Platelet rich plasma-derived microvesicles increased in vitro wound healing.

OBJECTIVE: Platelet rich plasma (PRP) is a haemoderivative used in clinical practice for the treatment of hard-to-heal wounds. Platelet (PLT) activation is a key factor in the wound healing process leading to the production of extracellular vesicles. We obtained PRP and PRP-derived microvesicles (PLT-MVs) from healthy donors and compared their pro-healing efficacy in an in vitro wound model using human keratinocytes. MATERIALS AND METHODS: We evaluated PLT-MVs' direct effect on an in vitro model of wound healing. PRP, PRP activated using calcimycin, and PLT-MVs separated by high speed centrifugation were added to scratched keratinocyte monolayers. Fluorescein diacetate was used in flow cytometry to distinguish PLTs and PLT-MVs from debris, and then, PLT-MVs were quantified on the basis of relative dimensions (Forward Scatter signals). RESULTS: Wound areas were measured at time 0 and after 24 hours and they were healed by 24.80 ± 4.28% in control conditions, while PRP, activated PRP, and PLT-MVs increased closure of 62.94 ± 0.96%, 52.69 ± 17.20% and 52.76 ± 9.44%, respectively. CONCLUSIONS: Our results indicate that PRP pro-healing effects were fully replicable by PLT-MVs, suggesting a key role of microvesicles in the healing process and a possible clinical use as an alternative to PRP.

Laser surgical approach to impacted maxillary incisors: case series and brief review.

OBJECTIVE: Report Authors' clinical case series on impacted maxillary incisors treatment with laser technology. PATIENTS AND METHODS: Studied population was composed by 6 male and 12 female undergoing orthodontic treatments for lack of eruption of 28 upper incisors; eight impacted teeth (4 patients) spontaneously erupted after orthodontic creation of the correct eruptive space. Twenty maxillary incisors were surgically exposed; in 5 patients seven un-erupted incisors were exposed through an apically positioned flap technique; in two patients a guided closed eruption technique was performed on a central and two lateral maxillary incisors; in seven patients laser exposure technique was applied on ten incisors. All impacted teeth resulted correctly aligned at the end of therapy. RESULTS: Impaction of incisors is not a frequent event in dental practice. The positioning of the incisors was obtained by creating the eruptive space and aligning the un-erupted teeth with orthodontic treatment or after removing any obstacle or after their exposure with different surgical methods. In all patients the treatment allowed the restoration of both the aesthetic and function aspect of the stomatognathic apparatus. CONCLUSIONS: In this case load, patients undergoing exposure of the dental crown using diode laser showed the best postoperative course.

Charged molecular silica trigger in vitro NETosis in human granulocytes via both oxidative and autophagic pathways.

OBJECTIVE: Neutrophils play a key role in immunity and are known to respond to exogenous threats by releasing neutrophil extracellular traps (NETs) through NETosis, a process involving the release of neutrophils nuclear DNA decorated with proteins into the extracellular space. In this study, attention has been focused on the ability of differently charged molecular systems polyhedral oligomeric silsesquioxanes (POSS) to induce NETosis. MATERIALS AND METHODS: NETs formation was induced by phorbol myristate acetate (PMA) (positive control) and POSS treatment and visualized by confocal microscopy. Moreover, NETs production was quantified by Sytox green staining. Oxidative stress, autophagy as well as endocytosis involvement in the observed phenomena was evaluated by a specific inhibitory approach. RESULTS: Results obtained in this study demonstrate a POSS time and dose-dependent ability in inducing NETs release irrespectively to their charge. POSS induced NETosis is a consequence of their internalization, as demonstrated by the strong reduction in NETs formation after endocytosis inhibition. Moreover, POSS induced NETosis involves both an increase in superoxide anion generation and autophagy pathway activation as demonstrated by the protective effect displayed by sodium azide and wortmannin. CONCLUSIONS: Data presented in this study indicate that nanomaterials and molecular systems could have a role in the onset of inflammatory phenomena.

Formaldehyde solutions in simulated sweat increase human melanoma but not normal human keratinocyte cells proliferation.

