Priming with proangiogenic growth factors and endothelial progenitor cells improves revascularization in linear diabetic wounds

Ackermann,Maximilian; Pabst,Andreas M.; Houdek,Jan P.; Ziebart,Thomas; Konerding,Moritz A.

doi:10.3892/ijmm.2014.1630

Priming with proangiogenic growth factors and endothelial progenitor cells improves revascularization in linear diabetic wounds

Authors:
- Maximilian Ackermann
- Andreas M. Pabst
- Jan P. Houdek
- Thomas Ziebart
- Moritz A. Konerding
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Affiliations: Institute of Functional and Clinical Anatomy, University Medical Center Mainz, D-55131 Mainz, Germany, Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, D-55131 Mainz, Germany
Published online on: January 21, 2014 https://doi.org/10.3892/ijmm.2014.1630
Pages: 833-839
Copyright: © Ackermann et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY_NC 3.0].

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Abstract

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.

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