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Erschienen in: Aesthetic Plastic Surgery 5/2019

09.08.2019 | Original Article

A Reliable Stem Cell Carrier: An Experimental Study in Wistar Rats

verfasst von: Ithamar Nogueira Stocchero, Nelson Foresto Lizier, Rafael Fantelli Stelini, Olívia Capela Grimaldi de Oliveira, Paulo Roberto Grimaldi de Oliveira, Carlos Alexandre Ayoub, Tainah Desuó Rotta, Guilherme Flosi Stocchero, Paulo Kharmandayan

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 5/2019

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Abstract

Introduction

Treatments based on cell biology need reliable and precise carriers for reaching the desired targets. For that reason, a PDO-based cell carrier was idealized, with the purpose of carrying stem cells to distant sites at room temperature.

Materials and Methods

Three modalities of the same carrier were evaluated: one containing undifferentiated human dental pulp stem cells (DPSCs); one loaded with stem cells induced to neurogenic differentiation (DPSCNs); and one without cells (Blank). The carriers were implanted in sciatic nerve gaps in 48 Wistar rats that were divided in three groups. Two other rats were included in a SHAM control group. Immunohistochemical, histological and clinical analyses were performed in two, four, six and eight weeks of time.

Results

Efficacy of human stem cell transportation at room temperature to rats was attested. Moreover, it was possible to confirm that those cells show tropism for inflamed environments and are also prone to induction of neurogenesis in the first two weeks, vanishing after that period.

Conclusion

Clinical evaluation of the animals’ gait recovery shows a promising perspective of success with the inclusion of stem cell-loaded PDO tubes in nerve gaps, which may be positively compared to previously published studies.

