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1.
Artículo en Alemán | MEDLINE | ID: mdl-38869847

RESUMEN

BACKGROUND: Despite the high burden in patients with chronic prurigo (CPG), the first and so far only approved systemic therapy for this disease, dupilumab, has only been available since 2022. Therefore, treatment is mostly based on expert recommendations for off-label therapies. We aim to provide an overview of current therapies and possible future therapeutic drugs for CPG patients, which are currently in clinical trials. MATERIALS AND METHODS: For this review, a systematic literature and clinical trial search was conducted via PubMed and Clinical Trials using the terms "chronic prurigo", "chronic nodular prurigo", "prurigo nodularis" and "therapy". CONCLUSION: Multiple new therapeutic agents are currently under investigation in clinical trials, providing promising results for future treatment options. Moreover, an annotated checklist was developed recently to improve therapeutic decision-making in daily clinical practice with CPG patients.

3.
Dermatologie (Heidelb) ; 74(9): 670-677, 2023 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-37599291

RESUMEN

BACKGROUND: Chronic pruritus (CP), a frequent (20.3%) symptom in the elderly, increases with age. It has a significant impact on the quality of life, ranking among the 50 most burdensome diseases worldwide (Global Burden of Disease Study). OBJECTIVES: The aim is to provide an overview of the symptom CP in the elderly and to improve differentiation of underlying conditions and management of this entity. MATERIALS AND METHODS: A literature search in PubMed was performed, using the terms 'pruritus', 'elderly' and 'gerontodermatology'. RESULTS: The main causes of CP in the elderly are the physiologic aging process (xerosis cutis, immunosenescence, neuropathy), the increase in potentially pruritic diseases with increasing age (diabetes mellitus, chronic renal failure), and polypharmacy. Therapeutic options relate to causes, severity of pruritus, and individual patient factors (multimorbidity, impaired organ function). The recently updated S2k guideline 'Diagnosis and therapy of chronic pruritus' is helpful. CONCLUSION: CP in the elderly is challenging for both patients and physicians. Not only the difficulty of identifying the underlying cause, but the complexity of treatment and its tolerability and practicability determines these patients' further burden.


Asunto(s)
Inmunosenescencia , Fallo Renal Crónico , Humanos , Calidad de Vida , Prurito/diagnóstico , Envejecimiento
4.
Z Rheumatol ; 82(2): 91-101, 2023 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-34851442

RESUMEN

BACKGROUND: The diagnosis of patients with polymyalgia rheumatica (PMR) has relied upon the clinical examination of symptoms and laboratory parameters of inflammation until now. Currently, the use of different imaging modalities is being explored, including ultrasound, MRI and PET. OBJECTIVES: The aim was to evaluate the diagnostic value of 18-fluorodeoxyglucose-positron-emission-tomography/computed tomography (18F-FDG-PET/CT) for PMR, in order to improve the sensitivity and specificity of diagnosing PMR and to improve the differential diagnosis of rheumatoid arthritis (RA). MATERIALS AND METHODS: Examinations using 18F-FDG-PET/CT of 284 rheumatological patients, including 97 patients with PMR, were retrospectively evaluated over a 44-month period. Furthermore, 13 regions changed by inflammation were analysed via a three-dimensional region of interest (ROI) measurement with determination of maximum standardized uptake values (SUVmax), followed by statistical analyses. RESULTS AND DISCUSSION: Patients with PMR presented significantly elevated uptake in all regions examined (p < 0.001), compared with a control group treated for rheumatological diseases. The method with the highest diagnostic relevance was represented by the combination of four SUVmax values of both anterolateral hip capsules and both ischial tuberosities, reaching a sensitivity of 91.3% and a specificity of 97.6% with a cut-off of 11.0 SUV at the initial diagnosis of PMR patients who had not yet received any immunosuppressive therapy. Patients with RA could be significantly distinguished from those with PMR at initial diagnosis in the same anatomical regions (p < 0.001).


