV were inoculated (c. 1 × 108 colony-forming units or PFU), dried onto porous and nonporous fomites (glass and paper), and exposed to combinations of altered environmental conditions ranging from 22 to 60°C and 30 to 75% relative humidity (RH). Viability of test organism was assessed after contact times ranging from 30 min to 10 days. Inactivation rates of F.t. and VEEV increased as both temperature and/or RH were increased. Greater efficacy was observed for paper as compared to glass for both test organisms. CONCLUSIONS: The use of elevated temperature and RH increased rate of inactivation for both organisms and greater than six log reduction was accomplished in as little as 6 h by elevating temperature to approximately 60°C. SIGNIFICANCE AND IMPACT OF THE STUDY: These results provide information for inactivation of nonspore-forming select agents using elevated temperature and humidity which may aid incident commanders following a biological contamination incident by providing alternative methods for remediation.


Asunto(s)
Descontaminación/métodos , Virus de la Encefalitis Equina Venezolana/crecimiento & desarrollo , Fómites/microbiología , Francisella tularensis/crecimiento & desarrollo , Fómites/clasificación , Vidrio/química , Humedad , Viabilidad Microbiana , Papel , Temperatura , Inactivación de Virus
3.
Contraception ; 101(2): 137-143, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31758920

RESUMEN

OBJECTIVE: To determine the pharmacokinetics (PK) of drospirenone (DRSP), alone versus in combination with ethinyl estradiol (EE), after single and repeated administration. STUDY DESIGN: We conducted a single-centre, open-label, crossover, 2-treatment, 2-period, 2-sequence study in which non-micronized DRSP 4 mg or a combination of DRSP 3 mg and EE 0.02 mg were administered to healthy female subjects on day 1 to obtain a single-dose kinetic profile, and from day 4 to day 15 to obtain a repeated-dose kinetic profile. The maximum observed concentration (Cmax) and area under the concentration/time curve (AUC) were determined in a model-independent way using non dose corrected data. Statistical analysis was based on a parametric method (ANOVA-log). RESULTS: A total of 24 healthy female subjects were randomized 1:1 into the study. The mean relative, non-dose-corrected PK estimates after single-dose administration for the endpoints AUC(0-72h), AUC(0-24h) and Cmax were 543.5 ng*h/mL, 296.1 ng*h/mL and 27.3 ng/mL for DRSP alone, and 442.0 ng*h/mL, 264.7 ng*h/mL and 37.5 ng/mL for the DRSP/EE combination; p < 0.001. The mean relative, non-dose-corrected PK estimates after repeated dose administration for the endpoints AUC(0-72h), AUC(0-24h) and Cmax were 1066.8 ng*h/ml, 570.2 ng*h/mL and 41.0 ng/mL for DRSP alone, and 1394.5 ng*h/mL, 732.8 ng*h/mL and 61.4 ng/mL for the DRSP/EE combination; p < 0.001. CONCLUSIONS: DRSP alone exhibits a lower accumulation ratio than together with EE. The extent of systemic exposure at steady-state is about 32% less with the new formulation (AUC(0-24h), steady-state geometric mean ratio: 77.8%; 90% confidence interval: 74.6%-81.1%). This PK profile may be caused by EE. IMPLICATIONS: Our results suggest that metabolic pathways of DRSP can be inhibited by EE resulting in higher DRSP plasma concentrations in DRSP/EE formulations than in a DRSP-alone formulation. The enzymes CYP3A4 and SULT1A1 may play a role. Additional drug-drug-interaction studies are needed to better understand these metabolic pathways and their future clinical implications.


