OBJECTIVETo investigate the dynamic process of the inflammatory response and the profile of Th1/Th2 cytokines after xenogenic acellular dermal matrix (ADM) transplantation with thin split-thickness skin autograft overlay.

METHODSSD rats were used in the study. In the control group, thin split-thickness skin autograft (STSG) was transplanted in the full-thickness skin defect of the SD rats; in the experimental group, the xenogenic acellular dermal matrix combined with thin split-thickness skin autograft was transplanted. The inflammatory response was examined histologically and Th1/Th2 cytokine mRNA expression in skin grafts was determined by reverse transcription-polymerase chain reaction.

RESULTSInflammatory reaction was induced by ADM at the early stage of transplantation and decreased gradually. Th2 cytokine mRNA expression was higher in the ADM group than that of the control group whereas the Th1 cytokine mRNA expression was undetected in both groups.

CONCLUSIONXenogenic acellular dermal matrix is immunogenic. The increased expression of Th2 cytokines may be related to the humoral immune responses and the absence of ADM graft rejection.

Animals ; Cytokines ; genetics ; Dermis ; immunology ; transplantation ; Gene Expression ; Inflammation ; immunology ; Interferon-gamma ; genetics ; Interleukin-2 ; genetics ; Male ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Skin Transplantation ; methods ; Swine ; Transplantation, Autologous ; Transplantation, Heterologous

OBJECTIVETo observe the dynamic process of basement membrane remodeling after the combined grafting of xenogenic acellular dermal matrix with autoskin.

METHODSThe rat skin wounds were covered with xenogenic porcine acellular dermal matrix overlaid with razor thin autoskin. The skin samples were collected at 1, 2, 3, 4, 8, 12 and 16 post-grafting weeks. The changes in laminin expression in the basement membrane and the ultrastructure of the basement membrane at 12 post-grafting weeks were observed by immunohistochemistry and transmission electron microscopy. The results were compared with those in simple thin autoskin grafting as the control.

RESULTSThe laminin expression in the combined grafting was higher than that in control. At 12 post-grafting weeks, the basement membrane in combined grafting rats was clear and continuous and the hemidesmosome was relatively more in amount and distributed evenly. While in the autoskin group, the lamina densa in the basement membrane was blurred and discontinuous with a decrease in and uneven distribution of hemidesmosome.

CONCLUSIONThe increased expression of laminin in the basement membrane in the combined grafting rats might be beneficial to the remodeling of the basement membrane and to strengthening the connection of epithelium to the dermis, thus wound healing quality would be improved.

Animals ; Basement Membrane ; metabolism ; ultrastructure ; Burns ; surgery ; Dermis ; transplantation ; Immunohistochemistry ; Laminin ; biosynthesis ; Male ; Microscopy, Electron ; Rats ; Rats, Wistar ; Skin Transplantation ; methods ; Swine ; Time Factors ; Transplantation, Autologous ; Transplantation, Heterologous ; Wound Healing

Objective To compare the clinical efficacy and safety between recombinant human parathyroid hormone ( rhPTH) ( 1 -34) and elcatonin in the treatment of postmenopausal women with osteoporosis in China.Methods This 6 month, multicenter, randomized and controlled study enrolled 205 postmenopausal women with osteoporosis.They were randomized to receive either rhPTH (1 -34) 20 μg (200 U) daily or elcatonin 20 U weekly.Lumbar spine (L1-4 ) and femoral neck bone mineral density (BMD) and biochemical markers of bone turnover were measured. In the meantime adverse events were recorded. Results The results showed that both rhPTH ( 1 -34) and elcatonin increased L1-4 BMD significantly at the endpoint of the study, but femoral neck BMD did not change significantly.From baseline to endpoint, BMD of L1-4 and femoral neck in the rhPTH( 1-34) group increased by 5.51% (P <0.01) and 0.65% (P >0.05), but BMD of L1-4 and femoral neck in elcatonin group increased by 1.55% (P <0.05) and 0.11% (P>0.05).Moreover, the rhPTH(1-34) group had better improvement in L1-4 BMD than the elcatonin group at 3, 6 months, but there was no difference of BMD in these two groups with regard to femoral neck.There were greater mean increases of the bone markers in the rhPTH( 1-34) group than those in the elcatonin group at 3, 6 months [serum bone-specific alkaline phosphatase ( BSAP) 36.79% vs 0.31% ; 92.42% vs -0.17% ; the ratio of urine N-telopeptide of type I collagen and creatinine (NTX/Cr) 48.91% vs -5.32% ; 68.82% vs - 10.86%].Both kinds of treatment were well tolerated and there were no differences between the two groups in the rates of adverse events and serious adverse events.Conclusion It is concluded that rhPTH (1 -34) has more positive effects on bone formation than elcatonin as shown by the greater increments of L1-4 BMD and bone formation markers and the less occurrence of adverse events as well as no significant change in hepatic, renal or hemopoietic function.