Asunto(s)
Artritis Reumatoide , Arteritis de Células Gigantes , Polimialgia Reumática , Humanos , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Fluorodesoxiglucosa F18/uso terapéutico , Polimialgia Reumática/tratamiento farmacológico , Estudios Retrospectivos , Electrones , Tomografía de Emisión de Positrones , Artritis Reumatoide/diagnóstico por imagen , Inflamación
5.
Rechtsmedizin (Berl) ; 30(5): 325-331, 2020.
Artículo en Alemán | MEDLINE | ID: mdl-32836898

RESUMEN

Background: Coronavirus disease 2019 (COVID-19), a disease caused by the new coronavirus (SARS-CoV-2), is a particular threat to old people. At the end of March 2020, the first and so far largest outbreak of the disease occurred in a retirement home in Hamburg. Methods: Analysis of procedures in dealing with a residential unit affected by SARS-CoV­2, accommodating a risk group of 60 seniors with dementia is presented as well as a detailed presentation of post-mortem examination results of all 8 deceased tested positive for SARS-CoV­2. Results: Out of 60 residents, 39 were infected by SARS-CoV­2. Due to preventive procedures it was possible to stop further spreading of the infection to other residential areas. In all 8 fatal cases, the autopsy diagnosis was death due to COVID-19. Autopsies revealed all COVID-19 patients to have a fatal (broncho)pneumonia and signs of relevant pre-existing cardiac, renal and pulmonary conditions in all cases. In 75% (n = 6) of the cases a fresh venous thrombosis was found. In 66.7% (n = 4) of the cases thrombotic events were combined with peripheral pulmonary artery thromboembolisms. Conclusion: The cohort of SARS-CoV­2 infected residents of a nursing home is characteristic for clinical and epidemiological features of the new coronavirus disease. Due to a centralized evaluation of all fatalities at the Institute of Legal Medicine in Hamburg, a detailed examination of all deceased positive for SARS-CoV­2 was possible. Thereby, increased case fatality rates of approximately 20% could in all cases be assigned to a relevant number of pre-existing comorbidities of multiple organ systems, which was consistent with the clinical data available.

6.
J Microsc ; 277(3): 179-196, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31701530

RESUMEN

Bone as such displays an intrinsic regenerative potential following fracture; however, this capacity is limited with large bone defects that cannot heal spontaneously. The management of critical-sized bone defects remains a major clinical and socioeconomic need with osteoregenerative biomaterials constantly under development aiming at promoting and enhancing bone healing. X-ray computed tomography (XCT) has become a standard and essential tool for quantifying structure-function relationships in bone and biomaterials, facilitating the development of novel bone tissue engineering strategies. This paper presents recent advancements in XCT analysis of biomaterial-mediated bone regeneration. As a noninvasive and nondestructive technique, XCT allows for qualitative and quantitative evaluation of three-dimensional (3D) scaffolds and biomaterial microarchitecture, bone growth into the scaffold as well as the 3D characterisation of biomaterial degradation and bone regeneration in vitro and in vivo. Furthermore, in combination with in situ mechanical testing and digital volume correlation (DVC), XCT demonstrated its potential to better understand the bone-biomaterial interactions and local mechanics of bone regeneration during the healing process in relation to the regeneration achieved in vivo, which will likely provide valuable knowledge for the development and optimisation of novel osteoregenerative biomaterials. LAY DESCRIPTION: Bone, being a dynamically adaptable material, displays excellent regenerative properties following fracture. However, the self-healing capacity of bone becomes more difficult with large bone defects. Those defects are common and occur in many clinical situations; hence, biomaterials are mostly used to restore both bone structure and function in the defect site. X-ray computed tomography (XCT) is a powerful tool to evaluate bone regeneration in critical-sized defects after the implantation of biomaterials, allowing to an improved understanding of the regeneration process following different bone tissue engineering approaches. This paper focuses on recent advancements in XCT analysis to characterise biomaterial-mediated bone regeneration in critical-sized defects. XCT supports three-dimensional (3D) analysis of biomaterials, scaffolds and regenerated bone microarchitecture, as well as bone ingrowth into the scaffold. As a nondestructive technique, XCT allows for a 3D characterisation of biomaterial degradation and bone regeneration over time. In addition, XCT combined with in situ mechanical experiments and digital volume correlation (DVC) provides a 3D evaluation and quantification of bone-biomaterial interactions and deformation mechanisms during the regeneration process. This remains essential for the development and enhancement of novel biomaterials able to produce bone that is comparable with the native tissue they aim to replace.


