Growth factors in dentin matrix and their role.
\\n\\n
IntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\\n\\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\\n\\nLaunching 2021
\\n\\nArtificial Intelligence, ISSN 2633-1403
\\n\\nVeterinary Medicine and Science, ISSN 2632-0517
\\n\\nBiochemistry, ISSN 2632-0983
\\n\\nBiomedical Engineering, ISSN 2631-5343
\\n\\nInfectious Diseases, ISSN 2631-6188
\\n\\nPhysiology (Coming Soon)
\\n\\nDentistry (Coming Soon)
\\n\\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\\n\\nNote: Edited in October 2021
\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/132"}},components:[{type:"htmlEditorComponent",content:'With the desire to make book publishing more relevant for the digital age and offer innovative Open Access publishing options, we are thrilled to announce the launch of our new publishing format: IntechOpen Book Series.
\n\nDesigned to cover fast-moving research fields in rapidly expanding areas, our Book Series feature a Topic structure allowing us to present the most relevant sub-disciplines. Book Series are headed by Series Editors, and a team of Topic Editors supported by international Editorial Board members. Topics are always open for submissions, with an Annual Volume published each calendar year.
\n\nAfter a robust peer-review process, accepted works are published quickly, thanks to Online First, ensuring research is made available to the scientific community without delay.
\n\nOur innovative Book Series format brings you:
\n\nIntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\n\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\n\nLaunching 2021
\n\nArtificial Intelligence, ISSN 2633-1403
\n\nVeterinary Medicine and Science, ISSN 2632-0517
\n\nBiochemistry, ISSN 2632-0983
\n\nBiomedical Engineering, ISSN 2631-5343
\n\nInfectious Diseases, ISSN 2631-6188
\n\nPhysiology (Coming Soon)
\n\nDentistry (Coming Soon)
\n\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\n\nNote: Edited in October 2021
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He has been employed by the Pidstryhach Institute for Applied Problems of Mechanics and Mathematics (IAPMM), Ukraine for more than 40 years. Currently, he is the Head of Department of the Numerical Methods in Mathematical Physics at the IAPMM. His professional performance includes more than 160 papers in the scientific journals and international conference proceedings, which concern to the diffraction and antenna synthesis theory, optimization methods and nonlinear integral and matrix equations. He is author of two monographs in antenna theory. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"314",title:"Regenerative Medicine and Tissue Engineering",subtitle:"Cells and Biomaterials",isOpenForSubmission:!1,hash:"bb67e80e480c86bb8315458012d65686",slug:"regenerative-medicine-and-tissue-engineering-cells-and-biomaterials",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/314.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"57",title:"Physics and Applications of Graphene",subtitle:"Experiments",isOpenForSubmission:!1,hash:"0e6622a71cf4f02f45bfdd5691e1189a",slug:"physics-and-applications-of-graphene-experiments",bookSignature:"Sergey Mikhailov",coverURL:"https://cdn.intechopen.com/books/images_new/57.jpg",editedByType:"Edited by",editors:[{id:"16042",title:"Dr.",name:"Sergey",surname:"Mikhailov",slug:"sergey-mikhailov",fullName:"Sergey Mikhailov"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1373",title:"Ionic Liquids",subtitle:"Applications and Perspectives",isOpenForSubmission:!1,hash:"5e9ae5ae9167cde4b344e499a792c41c",slug:"ionic-liquids-applications-and-perspectives",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/1373.