Asunto(s)
Androstenos/farmacocinética , Etinilestradiol/farmacocinética , Sustancias para el Control de la Reproducción/farmacocinética , Administración Oral , Adulto , Androstenos/administración & dosificación , Bulgaria , Estudios Cruzados , Esquema de Medicación , Interacciones Farmacológicas , Etinilestradiol/administración & dosificación , Femenino , Humanos , Adulto Joven
4.
Phys Rev Lett ; 122(23): 232701, 2019 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-31298878

RESUMEN

The ^{23}Al(p,γ)^{24}Si reaction is among the most important reactions driving the energy generation in type-I x-ray bursts. However, the present reaction-rate uncertainty limits constraints on neutron star properties that can be achieved with burst model-observation comparisons. Here, we present a novel technique for constraining this important reaction by combining the GRETINA array with the neutron detector LENDA coupled to the S800 spectrograph at the National Superconducting Cyclotron Laboratory. The ^{23}Al(d,n) reaction was used to populate the astrophysically important states in ^{24}Si. This enables a measurement in complete kinematics for extracting all relevant inputs necessary to calculate the reaction rate. For the first time, a predicted close-lying doublet of a 2_{2}^{+} and (4_{1}^{+},0_{2}^{+}) state in ^{24}Si was disentangled, finally resolving conflicting results from two previous measurements. Moreover, it was possible to extract spectroscopic factors using GRETINA and LENDA simultaneously. This new technique may be used to constrain other important reaction rates for various astrophysical scenarios.

5.
Osteoarthritis Cartilage ; 27(8): 1208-1218, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31009748

RESUMEN

OBJECTIVE: Elucidation of whether miRs are involved in mechanotransduction pathways by which cartilage is maintained or disturbed has a particular importance in our understanding of osteoarthritis (OA) pathophysiology. The aim was to investigate whether mechanical loading influences global miR-expression in human chondrocytes and to identify mechanosensitive miRs responding to beneficial and non-beneficial loading regimes as potential to obtain valuable diagnostic or therapeutic targets to advance OA-treatment. METHOD: Mature tissue-engineered human cartilage was subjected to two distinct loading regimes either stimulating or suppressing proteoglycan-synthesis, before global miR microarray analysis. Promising candidate miRs were selected, re-evaluated by qRT-PCR and tested for expression in human healthy vs OA cartilage samples. RESULTS: After anabolic loading, miR microarray profiling revealed minor changes in miR-expression while catabolic stimulation produced a significant regulation of 80 miRs with a clear separation of control and compressed samples by hierarchical clustering. Cross-testing of selected miRs revealed that miR-221, miR-6872-3p, miR-6723-5p were upregulated by both loading conditions while others (miR-199b-5p, miR-1229-5p, miR-1275, miR-4459, miR-6891-5p, miR-7150) responded specifically after catabolic loading. Mechanosensitivity of miR-221 correlated with pERK1/2-activation induced by both loading conditions. The miR-response to loading was transient and a constitutive deregulation of mechano-miRs in OA vs healthy articular cartilage was not observed. CONCLUSIONS: MiRs with broader vs narrower mechanosensitivity were discovered and the first group of mechanosensitive miRs characteristic for non-beneficial loading was defined that may shape the proteome differentially when cartilage tissue is disturbed. The findings prompt future investigations into miR-relevance for mechano-responsive pathways and the corresponding miR-target molecules.


Asunto(s)
Cartílago Articular/metabolismo , Mecanotransducción Celular , MicroARNs/metabolismo , Estrés Mecánico , Colágeno Tipo II/metabolismo , Humanos , Análisis por Micromatrices , Osteoartritis/metabolismo , Proteoglicanos/metabolismo
6.
Eur Spine J ; 27(10): 2639-2649, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30141058

RESUMEN

PURPOSE: Disc regeneration through matrix-assisted autologous mesenchymal stromal cell therapy seems promising against disc degeneration with convincing results in small animal models. Whether these positive results can be transferred to larger animal models or humans is unclear. METHODS: Fibrin matrix-assisted autologous bone-marrow-derived mesenchymal stromal cell therapy was compared to acellular fibrin matrix therapy in a porcine in vivo model. First, disc degeneration was induced by annular puncture and partial nucleotomy with a large 16G-needle, and 12 weeks later, disc therapy was performed in a second surgery with a thinner 26G needle. Seventy-two lumbar discs from 12 aged adult pigs were evaluated by histology, micro-CT, and gene expression analysis 13 and 24 weeks after nucleotomy and 1 and 12 weeks after treatment, respectively. RESULTS: Radiologic disc height was not significantly different in both treatment groups. In the semi-quantitative histologic degeneration score, significant disc degeneration was still evident 1 week after treatment both in the mesenchymal stromal cell group and in the acellular fibrin matrix group. 12 weeks after treatment, degeneration was, however, not further increased and mesenchymal-stromal-cell-treated discs showed significantly less disc degeneration in the annulus fibrosus (p = 0.02), whereas reduction in the nucleus pulposus did not reach statistical significance. Cell treatment compared to matrix alone found less Col1 gene expression as a marker for fibrosis and more expression of the trophic factor BMP2 in the nucleus pulposus, whereas the inflammation marker IL1ß was reduced in the annulus fibrosus. CONCLUSIONS: Disc treatment with fibrin matrix-assisted autologous mesenchymal stromal cells reduced degenerative findings compared to acellular fibrin matrix alone. Regenerative changes, however, were not significant for all parameters showing limitations in a large biomechanically demanding model with aged discs. These slides can be retrieved under Electronic Supplementary Material.


