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Early osteoimmunomodulation by mucin hydrogels augments the healing and revascularization of rat critical-size calvarial bone defects

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Bioactive Materials 2023年第7期25卷 176-188页

作者： Song Chen Huan Wang Dachuan Liu Jianzhong Bai Håvard Jostein Haugen Bin Li Hongji Yan Orthopedic Institute Department of Orthopedic SurgeryThe First Affiliated HospitalSchool of Biology&Basic Medical SciencesSuzhou Medical CollegeSoochow UniversitySuzhouJiangsuChina Department of Biomaterials Institute for Clinical DentistryUniversity of OsloPO Box 1109 BlindernOslo0376Norway AIMES-Center for the Advancement of Integrated Medical and Engineering Sciences at Karolinska Institute and KTH Royal Institute of Technology 17177StockholmSweden Department of Neuroscience Karolinska Institute17177StockholmSweden Division of Glycoscience Department of ChemistrySchool of Engineering Sciences in ChemistryBiotechnology and HealthKTH Royal Institute of TechnologyAlbaNova University Center10691StockholmSweden

The design principle of osteogenic bone grafts has shifted from immunological inertness to limiting foreign body response to combined osteoimmunomodulatory activity to promote high-quality endogenous bone regeneration.Recently developed immunomodulatory mucin hydrogels have been shown to elicit very low complement activation and suppress macrophage release and activation after implantation in vivo.However,their immunoregulatory activity has not yet been studied in the context of tissue repair.Herein,we synthesized mucin-monetite composite materials and investigated their early osteoimmunomodulation using a critical-size rat bone defect model.We demonstrated that the composites can polarize macrophages towards the M2 phenotype at weeks 1 and 2.The early osteoimmunomodulation enhanced early osteogenesis and angiogenesis and ultimately promoted fracture healing and engraftment(revascularization of the host vasculature)at weeks 6 and 12.Overall,we demonstrated the applicability of mucin-based immunomodulatory biomaterials to enhance tissue repair in tissue engineering and regenerative medicine.

关键词： Mucin hydrogels Monetite osteoimmunomodulation Bone revascularization

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Delivery of nitric oxide-releasing silica nanoparticles for in vivo revascularization and functional recovery after acute peripheral nerve crush injury

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Neural Regeneration Research 2022年第9期17卷 2043-2049页

作者： Jung Il Lee Ji Hun Park Yeong-Rim Kim Kihak Gwon Hae Won Hwang Gayoung Jung Joo-Yup Lee Jeong-Yun Sun Jong Woong Park Jae Ho Shin Myoung-Ryul Ok Department of Orthopedic Surgery College of MedicineKorea UniversitySeoulRepublic of Korea Medical Sensor Biomaterial Research Institute Kwangwoon UniversitySeoulRepublic of Korea Center for Biomaterials Korea Institute of Science&TechnologySeoulRepublic of Korea Department of Materials Science and Engineering Seoul National UniversitySeoulRepublic of Korea Department of Orthopedic Surgery College of MedicineCatholic UniversitySeoulRepublic of Korea Department of Chemistry Kwangwoon UniversitySeoulRepublic of Korea

Nitric oxide(NO)has been shown to promote revascularization and nerve regeneration after peripheral nerve injury.However,in vivo application of NO remains challenging due to the lack of stable carrier materials capable of storing large amounts of NO molecules and releasing them on a clinically meaningful time scale.Recently,a silica nanoparticle system capable of reversible NO storage and release at a controlled and sustained rate was introduced.In this study,NO-releasing silica nanoparticles(NO-SNs)were delivered to the peripheral nerves in rats after acute crush injury,mixed with natural hydrogel,to ensure the effective application of NO to the lesion.Microangiography using a polymer dye and immunohistochemical staining for the detection of CD34(a marker for revascularization)results showed that NO-releasing silica nanoparticles increased revascularization at the crush site of the sciatic nerve.The sciatic functional index revealed that there was a significant improvement in sciatic nerve function in NO-treated animals.Histological and anatomical analyses showed that the number of myelinated axons in the crushed sciatic nerve and wet muscle weight excised from NO-treated rats were increased.Moreover,muscle function recovery was improved in rats treated with NO-SNs.Taken together,our results suggest that NO delivered to the injured sciatic nerve triggers enhanced revascularization at the lesion in the early phase after crushing injury,thereby promoting axonal regeneration and improving functional recovery.

