Multifaceted role of hair follicle dermal cells in bioengineered skins.

BACKGROUND: The method of generating bioengineered skin constructs was pioneered several decades ago; nowadays these constructs are used regularly for the treatment of severe burns and nonhealing wounds. Commonly, these constructs are comprised of skin fibroblasts within a collagen scaffold, forming the skin dermis, and stratified keratinocytes overlying this, forming the skin epidermis. In the past decade there has been a surge of interest in bioengineered skins, with researchers seeking alternative cell sources, or scaffolds, from which constructs can be established, and for more biomimetic equivalents with skin appendages. OBJECTIVES: To evaluate whether human hair follicle dermal cells can act as an alternative cell source for engineering the dermal component of engineered skin constructs. METHODS: We established in vitro skin constructs by incorporating into the collagenous dermal compartment: (i) primary interfollicular dermal fibroblasts, (ii) hair follicle dermal papilla cells or (iii) hair follicle dermal sheath cells. In vivo skins were established by mixing dermal cells and keratinocytes in chambers on top of immunologically compromised mice. RESULTS: All fibroblast subtypes were capable of supporting growth of overlying epithelial cells, both in vitro and in vivo. However, we found hair follicle dermal sheath cells to be superior to fibroblasts in their capacity to influence the establishment of a basal lamina. CONCLUSIONS: Human hair follicle dermal cells can be readily interchanged with interfollicular fibroblasts and used as an alternative cell source for establishing the dermal component of engineered skin both in vitro and in vivo.

Where civics meets science: building science for the public good through Civic Science.

Public understanding of science and civic engagement on science issues that impact contemporary life matter more today than ever. From the Planned Parenthood controversy, to the Flint water crisis and the fluoridation debate, societal polarization about science issues has reached dramatic levels that present significant obstacles to public discussion and problem solving. This is happening, in part, because systems built to support science do not often reward open-minded thinking, inclusive dialogue, and moral responsibility regarding science issues. As a result, public faith in science continues to erode. This review explores how the field of Civic Science can impact public work on science issues by building new understanding of the practices, influences, and cultures of science. Civic Science is defined as a discipline that considers science practice and knowledge as resources for civic engagement, democratic action, and political change. This review considers how Civic Science informs the roles that key participants-scientists, public citizens and institutions of higher education-play in our national science dialogue. Civic Science aspires to teach civic capacities, to inform the responsibilities of scientists engaged in public science issues and to inspire an open-minded, inclusive dialogue where all voices are heard and shared commitments are acknowledged.

Normal keratinocytes suppress early stages of neoplastic progression in stratified epithelium.

The importance of interactions between potentially neoplastic cells and their normal neighbors on malignant progression of precancerous lesions is not well understood. In this study, we have established novel human tissue models that simulate intraepithelial neoplasia in stratified epithelia to investigate the fate and phenotype of neoplastic keratinocyte clones in normal cell context during clonal expansion and early malignant progression. This was accomplished by mixing genetically marked keratinocytes with malignant potential (II-4) with normal keratinocytes at ratios of 1:1, 4:1, 12:1, and 64:1 (normal:II-4) to visualize nests of marked, dysplastic cells in organotypic cultures and in cultures transplanted to nude mice. Four weeks after transplantation of 4:1 mixtures, grafts were normal and demonstrated no beta-galactosidase (beta-gal)-positive cells, suggesting that cells with malignant potential were eliminated from the tissue at this mixing ratio. However, grafted 1:1 mixtures demonstrated persistence of expanded foci of dysplastic cells (4 weeks) and invasion (8 weeks). This demonstrated that the capacity of a keratinocyte clone with neoplastic potential to persist and invade is directly related to the threshold number of such keratinocytes present in the tissue. To explain the failure of II-4 to persist in vivo, the intraepithelial dynamics between the two populations were studied before grafting. Double-stain immunofluorescence for bromodeoxyuridine/beta-gal and filaggrin/beta-gal of mixtures grown in organotypic cultures for 7 days demonstrated that when increasing numbers of normal cells were added (12:1), II-4 ceased to proliferate and expressed filaggrin. This suggests a novel mechanism of tumor suppression wherein contact with normal cells induces cell cycle withdrawal and terminal differentiation of potentially malignant cells. These findings support the view that normal tissue architecture acts as a dominant suppressor of early neoplastic progression in stratified epithelium.

12-O-tetradecanoylphorbol-13-acetate induces clonal expansion of potentially malignant keratinocytes in a tissue model of early neoplastic progression.