Our skin is in close contact with clothes most of the time thus risking potentially noxious chemicals contact. One of the potentially harmful manufacturing by-products that can be released by textiles when sweating is formaldehyde, used as an anti-crease treatment. As it is known to be carcinogenic to humans and a potent skin sensitizer, the aim of this study was to investigate its effects on both normal human keratinocytes (HaCaT cells) and on a highly invasive malignant melanoma cell line (SK-MEL-28) in order to contribute to the definition of safety cut-off to be applied to the production processes. Formaldehyde concentrations below the commonly accepted limits (10-50µM) were obtained by diluting formaldehyde in simulated sweat (UNI EN ISO 105-E04). The effects on cell proliferation were evaluated by cell counting, while ERK pathway activation was evaluated by western blot. Low concentrations of formaldehyde (10µM) in both acidic and alkaline simulated sweat were able to increase malignant melanoma cell proliferation, while not affecting normal keratinocytes. Melanoma proliferation increase was greater in acidic (pH=5.5) than in alkaline (pH=8) conditions. Moreover, formaldehyde stimulation was able to induce ERK pathway activation. The data obtained suggest the need for an even increasing attention to the potentially harmful effects of textile manufacturing by-products.

Epiregulin-loaded PLGA nanoparticles increase human keratinocytes proliferation: preliminary data.

OBJECTIVE: Epiregulin is a member of the epidermal growth factor (EGF) family produced by keratinocytes: the aim of this study was to investigate the ability of biocompatible nanoparticles loaded with such growth factor to increase human keratinocytes proliferation. MATERIALS AND METHODS: Different PLGA (Poly-d,l-lactide-co-glycolide)-nanoparticles (NPs) formulations have been characterized in size and zeta potential by dynamic light scattering (DLS) analysis. The ability of the different PLGA-NPs formulations to adhere onto dental surfaces has been tested, and epiregulin-enriched PLGA-NPs has been produced. Epiregulin release from NPs has been tested by enzyme-linked immunosorbent (ELISA) assay and the proliferative effects of epiregulin-NPs on human keratinocytes have been evaluated. RESULTS: DLS analysis revealed a different size distribution depending on the PLA/PGA (poly lactic acid/poly glycolic acid) ratio used. 50:50 PLGA-NPs exhibited the smaller size and the best dental adhesive ability. Moreover, such epiregulin-loaded NPs was able to increase cell proliferation. CONCLUSIONS: Direct dental pocket drug delivery implies the NPs solution loading onto the dental surface at the cement-enamel junction level: 50:50 PLGA-NPs, with their small size and excellent adhesive ability, represent an interesting tool to deliver epiregulin directly where there is the need for epithelial proliferation. These results describe a possible strategy for periodontal pocket delivery of Epiregulin-loaded PLGA-NPs and might provide a new approach for the treatment of gingival recession, where gingival epithelium proliferation is needed.

Pre-odontoblast proliferation induced by near-infrared laser stimulation.

OBJECTIVE: Laser therapy is known to stimulate cell proliferation and differentiation, an effect called "biostimulation". Although many clinical applications of laser therapy take advantage from such positive effect, the underlying molecular mechanisms are not fully understood. The aim of this work was to investigate the effect of near-infrared laser stimulation on rat pre-odontoblast cells (MDPC-23 cells) and the molecular mechanism/s involved. MATERIALS AND METHODS: MDPC-23 cells were stimulated with a near-infrared (980 nm) laser source with different energy settings (1-50 J, corresponding to 0.65-32.47 J/cm2) and cell proliferation was evaluated by manual count. ERK 1/2 pathway activation was evaluated by Western blot analysis. RESULTS: 1-10 J stimulation (corresponding to 0.65-6.5 J/cm2) significantly increase MDPC-23 cell proliferation and such effect seems to be mediated by ERK 1/2 signalling pathway activation, showing a key role of ERK 1/2 pathway in mediating the proliferative response induced by laser stimulation. CONCLUSIONS: Near infrared laser stimulation with low energies (1-10 J) is able to increase cell proliferation through ERK 1/2 signalling pathway activation. At the same time, higher energy stimulation (25-50 J) induces an initial toxic effect, probably activating pro-apoptotic signalling molecules, downstream ERK 1/2 kinase. Such results foster the application of this therapeutic approach in different clinical settings in which a regenerative tissue response is needed.

Mini invasive skeletal muscle biopsy technique with a tri-axial end cut needle.