关键词： crush injury nerve injury,nerve regeneration nitric oxide peripheral nerve revascularization silica nanoparticles

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Alloyed nanostructures integrated metal-phenolic nanoplatform for synergistic wound disinfection and revascularization

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Bioactive Materials 2022年第10期7卷 95-106页

作者： Yi Xie Shengqiu Chen Xu Peng Xiaoling Wang Zhiwei Wei Joseph J.Richardson Kang Liang Hirotaka Ejima Junling Guo Changsheng Zhao College of Polymer Science and Engineering State Key Laboratory of Polymer Materials EngineeringSichuan UniversityChengduSichuan610065China BMI Center for Biomass Materials and Nanointerfaces College of Biomass Science and EngineeringSichuan UniverisityChengduSichuan610065China Laboratory Animal Center Sichuan UniversityChengduSichuan610065China School of Chemical Engineering Graduate School of Biomedical Engineeringand Australian Centre for NanoMedicineUniversity of New South WalesSydneyNSW2052Australia Department of Materials Engineering School of EngineeringThe University of Tokyo7-3-1 HongoBunkyo-kuTokyo113􀀀8656Japan Bioproducts Institute Departments of Chemical and Biological EngineeringThe University of British ColumbiaVancouverBCV6T 1Z4Canada School of Chemical Engineering Sichuan UniversityChengduSichuan610065China

New materials for combating bacteria-caused infection and promoting the formation of microvascular networks during wound healing are of vital importance.Although antibiotics can be used to prevent infection,treatments that can disinfect and accelerate wound healing are scarce.Herein,we engineer a coating that is both highly compatible with current wound dressing substrates and capable of simultaneously disinfecting and revascularizing wounds using a metal-phenolic nanoplatform containing an alloyed nanostructured architecture(Ag@Cu-MPNNC).The alloyed nanostructure is formed by the spontaneous co-reduction and catalytic disproportionation reaction of multiple metal ions on a foundation metal-phenolic supramolecular layer.This synergistic presence of metals greatly improves the antibacterial activity against both Gram-negative and Gram-positive pathogenic bacteria,while demonstrating negligible cytotoxicity to normal tissue.In infected rat models,the Ag@Cu-MPNNC could kill bacteria efficiently,promoting revascularization and accelerate wound closure with no adverse side effects in infected in vivo models.In other words,this material acts as a combination therapy by inhibiting bacterial invasion and modulating bio-nano interactions in the wound.

关键词： Metal-phenolic network Wound healing Antibacterial activity revascularization

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Hybrid coronary revascularization vs. percutaneous coronary interventions for multivessel coronary artery disease

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Journal of Geriatric Cardiology 2021年第3期18卷 159-167页

作者： Edward L.Hannan Yi-Feng WU Kimberly Cozzens Jacqueline Tamis-Holland Frederick S.K.Ling Alice K.Jacobs Ferdinand J.Venditti Peter B.Berger Gary Walford Spencer B.KingⅢ University at Albany State University of New YorkAlbanyNYUSA Mount Sinai St.Luke’s Hospital New YorkNYUSA University of Rochester Medical Center RochesterNYUSA Boston Medical Center BostonMAUSA Albany Medical Center AlbanyNYUSA Unaffiliated Johns Hopkins Medical Center Emory Health System AtlantaGAUSA

