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[Oxygen metabolism in roots resorbing granulated tissue from bovine deciduous teeth, from the aspects of superoxide dismutase, lactate dehydrogenase, and lipid peroxidation].

Root resorbing of deciduous teeth is a general phenomenon during eruption of the permanent teeth. In the present study, we tried to clarify the active-oxygen metabolism of root resorped granulated tissues. Granulated tissues were obtained from two fresh mandibles of young bovine about 1 year old undergoing root resorption. Cu-Zn-Superoxide dismutase (SOD), Mn-SOD, Lactate dehydrogenase (LDH), and concentration of lipid-peroxidated products were determined on the supernatants from homogenized tissues. We obtained the following results. 1) Cytosolic Cu-Zn-SOD activity did not elevate as compared to control tissues. 2) Elevation of mitochondrial Mn-SOD activity was observed in granulated tissues. 3) LDH activity did not elevate as compared to control tissues. 4) Lipid-peroxidated products in granulated tissues showed high concentration as compared to control tissues. Based on the above, we specurated that the active-oxygen metabolism in the root resorped granulated tissues, at least in mitochondria, was elevated.

Animals↗

Studies on the endothelin-1-induced contraction of rat granulation tissue pouch mediated by myofibroblasts.

A granulation tissue pouch, mostly composed of myofibroblasts, was prepared by injecting rats subcutaneously with croton oil. The contraction of the granulation tissue pouch caused by endothelin-1 (ET-1) and the effects of the ET receptor antagonists, BQ123 and BQ788 on it were thus examined. ET-1 produced contractions in a dose-dependent manner. Pretreatment with BQ123, an ETA receptor selective antagonist, shifted the dose-response curve to the right, whereas pretreatment with BQ788, an ETB receptor selective antagonist, showed little effect. IRL1620, an ETB receptor selective agonist, did not cause any contraction in the granulation tissue pouch. The existence of both ETA and ETB receptors in the granulation tissue pouch and in cultured myofibroblasts was demonstrated by RT-PCR. Intracellular Ca2+ mobilization in Fura-2/acetyl-methoxy ester loaded cultured myofibroblasts isolated from the granulation tissue was also examined. ET-1 produced a transient increase in [Ca2+]i followed by a sustained elevation of [Ca2+]i, whereas IRL1620 caused only a transient peak. These results suggest that the ET-1 induced contraction of granulation tissue is mainly mediated through the mobilization of Ca2+ from the extracellular space caused by stimulation with ETA receptor.

Animals↗

Transient increase in telomerase activity of proliferating fibroblasts and endothelial cells in granulation tissue of the human skin.

Although granulation tissue formation is an important step for second-intention wound healing, the molecular events underlying this process are still poorly understood. To investigate the role of telomerase in the formation of granulation tissue, we measured the activity of this enzyme and determined the expression and localization of human telomerase reverse transcriptase mRNA using human skin samples. Telomerase activity in the tip of the granulation tissue where fibroblasts actively proliferate was detected at a level 5.6 +/- 1.5 times higher than that at the edge of the tissue when using a polymerase chain reaction-based telomeric repeat amplification protocol assay coupled with enzyme-linked immunosorbent assay. This, together with the findings from semiquantitative reverse transcriptase-polymerase chain reaction and in situ hybridization of human telomerase reverse transcriptase, revealed that proliferating cell nuclear antigen-positive fibroblasts and endothelial cells in the progressing granulation tissue showed de novo activation of telomerase with high human telomerase reverse transcriptase mRNA expression. This condition may be a prolongation of cellular replicative capacity taking advantage of the positive regulatory dynamics of cell growth. We conclude that the regulation of telomerase activity may play an important role in granulation tissue formation in wound healing.

Adult↗

The origin and mode of fibroblast migration and proliferation in granulation tissue.