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2270",title:"Fourier Transform",subtitle:"Materials Analysis",isOpenForSubmission:!1,hash:"5e094b066da527193e878e160b4772af",slug:"fourier-transform-materials-analysis",bookSignature:"Salih Mohammed Salih",coverURL:"https://cdn.intechopen.com/books/images_new/2270.jpg",editedByType:"Edited by",editors:[{id:"111691",title:"Dr.Ing.",name:"Salih",surname:"Salih",slug:"salih-salih",fullName:"Salih Salih"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"872",title:"Organic Pollutants Ten Years After the Stockholm Convention",subtitle:"Environmental and Analytical Update",isOpenForSubmission:!1,hash:"f01dc7077e1d23f3d8f5454985cafa0a",slug:"organic-pollutants-ten-years-after-the-stockholm-convention-environmental-and-analytical-update",bookSignature:"Tomasz Puzyn and Aleksandra Mostrag-Szlichtyng",coverURL:"https://cdn.intechopen.com/books/images_new/872.jpg",editedByType:"Edited by",editors:[{id:"84887",title:"Dr.",name:"Tomasz",surname:"Puzyn",slug:"tomasz-puzyn",fullName:"Tomasz Puzyn"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"16787",title:"Designing Lentiviral Gene Vectors",doi:"10.5772/17361",slug:"designing-lentiviral-gene-vectors",body:'Gene therapy relies on the delivery of therapeutic genes into patients’ cells. The micro-devices used to reach the cells and to transfer the gene payload are called gene vectors. Viral packaging machinery is often utilized to generate the particles transporting the cargo genes. Lentiviruses, a subgroup of retroviruses, are highly suitable for remodeling into gene transfer vectors because they offer the stability of transgene expression, the ability to reach the nuclei of the therapeutically important non-dividing cells and are known to have a low immunogenic profile. Well studied members of the lentiviruses include human immunodeficiency viruses 1 and 2 (HIV-1 and HIV-2), feline immunodeficiency virus (FIV) and equine infectious anemia virus (EIAV).
It is important not to confuse “gene delivery vectors” and “gene cloning vectors”. While the former are microparticles delivering genes, the latter are replicating vehicles for the amplification of nucleic acid sequences. “Gene delivery vectors” and “gene cloning vectors” coincide when the naked DNA of replicating bacterial plasmids or replication competent viruses is used for gene delivery into cells. Viral gene delivery vectors are normally non-replicating and should correctly be referred to as “viral vectors”, not “viruses”. Particles of viral vectors can be referred to as “virions” or “transducing particles”, because viral gene transfer is traditionally described as “transduction”. Replication deficient viral gene vector particles are similar to “defective interfering particles”, that is, faulty non-self-viable virions arising during natural viral infections and competing with non-defective virions, which were described in virology literature many years ago.
Native lentiviral envelope proteins, which determine the cell range of viral infectivity (tropism) and mediate the fusion of viral and cellular membranes, are always composed from two non-covalently attached subunits, one of which (e.g. gp41 glycoprotein in HIV-1) is membrane-embedded and the other is an external subunit (e.g. gp120 glycoprotein in HIV-1). This arrangement makes lentiviruses notoriously unstable because of their tendency to shed the external subunit of the envelope protein. As the virion’s stability is a pre-requisite for the effective purification and concentration of viral vector preparations, in lentiviral gene vectors native lentiviral envelope proteins are routinely replaced with stable heterologous viral envelope glycoproteins, most commonly G-protein of Vesicular Stomatitis Virus (VSV) or, alternatively, G protein of Rabies Virus. Both VSV and Rabies Virus belong to the family of rhabdoviruses. VSV-G protein has a broad tropism towards lipid membranes while rabies G has a distinct tropism to neural cells. The interchangeable use of envelope proteins by viruses belonging to different groups is very common and is called “pseudotyping”. Lentiviral vectors can be pseudotyped with many other proteins, including artificially designed proteins, in order to improve infectivity for a particular cell type or, alternatively, to restrict the viral tropism. The rules of efficient pseudotyping are not yet completely clear, but one of the obvious requirements is the ability of the “cytoplasmic tails” of the membrane-embedded putative envelope proteins to fit into the available space between the viral capsid and the lipid envelope of the virion. Sometimes lentiviral vectors are pseudotyped by a cocktail of various viral, cellular or artificial membrane proteins. The structure of the lentiviral gene vector virion is presented in Figure 1.
