VIETNAM NATIONAL UNIVERSITY, HANOI VIETNAM JAPAN UNIVERSITY NGUYEN THI THANH HOAI STUDY ON SYNTHESIS OF COMBINATION OF SILVER NANOPARTICLES AND MESENCHYMAL STEM CELL PRODUCTS FOR WOUND HEALING MASTER'S THESIS LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com VIETNAM NATIONAL UNIVERSITY, HANOI VIETNAM JAPAN UNIVERSITY NGUYEN THI THANH HOAI STUDY ON SYNTHESIS OF COMBINATION OF SILVER NANOPARTICLES AND MESENCHYMAL STEM CELL PRODUCTS FOR WOUND HEALING MAJOR: NANOTECHNOLOGY CODE: 8440140.11QTD RESEARCH SUPERVISORS: Prof. NGUYEN HOANG LUONG Associate Prof. HOANG THI MY NHUNG Hanoi, 2020 LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com ACKNOWLEDGMENTS First of all, I would like to express my deepest gratitude to my supervisors Prof. Nguyen Hoang Luong and Assoc.
Hoang Thi My Nhung for their enthusiastic guidance and inspiration throughout the implementation of the thesis. I also wish to thank Assoc. Nguyen Hoang Nam, Dr. Luu Manh Quynh (Center for Materials Science, VNU University of Science), Dr.
Le Tra My, MSc. Bui Thi Van Khanh (Department of Cell Biology, VNU University of Science) for the wholehearted instruction and useful suggestion. Besides, I am extremely grateful to Dr. Than Thi Trang Uyen (Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Health Care System) for all her support.
My sincere thanks to lecturers in the Nanotechnology program for their helpful instruction when I have learned at Vietnam Japan University. I am truly thankful for all the encouragement from my family and my friends. My thesis would not be done without their support. Finally, I would like to thank my classmates and my friends from Vietnam Japan University, VNU University of Science, Vinmec Research Institute of Stem Cell and Gene Technology who help me accomplish this thesis.
Hanoi, July 2020 Student Nguyen Thi Thanh Hoai i LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com TABLE OF CONTENTS Page ACKNOWLEDGMENTS. i TABLE OF CONTENTS .ii LIST OF FIGURES. iv LIST OF TABLES. v LIST OF ABBREVIATIONS.
Cutaneous wound and wound healing process. The normal wound healing process. The two therapeutic targets in wound treatment. AgNPs – an outstanding antimicrobial and anti-inflammatory agent in the inflammation phase.
AgNPs as a topical antimicrobial agent. AgNPs as an anti-inflammatory agent. Concerned factors for using AgNPs in wound treatment. Effect of particle size.
Effect of capping agents. Products derived from MSC - cytokines and growth factors-modulated agent in wound healing. Stem cells and mesenchymal stem cells. What are stem cells (SCs)?.
Mesenchymal stem cells (MSCs). Products derived from MSCs. MSC-derived conditioned medium (CM) in wound healing. Combined using of silver nanoparticles and bio-factors for wound healing.
17 CHAPTER 2: MATERIALS AND METHODS. Overview of experimental design. Preparation of AgNPs. Synthesis of AgNPs.
Characterization of AgNPs. Evaluation of the antimicrobial activity of AgNPs. Determination of the cytotoxic effect of AgNPs on NIH 3T3 cell. Preparation of CM and effect of CM on NIH 3T3 migration in vitro.
Preparation of CM. Effect of CM on NIH 3T3 migration - Scratch assay in vitro. Skin wound model in vivo. 29 ii LUAN VAN CHAT LUONG download : add luanvanchat@agmail.
Deep partial-thickness burn wound model. Excisional wound model. 33 CHAPTER 3: RESULTS AND DISCUSSION. Characterization of AgNPs.
UV-Vis spectra. Evaluation of the antimicrobial activity of AgNPs. Sterility of AgNPs. Antimicrobial effect of AgNPs.
Cytotoxic effect of AgNPs solution on NIH 3T3 cells in vitro. Effect of CM on NIH 3T3 migration - Scratch assay in vitro. Skin wound model in vivo. Deep second-degree burn model.