The factors which regulate the properties of granulation tissue remain uncertain. The key cells in granulation tissue are fibroblasts and their role was investigated in rat skin excisional wounds. Full thickness wounds in 28 Hooded Lister rats were made and traced. On days 1 to 7, animals in groups of 4 received colchicine 1 mg/kg subcutaneously, 4 h before being killed. Wound sections were stained to locate and count mitotic cells. All wounds healed with a normal coefficient of contraction. The fibroblasts' mitotic indices (% of mitotic cells) were calculated. Dermis: 0.1% vs. 2.9% (control vs. test P < 0.001, paired t-test); fascia; 0.07% vs. 5.6% (control vs. test P < 0.001); granulation tissue: 9.7%. Granulation tissue fibroblasts come mainly from the adjacent fascia although the dermis may have an initial role. Once they are in the wound replication is extremely rapid. This study highlights for the first time the rapidity of fibroblastic migration and proliferation in excisional wounds, and suggests that future therapeutic interventions to control granulation tissue should consider these kinetics.

Animals↗

Totally obstructing tracheotomy-associated suprastomal granulation tissue.

Although tracheotomy-associated suprastomal granulation tissue is quite common, suprastomal granulation tissue that totally obstructs the airway is relatively rare and can be associated with serious complications. In this report the complications and management of six cases of totally obstructing suprastomal granulation tissue (TOSGT) are presented. Complications associated with the presence or management of TOSGT included progression of subglottic stenosis, development of posterior laryngeal stenosis, development of supraglottic stenosis following CO(2) laser supraglottoplasty, and dislodgement of the TOSGT with distal tracheal obstruction resulting in anoxic brain injury. It is recommended that the tracheotomy tube remains in position at all times during attempted removal, and that if endoscopic removal is not possible, that open tracheoplasty is the safest method for removal. Measures that may decrease the chances of recurrence include diligent diagnosis and treatment of gastroesophageal reflux disease (GERD) and bacterial infection. TOSGT may be a marker for some patients with abnormal wound healing.

Bronchoscopy↗

Effect of D-penicillamine on collagen, glycosaminoglycans, DNA and RNA of granulation tissue and connective tissue of skin, bone and aorta in rats.

Granulation tissue was produced by subcutaneous implantation of viscose-cellulose sponges on rats. The effect of D-penicillamine 500 mg/kg/day for 10 days on granulation tissue and the connective tissue of skin, bone and aorta was studied ny comparison of treated animals with operated and unoperated controls. In addition, the effect of sponge implantation on intact tissues was studied by comparison between the control groups. The amount of granulation tissue was not affected by D-penicillamine, and the granulomas-DNA content even increased. D-penicillamine increased the amount of salt soluble collagen in all tissues consistent with an inhibition of collagen crosslinking as reflected by increased aldehyde content and alpha/beta chain ratio in soluble skin collagen. Skin appeared to be most sensitive. The content of free hydroxyproline and RNA and the RNA/DNA ratio in skin decreased suggesting a decreased collagen biosynthesis. The hydroxylation of proline and lysine was not affected by the treatment. The water percentage of aorta increased during D-penicillamine treatment, and the 35S-sulphate uptake in the sulphated glycosaminoglycans was stimulated in all tissues, in granulation tissue mainly in the chondroitin-4/6-sulphate fraction. No quantitative glycosaminoglycan changes occurred in granulation tissue. Sponge implantation caused an increase in the amount of salt soluble skin collagen without any change in alpha/beta chain ratio and aldehyde content of purified, soluble collagen. D-penicillamine plus operation reduced the collagen content of aorta. The effects of D-penicillamine on connective tissue compounds may be of importance for its antirheumatic efficacy, but the accompanying effect on normal tissues may imply side effects.

Animals↗

Fibronectin in experimental granulation tissue.