A typical lentiviral vector particle
Lentiviral vectors are a promising tool for both
In some situations the use of classical lentiviral vectors can be compounded by the following problems: 1) insertional mutagenesis with a potential for malignant transformation; 2) relative difficulty of obtaining high titre concentrated viral vector preparations and the related problem of transduction inhibitors in the viral preparations; 3) toxicity of the commonly used VSV-G envelope protein at high multiplicity of infection; 4) limited insert capacity because of the RNA size packaging constraints specified by the lentiviral Gag complex.
Some of the above problems can be overcome. For example, contamination of lentiviral vector preparations with some inhibitors of infection can be avoided by the viral preparation concentration and purification by chromatography methods, which can be sufficiently gentle in comparison to ultracentrifugation based methods, which often result in a substantial fraction of the viral vector particles becoming inactivated. The reduction of viral vector losses during concentration is important, in particular because defective virions can compete with the functional virions and inhibit transduction (Geraerts, Willems et al. 2006). Perhaps the most dramatic improvement of the lentiviral vectors was the introduction of non-integrating lentiviral vectors, which do not cause genomic mutations arising via the random genomic integration of the classical lentiviral vectors (Section 5 of this review).
Lentiviral vectors can be assembled through transient co-transfection of the lentiviral vector backbone plasmid with helper plasmids expressing viral packaging functions or by stably transfected packaging cell lines. The first production method is currently a preferred choice because of its greater flexibility. A small undesirable possibility of reconstitution of the replication competent virus in the cells used for the lentiviral vector packaging can compromise safety. So, the chances of formation of a complete viral genome are customarily reduced by splitting genes for helper packaging functions between separate plasmids. For example, a common three-plasmid transient co-transfection packaging system employs a helper plasmid with genes for the structural Gag polyprotein, the catalytic GagPol polyprotein and the accessory HIV-1 Rev and Tat proteins (e.g. psPAX2) plus a helper plasmid for an envelope protein (e.g. VSV-G plasmid pMD2G). In a four-plasmid packaging system the genes for the Gag and GagPol functions on the one hand and the Rev function on the other hand are split between two different helper plasmids (with the Tat function missing altogether). Universally used cell lines for the packaging of lentiviral vectors in transient co-transfection are HEK293 cell line and its derivatives. HEK293 cells were produced by selecting an individual immortalised clone among a mixed population of human embryonic kidney cells transformed with DNA fragments of adenovirus type 5. HEK293 cells can be efficiently transfected by the calcium phosphate method, protocols involving cationic lipids (e.g. Fugene 6 and Fugene HD) or electroporation. Contamination of plasmid DNA with co-purifying bacterial lypopolysaccharides should be avoided, as these endotoxins can substantially reduce the efficiency of transfection. HEK293T cells, which were derived from HEK293 cells and stably express large Simian Virus 40 (SV40) large T-antigen, are purported to generate retroviral and lentiviral vector preparations with particularly high titres. Thus, at present HEK293T and closely related HEK293FT cells are predominantly used for lentiviral vector production via transient co-transfection of the backbone vector plasmid and the helper plasmids. The abundance of lentiviral vector genomic RNA and levels of expression of VSV-G protein, Gag and GagPol polyproteins plus the accessory protein Rev in the packaging cells are of paramount importance for the resultant lentiviral vector titre. The ratio of a lentiviral backbone vector plasmid DNA and non-vector helper packaging plasmids is used to regulate the relative amount of genomic RNA and packaging proteins. In part, the optimal balance depends on the known toxicity of the excess VSV-G protein to mammalian cells. Clontech-Takara and ThermoFisherScientific-OpenBiosystems offer mixtures of plasmids with tetracycline-inducible expression of the
The process of cell transduction by a viral vector follows the infection pathway of the cognate virus. There are several parameters characterizing the transduction of cells with a viral vector. Firstly, efficiency of transduction, defined as percentage of transduced cells out of all cells treated with a viral vector preparation, is a common and readily-obtained read-out quantity in transduction experiments. The second commonly used parameter is end-point titre, which is the number of “transduction units” per volume of the viral vector preparation with the number of transduced cells (corresponding to the “transduction units”) estimated when one of the highest dilutions of the viral preparation is used to infect the cells. The third important parameter describing transduction by a viral vector is the multiplicity of infection, that is, the average number of functional transducing particles infecting one cell. The infection of a cell by a lentiviral vector normally results in the establishment of one or several copies of the corresponding provirus. The efficiency of the transduction of the cell population by a retroviral vector, which is a function of the multiplicity of infection, correlates with a number of proviruses in the genome of the infected cell (Kustikova, Wahlers et al. 2003). Thus, the obtained transgene copy number reflects the multiplicity of infection. Expression of retroviral envelope proteins is known to block superinfection (i.e. extra-infection by the same virus) of the infected cells through the depletion of the cognate cellular receptor molecules during their intracellular transport. This mechanism, though, does not apply to VSV-G protein pseudotyped lentiviral vectors, which neither have protein cellular receptors, nor code for an envelope protein under typical circumstances. Therefore, it is possible to increase the number of the lentiviral vector proviruses and, hence, transgene copy number by repeated rounds of superinfection.