Asunto(s)
Materiales Biocompatibles , Regeneración Ósea , Procesamiento de Imagen Asistido por Computador/métodos , Ingeniería de Tejidos/métodos , Andamios del Tejido , Tomografía Computarizada por Rayos X/métodos , Animales , Fenómenos Biomecánicos , Análisis de Elementos Finitos , Humanos , Imagenología Tridimensional , Osteogénesis , Porosidad , Impresión Tridimensional , Ratas
7.
Acta Biomater ; 98: 186-195, 2019 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-31352109

RESUMEN

Volume stable barrier membranes made of magnesium are very promising in Guided Bone Regeneration (GBR) to treat periodontal bone defects in dentistry due to their excellent biocompatibility and biodegradability. During the degradation process the cells are exposed to the alteration of various parameters, so called physical cues, involving surface alterations due to the formed corrosion layer and medium alterations arising from the dissolved corrosion products. Cell migration of human gingival fibroblasts (HGF), as a crucial parameter for optimal healing process in GBR, has been investigated on magnesium membranes and revealed that medium alterations by dissolved corrosion products have a higher impact on cell migration than surface alterations. However, the effect of each altered medium parameter on cell migration has not been adequately studied, but their roles are crucial to explain the slower migration rate on magnesium surfaces compared to titanium and tissue culture plastic surfaces. Our study investigates the single effect of Mg2+, Ca2+, H2 and increased osmolality as well as the effect of magnesium extracts, which contain a dynamic mixture of previous parameters on cell migration, proliferation and viability of HGF. We showed that at 75 mM Mg2+ concentration and at 0 mM Ca2+, respectively, the cell migration rate is greatly reduced. In complex magnesium extract media, we found that a temporarily increased ratio of Mg2+ to Ca2+ conditioned a slow HGF migration rate. Based on these findings and the characterization of supernatants from HGF migration assays on Mg membranes, we propose, that the slower migration rate of HGF can be explained by the altered ratio of Mg2+ to Ca2+, caused by increasing concentrations of Mg2+ and decreasing concentrations of Ca2+ in the vicinity of the corroding Mg implant, combined with a constantly increased molecular hydrogen concentration in the supernatant. These results are cell type specific and should be checked carefully, if necessary, for Mg implant performance. STATEMENT OF SIGNIFICANCE: The study is providing a systematic approach to explain the main effects of extract medium parameters (physical cues) such as magnesium or calcium ion concentration, osmolality and dissolved molecular hydrogen and CO2 in cell culture media modified by co-incubating with corroding magnesium implants on the migration rate of human gingival fibroblasts (HGF). This study uncovers for the first time the combinatory effect of slightly increased molecular hydrogen and the change in Mg2+/Ca2+ ratio on HGF cell migration.


Asunto(s)
Implantes Absorbibles , Fibroblastos/citología , Encía/citología , Magnesio/farmacología , Calcio/farmacología , Movimiento Celular/efectos de los fármacos , Corrosión , Medios de Cultivo , Fibroblastos/efectos de los fármacos , Humanos , Hidrógeno/farmacología , Iones
8.
Acta Biomater ; 79: 158-167, 2018 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-30172066