51 CONCLUSIONS AND PERSPECTIVES. 60 iii LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com LIST OF FIGURES Page Figure 1. Phases in wound healing. The types of wound treatment applied for different wound categories.
Mechanism of antimicrobial action of AgNPs. Factors impacted their cytotoxicity. MSC capacity of differentiation. Overall experimental design of the study.
Schematic procedure of AgNPs synthesis. Examination of 4 media on NIH 3T3 cells migration. Analysis of wound images by Image-J. Analysis of wound area by Image-J.
Determination of wound area based on the stage of healing process. XRD pattern of synthesized AgNPs. TEM image shows the morphology of AgNPs and sizes of particles ranged from 10 to 45 nm. UV-Vis spectra of synthesized AgNPs.
Agar plate without detection of microbial colony. AgNPs plates with less of microorganisms than the Control (-) plates. Morphology of NIH 3T3 cells. Image of 96-well plate after SRB staining.
Cell viability measured by SRB assay on NIH 3T3 cells. Effect of 4 media on the migration of fibroblast cells. The migration rate of fibroblast treated with 4 media. The healing process of burn wounds in mice.
Statistical analysis of healing rate of burn wounds at day 23 and day 30 after creating burns. Values are represented as mean ± SD.13 Uneven healing rate in the MSC group. Statistical analysis of healing rate of excisional wounds with different treatments. The healing rate of excisional wounds.53 iv LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com LIST OF TABLES Page Table 1.1: Topical antimicrobial agents for wound healing .2: Effect of AgNPs size on cytotoxicity.
Number and size of microbial colonies in each group. Descriptive qualitative assessment for the healing process in the burn model. 50 v LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com LIST OF ABBREVIATIONS AgNPs Silver nanoparticles CM Conditioned medium DFUs Diabetic foot ulcers DMEM Dulbecco’s modified Eagle’s medium EGF Epidermal growth factor ECM Extracellular matrix EVs Extracellular vesicles FBS Fetal bovine serum fcc Face centered cubic FDA Food and Drug Administration hUCB CM Human umbilical cord blood-derived mesenchymal stem cell conditioned medium hUCB MSCs Human umbilical cord blood-derived mesenchymal stem cells IL-1, IL-6, IL-8 Interleukin-1, Interleukin-6, Interleukin-8 IGF Insulin-like growth factor KGF Keratinocyte growth factor MSCs Mesenchymal stem cells OD Optical density PDGF Platelet-derived growth factor ROS Reactive oxygen species SDF Stromal cell-derived factor SRB Sulforhodamine B TEM Transmission electron microscopy TGF-α, TGF-β Transforming growth factor α, transforming growth factor β TSC Trisodium citrate UV-Vis Ultraviolet visible spectroscopy XRD X-ray diffraction vi LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com INTRODUCTION Wounds are a silent burden on the healthcare system. In 2018, Medicare beneficiaries analyzed that around 8.2 million people who have at least one type of wounds.
Wounds often classified into acute (traumatic, abrasions, surgical) and chronic wounds (diabetic foot ulcers (DFUs), leg ulcers, and pressure ulcers) based on healing time. The challenges of healing wounds are the increase of infection, age and pathological background of the patient. Hence, we need to come up with novel strategies to solve these problems. Over the past few decades, silver nanoparticles (AgNPs) attract rapt attention in wound treatment due to various featured natures such as the history of using silver, simple and effective synthesized methods, and above all the outstanding antimicrobial activity.
These make AgNPs become one of the most widely used agents for preventing infection. On the other hand, mesenchymal stem cells (MSCs) and products derived from MSCs, which appear as advanced therapies, have recently been studied and applied in the field of medicine. In terms of wound healing, many studies suggest that paracrine signaling of MSCs rather than tissue differentiation and engraftment is a pivotal element for promoting wound healing. That indicates the capacity to use conditioned medium (CM), which is one of the products derived from MSCs for wound treatment.