No level assigned

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Literatur
1.
Zurück zum Zitat Rodbell M (1964) Metabolism of isolated fat cells. Effects of hormones on glucose metabolism and lipolysis. J Biol Chem 239:357–380 Rodbell M (1964) Metabolism of isolated fat cells. Effects of hormones on glucose metabolism and lipolysis. J Biol Chem 239:357–380
2.
Zurück zum Zitat Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, Bwnhaim P, Lorenz HP, Hedrick MH (2001) Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng 7:211–228CrossRefPubMed Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, Bwnhaim P, Lorenz HP, Hedrick MH (2001) Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng 7:211–228CrossRefPubMed
3.
Zurück zum Zitat Zuk PA, Zhu M, Ashjian P, De Ugarte DA, Huang J, Mizuno H, Alfonso ZC, Fraser JK, Benhaim P, Hedrick MH (2002) Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell 13:4279–4295CrossRefPubMedPubMedCentral Zuk PA, Zhu M, Ashjian P, De Ugarte DA, Huang J, Mizuno H, Alfonso ZC, Fraser JK, Benhaim P, Hedrick MH (2002) Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell 13:4279–4295CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Gimble JM, Guilak F (2003) Adipose-derived adult stem cells: isolation, characterization and differentiation potential. Cytotherapy 5:362–369CrossRefPubMed Gimble JM, Guilak F (2003) Adipose-derived adult stem cells: isolation, characterization and differentiation potential. Cytotherapy 5:362–369CrossRefPubMed
5.
Zurück zum Zitat Ogawa R, Mizuno H, Watanabe A, Migita M, Shimada T, Hyakusoku H (2004) Osteogenic and chondrogenic differentiation by adipose-derived stem cells harvested from GFP transgenic mice. Biochem Biophys Res Commun 313:871–877CrossRefPubMed Ogawa R, Mizuno H, Watanabe A, Migita M, Shimada T, Hyakusoku H (2004) Osteogenic and chondrogenic differentiation by adipose-derived stem cells harvested from GFP transgenic mice. Biochem Biophys Res Commun 313:871–877CrossRefPubMed
6.
Zurück zum Zitat Mitchell JB, McIntosh K, Zvonic S, Garrett S, Floyd ZE, Kloster A, Halvorsen YD, Storms RW, Goh B, Kilroy G, Wu X, Gimble JM (2006) Immunophenotype of human adipose-derived cells: temporal changes in stromal-associated and stem cell-associated markers. Stem Cells 24:376–385CrossRefPubMed Mitchell JB, McIntosh K, Zvonic S, Garrett S, Floyd ZE, Kloster A, Halvorsen YD, Storms RW, Goh B, Kilroy G, Wu X, Gimble JM (2006) Immunophenotype of human adipose-derived cells: temporal changes in stromal-associated and stem cell-associated markers. Stem Cells 24:376–385CrossRefPubMed
7.
Zurück zum Zitat Faroni A, Terenghi G, Reid AJ (2013) Adipose-derived stem cells and nerve regeneration: promises and pitfalls. Int Rev Neurobiol 108:121–136CrossRefPubMed Faroni A, Terenghi G, Reid AJ (2013) Adipose-derived stem cells and nerve regeneration: promises and pitfalls. Int Rev Neurobiol 108:121–136CrossRefPubMed
8.
Zurück zum Zitat Volpe BB, Santos Duarte AD, Ribeiro TB, Stocchero IN, Kharmandayan P, Olalla Saad ST, Bustorff-Silva JM, Malheiros Luzo AC (2014) Mesenchymal stromal cells from adipose tissue attached to suture material enhance the closure of enterocutaneous fistulas in a rat model. Cytotherapy 16:1709–1719CrossRefPubMed Volpe BB, Santos Duarte AD, Ribeiro TB, Stocchero IN, Kharmandayan P, Olalla Saad ST, Bustorff-Silva JM, Malheiros Luzo AC (2014) Mesenchymal stromal cells from adipose tissue attached to suture material enhance the closure of enterocutaneous fistulas in a rat model. Cytotherapy 16:1709–1719CrossRefPubMed
9.
Zurück zum Zitat Tarasidis G, Watanabe O, Mackinnon SE, Strasberg SR, Haughey BH, Hunter DA (1997) End-to-side neurorrhaphy resulting in limited sensory axonal regeneration in a rat model. Ann Otol Rhinol Laryngol 106:506–512CrossRefPubMed Tarasidis G, Watanabe O, Mackinnon SE, Strasberg SR, Haughey BH, Hunter DA (1997) End-to-side neurorrhaphy resulting in limited sensory axonal regeneration in a rat model. Ann Otol Rhinol Laryngol 106:506–512CrossRefPubMed
10.
