Infrared Laser Effect on Healthy and Ossified Costal Cartilage: The Development of Stable Load-Bearing Autoimplants.

BACKGROUND AND OBJECTIVE: The laser-induced stress relaxation provides new prospects to obtain stable long fragments of costal cartilage for autoimplantation avoiding the risk of spontaneous deformation and poor engraftment. However, the age-related alterations of cartilage may sufficiently influence its interaction with infrared (IR) laser radiation and disrupt the effectiveness and safety of the technique. The aim of the work is to study the influence of the structural quality of costal cartilage on its interaction with IR laser and efficiency of obtaining of curved implants for trachea surgery. STUDY DESIGN/MATERIALS AND METHODS: Healthy costal cartilage was taken from pigs and human. Ossified costal cartilage was taken from humans of age 65 ± 7. The cartilage slices with a mean thickness of 3 mm were mechanically curved and processed to stress relaxation by laser irradiation with the wavelength 1.56 µm. The structure and mineral content were studied by X-ray microtomography and element analysis. The optical measurements included the study of the propagation of IR radiation, speckle interferometry, and IR radiometry. RESULTS: The aged cartilage demonstrates a high level of heterogeneity in structure and properties and decreased water content. The presence of dense inclusions consisting of amorphous calcined volumes makes the tissue more fragile and less elastic. The IR radiation propagation intensity for aged cartilage is at least twice higher than that for healthy cartilage. The thermal-induced motion of scatterers in aged cartilage is slower. X-ray microtomography showed the cartilage-like and the bone-like structures within the ossified samples. CONCLUSIONS: The main challenge for laser reshaping of aged cartilage is the presence of ossifications. However, the new stable curvature can be obtained with adjustment of laser power. To obtain the satisfying stable curvature of an implant the ossified volumes should be avoided The laser-induced stress-relaxation mechanism for aged cartilage can be particularly different from that of healthy tissue and the optimal laser regimes should be specified. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.

Collagen fibrillar structures in vocal fold scarring and repair using stem cell therapy: a detailed histological, immunohistochemical and atomic force microscopy study.

Regenerative medicine opens new opportunities in the repair of cicatricial lesions of the vocal folds. Here, we present a thorough morphological study, with the focus on the collagen structures in the mucosa of the vocal folds, dedicated to the effects of stem cells on the vocal folds repair after cicatricial lesions. We used a conventional experimental model of a mature scar of the rabbit vocal folds, which was surgically excised with a simultaneous implantation of autologous bone marrow-derived mesenchymal stem cells (MSC) into the defect. The restoration of the vocal folds was studied 3 months postimplantation of stem cells and 6 months after the first surgery. The collagen structure assessment included histology, immunohistochemistry and atomic force microscopy (AFM) studies. According to the data of optical microscopy and AFM, as well as to immunohistochemical analysis, MSC implantation into the vocal fold defect leads not only to the general reduction of scarring, normal ratio of collagens type I and type III, but also to a more complete restoration of architecture and ultrastructure of collagen fibres in the mucosa, as compared to the control. The collagen structures in the scar tissue in the vocal folds with implanted MSC are more similar to those in the normal mucosa of the vocal folds than to those of the untreated scars. AFM has proven to be an instrumental technique in the assessment of the ultrastructure restoration in such studies. LAY DESCRIPTION: Regenerative medicine opens new opportunities in the repair of the vocal fold scars. Because collagen is a main component in the vocal fold mucosa responsible for the scar formation and repair, we focus on the collagen structures in the mucosa of the vocal folds, using a thorough morphological study based on histology and atomic force microscopy (AFM). Atomic force microscopy is a scanning microscopic technique which allows revealing the internal structure of a tissue with a resolution up to nanometres. We used a conventional experimental model of a mature scar of the rabbit vocal folds, surgically excised and treated with a mesenchymal stem cells transplant. Our morphological study, primarily AFM, explicitly shows that the collagen structures in the scarred vocal folds almost completely restore after the stem cell treatment. Thus, the modern microscopic methods, and especially AFM are instrumental tools for monitoring the repair of the vocal folds scars.