OBJECTIVE: Skeletal Muscle Biopsy is a minor surgical procedure for the diagnosis of different neuromuscular pathological conditions and has recently gained popularity also in the research field of age-related muscular modifications and sarcopenia. Few studies focused on the application of mini-invasive muscular biopsy in both normal and pathological conditions. The aim of our study was to describe a mini invasive ultrasound-guided skeletal muscular biopsy technique in complete spinal cord injured (SCI) patients and healthy controls with a tri-axial end-cut needle. PATIENTS AND METHODS: Skeletal muscle biopsies were collected from 6 chronic SCI patients and 3 healthy controls vastus lateralis muscle with a tri-axial end cut needle (Biopince© - Angiotech). Muscle samples were stained for ATPase to determine fibers composition, moreover, gene expression of cyclooxygenase-1 (COX-1) and prostaglandin E2 receptor has been analyzed by Real Time RT-PCR. RESULTS: All the procedures were perfomed easily without failures and complications. Control tissue was macroscopically thicker than SCI one. Control specimen displayed an equal distribution of type I and type II fibers, while SCI sample displayed a prevalence of type II fibers SCI specimen displayed a significant reduction in COX-1 gene expression. This mini-invasive approach was easy, accurate and with low complication rate in performing skeletal muscle biopsy in both SCI patients and controls. CONCLUSIONS: This technique could be useful in conditions in which the overall quantity of specimen required is small like for molecular biology analysis. For histological diagnostic purposes and/or conditions in which the original tissue is already pathologically modified, this technique should be integrated with more invasive techniques.

Evaluation of serum myostatin and sclerostin levels in chronic spinal cord injured patients.

STUDY DESIGN: Case-control study. OBJECTIVES: To assess serum myostatin levels, bone mineral density (BMD), appendicular skeletal muscle mass (ASMM) and serum sclerostin levels in chronic spinal cord injured (SCI) patients and healthy controls. SETTING: SCI centre in Italy. METHODS: Blood samples, whole-body bioelectrical impedance analysis and BMD measurement with the ultrasound technique at the calcaneus level were taken from patients suffering from chronic SCI (both motor complete and incomplete) and healthy control subjects. RESULTS: A total of 28 SCI patients and 15 healthy controls were enrolled. Serum myostatin levels were statistically higher (P<0.01) in SCI patients compared with healthy controls. Similar results were found comparing both the motor complete and the motor incomplete SCI subgroups to healthy controls. Serum sclerostin was significantly higher in patients with SCI compared with healthy controls (P<0.01). BMD, stiffness and mean T-score values in SCI patients were significantly lower than those in healthy controls. Serum myostatin concentrations in the motor complete SCI subgroups correlated only with serum sclerostin levels (r(2)=0.42; P=0.001) and ASMM (r(2)=0.70; P=0.002) but not in healthy controls. DISCUSSION: Serum myostatin and serum sclerostin are significantly higher in chronic SCI patients compared with healthy controls. They are potential biomarkers of muscle and bone modifications after SCI. This is the first study reporting an increase in serum myostatin in patients suffering from chronic SCI and a correlation with ASMM.

Textile industry manufacturing by-products induce human melanoma cell proliferation via ERK1/2 activation.

OBJECTIVES: Textiles used to make clothing can represent a source, often ignored, of chemicals potentially noxious to both skin and the whole organism. Among the most frequently produced potentially noxious chemical manufacturing by-products are formaldehyde (FA), nickel (Ni) and hexavalent chromium (Cr); they are of potential clinical interest as all are known to be carcinogenic to humans and to be potent skin sensitizers. The aim of this study was to investigate, in vitro, effects of these potentially dangerous compounds on two different melanoma cell lines. In particular, attention was focused on A375P, a poorly metastatic and low invasive cell line and SK-MEL-28, a highly metastatic cell line. MATERIALS AND METHODS: Effects of these compounds was evaluated on A375P and SK-MEL-28 cells. FA (1-5 × 10(-5)  m), NiSO4 (10(-6) -10(-3)  m), K2 Cr2 O7 (10(-7) -10(-6)  m) effects on cell proliferation were evaluated by cell counting, while ERK pathway involvement was evaluated by Western blot analysis. RESULTS: Low concentrations of the chemicals, covering a range that corresponds to commonly accepted limits in textile production, induced a significant increase in cell proliferation concomitant with transient activation of phosphorylated ERK expression. CONCLUSIONS: Data obtained suggest that increasing attention must be focused on these by-products' potentially harmful effects in chemical manufacturing of clothes and accessories, that remain for long periods of time, in contact with human skin.

Position sensitivity in the visual word form area.

