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Biomedical subjects

M D Caldwell

Publications and source records attributed to M D Caldwell.

At least 19 recordsLinked to original sources

Macrophages influence a competition of contact guidance and chemotaxis for fibroblast alignment in a fibrin gel coculture assay.

Rat dermal fibroblasts were dispersed initially in the outer shell of a fibrin gel sphere, while the inner core either was devoid of cells or contained peritoneal exudate cells (primarily macrophages), thereby mimicking the inflammatory phase of wound healing. The fibroblasts compacted floating fibrin microspheres over time. In the absence of macrophages, the initial distribution of fibroblasts (only in the shell) induced circumferential alignment of fibrin fibrils via compaction of the shell relative to the core. The aligned fibrils created a contact guidance field, which was manifested by strong circumferential alignment of the fibroblasts. However, in the presence of macrophages, the fibroblasts exhibited more radial alignment despite the simultaneous contact guidance field in the circumferential direction associated with compaction. This was attributed to a chemotactic gradient emanating from the core due to a putative factor(s) released by the macrophages. The presence of a radial chemotactic stimulus was supported by the finding of even greater radial alignment when fibrin microspheres were embedded in an agarose-fibrin gel that abolished compaction and consequently the contact guidance field. Our assay permits the simulation of tissue morphogenetic processes that involve cell guidance phenomena and tractional restructuring of the extracellular matrix.

Animals↗

Cystic adventitial disease of the popliteal artery: diagnosis and treatment.

PURPOSE: This paper represents the presentation of a case of cystic adventitial disease of the popliteal artery and an exhaustive review of the literature with an emphasis on optimal means for diagnosis and treatment of this unusual disease. METHODS: We collect all reported cases of cystic adventitial disease of the popliteal artery since the last review in 1987 with an additional review of these cases reported in the U.S. since the initial description of the disease. RESULTS: We found 264 cases of cystic adventitial disease (CAD) of the popliteal artery from 1954 to 1995, with 38 reported in the U.S. Fifty-eight new cases of CAD have been reported since the last review in 1987; 11 of these were reported in the U.S. Diagnosis of the disease has improved in the last few years with non-invasive techniques. Duplex color scanning followed by T2-weighted MRI now appears to be the best diagnostic choice. Various therapeutic methods have been described for the treatment of CAD. The recommended treatments are excision of the cyst with the cystic wall when the artery is stenotic and resection of the affected artery, followed by an interposition graft, when the artery is occluded. CONCLUSION: Claudication in young, healthy patients resulting from popliteal artery stenosis or occlusion is a leading symptom of CAD. This disease affects males in a ratio of approximately 5:1 and appears predominantly in the fourth and fifth decades. The incidence is approximately 1 in 1200 cases of claudication or 1 in 1000 peripheral arteriograms. The predominance of reported cases is found in Japan and Europe. Optimal diagnostic techniques include duplex color scanning and T2-weighted MRI. The lesions can be effectively treated by resectional or non-resectional means depending on the presence or absence of complete arterial occlusion.

Adult↗

Continuity between wound macrophage and fibroblast phenotype: analysis of wound fibroblast phagocytosis.

Analysis of phagocytic activity in wound fibroblasts was chosen as a means to assess the possible continuity between macrophage and fibroblast phenotypes. Fibroblast phagocytosis of uncoated, IgG-coated, or collagen-coated fluorescent beads was analyzed by flow cytometry in vivo and in vitro. Phagocytosis of fluorescent beads by procollagen I-positive cells (fibroblasts) was evaluated in vivo by injecting beads into subcutaneously implanted sponge wounds in anesthetized Fisher rats. Phagocytic activity of a purified population of wound fibroblasts was measured in vitro and correlated with oxidation state using hydroethidium. In the wound environment, 50-60% of the cells that engulfed uncoated, IgG-coated, or collagen-coated beads were procollagen I-positive cells (i.e., fibroblasts). Procollagen I-positive cells engulfed uncoated and IgG-coated beads in preference to collagen-coated beads in vivo. Cultured wound fibroblasts engulfed uncoated, IgG-coated, and collagen-coated particles. The majority of fibroblasts that engulfed beads were in an elevated oxidation state. We conclude that substantial fibroblast phagocytosis occurs in the wound, but scavenger receptor-mediated fibroblast phagocytosis is different from that of macrophages. Additional markers will be helpful in defining the macrophage fibroblast continuum.