The temporal appearance of fibronectin in experimental granulation tissue has been studied using the immunoperoxidase technique on material fixed in formaldehyde, embedded in paraffin and pretreated with pepsin. Furthermore, the relationship between the distribution of fibronectin and connective tissue fibres, demonstrated as either argyrophilic or red by the van Gieson method, has been investigated. Fibronectin was demonstrated as part of the fibrinous network in the sponge before the formation of granulation tissue. In the development of granulation tissue fibronectin was seen in the initial cellular stage codistributed with the newly formed fibres, first the argyrophilic fibres and later with those stained red by the van Gieson method, too. With maturation of the granulation tissue, predominated by these fibres, the amount of fibronectin was gradually reduced. The presence of fibronectin in the sponge already before the formation of granulation tissue suggests that fibronectin in the initial stage of inflammation derives from plasma. The increase in amount of fibronectin corresponding to the cellular (fibroblastic) proliferation and the formation of fibres, both argyrophilic and van Gieson positive, indicates that fibronectin in young granulation tissue is synthesized by fibroblastic cells. The relationship between the morphologically demonstrated argyrophilic fibres and van Gieson positive fibres and the biochemical type III and type I collagens is discussed.

Animals↗

Cyclophosphamide effect on collagen metabolism in granulation tissue, skin, and aorta of rats.

Granulation tissue was produced in rats by subcutaneous implantation of viscose cellulose sponges. Cyclophosphamide 10 mg/kg was given daily intraperitoneally to 15 rats from the day of sponge implantation. Fifteen rats served as pair-fed controls, and 15 rats served as non-starved controls. After 14 days of treatment the animals were decapitated. Groups of 3 rats were given 50 muci 14C-proline intraperitoneally 1, 3, 6, 12, or 24 hours before death. The aorta, skin, and granulation tissue were examined. Cyclophosphamide caused no effect on collagen of the aorta, while in skin, the only detectable effect was a decrease in 14C-OH-proline biosynthesis. In granulation tissue, cyclophosphamide caused a fall in the dry weight, a decrease in 14C-proline uptake and 14C-OH-proline synthesis, as well as an increase in the alpha-amino nitrogen to OH-proline ratio in purified collagen. These results indicate that cyclophosphamide inhibits the synthesis of proteins, including collagen, and inhibits the hydroxylation of proline in collagen. No effect of cyclophosphamide could be detected on the amount of salt soluble OH-proline or on collagen cross-linking. The registered effects of cyclophosphamide on granulation tissue is probably of importance with regard to the anti-inflammatory action of cyclophosphamide. This action as well as the tissue differences in the sensitivity of cyclophosphamide may be of relevance to the clinical application of cytostatics in rheumatological diseases.

Animals↗

Mesenchymal cell activation is the rate-limiting step of granulation tissue induction.

During wound repair a 3-day lag occurs between injury and granulation tissue development. When full-thickness, 8-mm-round, excisional wounds were made in the paravertebral skin of outbred Yorkshire pigs and harvested at various times, no granulation tissue was observed before day 4. Day 4 wounds were 3% filled with granulation tissue, day 5 wounds 48% filled, and day 7 wounds 88% filled. The prerequisites for granulation tissue induction are not known but hypothetically include fibrin matrix maturation or cell activation. To examine whether matrix maturation was necessary, wounds were allowed to heal for 5 or 7 days and then aggressively curetted, resulting in the formation of fresh fibrin clots in the newly formed wound spaces. In contrast to original wounds, no lag phase was observed; wounds curetted on day 5 were 23% filled with granulation tissue 1 day later and 99% filled 3 days later, whereas wounds curetted on day 7 were 47% filled 1 day later and completely filled within 2 days. Thus, granulation tissue formation resumed promptly and independently of fibrin clot matrix maturation. This observation suggested that mesenchymal cell activation might be the rate-limiting step in granulation tissue formation. To address this hypothesis more directly, cultured porcine or human fibroblasts, grown to 80% confluence in Dulbecco's minimal essential medium plus 10% fetal calf serum, were added to new wounds. These wounds were sealed with a freshly made exogenous fibrin clot. In some wounds, platelet releasate was added to the fibrin clot. Granulation tissue did not form in day 3 wounds, which had received either fibrin alone, fibrin and platelet releasate, or fibrin and fibroblasts. In contrast, granulation tissue was observed in wounds receiving fibrin, human fibroblasts, and platelet releasate. By day 4, wounds receiving cultured human fibroblasts, fibrin, and platelet releasate were 14% filled with granulation tissue compared with less than 4% granulation tissue in control wounds. Thus, fibroblast activation is a limiting step of granulation tissue formation, and continued cell stimulation is required for accelerated development.

