Kwok, Po Lam. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 124-130). / Abstracts in English and Chinese. / Thesis/Assessment Committee --- p.i / Abstract --- p.ii / 中文摘要 --- p.v / Acknowledgements --- p.vii / List of Figures --- p.viii / List of Tables --- p.x / Table of Abbreviations --- p.xii / Contents --- p.xix / Chapter Chapter 1 --- General Introduction --- p.1 / Chapter Chapter 2 --- The Biology of Human Umbilical Cord Perivascular Cells (HUCPVs) and Their Potential Applications in Tissue Regeneration / Chapter 2.1 --- INTRODUCTION --- p.5 / Chapter 2.1.1 --- Stem cells --- p.5 / Chapter 2.1.2.1 --- Embryonic stem cells --- p.6 / Chapter 2.1.2.2 --- iPS cells --- p.7 / Chapter 2.1.2.3 --- Somatic stem cells --- p.8 / Chapter 2.1.3 --- Mesenchymal stem cells --- p.9 / Chapter 2.1.4 --- Pericytes --- p.11 / Chapter 2.1.5 --- CD146 positive MSCs --- p.12 / Chapter 2.1.6 --- Human umbilical cord perivascular cells (HUCPVs) --- p.13 / Chapter 2.1.7 --- The biology of stem cell microenvironment (niche) --- p.14 / Chapter 2.1.8 --- Current applications of HUCPVs --- p.17 / Chapter 2.1.9 --- Regenerative medicine --- p.17 / Chapter 2.1.10 --- Applications of stem cells in bone regeneration --- p.19 / Chapter 2.2 --- MATERIALS AND METHODS --- p.22 / Chapter 2.2.1 --- Cell culture --- p.22 / Chapter 2.2.2 --- Preparation of Human Umbilical Cord Perivascular (HUCPV) cells --- p.22 / Chapter 2.2.2.1 --- Isolation of Human Umbilical Cord Perivascular (HUCPV) cells from human umbilical cord --- p.22 / Chapter 2.2.2.2 --- Purification of HUCPV cells --- p.23 / Chapter 2.2.3 --- Immunocytochemsitry --- p.24 / Chapter 2.2.4 --- Semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) --- p.25 / Chapter 2.2.4.1 --- Isolation of total cellular RNA --- p.25 / Chapter 2.2.4.2 --- Complementary DNA (cDNA) synthesis --- p.26 / Chapter 2.2.4.3 --- Polymerase chain reaction (PCR) --- p.26 / Chapter 2.2.5 --- Quantitative real-time reverse transcriptionpolymerase chain reaction (qRT-PCR) --- p.30 / Chapter 2.2.6 --- In vitro differentiation assays --- p.33 / Chapter 2.2.6.1 --- Osteogenic differentiation --- p.33 / Chapter 2.2.6.2 --- Adipogenic differentiation --- p.33 / Chapter 2.2.6.3 --- Chondrogenic differentiation --- p.34 / Chapter 2.2.6.4 --- In vitro chondrogenic differentiation on gelfoam® --- p.34 / Chapter 2.2.7 --- Cytochemistry staining --- p.35 / Chapter 2.2.7.1 --- Alkaline Phosphatase staining --- p.35 / Chapter 2.2.7.2 --- Alizarin Red S staining --- p.35 / Chapter 2.2.7.3 --- Oil Red O staining --- p.36 / Chapter 2.2.7.4 --- Alcian Blue staining --- p.36 / Chapter 2.2.8 --- Scanning electron microscopy (SEM) --- p.37 / Chapter 2.2.9 --- Transmission electron microscopy (TEM) --- p.37 / Chapter 2.2.10 --- Paraffin tissue embedding --- p.38 / Chapter 2.2.10 --- Haematoxylin and Eosin staining --- p.38 / Chapter 2.3 --- RESULTS --- p.40 / Chapter 2.3.1 --- Isolation and purification of HUCPVs --- p.40 / Chapter 2.3.2 --- Osteogenic differentiation of HUCPVs under normoxia --- p.41 / Chapter 2.3.3 --- Osteogenic differentiation of HUCPVs under hypoxia --- p.42 / Chapter 2.3.4 --- Adipogenic differentiation of HUCPVs --- p.43 / Chapter 2.3.5 --- Chondrogenic differentiation of HUCPVs --- p.43 / Chapter 2.3.6 --- Chondrogenic differentiation of HUCPVs on gelfoam® --- p.44 / Chapter 2.4 --- DISCUSSION --- p.59 / Chapter Chapter 3 --- Calcium and Calcium-sensing Receptor (CaSR) in osteogenesis / Chapter 3.1 --- INTRODUCTION --- p.62 / Chapter 3.1.1 --- Metabolism of calcium --- p.62 / Chapter 3.1.2 --- Calcium-sensing receptor --- p.64 / Chapter 3.1.2.1 --- The molecular structure of calcium-sensing Receptor (CaSR) --- p.64 / Chapter 3.1.2.2 --- The expression pattern of calciumsensing receptor (CaSR) --- p.67 / Chapter 3.1.2.3 --- The physiological function of calcium-sensing receptor in different tissues or organs --- p.68 / Chapter 3.1.2.4 --- Regulatory role of calcium-sensing receptor in calcium