Animals↗

Altered wound arginine metabolism by corticosterone and retinoic acid.

Arginine metabolism plays an important role in many aspects of inflammation and wound healing. In this study, we tested the hypothesis that steroids and vitamin A have differential effects on arginine metabolism and thereby may provide a mechanism by which steroids impair wound healing, and vitamin A improves this impairment. Rats were treated with subcutaneous corticosterone pellets 2 days prior to wounding. Intraperitoneal injections of all-trans retinoic acid in peanut oil were administered at the same time and repeated 2 and 4 days later. Polyvinyl alcohol sponges were implanted subcutaneously through a dorsal incision. On Postwounding Days 1, 5, 10, and 15, wound fluid was recovered from the sponges and assayed for nitrite/nitrate (NOx), citrulline, arginine, and ornithine concentrations as well as arginase activity. Steroid treatment decreased the metabolism of arginine to nitric oxide in the early phase of wound healing, and retinoic acid did not change this relationship. Corticosterone also decreased metabolism of arginine to ornithine in the later wound. This depression was inhibited by concomitant administration of retinoic acid. Considering the importance of nitric oxide in host defense and ornithine as a precursor for polyamine and proline synthesis, these data provide a mechanism by which vitamin A improves wound strength, but does not improve wound infection rates in steroid-treated animals.

Animals↗

Differential regulation of macrophage arginine metabolism: a proposed role in wound healing.

Nitric oxide (NO) and ornithine, products of NO synthase or arginase, respectively, have opposing biological activities. The effect of mediators of leukocyte activation and inhibition on arginine metabolism of resident mouse peritoneal exudate cells (MPEC) was determined. Factors that increased basal NO synthase activity, interferon (IFN)-gamma and lipopolysaccharide (LPS), decreased arginase activity in intact cells. Transforming growth factor (TGF)-beta1 decreased IFN-gamma-stimulated NO synthase activity and produced a reciprocal increase in urea and ornithine release. TGF-beta1 had no effect on the activity of these enzymes in LPS-stimulated MPEC. Corticosterone (Cort, 100 ng/ml) decreased the basal activity of both enzymes. However, Cort inhibited NO synthase activity and increased ornithine release in MPEC exposed to IFN-gamma or LPS. The difference between arginase activity in intact cells vs. that of cell lysates suggested intracellular inhibition of arginase activity. Products of NO synthase, NO and citrulline, were shown to inhibit MPEC arginase activity under maximal assay conditions. Intracellular pH was not altered by exposure of MPEC to LPS, IFN-gamma, TGF-beta, and Cort. This reciprocal change in arginine metabolism is proposed to be an important component of wound healing. Expression of NO synthase creates a cytotoxic environment that may be important to the early phase of wound healing. As wound healing progresses, increased arginase activity produces an environment favorable for fibroblast replication and collagen production.

Amino Acids↗

Insulin is degraded extracellularly in wounds by insulin-degrading enzyme (EC 3.4.24.56).

The exact mechanism by which insulin reverses impaired wound healing is unknown. Previous investigators have shown that insulin is degraded in experimental wounds, suggesting that the action of insulin may be locally modified. The following study corroborates these findings and identifies the major proteinase responsible for insulin degradation in wound fluid (WF). Adult male Fisher rats were wounded by subcutaneous implantation of polyvinyl alcohol sponges while under pentobarbital sodium anesthesia. WF and serum were collected on 1, 5, 10, and 14 days postinjury. Decreased insulin concentration in late WF correlated with an increased insulin-degrading activity. Multiple proteinases appear to participate in the overall degradation of insulin in WF. However, the primary enzyme responsible for insulin degradation in WF was characterized by immunoprecipitation and immunoblotting and identified as the neutral thiol-dependent metalloproteinase, insulin-degrading enzyme (EC 3.4.24.56). Exogenous steroid administration caused a decrease in WF insulin-degrading activity. Glucagon and adrenocorticotrophin degradation was also observed, whereas minimal degradation of insulin-like growth factors I and II and epidermal growth factor was detected in WF. The ability to extracellularly degrade insulin may represent a unique mechanism for the regulation of this hormone's role in healing wounds.

Adrenocorticotropic Hormone↗

The effect of aging on the transarterial wall oxygen gradient.