Animals↗

Evaluation of shikonin on granulation tissue formation compared with carrageenan.

The effect of shikonin (SK) on granulation tissue formation was biochemically evaluated and the biological effect of SK on cotton pellet induced granulation tissue formation and the induction of hind paw edema was compared with that of lambda-carrageenan (carrageenan) in rats. The dry weight of granulation tissue formed was increased by SK. The amounts of hemoglobin and hydroxyproline in granulation tissue were also increased by SK. These results suggest that SK has an enhancing effect on the formation of granulation tissue, accompanied by the proliferation of capillaries and the increased production of collagen in rats. SK showed mild stimulation toward swelling when injected into the hind paws of rats, as did carrageenan, while it showed a marked enhancing effect on granulation tissue formation compared with carrageenan. These results suggest that the mechanism underlying the biological effect of SK on granulation tissue formation is different from that of carrageenan, though the mild stimulation by SK might still contribute in part to the enhancing effect on granulation tissue formation.

Animals↗

Granulation tissue regression induced by musculocutaneous advancement flap coverage.

BACKGROUND: Clinical experience suggests that granulation tissue may be inhibited by coverage with a musculocutaneous flap. We hypothesized that coverage of an open wound with a musculocutaneous flap would result in regression and apoptosis of the wound's granulation tissue. METHODS: In the first experiment, 32 rats underwent excisional wounding; 16 underwent musculocutaneous flap coverage of their granulation tissue on postwounding day 8, and then 16 rats (8 controls + 8 flaps) were killed on both postwounding days 10 and 12 (2 and 4 days after the flap procedure, respectively). In the second experiment, 18 rats were wounded, and on postwounding day 5 the rats underwent flap coverage (n = 6), wound edge release/mobilization (the first step of the flap procedure) without flap coverage (n = 6), or dressing change only (n = 6); all rats were killed on postwounding day 6 (24 hours after the secondary intervention). Apoptosis was quantified with the terminal deoxynucleotidyl transferase-mediated nick-end labeling assay. RESULTS: Placement of a musculocutaneous flap over an 8-day-old excisional wound in the first experiment increased the apoptotic rate in the granulation tissue from 0% to 1% (controls) to 5% to 10% at both 2 and 4 days after flap coverage (P <.05). Cell population density decreased 50% in the flap-covered granulation tissue compared with the controls (P <.05). In the second experiment, circumferential release of the granulation tissue resulted in an equivalent increase in granulation tissue apoptosis over controls compared to that induced by the full flap procedure. CONCLUSIONS: Coverage of established granulation tissue with a musculocutaneous flap resulted in histologic regression of the wound's granulation tissue after 2 to 4 days of flap coverage and induced at least a 5-fold increase in the apoptotic rate of the granulation tissue. Releasing the wound edge increased granulation tissue apoptosis to a level equivalent to that produced by the musculocutaneous flap procedure, suggesting that alteration of the wound's mechanical environment is responsible for the acute induction of apoptosis in this model.

Animals↗

Skin flap-induced regression of granulation tissue correlates with reduced growth factor and increased metalloproteinase expression.