sensing and homeostasis --- p.71 / Chapter 3.1.2.5 --- The role of calcium-sensing receptor in diseases --- p.72 / Chapter 3.1.2.6 --- Genetic animal models targeting calciumsensing receptor --- p.73 / Chapter 3.1.2.7 --- Calcium-sensing receptor in mesenchymal lineage Differentiation --- p.76 / Chapter 3.1.2.8 --- The role of calcium-sensing receptor in the skeleton --- p.76 / Chapter 3.1.3 --- Calcium-sensing receptor related pathway --- p.78 / Chapter 3.1.3.1 --- Cyclic AMP pathway --- p.78 / Chapter 3.1.3.2 --- Cyclic AMP response element-binding protein (CREB) --- p.80 / Chapter 3.2 --- MATERIALS AND METHODS --- p.83 / Chapter 3.2.1 --- Preparation of primary mouse osteoblasts (MOB) from long bone --- p.83 / Chapter 3.2.2 --- Preparation of primary mouse osteoblasts (CMOB) from calvaria --- p.84 / Chapter 3.2.3 --- Immunocytochemistry --- p.84 / Chapter 3.2.4 --- Osteogenic differentiation --- p.85 / Chapter 3.2.3 --- Quantitative real-time reverse transcriptionpolymerase chain reaction (qRT-PCR) --- p.85 / Chapter 3.2.4 --- Cell proliferation measurement by BrdU ELISA (colorimetric) assay --- p.85 / Chapter 3.2.5 --- Western blotting analysis --- p.86 / Chapter 3.2.5.1 --- Preparation of the protein lysate --- p.86 / Chapter 3.2.5.2 --- Protein quantitation --- p.86 / Chapter 3.2.5.3 --- SDS-PAGE --- p.87 / Chapter 3.2.5.4 --- Protein transfer --- p.87 / Chapter 3.2.5.5 --- Immunodetection --- p.88 / Chapter 3.2.6 --- cAMP EIA assay --- p.89 / Chapter 3.3 --- RESULTS --- p.91 / Chapter 3.3.1 --- "Expression of CD 146 and CaSR in HUCPVs, primary mouse long bone osteoblasts and MC3T3-E1 cell line" --- p.91 / Chapter 3.3.2 --- The effect of calcium treatment on the osteogenic differentiation potential of MC3T3-E1 cells under normoxia --- p.91 / Chapter 3.3.3 --- The effect of calcium treatment on the osteogenic differentiation potential of MC3T3-E1 cells under hypoxia --- p.92 / Chapter 3.3.4 --- The effect of calcium treatment on cell proliferation in primary mouse long bone osteoblasts --- p.93 / Chapter 3.3.5 --- The effect of calcium treatment on calcium-sensing receptor expression in primary mouse long bone osteoblasts --- p.94 / Chapter 3.3.6 --- The effect of calcium treatment on calcium-sensing receptor expression in HUCPVs --- p.95 / Chapter 3.3.7 --- The effect of calcium treatment on calcium-sensing receptor expression in primary mouse calvarian osteoblasts --- p.96 / Chapter 3.3.8 --- The effect of calcium treatment on cyclic AMP levels in primary mouse long bone osteoblasts --- p.97 / Chapter 3.4 --- DISCUSSION --- p.117 / Chapter Chapter 4 --- General Discussions --- p.121 / References --- p.124 / Appendices --- p.131

Foram analisados 106 pacientes portadores de Linfoma de Hodgkin (LH) com recidiva da doença ou refratários ao tratamento inicial que foram submetidos ao transplante autólogo de células tronco hematopoiéticas (TCTH), na ordem consecutiva de sua realização, entre o mês de abril de 1993 a dezembro de 2007 em um único Centro Brasileiro: o Serviço de Transplante de Medula Óssea da FMUSP. O grupo teve a mediana etária de 28 anos, 55 pacientes (51,9%) eram do sexo masculino e houve predomínio da raça branca (87,6%). A mediana de seguimento clínico foi de 56,4 meses. Todos pacientes foram submetidos no pré TCTH a protocolos de tratamento convencionais, sendo que o uso dos protocolos MOPP, ABVD e sua associação foram utilizados em 97 pacientes (91,5%). Os pacientes foram classificados, de acordo com a resposta ao tratamento utilizado antes do TCTH, sendo 38,1% considerados refratários e 61,9% responsivos. Dos responsivos, 54 pacientes estavam em segunda remissão completa (85%). Tratamento com quimioterapia em alta dose pré TCTH foi feito em 45 (42,4%) dos pacientes (salvamento). A mobilização das células tronco hematopoiéticas foi realizada com ciclofosfamida 120 mg/kg dividida em dois dias seguido de fator estimulador de colônias de granulócitos (G-CSF) na dose de 6 a 17 mcg/kg