Matériaux polymères avec hydrophilie contrôlée. Applications en ingénierie tissulaire du cartilage articulaire

Les maladies ostéoarticulaires représentent environ 10% de l ensemble des pathologies identifiées en France chaque année. Ces maladies inflammatoires et dégénératives des articulations sont pour la plupart consécutives au vieillissement ou à un traumatisme et évoluent vers l usure des cartilages, d où un handicap sévère. Comme aucun traitement ne permet la réparation totale du tissu cartilagineux, la recherche médicale développe des techniques d ingénierie tissulaire. Ces techniques utilisent des substrats polymériques et des cellules souches qui sont contraints de se développer pour former du tissu cartilagineux. Cependant, ces techniques ne peuvent pas encore être utilisées à l échelle d une articulation complète car il n est pas possible de reproduire ex vivo à grande échelle la structure et les propriétés mécaniques et physicochimiques du cartilage articulaire. Dans ce contexte, les travaux de cette thèse ont permis de développer des matériaux polymères capables d être implantés à l échelle macroscopique dans les articulations pathologiques afin de combler l usure des cartilages. Pour se faire, de nouveaux biomatériaux - hydrogels p(HEMA) - ont été obtenus en contrôlant le caractère hydrophile des hydrogels p(HEMA) au cours de leur synthèse chimique en présence de différents co-monomères (acide acrylique, acrylamide, acrylate d'éthylène et acrylate de butyle). Partant de là, les propriétés physicochimiques, mécaniques et tribologiques de ces nouveaux hydrogels ont été optimisées afin d obtenir des propriétés similaires à celles du cartilage articulaire sain. Ensuite, la libération contrôlée de médicaments par ces hydrogels a été étudiée afin de minimiser les risques inflammatoires lors de leur utilisation en ingénierie tissulaire du cartilage articulaire.Osteoarticular diseases re present approximately 10% of all diseases identified in France each year. These inflammatory and degenerative joint disease are mostly consecutive with age or injuries and the wear progress of cartilage, resulting in severe disability. Because no treatment will total repair the cartilage tissue, medical research is developing techniques based on tissue engineering. These techniques use polymer substrates and stem cells that are "forced" to develop into cartilage tissue. However, these techniques cannot be used across a run articulation because Il is not possible-to replicate ex vivo a large-scale structure and the physicochemical and mechanical properties of articular cartilage. In this context, the purpose of this thesis is to develop polymer materials that can be implanted at the macroscopic level in the joints disease that will fill the wear of the cartilage. To do so, new biomaterials - hydrogels p (HEMA)- were obtained by controlling the hydrophilic nature of hydrogels p (HEMA) during their chemical synthesis in the presence of various co-monomers (acrylic acid, acrylamide, acrylate ethylene and butyl acrylate). From there, physicochemical, mechanical and tribological properties of these novel hydrogels have been optimized to obtain similar properties to those of healthy articular cartilage. Then, the controlled release of drugs from these hydrogels was studied to minimize inflammatory when used in tissue engineering of articular cartilage.VILLEURBANNE-DOC'INSA LYON (692662301) / SudocVILLEURBANNE-DOC'INSA-Bib. elec. (692669901) / SudocSudocFranceF

Polymeric materials with controlled hydrophilic character. Applications in articular cartilage tissue engineering

