O. L. Zakharkina

IR Laser and Heat-induced Changes in Annulus Fibrosus Collagen Structure

The purpose of this study was to characterize essential changes in the structure of annulus fibrosus (AF) after hydrothermal and infrared (IR) laser treatment and to correlate these results with alterations in tissue state. Polarization‐sensitive optical coherence tomography imaging was used to measure collagen birefringence in AF. Differential scanning calorimetry was used as a complementary technique, providing detailed information on thermodynamic processes in the tissue. Birefringence, peak of the denaturation endotherm, and the enthalpy of denaturation (ΔHm) were determined before and after hydrothermal heat treatment (85°C for 15 min) and non‐ablative Er:glass fiber laser exposures on AF in the whole disk (vertebrae‐disk–vertebrae complex). Our data have demonstrated quantitative differences between results of laser and hydrothermal heating. Birefringence did not disappear and ΔHm did not change after treatment in the water bath, but loss of birefringence and a decrease in the enthalpy did occur after laser exposure. These results could be explained by the photomechanical effect of laser irradiation. We suggest that thermo‐mechanical stress played a dominant role in the disruption of the collagen network of AF under non‐homogeneous laser heating.

Effects of laser irradiation on collagen organization in chemically induced degenerative annulus fibrosus of lumbar intervertebral disc

The number of in vitro experimental studies was carried out with the use of intact tissues to establish a mechanism of laser–tissue interaction. However, in the process of degeneration, both biochemical composition and behavior of the disc were altered drastically. The objective of this study was to evaluate the role of the main matrix components in laser modification of annulus fibrosus (AF) under IR laser irradiation.

Effects of gamma irradiation on collagen damage and remodeling

Abstract Purpose: To evaluate the dose-time dependences of structural changes occurring in collagen within 24 hours to three months after gamma-irradiation at doses from 2–40 Gy in vivo. Materials and methods: Rats tail tendon was chosen as in vivo model, with its highly ordered collagen structure allowing the changes to be interpreted unambiguously. Macromolecular level (I) was investigated by differential scanning calorimetry (DSC); fibers and bundles level (II) by laser scanning microscopy (LSM), and bulk tissue microstructural level (III) by cross-polarization optical coherence tomography (CP-OCT). Results: For (I), the formation of molecular cross-links and breaks appeared to be a principal mechanism of collagen remodeling, with the cross-links number dependent on radiation dose. Changes on level (II) involved primary, secondary and tertiary bundles splitting in a day and a week after irradiation. Bulk collagen microstructure (III) demonstrated early widening of the interference fringes on CP-OCT images observed to occur in the tendon as result of this splitting. At all three levels, the observed collagen changes demonstrated complete remodeling within ∼ a month following irradiation. Conclusion: The time course and dose dependencies of the observed collagen changes at different levels of its hierarchy further contribute to elucidating the role of connective tissue in the radiotherapy process.

Regeneration of spine disc and joint cartilages under temporal and space modulated laser radiation

The effect of laser radiation on the generation of hyaline cartilage in spine disc and joints has been demonstrated. The paper considers physical processes and mechanisms of laser regeneration, presents results of investigations aimed to optimize laser settings and to develop feedback control system for laser reconstruction of spine discs. Possible mechanisms of laser-induced regeneration include: (1) Space and temporary modulated laser beam induces nonhomogeneous and pulse repetitive thermal expansion and stress in the irradiated zone of cartilage. Mechanical effect due to controllable thermal expansion of the tissue and micro and nano gas bubbles formation in the course of the moderate (up to 45-50 oC) heating of the NP activate biological cells (chondrocytes) and promote cartilage regeneration. (2) Nondestructive laser radiation leads to the formation of nano and micro-pores in cartilage matrix. That promotes water permeability and increases the feeding of biological cells. Results provide the scientific and engineering basis for the novel low-invasive laser procedures to be used in orthopedics for the treatment cartilages of spine and joints. The technology and equipment for laser reconstruction of spine discs have been tested first on animals, and then in a clinical trial. Since 2001 the laser reconstruction of intervertebral discs have been performed for 340 patients with chronic symptoms of low back or neck pain who failed to improve with non-operative care. Substantial relief of back pain was obtained in 90% of patients treated who returned to their daily activities. The experiments on reparation of the defects in articular cartilage of the porcine joints under temporal and spase modulated laser radiation have shown promising results.

Laser Regeneration of Spine Discs Cartilage: Mechanism, In-Vivo Study and Clinical Applications

Laser Reconstruction of the spine discs (LRD) is a novel minimally invasive approach for the treatment of spine diseases. This approach belongs to the laser therapy, but it differs from low intensity laser therapy because LRD uses local and moderate heterogeneous laser heating that mostly does not effect directly on the cells; LRD procedure modifies the extra cellular matrix to provide better surroundings for the cells. Our main finding is that laser irradiation can activate the growth of hyaline cartilage. The predictability of the result, the locality and safety of laser effect allowed to use the technology for spine problems. LRD can be performed in an outpatient setting requiring only 30 min to complete without the need for general anesthesia. The new type of Erbium doped glass fiber laser (1.56 mm in wavelength) has been tested first on animals and then in a clinical trial. The mechanism of laser-induced tissue regeneration include: (1) formation of nanopores enchasing water permeability through end plates and annulus fibrosus of the disc that provide feeding for biological cells, and (2) activation of cell due to mechanical oscillations resulting from the periodically thermo expansion of nucleus pulposus under modulated laser irradiation. The clinical trials have shown positive results for 90% from 240 laser treated patients.