em 83 (78%) pacientes. Em 25 pacientes (22%) houve falha de mobilização e a coleta foi realizada por múltiplas punções da medula óssea em centro cirúrgico. O valor mediano de células CD 34 coletadas foi de 2,6 x 106 células CD34/Kg de peso do paciente. Os condicionamentos mais utilizados foram BEAM e CVB, e não se encontrou diferença na sobrevida em relação ao regime empregado (p=0,17). A mediana de enxertia das células transplantadas foi de 12 dias. A sobrevida global após o TCTH pelo método de Kaplan-Meier foi, respectivamente, de 86% e 70% aos 5 e 10 anos. Não influenciaram a sobrevida na análise univariada o sexo, o estadio da doença e a presença de massa tumoral extensa. O principal fator preditivo de melhor sobrevida foi a presença de resposta a quimioterapia pré TCTH (p=0,0095) e hemoglobina maior que 10g/dL ao diagnóstico (p=0,0229). A mortalidade relacionada ao procedimento até o centésimo dia após o TCTH foi de 3,74%, e a principal causa de mortalidade tardia após TCTH foi a recidiva da doença / The study enrolled 106 patients with classic Hodgkin disease (HD) refractory or relapsed after initial treatment who underwent to autologous hematopoietic stem cell transplantation (HSCT) between April 1993 and December 2007. Median age was 28 years and 55 (51,9%) patients were male. Ninety three (87,6%) of patients were white. All patients underwent to conventional chemotherapy protocols prior HSCT. The use of MOPP, ABVD protocols and their associations were used in 97 (91,5%) of the patients. Disease classification was done according to the response to initial treatment and comprised 38,1% refractory and 61,9% responsive patients. In the group of responsive, 54 (85%) patients were in second complete remission. High dose chemotherapy prior HSCT was done as salvage in 45 (42,4%) patients. Stem cell mobilization was done after cyclophosphamide 120mg/kg divided in two days. Granulocyte-colony stimulating factor (G-CSF) 617 mcg/kg was given after cyclophosphamide in 83 (78%) patients. Twenty five (22%) patients failed the mobilization and stem cell harvest was done by bone marrow aspirations. The median number of CD34 collected was 2.6 x 106/L. Preparative regimen mostly used comprised BEAM and CVB and no differences was observed in overall survival (p=0.17). Median time to engraftment was 12 days. Median time of follow-up was 56.4 months. The overall survival (OS) was calculated by the Kaplan-Meier method and was 86% and 70% at 5 and 10 years, respectively. In the univariate analysis, response to initial treatment (p=0.009) and hemoglobin greater than 10g/dL at the time of diagnosis (p=0.02) were factors that influenced better OS. The gender, stage of disease and presence of bulky disease were not significant regarding OS in the univariate analysis. Treatment-related mortality (TRM) in 100-days was 3.74%. The major cause of late mortality was relapse of the disease

Cheuk, Yau Chuk. / Thesis submitted in: Dec 2008. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 132-144). / Abstracts in English and Chinese. / ABSTRACT --- p.i / 論文摘要 --- p.iii / PUBLICATIONS --- p.v / ACKNOWLEDGEMENT --- p.vi / LIST OF ABBREBIVIATIONS --- p.vii / INDEX FOR FIGURES --- p.x / INDEX FOR TABLES --- p.xiv / TABLE OF CONTENTS --- p.xv / Chapter CHAPTER ONE - --- INTRODUCTION / Chapter 1.1 --- "Joint function, structure and biochemistry" / Chapter 1.1.1 --- Function of joint --- p.1 / Chapter 1.1.2 --- Types of cartilage --- p.1 / Chapter 1.1.3 --- Composition and structure of articular cartilage --- p.2 / Chapter 1.1.4 --- The subchondral bone --- p.3 / Chapter 1.1.5 --- Maturation of articular cartilage and subchondral bone --- p.3 / Chapter 1.2 --- Osteochondral defect / Chapter 1.2.1 --- Clinical problem --- p.6 / Chapter 1.2.2 --- Spontaneous repair --- p.7 / Chapter 1.2.3 --- Current treatment strategies --- p.7 / Chapter 1.2.4 --- Limitations of current treatment strategies --- p.8 / Chapter 1.2.5 --- Treatments under