No description available.

Regenerative medicine (RM) has the potential to develop new treatments for chronic disease and injury that are desperately needed in developing countries. Several emerging economies are actively participating in RM, producing new knowledge and initiating clinical trials. This thesis presents case studies of RM in China and Brazil and a comparative analysis of RM across Brazil, China and India. I aim to better understand the state of RM, how it has developed and what is needed for RM innovation to succeed within these countries. Case studies were conducted using face-to-face in-depth semi-structured interviews with RM experts from different areas including research institutes, hospitals, firms, educational institutes, government, policy agencies, and bioethics groups. Interviews were analysed using thematic analysis and triangulated with the analysis of research articles, government reports, laws and other primary and grey literature. China is now the 5th most prolific publisher on stem cells in the world. Chinese RM benefits from permissive regulations and the expertise of Chinese returnees that have trained abroad, but the field’s reputation is challenged by a weak regulatory system and the clinical availability of untested stem cell therapies. Brazil has created a small but strong RM program, but needs to address challenges to the field including inconsistent funding, slow importation of materials, and weak linkages between stake-holders. Comparative analysis of the three countries identifies several common elements that support RM, including linkages between stake-holders, government support, infrastructure, human resources, and good governance. RM capacity is clustered in large urban centres, which could exacerbate socio-economic and health disparities unless measures are taken to ensure equitable distribution of benefits. RM does not adhere to classical views of southern innovation, suggesting that new models are needed to describe innovation in emerging technologies, where countries are keeping up instead of catching up.

Regenerative medicine (RM) has the potential to develop new treatments for chronic disease and injury that are desperately needed in developing countries. Several emerging economies are actively participating in RM, producing new knowledge and initiating clinical trials. This thesis presents case studies of RM in China and Brazil and a comparative analysis of RM across Brazil, China and India. I aim to better understand the state of RM, how it has developed and what is needed for RM innovation to succeed within these countries. Case studies were conducted using face-to-face in-depth semi-structured interviews with RM experts from different areas including research institutes, hospitals, firms, educational institutes, government, policy agencies, and bioethics groups. Interviews were analysed using thematic analysis and triangulated with the analysis of research articles, government reports, laws and other primary and grey literature. China is now the 5th most prolific publisher on stem cells in the world. Chinese RM benefits from permissive regulations and the expertise of Chinese returnees that have trained abroad, but the field’s reputation is challenged by a weak regulatory system and the clinical availability of untested stem cell therapies. Brazil has created a small but strong RM program, but needs to address challenges to the field including inconsistent funding, slow importation of materials, and weak linkages between stake-holders. Comparative analysis of the three countries identifies several common elements that support RM, including linkages between stake-holders, government support, infrastructure, human resources, and good governance. RM capacity is clustered in large urban centres, which could exacerbate socio-economic and health disparities unless measures are taken to ensure equitable distribution of benefits. RM does not adhere to classical views of southern innovation, suggesting that new models are needed to describe innovation in emerging technologies, where countries are keeping up instead of catching up.

Während der letzten Jahre zeigten einige Studien, dass die Behandlung mit Knochenmark- Stammzellen (KMSZ) eine vielversprechende neue Therapieoption für den geschädigten Herzmuskel darstellen könnte. In dieser Arbeit wurde untersucht, ob es unter Behandlung mit Stammzellen zu einer zellulären Antwort in angezüchteten Kardiomyozyten (KMZ) kommt. Dafür wurden subkonfluente Kulturen aus Herzmuskelzellen von neonatalen Ratten für drei Tage mit Vybrant CM-DiI-markierten, sternalen humanen Knochenmarkstammzellen co-kultiviert. Im Anschluss wurden immunohistochemische Färbungen sowie eine quantitative Analyse mittels Western Blot für das Protoonkogen c-Myc durchgeführt. Des Weiteren wurde die Dichte der Beta-Adrenozeptoren unter Anwendung einer Histoautoradiographie mittels [125I]- iodocyanopindolol-Bindung analysiert. Die Auswertung der Immunohistochemie und der Western Blots zeigte eine signifikante Erhöhung der Expression von c-Myc in den Kardiomyozyten, welche in naher Umgebung der Stammzellen lagen. Dieser Effekt war direkt abhängig von der Entfernung der KMZ zur SZ. Die Histoautoradiographie zeigte eine signifikant höhere Beta-Rezeptor-Dichte in Kardiomyozyten in direkter Nähe zur Stammzelle. Mit steigender Entfernung von der Stammzelle verringerte sich die Rezeptordichte. Somit konnte gezeigt werden, dass eine kleine Anzahl von Knochenmark-Stammzellen ausreicht, um eine große Zahl von Kardiomyozyten zu beeinflussen, indem eine intrazelluläre Signalkaskade über c-Myc aktiviert und die Anzahl der Beta-Adrenozeptoren erhöht wird.