RESUMEN

A novel regenerative approach to Guided Bone Regeneration (GBR) in dental surgery is based on the development of biodegradable and volume stable barrier membranes made of metallic magnesium. Currently used volume stable barrier membranes are made of titanium-reinforced PTFE or titanium-reinforced collagen membranes, both, however, are accompanied by a high incidence of wound dehiscence resulting in membrane exposure, which leads to an increased infection risk. An exposed membrane could also occur directly after insertion due to insufficient soft tissue coverage of the membrane. In both cases, fast wound margin regeneration is required. As a first step of soft-tissue regeneration, gingival fibroblasts need to migrate over the barrier membrane and close the dehiscent wound. Based on this aim, this study investigated the migration behaviour of human gingival fibroblasts on a magnesium surface. Major experimental challenges such as formation of hydrogen bubbles due to initial magnesium corrosion and non-transparent material surfaces have been addressed to allow cell adhesion and to follow cell migration. The designed scratch-based cell migration assay involved vital fluorescent cell staining on a pre-corroded magnesium membrane to simulate invivo wound dehiscence. The assay has been used to compare cell migration on pre-corroded magnesium to titanium surfaces and tissue culture plastic as control substrates. First results of this assay showed that human gingival fibroblasts migrate slower on pre-corroded magnesium compared to plastic and titanium. However, the scratch was finally closed on all materials. Compared to titanium surfaces and tissue culture plastic, the surface roughness and the surface free energy (SFE) could not explain slower cell migration on magnesium surfaces. Immunohistological investigations of cellular structure revealed, that magnesium ions increased focal adhesion at concentration of additionally 75 mM MgCl2 in cell culture medium. The use of our designed cell migration assay has shown that ionic medium alterations due to magnesium corrosion has a higher impact on the cell migration rate than surface alterations. STATEMENT OF SIGNIFICANCE: The design of a migration assay on non-transparent magnesium surfaces will add the option to study cell response to surface modifications, coatings and the corrosion process itself under life view conditions.


Asunto(s)
Ensayos de Migración Celular/métodos , Fibroblastos/citología , Encía/citología , Magnesio/farmacología , Animales , Fenómenos Biomecánicos , Adhesión Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Perros , Femenino , Fibroblastos/efectos de los fármacos , Humanos , Concentración de Iones de Hidrógeno , Microscopía de Fuerza Atómica , Concentración Osmolar , Plásticos/farmacología , Propiedades de Superficie , Resistencia a la Tracción , Termodinámica , Titanio/farmacología , Cicatrización de Heridas/efectos de los fármacos
9.
Acta Biomater ; 9(10): 8611-23, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23542554

RESUMEN

A cytocompatible and biocompatible, degradable, open-porous, mechanically adaptable metal scaffold made of magnesium alloy W4 melt-extracted short fibres was fabricated by liquid phase sintering. Cylindrical samples (3×5 mm) of sintered W4 short fibres were evaluated under in vitro (L929, HOB, eudiometer, weight loss) and in vivo conditions (rabbits: 6 and 12 weeks). The in vitro corrosion environment (e.g., temperature, flow, composition of corrosion solution, exposure time) significantly influenced the corrosion rates of W4 scaffolds compared with corrosion in vivo. Corrosion rates under cell culture conditions for 72 h varied from 1.05 to 3.43 mm y(-1) depending on the media composition. Corrosion rates measured in eudiometric systems for 24 h were ~24-27 times higher (3.88-4.43 mm y(-1)) than corrosion in vivo after 6 weeks (0.16 mm y(-1)). Moreover, it was found that the cell culture media composition significantly influences the ionic composition of the extract by selectively dissolving ions from W4 samples or their corrosion products. A pilot in vivo study for 6 and 12 weeks demonstrated active bone remodelling, no foreign body reaction and no clinical observation of gas formation during W4 scaffold implantation. Long-term in vivo studies need to be conducted to prove complete degradation of the W4 scaffold and total replacement by the host tissue.


Asunto(s)
Aleaciones/farmacología , Materiales Biocompatibles/farmacología , Andamios del Tejido/química , Animales , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Células Cultivadas , Fuerza Compresiva/efectos de los fármacos , Corrosión , Medios de Cultivo/química , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Ratones , Microscopía Electrónica de Rastreo , Osteogénesis/efectos de los fármacos , Porosidad , Implantación de Prótesis , Conejos
11.
J Biomed Mater Res B Appl Biomater ; 96(2): 303-9, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-21210510

RESUMEN

Applications of magnesium alloys as biodegradable orthopaedic implants are critically dependent on the mechanical integrity of the implant during service. In this study, the mechanical integrity of an AZ91 magnesium alloy was studied using a constant extension rate tensile (CERT) method. The samples in two different geometries that is, circumferentially notched (CN), and circumferentially notched and fatigue cracked (CNFC), were tested in air and in simulated body fluid (SBF). The test results show that the mechanical integrity of the AZ91 magnesium alloy decreased substantially (∼50%) in both the CN and CNFC samples exposed to SBF. Fracture surface analysis revealed secondary cracks suggesting stress corrosion cracking susceptibility of the alloy in SBF.


