Maria Werthén

The Extracellular Matrix in Wound Healing: A Closer Look at Therapeutics for Chronic Wounds

Disappointing results with the use of exogenous recombinant growth factors in chronic wounds have redirected the focus to the extracellular matrix (ECM). Newer research has clearly changed our view on the role of the ECM in tissue repair and dismissed the dogma that the sole function of ECM is a passive physical support for cells. It is now clear that intact or fragmented ECM molecules are capable of transducing signals pivotal for cell processes in wound healing primarily via integrin interactions in concert with growth factor activation. In addition, our knowledge about ECM molecules in minute concentrations with biological activity, but devoid of significant structural influence, is increasing. This article reviews the multifaceted molecular roles of ECM in the normal wound-healing process and some molecular abnormalities in chronic wounds, and touches on potential therapies based on the developments of tissue biology.

A diffusion limited reaction theory for a microtiter plate assay

Calculations are presented describing the diffusion limited kinetics of a solid-phase immunoassay in which reactants are immobilized at the inner surface of a cylindrical well. The calculations refer to an unstirred situation and simplified expressions are presented which can be used for calibration and optimization of the assay.

Evaluation of a near-senescent human dermal fibroblast cell line and effect of amelogenin

Background  Fibroblast senescence may delay healing of chronic wounds.

Apoptosis and cytokine release in human monocytes cultured on polystyrene and fibrinogen-coated polystyrene surfaces.

The effects of polystyrene (PS) material surface preadsorption with fibrinogen (3 mg/ml) and a low concentration of lipopolysaccharide (LPS; 10 ng/ml) and polystyrene particles (PS; 10(5)/ml) on human monocyte adhesion, viability and cytokine release were studied during 24h culture in vitro. LPS caused an upregulation of CD14 in adherent cells. In comparison with unstimulated cells on uncoated polystyrene surfaces, LPS did not alter the number of adherent cells but caused a markedly increased release of the proinflammatory cytokines (IL-1alpha and TNF-alpha) and the down-regulating IL-10. The expression of indicators of various stages of cell death, TdT, annexin-V, propidium iodide (PI) and lactate dehydrogenase (LDH), were unaltered, decreased, decreased and increased, respectively, after LPS stimulation. PS particles (3 microm psi) caused an increased DNA fragmentation but had a reduced proportion of annexin-V and PI positive cells in comparison with unstimulated cells on uncoated PS. In contrast, 1microm psi particles had a similar proportion of TdT, annexin-V and PI expressing cells as unstimulated controls. Cultures stimulated with particles (irrespective of size), had a similar concentration of proinflammatory cytokines as unstimulated controls, whereas a higher level of IL-10 was detected. Precoating of PS with fibrinogen revealed an enhanced cell adhesion and a concomitant reduction of CD14 expression. irrespective of stimulation with various agonists. The proportions of TdT, annexin-V and PI positive cells were unaltered or reduced on fibrinogen-coated PS in both unstimulated and agonist-challenged cultures. However, depending on the presence and type of agonist, fibrinogen mediated either a markedly increased (LPS) or equivalent (particles and unstimulated) IL-1alpha and TNFalpha release. Further, in comparison with uncoated substrates, fibrinogen was associated with a reduction of IL-10 release, irrespective of the type of stimuli. These observations, using low concentrations of bacterial and material products, indicate that fibrinogen modulates cell material interactions and up- and down-regulates specific events depending on the nature/ type of immediate stimuli.

Cooperativity in the antibody binding to surface-adsorbed antigen

The binding to surface-adsorbed antigen of monoclonal mouse IgG-antibodies (mAbs), with two different affinities to dinitrophenyl (DNP), was measured by a calibrated ELISA. The concentration-dependence of antibody binding to surface-bound antigen of different epitope densities was analysed using Scatchard plots. The dissociation of bound tritium-labelled antibodies was measured in the presence of unlabelled antibodies in the bulk. At low surface concentration of bound anti-DNP, both high-affinity mAb and low-affinity mAb show a positive cooperativity in the binding reaction to antigen of high epitope density. Using antigen of lower epitope densities, the positive cooperativity is more pronounced for low-affinity clones. At higher surface concentrations of bound anti-DNP, the Scatchard plots indicate a negative cooperativity of binding, which is also implied by the increased dissociation found in the presence of antibodies in solution. The study confirms previous findings that the binding of antibodies to surface-bound antigen not only depends on intrinsic antibody affinity measured in solution. Other factors, such as self-interaction, also affect the heterogeneous binding reaction.

Amelogenins modulate cytokine expression in LPS-challenged cultured human macrophages.

Amelogenins are enamel matrix proteins with a proven ability to restore tissues in patients with advanced periodontitis and chronic skin wounds. To explore the mechanisms of action of amelogenins in wound inflammation, the in vitro effect on the expression of selected cell mediators involved in inflammation and tissue repair from human monocyte-derived macrophages was studied. Macrophages were treated with amelogenins in serum-enriched medium with simultaneous lipopolysaccharide (LPS) stimulation, for 6, 24 and 72 h, and the conditioned culture medium was analysed for 28 different cytokines. Amelogenin treatment directed the LPS-induced release of both pro- and anti-inflammatory cytokines towards an alternatively activated macrophage phenotype. This change in activation was also demonstrated by the amelogenin-induced secretion of alternative macrophage activation-associated CC chemokine-1 (AMAC-1, also known as CCL18; p<0.001), a well-documented marker of alternative activation. Amelogenins were also shown significantly to increase the macrophage expression of vascular endothelial growth factor and, to a lesser but significant extent, insulin-like growth factor-1 after 24h of culture. The results of the present in vitro study show that monocyte-derived macrophages stimulated by inflammatory agonist LPS respond to the treatment with amelogenins by reducing the pro-inflammatory activity and increasing the expression of tissue repair mediators.

Amelogenins promote an alternatively activated macrophage phenotype in vitro

Amelogenins are extracellular matrix proteins used for the topical treatment of chronically inflamed tissues. The influence of amelogenins on human monocyte-derived macrophages was studied by measuring the concentrations of cytokines in culture supernatants. The interactions of cells and protein aggregates were visualised by transmission electron microscopy. The amelogenin treatment of macrophages increased several pro- and anti-inflammatory cytokines, including alternative macrophage activation marker AMAC-1 (p < 0.001) and vascular endothelial growth factor (VEGF; p < 0.001). The levels were independent of cytochalasin B, although amelogenin aggregates were ingested by macrophages. Amelogenin effect was compared with that of tyrosine-rich amelogenin peptide, which apart from augmented VEGF levels (p < 0.05), had no significant influence on the other cytokines analysed. In conclusion, amelogenins increased the macrophage release of key cell mediators involved in tissue repair. The effect was independent of phagocytosis, implying a receptor-mediated signal. The markedly increased levels of AMAC-1 suggest that amelogenins promote a reparative macrophage phenotype.