Asunto(s)
Degeneración del Disco Intervertebral/cirugía , Disco Intervertebral/cirugía , Trasplante de Células Madre Mesenquimatosas/métodos , Animales , Modelos Animales de Enfermedad , Porcinos
8.
Drug Res (Stuttg) ; 66(7): 351-6, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27120083

RESUMEN

Bendamustine is an alkylating agent administered as 1 h intravenous infusion in the clinic for the treatment of malignant haematological cancers. The aim of the study was to evaluate the pharmacokinetics of bendamustine and its key cytochrome P 450 (CYP) 1A2 mediated γ-hydroxybendamustine (M3) metabolite after 30- and 60-min intravenous infusion of bendamustine in rats. 2 groups were assigned to receive bendamustine either as 30- or 60-min infusion and doses were normalized to 15 mg/kg for the sake of statistical evaluation. Serial pharmacokinetic samples were collected and were analysed for the circulatory levels of bendamustine and its M3 metabolite. Standard pharmacokinetic parameters were generated for bendamustine and its M3 metabolite. Regardless of the intravenous regimens, Cmax coincided with end of infusion for both bendamustine and its M3 metabolite. Immediately after stoppage of infusion, a rapid decline in the plasma levels occurred for both bendamustine and M3 metabolite. The Cmax and AUC0-∞ parameters for bendamustine after 60-min infusion were 1.90 and 1.34-fold higher; while CL was lower by 1.32-fold as compared to the 30-min infusion. In contrast, the Cmax and AUC0-∞ after 30-min infusion for the M3 metabolite was 2.15- and 2.78-fold greater; while CL was 2.32-fold lower when compared to the 60-min infusion. However, T1/2 and Vz values were similar between the 2 intravenous treatments for bendamustine or the M3 metabolite. The data unequivocally confirmed the existence of differential pharmacokinetics of bendamustine and its M3 metabolite as the function of the duration of intravenous infusion.


Asunto(s)
Clorhidrato de Bendamustina/análogos & derivados , Clorhidrato de Bendamustina/administración & dosificación , Clorhidrato de Bendamustina/farmacocinética , Animales , Clorhidrato de Bendamustina/sangre , Clorhidrato de Bendamustina/metabolismo , Infusiones Intravenosas , Masculino , Ratas , Factores de Tiempo
9.
Knee ; 23(3): 426-35, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26947215

RESUMEN

BACKGROUND: Autologous chondrocyte implantation (ACI) is an established and well-accepted procedure for the treatment of localised full-thickness cartilage defects of the knee. METHODS: The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU) describes the biology and function of healthy articular cartilage, the present state of knowledge concerning therapeutic consequences of primary cartilage lesions and the suitable indication for ACI. RESULTS: Based on best available scientific evidence, an indication for ACI is given for symptomatic cartilage defects starting from defect sizes of more than three to four square centimetres; in the case of young and active sports patients at 2.5cm(2), while advanced degenerative joint disease needs to be considered as the most important contraindication. CONCLUSION: The present review gives a concise overview on important scientific background and the results of clinical studies and discusses the advantages and disadvantages of ACI. LEVEL OF EVIDENCE: Non-systematic Review.