Previous studies have shown that covering granulation tissue of a full-thickness skin wound by a vascularized skin flap induces tissue remodeling, with a rapid loss of granulation tissue cells by apoptosis. In the present study, in situ hybridization has been used to examine mRNA expression for several factors that may be implicated in the apoptosis seen in this tissue. Skin wounds were made on the dorsal skin of 8-week-old rats. Ten days after wounding, skin flaps were created surgically and sutured over the granulation tissue. Tissue sections of granulation tissue from various times after addition of the skin flap were hybridized with 33P-labelled cRNA probes for transforming growth factor-beta1 (TGF-beta1), beta-inducible gene H3 (beta-ig-h3), alpha1 (1) procollagen, alpha-smooth muscle actin, matrix metalloproteinase-13 (MMP-13) and -2 (MMP-2), tissue inhibitor of metalloproteinase-1 (TIMP-1), and inducible nitric oxide synthase (iNOS). Control granulation tissue prior to addition of the skin flap showed high levels of TGF-beta1, beta-ig-h3, alpha1 (1) procollagen, alpha-smooth muscle actin, and TIMP-1 expression. MMP-13, MMP-2, and iNOS mRNA were low in 10-day granulation tissue. Addition of a skin flap resulted in a decrease in the expression of TGF-beta1, beta-ig-h3, alpha1 (I) procollagen, alpha-smooth muscle actin, and TIMP-1, but increased expression of MMP-13 and MMP-2. Similarly, an increase in iNOS mRNA expression was observed in the granulation tissue after addition of the skin flap. Addition of a vascularized skin flap may result in rapid remodelling of granulation tissue due to a decrease in expression of the trophic growth factor TGF-beta1 and increased degradation of extracellular matrix due to an alteration in the balance between MMPs and their inhibitor, TIMP-1. Additionally, increased iNOS expression may also favour apoptosis through the generation of free radicals. The additive effect of reduced growth factor expression, increased extracellular matrix turnover, and nitric oxide generation may result in the fibroblast and vascular cell apoptosis seen during the rapid remodelling of this tissue.

Animals↗

Analysis of the leukotriene D4 receptor in the granulation tissue of allergic inflammation in rats.

Leukotriene (LT) D4 receptor in the granulation tissue formed in the air pouch-type allergic inflammation model in rats was analyzed. Membrane preparation of the granulation tissue obtained 3-9 days after the antigen challenge has specific binding sites of [3H]LTD4. Scatchard analysis showed that the affinity (Kd) and the density (Bmax) were not changed among the granulation tissue obtained 3-9 days after the antigen challenge. The Kd value in the granulation tissue (0.90 +/- 0.12 nM) was close to that in the rat lung (1.00 +/- 0.24 nM) and the guinea pig lung (0.86 nM). On the other hand, Bmax (62 +/- 8 fmol/mg protein) in the granulation tissue was higher than that in the rat lung (21 +/- 4 fmol/mg protein) but was far less than that in the guinea pig lung (405 fmol/mg protein). LTC4 and LTE4 inhibited the binding of [3H]LTD4 to the membrane preparation of the granulation tissue in a concentration-dependent manner. IC50 of LTC4 and LTE4 were 1 x 10(-7) and 2 x 10(-7) M, respectively. A guanine nucleotide, guanyl-5'-yl-imido-diphosphate (GppNHp), reduced [3H]LTD4 binding to the membrane preparation of the granulation tissue suggesting that LTD4 receptors in the granulation tissue are associated with G proteins. These results indicate that LTD4 binding sites in the granulation tissue are high affinity receptors for LTD4. A possible role of LTD4 in the recurrence of allergic inflammation in the chronic phase is discussed.

Animals↗

[Wound healing models for studying the formation of granulation tissue].