Les maladies ostéoarticulaires représentent environ 10% de l’ensemble des pathologies identifiées en France chaque année. Ces maladies inflammatoires et dégénératives des articulations sont pour la plupart consécutives au vieillissement ou à un traumatisme et évoluent vers l’usure des cartilages, d’où un handicap sévère. Comme aucun traitement ne permet la réparation totale du tissu cartilagineux, la recherche médicale développe des techniques d’ingénierie tissulaire. Ces techniques utilisent des substrats polymériques et des cellules souches qui sont « contraints » de se développer pour former du tissu cartilagineux. Cependant, ces techniques ne peuvent pas encore être utilisées à l’échelle d’une articulation complète car il n’est pas possible de reproduire ex vivo à grande échelle la structure et les propriétés mécaniques et physicochimiques du cartilage articulaire. Dans ce contexte, les travaux de cette thèse ont permis de développer des matériaux polymères capables d’être implantés à l’échelle macroscopique dans les articulations pathologiques afin de combler l’usure des cartilages. Pour se faire, de nouveaux biomatériaux - hydrogels p(HEMA) - ont été obtenus en contrôlant le caractère hydrophile des hydrogels p(HEMA) au cours de leur synthèse chimique en présence de différents co-monomères (acide acrylique, acrylamide, acrylate d'éthylène et acrylate de butyle). Partant de là, les propriétés physicochimiques, mécaniques et tribologiques de ces nouveaux hydrogels ont été optimisées afin d’obtenir des propriétés similaires à celles du cartilage articulaire sain. Ensuite, la libération contrôlée de médicaments par ces hydrogels a été étudiée afin de minimiser les risques inflammatoires lors de leur utilisation en ingénierie tissulaire du cartilage articulaire.Osteoarticular diseases re present approximately 10% of all diseases identified in France each year. These inflammatory and degenerative joint disease are mostly consecutive with age or injuries and the wear progress of cartilage, resulting in severe disability. Because no treatment will total repair the cartilage tissue, medical research is developing techniques based on tissue engineering. These techniques use polymer substrates and stem cells that are "forced" to develop into cartilage tissue. However, these techniques cannot be used across a run articulation because Il is not possible-to replicate ex vivo a large-scale structure and the physicochemical and mechanical properties of articular cartilage. In this context, the purpose of this thesis is to develop polymer materials that can be implanted at the macroscopic level in the joints disease that will fill the wear of the cartilage. To do so, new biomaterials - hydrogels p (HEMA)- were obtained by controlling the hydrophilic nature of hydrogels p (HEMA) during their chemical synthesis in the presence of various co-monomers (acrylic acid, acrylamide, acrylate ethylene and butyl acrylate). From there, physicochemical, mechanical and tribological properties of these novel hydrogels have been optimized to obtain similar properties to those of healthy articular cartilage. Then, the controlled release of drugs from these hydrogels was studied to minimize inflammatory when used in tissue engineering of articular cartilage

Matériaux polymères avec hydrophilie contrôlée. Applications en ingénierie tissulaire du cartilage articulaire

Osteoarticular diseases re present approximately 10% of all diseases identified in France each year. These inflammatory and degenerative joint disease are mostly consecutive with age or injuries and the wear progress of cartilage, resulting in severe disability. Because no treatment will total repair the cartilage tissue, medical research is developing techniques based on tissue engineering. These techniques use polymer substrates and stem cells that are "forced" to develop into cartilage tissue. However, these techniques cannot be used across a run articulation because Il is not possible-to replicate ex vivo a large-scale structure and the physicochemical and mechanical properties of articular cartilage. In this context, the purpose of this thesis is to develop polymer materials that can be implanted at the macroscopic level in the joints disease that will fill the wear of the cartilage. To do so, new biomaterials - hydrogels p (HEMA)- were obtained by controlling the hydrophilic nature of hydrogels p (HEMA) during their chemical synthesis in the presence of various co-monomers (acrylic acid, acrylamide, acrylate ethylene and butyl acrylate). From there, physicochemical, mechanical and tribological properties of these novel hydrogels have been optimized to obtain similar properties to those of healthy articular cartilage. Then, the controlled release of drugs from these hydrogels was studied to minimize inflammatory when used in tissue engineering of articular cartilage.Les maladies ostéoarticulaires représentent environ 10% de l’ensemble des pathologies identifiées en France chaque année. Ces maladies inflammatoires et dégénératives des articulations sont pour la plupart consécutives au vieillissement ou à un traumatisme et évoluent vers l’usure des cartilages, d’où un handicap sévère. Comme aucun traitement ne permet la réparation totale du tissu cartilagineux, la recherche médicale développe des techniques d’ingénierie tissulaire. Ces techniques utilisent des substrats polymériques et des cellules souches qui sont « contraints » de se développer pour former du tissu cartilagineux. Cependant, ces techniques ne peuvent pas encore être utilisées à l’échelle d’une articulation complète car il n’est pas possible de reproduire ex vivo à grande échelle la structure et les propriétés mécaniques et physicochimiques du cartilage articulaire. Dans ce contexte, les travaux de cette thèse ont permis de développer des matériaux polymères capables d’être implantés à l’échelle macroscopique dans les articulations pathologiques afin de combler l’usure des cartilages. Pour se faire, de nouveaux biomatériaux - hydrogels p(HEMA) - ont été obtenus en contrôlant le caractère hydrophile des hydrogels p(HEMA) au cours de leur synthèse chimique en présence de différents co-monomères (acide acrylique, acrylamide, acrylate d'éthylène et acrylate de butyle). Partant de là, les propriétés physicochimiques, mécaniques et tribologiques de ces nouveaux hydrogels ont été optimisées afin d’obtenir des propriétés similaires à celles du cartilage articulaire sain. Ensuite, la libération contrôlée de médicaments par ces hydrogels a été étudiée afin de minimiser les risques inflammatoires lors de leur utilisation en ingénierie tissulaire du cartilage articulaire