Objective Recombinant human parathyroid hormone(1-34) [ rhPTH(1-34)] is the unique anabolic substance acting on the skeleton. The efficacy and safety of long-term administration of rhPTH(1-34) in Chinese postmenopausal women have not been evaluated. This study compared the clinical efficacy and safety of rhPTH(1-34) with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China. Methods A total of453 postmenopausal women with osteoporosis were enrolled in an 18-month, multi-center, randomized, controlled study. They were randomized to receive either rhPTH(1-34) 20 μg(200 U) daily for 18 months, or elcatonin 20 U weekly for 12 months. Lumbar spine ( L1-4) and femoral neck bone mineral density (BMD), fracture rate, back pain as well as biochemical markers of bone turnover ( serum bone-specific alkaline phosphatase was measured by radioimmunoassay; C-telopeptide/ creatinine ( CTX/ Cr) measured by quantitative sandwich enzyme-linked immunosorbent assay) at 6, 12, and 18 months. Adverse events were recorded. Results rhPTH(1-34) increased lumbar BMD more significantly than that did by elcatonin at 6 months( M6), 12 months (M12), and 18 months(M18; 4. 3% vs 1. 94% , 6. 8% vs 2. 72% , 9. 51% vs 2. 86% , P<0. 01). There was only a small but significant increase of femoral neck BMD at M18(2. 64% , P<0. 01) in rhPTH(1-34) groups. There were greater increases in bone turnover markers in the rhPTH(1-34) group than in the elcatonin group at M6, M12, and M18[serum bone-specific alkaline phosphatase(BSAP) 93. 67% vs -3. 56% , 117. 78% vs -4. 12% , 49. 24% vs-5. 81% , P<0. 01; urinary CTX/ Cr 250% vs -29. 5% , 330% vs -41. 4% , 273 % vs -10. 6% , P<0. 01]. rhPTH (1-34) showed similar effect of pain relief as elcatonin. The incidence of clinical fractures was 5. 36% (6 / 112) in elcatonin group and 3. 23% ( 11 / 341 ) in rhPTH ( 1-34 ) group ( P = 0. 303 ). Both treatments were well tolerated. Hypercaluria(9. 38% ) and hypercalcemia(7. 04% ) in rhPTH(1-34) group was transient and caused no clinical symptoms. Pruritus(8. 21% vs 2. 68, P=0. 044) and redness of injection site(4. 40% vs 0, P=0. 024) were more frequent in rhPTH(1-34). Nausea / vomiting(16. 07% vs 6. 16% , P = 0. 001) and hot flushes(7. 14% vs 0. 59% , P<0. 001) were more common in elcatonin group. Conclusion rhPTH(1-34) treatment was associated with greater increases in lumbar spine BMD and bone formation markers. It could increase femoral BMD after 18 months treatment. rhPTH(1-34) could ameliorate back pain effectively. The results of the present study indicate that rhPTH(1-34) is an effective, and safe agent in treating postmenopausal women with osteoporosis.