Zurück zum Zitat Souza FI, Santos GB, Silva CF, Mattar R Jr, Zumiotti AV (2011) Avaliação Histológica da Neurorrafia Término-Lateral Estudo Experimental em Ratos. Acta Ortop Bras 19(3):129–131CrossRef Souza FI, Santos GB, Silva CF, Mattar R Jr, Zumiotti AV (2011) Avaliação Histológica da Neurorrafia Término-Lateral Estudo Experimental em Ratos. Acta Ortop Bras 19(3):129–131CrossRef
11.
Zurück zum Zitat Sasaki R, Aoki S, Yamato M, Uchiyama H, Wada K, Okano T, Ogiuchi H (2008) Tubulation with dental pulp cells promotes facial nerve regeneration in rats. Tissue Eng Part A 14(7):1141–1147CrossRefPubMed Sasaki R, Aoki S, Yamato M, Uchiyama H, Wada K, Okano T, Ogiuchi H (2008) Tubulation with dental pulp cells promotes facial nerve regeneration in rats. Tissue Eng Part A 14(7):1141–1147CrossRefPubMed
12.
Zurück zum Zitat Santiago LY, Clavijo-Alvarez J, Brayfield C, Rubin JP, Marra KG (2009) Delivery of adipose-derived precursor cells for peripheral nerve repair. Cell Transplant 18(2):145–158CrossRefPubMed Santiago LY, Clavijo-Alvarez J, Brayfield C, Rubin JP, Marra KG (2009) Delivery of adipose-derived precursor cells for peripheral nerve repair. Cell Transplant 18(2):145–158CrossRefPubMed
13.
Zurück zum Zitat Sasaki R, Aoki S, Yamato M, Uchiyama H, Wada K, Ogiuchi H, Okano T, Ando T (2011) PLGA artificial nerve conduits with dental pulp cells promote facial nerve regeneration. J Tissue Eng Regen Med 5(10):823–830CrossRefPubMed Sasaki R, Aoki S, Yamato M, Uchiyama H, Wada K, Ogiuchi H, Okano T, Ando T (2011) PLGA artificial nerve conduits with dental pulp cells promote facial nerve regeneration. J Tissue Eng Regen Med 5(10):823–830CrossRefPubMed
14.
Zurück zum Zitat Marconi S, Castiglione G, Turano E, Bissolotti G, Angiari S, Farinazzo A, Constantin G, Bedogni G, Bedogni A, Bonetti B (2012) Human Adipose-derived mesenchymal stem cells systemically injected promote peripheral nerve regeneration in the mouse model of sciatic crush. Tissue Eng Part A 18(11–12):1264–1272CrossRefPubMed Marconi S, Castiglione G, Turano E, Bissolotti G, Angiari S, Farinazzo A, Constantin G, Bedogni G, Bedogni A, Bonetti B (2012) Human Adipose-derived mesenchymal stem cells systemically injected promote peripheral nerve regeneration in the mouse model of sciatic crush. Tissue Eng Part A 18(11–12):1264–1272CrossRefPubMed
15.
Zurück zum Zitat Terada N, Bjursten LM, Papaloizos M, Lundborg G (1997) Resorbable filament structures as a scaffold for matrix formation and axonal growth in bioartificial nerve grafts: long term observations. Restor Neurol Neurosci 11(1–2):65–69PubMed Terada N, Bjursten LM, Papaloizos M, Lundborg G (1997) Resorbable filament structures as a scaffold for matrix formation and axonal growth in bioartificial nerve grafts: long term observations. Restor Neurol Neurosci 11(1–2):65–69PubMed
16.
Zurück zum Zitat Walsh S, Midha R (2009) Practical considerations concerning the use of stem cells for peripheral nerve repair. Neurosurg Focus 26(2):E2CrossRefPubMed Walsh S, Midha R (2009) Practical considerations concerning the use of stem cells for peripheral nerve repair. Neurosurg Focus 26(2):E2CrossRefPubMed
17.
Zurück zum Zitat Orbay H, Uysal AC, Hyakusoku H, Mizuno H (2012) Differentiated and undifferentiated adipose-derived stem cells improve function in rats with peripheral nerve gaps. J Plast Reconstr Aesthet Surg 65(5):657–664CrossRefPubMed Orbay H, Uysal AC, Hyakusoku H, Mizuno H (2012) Differentiated and undifferentiated adipose-derived stem cells improve function in rats with peripheral nerve gaps. J Plast Reconstr Aesthet Surg 65(5):657–664CrossRefPubMed
18.
Zurück zum Zitat Patel M, Vandevord PJ, Matthew HW, Desilva S, Wu B, Wooley PH (2008) Functional gait evaluation of collagen chitosan nerve guides for sciatic nerve repair. Tissue Eng Part C Methods 14(4):365–370CrossRefPubMed Patel M, Vandevord PJ, Matthew HW, Desilva S, Wu B, Wooley PH (2008) Functional gait evaluation of collagen chitosan nerve guides for sciatic nerve repair. Tissue Eng Part C Methods 14(4):365–370CrossRefPubMed
19.