As an alternative to gene delivery with packaged lentiviral vectors, the cargo genes within lentiviral vector DNA sequences can be transferred
The stable maintenance of lentiviral vectors makes them a highly suitable tool for various cell-fate mapping studies and also as sensors of cell differentiation. Tracing cells with a specific differentiation status is important in biomedical research, e.g. in stem cell studies (Gallo, Grimaldi et al. 2008). The packaging size constraints make it a challenge to avoid cross-talk between various elements within lentiviral vectors and, therefore, require the thoughtful design of lentiviral vectors with tissue specific transgene expression (Hager, Frame et al. 2008).
The lentiviral vector genome has the size of about 10 kb and can be conveniently amplified by cloning its complete or partial DNA copy in the bacterial plasmid cloning vectors. Such lentiviral vector backbone plasmids are similar to other vector plasmids for mammalian gene expression, which were recently reviewed (Tolmachov 2009). The immediate purpose of the lentiviral vector backbone plasmid is to serve as a template for the transcription generating viral vector genomic RNA, which can be packaged into the lentiviral vector particles. The bacterial portion of the vector plasmid is not transcribed and, therefore, is not included in the genomic RNA of the viral vector. Thus, a typical lentiviral vector backbone plasmid consists of a bacterial plasmid portion, lentiviral elements required for viral vector RNA packaging and intracellular transport, a marker gene and/or a cargo gene and elements for their regulation, optional chromatin-control elements and sites for convenient plasmid DNA re-engineering (Figure 2).
A typical lentiviral vector backbone plasmid. CMVp – the immediate early CMV promoter; delta 5’-LTR and delta 3’-LTR – the long terminal repeats with some deletions; Psi & RRE – the packaging sequence ψ and the Rev Response Element (RRE); PGKp – the mouse phosphoglycerol kinase promoter; EGFP-NLS – the gene for nuclear targeted enhanced GFP protein; ori-pMB1 – the multicopy origin of replication originating from the wild type plasmid pMB1; Ap-R – the ampicillin resistance marker, the gene for β-lactamase.
Evolution has shaped both bacterial plasmid and viral genomes as mosaic assemblies, which can be disassembled into individual functional units that can then be assembled back into new chimeras. Thus, the genomes of lentiviral vectors consist of a number of genetic elements, of which lentiviral elements
Other regulatory genetic elements within lentiviral vectors include viral or cellular promoters and enhancers, splicing control elements if an intron is included, RNA stabilizing components like Woodchuck hepatitis virus Post-transcriptional Regulatory Element (WPRE) and, with a pinch of salt, polyadenylation signals (see discussion in Section 2.4).
