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Biomedical subjects

J F Hansbrough

Publications and source records attributed to J F Hansbrough.

At least 19 recordsLinked to original sources

Absence of tumorigenicity in athymic mice by normal human epidermal keratinocytes after culture in serum-free medium.

The very rapid growth rate (1 population doubling/day) of normal human epidermal keratinocytes (HK) cultured in serum-free medium can be utilized for wound closure in burn treatment. However, rapid growth in vitro may present the possibility of neoplastic transformation. To investigate this possibility, HK were cultured from primary isolation to large populations in MCDB 153 medium supplemented with epidermal growth factor (EGF, 10 ng/ml), insulin (5 micrograms/ml), hydrocortisone (0.5 micrograms/ml), and Bovine Pituitary Extract (BPE, 70 micrograms/ml). HK were studied for their ability to form tumors in athymic mice after subcutaneous inoculation. Sixteen separate HK strains were inoculated from primary cultures, or from secondary cultures either before or after storage in liquid nitrogen. Transformed cell lines, SCC 13 and FL, derived from human epithelial carcinomata were used as controls for tumor formation. HK formed no tumors (0/79) after 26 weeks incubation, SCC 13 formed nodular tumors (3/5) after 20 weeks incubation, and FL formed tumors (5/5) after 4 weeks incubation. HK cells were not found by histological examination of inoculation sites of keratinocyte cultures derived from primary culture from skin. In contrast, palpable tumors from both SCC 13 and FL were returned to tissue culture and continued to proliferate. These results support the conclusion that the rapid growth rate of human epidermal keratinocytes in vitro can be attributed to permissive culture conditions, and not to neoplastic transformation.

Animals

Immunologic alterations in a murine model of hemorrhagic shock.

OBJECTIVE: To study multiple immune parameters in mice subjected to severe hemorrhage without fluid resuscitation. STUDY DESIGN: Controlled animal study. Anesthetized, female mice were hemorrhaged by tail bleeding. Immune parameters (spleen T-cell proliferation and activation, intracellular calcium flux, cytokine production, peritoneal neutrophil respiratory burst, and survival after intra-abdominal septic challenge) were measured at 24, 48, and 72 hrs after hemorrhage. MEASUREMENTS AND MAIN RESULTS: T-cell proliferation was decreased in animals after two 20% blood volume hemorrhages, 30 mins apart; single 30%, 40%, and 50% blood volume hemorrhages did not depress proliferation. "Helper/inducer" T cells from twice-hemorrhaged mice showed decreased expression of activation antigens (interleukin-2 receptor, Ia) after mitogen stimulation. In contrast, "suppressor/cytotoxic" T cells displayed increased activation, shown by augmented expression of interleukin-2 receptor and Ia antigens. Leukocyte production of prostaglandin E2, a mediator frequently implicated in immune down-regulation, was unaffected by hemorrhage. Secretion of tumor necrosis factor-alpha (TNF-alpha) in culture was increased when cells were harvested 48 hrs after injury. Intracellular calcium flux in stimulated lymphocytes was decreased 24 hrs after hemorrhage, suggesting deranged intracellular signal transduction. Respiratory burst activity of peritoneal neutrophils was unchanged following hemorrhage. When animals were subjected to septic challenge, the survival rate was markedly decreased after two hemorrhages (when sepsis was induced 24 hrs after hemorrhage). By 72 hrs posthemorrhage, most of the immunologic alterations, including resistance to septic challenge, had resolved. CONCLUSIONS: This uninstrumented hemorrhagic shock model allows quantification of multiple immune derangements. Immune suppression was identified after two smaller (20% blood volume) hemorrhages, but not after a single, larger hemorrhage. Immune derangements are maximal at 24 hrs posthemorrhage, and resolve in the subsequent 48 hrs.

Analysis of Variance

Evaluation of a biodegradable matrix containing cultured human fibroblasts as a dermal replacement beneath meshed skin grafts on athymic mice.