development --- p.11 / Chapter 1.2.6 --- Potential and limitations in cell therapies --- p.14 / Chapter 1.3 --- The 3-D scaffold-free cartilage / Chapter 1.3.1 --- Fabrication of scaffold-free cartilage --- p.16 / Chapter 1.3.2 --- Scaffold-free cartilage for chondral / osteochondral defect repair --- p.18 / Chapter 1.3.3 --- Scaffold-free bioengineered chondrocyte pellet from our group --- p.20 / Chapter 1.3.4 --- BCP as a possible treatment for OCD --- p.21 / Chapter 1.4 --- The objectives of the study --- p.22 / Chapter 1.5 --- The study plan / Chapter 1.5.1 --- Design of the study --- p.23 / Chapter 1.5.2 --- Choice of animal model --- p.23 / Chapter 1.5.3 --- Selection of evaluation time points --- p.24 / Chapter 1.5.4 --- Choice and modification of histological scoring system --- p.24 / Chapter CHAPTER TWO - --- METHODOLOGY / Chapter 2.1 --- Preparation of reagents and materials for tissue culture and histology --- p.26 / Chapter 2.2 --- Creation of osteochondral defect model --- p.28 / Chapter 2.3 --- Synthesis of scaffold-free cartilage using 3-D chondrocyte pellet culture / Chapter 2.3.1 --- Isolation of rabbit costal chondrocytes --- p.31 / Chapter 2.3.2 --- Three-dimensional chondrocyte pellet culture --- p.31 / Chapter 2.3.3 --- BrdU labeling for cell fate tracing --- p.32 / Chapter 2.4 --- Further characterization of the 3-D scaffold-free chondrocyte pellet / Chapter 2.4.1 --- Gross appearance --- p.35 / Chapter 2.4.2 --- Cell viability / Chapter 2.4.2.1 --- Alamar blue reduction assay --- p.35 / Chapter 2.4.3 --- Preparation of samples for histology --- p.36 / Chapter 2.4.4 --- General morphology and histomorphology / Chapter 2.4.4.1 --- H&E staining --- p.36 / Chapter 2.4.5 --- Cartilage properties / Chapter 2.4.5.1 --- Safranin O /Fast Green staining --- p.37 / Chapter 2.4.5.2 --- Immunohistochemistry of type II collagen --- p.37 / Chapter 2.4.5.3 --- Immunohistochemistry of type I collagen --- p.38 / Chapter 2.4.6 --- Angiogenic properties / Chapter 2.4.6.1 --- Immunohistochemistry of VEGF --- p.40 / Chapter 2.4.7 --- Osteogenic properties / Chapter 2.4.7.1 --- ALP staining --- p.40 / Chapter 2.5 --- Implantation of scaffold-free cartilage into osteochondral defect model / Chapter 2.5.1 --- Surgical procedures --- p.41 / Chapter 2.5.2 --- Experimental groups --- p.42 / Chapter 2.6 --- Assessment of osteochondral defect healing / Chapter 2.6.1 --- Macroscopic evaluation --- p.43 / Chapter 2.6.2 --- Preparation of samples for histology --- p.43 / Chapter 2.6.3 --- Histology for general morphology / Chapter 2.6.3.1 --- H&E staining --- p.45 / Chapter 2.6.4 --- Histological scoring / Chapter 2.6.4.1 --- Modification of the scoring system --- p.45 / Chapter 2.6.4.2 --- Procedures of scoring and validation --- p.45 / Chapter 2.6.5 --- Cell proliferation / Chapter 2.6.5.1 --- Immunohistochemistry of PCNA --- p.49 / Chapter 2.6.6 --- Cartilage regeneration / Chapter 2.6.6.1 --- Safranin O /Fast Green staining --- p.49 / Chapter 2.6.6.2 --- Immunohistochemistry of type II collagen --- p.49 / Chapter 2.6.6.3 --- Immunohistochemistry of type I collagen --- p.50 / Chapter 2.6.6.4 --- Polarized light microscopy --- p.50 / Chapter 2.6.7 --- Expression of angiogenic factor / Chapter 2.6.7.1 --- Immunohistochemistry of VEGF --- p.50 / Chapter 2.6.8 --- Bone regeneration / Chapter 2.6.8.1 --- μCT analysis --- p.50 / Chapter 2.6.9 --- Histomorphometric analysis of cartilage and bone regeneration --- p.53 / Chapter 2.6.10 --- BrdU detection for cell fate tracing --- p.55 / Chapter 2.6.11 --- Statistical analysis --- p.55 / Chapter CHAPTER THREE - --- RESULTS / Chapter 3.1 --- Further characterization of the 3-D chondrocyte pellet culture / Chapter 3.1.1 --- Gross examination --- p.57 / Chapter 3.1.2 --- Cell viability --- p.57 / Chapter 3.1.3 --- Cartilage properties --- p.61 / Chapter 3.1.4 --- Angiogenic properties --- p.63 / Chapter 3.1.5 --- Osteogenic properties --- p.64 / Chapter 3.2 --- Implantation