Polydeoxyribonucleotide, as a Novel Approach for the Management of Medication-Related Osteonecrosis of the Jaw: A Preliminary Observational Study

PURPOSE: Polydeoxyribonucleotide (PDRN), consisting of a mixture of deoxyribonucleotide polymers, has been suggested to have anti-inflammatory effects and enhance angiogenesis as an adenosine A(2A) receptor agonist. The aim of this study was to report the effectiveness of PDRN as an adjuvant therapy after surgical debridement in MRONJ (medication-related osteonecrosis of the jaw) patients. MATERIALS AND METHODS: Five patients (1 male, 4 females, age 65~79 years) who were diagnosed with MRONJ stage 2 or 3 underwent surgical debridement and PDRN mucosal injection. After surgical debridement, patients were subject to daily injection with 1 ml of PDRN around the surgical wound for 14 days. RESULT: The patients' symptoms gradually disappeared. The surgical wound uneventfully healed, and no recurrence was observed during the follow-up period. CONCLUSION: Although further studies are required, the present study first describes the possibility of PDRN as a useful option for MRONJ treatment.

Comparison of wound healing effects between Oncorhynchus keta-derived polydeoxyribonucleotide (PDRN) and Oncorhynchus mykiss-derived PDRN

BACKGROUND: Polydeoxyribonucleotide (PDRN) influencing cellular growth and differentiation is recognized to promote wound healing by stimulating tissue repair. Although PDRN can be extracted from human placentas, PDRN medications have recently been extracted from the semen of trout (Oncorhynchus mykiss) and salmon (Oncorhynchus keta). The present study was designed to evaluate the wound healing effects of O. keta-derived PDRN for injection (Rejuvenex) and PDRN cream (Rejuvenex Cream) in comparison with those of O. mykiss-derived PDRN injection (Placentex). METHODS: Full-thickness skin defects were made on the back of mice (n=60). The mice were divided into the following four groups according to the dressing used for the wounds: O. mykiss-derived PDRN injection group, O. keta-derived PDRN injection group, O. keta-derived PDRN cream group, and normal saline soaked dressing group (control group). We analyzed the gross findings, wound sizes, histological findings, immunohistochemistry and enzyme-linked immunosorbent assays for the groups immediately after the treatment, and again after 4, 7, and 10 days of treatment. RESULTS: The wound healing effects were the greatest in the O. keta-derived PDRN injection and O. mykiss-derived PDRN injection groups, which showed similar scores, followed by the O. keta-derived cream and normal saline soaked dressing groups. CONCLUSION: The injection of PDRN extracted from O. keta was found to be as effective at healing full-thickness skin defects as the O. mykiss-derived PDRN injection, which is currently used in the clinic. Moreover, the O. keta-derived PDRN injection was also found to reduce the time required for wound healing.

Effects of salmon DNA fraction in vitro and in a monosodium iodoacetate-induced osteoarthritis rat model

PRF001 is a fragmented DNA polymer extracted from the testes of salmon. The purpose of this study was to assess the anti-inflammatory effect of PRF001 in vitro as well as the protective effect of PRF001 intake against arthritis in a rat model. In vitro, cell survival and inflammatory markers after H₂O₂ treatment to induce cell damage were investigated in CHON-001 cells treated with different concentrations of PRF001. In vivo, osteoarthritis was induced by intra-articular injection of monosodium iodoacetate (MIA) into the knee joints of rats. After consumption of PRF001 (10, 50, or 100 mg/kg) for 4 weeks, inflammatory mediators and cytokines in articular cartilage were investigated. In vitro, the levels of inflammatory markers, IL-1β, TNF-α, COX-2, iNOS, and PGE2, were significantly suppressed by PRF001 treatment. In vivo, the inflammatory mediators and cytokines, IL-1β, p-Erk1/2, NF-κB, TNF-α, COX-2, and PGE2, as well as MMP3 and MMP7, which have catabolic activity in chondrocytes, were decreased in the MIA-induced osteoarthritic rats following intake of PRF001. Histological analysis revealed that PRF001 had a protective effect on the articular cartilage. Altogether, these results demonstrated that the anti-inflammatory property of PRF001 contributes to its protective effects in osteoarthritis through deregulating IL-1β, TNF-α, and subsequent signals, such as p-Erk1/2, NF-κB, COX-2, PGE2, and MMPs.