OBJECTIVE Hybrid coronary revascularization(HCR)combines a minimally invasive surgical approach to the left anterior descending(LAD)artery with percutaneous coronary intervention(PCI)for non-LAD diseased coronary arteries.It is associated with shorter hospital lengths of stay and recovery times than conventional coronary artery bypass surgery,but there is little information comparing it to isolated PCI for multivessel disease.Our objective is to compare long-term outcomes of HCR and PCI for patients with multivessel disease.METHODS This cohort study used data from New York’s cardiac surgery and PCI registries in 2010−2016 to examine mortality and repeat revascularization rates for patients with multivessel coronary artery disease who underwent HCR and PCI.Cox proportional hazards methods were used to reduce selection bias.Patients were followed for a median of four years.RESULTS There was a total of 335 HCR patients(1.2%)and 25,557 PCI patients(98.8%)after exclusions.There was no difference in 6-year risk adjusted survival between HCR and PCI patients 83.17%vs.81.65%,adjusted hazard ratio(aHR)=0.90(95%CI:0.67−1.20).However,HCR patients were more likely to be free from repeat revascularization in the LAD artery(91.13%vs.83.59%,aHR=0.51(95%CI:0.34−0.77)).CONCLUSIONS For patients with multi-vessel coronary artery disease,HCR is rarely performed.There are no differences in mortality rates after four years,but HCR is associated with lower repeat revascularization rates in the LAD artery,presumably due to better longevity in left arterial mammary grafts.

关键词： coronary revascularization mortality

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Diabetes mellitus, revascularization and outcomes in elderly patients with myocardial infarction-related cardiogenic shock

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Journal of Geriatric Cardiology 2020年第10期17卷 604-611页

作者： Miquel Gual Albert Ariza-Solé María García Márquez Cristina Fernández JoséL Bernal Francesc Formiga María-Isabel Barrionuevo JoséC Sánchez-Salado Victòria Lorente Júlia Pascual Isaac Llaó Oriol Alegre Angel Cequier Javier Elola Hospital Universitari de Bellvitge L’Hospitalet de LlobregatBarcelonaSpain Fundación Instituto para la Mejora de la Asistencia Sanitaria MadridSpain Hospital Clínico Universitario San Carlos MadridSpain Hospital Universitario 12 de Octubre MadridSpain

Background The prognostic role of diabetes mellitus(DM)in elderly patients with myocardial infarction-related cardiogenic shock(MI-CS)remains controversial.Little information exists about the impact of intensive cardiac care unit(ICCU)and revascularization on outcomes of elderly patients with MI-CS.We aimed to assess the prognostic impact of DM according to age in patients with MI-CS,and to analyze the impact ICCU management and revascularization on in-hospital mortality in MI-CS patients at older ages.Methods Discharge episodes with diagnosis of CS associated with MI were selected from the Spanish National Health System’s Basic Data Set.Centers were classified according to their availability of ICCU.Main outcome measured was in-hospital mortality.Results A total of 23,590 episodes of MI-CS were identified,of whom 12,447(52.8%)were in patients aged≥75 years.The impact of DM on in-hospital mortality was different among age subgroups.While in younger patients,DM was associated to a higher mortality risk(0.52 vs.0.47,OR=1.12,95%CI:1.06–1.18,χ^2revascularization(74.9%vs.77.3%,Prevascularization were associated with better outcomes in these complex patients.