Meshed, expanded split-thickness skin grafts (MSTSG) frequently achieve poor results when used to cover full-thickness wounds. Poor cosmetic and functional results occur in part because the epithelium that grows across the skin graft interstices lacks a dermis. We used a living dermal replacement composed of either polyglycolic acid (PGA) or polyglactin-910 (PGL) mesh containing confluent, cultured human fibroblasts. These grafts were applied to full-thickness wounds on athymic mice; widely expanded, 3:1 ratio human MSTSG was then placed over the dermal graft. Histologic examination of wounds during a 99-day period after graft placement showed that PGA/PGL-fibroblast grafts vascularized to the wound, and the MSTSG simultaneously vascularized to the PGA/PGL-fibroblast graft. Epithelialization from the MSTSG bridges proceeded rapidly across the surface of the PGA/PGL-fibroblast grafts, resulting in an epithelialized layer that covered a densely cellular substratum that resembled dermis. Basement membrane formation at the dermal-epidermal junction of the epithelialized interstices was confirmed by immunohistochemical microscopy. Minimal inflammatory reaction to the PGA/PGL-fibroblast grafts was seen. Grafts composed of PGA or PGL biodegradable meshes combined with cultured fibroblasts vascularize in full-thickness wounds, resulting in formation of organized tissue beneath the epithelialized surface that resembles dermis.

Animals

Effects of topical antimicrobial agents on the human neutrophil respiratory burst.

The neutrophil oxidative burst plays an important role in killing intracellular microorganisms. We studied the effects of topical antimicrobial agents on the N-formyl-L-methionyl-L-leucyl-L-phenylalanine-stimulated oxidative burst of human peripheral blood neutrophils, using a flow cytometric assay. Mafenide acetate, sulfadiazine silver, gentamicin sulfate, neomycin sulfate-polymyxin B sulfate (Neosporin GU irrigant), acetic acid, amphotericin B, and povidone-iodine inhibited the neutrophil oxidative burst at or below clinical concentrations, while 0.25% modified diluted sodium hypochlorite (Dakin's) solution caused cell death. Bacitracin-polymyxin B sulfate (Polysporin) greatly augmented the respiratory burst; this effect was due to the bacitracin component. Diluted gentamicin and acetic acid also augmented intracellular hydrogen peroxide production, but to a lesser extent than Polysporin. Inhibition of the respiratory burst of neutrophils might be considered when these agents are used for topical wound care, although clinical correlates of these effects have not been determined.

Acetates

In vivo optimization of a living dermal substitute employing cultured human fibroblasts on a biodegradable polyglycolic acid or polyglactin mesh.

The design of a skin-substitute must address the need for a dermal component, as this mesenchymally-derived tissue is important in maintaining the integrity and function of skin. An in vivo study was undertaken to assess the use of two biodegradable meshes, polyglycolic acid and polyglactin-910, as carriers for cultured human fibroblasts in a living dermal replacement. The consistent vascularization and epithelialization of these grafts placed on athymic mice showed that this has potential in re-creating the dermis in a skin-substitute.

Animals

The cytotoxic effects of commonly used topical antimicrobial agents on human fibroblasts and keratinocytes.

This study evaluated the cytotoxicity of commonly used topical agents to human dermal fibroblasts and epidermal keratinocytes, which play a prominent role in wound healing. The effects of these topical agents were assessed using two separate assays for the fibroblasts--tritiated thymidine incorporation and the uptake of a vital dye (neutral red). Keratinocytes were evaluated with the neutral red assay. Serial dilutions of each of 10 commonly used topical agents produced decreases in both the uptake of neutral red and the incorporation of thymidine at clinically relevant doses. Only Neosporin G.U. irrigant showed no significant difference compared with controls in the assays for both the fibroblasts and the keratinocytes. Careful attention must be paid to which agent is used in the clinical setting, since many of these can have profound effects on cells that influence wound healing.

Acetates

Reconstitution of the histologic characteristics of a giant congenital nevomelanocytic nevus employing the athymic mouse and a cultured skin substitute.