Tumor promoters stimulate the selective expansion of initiated mouse keratinocytes in the two-stage model of skin carcinogenesis. However, it is not clear whether these promoters directly modulate the growth of initiated cells or rather permit clonal expansion of initiated cells by modifying the environment of adjacent normal cells. The goal of this study was to further understand the mechanism of action of tumor promotion during early neoplastic progression of human stratified epithelium. To accomplish this, we have established an organotypic culture model that mimics a preneoplastic tissue and contains mixtures of genetically marked (beta-galactosidase), low-grade malignant keratinocytes (HaCaT-ras II-4) and normal human keratinocytes (NHKs) to monitor the fate and phenotype of these cells after treatment with 12-O-tetradecanoylphorbol-13-acetate (TPA). In submerged culture, concentrations of 0.001-1 microg/ml TPA were shown to limit the growth of NHKs yet had no effect on growth of II-4 cells. TPA (0.001 microg/ml) was then added to organotypic cultures containing mixtures of NHK:II-4 cells at varying ratios to determine whether this agent could selectively stimulate clonal expansion of II-4 cells in a normal epidermal background. Immunofluorescence for beta-galactosidase demonstrated that TPA caused a significant increase in the percentage of beta-galactosidase-positive areas in 12:1 and 4:1 mixtures. This TPA-induced expansion of II-4 cells was associated with a marked decrease in proliferation of NHKs, suggesting that II-4 could selectively expand because of its growth advantage relative to NHKs. Clonal expansion of tumor cells was temporally linked to the decreased expression of filaggrin and keratin 1 expression in adjacent NHKs. These findings indicate that TPA may enable expansion of potentially malignant cells through the epigenetic modification of proliferation in NHKs and differentiation of NHK and II-4 cells.

Effect of TGF-beta 1 on re-epithelialization of human keratinocytes in vitro: an organotypic model.

Transforming growth factor beta-1 (TGF-beta 1) has been shown to inhibit keratinocyte proliferation in vitro yet and migration was investigated in organotypic cultures after incisional wounding. Organotypic cultures provide a more in vivo-like epidermal tissue and may therefore respond in a different manner than previous culture models in which epidermal differentiation is incomplete. Without TGF-beta 1, keratinocytes were hyperproliferative in response to wounding. At doses of 2.5 ng/ml or greater, a delay in re-epithelialization was seen at 24 h post-wounding along with a reduction in hyperproliferation. By 48 h, however, re-epithelialization was complete in all cultures treated with TGF-beta 1. In particular, 7 ng/ml TGF-beta 1 inhibited proliferation yet had no effect on re-epithelialization by 48 h. These studies demonstrate that i) TGF-beta 1 induced a delay in re-epithelialization, ii) proliferation of wounded keratinocytes was not inhibited at 2.5 ng/ml doses of TGF-beta 1, and iii) at 7 ng/ml TGF-beta 1, re-epithelialization was complete by 48 h in spite of the profound inhibition of cell proliferation. In the organotypic model, TGF-beta 1 appears to alter re-epithelialization.

Retrovirus-mediated transduction of cultured epidermal keratinocytes.

Retrovirus-mediated gene transfer is an efficient means of introducing and expressing exogenous gene(s) in many cell types including keratinocytes. However, parameters of transduction and gene expression have not been systematically analyzed for keratinocytes. To carry out such a study we have transduced cultures of newborn foreskin cells with retroviral vectors that encode the genes for neomycin resistance (neor) and for beta-galactosidase (B-gal). The neor gene is a dominant selectable marker and the B-gal gene encodes a histochemically detectable product. Our key findings are the following: 1) all keratinocytes that form colonies can be successfully transduced at a viral titer greater than 5 x 10(6) colony-forming units/ml; 2) transduction is effected by integration of a single copy of retroviral DNA; 3) transduced cells are not at a growth disadvantage and, in fact, single clones of transduced keratinocytes can be expanded to yield over 10(9) cells, suggesting that stem cells are transduced; 4) whereas most transduced colonies exhibit B-gal staining in a high percentage of constituent cells, some colonies had a mosaic or sectored staining pattern; 5) expression of the non-selectable B-gal gene was somewhat greater in differentiated cells of the culture as compared to nondifferentiated precursors. The ability to transduce stem cells at a high efficiency and to follow expression of transduced genes in clonal progeny will allow lineage mapping in stratified epithelial tissues.