Thus, the lentiviral vector backbone plasmid normally includes a bacterial plasmid segment,
Lentiviral vector backbone plasmids are propagated in bacteria and hence need to contain a bacterial origin of replication to drive the DNA amplification. Plasmid origins of replication are traditionally classified into a “stringent control of the plasmid copy number” group and a “relaxed control of the plasmid copy number” group. High number of plasmid copies per cell, which is typical for the “relaxed control” group, insures the high yield of the plasmid DNA. However a high plasmid copy number can place substantial stress onto the host cells, thereby decreasing their growth rate and, thus, resulting in occasional accumulation of cells with the shortened, “deletion”, plasmid mutants or cells lacking the plasmid altogether. In contrast, replicons from a “stringent control” group have a lower number of plasmid copies per cell and hence comparatively small plasmid DNA yields, however plasmids driven by these replicons only rarely place a selective disadvantage onto their host cells. In addition, stable maintenance of the stringent control replicons is insured by their “partition” functions, which are responsible for the faithful distribution of plasmids between daughter cells after cell divisions. Classic relaxed control replicons are derived from plasmids ColE1 and pMB1, while typical stringent control replicons originate from plasmids RSF1010, pSC101, F-factor, and bacteriophage P1. A particularly convenient replication system, which is used in the lentiviral vector backbone plasmids, is borrowed from the plasmid R6K. This plasmid has several origins of replication, all dependent on the Π-protein encoded by the plasmid’s
To select bacterial tranformants during plasmid modifications and to prevent plasmid loss using selective pressure for plasmid-containing cells, the bacterial plasmid segment should include a suitable selection marker. The standard solution is to employ an antibiotic selection gene such as the ampicillin resistance gene for β-lactamase or the chloramphenicol resistance gene for chloramphenicol acetyl transferase. Large scale preparations of plasmid DNA with antibiotic resistance genes might lead to the undesirable escape of these genes into environment. Thus, genetic systems, which rely on a short RNA-expressing gene as a plasmid selection marker, can be contrived (Luke, Carnes et al. 2009).
Regrettably, it is relatively common for lentiviral vector backbone plasmids to suffer from structural and maintenance instability in bacteria. There are several common factors contributing to this instability. Lentiviral vector backbone plasmids are necessarily greater than 9 kb in size; if their replication is driven by a replication origin with “relaxed control” of the plasmid copy number, spontaneously arising deletion mutants have a propensity to replicate faster and, as a result, tend to establish dominance in the mixed plasmid population. Plasmid deletions can occur through homologous or illegitimate recombination between inverted repeats of the lentiviral LTRs. A mosaic of eukaryotic sequences within the lentiviral vector backbone plasmid might contain cryptic bacterial promoters, which could be able to drive the expression of toxic RNAs and polypeptides creating a negative selection pressure on the population of bacterial cells harbouring the desired plasmids. It should be noted that the ampicillin resistance gene coding for β-lactamase, which is often used in the commercially available lentiviral backbone plasmids as a selection marker, is poorly suited for long-term bacterial selection in liquid cultures. This is because wild type β-lactamase is secreted in
The standard purpose of lentiviral vector backbone plasmids is to provide a template for the synthesis of lentiviral vector genomic RNA, which can be successfully packaged into lentiviral vector virions, reverse transcribed and integrated within the cellular genome. The Ψ-sequence close to the 5’-LTR is strictly required for the packaging of RNA by the Gag polyprotein. A substantial portion of the sequences within the LTRs of the lentiviral genome is required for chromosomal integration. However, some sequences within the LTRs can be removed without reduction in the integration efficiency. Wild-type retroviral and lentiviral genomes contain a promoter within their 5’-LTR to drive expression of genomic RNA. The promoter sequences can be deleted from the 5’-LTR DNA segment in the lentiviral vector backbone plasmids and a strong constitutive promoter capable of directing synthesis of the vector genomic RNA, e.g. immediate early CMV promoter, can be placed externally to the bracket of the lentiviral sequences within the plasmids. As the accessory lentiviral protein Tat is required for the activation of the promoter within the wild type 5’-LTR of HIV-1, the use of an external promoter for genomic RNA synthesis allows exclusion of the Tat gene from the packaging system with the consequent reduction in the probability for the re-constitution of the replication competent virus and the corresponding improvement in safety (Dull, Zufferey et al. 1998). A substantial fraction of the currently used lentiviral vectors are “self-inactivating” (SIN) due to a deletion within their 3’-LTR. Indeed, as the DNA-copy of the 5’-LTR of the vector provirus is always synthesized by reverse transcription from the template of the 3’-LTR, proviruses of the SIN vectors lack sequences required for the re-constitution of the lentiviral promoter within the 5’-LTR segment of the vector provirus and the synthesis of the lentiviral vector genomic RNA from the provirus template. Thus, the SIN-vectors cannot be re-distributed from the target cells, which is beneficial for their safety profile.