Zurück zum Zitat Ganga MVM, Coutinho-Netto J, Colli O, Marques W Jr, Catalão CHR, Santana RT, Oltramari MRP, Carraro KT, Lachat JJ, Lopes LS (2012) Sciatic nerve regeneration in rats by a nerve conduit engineering with a membrane derived from natural látex. Acta Cir Bras 27(12):885–894CrossRefPubMed Ganga MVM, Coutinho-Netto J, Colli O, Marques W Jr, Catalão CHR, Santana RT, Oltramari MRP, Carraro KT, Lachat JJ, Lopes LS (2012) Sciatic nerve regeneration in rats by a nerve conduit engineering with a membrane derived from natural látex. Acta Cir Bras 27(12):885–894CrossRefPubMed
20.
Zurück zum Zitat Ghoreishian M, Rezaei M, Beni BH, Javanmard SH, Attar BM, Zalzali H (2013) Facial nerve repair with gore-tex tube and adipose-derived stem cells: an animal study in dogs. J Oral Maxillofac Surg 71:577–587CrossRefPubMed Ghoreishian M, Rezaei M, Beni BH, Javanmard SH, Attar BM, Zalzali H (2013) Facial nerve repair with gore-tex tube and adipose-derived stem cells: an animal study in dogs. J Oral Maxillofac Surg 71:577–587CrossRefPubMed
21.
Zurück zum Zitat Stocchero IN, Stocchero GF, Stocchero GF, Fonseca ASF (2006) Liposuctionable fat: a hypothetic model. Plast Reconstr Surg 117(1):337–338CrossRefPubMed Stocchero IN, Stocchero GF, Stocchero GF, Fonseca ASF (2006) Liposuctionable fat: a hypothetic model. Plast Reconstr Surg 117(1):337–338CrossRefPubMed
22.
Zurück zum Zitat Stocchero IN, Stocchero GF (2011) Isolation of stem cells from human adipose tissue: technique, problems, and pearls. In: Illouz YG, Sterodimas A (eds) Adipose stem cells and regenerative medicine. Springer, Berlin, pp 13–18CrossRef Stocchero IN, Stocchero GF (2011) Isolation of stem cells from human adipose tissue: technique, problems, and pearls. In: Illouz YG, Sterodimas A (eds) Adipose stem cells and regenerative medicine. Springer, Berlin, pp 13–18CrossRef
23.
Zurück zum Zitat Torres FC, Rodrigues CJ, Stocchero IN, Ferreira MC (2007) Stem cells from the fat tissue of rabbits: an easy-to-find experimental source Aesth. Plast Surg 31(5):574–578 Torres FC, Rodrigues CJ, Stocchero IN, Ferreira MC (2007) Stem cells from the fat tissue of rabbits: an easy-to-find experimental source Aesth. Plast Surg 31(5):574–578
24.
Zurück zum Zitat Almeida KA, Campa A, Alonso-Vale MIC, Lima FB, Daud ED, Stocchero IN (2008) Fracción Vascular Estromal: Cómo Obtener Células Madre y su Rendimiento de Acuerdo a la Topografia de las Áreas Donantes: Estúdio Preliminar. Cir.plást.iberolatinoam 34(1):71–77CrossRef Almeida KA, Campa A, Alonso-Vale MIC, Lima FB, Daud ED, Stocchero IN (2008) Fracción Vascular Estromal: Cómo Obtener Células Madre y su Rendimiento de Acuerdo a la Topografia de las Áreas Donantes: Estúdio Preliminar. Cir.plást.iberolatinoam 34(1):71–77CrossRef
25.
Zurück zum Zitat Rigotti G, Marchi A, Galiè M, Baroni G, Benati D, Krampera M, Pasini A, Sbarati A (2007) Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem. Cells Plast Reconstr Surg 119(5):1409–1422CrossRefPubMed Rigotti G, Marchi A, Galiè M, Baroni G, Benati D, Krampera M, Pasini A, Sbarati A (2007) Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem. Cells Plast Reconstr Surg 119(5):1409–1422CrossRefPubMed
26.
Zurück zum Zitat Stocchero IN, Stocchero GHF, Stocchero GF, Stocchero VGZ, Fonseca ASF, Fonseca EFS (2009) Lipoinjerto laminar: un tratamiento prometedor con factores vasculares estromales para las vulvo-vaginitis crónicas. Cir.plást.iberolatinoam 5(3):179–186 Stocchero IN, Stocchero GHF, Stocchero GF, Stocchero VGZ, Fonseca ASF, Fonseca EFS (2009) Lipoinjerto laminar: un tratamiento prometedor con factores vasculares estromales para las vulvo-vaginitis crónicas. Cir.plást.iberolatinoam 5(3):179–186
27.
Zurück zum Zitat Yoshimura K (2008) Clinical use of adipose-derived stem cells for breast volume enhancement. ISAPS News 2(3):6 Yoshimura K (2008) Clinical use of adipose-derived stem cells for breast volume enhancement. ISAPS News 2(3):6
28.
Zurück zum Zitat Chen ZL, Yu WM, Strickland S (2007) Peripheral regeneration. Ann. Rev Neurosci 30:209–233CrossRef Chen ZL, Yu WM, Strickland S (2007) Peripheral regeneration. Ann. Rev Neurosci 30:209–233CrossRef
29.
Zurück zum Zitat Nakashima M, Iohara K, Murakami M (2013) Dental pulp stem cells and regeneration. Endod Topics 28:38–50CrossRef Nakashima M, Iohara K, Murakami M (2013) Dental pulp stem cells and regeneration. Endod Topics 28:38–50CrossRef