This study addresses the development of an animal model for human giant congenital nevomelanocytic nevi (GCNN). Skin grafts were made from 1) non-involved split-thickness skin from a 12-month-old GCNN patient, 2) nevus split-thickness skin from the same GCNN patient, 3) nevus full-thickness skin, and 4) cadaveric human split-thickness skin. For groups 1) and 2), human epidermal and dermal cells were enzymatically isolated and expanded in tissue culture. Composite grafts were made by placing the cultured dermal cells into a collagen-glycosaminoglycan (GAG) matrix, followed by placement of the epidermal cells onto the opposite, laminated side of the matrix. All grafts were placed onto full-thickness wounds of athymic mice and biopsies were obtained from 6 to 38 weeks later for light microscopy including S-100 immunoperoxidase staining, and electron microscopy. The GCNN cultured skin mice (group 2) developed black, raised skin in the healed wounds. None of the group 1 mice developed lesions, grossly or histologically. All of the nevus full-thickness mice retained the nevus grossly. Histopathologic examination at 38 weeks of the black, raised plaques of group 2 demonstrated a reconstituted dermis similar to group 3. Nevus cells were larger and more epithelioid in the upper dermis, as seen with true GCNN. These nevomelanocytes were not seen in the dermis at 24 weeks, suggesting that the nevus cells migrated from the epidermal component of the cultured graft to the dermis during this time frame (24-38 weeks). The melanocyte identity of these cells was confirmed with S-100 immunoperoxidase staining and electron microscopy. These findings are unique to this composite cultured graft system. The ability to culture specific types of melanocytes and place them int skin substitutes on athymic mice provides a basis for the study of GCNN and melanocyte biology in vivo.

Animals

Skin wound closure in athymic mice with cultured human cells, biopolymers, and growth factors.

Skin wound closure remains a major problem in acute and reconstructive skin grafting after large burns because of limited availability of donor skin. This report evaluates six protocols for preparation in vitro of skin substitutes composed of cultured human cells, biopolymers, and growth factors for wound closure. Full-thickness wounds in athymic mice treated in a single procedure with cultured skin substitutes were compared directly to treatments with murine skin autograft, human skin xenograft, or no graft. Rectilinear planimetry of healed wounds 6 weeks after surgery showed that skin substitutes cultured in serum-free medium, and for 24 hours before surgery in defined medium with basic fibroblast growth factor (100 ng/ml), were not statistically different (p less than 0.05) in size from treatment with human skin xenograft. Acceptance and persistence of skin substitutes cultured in serum-free media were 70% at 6 weeks after surgery, as determined by staining of healed skin with a fluorescein-labeled monoclonal antibody against human HLA-ABC antigens. Ultrastructural examination of wounds with cultured human skin 6 weeks after treatment showed complete basement membrane, including anchoring fibrils, presence of melanocytes and pigment transfer to keratinocytes, and innervation of healed skin adjacent to basement membrane. These findings demonstrate effectiveness of cultured skin substitutes for closure of skin wounds and illustrate important capabilities to modulate the natural processes of wound repair, to increase supply of materials used for wound repair, and to enhance quality of wound healing.

Animals

Use of a composite skin graft composed of cultured human keratinocytes and fibroblasts and a collagen-GAG matrix to cover full-thickness wounds on athymic mice.

In patients with extensive full-thickness burns, wound coverage may be accelerated if skin can be expanded to produce a skin replacement that reproducibly supplies blood to the wound and has good structural qualities. In addition, development of skin replacements may benefit patients who require reconstruction or replacement of large areas of abnormal skin. We have developed a composite skin replacement composed of cultured human keratinocytes (HK) and fibroblasts. Cultured human fibroblasts are seeded into the interstices, and cultured HKs are applied to the surface of a matrix composed of type I collagen crosslinked with a glycosaminoglycan, which has a defined physical structure. After HKs reach confluence on the matrix surface, the composite grafts are placed on full-thickness wounds on the dorsum of athymic mice. Graft acceptance, confirmed by positive staining with antibodies specific for human HLA-ABC antigens on HKs, is approximately 90%. A defined skin structure is present histologically by day 10 after grafting, with a differentiated epithelium and a subepidermal layer densely populated by fibroblasts and capillaries without evidence of inflammation. Fluorescent light microscopy to identify laminin and type IV collagen and electron microscopy confirm the presence of basement membrane components by 10 days after grafting. Attachment of the graft to the wound is similar with and without the addition of human basic fibroblast growth factor, a potent angiogenic agent, to the skin replacement before graft placement on wounds.