In this report models of granulation tissue formation during wound healing are reviewed. As suggested by Kovac and Rudas a distinction is made between inflammatory, foreign body and reparative granulation tissue formation. The advantages and disadvantages of the different models are discussed. While the older studies mainly compared qualitative evaluation of granulation tissue, in recent experiments models involving predominantly quantitative histological and biochemical methods are of increasing importance. One of these is a spongiosa implant model designed by our group which is briefly discussed.

Animals↗

Effects of granulation-tissue extracts on collagen synthesis.

The effect of granulation-tissue extract on the synthesis of collagen in embryonic-chick tendon cells was found to depend on (i) the developmental phase of the granulation tissue, (ii) the concentration of the extract and (iii) the presence of diffusible components in it. The suppressing effect was maximal with concentrated extracts from 2--3-week granulation tissue (where the collagen synthesis is also maximal). The suppressing factor could be enriched by gel filtration chromatography. Cultured human synovial cells were affected like the embryonic-chick cells. When the sponge implant was imbibed with granulation-tissue extract in advance, the developing granuloma contained less collagen than the control. The stimulating effects with dilute extracts from granulation tissue were due to diffusible components. Blood serum and rheumatoid synovial fluid samples also stimulated collagen synthesis in granulation-tissue slices, less after dialysis.

Animals↗

Collagen in granulation tissues.

Collagen is abundantly synthesized in granulation tissues and reaches a concentration higher than in normal neighbouring tissues. Such newly formed collagen is characterized by an abnormally low solubility and an easy degradation by collagenases and collagenolytic cathepsins. The activities of these two types of enzymes are high (especially collagenases) in tissues of acute inflammations when the granuloma is resorbing. These activities are lower in sub-acute inflammation and the collagen content of the persistent granuloma remains high. The collagen synthesized in granulation tissues is cross linked by hydroxylysino-5-keto-norleucine, the stable cross-link of collagen in embryonic skin. It is progressively replaced by the two aldimine cross links of normal adult skin when the granuloma is resorbed (acute inflammations induced in rats; human normal scars). The cross link of embryonic skin, on the contrary, is permanently present in collagen of tissues of subacute, chronic inflammations (sponge implants in rats, human hypertrophic scars and keloids. Studies of the structure of alpha-chains revealed that type III collagen (embryonic collagen) is present in granulation tissues.

Animals↗

Cyclooxygenase-2-mediated angiogenesis in carrageenin-induced granulation tissue in rats.

The possible participation of cyclooxygenase (COX)-2 in angiogenesis in granulation tissue was analyzed using an air pouch-type carrageenin-induced inflammation model in rats. Injection of carrageenin solution into an air pouch induced gradual increases in the pouch fluid volume and granulation tissue weight as well as angiogenesis in granulation tissue. NS-398 (10-100 microg) inhibited all of these parameters in a dose-dependent manner. NS-398 (100 microg), indomethacin (100 microg), and dexamethasone (10 microg) markedly reduced prostaglandin (PG) E(2) levels in the pouch fluid at day 6. NS-398 and indomethacin did not affect protein levels of COX-1 and COX-2 but dexamethasone significantly reduced the level of COX-2 in granulation tissue at day 6. Protein levels of vascular endothelial growth factor (VEGF) in granulation tissue and in the pouch fluid were higher at day 6 than at day 3, and the levels were decreased by treatment with NS-398 (10-100 microg) in a dose-dependent manner. The inhibitory effects of NS-398 (100 microg) were almost the same as those of indomethacin (100 microg). Dexamethasone (10 microg) also reduced VEGF protein levels in granulation tissue at day 6. To clarify the role of PGE(2) in VEGF production, minced granulation tissue obtained 3 days after carrageenin injection from the indomethacin-treated rats was incubated in the presence of various concentrations of PGE(2). It was shown that VEGF mRNA and protein levels in the minced granulation tissue were increased by PGE(2) in a concentration-dependent manner. These findings suggest that COX-2-derived PGE(2) plays a significant role in angiogenesis in the carrageenin-induced granulation tissue through VEGF formation.

Animals↗