Lentiviruses possess molecular machinery to enter into the nuclei of postmitotic, non-dividing cells with an intact nuclear envelope. Lentiviral nuclear-penetration apparatus is in part dependent on the triple-stranded structure created during reverse transcription of the lentiviral genomic RNA, “the central DNA flap” (Riviere, Darlix et al. 2010). Central Polypurine Tract (cPPT) and Central Termination Sequence (CTS) are required for the formation of “the flap”. Therefore, DNA sequences for cPPT and CTS need to be present in the plasmid template of the nuclear penetrating lentiviral vectors.
Rev protein of HIV-1 is known to increase lentiviral vector titres by promoting the export of genomic RNA from the nucleus. This export depends on the Rev Response Element (RRE) sequence within genomic RNA. Therefore, the RRE sequence is a desirable building block for inclusion into the lentiviral vector backbone plasmids.
The concentration of lentiviral vector particles can be assessed by their ability to transduce cells and by physical measurements estimating the number of virions in a volume. A substantial number of virions in lentiviral preparations can be infection defective, so transduction data are vital for the evaluation of the titre of functional lentiviral vector particles. Convenient markers for the assessment of efficiency of transduction and for the fate mapping of transduced cells include genes for fluorescent proteins, drug resistance proteins, luciferase and cell surface antigens. More practical markers are easily detected in live cells, while others require fixation of the live material. Enzyme coding genes, such as the
Drug resistance (normally antibiotic resistance) genes are especially suitable for tasks requiring the establishment of stably transduced cell clones originating from individual transduced cells. The choice of a particular drug resistance gene can be affected by its size. The gene for blasticidin resistance,
Fluorescent proteins are remarkably convenient as gene transfer markers because they can be detected both in live and fixed cells. The largest family of fluorescent proteins originates from the green fluorescent protein (GFP) of jellyfish
The titre of a lentiviral vector depend to a large degree on the type of the marker used for analysis. Indeed, the titre determined by detecting the fluorescent transduction markers is usually higher than the titre obtained by counting drug resistant cell clones.
Genes for luminescence proteins can be transferred by lentiviral vectors and used as cell tracers (Reumers, Deroose et al. 2008). Luciferases from North American firefly
Surface antigen markers, e.g. extracellular domain of CD4, truncated low-affinity nerve growth factor (LNGFR) or truncated mouse MHC class I molecule H-2Kk can be used as cell markers for antibody-mediated conjugation with paramagnetic particles, which can be used for both magnetic cell sorting and magnetic resonance imaging (So, Hotee et al. 2005). The intracellular domains of these proteins are removed to avoid signal transduction and the extracellular domains are supplied with GPI-lipidation signal for plasma-membrane anchoring (as in Miltenyi Biotec MAC SelectTM system). Background signal during whole-animal imaging can be avoided by using species-specific monoclonal antibodies for the cell surface marker proteins in a heterologous host organism.
