Publications by authors named "Manal Moussa"

8 Publications

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Comparative Study on Bone Marrow-Versus Adipose-Derived Stem Cells on Regeneration and Re-Innervation of Skeletal Muscle Injury in Wistar Rats.

Tissue Eng Regen Med 2020 12 8;17(6):887-900. Epub 2020 Oct 8.

Department of Histology and Cell Biology, Faculty of Medicine, Ain Shams University, El-Khalyfa El-Mamoun Street Abbasya, Cairo, Egypt.

Background: Skeletal muscle injuries are frequent clinical challenges due to associated fibrosis and disability. Regenerative medicine is an emerging promising strategy for such cases. The aim of this study was to compare between the effects of bone marrow-mesenchymal stem cells (BM-MSCs) versus adipose tissue stromal cells (ADSCs) on regeneration and re-innervation of skeletal muscle laceration injury in Wistar rats at different time intervals.

Methods: Six young male rats were used as a source of allogenic MSCs. Eighty-four adult female rats were divided into: Group I (control), Group II (Untreated Laceration): right gluteal muscle was lacerated and left for spontaneous healing, Group III (BM-MSCs): right gluteal muscle was lacerated with concomitant local intramuscular injection of 1 × 10 BM-MSCs in the lacerated muscle, Group IV (ADSCs): right gluteal muscle was lacerated with concomitant local intramuscular injection of 1 × 10 ADSCs in lacerated muscle. Rats were sacrificed after one, two and eight weeks. Muscles were processed to prepare sections stained with H&E, Mallory's trichrome and immune-histochemical staining (neurofilament light chain).

Results: A significant increase in collagen fibers and failure of re-innervation were noticed in untreated laceration group. BM-MSCs-treated groups showed regeneration of muscle fibers but with increased collagen fibers. Meanwhile, ADSCs showed better regenerative effects evidenced by significant increase in the number of myotubes and significant decrease in collagen deposition. Re-innervation was noticed in MSCs-injected muscles after 8 weeks of laceration.

Conclusion: Both BM-MSCs and ADSCs improved regeneration of skeletal muscle laceration injury at short- and long-term durations. However, fibrosis was less in ADSCs-treated rats. Effective re-innervation of injured muscles occurred only at the long-term duration.
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December 2020

Comparative Study on Acellular Dermal Graft Versus Propylene Mesh Both Either Loaded or Unloaded with BM-MSCs in Healing of Skull Bone Defect in Rats: Histological and Immunohistochemical Study.

Int J Stem Cells 2018 Nov;11(2):216-226

Medical Research Center, Ain Shams University, Cairo, Egypt.

Bone defect occurs as a consequence of many conditions. Diseased bones don't heal properly and defects in face area need proper bone reconstruction to avoid psychological and social problems. Tissue engineering is an emerging new modality of treatment. We thought to study different methods to fill skull bone defect in rats in order to find the most safe and effective method. So, this study was designed to evaluate the efficacy of acellular dermal graft (ADM) versus propylene mesh both either loaded or unloaded with bone marrow derived mesenchymal stem cells (BM-MSCs) in healing of skull bone defect of a 5 mm diameter. The study included 36 adult male Wistar albino rats that were divided into three groups according to the way of filling skull bone defect. : (sham control), (negative control). : (unseeded propylene), (seeded propylene) and : (unseeded ADM), (seeded ADM). The trephine operation was done on the left parietal bone. Specimens were collected four weeks postoperative and processed for H&E, osteopontin immunohistochemistry and scanning electron microscope. Morphometric and statistical analysis were also performed. After studying the results of the experiment, we found that propylene mesh and ADM were suitable scaffolds that could support new bone formation in clavarial bone defect. Healing of skull bone defect was better in rats that received seeded scaffolds more than rats with unseeded scaffolds. The seeded ADM showed significant increase in bone forming activity as confirmed by histomorphometric and statistical results.
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November 2018

The role of prophylactic internal iliac artery ligation in abnormally invasive placenta undergoing caesarean hysterectomy: a randomized control trial.

J Matern Fetal Neonatal Med 2019 Oct 25;32(20):3386-3392. Epub 2018 Apr 25.

a Department of Obstetrics and Gynaecology , Cairo University , Cairo , Egypt.

