1. Treatment with Hyaluronic Acid and Collagen-Polyvinylpyrrolidone Improves Extracellular Matrix Assembly for Scarring after Tracheal Resection.
- Author
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Olmos-Zuñiga JR, Baltazares-Lipp M, Hernández-Jiménez C, Jasso-Victoria R, Gaxiola-Gaxiola M, Silva-Martínez M, Iñiguez-García MA, González-González AI, Vázquez-Minero JC, Luna-Flores A, Solis-Alanis N, and Baltazares-Lipp ME
- Subjects
- Anastomosis, Surgical, Animals, Cicatrix etiology, Cicatrix pathology, Collagen metabolism, Decorin metabolism, Disease Models, Animal, Dogs, Extracellular Matrix drug effects, Extracellular Matrix metabolism, Extracellular Matrix pathology, Female, Fibrosis, Humans, Male, Matrix Metalloproteinase 1 metabolism, Matrix Metalloproteinase 9 metabolism, Mitomycin administration & dosage, Postoperative Complications metabolism, Postoperative Complications pathology, Trachea drug effects, Trachea pathology, Trachea surgery, Wound Healing drug effects, Cicatrix drug therapy, Collagen administration & dosage, Hyaluronic Acid administration & dosage, Postoperative Complications drug therapy, Povidone administration & dosage, Tracheal Stenosis surgery
- Abstract
Treatment of tracheal stenosis is occasionally performed in combination with wound healing modulators to manipulate new extracellular matrix (ECM) formation and prevent fibrosis. Hyaluronic acid (HA) and collagen-polyvinylpyrrolidone (collagen-PVP) decrease fibrosis in experimental tracheal healing. However, they have not been used clinically as their effect on ECM components, which modify tracheal scarring, has not been described. Objective . To evaluate the effect of the application of HA, collagen-PVP, a mixture of HA and collagen-PVP (HA+collagen-PVP), and mitomycin C on the expression of decorin, matrix metalloproteinase 1 (MMP1), and MMP9, as well as the type of collagen and deposits formed in the scar after resection and end-to-end anastomosis (REEA) of the cervical trachea using an experimental model. Materials and Methods . Thirty dogs underwent REEA of the cervical trachea and were treated with different wound healing modulators: group I ( n = 6), control; group II ( n = 6), HA; group III ( n = 6), collagen-PVP; group IV ( n = 6), HA+collagen-PVP; and group V ( n = 6), mitomycin C. The dogs were evaluated clinically and endoscopically for 4 weeks. Subsequently, macroscopic and microscopic changes, expression of ECM proteins, and collagen deposition in tracheal scars were analysed. Results . Groups II, III, and IV showed reduced endoscopic, macroscopic, and microscopic inflammation, improved neovascularization, high decorin expression ( p < 0.01, analysis of variance (ANOVA)), and moderate expression of MMP1 ( p < 0.003, ANOVA) and type I and III collagen ( p < 0.05, Kruskal-Wallis). Groups IV and V developed fewer collagen deposits ( p < 0.001, ANOVA). Conclusion . Treatment with HA and collagen-PVP improved post-REEA healing by increasing neovascularization, stimulating the expression of decorin, and regulating the expression of MMP1, as well as type I and III collagen and their deposition., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020 J. Raúl Olmos-Zuñiga et al.)
- Published
- 2020
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