Cell interactions control the fate of malignant keratinocytes in an organotypic model of early neoplasia.

The role of cell interactions during early neoplastic progression in human skin is not well understood. We report that the fate and behavior of low-grade malignant cells in stratified epithelium is dependent on their interactions with neighboring cells and with extracellular matrix during the early events in neoplastic progression. We utilized an organotypic tissue model which mimics premalignancy to monitor malignant cells (II-4) genetically marked with beta-gal and grown in the context of either normal human keratinocytes or the immortalized cell line HaCaT. HaCaT cells were permissive for clonal expansion of II-4 cells at ratios of 4:1, 12:1, and 50:1 (HAC:II-4) when compared with coculture with normal human keratinocytes. This II-4 cell expansion was associated with the failure of neighboring HaCaT cells to induce differentiation and cell cycle withdrawal of II-4, as had been seen in the context of normal human keratinocytes. When 12:1 mixtures (NHK:II-4) were stripped of all suprabasal cells and regrown, all beta-gal cells were lost showing that these normal human keratinocyte-suppressed II-4 cells had been actively sorted to a suprabasal position where their clonal expansion was limited. These growth-suppressive effects of normal human keratinocytes were found to be conditional on direct cell-cell contact, as II-4 formed colonies when trypsinized from 12:1 (NHK:II-4) mixtures and grown at clonal density in submerged culture. The distribution and behavior of low-grade malignant cells was therefore dependent on the state of transformation of adjacent keratinocytes and on cell-matrix interactions. These results demonstrate that alterations in the cellular microenvironment are central to the induction of clonal expansion and early neoplastic progression in stratified epithelium.

Mast cells induce T-cell adhesion to human fibroblasts by regulating intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 expression.

The capacity of mast cell products to mediate T-cell adhesion to fibroblasts was explored using heterotypic coculture systems or by exposing fibroblasts to mast-cell-conditioned media (MCCM), prepared by degranulating mast cells with calcium ionophore. Experimental results indicated that fibroblasts exposed to MCCM for 24 h bound fivefold more T cells than control fibroblasts. Binding was inhibited with intercellular adhesion molecule-1 (ICAM-1) or vascular cell adhesion molecule-1 (VCAM-1) neutralizing antibodies. Enzyme-linked immunosorbent assay and fluorescence-activated cell sorter analysis revealed that fibroblasts exposed to MCCM markedly increased ICAM-1 and VCAM-1 surface expression by 4 h, with levels maximal at 16 h and returning toward baseline by 48 h. A dose-dependent response of ICAM-1 and VCAM-1 expression was noted using serial dilutions of MCCM or by altering the ratio of degranulated mast cells cocultured with fibroblasts. Similar results were obtained using human fibroblasts derived from the dermis, synovium, and lung, although lung fibroblasts were generally less responsive. Northern analysis confirmed that MCCM regulated ICAM-1 and VCAM-1 expression at the mRNA level. In summary, mast cell products stimulated fibroblast surface expression, steady-state mRNA levels, and functional expression of ICAM-1 and VCAM-1. Experimental data suggest that mast-cell-derived tumor necrosis factor-alpha may be in large part responsible for these observations, although further studies using human mast cells will be required. Using a skin-equivalent organotypic coculture model with fibroblasts admixed with mast cells, we observed increased ICAM-1 expression in both keratinocytes and fibroblasts after activation of the mast cells.

Smokeless tobacco extracts modulate keratinocyte and fibroblast growth in organotypic culture.

Smokeless tobacco is associated with pathologic alterations of the oral mucosa, yet its direct effects on human keratinocytes and fibroblasts in stratified squamous epithelium are not well-understood. We hypothesized that smokeless tobacco could modulate the growth of keratinocytes and fibroblasts in an in vivo-like, organotypic tissue model. To test this, we exposed organotypic cultures for 3 days to smokeless tobacco aqueous extracts and determined the changes in morphology and proliferation of human keratinocytes and fibroblasts. All smokeless tobaccos stimulated keratinocyte proliferation at low doses (0.25% w/v) and suppressed growth at higher doses (> 0.5% w/v). In contrast, smokeless tobacco extracts promoted fibroblast growth at all concentrations without inducing fibroblast turnover. Fibroblasts and keratinocytes, therefore, were differentially affected by smokeless tobacco extracts in an organotypic tissue model, suggesting incipient changes that may occur in vivo.

Re-epithelialization of human oral keratinocytes in vitro.