To identify the role of bilateral internal iliac artery (IIA) ligation on reducing blood loss in abnormally invasive placenta (AIP) undergoing caesarean hysterectomy. In this parallel-randomized control trial, 57 pregnant females with ultrasound features suggestive of AIP were enrolled. They were randomized into two groups; IIA group ( = 29 cases) performed bilateral IIA ligation followed by caesarean hysterectomies, while Control group ( = 28 cases) underwent caesarean hysterectomy only. The main outcome was the difference in the estimated intraoperative blood loss between the two groups. There was no significant difference between the two groups regarding the intraoperative estimated blood loss (1632 ± 804 versus 1698 ± 1251, value .83). The operative procedure duration (minutes) (223 ± 66 versus 171 ± 41.4, value .001) varied significantly between the two groups. Bilateral internal iliac artery ligation, in cases of AIP undergoing caesarean hysterectomy, is not recommended for routine practice to minimize blood loss intraoperatively.
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October 2019

Striae distensae: Immunohistochemical assessment of hormone receptors in multigravida and nulligravida.

J Cosmet Dermatol 2017 Jun 4;16(2):279-286. Epub 2017 Apr 4.

Department of Histology, Ain Shams University, Cairo, Egypt.

Background: Striae distensae (SD), a type of dermal scarring, are psychologically disappointing. To date, information and scientific research behind the role of hormonal factors in the development of SD are still unclear. It is vital to understand striae to offer patients the best therapeutic options.

Objectives: To investigate early alterations regarding the expression of estrogen, androgen, and glucocorticoid receptors (estrogen receptor (ER), androgen receptor (AR), glucocorticoid receptor (GR) in skin samples of multigravida (MG) and nulligravida (NG) cases and to compare them with normal controls.

Methods: This study included 30 subjects (10 MG and 10 NG cases with early SD and 10 healthy controls). Biopsies from SD lesions, perilesional normal skin of cases and normal skin of controls were examined immunohistochemically for ER, AR, and GR expression using immune peroxidase technique.

Results: Comparing MG and NG with controls, ER expression appeared reduced in MG and NG (P-value<.001), AR was elevated in MG (P-value<.05) with no considerable difference in NG (P-value>.05), while GR was elevated in both MG and NG (P-value<.05). On comparing perilesional skin with SD lesions in each of MG and NG groups, SD lesions revealed reduced ER expression in both groups (P-value<.05), whereas in MG group: AR expression was elevated with no difference detected regarding GR (P-value˃.05); meanwhile in NG, elevated expression in both AR and GR expression was noted (P-Value<.001) CONCLUSIONS: Striae distansae lesions demonstrated a significant increase in the expression of AR and GR and a declined expression of ER indicating their involvement in the development of early SD.
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June 2017

Image analyzer study of the skin in patients with morbid obesity and massive weight loss.

Eplasty 2015 23;15:e4. Epub 2015 Jan 23.

Plastic Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Objective: Studies in literature on skin of patients with massive weight loss are limited and somehow conflicting in their results. The aim of this study was to quantitatively assess the skin change after massive weight loss.

Method: This study was performed on 30 patients from whom skin biopsies were taken from the skin excised during operations, divided into 3 main groups. The first included patients who were undergoing cosmetic contouring procedures without history of massive weight loss. The second included patients with morbid obesity, who were undergoing bariatric surgery. The third included patients with massive weight loss submitted to cosmetic contouring procedures after stable weight reduction for 6 months. Biopsies were taken from the skin for histological testing. Hematoxylin and Eosin, Mallory, and Aldehyde fuchsin Stains were used to assess the skin collagen and elastic fibers. For quantitative assessment, the Image Analyzer System (Leica Q 500 MC program) was employed. Tensile tests were applied to skin samples using (Instron 5500R) Universal testing machine to measure the skin tensile strength to determine the maximum stress (Burst strength) that skin can induce before damage.

Results: Collagen was significantly thinner in massive weight loss group in both papillary and reticular dermis and significantly less dense in reticular dermis with damage to the elastic fiber network.

Conclusion: The skin of the patients with massive weight loss is weak due to lower density and thickness of collagen fibers and damage to its elastic fibers.
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February 2015

Expression of recombinant staphylokinase in the methylotrophic yeast Hansenula polymorpha.

BMC Biotechnol 2012 Dec 19;12:96. Epub 2012 Dec 19.

Minapharm Pharmaceuticals, Cairo, Egypt.