Tissue repair is a complex process that is difficult to emulate. The addition of the glycosaminoglycan heparan sulfate (HS), a multi-potential regulator of numerous growth factors and cytokines endogenously expressed during the repair process, may represent a valuable tool for tissue engineering. The addition of exogenous HS into wound site has previously been shown to promote tissue repair in a number of models, however, the incorporation of HS into controlled release systems or biomaterials for tissue engineering had not been explored prior to the work presented here. Thus, this thesis explores the incorporation of HS and its analogue heparin into synthetic biodegradable polymer biomaterials with different potential applications, either as a slow releasing drug reservoir, or as a drug releasing cell scaffold. Polycaprolactone was used to make microcapsules and electrospun fibers for HS or heparin entrapment. These materials were characterized for their drug release profiles, biocompatibility and bioactivity. Microcapsules encapsulating heparin or HS were made by the oil - in - water solvent evaporation method which allowed fabrication of slow releasing drug reservoirs. Either pure water or a poly(vinyl alcohol) solution was used in the drug phase which resulted in capsules with similar size and drug loading. However the internal morphology and drug release profiles showed differences depending on the drug phase, in either case release was sustained for over 30 days. These capsules elicited no pro-inflammatory response from macrophages in vitro, and the released HS retained its bioactivity to induce the proliferation of human mesenchymal stem cells, an important cell type for bone tissue engineering. Heparin and HS were incorporated into electrospun fibers as a drug releasing scaffold for two different tissue engineering applications. Heparin fibers were studied as a drug releasing membrane that could be used in vascular repair to prevent the unwanted proliferation of vascular smooth muscle cells. Heparin release was sustained from the fibers for at least 2 weeks. The fibers did not induce a pro-inflammatory response from macrophages in vitro and the released heparin retained the ability to inhibit the proliferation in vascular smooth muscle cells. HS fibers were studied as a tissue engineering scaffold for bone repair using human mesenchymal stem cells. HS release was maintained for over 30 days which is thought to be an appropriate time for bone repair applications. The release profiles depended on the HS concentration in the spinning solution which affected the morphology of the fibers. The fibers did not elicit a pro-inflammatory response in cultured macrophages and supported the proliferation and mineralization of human mesechymal stem cells. The HS fibers were then taken through to an in vivo model to study ectopic bone formation of pre-osteoblast cells on HS releasing scaffolds. The fibers produced a chronic inflammatory response in vivo, which lead to the clearance of implanted cells and no mineralization of the scaffold. The HS and heparin materials made in this work showed sustained release over appropriate time frames for different tissue repair applications. The released HS and heparin maintained bioactivity and showed good biocompatibility in vitro, however, further in vivo studies are required to fully test their efficacy for tissue engineering.

No description available.

