Rhinosinusitis derived Staphylococcal enterotoxin B possibly associates with pathogenesis of ulcerative colitis

BACKGROUND: During clinical practice, we noticed that some patients with both ulcerative colitis (UC) and chronic rhinosinusitis (CRS) showed amelioration of UC after treatment of CRS. This study was designed to identify a possible association between CRS and UC. METHODS: Thirty-two patients with both CRS and UC received treatment with functional endoscopic sinus surgery (FESS) for CRS. Clinical symptom scores for CRS and UC, as well as serum levels of anti-Staphylococcal enterotoxin B (SEB) were evaluated at week 0 and week 12. Sinus wash fluid SEB content was measured with enzyme-linked immunosorbent assay (ELISA). The surgically removed tissues were cultured to identify growth of Staphylococcus. aureus (S. aureus). Immunohistochemistry was employed to identify anti-SEB positive cells in the colonic mucosa. Colonic biopsies were obtained and incubated with SEB. Mast cell activation in the colonic mucosa in response to incubation with SEB was observed with electron microscopy and immunoassay. RESULTS: The clinical symptom scores of CRS and UC severe scores (UCSS) were significantly reduced in the UC-CRS patients after FESS. The number of cultured S. aureus colonies from the surgically removed sinus mucosa significantly correlated with the decrease in UCSS. High levels of SEB were detected in the sinus wash fluids of the patients with UC-CRS. Histamine and tryptase release was significantly higher in the culture supernate in the patients with UC-CRS than the patients with UC-only and normal controls. Anti-SEB positive cells were located in the colonic mucosa. CONCLUSION: The pathogenesis of UC in some patients may be associated with their pre-existing CRS by a mechanism of swallowing sinusitis-derived SEB. We speculate that SEB initiates inappropriate immune reactions and inflammation in the colonic mucosa that further progresses to UC

No effect of autologous growth factors (AGF) around ungrafted loaded implants in dogs

Autologous growth factors (AGF) is a growth-factor-rich concentrate of platelets, white blood cells and fibrinogen. Application of AGF was presumed to improve implant fixation and gap healing of non-grafted, loaded implants. We inserted one loaded titanium implant intra-articularly in each medial femoral condyle of eight dogs. Each implant was surrounded by a 0.75 mm gap. One implant in each dog was coated with AGF prior to implantation whereas the contralateral implant served as a control. AGF was prepared by isolating the buffy-coat from blood and further concentrated using an Interpore Cross UltraConcentrator. Platelet counts were increased from a median baseline of 168×103/μl to 1003×103/μl in AGF. However, AGF had no significant effect on implant fixation or bone formation. Even though AGF increased ultimate shear strength and energy absorption by approximately 50%, these differences had a p-value less than 0.05. The sample size in this study was small and any negative conclusions should be taken with caution due to low statistical power. We have previously demonstrated that AGF significantly improves fixation and incorporation of grafted implants. AGF might require mixing with an osteoconductive grafting material in order to provide a scaffold on which to foster bone growth and to keep the growth factors on location for a prolonged period

Adipose-derived stromal vascular fraction cells and platelet-rich plasma: Basic and clinical implications for tissue engineering therapies in regenerative surgery

Cell-based therapy and regenerative medicine offer a paradigm shift in regard to various diseases causing loss of substance or volume and tissue or organ damage. Recently, many authors have focused their attention on mesenchymal stem cells for their capacity to differentiate into many cell lineages. The most widely studied types are bone marrow mesenchymal stem cells and adipose derived stem cells (ADSCs), which display similar results. Based on the literature, we believe that the ADSCs offer advantages because of lower morbidity during the harvesting procedure. Additionally, platelet-rich plasma can be used in this field for its ability to stimulate tissue regeneration. The aim of this chapter is to describe ADSC preparation and isolation procedures, preparation of platelet-rich plasma, and the application of ADSCs in regenerative plastic surgery. We also discuss the mechanisms and future role of ADSCs in cell-based therapy and tissue engineering