关键词： Cardiogenic shock Diabetes mellitus Myocardial infarction revascularization The elderly

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revascularization and outcomes in Veterans with moderate to severe ischemia on myocardial perfusion imaging

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军事医学研究：英文版 2017年第3期4卷 127-131页

作者： David E.Winchester Alexander J.Bolanos Anita Wokhlu Rebecca J.Beyth Leslee J.Shaw Malcom Randall VAMC North Florida/South Georgia Veterans Health System Division of Cardiovascular Medicine University of Florida College of Medicine Malcom Randall VAMC Department of Medicine University of Florida College of Medicine Division of General Internal Medicine University of Florida College of Medicine Division of Cardiology Emory University School of Medicine

Background: The prevalence of ischemia on nuclear myocardial perfusion imaging(MPI) has been decreasing. Recent research has questioned the benefit of invasive revascularization for patients with moderate to severe ischemia. We hypothesized that patients with moderate to severe ischemia could routinely undergo successful revascularization.Methods: We analyzed data from 544 patients who underwent an MPI at a single academic Veterans Affairs Medical Center. Patients with moderate to severe ischemia, defined as a summed difference score(SDS) 8 or greater, were compared to the rest of the cohort.Results: Of the total cohort(n=544), 39 patients had MPI studies with resultant moderate to severe ischemia. Patients with ischemia were more likely to develop coronary artery disease(74.4% versus 38.8%, Prevascularization(38.5% versus 4.0%, Prevascularization was attempted in 31 patients with moderate to severe ischemia, though only 15(47%) of these attempts were successful. Ischemia was predictive of myocardial infarction(5.1% versus 0.8%, P=0.01) within 1 year.Conclusion: Moderate to severe ischemia is an uncommon finding in a contemporary nuclear laboratory. Among patients with ischemia, revascularization is typically attempted but is frequently unsuccessful.Trial registration: This trial does not appear on a registry as it is neither randomized nor prospective.

关键词： Myocardial ischemia Nuclear myocardial perfusion imaging Veterans revascularization

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Coronary angiography in the very old: impact of diabetes on long-term revascularization and mortality

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Journal of Geriatric Cardiology 2019年第1期16卷 27-32页

作者： Elad Shemesh Barak Zafrir Department of Cardiovascular Medicine Lady Davis Carmel Medical Center

Background Diabetes is often associated with coronary artery disease,leading to adverse clinical outcomes.Real-world data is limited regarding the impact of diabetes in very old patients undergoing coronary angiography on the risk for late or repeated coronary revascularization and mortality.Methods Retrospective analysis of 1,353 consecutive patients>80 years who were admitted to the cardiac unit and further underwent coronary angiography.Subsequent revascularization procedures and all-cause mortality were recorded over a median fbllow-up of 47 months and their relation to diabetic status and presentation with acute coronary syndrome(ACS)was studied.Results Diabetes was present in 31%of the patients undergoing coronary angiography,and was associated with higher rates of obesity,hypertension,hyperlipidemia,chronic kidney disease and female gender.ACS was the presenting diagnosis in 71%of the patients and was associated with worse survival(1-year mortality 20%in ACS vs.6.2%in non-ACS patients,Prevascularization and 1.48(1.26-1.74),Prevascularization and long-term mortality.

关键词： Cardiac catheterization Coronary artery disease Coronary revascularization Diabetes mellitus Mortality Very old age

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New debate of revascularization strategy of non-infarct-related artery lesions in patients with ST-segment elevation myocardial infarction and cardiogenic shock:decoding the CULPRIT-SHOCK trial,not enough to challenge the current guidelines

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Chinese Medical Journal 2019年第5期132卷 613-615页

作者： Fang Song Qiang Wu Xiao-Ping Chen West China School of Medicine Sichuan UniversityChengduSichuan 610041China Department of Cardiology Guizhou Provincial People's HospitalGuiyangGuizhou 550002China Medical College of Guizhou University GuiyangGuizhou 550025China Department of Cardiology West China HospitalSichuan UniversityChengduSichuan 610041China

To the Editor: Research result of CULPRIT-SHOCK trial[1] presented at the Transcatheter Cardiovascular Therapeutics (TCT) 2017 conference suggested that acute myocardial infarction (AMI) patients with multivessel disease (MVD) and cardiogenic shock undergoing primary percutaneous coronary interventions (PCI) treated with culprit-only revascularization (COR) strategy had lower mortality at one month compared with immediate complete revascularization in single procedure (CRS) strategy, which challenge current guidelines and years of consensus[2-5].