30.
Zurück zum Zitat Beigi M-H, Ghasemi-Mobarakeh L, Prabhakaran MP, Karbalaie K, Azadeh H, Ramakrishna S, Baharvand H, Nasr-Esfahani M-H (2014) In vivo integration of poly(e-caprolactone)/gelatin nanofibrous nerve guide seeded with teeth derived stem cells for peripheral nerve regeneration. J Biomed Mater Res Part A 4554–4567 Beigi M-H, Ghasemi-Mobarakeh L, Prabhakaran MP, Karbalaie K, Azadeh H, Ramakrishna S, Baharvand H, Nasr-Esfahani M-H (2014) In vivo integration of poly(e-caprolactone)/gelatin nanofibrous nerve guide seeded with teeth derived stem cells for peripheral nerve regeneration. J Biomed Mater Res Part A 4554–4567
31.
Zurück zum Zitat Malek S, Kaplan E, Wang JF, Ke Q, Rana JS, Chen Y, Rahim BG, Li M, Huang Q, Xiao Y-F, Verheugt FWA, Morgan JP, Min J-Y (2006) Successful implantation of intravenously administered stem cells correlates with severity of inflammation in murine myocarditis. Pflug Arch Eur J Physiol 452:268–275CrossRef Malek S, Kaplan E, Wang JF, Ke Q, Rana JS, Chen Y, Rahim BG, Li M, Huang Q, Xiao Y-F, Verheugt FWA, Morgan JP, Min J-Y (2006) Successful implantation of intravenously administered stem cells correlates with severity of inflammation in murine myocarditis. Pflug Arch Eur J Physiol 452:268–275CrossRef
32.
Zurück zum Zitat Lopatina T, Kalinina N, Karagyaur M, Stambolsky D, Rubina K, Revischin A, Pavlova G, Parfyonova Y, Tkachuk V (2011) Adipose-derived stem cells stimulate regeneration of peripheral nerves: BDNF secreted by these cells promotes nerve healing and axon growth de novo. PLoS ONE 6(3):e17899CrossRefPubMedPubMedCentral Lopatina T, Kalinina N, Karagyaur M, Stambolsky D, Rubina K, Revischin A, Pavlova G, Parfyonova Y, Tkachuk V (2011) Adipose-derived stem cells stimulate regeneration of peripheral nerves: BDNF secreted by these cells promotes nerve healing and axon growth de novo. PLoS ONE 6(3):e17899CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Spaeth E, Klopp A, Dembinski J, Andreeff F, Marini F (2008) Inflammation and tumor microenvironments: defining the migratory itinerary of mesenchymal stem cells. Gene Ther 15:730–738CrossRefPubMed Spaeth E, Klopp A, Dembinski J, Andreeff F, Marini F (2008) Inflammation and tumor microenvironments: defining the migratory itinerary of mesenchymal stem cells. Gene Ther 15:730–738CrossRefPubMed
34.
Zurück zum Zitat Rustad KC, Gurtner GC (2012) Mesenchymal stem cells home to sites of injury and inflammation. Adv Wound Care 1(4):147–152CrossRef Rustad KC, Gurtner GC (2012) Mesenchymal stem cells home to sites of injury and inflammation. Adv Wound Care 1(4):147–152CrossRef
35.
Zurück zum Zitat Kidd S, Spaeth E, Dembinski JL, Dietrich M, Watson K, Klopp A, Battula VL, Weil M, Andreeff M, Marini FC (2009) Direct evidence of mesenchymal stem cell tropism for tumor and wounding microenvironments using in vivo bioluminescent imaging. Stem Cells 27:2614–2623CrossRefPubMedPubMedCentral Kidd S, Spaeth E, Dembinski JL, Dietrich M, Watson K, Klopp A, Battula VL, Weil M, Andreeff M, Marini FC (2009) Direct evidence of mesenchymal stem cell tropism for tumor and wounding microenvironments using in vivo bioluminescent imaging. Stem Cells 27:2614–2623CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Dai LG, Huang GS, Hsu S (2013) Sciatic nerve regeneration by cocultured schwann cells and stem cells on microporous nerve conduits. Cell Transplant 22(11):2029–2039CrossRefPubMed Dai LG, Huang GS, Hsu S (2013) Sciatic nerve regeneration by cocultured schwann cells and stem cells on microporous nerve conduits. Cell Transplant 22(11):2029–2039CrossRefPubMed
Metadaten
Titel
A Reliable Stem Cell Carrier: An Experimental Study in Wistar Rats
verfasst von
Ithamar Nogueira Stocchero
Nelson Foresto Lizier
Rafael Fantelli Stelini
Olívia Capela Grimaldi de Oliveira
Paulo Roberto Grimaldi de Oliveira
Carlos Alexandre Ayoub
Tainah Desuó Rotta
Guilherme Flosi Stocchero
Paulo Kharmandayan
Publikationsdatum
09.08.2019
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 5/2019
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-019-01469-4

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