Asunto(s)
Implantes Absorbibles , Aleaciones/química , Magnesio , Ensayo de Materiales/métodos , Fenómenos Mecánicos , Líquidos Corporales , Corrosión , Resistencia a la Tracción
12.
Orthop Traumatol Surg Res ; 96(2): 155-60, 2010 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-20417914

RESUMEN

INTRODUCTION: The treatment of limb length discrepancies by distraction osteogenesis represents a significant challenge of predicting the load bearing capacity. Today, in vivo stiffness measurements by applying compressive, bending or torsional stress on the callus tissue are quantitative methods. Therefore, it is relevant to know how regenerating bone tissue regains its various stiffness characteristics. Knowledge of the development of each type of stiffness is important in order to prevent an over- or underestimation of the actual load bearing capacity. HYPOTHESIS: Various types of stiffness are supposed to evolve similar during consolidation. SUBJECTS AND METHODS: In this ex vivo study, an analysis of torsional, compressive and bending stiffness of callus tissue during consolidation was performed on 26 sheep tibiae after distraction osteogenesis. RESULTS: This study indicates differences within the quantity of stiffness during consolidation. DISCUSSION: Thus, in vivo stiffness measurements have to be interpreted carefully in order to prevent false estimation of the load bearing capacity of new bone.


Asunto(s)
Callo Óseo/patología , Osteogénesis por Distracción , Animales , Fenómenos Biomecánicos , Femenino , Diferencia de Longitud de las Piernas/cirugía , Ovinos , Torsión Mecánica
13.
Acta Biomater ; 6(5): 1714-25, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-19788945

RESUMEN

Magnesium alloys have attracted increasing interest in the past years due to their potential as implant materials. This interest is based on the fact that magnesium and its alloys are degradable during their time of service in the human body. Moreover magnesium alloys offer a property profile that is very close or even similar to that of human bone. The chemical composition triggers the resulting microstructure and features of degradation. In addition, the entire manufacturing route has an influence on the morphology of the microstructure after processing. Therefore the composition and the manufacturing route have to be chosen carefully with regard to the requirements of an application. This paper discusses the influence of composition and heat treatments on the microstructure, mechanical properties and corrosion behaviour of cast Mg-Gd alloys. Recommendations are given for the design of future degradable magnesium based implant materials.


Asunto(s)
Aleaciones/química , Gadolinio/química , Magnesio/química , Ensayo de Materiales/métodos , Prótesis e Implantes , Corrosión , Guías como Asunto , Humanos , Fenómenos Mecánicos , Microscopía Electrónica de Rastreo , Tamaño de la Partícula , Transición de Fase , Resistencia a la Tracción , Difracción de Rayos X
14.
Acta Biomater ; 6(5): 1792-9, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-19822226

RESUMEN

The aim of this study was to investigate whether the extruded magnesium alloy LAE442 reacts in vivo with an appropriate host response and to investigate how an additional magnesium fluoride (MgF(2)) coating influences the in vivo corrosion rate. Forty cylinders were machined from extruded LAE442 and 20 of these were coated additionally with MgF(2) and implanted into the medial femur condyle of adult rabbits. Synchrotron-radiation-based X-ray computed micro-tomography (SRmicroCT) was used to quantitatively analyse corrosion non-destructively in vivo and comparisons were made to magnesium degradation rates based on area measurements of the remaining metal on uncalcified sections. Blood concentrations of the alloying elements were measured below toxicological limits. The MgF(2) layer was no longer detected after 4 weeks of implantation by particle-induced gamma emission, and the MgF(2) coating reduced the blood content of alloying elements during the first 6 weeks of implantation with no elevated fluoride concentration in the adjacent bone. Histopathological examinations of liver showed in 9 out of 40 cases minimal infiltrations of heterophil granulocytes of unknown origin (5 LAE442, 4 LAE442+MgF(2)). The kidneys were mainly regular in structure. The synovial tissue showed a granular cell infiltration as a temporary observation in the LAE442+MgF(2) group after 2 weeks. No subcutaneous gas cavities were observed clinically and on postoperative X-rays in all animals. All specimens were scanned by SRmicroCT at 2, 4, 6 and 12 weeks postoperatively before uncalcified sections were performed. All magnesium implants have been observed in direct bone contact and without a fibrous capsule. Localized pitting corrosion occurred in coated and uncoated magnesium implants. This study shows that the extruded magnesium alloy LAE442 provides low corrosion rates and reacts in vivo with an acceptable host response. The in vivo corrosion rate can be further reduced by additional MgF(2) coating.