关键词： revascularization strategy non-infarct-related artery lesions ST-segment elevation myocardial infarction

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Evaluation of revascularization after total arch replacement in common carotid artery occlusion

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World Journal of Clinical Cases 2018年第1期6卷 6-10页

作者： Yasuhiro Matsuda Tadaaki Koyama Department of Cardiovascular Surgery Kobe City Medical Center General Hospital

Occlusion of the common carotid artery(CCA) is rare. CCA occlusion(CCAO) can present as drowsiness and right hemiplegia related to emboli after total arch replacement. Although we selected a follow-up at first because color duplex sonography showed retrograde flow from the left external carotid artery to the internal carotid artery, this patient had epilepsy and single-photon emission computed tomography(SPECT) acquired quantitative results of actual brain perfusion and showed insufficient collateral blood flow. To improve brain perfusion, we performed a bypass of the left subclavian artery to left CCA bypass. Postoperatively, the patient did not have epilepsy and drowsiness. Also, right hemiplegia improved enough for him to walk with support. SPECT showed increased left cerebral flow(the asymmetry ratio was 71% to 81%). Evaluation of the carotid artery with color duplex sonography alone was insufficient when CCAO showed retrograde or collateral flow. We should have performed quantitative evaluation with SPECT at the same time.

关键词： Color duplex sonography Common carotid artery occlusion revascularization Single-photon emission computed tomography Total arch replacement

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Effect of complete revascularization in acute coronary syndrome after 75 years old:insights from the BleeMACS registry

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Journal of Geriatric Cardiology 2023年第10期20卷 728-736页

作者： Ge WANG Xiu-Huan CHEN Si-Yi LI Ze-Kun ZHANG Wei GONG Yan YAN Shao-Ping NIE JoséP.Henriques on behalf of the BleeMACS registry investigators Center for Coronary Artery Disease Beijing Anzhen HospitalCapital Medical UniversityBeijingChina Department of Cardiology Amsterdam University Medical CenterAmsterdamthe Netherlands 不详

BACKGROUND The prognostic benefit of complete revascularization in elderly patients(aged over 75 years)with multi-vessel disease and acute coronary syndrome(ACS)is currently unclear.This study aimed to determine the long-term prognostic impact of complete revascularization in this population.METHODS We conducted this study using data obtained from the BleeMACS(Bleeding complications in a Multicenter registry of patients discharged after an Acute Coronary Syndrome)registry,which was carried out from 2003 to 2014.The objective was to categorize older patients diagnosed with ACS into two groups:those who underwent complete revascularization and those who did not.Propensity score matching and the Kaplan-Meier analysis were employed to examine differences in one-year clinical outcomes.The primary endpoint was major adverse cardiovascular event(MACE),which encompassed a combination of all-cause mortality and myocardial infarction.RESULTS Out of 1263 patients evaluated,445 patients(35.2%)received complete revascularization.Patients who underwent complete revascularization had a higher prevalence of hypertension and prior percutaneous coronary intervention compared to those who did not.During the one-year follow-up period,complete revascularization was associated with a significantly decreased risk of MACE[13.7%vs.20.5%,hazard ratio(HR)=0.63,95%CI:0.45–0.88,P=0.007]and a lower risk of myocardial infarction(5.9%vs.9.9%,HR=0.55,95%CI:0.33–0.92,P=0.02).However,it was not linked to a lower risk of all-cause death(9.5%vs.13.5%,HR=0.68,95%CI:0.45–1.02,P=0.06).Similar results were observed in the subgroup analysis.CONCLUSIONS Long-term clinical improvements were observed in ACS patients aged over 75 years with multi-vessel disease who achieved complete revascularization.Therefore,adhering to guidelines for complete revascularization should be recommended for elderly patients.

关键词： coronary revascularization acute

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