Asunto(s)
Enfermedades de los Cartílagos/cirugía , Cartílago Articular/cirugía , Condrocitos/trasplante , Articulación de la Rodilla/cirugía , Osteoartritis de la Rodilla/cirugía , Trasplante Autólogo/métodos , Humanos
10.
Expert Rev Mol Med ; 16: e9, 2014 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-24810570

RESUMEN

The identification of multipotent adipose-derived stromal cells (ASC) has raised hope that tissue regeneration approaches established with bone-marrow-derived stromal cells (BMSC) can be reproduced with a cell-type that is far more accessible in large quantities. Recent detailed comparisons, however, revealed subtle functional differences between ASC and BMSC, stressing the concept of a common mesenchymal progenitor existing in a perivascular niche across all tissues. Focussing on bone and cartilage repair, this review summarises recent in vitro and in vivo studies aiming towards tissue regeneration with ASC. Advantages of good accessibility, high yield and superior growth properties are counterbalanced by an inferiority of ASC to form ectopic bone and stimulate long-bone healing along with their less pronounced osteogenic and angiogenic gene expression signature. Hence, particular emphasis is placed on establishing whether stem cell activity of ASC is so far proven and relevant for successful osteochondral regeneration, or whether trophic activity may largely determine therapeutic outcome.


Asunto(s)
Tejido Adiposo Blanco/citología , Células Madre Adultas/fisiología , Células Madre Adultas/trasplante , Animales , Antígenos CD/metabolismo , Diferenciación Celular , Proliferación Celular , Forma de la Célula , Humanos , Regeneración
11.
Eur Spine J ; 23(9): 1837-47, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24801573

RESUMEN

PURPOSE: Cell therapy would be favorably performed immediately after nucleotomy, to restore intervertebral disc functionality and to slow down disc degeneration. Promising results were reported from small animal models but remaining problems, especially in larger animals, include loss of vital cells due to annular damage at the injection site and detrimental intradiscal conditions. The aim of the present study was to optimize cell-based disc therapy using a new albumin-hyaluronan hydrogel together with bone marrow-derived mesenchymal stem cells in a large porcine disc model. METHODS: Luciferase cell labeling was evaluated to follow-up stem cells metabolically up to 7 days in 3D cell cultures mimicking the harsh disc environment with low oxygen and glucose concentrations. As a pilot in vivo study, the implant was injected into porcine discs after removal of ~10% of nucleus volume and animals were killed immediately after surgery (n = 6) and 3 days later (n = 6). 24 discs were analyzed. Implant persistence and cell activity (luciferase + WST assay) were observed simultaneously. RESULTS: In vitro cell culture with reduction of glucose (20, 5, 0.5, 0 mM) and oxygen (21, 5, 2%) significantly decreased metabolic cell activity and luciferase activity after 3 days, with no recovery and a further decrease after 7 days, establishing luciferase activity as a metabolic sensor. During 3 days of 3D culture with disc-like conditions, luciferase activity decreased to 8%. In vivo, initial implant volume shrank to 61% at day 3 with evidence for hydrogel compression. Luciferase activity in vivo at day 3 was 2% without referencing but 23% after referencing to in vitro cell adaptation, and 38% after additional consideration of detected implant volume loss. CONCLUSION: In vitro analysis up to 7 days established for the first time luciferase activity as a metabolic sensor for mesenchymal stem cells used in regenerative disc therapy. Under the present protocol, short-term in vivo analysis after 3 days suggests improved implant retainment inside the disc and persistence of metabolically active cells; however, further studies will have to prove long-term in vivo outcome.


Asunto(s)
Discectomía/métodos , Hidrogel de Polietilenoglicol-Dimetacrilato/farmacología , Degeneración del Disco Intervertebral , Disco Intervertebral/metabolismo , Trasplante de Células Madre Mesenquimatosas/métodos , Albúminas/farmacología , Animales , Técnicas de Cultivo de Célula , Modelos Animales de Enfermedad , Estudios de Seguimiento , Glucosa/metabolismo , Ácido Hialurónico/farmacología , Disco Intervertebral/diagnóstico por imagen , Degeneración del Disco Intervertebral/diagnóstico por imagen , Degeneración del Disco Intervertebral/cirugía , Degeneración del Disco Intervertebral/terapia , Luciferasas , Vértebras Lumbares , Células Madre Mesenquimatosas/citología , Oxígeno/metabolismo , Porcinos , Tomografía Computarizada por Rayos X
12.
Drug Res (Stuttg) ; 64(11): 569-75, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24452524