Salvage of Unilateral Complete Ear Amputation with Continuous Local Hyperbaric Oxygen, Platelet-Rich Plasma and Polydeoxyribonucleotide without Micro-Revascularization

In many cases of complete ear amputation, microvascular surgery is required for tissue perfusion and organ survival. However, microvascular reconstruction is not always feasible in the absence of suitable vessels. Here, we present the case of a 76-year-old man who underwent complete amputation of the left ear after a collapse at home because of cardiogenic syncope. He was treated with primary replantation and underwent a postoperative salvage course including continuous local hyperbaric oxygen therapy (HBOT), platelet-rich plasma (PRP) injections, and polydeoxyribonucleotide (PDRN) injections. The ear was almost completely salvaged, with a tiny eschar at the mid-scapha on both the anterior and posterior aspects. This case demonstrates the efficacy of local HBOT with PRP and PDRN injections.

Histologic study of bone-forming capacity on polydeoxyribonucleotide combined with demineralized dentin matrix / 대한악안면성형재건외과학회지

BACKGROUND: This study examined the osteoinductive activity of demineralized dentin matrix (DDM) from human and polydeoxyribonucleotide (PDRN) for nude mice. METHODS: Twenty healthy nude mice, weighing about 15~20 g, were used for the study. DDM from human and PDRN were prepared and implanted subcutaneously into the dorsal portion of the nude mice. The nude mice were sacrificed at 1, 2, and 4 weeks after grafting and evaluated histologically by hematoxylin-eosin and Masson's trichrome staining. The specimens were also evaluated via a histomorphometric study. RESULTS: The DDM and PDRN induced new bone, osteoblasts, and fibroblasts in soft tissues. The histological findings showed bone-forming cells like osteoblasts and fibroblasts at 1, 2, and 4 weeks. New bone formation was observed in the histomorphometric study. In particular, the ratio of new bone formation was the highest at 2 weeks compared with the first week and fourth week. CONCLUSIONS: In this study, we showed that the PDRN used in this experimental model was able to induce bone regeneration when combined to the DDM.

Effectiveness of Polydeoxyribonucleotide (PDRN) Material on Murine Subcutaneous Laceration Wounds

PURPOSE: To evaluate the effectiveness of polydeoxyribonucleotide (PDRN) material on murine subcutaneous laceration wounds. METHODS: Subcutaneous laceration wounds were made on the back of mice. The mice were divided into two groups according to method of PDRN applied: Group I (control, general dressing, and management) and Group II (PDRN injection). We evaluated gross findings and histological findings for the groups. RESULTS: A total of 18 mice (9 in the Suture group and 9 with Suture+PDRN) were enrolled. In the mean results of gross finding (5-point Likert scale), the mean gross findings for wounds in the PDRN group were significantly higher than the suture groups on post-operative day 4 and 7 (for day 4, Suture: 2, Suture+PDRN: 3.2; for day 7, Suture: 2.7, Suture+PDRN: 4.2; p<0.05). In the histological analysis of wounds in the Suture+PDRN group after 10 days, re-epithelization and granulation tissue formation were better than the Suture group. In terms of wound-healing grade, re-epithelization and inflammation were not different; however, in the Suture+PDRN group, more granulation tissue formation was noted compared to the Suture group (p<0.05). In addition, the expression of VEGF in the Suture+PDRN group significantly increased compared to the Suture group (Suture: 11170+/-2475, Suture + PDRN: 27243+/-6621, p<0.05). CONCLUSION: The Suture+PDRN group can be used for the early treatment and histological healing of subcutaneous laceration wounds.

The Wound Healing Effect of PDRN(polydeoxyribonucleotide) Material on Full Thickness Skin Defect in the Mouse

PURPOSE: Many topical agents had been used for burn or wound treatment. An awareness of topical agents on various aspects of wound healing permits the clinician to choose the most appropriate material to advantageously control the wound process and final results. Although polydeoxyribonucleotide(PDRN) was used as a tissue repair stimulating agent in a number of human diseases, such as ulcers and burns, its wound healing effects were largely unreported. We aimed to compare the wound-healing effects of PDRN and common dressing materials on full-thickness skin defect in the mouse. METHODS: Full-thickness skin defects were made on the back of mice(N=60). The mice were divided into the following 4 groups according to the dressing used for the wounds: group O(Polydeoxyribonucleotide cream), group I (Polydeoxyribonucleotide solution), group M(Medifoam(R)), and group G(dry gauze, control group). We analyzed the gross findings, wound sizes and histological findings for the groups. RESULTS: The rate of wound size was decreased in order of group I, group O, group M and group G. The histological findings revealed that the I group showed more reepithelialization and granulation tissue formation and less inflammatory cell infiltration than the other materials. The grade score of wound healing was increased in order of group I, group O, group M and group G. CONCLUSION: PDRN applicated wound dressings can be used for treating a full-thickness skin defect wounds. Considering its superior efficacy in comparison to the efficacies of other wound dressings, PDRN soaked gauze dressing should be preferentially used for the treatment of full-thickness skin wounds.