of scaffold-free cartilage and assessment / Chapter 3.2.1 --- Gross examination --- p.65 / Chapter 3.2.2 --- General morphology --- p.67 / Chapter 3.2.3 --- Histological scores --- p.71 / Chapter 3.2.4 --- Cell proliferation --- p.75 / Chapter 3.2.5 --- Cartilage regeneration --- p.78 / Chapter 3.2.6 --- Expression of angiogenic factor --- p.90 / Chapter 3.2.7 --- Bone regeneration --- p.93 / Chapter 3.2.8 --- Histomorphometric analysis on cartilage and bone regeneration --- p.96 / Chapter 3.2.9 --- Cell fate tracing --- p.100 / Chapter CHAPTER FOUR - --- DISCUSSION / Chapter 4.1 --- Summary of key findings / Chapter 4.1.1 --- Further characterization of BCP and determination of implantation time --- p.102 / Chapter 4.1.2 --- Implantation of BCP in OCD --- p.102 / Chapter 4.2 --- Spontaneous healing in osteochondral defect / Chapter 4.2.1 --- Findings from the current study --- p.104 / Chapter 4.2.2 --- Comparison with other studies --- p.104 / Chapter 4.2.3 --- Factors affecting spontaneous healing --- p.105 / Chapter 4.3 --- Fabrication and further characterization of the 3-D chondrocyte pellet / Chapter 4.3.1 --- Comparison of different methods of producing scaffold-free cartilage construct --- p.106 / Chapter 4.3.2 --- Cartilage phenotype of the BCP --- p.107 / Chapter 4.3.3 --- Angiogenic and osteogenic potential of the BCP --- p.108 / Chapter 4.3.4 --- Role of mechanical stimulation on tissue-engineered cartilage --- p.109 / Chapter 4.4 --- Repair of osteochondral defect with allogeneic scaffold-free cartilage / Chapter 4.4.1 --- Advantages of the current scaffold-free chondrocyte pellet --- p.111 / Chapter 4.4.2 --- Remodeling of BCP after implantation --- p.111 / Chapter 4.4.3 --- Effect of BCP on cartilage repair --- p.112 / Chapter 4.4.4 --- Effect of BCP on bone regeneration / Chapter 4.4.4.1 --- Findings in the present study --- p.113 / Chapter 4.4.4.2 --- Possible reasons of slow bone repair --- p.114 / Chapter 4.4.4.3 --- Effect of BCP on bone region peripheral to defect --- p.115 / Chapter 4.4.5 --- Immunorejection-free properties of the BCP --- p.116 / Chapter 4.4.6 --- Comparison with other animal studies using scaffold-free cartilage --- p.117 / Chapter 4.4.7 --- Possibility of implanting a BCP cultured for shorter or longer period --- p.118 / Chapter 4.4.8 --- Scaffold-free cartilage construct and construct with scaffold for OCD repair --- p.119 / Chapter 4.4.9 --- Chondrocytes and stem cells for OCD repair --- p.120 / Chapter 4.5 --- Limitations of the study / Chapter 4.5.1 --- Animal model --- p.122 / Chapter 4.5.2 --- Histomorphometric analysis --- p.122 / Chapter 4.5.3 --- Lack of quantitative data analysis --- p.122 / Chapter 4.5.4 --- BrdU labeling of cells --- p.123 / Chapter 4.5.5 --- Lack of biomechanical test --- p.123 / Chapter 4.5.6 --- Small sample size --- p.123 / Chapter CHAPTER FIVE - --- CONCLUSION --- p.124 / Chapter CHAPTER SIX - --- FUTURE STUDIES / Chapter 6.1 --- Identification of factors affecting bone repair after OCD treatment --- p.125 / Chapter 6.2 --- Modifications of BCP treatment --- p.125 / Chapter 6.3 --- Alternative cell source --- p.126 / Chapter 6.4 --- Alternative cell tracking methods --- p.126 / Chapter 6.5 --- Inclusion of biomechanical test --- p.126 / APPENDICES / Appendix 1. Conference paper 1 --- p.129 / Appendix 2: Conference paper 2 --- p.130 / Appendix 3: Animal experimentation ethics approval --- p.131 / BIBLIOGRAPHY --- p.132