CM contains a variety of cytokines, growth factors, chemokines that modulate the healing process through induction of re-epithelialization, angiogenesis, and remodeling. Therefore, we assume the synergistic effect of the combined use of AgNPs and CM, in which AgNPs with antibacterial, anti-inflammatory activities support CM to promote wound healing. Our target is chronic wounds that require advanced therapies for treatment. At the beginning of the research process, we aim to examine the healing effect of the combined use of AgNPs and CM on an acute wound, then perform it on a chronic wound model at a later stage.
This thesis is the first step of research, so in this study, three objectives need to be fulfilled. (1) Synthesize and characterize properties of silver nanoparticles (AgNPs) including physicochemical properties, sterility, antimicrobial activity and cytotoxicity; 1 LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com (2) Evaluate the healing potential of conditioned medium (CM) by scratch assay in vitro; (3) Initially evaluate the therapeutic effect of each treatment: AgNPs and CM and the combined use of AgNPs and CM on the wound models in vivo. 2 LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com CHAPTER 1: OVERVIEW 1. Cutaneous wound and wound healing process 1.
Cutaneous wound Wounds are considered a growing challenge for the healthcare system. There are variety of reasons that can lead to injury, from extrinsic factors, such as shear, thermal, pressure to underlying causes such as diabetes, stress [61]. The injuries not only cause burden to patients, family, and healthcare system but also resulted in significant economic costs. A retrospective analysis of Medicare beneficiaries (2018) reported that approximately 8.2 million people who suffered from at least one type of wounds with or without infection.
The cost of wound care ranged from $28.8 billion involving costs for chronic and acute wounds [52]. Wound injuries are often classified into acute wounds including surgical wounds, traumatic, abrasions, or superficial burn, and chronic wounds, such as ulcers, diabetic foot ulcers (DFUs). Risk of chronic wounds is developed from an increase of age, the complication of diabetes, vascular diseases, obesity, etc. The market for advanced wound care for chronic and surgical wounds is expected to $22 billion by 2024 [61].
On the other hand, acute wounds are at risk of wound infection, particularly in post- surgery [61]. Another challenge for acute wounds is that prolonged healing can lead the wounds to enter a chronic state (non-healing) [16]. Therefore, novel concepts to prevent infection and promote the healing process are vital to managing wounds. The normal wound healing process Wound healing is a dynamic process involving 4 phases – hemostasis, inflammation, proliferation, and remodeling, that overlap in time This process is regulated by a complex system of mediators, which are responsible for cell-cell communication, involving various cytokine, growth factors, and chemokines [9], [13], [53] (Figure 1.
3 LUAN VAN CHAT LUONG download : add luanvanchat@agmail. Phases in wound healing [43]. Hemostasis begins immediately after an injury created, platelets form a plug and release several mediators, for example, platelet-derived growth factor (PDGF), which subsequently recruit leukocytes to the wound site. In the inflammatory phase, neutrophils start to cleanse the injury area from microorganisms and foreign contaminants, and then phagocytosed by macrophages or formed the eschars.
Chemokines, transforming growth factor β (TGF-β), and monocyte chemoattractant protein 1 (MCP-1) are released that lead to the infiltration of monocytes to the injury site that later transformed to macrophages. The monocyte and macrophages play a crucial role in inflammatory phase by releasing various cytokine such as vascular endothelial growth factor (VEGF), colony-stimulating factor 1 (CSF-1), PDGF, transforming growth factor α (TGF-α), TGF-β, interleukin-1 (IL-1), etc. that initiate the formation of granulation tissue. The proliferation phase started with re-epithelialization, in which several growth factors including TGF-α, epidermal growth factor (EGF) and keratinocyte growth factor (KGF) were released to stimulate the proliferation of epidermal cells at the margin.
Granulation tissue, which is the new stroma, forms in the wound site. The 4 LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com concert of extracellular matrix (ECM) molecules and growth factors, PDGF, TGF-β induce fibroblasts around the wound to proliferate and migrate into the wound area. The structural molecules of new ECM involving fibrin, fibronectin, hyaluronic, providing a scaffold for cell migration and the formation of granulation tissue. The fibroblasts play an important role in synthesis, deposition, and remodeling of the ECM.