Submitted by ISABELE SILVEIRA ROSA null (isabelesrv@gmail.com) on 2016-08-08T14:40:35Z No. of bitstreams: 1 IsabeleSilveiraRosaVanniMestrado - ok pdf.pdf: 3226160 bytes, checksum: 4bfd14d4c9a8ade0e472c57642b58870 (MD5) / Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2016-08-10T12:14:01Z (GMT) No. of bitstreams: 1 vanni_isr_me_bot.pdf: 3226160 bytes, checksum: 4bfd14d4c9a8ade0e472c57642b58870 (MD5) / Made available in DSpace on 2016-08-10T12:14:02Z (GMT). No. of bitstreams: 1 vanni_isr_me_bot.pdf: 3226160 bytes, checksum: 4bfd14d4c9a8ade0e472c57642b58870 (MD5) Previous issue date: 2016-07-18 / Não recebi financiamento / Muitas especialidades médicas têm utilizado o Plasma Rico em Plaquetas (PRP) em diferentes modalidades terapêuticas, como está ocorrendo com a Ortopedia e em Cirurgia Plástica. No entanto, a denominação utilizada para o PRP é muitas vezes equivocada. Diante do crescente número de especialidades médicas usando PRP ou Hormônios Derivados de Plaquetas (HDP) este trabalho foi delineado. Objetivo: compreende três etapas: 1) Levantamento bibliográfico em base de dados com a palavra-chave: platelet rich plasma com intuito de avaliar criticamente os artigos publicados na literatura em revistas com Fator de Impacto (FI)≥1; 2) Obter PRP, Concentrado de Plaquetas (CP) e HDP de indivíduos saudáveis, pela técnica de lisado plaquetário, após a utilização de agonista e congelamento / descongelamento (N=10) e 3) Avaliar o desempenho destes preparados como substituto do Soro Fetal Bovino na cultura de Células Tronco Mesenquimais humanas (CTMh). Casuística e Métodos: Os indicadores monitorados foram: idade, sexo, tipagem ABO/RhD, fenotipagem eritrocitária Rh, Kell e determinação de fatores de crescimento pelo sistema Multiplex-Milliplex®: PDGF- AA, RANTES/CCL5, PAI-1 (total), VEGF-A, FGF-1/FGF-ácido, FGF-2/FGF-básico, EGF, Angiopoietina-2, Fibrinogênio e Fator von Willebrand, estes dosados nas 3 preparações: PRP, CP e HDP. Todos os indicadores monitorados foram realizados análise estatística. Resultados: Foram analisados 50 artigos entre 2012-2016, destes, 29 com a palavra-chave platelet-rich plasma, 14 platelet lysate (PL) e 7 platelet growth factor (PGF). Os artigos publicados com a palavra-chave PL são de periódicos com maior FI e maior coerência com a metodologia, seguida do PGF e PRP. Contata-se que a maioria dos trabalhos com a terminologia PRP foi empregada de forma equivocada. Estes indicadores registram que não existe correlação entre a contagem plaquetária e a dosagem de hormônios. A idade dos indivíduos está inversamente relacionada com a concentração de fator, à exceção do FGF. Não há correlação da quantidade de fatores de crescimento e sexo. Indivíduos do grupo sanguíneo A, e fenótipo ee são melhores secretores de hormônios de crescimento. Quando se comparam os 3 métodos analisados, o CP e o HDP são estatisticamente superiores ao PRP quanto à dosagem de fatores de crescimento. A análise desempenho dos preparados, na concentração de 20% quando comparado com o Soro Fetal Bovino na mesma concentração, identifica que o melhor desempenho quantitativamente foi CP>PRP>HDP=CTLE. No entanto a análise histológica evidencia um grande número de células aderidas ao scaffold de fibrina, com desempenho nitidamente superior para o HDP. Conclusão: A maioria dos trabalhos publicados usa a terminologia PRP incorretamente. Levando-se em consideração a quantificação dos hormônios plaquetários dosados e o desempenho em cultura celular as melhores técnicas são CP e HDP, ficando o PRP em desvantagem. / Diversity medical specialties have been using Platelet Rich Plasma (PRP) therapy form as is happening with the Orthopedics and Plastic Surgery. However, the name used for the PRP is often used wrongly. This work was outlined considering the growing number of medical specialties using PRP or platelet-derived hormones (PDH). Objective: The work consisted of three steps: 1) Bibliographic search with the key word PRP in order to evaluate the articles published in journals with Impact Factor (IF) ≥1; 2) obtaining of PRP, platelet concentrate (PC) and PDH from healthy individuals using the platelet lysate technique after use agonist and freeze / thaw (N = 10); 3) evaluate the performance of these preparations as substitute for fetal bovine serum in culture of human mesenchymal stem cells. Methods: The indicators monitored were: age, sex, ABO / RhD, erythrocyte phenotyping Rh, Kell and determination of growth factors by Multiplex-Milliplex® system(PDGF-AA, RANTES / CCL5, PAI-1 (total), VEGF-A, FGF-1 / FGF-acid, FGF-2 / FGF-basic, EGF, Angiopoietin-2, fibrinogen and Factor von Wilebrand. The monitored indicators were performed statistical analysis. Results: These parameters were measured in three preparations: PRP, PC and PDH. It was analyzed 50 articles between 2012-2016, of these, 29 with the platelet-rich plasma password, 14 platelet lysate (PL) 7 and platelet growth factor (PGF). Articles published with the keyword PL are journals with higher IF and greater consistency with the methodology followed by PGF and last PRP. It was observed that most of the work with the PRP terminology was used wrongly. These indicators showed that there is no correlation between the platelet count and the dosage of hormones. The age of individuals is inversely related with the concentration of factors, excepting FGF. There is no correlation between the amount of growth factors and gender. Individuals belonging to blood group A and no phenotype E are better secreting of growth hormones. When comparing the three methods analyzed, PC and PDH are statistically higher than PRP on the dosage of growth factors. Compared with 20% of Fetal Bovine Serum, the performance was quantitatively better to PC> PRP> CTL=PDH on the viability of suspension cell. However, the histological analysis showed a large number of cells attached to the fibrin scaffold with higher performance to the PDH. Conclusion: The majority of published studies using PRP terminology are incorrectly. Considering the quantitation of platelet hormones and the performance in cell culture, the best techniques are PC and PDH.