The influence of incontinence pads moisture at the loaded skin interface

Aim: prolonged mechanical loading on soft tissues adjacent to bony prominences can lead to pressure ulcers. The presence of moisture at the skin interface will lower the tolerance to load. Absorbent pads manage moisture in individuals with incontinence, although their role in maintaining skin health is unknown. The present study investigated the effects of moist incontinence pads on skin physiology after periods of mechanical loading.Material and methods: twelve healthy participants were recruited to evaluate a single incontinence pad design under three moisture conditions: 0% (dry), 50% and 100% fluid capacity. For each pad condition, pressure (9 kPa) or pressure in combination with shear (3 N) was applied to the sacrum, followed by a period of off-loading. Measures included trans-epidermal water loss (TEWL) and inflammatory biomarkers sampled at the skin interface.Results: results revealed no change in TEWL in the loaded dry pad condition. By contrast, when the pads contained moisture, significant increases in TEWL were observed. These increases were reversed during off-loading. Inflammatory biomarkers, specifically IL-1α/total protein ratio, were up-regulated during dry pad loading, which recovered during off-loading. Loaded moist pads caused a significant increase in biomarkers, which remained elevated throughout the test period.Conclusion: the study revealed a marked compromise to stratum corneum integrity when the skin was exposed to moist incontinence pads in combination with mechanical loads. These physiological changes were largely reversed during off-loading. Incontinence pads provided some protection in the dry state, although more research is required to determine optimal clinical guidance for their use

Establishing a measurement array to assess tissue tolerance during loading representative of prosthetic use

Background: In the early stages of rehabilitation after primary amputation, residual limb soft tissues have not been mechanically conditioned to support load and are vulnerable to damage from prosthetic use. There is limited quantitative knowledge of skin and soft tissue response to prosthetic loading. Methods: An in-vivo protocol was developed to establish suitable measures to assess tissue tolerance during loading representative of early prosthesis use. Ten participants without amputation one participant with trans-tibial amputation were recruited, and pressure applied to their calf in increments from 20 to 60 mmHg. Measurements were recorded at relevant skin sites including interface pressures, transcutaneous oxygen (T CPO 2) and carbon dioxide (T CPCO 2) tensions and inflammatory biomarkers. Findings: At the maximum cuff pressure, mean interface pressures were between 66 and 74 mmHg, associated with decreased T CPO 2 values. On the release of pressure, the ischaemic response was reversed. Significant upregulation (p &lt; 0.05) in inflammatory biomarker IL-1α and its antagonist IL-1RA were observed at all sites immediately following loading. Interpretation: The protocol was successful in applying representative prosthetic loads to lower limb tissues and monitoring the physiological response, both in terms of tissue ischemia and skin inflammation. Results indicated that the measurement approaches were sensitive to changes in interface conditions, offering a promising approach to monitor tissue status for people with amputation. </p

Dataset for &quot;Establishing a measurement array to assess tissue tolerance during loading representative of prosthetic use&quot;

Dataset for journal paper: AUTHORS- Bramley, J.L., Worsley, P.R., Bostan, L.E., Bader, D.L., Dickinson, A.S. TITLE- Establishing a measurement array to assess tissue tolerance during loading representative of prosthetic use This is a simple Excel spreadsheet containing the raw data behind the figures in the linked journal paper.</span

Evaluating the effects of sedentary behaviour on plantar skin health in people with diabetes

Background: Diabetes-Related Foot Ulcers (DRFUs) are a common and devastating consequence of Diabetes Mellitus and are associated with high morbidity, mortality, social and economic costs. Whilst peak plantar pressures during gait are implicated cited as a major contributory factor, DRFU occurrence has also been associated with increased periods of sedentary behaviour. The present study was designed aimed to assess the effects of sitting postures on plantar tissue health. Methods: After a period of acclimatisation, transcutaneous oxygen tensions (TCPO2) and inflammatory cytokines (IL-1α and IL-1RA) were measured at the dorsal and plantar aspects of the forefoot before, during and after a 20-min period of seated-weight-bearing in participants with diabetes (n = 11) and no diabetes (n = 10). Corresponding interface pressures at the plantar site were also measured. Results: During weight-bearing, participants with diabetes showed increases in tissue ischaemia which were linearly correlated proportional to plantar pressures (Pearson's r = 0.81; p 0.05). There were also significant increases in post seated weight-bearing values for ratio for IL-1α and IL-1RA, normalised to total protein, post seated weight-bearing in participants with diabetes compared to healthy controls. Conclusion: This study shows that prolonged sitting may be detrimental to plantar skin health. It highlights the need to further examine the effects of prolonged sitting in individuals, who may have a reduced tolerance to loading in the plantar skin and soft tissues