Priming with proangiogenic growth factors and endothelial progenitor cells improves revascularization in linear diabetic wounds.
In the present study, we investigated whether proangiogenic growth factors and endothelial progenitor cells (EPCs) induce favourable effects on cutaneous incisional wound healing in diabetic mice. The proangiogenic effects of human EPCs were initially analyzed using a HUVEC in vitro angiogenesis assay and an in vivo Matrigel assay in nude mice (n=12). For the diabetic wound model, 48 Balb/c mice with streptozotocin (STZ)-induced diabetes were divided randomly into 4 groups (12 mice in each group). Subsequently, 3, 5 and 7 days before a 15-mm full-thickness incisional skin wound was set, group 1 was pre-treated subcutaneously with a mixture of vascular endothelial growth factor (VEGF)/basic fibroblast growth factor (bFGF)/platelet-derived growth factor (PDGF) (3.5 µg of each), group 2 with 3.5 µg PDGF and group 3 with an aliquot of two million EPCs, whereas the control animals (group 4) were pre-treated with 0.2 ml saline solution. The wounds were assessed daily and the repaired tissues were harvested 7 days after complete wound closure. The angiogenesis assay demonstrated significantly increased sprout densities, areas and lengths in the EPC-treated group (all p<0.01). In the Matrigel assay, significantly increased microvessel densities, areas and sizes (all p<0.001) were also detected in the EPC-treated group. In the STZ-induced model of diabetes, the animals pre-treated with a combination of proangiogenic factors and EPCs showed in general, a more rapid wound closure. Vessel densities were >2-fold higher in the mice treated with a combination of proangiogenic factors and EPCs (p<0.05) and tensile strengths were higher in the groups treated with proangiogenic growth factors compared to the controls (p<0.05). These results suggest a beneficial effect of pre-treatment with proangiogenic growth factors and EPCs in incisional wound healing.
Institute of Functional and Clinical Anatomy, University Medical Center Mainz, D-55131 Mainz, Germany.
Maximilian
M
Ackermann
Institute of Functional and Clinical Anatomy, University Medical Center Mainz, D-55131 Mainz, Germany.
Andreas M
AM
Pabst
Institute of Functional and Clinical Anatomy, University Medical Center Mainz, D-55131 Mainz, Germany.
Jan P
JP
Houdek
Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, D-55131 Mainz, Germany.
Thomas
T
Ziebart
Institute of Functional and Clinical Anatomy, University Medical Center Mainz, D-55131 Mainz, Germany.
Moritz A
MA
Konerding
D000818:Animals; D001681:Biological Assay; D003094:Collagen / Q000378:metabolism; D003921:Diabetes Mellitus, Experimental / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D004338:Drug Combinations; D042783:Endothelial Cells / Q000166:cytology* / Q000187:drug effects; D061307:Human Umbilical Vein Endothelial Cells; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000494:pharmacology*; D007797:Laminin / Q000378:metabolism; D051379:Mice; D008807:Mice, Inbred BALB C; D008819:Mice, Nude; D055806:Microvessels / Q000187:drug effects / Q000473:pathology; D018919:Neovascularization, Physiologic / Q000187:drug effects*; D011509:Proteoglycans / Q000378:metabolism; D033581:Stem Cell Transplantation; D013234:Stem Cells / Q000166:cytology* / Q000187:drug effects; D013718:Tensile Strength / Q000187:drug effects; D014945:Wound Healing / Q000187:drug effects*
D004338:Drug Combinations; D036341:Intercellular Signaling Peptides and Proteins; D007797:Laminin; D011509:Proteoglycans; C059485:matrigel; D003094:Collagen