INTRODUÇÃO: O método padrão de reparo de falhas ósseas é o transplante do osso autólogo. No entanto, novas técnicas de bioengenharia de tecido ósseo poderão substituir o método padrão. A construção de uma técnica em bioengenharia de tecido ósseo é feita pela associação entre fatores ou células indutoras de osso e biomateriais carreadores. O objetivo do presente trabalho foi mensurar a neoformação óssea em falha óssea alveolar de modelo animal após o reparo com fontes diferentes de bioengenharia de tecido ósseo e compará-las com o reparo com o osso autólogo transplantado da região craniana. MÉTODOS: Foi criada uma falha óssea na região alveolar de 28 ratos Wistar medindo 5 mm de diâmetro. Quatro modalidades de reparo foram comparadas ao método padrão: No grupo 1 (método padrão), as falhas ósseas foram reparadas com o transplante de osso autólogo da região parietal da calvária; nos grupos 2 e 3, as falhas ósseas foram reparadas com o biomaterial carreador osso bovino mineral sem e com o emprego de células-tronco mesenquimais humanas indiferenciadas, respectivamente; nos grupos 4 e 5, as falhas ósseas foram reparadas com o biomaterial carreador -tricálcio fosfato sem e com o emprego de células-tronco mesenquimais humanas indiferenciadas, respectivamente. A neoformação óssea na falha alveolar foi aferida por meio de imagens de tomografia computadorizada e avaliação histomorfométrica após 8 semanas da cirurgia. A neoformação óssea obtida por meio da avaliação histomorfométrica possibilitou a comparação dos grupos 2, 3, 4 e 5 com o grupo 1. Foi criado um sistema de pontos para determinar a distribuição do osso na falha óssea alveolar por meio das imagens de tomografia computadorizada em cinco animais por grupo, sendo 1 ponto para ossificação parcial, 2 pontos para ossificação total e heterogênea e 3 pontos para ossificação total e homogênea. O índice de significância estatístico p<0,05 foi determinado pelo teste não paramétrico de Mann-Whitney. RESULTADOS: Na avaliação histomorfométrica, o grupo 1 apresentou 60,27% ± 16,13% de osso na falha (n=7). Os grupos 2 e 3 apresentaram respectivamente, 23,02% ± 8,6% (n=3) Resumo (p=0,01) e 38,35% ± 19,59% (n=5) (p=0,06) de osso na falha. Os grupos 4 e 5 apresentaram respectivamente, 51,48% ± 11,7% (n=3) (p=0,30) e 61,8% ± 2,14% (n=6) (p=0,88) de osso na falha. Na avaliação radiológica, os animais dos grupos 1, 2, 3, 4 e 5 apresentaram média de pontos respectivamente igual a 2; 1,4; 1,5; 1,6, 1,8. CONCLUSÕES: O grupo de animais cujas falhas ósseas alveolares foram reparadas com -tricálcio fosfato e células-tronco mesenquimais apresentou a neoformação óssea mais semelhante a do grupo de animais cujas falhas ósseas foram reparadas com osso autólogo / INTRODUCTION: The current criterion standard to repair bone defects is an autogenous bone transfer. However, bone engineering strategies may become the first choice in the future. Bone bioengineering strategies are created through the association of inductive factors, stem cells and biomaterial matrices. The objective of this study was to measure the bone formation in an alveolar osseous defect animal model using different bone tissue engineering strategies and to compare them with the autogenous bone transfer. METHODS: Alveolar circular bone defects measuring 5 mm of diameter were created in 28 Wistar rats. Four alternative modalities were compared to the traditional modality of autogenous bone transfer: In group 1 (traditional modality), defects were repaired with autogenous bone graft from the calvarial region; in groups 2 and 3, defects were repaired using bovine bone mineral free of cells and loaded with undifferentiated mesenchymal stem cells, respectively; in groups 4 and 5, defects were repaired with - tricalcium phosphate free of cells and loaded with mesenchymal stem cells, respectively. Groups 2, 3, 4 and 5 were compared with group 1. Bone formation was evaluated by computed tomography imaging, and by histomorphometry at 8 weeks after surgery. Radiologically, a score system was developed to determine the bone distribution measured by computed tomography imaging in five animals of each group. Statistical significance was determined as p<0.05 by the non-parametric statistical hypothesis test called the Mann-Whitney test. RESULTS: Histomorphometrically, group 1 showed 60.27% ± 16.13% of bone in the defect (n=7). Groups 2 and 3 showed respectively, 23.02% ± 8.6% (n=3) (p=0.01) and 38.35% ± 19.59% (n=5) (p=0.06) of bone in the defect. Groups 4 and 5 showed respectively, 51.48% ± 11.7% (n=3) (p=0.30) and 61.80% ± 2.14% (n=6) (p=0.88) of bone in the defect. Radiologically, groups 1, 2, 3, 4 and 5 scored on average 2, 1.4, 1.5, 1.6, 1.8, respectively. CONCLUSION: The group of animals whose alveolar osseous defects Summary were repaired with -tricalcium phosphate and mesenchymal stem cells showed the most similar bone formation to the group whose alveolar osseous defects were repaired with autogenous bone

