Osteogenic differentiation driven by osteoclasts and macrophages

Introduction Osteoclasts are bone-resorbing cells closely related to bone turnover, whereas different macrophage subtypes contribute to bone fracture healing. As osteoclasts and macrophages share the same hematopoietic origin, the difference between both cell types on osteoblast coupling, crosstalk extent and consequent bone formation remains poorly understood. This study compares the potential of primary cells that are routinely considered as osteoclast and macrophage cultures on their ability to support osteogenic differentiation of human mesenchymal stromal cells (hMSCs). Methods Human Peripheral Blood Mononuclear Cells (hPBMCs) were used to obtain macrophage or osteoclast cultures using appropriate stimulatory factors. With different seeding densities of hPBMCs, conditioned media from macrophage or osteoclast cultures were harvested for comparative evaluation of effects thereof on the osteogenic differentiation of hMSCs. Specific cytological staining was used to qualitatively evaluate macrophage and osteoclast cultures. Additionally, quantitative data on hMSC proliferation, osteogenic differentiation and mineralization were obtained via biochemical assays. Results Conditioned medium from osteoclast cultures obtained via low hPBMCs seeding densities, but not from high hPBMCs seeding densities or macrophages, stimulated hMSC osteogenic differentiation and mineralization. Upon cellular crosstalk, both pre-differentiated osteoclasts and non-polarized macrophages equally supported early hMSC osteogenic differentiation and mineralization, as confirmed by increased alkaline phosphatase levels within 7 days and increased calcium content within 14 days in comparison with undifferentiated controls. Initial hPBMCs seeding density strongly influences osteoclastogenesis and the paracrine effect of the resultant osteoclast population on the osteogenic differentiation of hMSCs. In addition, only in indirect coculture, macrophages provide similar stimulatory effects as pre-differentiated osteoclasts on the osteogenic differentiation of MSCs and mineralization. Conclusion Our results demonstrate stimulatory effects of osteoclast conditioned medium on hMSC osteogenic differentiation, depending on initial hPBMC seeding density. In addition, we show that osteoclast and macrophage cultures contain pools of polarized macrophages, which may be involved in the osteogenic effects. Our data provide insight into bone tissue engineering approaches by using multicellular interactions related to bone remodeling and healing for the in vitro modulation of osteogenic differentiation

Unicentric study of cell therapy in chronic obstructive pulmonary disease/pulmonary emphysema

Within the chronic obstructive pulmonary disease (COPD) spectrum, lung emphysema presents, as a primarily histopathologic feature, the destruction of pulmonary parenchyma and, accordingly, an increase in the airflow obstruction distal to the terminal bronchiole. Notwithstanding the significant advances in prevention and treatment of symptoms, no effective or curative therapy has been accomplished. In this context, cellular therapy with stem cells (SCs) arises as a new therapeutic approach, with a wide application potential. The purpose of this study is to evaluate the safety of SCs infusion procedure in patients with advanced COPD (stage IV dyspnea). After selection, patients underwent clinical examination and received granulocyte colony-stimulating factor, immediately prior to the bone marrow harvest. The bone marrow mononuclear cells (BMMC) were isolated and infused into a peripheral vein. The 12-month follow-up showed a significant improvement in the quality of life, as well as a clinical stable condition, which suggest a change in the natural process of the disease. Therefore, the proposed methodology in this study for BMMC cell therapy in sufferers of advanced COPD was demonstrated to be free of significant adverse effects. Although a larger sample and a greater follow-up period are needed, it is possible to infer that BMMC cell therapy introduces an unprecedented change in the course or in the natural history of emphysema, inhibiting or slowing the progression of disease. This clinical trial was registered with ClinicalTrials.gov (NCT01110252) and was approved by the Brazilian National Committee of Ethics in Research (registration no. 14764, CONEP report 233/2009)

Cell therapy in pulmonary diseases: are there perspectives?