Eye tissue structure and refraction alterations upon nondestructive laser action

A new approach to alterations in eye refraction upon nondestructive laser action on the sclera and cornea is studied. It is demonstrated in in vivo experiments on rabbit eyes that sequential laser irradiation of the sclera and cornea yields a significant alteration in the eye refraction. The collagen structure of the sclera and cornea is studied after the nondestructive laser action with noninvasive polarization-sensitive optical coherence tomography. It is demonstrated that collagen fibers that provide for the cornea tension and applanation partially survive in the zone of the local denaturation of sclera. An irradiation mode that corresponds to an increase in the cornea’s plasticity and does not cause visible structural changes is chosen. The simplest theoretical model for alterations in the eye refraction upon the nonablative laser action on sclera is analyzed. The alteration in the cornea curvature upon stretching resulting from the local sclera coagulation and the corresponding decrease in its volume is calculated. The model makes it possible to approximately estimate the laser irradiation modes that provide the desired alterations in eye refraction.

Ex vivo laser thermoplasty of whole costal cartilages

To examine the possibilities of laser thermoplasty of whole costal cartilages for correction the human congenital chest wall deformities.

[Morphology of collagen matrices for tissue engineering (biocompatibility, biodegradation, tissue response)].

OBJECTIVE to perform a comparative morphological study of biocompatibility, biodegradation, and tissue response to implantation of collagen matrices (scaffolds) for tissue engineering in urology and other areas of medicine. MATERIAL AND METHODS Nine matrix types, such as porous materials reconstructed from collagen solution; a collagen sponge-vicryl mesh composite; decellularized and freeze-dried bovine, equine, and fish dermis; small intestinal submucosa, decellularized bovine dura mater; and decellularized human femoral artery, were implanted subcutaneously in 225 rats. The tissues at the implantation site were investigated for a period of 5 to 90 days. Classical histology and nonlinear optical microscopy (NLOM) were applied. RESULTS The investigations showed no rejection of all the collagen materials. The period of matrix bioresorption varied from 10 days for collagen sponges to 2 months for decellularized and freeze-dried vessels and vicryl meshes. Collagen was prone to macrophage resorption and enzymatic lysis, being replaced by granulation tissue and then fibrous tissue, followed by its involution. NLOM allowed the investigators to study the number, density, interposition, and spatial organization of collagen structures in the matrices and adjacent tissues, and their change over time during implantation. CONCLUSION The performed investigation could recommend three matrices: hybrid collagen/vicryl composite; decellularized bovine dermis; and decellularized porcine small intestinal submucosa, which are most adequate for tissue engineering in urology. These and other collagen matrices may be used in different areas of regenerative medicine.

Effect of Venous Wall Immobilization on the Thermal Degradation of Collagen

The results from a comparative study of the thermal denaturation of collagen in the venous walls of reference samples and samples with varicose disease are presented. Changes in the organization of collagen network of the tissue matrix are detected via thermal analysis and multiphoton microscopy with recording of the second harmonic generation (SHG). It is established that the collagen network of venous walls degrades in varicose disease. It is shown that the disordering of the tertiary structure of collagen molecules is reflected in a 40% drop in the enthalpy of protein denaturation compared to reference (ΔHD = 12.4 ± 4.9 J/g dry residue). The disorganization of fiber structures is recorded on SHG images. It is shown that upon the hydrothermal heating of sequestered samples of venous walls, the complete degradation of the tissue network occurs at 75°C. However, it is noted that upon the mechanical immobilization of samples of both types, the stability of collagen increases and complete denaturation is observed at temperatures above 84°C. It is suggested that the number of available conformations of polypeptide chains in the random coil state falls under tension, lowering ΔSD and raising the temperature of the denaturation of protein.

The study of radiation-induced damage and remodeling of extracellular matrix of rectum and bladder by second-harmonic generation microscopy

Adverse events in normal tissues after irradiation of malignant tumors are of great importance in modern radiation oncology. Second harmonic generation (SHG) microscopy allows observe the structure of collagen fibers and bundles without additional staining. The study objective was evaluation the dose-time dependences of the structural changes occurring in collagen of rat rectum and bladder after gamma-irradiation. Animals were irradiated by a local field at single doses of 10 Gy and 40 Gy. The study of collagen state was carried out in a week and a month after radiation exposure. Paraffin-embedded material was sectioned on the slices 10 mkm thick and SHG-imaging was performed by LSM 510 Meta (Carl Zeiss, Germany). Excitation was implemented with a pulsed (100-fs) titanium-sapphire laser at a wavelength of 800 nm and a pulse repetition frequency of 80 MHz, registration was performed at two wavelengths: 362-415 nm according to collagen fluorescence and 512-576 nm according to myoglobin fluorescence. In a week after irradiation, sings of epithelial damage and edema of submucosal layer, more significant after the dose of 40 Gy were observed on LSM-images. The SHG signal decreased at this time reflecting the processes of collagen degradation independently either in bladder or in rectum. In a month after radiation the increase of size and number of collagen-bearing structures was observed, more essential after irradiation in a dose of 40 Gy. LSM microscopy with SHG allows evaluate changes of normal tissues after ionizing radiation and get information in addition to standard and special histological staining.