Asunto(s)
Aleaciones/farmacología , Magnesio/farmacología , Animales , Materiales Biocompatibles Revestidos , Corrosión , Elementos Químicos , Femenino , Fémur/efectos de los fármacos , Fémur/patología , Fluoruros/farmacología , Hidrógeno/química , Implantes Experimentales , Compuestos de Magnesio/farmacología , Conejos , Sincrotrones , Factores de Tiempo , Microtomografía por Rayos X
15.
Acta Biomater ; 6(5): 1861-8, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-20035905

RESUMEN

Repeated observations of enhanced bone growth around various degradable magnesium alloys in vivo raise the question: what is the major mutual origin of this biological stimulus? Several possible origins, e.g. the metal surface properties, electrochemical interactions and biological effects of alloying elements, can be excluded by investigating the sole bone response to the purified major corrosion product of all magnesium alloys, magnesium hydroxide (Mg(OH)(2)). Isostatically compressed cylinders of pure Mg(OH)(2) were implanted into rabbit femur condyles for 2-6 weeks. We observed a temporarily increased bone volume (BV/TV) in the vicinity of Mg(OH)(2) at 4 weeks that returned to a level that was equal to the control at 6 weeks. The osteoclast surface (OcS/BS) was significantly reduced during the first four weeks around the Mg(OH)(2) cylinder, while an increase in osteoid surface (OS/BS) was observed at the same time. At 6 weeks, the OcS/BS adjacent to the Mg(OH)(2) cylinder was back within the same range of the control. The mineral apposition rate (MAR) was extensively enhanced until 4 weeks in the Mg(OH)(2) group before matching the control. Thus, the enhanced bone formation and temporarily decreased bone resorption resulted in a higher bone mass around the slowly dissolving Mg(OH)(2) cylinder. These data support the hypothesis that the major corrosion product Mg(OH)(2) from any magnesium alloy is the major origin of the observed enhanced bone growth in vivo. Further studies have to evaluate if the enhanced bone growth is mainly due to the local magnesium ion concentration or the local alkalosis accompanying the Mg(OH)(2) dissolution.


Asunto(s)
Remodelación Ósea/efectos de los fármacos , Implantes Experimentales , Hidróxido de Magnesio/farmacología , Osteoblastos/citología , Osteoclastos/citología , Animales , Materiales Biocompatibles/farmacología , Huesos/efectos de los fármacos , Huesos/patología , Recuento de Células , Femenino , Fluorescencia , Ensayo de Materiales , Minerales/metabolismo , Osteoblastos/efectos de los fármacos , Osteoclastos/efectos de los fármacos , Osteogénesis/efectos de los fármacos , Implantación de Prótesis , Conejos , Coloración y Etiquetado
16.
Orthopade ; 37(2): 125-30, 2008 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-18214423

RESUMEN

In the last decade biodegradable synthetic implant materials have been established for various clinical applications. Ceramic materials such as calcium phosphate, bioglass and polymers are now routinely used as degradable implants in the clinical practice. Additionally these materials are now also used as coating materials or as microspheres for controlled drug release and belong to a series of examples for applications as scaffolds for tissue engineering. Because immense local concentrations of degradation products are produced during biodegradation, this review deals with the question whether allergic immune reactions, which have been reported for classical metallic and organic implant materials, also play a role in the clinical routine for synthetic biodegradable materials. Furthermore, possible explanatory theories will be developed to clarify the lack of clinical reports on allergy or sensitization to biodegradable synthetic materials.