RESUMEN

This overview article describes the non-clinical pharmacology, pharmacokinetic and clinical dose-finding programs supporting the development of a novel subcutaneous formulation for rituximab, a monoclonal antibody that selectively targets CD20-positive B-lymphocytes. The subcutaneous route of administration is expected to improve convenience for patients and to reduce healthcare professional resource use compared with conventional intravenous infusion. Various non-clinical and clinical studies were conducted to support the bridge from the approved intravenous formulation to the novel subcutaneous treatment. The underlying hypothesis for these studies was that achieving subcutaneous rituximab serum trough concentrations that are at least as high as those reached with the intravenous formulation would result in at least the same degree of receptor saturation. Preclinical mouse xenograft and cynomolgus monkey B-cell depletion studies were performed at intravenous and subcutaneous doses that were previously found to result in comparable serum concentrations in pharmacokinetic studies in the same species. Results from these non-clinical assessments guided dose selection for the subsequent phase 1b dose finding trials in patients with follicular lymphoma as part of maintenance treatment. A fixed dose of 1 400 mg was found to result in noninferior serum trough concentrations to the intravenous formulation. Clinical trials in the induction setting in patients with follicular lymphoma and chronic lymphocytic leukemia are currently ongoing.


Asunto(s)
Anticuerpos Monoclonales de Origen Murino/administración & dosificación , Animales , Anticuerpos Monoclonales de Origen Murino/farmacocinética , Anticuerpos Monoclonales de Origen Murino/farmacología , Química Farmacéutica , Ensayos Clínicos como Asunto , Humanos , Inyecciones Subcutáneas , Ratones , Rituximab
13.
Osteoarthritis Cartilage ; 22(2): 284-92, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24280245

RESUMEN

OBJECTIVES: Bone morphogenetic protein (BMP-) and Wnt-signalling play crucial roles in cartilage homeostasis. Our objective was to investigate whether activation of the BMP-pathway or stimulation of Wnt-signalling cascades effectively enhances cartilage-specific extracellular matrix (ECM) accumulation and functional biomechanical parameters of chondrocyte-seeded tissue engineering (TE)-constructs. DESIGN: Articular chondrocytes were cultured in collagen-type-I/III-matrices over 6 weeks to create a biomechanical standard curve. Effects of stimulation with 100 ng/mL BMP-4/-7 heterodimer or 10 mM lithium chloride (LiCl) on ECM-deposition was quantified and characterized histologically. Biomechanical parameters were determined by the Very Low Rubber Hardness (VLRH) method and under confined compression stress relaxation. RESULTS: BMP-4/-7 treatment resulted in stronger collagen type-II staining and significantly enhanced glycosaminoglycan (GAG) deposition (3.2-fold; *P < 0.01) correlating with improved hardness (∼1.7-fold; *P = 0.001) reaching 83% of native cartilage values after 28 days, a value not reached before 9 weeks without stimulation. LiCl treatment enhanced VLRH slightly, but significantly (∼1.3-fold; *P = 0.016) with a trend to more ECM-deposition. BMP-4/-7 treatment significantly enhanced the E Modulus (105.7 ± 34.1 kPa; *P = 0.000001) compared to controls (8.0 ± 4.2 kPa). Poisson's ratio was significantly improved by BMP-4/-7 treatment (0.0703 ± 0.0409; *P = 0.013) vs controls (0.0432 ± 0.0284) and a significantly lower permeability (5.8 ± 2.1056 × 10(-14) m4/N.s; *P = 0.00001) was detected compared to untreated scaffolds (4.4 ± 3.1289 × 10(-13) m4/N.s). CONCLUSIONS: While Wnt-activation is less effective, BMP-4/-7 heterodimer stimulation approximated native cartilage features in less than 50% of standard culture time representing a promising strategy for functional cartilage TE to improve biomechanical parameters of engineered cartilage.