In general,
The Polymerase II transcripts, e.g. mRNAs, are nearly always modified by the addition of 7-methylguanosine (the “cap”) to their 5’-ends and the addition of the homopolymeric tail of adenosine nucleotides to their 3’-ends. Polyadenylation of eukaryotic mRNAs is important for their protection from exonucleolytic attack and for their export out of nucleus. It also serves as a means of transcription termination. For mRNA to be polyadenylated, it should contain a specific signal sequence downstream of its polypeptide coding sequence. In general, a DNA sequence for the functional “polyadenylation signal” (pA signal), which is suitable for insertion into lentiviral vector backbone plasmids, is several hundred nucleotides long and is borrowed from a mammalian gene or a viral genome. Commonly used pA signal sites are taken from the rabbit β-globin gene, human growth hormone gene and human herpes virus (HSV) thymidine kinase (TK) gene. The sequence 5’-AAUAAA-3’ located 10-30 nucleotides upstream of the cleavage site is highly conserved but is not strictly required for the polyadenylation of mammalian mRNAs. A very important feature of the lentiviral vector backbone is the pA signal in its 3’-LTR. This signal functions as a terminator for wild type lentiviral RNAs including complete lentiviral genomic RNA. As the 3’-LTR sequence itself is strictly required for chromosomal integration in lentiviruses, any foreign pA signals which can cause premature termination of the genomic RNA are bound to reduce the amount of transductionally active genomic RNA, and, therefore, to diminish drastically the titre of the functional lentiviral vector particles (Hager, Frame et al. 2008). Thus, foreign pA signals within lentiviral vectors should be either avoided altogether, or weakened, or positioned to terminate the transcription of the anti-genomic DNA strand only. With this challenge in view, it should be noted that while most pA signal sites act unidirectionally, a pA signal borrowed from SV40 viral genome is known to terminate RNA and to promote polyadenylation irrespective of transcription direction. A brief look at the transcription map of SV40 can explain this fluke. Indeed, two opposing transcription waves of SV40 meet and terminate at its polyadenylation signal site, which is, therefore, an overlap of two opposing polyadenylation signals.
Natural Polymerase II promoters are nearly always supplemented with one or several “enhancers”, that is, genetic elements, which up-regulate the activity of the promoter through binding to specific nuclear proteins, so-called “transcription factors”. Size limitations of the lentiviral payload and insufficiently precise enhancer localization data restrict the use of enhancers in the lentiviral vectors. However, small enhancer elements can still be used where, for example, tissue-specific or inducible transgene expression is desired.
A typical eukaryotic protein-coding gene is a patchwork of coding exons and non-coding introns, so that the translation-grade mRNA is produced by the splicing of the primary transcript. The result of the splicing is the establishment of the phosphodiester bond between the AG dinucleotide at the 3’-end of the preceding exon and the G nucleotide at the 5’-end of the subsequent exon within the transcript (Hiller and Platzer 2008). The interlacing sequences, the introns, are flanked with a “splice-donor” consensus sequence 5’-GTRAGT-3’ at their 5’-ends and a “splice-acceptor” sequence 5-YAG-3’ at their 3’-ends (where R is A or G, Y is C or T). In addition, introns contain a “branch point” 5’-YTRAY-3’ and a polypyrimidine tract, which are functionally important for successful splicing. As the payload space within the lentiviral vectors is limited, the standard practice is to include the genes in their complementary DNA (cDNA) form, that is, as spliced versions without introns. The introns, however, are not entirely inert genetically and occasionally take part in the regulation of gene expression. In such situations, the inclusion of small regulatory introns within lentiviral vectors can be considered (Le Hir, Nott et al. 2003).
Coding sequences delivered by lentiviral vectors are often derived from non-mammalian organisms where the translation machinery is adapted to a non-mammalian profile of codon frequencies. Unusual codons, also called “hungry codons”, can cause undesirable pauses during translation and reduce the efficiency of gene expression. Therefore, the optimization of codon frequencies for the genes, which are born on the lentiviral vectors, is often advantageous. If the frequencies in a coding sequence are adapted to the human codon usage profile, the sequence is said to be “humanized” (Zeeberg 2002; Burgess-Brown, Sharma et al. 2008).
The stability of genomic RNA of lentiviral vectors is crucial for attaining high lentiviral vector titres and stability of the lentiviral vector encoded mRNAs is important for efficient transgene expression. It was discovered that an element from Woodchuck Hepatitis Virus (WHV) genome can operate at a post-transcriptional level to improve transgene expression. The sequence, called WHV Post-transcriptional Regulatory Element (WPRE) is thought to act by expediting the export of RNA from the nucleus with the concomitant reduction of the intra-nuclear RNA degradation. WPRE and a similar element from Human Hepatitis Virus (HBV) are extensively used in lentiviral vectors, where they are normally positioned immediately upstream from the 3’-LTR, primarily because of their vector titre enhancing properties. WPRE, as defined originally, was known to cause tumours in rodents, therefore, a safer version of WPRE with deleted sequences for the WHV X protein and its promoter was generated (Schambach, Bohne et al. 2006).