A terapia celular poderia ser conceituada de forma ampla e genérica como o emprego de células para tratamento de doenças. Apesar de um número não tão expressivo de relatos tendo o pulmão como objeto de estudo na terapia celular em pacientes humanos, há dados consistentes da literatura, tanto em humanos, quanto em modelos animais,que evidenciam a migração de células-tronco da medula óssea para o pulmão,em diferentes situações experimentais. Esses resultados forneceram o embasamento experimental para o emprego de células-tronco na regeneração do tecido pulmonar em modelos animais. Em nosso laboratório, vários projetos de pesquisa têm sido conduzidos com a finalidade de avaliar a resposta pulmonar (morfológica e funcional) ao tratamento com células-tronco adultas em camundongos com doença pulmonar obstrutiva crônica (DPOC) induzida experimentalmente. Os resultados obtidos, aliados àqueles de outros grupos de pesquisa, permitem aventar a possibilidade de aplicação, a curto prazo, da terapia celular em pacientes com DPOC. Em outra patologia pulmonar, fibrose cística (FC), cuja abordagem terapêutica com células-tronco apresenta aspectos particulares em relação às patologias pulmonares crônico-degenerativas, há avanços promissores e potencialmente interessantes; no entanto, os resultados podem ser considerados incipientes e deve-se assinalar, portanto, que a associação da terapia gênica e celular apresenta-se como uma alternativa possível, mas ainda muito distante quanto à sua consolidação e incorporação como opção terapêutica segura e eficaz em FC. Por outro lado, tendo por embasamento os resultados obtidos em modelos experimentais, é possível postular que a terapia celular com células-tronco hematopoéticas (ou de outras fontes) encerra perspectivas consistentes de aplicação em diversas outras patologias pulmonares humanas, especialmente em DPOC.Cell therapy can be briefly described as the use of cells in the treatment of diseases. Although the number of scientific reports involving lung and cell therapy in humans is not expressive, there are consistent data, both in humans and animal models. Experiments show the migration of bone marrow stem cells to the lung, in different situations. These results provide the experimental basis for the use of stem cells in the regeneration of the lung tissue in animal models. In our laboratory, several projects have been conducted aiming to evaluate the pulmonary response (morphological and functional) to treatment with adult stem cells in mice with experimentally induced chronic obstructive pulmonary disease. The results obtained, together with those from other research groups, allow us to consider the possibility of application, in the near future, of cell therapy in chronic obstructive pulmonary disease patients. For another disease, cystic fibrosis, cell therapy shows particular aspects in relation to other chronic degenerative pulmonary diseases. In this pathology, there are interesting and promising advances, however, the results are incipient and, thus, it must be said that the association between genetic and cell therapy appears to be a possibility, but still far from being consolidated and incorporated as a safe and effective therapeutic alternative in cystic fibrosis. On the other hand, based on the results obtained in experimental models, it is possible to postulate that cell therapy with hematopoietic stem cells (or from other sources) brings consistent application perspectives in several other human pulmonary diseases, especially in chronic obstructive pulmonary disease.CNPqFundunesp Fundação BiomaVal

The effect of mesenchymal stem cells combined with platelet-rich plasma on skin wound healing

INTRODUCTION: Mesenchymal stem cells (MSCs) are multipotent stem cells that have the potential of proliferation, high self-renewal, and the potential of multilineage differentiation. The differentiation potential of the MSCs in vivo and in vitro has caused these cells to be regarded as potentially appropriate tools for wound healing. After the burn, trauma or removal of the tumor of wide wounds is developed. Although standard treatment for skin wounds is primary healing or skin grafting, they are not always practical mainly because of limited autologous skin grafting. EVIDENCE ACQUISITIONS: Directory of Open Access Journals (DOAJ), Google Scholar, PubMed (NLM), LISTA (EBSCO), and Web of Science have been searched. EVIDENCE SYNTHESIS: For clinical use of the MSCs in wound healing, two key issues should be taken into account: First, engineering biocompatible scaffolds clinical use of which leads to the least amount of side effects without any immunologic response and secondly, use of stem cells secretions with the least amount of clinical complications despite their high capability of healing damage. CONCLUSION: In light of the MSCs' high capability of proliferation and multilineage differentiation as well as their significant role in modulating immunity, these cells can be used in combination with tissue engineering techniques. Moreover, the MSCs' secretions can be used in cell therapy to heal many types of wounds. The combination of MSCs and PRP aids wound healing which could potentially be used to promote wound healing

Cell therapy in chronic ulcers with implant of mesenchymal stem cells associated with platelet-rich plasma.