Seeing words involves the activity of neural circuitry within a small region in human ventral temporal cortex known as the visual word form area (VWFA). It is widely asserted that VWFA responses, which are essential for skilled reading, do not depend on the visual field position of the writing (position invariant). Such position invariance supports the hypothesis that the VWFA analyzes word forms at an abstract level, far removed from specific stimulus features. Using functional MRI pattern-classification techniques, we show that position information is encoded in the spatial pattern of VWFA responses. A right-hemisphere homolog (rVWFA) shows similarly position-sensitive responses. Furthermore, electrophysiological recordings in the human brain show position-sensitive VWFA response latencies. These findings show that position-sensitive information is present in the neural circuitry that conveys visual word form information to language areas. The presence of position sensitivity in the VWFA has implications for how word forms might be learned and stored within the reading circuitry.

Visual feature-tolerance in the reading network.

A century of neurology and neuroscience shows that seeing words depends on ventral occipital-temporal (VOT) circuitry. Typically, reading is learned using high-contrast line-contour words. We explored whether a specific VOT region, the visual word form area (VWFA), learns to see only these words or recognizes words independent of the specific shape-defining visual features. Word forms were created using atypical features (motion-dots, luminance-dots) whose statistical properties control word-visibility. We measured fMRI responses as word form visibility varied, and we used TMS to interfere with neural processing in specific cortical circuits, while subjects performed a lexical decision task. For all features, VWFA responses increased with word-visibility and correlated with performance. TMS applied to motion-specialized area hMT+ disrupted reading performance for motion-dots, but not line-contours or luminance-dots. A quantitative model describes feature-convergence in the VWFA and relates VWFA responses to behavioral performance. These findings suggest how visual feature-tolerance in the reading network arises through signal convergence from feature-specialized cortical areas.

A rare case of colic thrombotic microangiopathy in renal transplantation.

INTRODUCTION: We report a case of thrombotic microangiopathy (TM) in patient with UC and kidney transplantation. CASE REPORT: A 59-year-old Caucasian may with a renal transplant, with atrial fibrillation and ulcerative colitis (UC), was referred for asthenia, fever (38 degrees C), anemia, colicky pain, and bloody diarrhea. The maintenance therapy consisted of CSA, sodium mycophenolate, steroids, ticlopidine, and mesalazine. Laboratory data, colonscopy, and colic mucosal biopsy revealed de novo colic TM. We administered antibiotics and antishock therapy, reducing CSA, withdrawing ticlopedine and maintaining mesalazine with the resolution of the problem. CONCLUSION: Posttransplantation TM is an uncommon but severe complication of kidney transplantation associated with reduced graft survival and a high risk for death. Only an early, accurate diagnosis with optimal treatment permits resolution of the problem.

Serum anti-p53 antibodies as a diagnostic tumor marker: observations in patients with malignant and premalignant oral cavity lesions.

AIM: To determine whether serum anti-p53 antibody (p53-Abs) positivity in patients with oral carcinoma corresponds with tumor localization, histological grade, stage, and recurrence. METHODS: The study population was divided into three groups: controls; patients with a premalignant lesion; and patients with oral squamous cell carcinoma (SCC). The third group was composed of patients attending outpatient services for pathological diagnosis or for follow-up monitoring only. The cancer patients had undergone resective surgery in local anesthesia. Serum p53-Abs levels were measured using a commercial enzyme-linked immunosorbent assay (ELISA) and monitored over a 3-year follow-up period. RESULTS: Controls and patients with premalignant lesions did not test positive for p53-Abs at ELISA testing. Patients with a malignant lesion tested positive at initial diagnosis when a high histopathological grade lesion was present or localized to the posterior region of the oral cavity. Postoperative serum p53-Abs levels gradually declined until complete seronegativity. Patients with a recurrent tumor tested positive for p53-Abs. CONCLUSION: Seropositivity for p53-Abs may be associated with histopathological tumor grade, localization, and recurrence. The findings suggest that serum p53-Abs analysis is a useful diagnostic marker for oral SCC.

Functionalization of a poly(D,L)lactic acid surface with galactose to improve human keratinocyte behavior for artificial epidermis.