Re-epithelialization involves interactions between keratinocytes and the extracellular matrix upon which these cells move. It is hypothesized that keratinocytes are activated when wounded, and the resultant phenotypic change directs re-epithelialization. We have adapted organotypic cultures, in which oral gingival keratinocytes are fully differentiated, to study re-epithelialization following wounding. To elucidate keratinocyte behavior and phenotype during re-epithelialization, we have investigated this process in the presence and absence of the growth factor TGF-beta 1 and have monitored expression of MMP-1 (Type I collagenase) mRNA by in situ hybridization. In addition, we have followed proliferation and migration of wound keratinocytes by genetically marking these cells with a retroviral vector and by measuring their proliferative index. We found that keratinocytes grown without TGF-beta 1 were hyperproliferative in response to wounding, and re-epithelialization was complete by 24 h. However, 2.5 ng/mL TGF-beta 1 induced a transient delay in re-epithelialization, a reduction in proliferation, and fewer clusters of genetically marked cells. Keratinocytes expressed MMP-1 mRNA only when they covered the wounded surface, suggesting that the cells acquire a collagenolytic phenotype during re-epithelialization and that contact with different ECM components may modulate keratinocyte expression of MMP-1. We conclude that the phenotype of oral keratinocytes is altered during re-epithelialization in vitro and that this process is modulated by TGF-beta 1. Re-epithelialization occurs as keratinocytes are activated to move over the wound bed. Understanding the phenotype of wounded keratinocytes may facilitate treatment of chronic oral wounds and periodontal disease.

Use of skin equivalent technology in a wound healing model.

Re-epithelialization is defined as the reconstitution of cells into an organized, stratified squamous epithelium that permanently covers a wound defect and restores function (1). Following wounding, keratinocytes are activated to undergo a series of phenotypic changes that have been well-characterized in vivo (2-4). However, in vitro studies of re-epithelialization have often been limited by their inability to simulate the in vivo tissue. Wound models using skin explants (5-8) or submerged keratinocyte cultures (9,10) demonstrate only partial differentiation and hyperproliferative growth. These systems have been useful for studying keratinoctye migration (11), but are limited in studying other aspects of re-epithelialization.

The fate of genetically marked human oral keratinocytes in vitro.

The fate of the progeny of human oral gingival keratinocytes was mapped in stratified epithelial tissues in vitro by following the expression of a marker gene in genetically related clones. Oral epithelial progenitor cells were genetically marked at high efficiency by transducing them with a retrovirus vector that carried the gene for a histochemically detectable product, Escherichia coli beta-galactosidase (beta-gal). These cells were then grown in submerged cultures and on collagen rafts at the air-liquid interface to demonstrate the distribution of genetically marked cells in a differentiating tissue in vitro. The dynamics of transduced cells showed that clonally related cells were arranged in discrete units of labelled cells and these clusters were defined as 'clonal proliferation units'. The size and configuration of these units were related to the proliferative potential and differentiating capacity of the cell that was initially transduced. This model demonstrates the relation between clonally related cells and tissue architecture for oral keratinocytes in vitro.

Surgical excision of a congenital lateral fistula of the upper lip. An intra-oral approach.

A new technique for removal of a congenital lateral upper lip fistula is described, using an intra-oral approach. Previous reports of removal of such a congenital malformation have used an extra-oral approach. The technique described allows for excellent visualization of the fistula without cutaneous lip incision. Using this approach, good aesthetic results and complete removal of the fistula and associated mucous glands can be obtained.

A technique for the treatment of mandibular body fractures in young children.

Mandibular body fractures in young children are uncommon, yet their treatment and management often present several difficulties. The presence of developing dental follicles may lead to irregular fracture lines and precludes the use of intraosseus wiring. In addition, treatment of fractures in children of this age requires a technique that limits the number of separate procedures that they are subjected to. The technique outlined below for the treatment of mandibular body fractures in young children, uses a plastic impression tray as a splint and provides a simple means for their reduction and fixation.

A model to study the fate of genetically-marked keratinocytes in culture.

In this study we demonstrate a method for analyzing the spatial distribution or fate of progeny keratinocytes derived from single progenitor cells. The method relies upon the use of retroviral vectors to introduce a reporter gene into replicating cells and to effect integration and expression of that new gene. All progeny cells from that initial cell inherit and express the transferred gene. The reporter gene is the E. coli beta-galactosidase gene (B-gal), which encodes a histochemically-detectable product in the cytoplasm. Using this method, we show that foci of genetically marked, B-gal positive cells can be readily identified in submerged cultures and we term this grouping of cells a "clonal proliferation unit". Analysis of B-gal stained whole mounts and paraffin sections allows visualization of the proliferative potential and differentiating capacity of clonogenic cells. This model will allow exploration of how agents known to alter epidermal proliferation and differentiation affect lineage relationships.