Animals

Cardiovascular and neurohumoral responses following burn injury.

Cardiovascular and endocrine responses were evaluated in 12 adult patients over a 5-day period following 30% to 66% burn injury. Heart rate, mean arterial pressure, central venous pressure, pulmonary capillary wedge pressure, cardiac output, systemic vascular resistance, and stroke volume were measured. Plasma concentrations of angiotensin II, atrial natriuretic peptide, vasopressin, neuropeptide Y, norepinephrine, and epinephrine were measured. On the day of burn injury, systemic vascular resistance was markedly elevated, and stroke volume and cardiac output were low, but all normalized by day 3, and cardiac output and stroke volume increased by day 5 without significant changes of central venous pressure or pulmonary capillary wedge pressure. Mean arterial pressure and heart rate did not change significantly over the 5-day period. Vasopressin, angiotensin II, neuropeptide Y, norepinephrine, and epinephrine concentrations in plasma were elevated on admission. Vasopressin concentrations were elevated 50 times normal on admission and returned to normal levels by days 4 to 5. Plasma atrial natriuretic peptide concentrations were normal on admission and increased significantly on days 3 to 5. The reciprocal relationship between systemic vascular resistance and cardiac output and between vasopressin and atrial natriuretic peptide correlate with each other and the observed physiologic events that occurred following burn injury and resuscitation. All of these changes in cardiac performance occurred without significant alterations in preload or afterload as measured by central venous pressure, pulmonary capillary wedge pressure, and mean arterial pressure. Increases in plasma levels of atrial natriuretic peptide correlated with the increased stroke volume and cardiac output observed in these patients. The results of this study are consistent with the conclusion that the extreme elevations of plasma vasopressin levels contribute to the vascular complications of increased systemic vascular resistance and decreased cardiac output and contractility seen following burn injury.

Adult

Postburn suppression of murine lymphocyte and neutrophil functions is not reversed by prostaglandin blockade.

Certain arachidonic acid metabolites, including prostaglandins (PGs) E1 and E2, have been shown to exert marked immunosuppressive effects on T-cell and macrophage functions. Cyclooxygenase blockade with indomethacin or ibuprofen may ameloriate these effects. In the current study we measured lymphocyte proliferation by thymidine incorporation, the presence of T-cell activation antigens with monoclonal antibodies and two-color flow cytometry, and neutrophil (PMN) oxidative burst using a fluorescent marker, in control mice and in burned mice treated with indomethacin for 10 days after injury. One-half of the cell cultures were treated with indomethacin in vitro to ensure its continued presence during stimulation. Separate groups of mice were fed a fish oil-based diet which leads to the production of PGE3 rather than PGE2, versus standard mouse chow, a soy-bean oil-based diet which leads to PGE2 production. Lymphocyte proliferation, expression of T-cell activation antigens, and PMN oxidative burst remained depressed in burned mice treated with indomethacin in vivo (plus in vitro) and in those which received the fish oil-based diet, compared to control. Blockade of PG synthesis after murine burn injury by cyclooxygenase inhibition or alterations in the diet failed to restore T-lymphocyte activation or proliferation or to improve PMN oxidative burst. These data suggest that PGE2 alone does not explain the immunosuppression noted after burn injury.

Animals

Cytotoxicity to cultured human keratinocytes of topical antimicrobial agents.

Cultured skin grafts administered clinically for closure of burn wounds may be contacted by topically applied antimicrobial agents. A study was performed to assess whether commonly used topical antimicrobial agents are toxic to cultured human keratinocytes (HK) in vitro. Serum-free MCDB 153 culture medium containing Neosporin G.U. irrigant (Neomycin, 40 micrograms/ml-polymyxin B sulfate, 200 units/ml) and a standard tissue culture antimicrobial agent of penicillin (10,000 units/ml)-streptomycin (10,000 micrograms/ml)-amphotericin B (25 micrograms/ml) had no effect on the keratinocyte growth rates when compared to standard MCDB 153 medium without antibiotics. Medium containing Sulfamylon (mafenide acetate, 0.85%), Polysporin (polymyxin B sulfate, 1 x 10(4) units/ml-bacitracin, 500 units/ml), gentamicin sulfate (0.1%), modified Dakins solution (25%), and acetic acid (0.25%) all showed statistically significant (P less than 0.01) decreases in keratinocyte growth rates. This data suggests that commonly applied antimicrobials may not be appropriate for cultured grafts in the concentrations that are used clinically.