Submitted by Ana Guimarães Pereira (agpereir@ucs.br) on 2015-03-10T12:51:11Z No. of bitstreams: 1 Tese Manuela Figueiro.pdf: 250850 bytes, checksum: e153c825a1349b3d0f2190178c5ec5c5 (MD5) / Made available in DSpace on 2015-03-10T12:51:12Z (GMT). No. of bitstreams: 1 Tese Manuela Figueiro.pdf: 250850 bytes, checksum: e153c825a1349b3d0f2190178c5ec5c5 (MD5) / Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul.

Orientador: Elenice Deffune / Resumo: Muitas especialidades médicas têm utilizado o Plasma Rico em Plaquetas (PRP) em diferentes modalidades terapêuticas, como está ocorrendo com a Ortopedia e em Cirurgia Plástica. No entanto, a denominação utilizada para o PRP é muitas vezes equivocada. Diante do crescente número de especialidades médicas usando PRP ou Hormônios Derivados de Plaquetas (HDP) este trabalho foi delineado. Objetivo: compreende três etapas: 1) Levantamento bibliográfico em base de dados com a palavra-chave: platelet rich plasma com intuito de avaliar criticamente os artigos publicados na literatura em revistas com Fator de Impacto (FI)≥1; 2) Obter PRP, Concentrado de Plaquetas (CP) e HDP de indivíduos saudáveis, pela técnica de lisado plaquetário, após a utilização de agonista e congelamento / descongelamento (N=10) e 3) Avaliar o desempenho destes preparados como substituto do Soro Fetal Bovino na cultura de Células Tronco Mesenquimais humanas (CTMh). Casuística e Métodos: Os indicadores monitorados foram: idade, sexo, tipagem ABO/RhD, fenotipagem eritrocitária Rh, Kell e determinação de fatores de crescimento pelo sistema Multiplex-Milliplex®: PDGF- AA, RANTES/CCL5, PAI-1 (total), VEGF-A, FGF-1/FGF-ácido, FGF-2/FGF-básico, EGF, Angiopoietina-2, Fibrinogênio e Fator von Willebrand, estes dosados nas 3 preparações: PRP, CP e HDP. Todos os indicadores monitorados foram realizados análise estatística. Resultados: Foram analisados 50 artigos entre 2012-2016, destes, 29 com a palavra-chave platelet-rich ... (Resumo completo, clicar acesso eletrônico abaixo) / Mestre