Atherosclerosis is associated with aging based on numerous epidemiologic studies, whereas arterial wall hypoxia has been associated with other risk factors for atherosclerosis. We studied the effect of age on the transarterial wall oxygen gradient in the rat using an oxygen microelectrode. A decrease in oxygen tension in the outer 35% of the artery wall was noted in 36- to 40-week-old rats when compared to 3- to 4-week-old rats. These findings were noted despite no difference in arterial blood oxygen tension between the two groups and prior to any histologic evidence of atherosclerotic lesion formation. Our observations suggest that aging decreases the delivery of oxygen to the outer artery wall.

Aging↗

Transarterial wall oxygen gradients at the dog carotid bifurcation.

The purpose of this study was to determine the effect of the carotid artery bifurcation on the delivery of oxygen to the artery wall by measuring the transarterial wall oxygen gradient. Transarterial wall oxygen gradient measurements were performed in dogs anesthetized with thiopental sodium and isoflurane by means of an oxygen microelectrode. Measurements were performed at six locations along the carotid bifurcation. Oxygen tensions at the carotid sinus were decreased in the inner 40% of the artery wall compared with control locations. Oxygen tensions at the flow divider were increased throughout the artery wall compared with control locations. These effects were noted without differences in blood pressure, arterial blood oxygen tension, or histological evidence of atherosclerotic lesion formation. These findings suggest that the delivery of oxygen to the artery wall is altered by the bifurcation of the carotid artery. Low arterial oxygen tensions at the carotid sinus support a role for artery wall hypoxia in the formation of atherosclerotic lesions.

Analysis of Variance↗

Macrophage arginine metabolism and the inhibition or stimulation of cancer.

The potential of the immune system to inhibit or stimulate tumor growth is a vivid example of the "two-edged sword" nature of immune responses. Our results provide evidence that this dual capacity can be attributed, in part, to the dual pathways of arginine metabolism exhibited by intratumor macrophages. Specifically, i.p. tumor rejection in P815-preimmunized mice is accompanied by an upshift in intratumor macrophage arginine metabolism to the nitric oxide (NO) synthase pathway that yields citrulline and NO. A rapid and marked local increase in IFN-gamma (both mRNA and protein) in preimmunized mice during tumor rejection suggests that this cytokine plays a role in up-regulating nitric oxide production in vivo. Unlike tumor rejection, progressive i.p. P815 tumor growth in naive mice is associated with a marked decline in the production of citruline/NO by intratumor macrophages. Examination of macrophage arginine metabolism via arginase revealed a pattern opposite that of NO synthase. The local production of ornithine/urea markedly increases during progressive tumor growth whereas arginase activity decreases during tumor rejection. Inasmuch as nitric oxide inhibits tumor cell replication whereas ornithine is the precursor of polyamines required for cell replication, these results are consistent with the conclusion that the pathway macrophages use to metabolize arginine can influence the type of host immune responses against cancer and other conditions.

Animals↗

Insulin-like growth factors I and II expression in the healing wound.

Demonstrating temporal variation in the expression of messenger RNA (mRNA) for growth factors may give some indication as to whether growth factor synthesis is regulated in wound healing. The aim of this study was to evaluate the expression of insulin-like growth factors (IGF) I and II in the wound. Two wound models, an incisional model and a subcutaneous sponge implant model, were used in this study. The RNA was extracted and reverse transcribed and mRNA was amplified using polymerase chain reaction (PCR). Semiquantitation of PCR products was accomplished using [3H]dGTP incorporation. Levels of expression for both IGF-I and -II were found to be low in unwounded skin and at 12 hr postwounding. However, in both wound models expression increased substantially from 1 to 21 days postwounding. Both factors also were found to be expressed by fibroblasts and polymorphonuclear leukocytes (PMN). Additionally, two transcripts were found for IGF-II, the larger of which appeared to be specific for PMN and possibly cells involved in angiogenesis. Levels of message expressed in healing wounds for IGF-I and -II appear to be regulated with the highest levels of message found at time points coinciding with fibroblast predominance in the wound. Since fibroblasts are known to both secrete and respond to IGF-I, it is possible that IGF-I and IGF-II are acting to influence fibroblast differentiation and function in the later stages of wound healing.

Animals↗

Wound fluid amino acid concentrations regulate the effect of epidermal growth factor on fibroblast replication.

