Effects of Prisma® Skin dermal regeneration device containing glycosaminoglycans on human keratinocytes and fibroblasts

Prisma® Skin is a new pharmaceutical device developed by Mediolanum Farmaceutici S.p.a. It includes alginates, hyaluronic acid and mainly mesoglycan. The latter is a natural glycosaminoglycan preparation containing chondroitin sulfate, dermatan sulfate, heparan sulfate and heparin and it is used in the treatment of vascular disease. Glycosaminoglycans may contribute to the re-epithelialization in the skin wound healing, as components of the extracellular matrix. Here we describe, for the first time, the effects of Prisma® Skin in in vitro cultures of adult epidermal keratinocytes and dermal fibroblasts. Once confirmed the lack of cytotoxicity by mesoglycan and Prisma® Skin, we have shown the increase of S and G2 phases of fibroblasts cell cycle distribution. We further report the strong induction of cell migration rate and invasion capability on both cell lines, two key processes of wound repair. In support of these results, we found significant cytoskeletal reorganization, following the treatments with mesoglycan and Prisma® Skin, as confirmed by the formation of F-actin stress fibers. Additionally, together with a significant reduction of E-cadherin, keratinocytes showed an increase of CD44 expression and the translocation of ezrin to the plasma membrane, suggesting the involvement of CD44/ERM (ezrin-radixin-moesin) pathway in the induction of the analyzed processes. Furthermore, as showed by immunofluorescence assay, fibroblasts treated with mesoglycan and Prisma® Skin exhibited the increase of Fibroblast Activated Protein α and a remarkable change in shape and orientation, two common features of reactive stromal fibroblasts. In all experiments Prisma® Skin was slightly more potent than mesoglycan. In conclusion, based on these findings we suggest that Prisma® Skin may be able to accelerate the healing process in venous skin ulcers, principally enhancing re-epithelialization and granulation processes.     

Purification of flounder (Paralichthys olivaceus) fibronectin and its localization during re-epithelialization at a fin wound

Plasma fibronectin (FN) of flounder Paralichthys olivacem was purified and characterized. Flounder FN was purified by a combination of affinity chromatography using Sepharose coupled with flounder gelatin and gel filtration on Superose 6. Flounder FN was found to be a disulphide-linked heterodimer of 220 and 230 kDa polypeptides. It had cell-spreading activity for baby hamster kidney (BHK) cells, which was inhibited by the synthetic peptide, Gly-Arg-Gly-Asp-Ser-Pro. In flounder explants, anti-flounder FN antiserum distinguished fibroblast-like cells from epithelial cells; indirect immunofluorescence showed that the fibroblast-like cells exhibited a fibrous staining to the antiserum, but that epithelial cells did not. These results suggest that flounder FN is a homologue of mammalian FN.
The localization of FN during re-epithelialization at the site of a severed fin was investigated. When the top of the fin was cut, epidermal cells covered the surface of the wound within 1 h. FN is detected at the wound site during epidermal cell migration, suggesting that it serves as a cell-adhesion factor for prompt re-epithelialization at wound sites.     

Expression of P-cadherin distinct from that of E-cadherin in re-epithelialization in neonatal rat skin

Our previous study showed that an open wound made in neonatal rat skin was covered by migration of certain undifferentiated populations of keratinocytes as a multilayered cell sheet. In this study, the expression of the components of adherens junctions (AJ), E- and P-cadherins, and beta-catenin, was examined to understand the underlying mechanisms. Both E- and P-cadherins were downregulated in the basal layer at 6 h post-wounding (PW), indicating a reduction in the intercellular adhesiveness. The expression of P-cadherin but not E-cadherin was expanded to the suprabasal layers at the wound margin at 12 h PW. Moreover, the expression pattern of P-cadherin at sites of cell-cell contact was punctate rather than linear. By 24 h PW, cells accumulated beta-catenin in the cytoplasm in a suprabasal layer contacting the basal layer at the wound margin. Both the E- and P-cadherins showed a punctate AJ pattern at the confined suprabasal layer. Such differential expression of the E- and P-cadherins strongly suggests that these two classic cadherins play distinct roles in re-epithelialization. The changing of the E- and/or P-cadherin expression may participate in a delay of terminal differentiation of keratinocytes for cell supply toward a wound.     

Tissue engineered esophagus by copper——small intestinal submucosa graft for esophageal repair in a canine model

Acellular porcine small intestinal submucosa(SIS)has been used for esophagoplasty with success in a canine model.However,it did not lead to complete epithelialization.For better reconstruction,a cellular component is required.Moreover,promotion of angiogenesis with copper has been widely recognized by basic research as well as clinical studies.In this study,we have evaluated the feasibility and effectiveness of combined Cu and SIS(SIS-Cu patch)for the esophageal repair using a canine model.Eighteen male beagle dogs were subjected to surgical resection to produce cervical esophageal defects(5 cm in length,180°in range).SIS with Cu(5 or 25μmol L 1copper)or without Cu was patched on the esophageal defects.Barium esophagram and histology exam were carried out to evaluate the effectiveness of the therapy.As shown,the SIS-Cu graft promoted re-epithelialization,re-vascularization and muscular regeneration.SIS-Cu patch is more effective than SIS alone for esophageal repair,and the SIS+25μmol L 1Cu group demonstrated additional advantages over the SIS+5μmol L 1Cu.     