The production of artificial epidermis using reabsorbable polymeric matrices is one of possible goals; one of most used strategies in this field is the polymer substrate functionalitation using specific growth factors, in order to accelerate and improve keratinocyte adhesion and proliferation. In this study films of poly(D,L)lactide (P(D,L)LA), have been functionalized with various concentrations of galactose (GAL, 1-5-10%, w/v) conjugated with poly-L-lysine (PLL) using 1-etil-3-(3-diaminopropil) carbodiimide (EDC) as a coupling agent. GAL is a disaccharide present in the extracellular matrix (ECM) and it is bind by Galectines, a family of cell receptors whose activation regulate the cell-matrix interaction and cell growth and apoptosis. One of these receptors, Galectin-7 (Gal-7), is selectively expressed by human keratinocytes. Spontaneously immortalized human keratinocytes (HaCaT) that express high level of Gal-7 were allowed to adhere for 4 h in serum free condition on control P(D,L)LA (PLA), and on PLA-GAL and cell proliferation; the production of matrix metalloproteinases (MMP-2, MMP-9, and MMP-28), involved in cellular migration and tissue homeostasis have been analyzed after 24 h. The presence of GAL onto the polymer surface increased both cell adhesion, spreading and proliferation along with MMP-9 and MMP-28 production, suggesting that polymer functionalization using GAL could be an useful tool for the production of an artificial epidermis.

Exogenous prostaglandin E2 inhibits TPA induced matrix metalloproteinase-9 production in MCF-7 cells.

Elevated levels of prostaglandin E2 (PGE2) have been reported in many high metastatic human breast cancers, but no relationship between exogenous PGE2 activity, expression of matrix metalloproteinases (MMPs) and metastasis in human tumor cells has been reported. The poorly invasive human breast cancer cell line MCF-7 was cultured for 24h in the presence of both phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA, 50 nM) and PGE2 (1 microM) and the activity of MMP-9, one of the MMPs involved in metastasis, was measured, in growth medium by gelatin substrate zymography. TPA induced a strong production of MMP-9 while exogenous PGE2 had no effect on the basal MMP-9 level, but inhibited the TPA induced enzyme expression and matrigel invasiveness. We showed that MCF-7 cells expressed EP2, EP3 and EP4 receptors for PGE2 and that its action was probably mediated by EP4 receptor and adenylyl cyclase activation while cAMP dependent PKA was not involved in the process of inhibition of MMP-9 production. These findings suggest a possible inhibitory role for exogenous PGE2 in the metastatic process development.

Polystyrene surface coated with vitamin E modulates human granulocyte adhesion and MMP-9 release.

Vitamin E (Vit.E, alpha-tocopherol) is a natural biological antioxidant and antinflammatory agent, which protects cells from the effects of free radicals and inhibits inflammation. For such properties Vit.E has been used to improve the biocompatibility of materials such as cellulose membrane for hemodialysis. In this study granulocytes adhesion and activation have been studied after contact with normal cell culture grade polystyrene (PS) and Vit.E-coated polystyrene (Vit.E 0.1 and 0.3% (v/v)) using optical microscopy, flow cytometry and substrate zymography. Vit.E increased the number of adherent granulocytes both at 0.1% (11470 +/- 1064 cells/cm(2), P < 0.01) and 0.3% ( 13706 +/-818) cells/cm(2), P < 0.001) concentration compared to normal PS (5529+/-692 cells/cm(2)). The morphology of granulocytes adherent to Vit.E-PS appeared lightly altered and no differences have been observed in their respiratory burst compared to control granulocyte, while matrix metalloproteinase 9 or gelatinase B (MMP-9) release and activation were increased compared to the normal PS samples. Our data indicate that Vit.E-coated surface induced an increase in granulocytes adhesion and MMP-9 release in the absence of the typical oxidative stress, hallmark of granulocytes activation. A possible explanation of the phenomenon is that Vit.E modifies the surface protein adsorption thus increasing cell adhesion and in turn MMP-9 releasing.

Surface-adsorbed alpha1-microglobulin modulation of human fibroblasts spreading and matrix metalloproteinases release.

The lipocalin alpha1-microglobulin (alpha1-m), an immunoregulatory protein produced by human hepatocytes and distributed in various organs and fluids, is physiologically adsorbed onto polymer surfaces from both serum and urine, and its adsorption correlated to the degree of surface hydrophobicity. Starting from the hypothesis that alpha1-m holds a modulatory role at the biomaterials-tissue interface, we have observed a dose-dependent reduction in adhesion of human fibroblasts (cell line MRC-5) seeded onto polystyrene (PS) in a serum-free medium in the presence of adsorbed alpha(1)-m (2.1+/-0.2 x 10(4) cells/cm2 at 200 ng/ml alpha1-m ) compared to cells seeded onto cell grade PS (2.9+/-0.05 x 10(4) cells/cm2) after 72 h. Moreover, in the presence of alpha1-m, adherent MRC-5 cells exhibit an altered shape due to inhibition of cell spreading, and release of matrix metalloproteinase -2 (gelatinase A, MMP-2) by fibroblasts was also increased by 1.6-1.9-fold after 72 h of incubation. These data extend the known spectrum of alpha1-m activities, suggesting a possible role of this protein in the complex series of events occurring at the tissue-biomaterial interface.