Asunto(s)
Implantes Absorbibles/efectos adversos , Hipersensibilidad/inmunología , Placas Óseas/efectos adversos , Tornillos Óseos/efectos adversos , Fosfatos de Calcio/inmunología , Cerámica/efectos adversos , Fijación Interna de Fracturas , Humanos , Compuestos de Magnesio/efectos adversos , Metales/efectos adversos , Polímeros/efectos adversos , Factores de Riesgo
17.
J Biomed Mater Res A ; 86(1): 61-75, 2008 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-17941017

RESUMEN

In this in vitro study, we compared the cytocompatibility and osteoblast promoting potency on human bone marrow cell culture with three different alloys (surgical steel, CoCr, Ti6Al4V) and three different surface structures (polished, sandblasted, porous coated). These biometals were specifically chosen because of their current applications in clinical orthopedic practices. Human mononuclear bone marrow cells were cultivated onto the surface of the different biomaterials and stimulated by dexamethasone, L-ascorbic-acid-2-phoshpate and beta-glycerolphosphate over a 3-week period. Immunofluorescent stainings against several antigens (ALP, RANKL, osteopontin, collagen I), mRNA-expression of collagen (Col) I/II, BSP, osteopontin, osteocalcin, TRAP, light and scanning electron microscopy evaluation were used to evaluate cellular growth and osteoblast differentiation. For surface roughness and energy analysis of the specimen, roughness profile (Ra, Rz) and contact angle (CA) measurements were performed. We found differences between the different biometals and surface structures. Steel showed potential cytotoxic effects whereas CoCr and more Ti6Al4V showed an excellent cytocompatibility. There were no qualitative differences in mRNA expression between each of the tested biomaterials. In terms of antigen expression, a sandblasted Ti6Al4V surface showed enhanced osteoblastic differentiation. A porous-coated surface improved the osteoconductivity of CoCr when compared to a polished surface. In contrast to controls all cells cultivated with biometals induced a RANKL expression. Cells increased the implant roughness with the exception of sandblasted Ti6Al4V. Our data show that surface topography and physicochemical properties of biometals influence osteoblast differentiation in vitro.


Asunto(s)
Materiales Biocompatibles/química , Células de la Médula Ósea/efectos de los fármacos , Metales/química , Osteoblastos/citología , Aleaciones , Células de la Médula Ósea/citología , Diferenciación Celular , Células Cultivadas , Cromo/química , Cobalto/química , Humanos , Osteogénesis/efectos de los fármacos , Diseño de Prótesis , ARN Mensajero/metabolismo , Acero/química , Propiedades de Superficie , Titanio/química
18.
Am J Physiol Regul Integr Comp Physiol ; 293(3): R1376-83, 2007 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-17626121

RESUMEN

Many fish species adapt to hypoxia by reducing their metabolic rate and increasing hemoglobin-oxygen (Hb-O(2)) affinity. Pilot studies with young broods of cichlids showed that the young could survive severe hypoxia in contrast with the adults. It was therefore hypothesized that early exposure results in improved oxygen transport. This hypothesis was tested using split brood experiments. Broods of Astatoreochromis alluaudi, Haplochromis ishmaeli, and a tilapia hybrid (Oreochromis) were raised either under normoxia (NR; 80-90% air saturation) or hypoxia (HR; 10% air saturation). The activity of the mitochondrial citrate synthase was not different between NR and HR tilapia, but was significantly decreased in HR A. alluaudi and H. ishmaeli, indicating lowered maximum aerobic capacities. On the other hand, hemoglobin and hematocrit levels were significantly higher in all HR fish of the three species, reflecting a physiological adaptation to safeguard oxygen transport capacity. In HR tilapia, intraerythrocytic GTP levels were decreased, suggesting an adaptive increase of blood-O(2) affinity. Similar changes were not found in HR H. ishmaeli. In this species, however, all HR specimens exhibited a distinctly different iso-Hb pattern compared with their NR siblings, which correlated with a higher intrinsic Hb-O(2) affinity in the former. All HR cichlids thus reveal left-shifted Hb-O(2) equilibrium curves, mediated by either decreased allosteric interaction or, in H. ishmaeli, by the production of new hemoglobins. It is concluded that the adaptation to lifelong hypoxia is mainly due to improved oxygen transport.