Asunto(s)
Proteínas Morfogenéticas Óseas/fisiología , Cartílago Articular/fisiología , Ingeniería de Tejidos/métodos , Vía de Señalización Wnt/fisiología , Animales , Fenómenos Biomecánicos , Proteína Morfogenética Ósea 4/farmacología , Proteína Morfogenética Ósea 7/farmacología , Cartílago Articular/citología , Cartílago Articular/metabolismo , Células Cultivadas , Condrocitos/efectos de los fármacos , Condrocitos/metabolismo , Colágeno Tipo II/metabolismo , Matriz Extracelular/fisiología , Glicosaminoglicanos/metabolismo , Dureza , Cloruro de Litio/farmacología , Sus scrofa
14.
Unfallchirurg ; 117(3): 235-41, 2014 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-23179821

RESUMEN

BACKGROUND: Over the course of the past two decades autologous chondrocyte implantation (ACI) has become an important surgical technique for treating large cartilage defects. The original method using a periostal flap has been improved by using cell-seeded scaffolds for implantation, the matrix-based autologous chondrocyte implantation (mb-ACI) procedure. MATERIAL AND METHODS: Uniform nationwide guidelines for post-ACI rehabilitation do not exist. A survey was conducted among the members of the clinical tissue regeneration study group concerning the current rehabilitation protocols and the members of the study group published recommendations for postoperative rehabilitation and treatment after ACI based on the results of this survey. RESULTS: There was agreement on fundamentals concerning a location-specific rehabilitation protocol (femoral condyle vs. patellofemoral joint). With regard to weight bearing and range of motion a variety of different protocols exist. Similar to this total agreement on the role of magnetic resonance imaging (MRI) for postsurgical care was found but again a great variety of different protocols exist. CONCLUSIONS: This manuscript summarizes the recommendations of the members of the German clinical tissue regeneration study group on postsurgical rehabilitation and MRI assessment after ACI (level IVb/EBM).


Asunto(s)
Enfermedades de los Cartílagos/terapia , Trasplante de Células/rehabilitación , Trasplante de Células/normas , Condrocitos/trasplante , Ortopedia/normas , Guías de Práctica Clínica como Asunto , Rehabilitación/normas , Enfermedades de los Cartílagos/patología , Alemania , Trasplante Autólogo/rehabilitación , Trasplante Autólogo/normas
15.
Stem Cell Res ; 11(3): 1393-406, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24140198

RESUMEN

Human mesenchymal stromal cells derived from bone marrow (BMSC) and adipose tissue (ATSC) represent a valuable source of progenitor cells for cell therapy and tissue engineering. While ectopic bone formation is a standard activity of human BMSC on calcium phosphate ceramics, the bone formation capacity of human ATSC has so far been unclear. The objectives of this study were to assess the therapeutic potency of ATSC for bone formation in an ectopic mouse model and determine molecular differences by standardized comparison with BMSC. Although ATSC contained less CD146(+) cells, exhibited better proliferation and displayed similar alkaline phosphatase activity upon osteogenic in vitro differentiation, cells did not develop into bone-depositing osteoblasts on ß-TCP after 8weeks in vivo. Additionally, ATSC expressed less BMP-2, BMP-4, VEGF, angiopoietin and IL-6 and more adiponectin mRNA, altogether suggesting insufficient osteochondral commitment and reduced proangiogenic activity. Chondrogenic pre-induction of ATSC/ß-TCP constructs with TGF-ß and BMP-6 initiated ectopic bone formation in >75% of samples. Both chondrogenic pre-induction and the osteoconductive microenvironment of ß-TCP were necessary for ectopic bone formation by ATSC pointing towards a need for inductive conditions/biomaterials to make this more easily accessible cell source attractive for future applications in bone regeneration.