The induction of MMP-9 release from granulocytes by vitamin E in UHMWPE.

Ultra-high molecular weight polyethylene (UHMWPE) is a biopolymer widely used in orthopaedic implants and its oxidation is considered as major responsible for inflammation and the prosthesis failure. We have studied the effect on the activation of resting human granulocytes of the addition of Vitamin E (Vit.E, alpha-tocopherol), a natural biological antioxidant and antiinflammatory agent, to UHMWPE. We have measured changes in granulocytes morphology and respiratory burst by flow cytometry using Dihydrorhodamine 123 and matrix metalloproteinase 9 (MMP-9, gelatinase B) release and activity in the growth medium using substrate zymography following contact (60 min at 37 degrees C) with cell grade polystyrene (PS), normal UHMWPE (PE) and Vit.E added UHMWPE (PE Vit.E). FTIR analyses showed that the surfaces of PE and PE-Vit.E were not significantly different. PS, PE and PE Vit.E did not alter granulocytes morphology and respiratory burst as showed by the mean fluorescence emitted (PS=12.0+/-0.1, PE=13.0+/-0.4, PE Vit.E=14.5+/-0.1). PE Vit.E was able to increase MMP-9 release compared to PS and normal PE (215+/-16% of the control, p<0.001). The PE Vit.E-induced MMP-9 release was abolished by okadaic acid (0.5 nM), suggesting a direct role of Vit.E in the phenomenon.

Fibroblast apoptosis and caspase-8 activation in aseptic loosening.

The presence of apoptosis has been investigated in the interface membranes collected during revision surgery of loosened total hip joint arthroplasty (THAs). Terminal deoxyrobonucleotidyl transferase (TdT) assay for apoptotic DNA fragmentation quantification revealed a statistically significant presence of apoptosis in aseptic samples, obtained from both cementless (2.37+/-0.6%) and cemented (12.01+/-1%) prosthesis compared to septic samples where apoptosis was almost absent. Activated caspase-8 immunostaining was almost undetectable in septic samples, while in the aseptic samples active caspase-8 was present weakly in the cementless samples (1.35+/-0.22%) and strongly in the cemented ones (9.0+/-0.40%). The caspase-8 cytoplasmatic staining allowed the morphological recognition of positive cells both as fibroblast-like and immunocompetent cells. In aseptic cemented samples fibroblast-like cells were the most represented subpopulation in the caspase-8 positive population scored (76.6%) compared to the immunocompetent cells (23.4%). Caspase-8 activation is an upstream event in the apoptotic pathway triggered by the activation of cytokines receptors such as TNF-alpha receptor 1 (TNFR-1), and the presence of caspase-8 activation in fibroblast-like cells in the aseptic interface membranes of THAs suggests a possible TNF-alpha dependent apoptosis.

UHMWPE oxidation increases granulocytes activation: a role in tissue response after prosthesis implant.

Ultra-high molecular weight polyethylene (UHMWPE), a biopolymer widely used in orthopaedic implants, is oxidized during gamma-ray sterilization; such surface oxidation is considered as major responsible for inflammation and prosthesis failure. As granulocytes are involved in first contact inflammation, we have measured their oxidative burst by flow cytometry using dihydrorhodamine 123 (DRH) to evaluate their activation following contact with normal and oxidized UHMWPE. Peripheral blood cells (obtained by lysed blood) were loaded with DRH, seeded onto polystyrene, normal and heat-oxidized UHMWPE disks for 30min and then collected for analysis. Granulocytes were individuated using FSC and SSC signals and their cell associated green fluorescence was analyzed. Both normal and oxidized UHMWPE stimulated granulocytes activation as showed by the mean fluorescence emitted (109.3+/-3.8 and 150.1+/-9.2, respectively) compared to control samples (81.6+/-0.3). Moreover oxidized UHMWPE activated a significantly higher percentage of granulocytes (73.35+/-5.2%) compared to not-oxidized UHMWPE (21.5+/-3.8%). UHMWPE surface oxidation responsible for increased granulocyte activation seems to play a role in tissue response to implants.