Doenças crônicas sistêmicas, em especial o diabetes mellitus, favorecem o aparecimento e a continuidade de lesões dermo-epidérmicas, sendo o impacto econômico e social significativo. No âmbito da medicina regenerativa para o tratamento de lesões cutâneas crônicas, o emprego clínico da bioengenharia de tecidos associada à terapia celular tem sido considerado uma promissora alternativa terapêutica. Neste contexto, o estudo tem como objetivo avaliar a eficácia terapêutica no tratamento de úlceras cutâneas de pacientes diabéticos, empregando células-tronco mesenquimais do tecido adiposo (CT-TA) associadas a plasma rico em plaquetas (PRP) obtido de sangue autólogo. A pesquisa aplicada foi composta por seis pacientes diabéticos e portadores de úlceras cutâneas crônicas. A reepitelização total ocorreu em 5 das 9 lesões tratadas, sendo o índice de cicatrização médio superior a 70% após 3 meses da aplicação. Desta forma, é possível concluir que a terapia com CT-TA associadas a PRP proporciona uma redução na área ulcerosa de lesões cutâneas crônicas em pacientes diabéticos.Systemic chronic diseases, especially diabetes mellitus, favor the emergency and continuity of dermal-epidermal lesions, being significant the economic and social impact. Within the regenerative medicine field for treatment of cutaneous chronic wounds, the clinical use of tissue bioengineering and cell therapy has been considered as a promising therapeutic alternative. In this context, the present study aims to evaluate the therapeutic efficiency, using adipose-derived mesenchymal stem cells (ADSC) associated with platelet-rich plasma (PRP) obtained from autologous blood, for the treatment of cutaneous ulcers from diabetic patients. The applied research was composed of six diabetic patients with chronic skin ulcers. The total re-epithelialization occurred in 5 of the 9 lesions treated, and the average wound healing index greater than 70% after 3 months of application. In this way, it can be concluded that ADSC therapy associated with PRP provides a reduction in ulcer area of chronic skin lesions in diabetic patients

Magma: breviário de rosa

Magma é o volume de poemas que marcou a estréia literária de João Guimarães Rosa, tendo no entanto permanecido inédito por mais de sessenta anos e sido até o momento relegado à marginalidade pela maior parte da crítica. O presente trabalho tem como objetivo contribuir para o resgate desse livro, bem como levantar, no discurso do mesmo, elementos úteis para o reconhecimento da sua inserção ideológica no conjunto da obra do autor. Com esse intento, procede-se à análise do universo simbológico plasmado por seus textos componentes, através do que se consegue identificar em Magma a inquietação anagógica que é o cerne da literatura rosiana.Magma is the poems volume that set out the literary debut of João Guimarães Rosa, although have stayed inedited over sixty years and until now have been discarded by the majority of the critique. The aim of the present work is to contribute to the ransom of that book and to find in its discourse able factors to its insertion into the whole author production. With that purpose, is accomplished the analysis of the symbological universe shaped by its component texts, with what is possible to identify in Magma the anagogical inquietud that is the pith of the Guimarães Rosa literature.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Introdução ao rosário magmático de Guimarães Rosa

Magma é o volume de poemas que marcou a estréia de João Guimarães Rosa, tendo no entanto permanecido inédito por mais de sessenta anos. O presente trabalho tem como objetivo realizar uma introdução ao universo simbológico desse livro através da análise dos três primeiros poemas que o compõem.Magma is the poems volume that set out the debut of João Guimarães Rosa, although have been inedited over sixty years. The aim of the present work is to realize an introduction to the symbological universe of that book troughout the analysis of the three first poems that compose it