O fator de crescimento transformante beta tipo 1, TGF-β1, é uma proteína extracelular homodimérica secretada por vários tipos celulares, que pode ter ação parácrina ou endócrina. Essa proteína está envolvida em processos celulares de diferenciação, proliferação, mobilidade e formação de matriz extracelular. Além disso, é parte importante dos processos de regeneração tecidual, atuando, de maneira decisiva, no reparo, atraindo macrófagos e fibroblastos para o local da injúria e estimulando a angiogênese. Assim, considerando o papel desse peptídeo no processo regenerativo, o uso de TGF-β1 como proteína terapêutica na área de Bioengenharia Tecidual é bastante promissor. Apesar disso, a venda dessa proteína, para fins terapêuticos, é inexistente no mercado e a proteína recombinante vendida, que só pode ser utilizada em pesquisas científicas, não é produzida nacionalmente e chega a custar R$200.000,00/mg. Nesse contexto, o objetivo do presente trabalho é desenvolver uma metodologia de produção do fator recombinante TGF-β1 em células de ovário de hamster chinês (CHO), visando à obtenção de níveis altos de rendimento, e, futuramente, a transferência da tecnologia de produção para a iniciativa privada, tornando possível seu uso na Medicina Regenerativa, sozinho ou em combinação com outros fatores de crescimento. O cDNA de TGF-β1 foi amplificado a partir de um banco de cDNA humano e clonado no vetor proprietário pNU1 de expressão de mamífero. A construção pNU1/TGF-β1 foi utilizada para transfectar estavelmente células CHO DG44 e uma estratégia de co-amplificação foi utilizada para selecionar células transfectantes com maior número de cópias da sequência correspondente a TGF-β1. Estas culturas foram submetidas ao processo de amplificação gênica com concentrações crescentes de metotrexato. Ensaios de Western Blot e ELISA foram realizados utilizando-se o meio condicionado pelas populações selecionadas e por clones superprodutores. Entre os 41clones obtidos, cinco apresentaram maiores níveis de produção de TGF-β1, entre 1.000 e 2.000 ng/mL. Estes clones foram selecionados para a realização de testes de atividade in vitro utilizando-se células A549, que permitem avaliar a transição epitélio-mesênquima. Um ensaio de cicatrização de feridas em peles do dorso de camundongos foi padronizado e utilizado para avaliar a atividade in vivo do clone que apresentou melhor resultado in vitro. A proteína TGF-β1 foi parcialmente purificada por HPLC em uma coluna de afinidade. Portanto, a proteína TGF-β1 humana recombinante foi produzida, apresentando atividade biológica in vitro e in vivo, sendo capaz de reparar eficientemente feridas cutâneas. Essa iniciativa pode oferecer aos pacientes uma alternativa para o tratamento de lesões teciduais, acelerando a cicatrização de feridas e o reparo de tecidos. / The transforming growth factor beta 1, TGF-β1, is a homodimeric extracellular protein secreted by several cell types, which may have paracrine or endocrine action. This protein is involved in cellular processes of differentiation, proliferation, mobility and formation of extracellular matrix. In addition, it is an important part of the tissue regeneration processes, acting decisively on repair, attracting macrophages and fibroblasts to the site of injury and stimulating angiogenesis. Therefore, considering the role of this peptide in the regenerative process and the use of TGF-β1 as a therapeutic protein in the field of Tissue Bioengineering is very promising. Despite this, the sale of this protein for therapeutic purposes is nonexistent in the market and the recombinant protein available in the market, which can only be used in scientific research, is not produced nationally and the costs are in the order of R$ 200,000.00/mg. In this context, the objective of the present work is to develop a methodology for the production of the TGF-β1 recombinant factor in Chinese hamster ovary (CHO) cells, aiming at obtaining high yields, and, in the future, transfering the production technology to the private initiative, allowing its use in Regenerative Medicine, alone or in combination with other growth factors. The TGF-β1 cDNA was amplified from a human cDNA library and cloned into the proprietary pNU1 mammalian expression vector. The pNU1/TGF-β1 construct was used to stably transfect CHO DG44 cells, and a co-amplification strategy was used to select transfectant cells with the largest number of gene copies. These cultures were subjected to the process of gene amplification with methotrexate. Western Blot and ELISA were used to assay the conditioned medium obtained from the selected cell populations and from overproducing cell clones. Among the 41 clones obtained, five presented higher levels of TGF-β1 production, between 1,000 and 2,000 ng/mL. These clones were selected for in vitro activity testing using A549 cells to evaluate the epithelial-mesenchymal transition. Awound healing assay on mouse dorsal skin was standardized and used to evaluate the in vivo activity of the cell clone which displayed the highest result in vitro. The TGF-β1 protein was partially purified by HPLC on an affinity column. Therefore, the recombinant human TGF-β1 protein was produced and shown to display biological activity both in vitro and in vivo, being able to eficiently repair cutaneous wounds. This initiative may provide patients with an alternative treatment for tissue damage, accelerating wound healing and tissue repair.