A desmoplastic granular cell tumour of the oral cavity: report of a case.

A case of granular cell tumour of the buccal mucosa demonstrating marked desmoplasia is presented. The bulk of the tumour is composed of dense collagenous stroma, which surrounds isolated nests of tumour cells. Since the histomorphologic appearance of this variant is different from that usually seen in this lesion, the diagnosis is supported by immunohistochemical demonstration of S-100 and Vimentin in the tumour cells. The authors believe that this case represents the first report of a desmoplastic granular cell tumour of the oral tissues.

RalA suppresses early stages of Ras-induced squamous cell carcinoma progression.

Ras proteins activate Raf and PI-3 kinases, as well as exchange factors for RalA and RalB GTPases. Many previous studies have reported that the Ral-signaling cascade contributes positively to Ras-mediated oncogenesis. Here, using a bioengineered tissue model of early steps in Ras-induced human squamous cell carcinoma of the skin, we found the opposite. Conversion of Ras-expressing keratinocytes from a premalignant to malignant state induced by decreasing E-cadherin function was associated with and required an approximately two to threefold decrease in RalA expression. Moreover, direct knockdown of RalA to a similar degree by shRNA expression in these cells reduced E-cadherin levels and also induced progression to a malignant phenotype. Knockdown of the Ral effector, Exo84, mimicked the effects of decreasing RalA levels in these engineered tissues. These phenomena can be explained by our finding that the stability of E-cadherin in Ras-expressing keratinocytes depends upon this RalA signaling cascade. These results imply that an important component of the early stages in squamous carcinoma progression may be a modest decrease in RalA gene expression that magnifies the effects of decreased E-cadherin expression by promoting its degradation.

The role of fibroblast Tiam1 in tumor cell invasion and metastasis.

The co-evolution of tumors and their microenvironment involves bidirectional communication between tumor cells and tumor-associated stroma. Various cell types are present in tumor-associated stroma, of which fibroblasts are the most abundant. The Rac exchange factor Tiam1 is implicated in multiple signaling pathways in epithelial tumor cells and lack of Tiam1 in tumor cells retards tumor growth in Tiam1 knockout mouse models. Conversely, tumors arising in Tiam1 knockout mice have increased invasiveness. We have investigated the role of Tiam1 in tumor-associated fibroblasts as a modulator of tumor cell invasion and metastasis, using retroviral delivery of short hairpin RNA to suppress Tiam1 levels in three different experimental models. In spheroid co-culture of mammary epithelial cells and fibroblasts, Tiam1 silencing in fibroblasts led to increased epithelial cell outgrowth into matrix. In tissue-engineered human skin, Tiam1 silencing in dermal fibroblasts led to increased invasiveness of epidermal keratinocytes with pre-malignant features. In a model of human breast cancer in mice, co-implantation of mammary fibroblasts inhibited tumor invasion and metastasis, which was reversed by Tiam1 silencing in co-injected fibroblasts. These results suggest that stromal Tiam1 may have a role in modulating the effects of the tumor microenvironment on malignant cell invasion and metastasis. This suggests a set of pathways for further investigation, with implications for future therapeutic targets.

Biofunctionalized electrospun silk mats as a topical bioactive dressing for accelerated wound healing.

Materials able to deliver topically bioactive molecules represent a new generation of biomaterials. In this article, we describe the use of silk mats, made of electrospun nanoscale silk fibers containing epidermal growth factor (EGF), for the promotion of wound healing processes. In our experiments, we demonstrated that EGF is incorporated into the silk mats and slowly released in a time-dependent manner (25% EGF release in 170h). We tested these materials using a new model of wounded human skin-equivalents displaying the same structure as human skin and able to heal using the same molecular and cellular mechanisms found in vivo. This human three-dimensional model allows us to demonstrate that the biofunctionalized silk mats, when placed on the wounds as a dressing, aid the healing by increasing the time of wound closure by the epidermal tongue by 90%. The preservation of the structure of the mats during the healing period as demonstrated by electronic microscopy, the biological action of the dressing, as well as the biocompatibility of the silk demonstrate that this biomaterial is a new and very promising material for medical applications, especially for patients suffering from chronic wounds.