Acetates

In vitro effects of matrix peptides on a cultured dermal-epidermal skin substitute.

Composite dermal-epidermal skin substitutes rely on a firm attachment of human keratinocytes (HK) to the dermal substrate for graft survival on the wound. An in vitro study was performed assessing whether the addition of matrix peptides to the dermal substrate effected the epithelial thickness. Cultured grafts were made by attaching HK to the external surface of a collagen-chondroitin 6-sulfate (GAG) membrane and inoculating human fibroblasts (HF) internally. If the matrix peptide (RGD Peptide) was added to the collagen-GAG membrane prior to placement of the HK and HF, the resultant epithelial layer at the end of the normal 4-day culture period was significantly thicker (19.7 +/- 0.9 microns versus 13.5 +/- 1.0 microns). Subjectively, the HF content was also greater on the peptide-treated grafts. When HF were not placed on the cultured graft, i.e., only collagen-GAG membrane, RGD peptide, and HK, the resultant epithelial thickness was even greater (28.3 +/- 1.0 microns). These data suggest that addition of matrix peptides, which increase cell attachment to the dermal substrate, may prove effective in the improvement of this cultured composite dermal-epidermal skin substitute.

Bandages

Patient tolerance study of topical chlorhexidine diphosphanilate: a new topical agent for burns.

Effective topical antimicrobial agents decrease infection and mortality in burn patients. Chlorhexidine phosphanilate (CHP), a new broad-spectrum antimicrobial agent, has been evaluated as a topical burn wound dressing in cream form, but preliminary clinical trials reported that it was painful upon application. This study compared various concentrations of CHP to determine if a tolerable concentration could be identified with retention of antimicrobial efficacy. Twenty-nine burn patients, each with two similar burns which could be separately treated, were given pairs of treatments at successive 12-h intervals over a 3-day period. One burn site was treated with each of four different CHP concentrations, from 0.25 per cent to 2 per cent, their vehicle, and 1 per cent silver sulphadiazine (AgSD) cream, an antimicrobial agent frequently used for topical treatment of burn wounds. The other site was always treated with AgSD cream. There was a direct relationship between CHP concentration and patients' ratings of pain on an analogue scale. The 0.25 per cent CHP cream was closest to AgSD in pain tolerance; however, none of the treatments differed statistically from AgSD or from each other. In addition, ease of application of CHP creams was less satisfactory than that of AgSD. It was concluded that formulations at or below 0.5 per cent CHP may prove acceptable for wound care, but the vehicle system needs pharmaceutical improvement to render it more tolerable and easier to use.

Administration, Topical

Effect of hyperbaric oxygen on murine neutrophil and T-lymphocyte functions.

We investigated the effect of repeated hyperbaric oxygen (HBO) exposure on PMN and T-lymphocyte functions in a murine model. Animals received eight 90-min exposures twice daily to 2.4 ata and 100% or 10% oxygen. Control animals were maintained in room air. On the ninth day spleens and peritoneal cell exudates were harvested. Phagocytosis was measured by flow-cytometric analysis of the ability of PMN to engulf formalin-killed, fluorescence-labeled Staphylococcus aureus. PMN-killing capacity was measured by the ability of PMN to undergo an oxidative burst after stimulation with N-formyl methionyl-leucyl-phenylalanine, phorbol myristate, or opsonized zymosan. T-lymphocyte subpopulations were identified using monoclonal antibodies and two-color flow cytometry after 48 h stimulation with phytohemagglutinin, and lymphocyte proliferation was measured by 3 H-thymidine incorporation. We found PMN phagocytosis and oxidative burst were unchanged after HBO treatment. Lymphocyte proliferation was decreased, and an activated population of CD8+ T cells appeared after mitogen stimulation. We conclude that, although PMN function is not affected by prior HBO, lymphocyte proliferation is decreased.

Animals