Growth factors and amino acids (AA) are required for cell proliferation. A comparison of the AA composition of wound fluid (WF) to that of Eagle's medium reveals that AA in WF may be limiting to cell replication. Yet WF supports fibroblast replication and stimulates AA uptake. Epidermal growth factor (EGF) stimulates fibroblast replication and stimulates human wound healing when applied topically. We evaluated the interactions between EGF and AA concentrations found in WF. Wound fibroblasts were cultured in media prepared to mimic the AA concentrations found in WF on days 1, 5, and 10 and in the presence of varying concentrations of EGF. Fibroblasts cultured in all three experimental media showed a dose response to EGF for both tritiated-thymidine uptake (proliferation) and AA uptake. The fibroblast proliferation in response to EGF was augmented by the AA composition of day-5 WF. These data show a dose-dependent effect of EGF on fibroblast replication and AA uptake in the absence of serum that is augmented by the particular AA combination found in day-5 WF and suggests that an optimal physiologic AA profile may aid in EGF stimulation of wound fibroblast replication.

Amino Acids↗

Temporal expression of different pathways of 1-arginine metabolism in healing wounds.

Arginine can be metabolized by inflammatory cells through at least two pathways. One is an oxidative l-arginine deiminase (OAD) that results in the formation of citrulline and reactive nitrogen intermediates. The other is arginase, which determines the production of ornithine and urea. The temporal expression of these pathways in an experimental wound model (s.c. implanted polyvinyl alcohol sponges in the rat) was investigated by examining the concentrations of amino acids and of nitrite in fluids obtained from the sponges 6 h to 15 day after implantation. These analyses revealed two distinct periods during which the arginine concentration in the fluids was markedly below plasma levels. During the early period (less than 3 days after sponge implantation) wound fluid contained more citrulline and nitrite than at any other time, suggesting OAD activity. In contrast, ornithine accumulated in the fluids during the late decrease in arginine concentration that extended beyond day 3, during which time the wound fluid also contained a high arginase activity. This time-dependent expression of different pathways of arginine metabolism in wounds was confirmed in sponge cultures containing [guanido-14C]-l-arginine. Cells contained in sponges harvested less than 48 h after implantation metabolized labeled arginine mainly to labeled citrulline, whereas labeled urea was produced during culture of sponges harvested after this time. The low arginine content of wound fluid did not appear to be rate limiting for the expression of OAD in late sponges because no OAD activity was evidenced when 4 mM arginine was added to the cultures. These results indicate that the OAD pathway is expressed in this model predominantly during the early, polymorphonuclear leukocyte-predominant, phase of repair. At this time, the reactive nitrogen intermediates resulting from the metabolism of arginine may mediate some of the events characteristic of early inflammation, including microbiostasis, vasodilation, and inhibition/reversal of platelet aggregation. In turn, the late suppression of this pathway and the catabolism of arginine through arginase may promote macrophage function within wounds.

Animals↗

Modulatory activities of wound fluid on fibroblast proliferation and collagen synthesis.

Several different cell types play a role in the regulatory mechanisms involved in wound healing. A rat wound model was used to evaluate temporal changes in the cellular infiltrate, histology, and effects of wound fluid (WF) on fibroblast growth and collagen synthesis in vitro. Polyvinyl alcohol sponges were implanted in male Sprague/Dawley rats and harvested after 1, 3, 5, 7, 10, and 15 days. Rat wound fibroblasts were cultured in different media with 10 or 20% WF pooled from five or more rats from each time interval, and then pulsed with [3H]thymidine. Days 1 through 5 WF stimulated proliferation, whereas Days 10 and 15 WF inhibited proliferation. Stimulatory activity was found in the greater than 300 kDa molecular weight fraction; inhibitory activity was in the less than 10 kDa molecular weight fraction. Ten percent WF from both Day 1 and Day 15 sponges exerted a stimulatory effect in incubated fibroblasts on collagen production, measured as protein-bound [3H]hydroxyproline. Fibroblast proliferation and collagen synthesis appeared to be independently regulated functions. Fibroblasts were stimulated by the wound environment to proliferate for about 1 week after injury, at which point further growth was inhibited, while collagen production was maintained.

Animals↗

Wound metabolism.

The science of wound healing is vital to all aspects of plastic surgery. Knowledge of wound metabolism is essential to a complete understanding of wound healing. Through various laboratory models, we have isolated and studied many of the parameters involved in tissue repair and metabolism. Our findings suggest that biochemical aspects of wound healing are directed by the metabolism of the cellular infiltrate in the wound. These findings help to explain the independent nature of the wound during its healing process ("biological priority").

Amino Acids↗