Abstract not available

<p>Syfte: Syftet med föreliggande uppsats är att mäta och beskriva hälsorelaterad livskvalitet hosnjurtransplanterade patienter, tolv till 24 månader efter transplantationen, i relation till den svenskanormalpopulationen. Vidare kommer korrelationen mellan livskvalitet och demografiska faktorer attundersökas. Metod: 54 patienter som njurtransplanterats för tolv till 24 månader sedan har deltagit i studien.Hälsorelaterad livskvalitet undersöktes med hjälp av SF-36 Hälsoenkät. Resultat: Undersökningsgruppen ansersig vara mer fysiskt begränsade och uppger i större utsträckning att de är begränsade att utföra arbete eller andrafysiska aktiviteter på grund av fysisk ohälsa, jämfört med motsvarande åldersgrupp i normalpopulationen.Dessutom värderar undersökningsgruppen sitt generella hälsotillstånd lägre än jämförelsegruppen. Det finnsingen signifikant skillnad i hälsorelaterad livskvalitet mellan njurtransplanterade kvinnor och män med avseendepå fysisk hälsa. Däremot skattar njurtransplanterade män sitt psykiska välbefinnande högre ännjurtransplanterade kvinnor (m=82,7/m=71,6). Ingen korrelation har kunnat påvisas beträffande ålder ochhälsorelaterad livskvalitet hos den valda patientgruppen. Slutsats: Njurtransplanterade patienter värderar sinhälsorelaterade livskvalitet lägre i flera aspekter än den svenska normalpopulationen. Detta gäller framför alltpatienternas fysiska hälsa. Skillnaderna är inte lika uttalade när det gäller psykisk hälsa.</p>

Cardiac transplantation is governed by complex immunological mechanisms contributing to different types of allograft rejection. Early non-specific graft failure and chronic rejection (cardiac allograft vasculopathy) represent the main limitations for the recipients’ short- and long-term survival respectively. To date, the pathogenesis of both rejection types remains ill-defined. However, it is believed that they are related to an immunologically mediated potent inflammatory process, occurring whether early after transplantation (acute), or lasting for the lifetime of the graft (chronic). The initiating mechanisms of chronic rejection in solid organ transplantation remain ill-defined. Emerging evidence sustains that graft vasculopathy is primarily driven by alloreactive CD4+ T lymphocytes sensitized by the indirect pathway of allorecognition. To date, whereas the nature of APCs involved in this particular pathway has yet to be identified, it appears challenging to speculate that recipient-derived endothelial cells (ECs) repopulating the graft may represent the main cell targets recognized by indirectly primed alloreactive CD4+ T cells to mediate the rejection of cardiac transplants. In the first part of this thesis, we specifically studied the indirect pathway of allorecognition with a transgenic mice (Marilyn mice) model that expresses a T cell receptor (TCR) transgene which recognizes the male antigen H-Y in an I-Ab-restricted fashion. Our results provide evidence that graft endothelium replacement by recipient-type cells expressing MHC Class II molecules is required for the chronic rejection of vascularized cardiac transplants mediated by indirect pathway alloreactive CD4+ T cells. The purpose of the second part of the thesis was to investigate the potential implication of interleukin-22 (IL-22), an early phase secreted proinflammatory cytokine of the IL-10 family, in the acute rejection of cardiac allografts. IL-22 was recently described as an effector key