Asunto(s)
Tejido Adiposo/citología , Células de la Médula Ósea/citología , Células Madre Mesenquimatosas/citología , Osteogénesis , Tejido Adiposo/metabolismo , Adulto , Anciano , Animales , Biomarcadores/metabolismo , Células de la Médula Ósea/metabolismo , Proteína Morfogenética Ósea 6/farmacología , Huesos/patología , Huesos/fisiología , Fosfatos de Calcio/farmacología , Diferenciación Celular/efectos de los fármacos , Células Cultivadas , Femenino , Humanos , Masculino , Trasplante de Células Madre Mesenquimatosas , Células Madre Mesenquimatosas/metabolismo , Ratones , Ratones SCID , Persona de Mediana Edad , Osteogénesis/efectos de los fármacos , Regeneración , Ingeniería de Tejidos , Factor de Crecimiento Transformador beta/farmacología
16.
Cell Prolif ; 46(4): 396-407, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23869761

RESUMEN

OBJECTIVES: Although clinical applications using mesenchymal stromal cells (MSCs) are becoming more frequent, procedures for their in vitro culture are far from standardized. Growth factors such as FGF-2 are frequently added during expansion to improve population growth and differentiation characteristics. However, up to now its influence on surface marker distribution of MSCs has been close to unknown. The purpose of this study was therefore to analyse effects of FGF-2 supplementation on pre-selection of MSC subpopulations. MATERIALS AND METHODS: Mesenchymal stromal cells were harvested from bone marrow of six patients and expanded in alpha-MEM or DMEM-LG. Starting in passage 2, 10 ng/ml FGF-2 was administered and non-supplemented media were used as controls. Growth indices were calculated from P0 to P4. After P4, fluorescence cytometry for common MSC surface markers was performed and standard chondrogenic, adipogenic and osteogenic differentiation protocols were applied. RESULTS: Cell population growth indices were higher for those in FGF-2 supplemented media. Significant differences in surface marker distribution were observed for CD13, CD14, CD49, CD90, CD340 and STRO-1 depending on respective culture conditions. FGF-2 suppressed CD146 expression in both alpha-MEM and DMEM-LG. No differences in adipogenic and osteogenic differentiation potential could be observed, while FGF-2 significantly improved chondrogenic differentiation in DMEM-LG. CONCLUSIONS: While holding the benefit of improving MSC chondrogenic differentiation potential, FGF-2 pre-selects certain MSC subtypes. Our data clearly show that expansion culture conditions have a significant effect on distribution of a number of MSC surface markers.


Asunto(s)
Biomarcadores/metabolismo , Factor 2 de Crecimiento de Fibroblastos/farmacología , Células Madre Mesenquimatosas/efectos de los fármacos , Osteogénesis/efectos de los fármacos , Adipogénesis/efectos de los fármacos , Adulto , Diferenciación Celular/efectos de los fármacos , Células Cultivadas , Femenino , Factor 2 de Crecimiento de Fibroblastos/metabolismo , Humanos , Masculino , Células Madre Mesenquimatosas/citología , Células Madre Mesenquimatosas/metabolismo
17.
Orthopade ; 42(4): 262-70, 2013 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-23508464

RESUMEN

Specific biomechanical properties represent important quality markers of cartilage tissue engineering (TE) constructs. The aim of the study was to identify a sensitive biomechanical test to assess mechanical properties of cartilage TE constructs. Biomechanical testing of in vitro cultivated constructs following the very low rubber hardness (VLRH) principle illustrated significant differences between constructs cultured under chondrogenic conditions over various periods of time. An increase in proteoglycan and collagen type II deposition corresponded to increasing VLRH hardness values. Although a decrease in proteoglycan was detected after ectopic implantation of constructs into SCID mice, no reduction in biomechanical hardness values was observed. A functional estimation of TE constructs requires determination of biomechanical and biochemical parameters as quality features.