Asunto(s)
Cíclidos/fisiología , Hemoglobinas/metabolismo , Hipoxia/fisiopatología , Adaptación Fisiológica/fisiología , Adenosina Trifosfato/sangre , Animales , Peso Corporal/fisiología , Enfermedad Crónica , Metabolismo Energético/fisiología , Eritrocitos/química , Eritrocitos/metabolismo , Guanosina Trifosfato/sangre , Hematócrito , Hidrocortisona/sangre , Concentración de Iones de Hidrógeno , Focalización Isoeléctrica , Músculo Esquelético/metabolismo , Consumo de Oxígeno/fisiología , Especificidad de la Especie
19.
J Biomed Mater Res A ; 81(3): 757-65, 2007 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-17390322

RESUMEN

In this study, histomorphometrical parameters of the peri-implant bone remodeling around degrading open-porous scaffolds made of magnesium alloy AZ91D were investigated and compared with the peri-implant bone remodeling around an autologous bone transplant in the contralateral side in a rabbit model after 3 and 6 months. Osteoblast activity was displayed by collagen I (alpha 2) mRNA in situ hybridization. Major scaffold degradation was completed within 3 months after implantation showing no osteolysis around the scaffolds, both after 3 and 6 months. Enhanced formation of unmineralized extracellular matrix and an enhanced mineral apposition rate adjacent to the degrading magnesium scaffolds were accompanied by an increased osteoclastic bone surface, which resulted in higher bone mass and a tendency to a more mature trabecular bone structure around the magnesium scaffolds compared to the control. These results show that even fast-degrading magnesium scaffolds induce extended peri-implant bone remodeling with a good biocompatibility. In summary, this study shows that degrading magnesium scaffolds promote both bone formation and resorption in a rabbit model and are therefore very promising candidates for the development of novel implants in musculoskeletal surgery.


Asunto(s)
Implantes Absorbibles , Remodelación Ósea/fisiología , Magnesio/metabolismo , Fosfatasa Ácida/metabolismo , Animales , Huesos/citología , Colágeno Tipo I/genética , Colágeno Tipo I/metabolismo , Regulación de la Expresión Génica , Isoenzimas/metabolismo , Osteoblastos/citología , Osteoblastos/enzimología , ARN Mensajero/genética , ARN Mensajero/metabolismo , Conejos , Fosfatasa Ácida Tartratorresistente
20.
J Biomed Mater Res A ; 81(3): 748-56, 2007 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-17390368

RESUMEN

Current tissue engineering strategies focus on the replacement of pathologically altered tissues by the transplantation of cells in combination with supportive biocompatible scaffolds. Scaffolds for tissue engineering strategies in musculoskeletal research require an appropriate mechanical stability. In recent studies, considerable attention has thus been given to magnesium alloys as biodegradable implants. The aim of this study was to characterize the biocompatibility of magnesium scaffolds by the inflammatory host response. Open porous scaffolds made of the magnesium alloy AZ91D were implanted into the distal femur condyle of rabbits and were compared to autologous bone, which was transplanted into the contralateral condyle in a 3 and 6 months follow-up group. After 3 months, magnesium scaffolds were already largely degraded and most of the original magnesium alloy has disappeared. Concomitantly, a fibrous capsule enclosed the operation site. Histological analysis revealed that the magnesium scaffolds caused no significant harm to their neighboring tissues. This study shows that even fast degrading magnesium scaffolds show a good biocompatibility and react in vivo with an appropriate inflammatory host response. Magnesium alloy based implants are therefore a very promising approach in the development of mechanically suitable and open porous scaffolds for the replacement of subchondral bone in cartilage tissue engineering.


Asunto(s)
Implantes Absorbibles , Inflamación , Magnesio/metabolismo , Animales , Apoptosis , Ácido Aurintricarboxílico , Materiales Biocompatibles/metabolismo , Vasos Sanguíneos/citología , Granulocitos/citología , Miembro Posterior/citología , Etiquetado Corte-Fin in Situ , Conejos , Linfocitos T/citología
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