Enhancement of Rotator Cuff Healing with Farnesol-Impregnated Gellan Gum/Hyaluronic Acid Hydrogel Membranes in a Rabbit Model.

Yen-Hung Lin,Shyh-Ming Kuo,Chun-Shien Wu,Sheng-I Lee,Feng-Huei Lin,Guan-Xuan Wu

doi:10.3390/pharmaceutics13070944

Yen-Hung Lin, Shyh-Ming Kuo + Show 4 more

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https://doi.org/10.3390/pharmaceutics13070944

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Abstract

Most rotator cuff (RC) tears occur at the bone–tendon interface and cause disability and pain. Farnesol, a sesquiterpene compound, can exert antioxidative and anti-inflammatory effects and promote collagen synthesis. In this rabbit model, either commercial SurgiWrap membrane or hydrogel membranes containing various compositions of gellan gum, hyaluronic acid, and farnesol (hereafter GHF membranes) were applied to the tear site, and the repair of the cuff was examined 2 and 3 weeks afterward. The designed membranes swelled rapidly and adsorbed onto the tear site more readily and closely than the SurgiWrap membrane. The membranes degraded slowly and functioned as both a barrier and a vehicle of slow farnesol release during the repair period. Farnesol enhanced collagen production in myoblasts and tenocytes, and interleukin 6 and tumor necrosis factor α levels were modulated. Gross observations and histological examinations indicated that the GHF membranes impregnated with 4 mM farnesol resulted in superior RC repair. In sum, the slow release of farnesol from hydrogel membranes can be beneficial in the repair of RC injuries.

Highlights

Published: 24 June 2021Shoulder pain is the most common functional problem involving the upper limbs, and rotator cuff (RC) tears are a common cause of shoulder dysfunction
Our previous study indicated that farnesol improved wound healing by reducing oxidative stress and inflammation and enhancing collagen production [11,12]. These findings suggest that farnesol can modulate connective tissue and extracellular matrix (ECM) synthesis and promote wound healing in tissue engineering applications
This study examined the ability of farnesol to promote collagen production and exert This study examined the ability of farnesol to promote collagen production and exert anti-inflammatory effects

Summary

Introduction

Shoulder pain is the most common functional problem involving the upper limbs, and rotator cuff (RC) tears are a common cause of shoulder dysfunction. Knowledge regarding the pathology and healing pattern of the RC, use of biological repair techniques and better suture anchors, and gradual rehabilitation after surgical repair of RC tears can lead to satisfactory outcomes [2]. Numerous studies have examined whether biological agents such as platelet-rich plasma, transforming growth factor-β1 (TGF-β1), fibroblast growth factor-2, and stem cells can augment healing after RC repair [3,4]. The use of growth factors raises various concerns with regard to optimal amount, time points, and half-life, as does the sequential emergence of factors involved in the healing process. The long-term delivery of growth factors through controlled release from biomaterial vehicles can enhance RC repair [5,6,7]

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