modulator of the inflammatory process produced mainly by differentiated CD4+ T cells of the Th17 lineage. As being closely related to IL-10 and IL-17, both involved in the rejection process of vascularized heart allografts, we attempted to determine the precise role of IL-22 in this process. Experiments were conducted with a recently developed murine model deficient for the IL-22 gene (IL-22KO). The results of the second part of the thesis show that IL-22 is not an effector cytokine in cardiac allograft rejection. In contrast, as being early expressed into the allograft, likely IL-22 plays a protective role in the inflammation leading to acute cardiac rejection, probably depending on a neutrophil-related mechanism. In conjunction with current understanding of inflammatory and antigen-specific events in allografts, overall, our results provide new insights into the mechanisms of chronic and acute cardiac rejection, thus prompting to further interrogations and appealing novel therapeutic strategies. Pharmacologic manipulation of endothelium is challenging. Given their capacity to sense and rapidly respond to the local environment, ECs are the ideal targets for rapid systemic delivery of therapeutic agents. Combination therapy is required to reduce inflammatory reaction and endothelial activation, to modulate endothelial dysfunction and promote endothelial survival. Also, given that IL-22 may alleviate tissue destruction during inflammatory responses, therapies that enhance its production and protective action in the transplanted organs seem attractive to specifically affect tissue responses, without exerting direct effects on the immune response.

Hepatozyten sind von großer Bedeutung in Klinik und Forschung. Da sie derzeit nicht kultiviert werden können wird vielfach versucht sie aus Vorläuferzellen zu generieren. In dieser Arbeit wurde die Entwicklung von zwei Stammzelllinien in einem xenogenen Transplantationsmodell mit immundefizienten Mäusen untersucht. Verwendet wurden Stammzellen aus humanem Nabelschnurblut und vordifferenzierte humane Monozyten, sogenannte Neohepatozyten. Es wurden jeweils 750.000 dieser Zellen in die Leber von NOD/SCID-Mäusen transplantiert und die Lebern im Verlauf explantiert. Die Identifikation der transplantierten Zellen im Gewebeschnitt gelang durch den Membranfarbstoff CM-DiI. Zur genetischen Charakterisierung wurde eine in situ Hybridisierung mit human- bzw. mausspezifischen Gensonden etabliert. So konnten die transplantierten Zellen sicher in den Mauslebern detektiert werden. Im Weiteren wurde immunhistochemisch humanes Albumin in Mauslebern nachgewiesen. Humanes Albumin diente als Differenzierungsmarker und zeigt eine Entwicklung der transplantierten Zellen in Richtung Hepatozyten an. Interessanterweise wurden bei der Analyse beider Zelllinien zwei Typen Humanalbumin-positiver Zellen beobachtet: Typ I Zellen traten meist in Gruppen auf, waren kleiner als Hepatozyten und trugen einen dichten, dezentral gelegenen Kern. Sie lagen im Parenchym oder in kleineren Gefäßen und waren in der Lage, wie Hepatozyten, Glycogen und Eisen zu speichern. Typ II Zellen traten einzeln auf und glichen in ihrer Form exakt den Hepatozyten. Durch die Kombination von Immunhistochemie und in situ Hybridisierung konnten die Humanalbumin-positiven Zellen genetisch charakterisiert werden. Typ I Zellen trugen einen menschlichen Kern. Ihre Entstehung kann durch Teildifferenzierung der Stammzellen erklärt werden. Typ II Zellen wiesen einen Mauskern auf. Ein möglicher Entstehungsmechanismus ist der horizontale Gentransfer nach Zerfall der transplantierten Zellen im Zuge einer Immunreaktion. Der formale Nachweis eines solchen Phänomens steht noch aus.

Thèse de doctorat : Sciences de la vie et de la santé : Tours : 2008. / Titre provenant de l'écran-titre.

Source: Masters Abstracts International, Volume: 47-06, page: 3444. Advisers: Janet S. Butel; Linda B. Piller. Includes bibliographical references.