Background: Currently, the two most commonly used fibrinolytic agents in thrombolytic therapy are recombinant tissue plasminogen activator (rt-PA) and streptokinase (SK). Whereas SK has the advantage of substantially lower costs when compared to other agents, it is less effective than either rt-PA or related variants, has significant allergenic potential, lacks fibrin selectivity and causes transient hypotensive effects in high dosing schedules. Therefore, development of an alternative fibrinolytic agent having superior efficacy to SK, approaching that of rt-PA, together with a similar or enhanced safety profile and advantageous cost-benefit ratio, would be of substantial importance. Pre-clinical data suggest that the novel fibrinolytic recombinant staphylokinase (rSAK), or related rSAK variants, could be candidates for such development. However, since an efficient expression system for rSAK is still lacking, it has not yet been fully developed or evaluated for clinical purposes. This study's goal was development of an efficient fermentation process for the production of a modified, non-glycosylated, biologically active rSAK, namely rSAK-2, using the well-established single cell yeast Hansenula polymorpha expression system.

Results: The development of an efficient large scale (80 L) Hansenula polymorpha fermentation process of short duration for rSAK-2 production is described. It evolved from an initial 1mL HTP methodology by successive scale-up over almost 5 orders of magnitude and improvement steps, including the optimization of critical process parameters (e.g. temperature, pH, feeding strategy, medium composition, etc.). Potential glycosylation of rSAK-2 was successfully suppressed through amino acid substitution within its only N-acetyl glycosylation motif. Expression at high yields (≥ 1g rSAK-2/L cell culture broth) of biologically active rSAK-2 of expected molecular weight was achieved.

Conclusion: The optimized production process described for rSAK-2 in Hansenula polymorpha provides an excellent, economically superior, manufacturing platform for a promising therapeutic fibrinolytic agent.
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December 2012

Feasibility and safety of monopolar diathermy as an alternative to clip ligation in laparoscopic Fowler-Stephens orchiopexy.

J Pediatr Surg 2012 Oct;47(10):1907-12

Pediatric Surgery Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.

Purpose: The aims of the study were to study the effect of Fowler-Stephens orchiopexy (FSO) on testicular histology and to assess the feasibility of using monopolar diathermy as an alternative to clip ligation during laparoscopic FSO.

Patients And Methods: The study included 20 patients with 20 intraabdominal testes and short vessels managed by laparoscopic-staged FSO. Biopsies were taken from intraabdominal testes during the first and second stages of the procedure for histologic comparison. The patients in the study were divided into 2 groups according to the method of dividing the testicular vessels in stage 1. The first 13 patients (group A) were managed by clip ligation of the vessels, whereas monopolar diathermy was used in the following 7 patients (group B).

Results: Biopsy findings at stage 2 revealed an overall reduction in both the total number of germ cells per tubule and mean diameter of seminiferous tubules, whereas there was no statistically significant difference between the results in groups A and B.

Conclusion: The seminiferous cells can withstand (survive) dividing the main blood supply of the testis during FSO. The monopolar diathermy can be used as an alternative to clipping during laparoscopic procedures, having the advantages of lower expenses and using smaller instruments.
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October 2012

Sequential immunohistochemical study of depigmenting and repigmenting minigrafts in vitiligo.

Eur J Dermatol 2003 Nov-Dec;13(6):548-52

Department of Dermatology and Venereology, Ain Shams University, Cairo, Egypt.

The initial steps of melanocytic dysfunction in vitiligo are hitherto not well understood. The aim of the present study was to examine the sequence of early events that occur in melanocytes after autologous minigrafting in patients with vitiligo, depending on their clinical response. Six patients with non-segmental widespread vitiligo were included in the study. Specimens of vitiliginous lesions were used as preoperative controls and sequential punch biopsies were taken from the grafted areas on days 14, 17, 21 and 28 after minigrafting. Immunohistochemical stains using the MoAbs HMB-45, CD4, CD8, ICAM-1, and LFA-1 were performed in all biopsies and the labelled cells were counted by a digital image analyser. Results obtained show that in vitiligo patients not responding to minigrafting, significant numbers of cytotoxic T-lymphocytes and LFA-1 positive infiltrating cells occur in early phases (p < 0.05), suggesting that a cell-mediated immune response takes place towards the grafted melanocytes. Possibly this cell-mediated mechanism causing unresponsiveness to minigrafts may also play a role in the pathogenesis of vitiligo.
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April 2004