Asunto(s)
Materiales Biocompatibles/química , Fracturas del Cartílago/fisiopatología , Fracturas del Cartílago/cirugía , Regeneración Tisular Dirigida/instrumentación , Regeneración/fisiología , Andamios del Tejido , Animales , Fenómenos Biomecánicos , Diseño de Equipo , Análisis de Falla de Equipo/métodos , Fracturas del Cartílago/patología , Humanos , Ensayo de Materiales/métodos , Porcinos , Resultado del Tratamiento
18.
Z Orthop Unfall ; 151(1): 38-47, 2013 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-23423589

RESUMEN

Autologous chondrocyte transplantation/implantation (ACT/ACI) is an established and recognised procedure for the treatment of localised full-thickness cartilage defects of the knee. The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Traumatology (DGOU) describes the biology and function of healthy articular cartilage, the present state of knowledge concerning potential consequences of primary cartilage lesions and the suitable indication for ACI. Based on current evidence, an indication for ACI is given for symptomatic cartilage defects starting from defect sizes of more than 3-4 cm2; in the case of young and active sports patients at 2.5 cm2. Advanced degenerative joint disease is the single most important contraindication. The review gives a concise overview on important scientific background, the results of clinical studies and discusses advantages and disadvantages of ACI.


Asunto(s)
Enfermedades de los Cartílagos/cirugía , Condrocitos/trasplante , Articulación de la Rodilla/cirugía , Procedimientos Ortopédicos/normas , Ortopedia/normas , Guías de Práctica Clínica como Asunto , Traumatología/normas , Alemania , Humanos
19.
Orthopade ; 41(10): 827-36, 2012 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-23052849

RESUMEN

Values for the friction coefficient of articular cartilage are given in ranges of percentage and lower and are calculated as a quotient of the friction force and the perpendicular loading force acting on it. Thus, a sophisticated system has to be provided for analysing the friction coefficient under different conditions in particular when cartilage should be coupled as friction partner. It is possible to deep-freeze articular cartilage before measuring the friction coefficient as the procedure has no influence on the results. The presented tribological system was able to distinguish between altered and native cartilage. Furthermore, tissue engineered constructs for cartilage repair were differentiated from native cartilage probes by their friction coefficient. In conclusion a tribological equipment is presented to analyze the friction coefficient of articular cartilage, in vivo generated cartilage regenerates and in vitro tissue engineered constructs regarding their biomechanical properties for quality assessment.


Asunto(s)
Cartílago Articular/fisiología , Estimulación Física/instrumentación , Regeneración/fisiología , Ingeniería de Tejidos/instrumentación , Transductores , Animales , Fuerza Compresiva/fisiología , Módulo de Elasticidad/fisiología , Diseño de Equipo , Retroalimentación , Fricción , Dureza , Humanos , Proyectos Piloto , Resistencia a la Tracción/fisiología
20.
J Mater Sci Mater Med ; 23(12): 3029-40, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22965382

RESUMEN

Successful long term bone replacement and repair remain a challenge today. Nanotechnology has made it possible to alter materials' characteristics and therefore possibly improve on the material itself. In this study, biphasic hydroxyapatite/ß-tricalcium phosphate nanobioceramic scaffolds were prepared by the electrospinning technique in order to mimic the extracellular matrix. Scaffolds were characterised by scanning electron microscopy (SEM) and attenuated total reflectance-fourier transform infrared. Osteoblasts as well as monocytes that were differentiated into osteoclast-like cells, were cultured separately on the biphasic bioceramic scaffolds for up to 6 days and the proliferation, adhesion and cellular response were determined using lactate dehydrogenase cytotoxicity assay, nucleus and cytoskeleton dynamics, analysis of the cell cycle progression, measurement of the mitochondrial membrane potential and the detection of phosphatidylserine expression. SEM analysis of the biphasic bioceramic scaffolds revealed nanofibers spun in a mesh-like scaffold. Results indicate that the biphasic bioceramic electrospun scaffolds are biocompatible and have no significant negative effects on either osteoblasts or osteoclast-like cells in vitro.


Asunto(s)
Huesos/fisiología , Fosfatos de Calcio/química , Osteoblastos/citología , Osteoclastos/citología , Ingeniería de Tejidos/métodos , Andamios del Tejido/química , Materiales Biocompatibles/química , Regeneración Ósea , Adhesión Celular , Ciclo Celular , Línea Celular Tumoral , Núcleo Celular/metabolismo , Proliferación Celular , Cerámica , Citoesqueleto/metabolismo , Humanos , L-Lactato Deshidrogenasa/metabolismo , Potenciales de la Membrana , Microscopía Electrónica de Rastreo/métodos , Mitocondrias/metabolismo
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