Epimorphin expression in interstitial pneumonia

Epimorphin modulates epithelial morphogenesis in embryonic mouse organs. We previously suggested that epimorphin contributes to repair of bleomycin-induced pulmonary fibrosis in mice via epithelium-mesenchyme interactions. To clarify the role of epimorphin in human lungs, we evaluated epimorphin expression and localization in normal lungs, lungs with nonspecific interstitial pneumonia (NSIP), and lungs with usual interstitial pneumonia (UIP); we also studied the effect of recombinant epimorphin on cultured human alveolar epithelial cells in vitro. Northern and Western blotting analyses revealed that epimorphin expression in NSIP samples were significantly higher than those in control lungs and lungs with UIP. Immunohistochemistry showed strong epimorphin expression in mesenchymal cells of early fibrotic lesions and localization of epimorphin protein on mesenchymal cells and extracellular matrix of early fibrotic lesions in the nonspecific interstitial pneumonia group. Double-labeled fluorescent images revealed expression of matrix metalloproteinase 2 in re-epithelialized cells overlying epimorphin-positive early fibrotic lesions. Immunohistochemistry and metalloproteinase activity assay demonstrated augmented expression of metalloproteinase induced by recombinant epimorphin in human alveolar epithelial cells. These findings suggest that epimorphin contributes to repair of pulmonary fibrosis in nonspecific interstitial pneumonia, perhaps partly by inducing expression of matrix metalloproteinase 2, which is an important proteolytic factor in lung remodeling.     

NSAID inhibition of RGM1 gastric monolayer wound re-epithelialization: comparison of selective Cox-2 versus non-selective Cox inhibitors

Clinical studies indicate that specific cyclooxygenase-2 (Cox-2) inhibitors are less ulcerogenic than their non-selective predecessors (e.g. indomethacin). However, Cox-2 inhibitors may also interfere with ulcer healing. Re-epithelialization is a crucial factor in both gastrointestinal mucosal injury and ulcer healing. This study was aimed to compare the effects of selective Cox-2 inhibitor (NS398) versus non-selective Cox inhibitor (indomethacin) on basal and basic fibroblast growth factor (bFGF) - stimulated gastric wound re-epithelialization. In-vitro epithelial wounds were created in confluent monolayers of RGM1 rat gastric epithelial cells by a razor blade scrape. Following wounding there was a significant re-epithelialization by 24 hrs. Indomethacin (0.25 mM and 0.5 mM) significantly inhibited basal wound re-epithelialization in a dose dependent manner. In contrast, selective Cox-2 inhibitor NS398 did not inhibit the basal re-epithelialization process. Basic FGF treatment produced significant enhancement of wound re-epitheliazation at the various concentrations [10, 20, 30, 40, 50 and 70 ng/ml] studied. Both indomethacin and NS398 inhibited bFGF stimulated wound re-epithelialization, with indomethacin having a greater inhibitory effect. The extent of NS398 inhibition was limited to the bFGF-stimulated component, whereas indomethacin inhibition extended to both the bFGF-stimulated and the basal re-epithelialization components. These findings indicate that specific Cox-2 inhibitor (NS398) does not interfere with the basal re-epithelialization but significantly inhibits the bFGF - stimulated re-epithelialization, whereas indomethacin interferes with both the basal as well as the bFGF-stimulated wound re-epithelialization.     

Low dose ethanol potentiates indomethacin induced inhibition of wound re-epithelialization in duodenal monolayers

Nonsteroidal anti-inflammatory drugs (NSAIDs) induce gastroduodenal mucosal injury and ulceration, and delay ulcer healing. In contrast, the effects of low dose ethanol in induction of gastroduodenal mucosal injury, and the subsequent wound repair remains unclear. The aim of this study was to determine, using an in-vitro duodenal epithelial wound model, whether low clinically relevant doses of ethanol or indomethacin interfere with the wound re-epithelialization of duodenal epithelial monolayers. The possible potentiating effect of ethanol on indomethacin modulation of duodenal re-epithelialization was also examined. In-vitro epithelial wounds were created in confluent IEC-6 duodenal epithelial monolayers by a razor blade scrape. Ethanol at low concentrations (0.25, 0.5, 0.75%) did not have significant effect on duodenal wound re-epithelialization. Similarly, low doses of indomethacin (.01, .05, 0.1 mM) also did not have a significant effect on wound re-epithelialization. However, the combination of ethanol (0.5 or 0.75%) and indomethacin (0.1mM) produced a marked inhibition of IEC-6 re-epithelialization. At the low doses used, ethanol and indomethacin (individually or in combination) did not have direct cytotoxic effect on IEC-6 cells. Ethanol or indomethacin (at the studied concentrations) had only minimal effect on the actin stress fibers in the cells at the migration front. However, in combination, they almost completely abolished the actin stress fibers at the migration front. These findings demonstrate that while low clinically relevant doses of ethanol and indomethacin individually do not affect re-epithelialization of wounded duodenal epithelial monolayers, in combination they produce a significant inhibition.