Cistrons are not the only cargo genes delivered by the lentiviral vectors. Other payload genes include the genes for RNAi-exploiting “micro” RNAs (miRNAs) or their artificial analogues, “short hairpin” RNAs (shRNAs). These genes are transcribed by RNA Polymerases III or I from the corresponding promoters. The benefits of the lentiviral vectors, such as the relative stability of transgene expression and the ability to transduce postmitotic cells, considerably broaden the versatility of gene knock-down experiments with shRNAs (Rubinson, Dillon et al. 2003). A range of suitable lentiviral vectors, exploiting the high activity of hybrid miRNA-30-shRNA design, are offered by ThermoFisherScientific-OpenBiosystems (Silva, Li et al. 2005).
In summary,
It is a relatively common occurrence for transgene expression to die out both in terms of the reduction of the fraction of expressing cells and the decrease of the efficiency of expression. Integrated lentiviral proviruses are faithfully maintained in mammalian cells, so the reasons for the shutdown of transgene expression are mostly epigenetic. Malfunction of the transgene expression control elements is often blamed, indeed, the phenomenon is sometimes referred to as “promoter shut down”. Certainly, different promoters have various capabilities to maintain long-term transgene expression. In particular, some promoters tend to turn off in cell populations where they are not normally active. The shutdown of transgene expression is particularly common in cell populations undergoing differentiation (Bagchi, Kumar et al. 2006). Natural chromosomal integration of lentiviruses tends to occur in transcriptionally active areas of the genome where heterochromatin and DNA methylation are unlikely to interfere with transgene expression. However, as the cells differentiate, the pattern of heterochromatization and DNA methylation changes and some of the proviruses find themselves in the transcriptionally silent areas of the genome.
There are many levels at which the longevity of transgene expression can be addressed through the lentiviral vector design, including: 1) control of the provirus amenity to methylation (e.g. purposeful exclusion of the methylation-prone CpG islands); 2) chromatin re-modeling control via
In principle, the protection of proviruses from heterochromatin can be achieved with genomic insulators or other similar anti-heterochromatin elements. However, experiments with known insulators show that their effects on transgene expression from lentiviral proviruses are multi-vectorial depending on the cell context (Grandchamp, Henriot et al. 2011). Ideally, targeting proviruses to a continuously active locus (e.g. human homologue of the mouse Rosa 26 locus) can resolve the transgene expression shutdown problem. An alternative solution is to escape chromatin-remodeling events by creating episomally maintained lentiviral proviruses (Section 5).
The fairly large size of the lentiviral vector backbone plasmids means they contain a limited number of unique sites for restriction nucleases. Thus, it is often desirable to introduce artificial clusters of suitable unique restriction sites (polylinkers) to simplify the modification of these plasmids. Alternatively, selection schemes involving site-specific recombination can be used for repetitive modifications, e.g. for marker exchange or promoter exchange. In this scenario, the introduction of suitable site-specific recombination sites into the lentiviral vector backbone plasmid is required.
As discussed in Section 2.1, lentiviral vector backbone plasmids are occasionally structurally unstable and/or poorly maintained. These plasmids are particularly vulnerable during initial establishment in bacteria. Instability of nascent recombinant plasmids can result in a practical unfeasibility of seemingly straightforward DNA cloning strategies. For example, the generation of new lentiviral vector backbone plasmids through inefficient ligation of two DNA fragments with blunt ends is normally very challenging. In such situations we recommend splitting the DNA cloning procedure into separate cloning steps, each one relying on either effective positive selection of new recombinant plasmids or on efficient ligation. For example, the insertion of additional DNA sequences into lentiviral vector backbone plasmids can take advantage of the “pop-in-pop-out” cloning strategy. In this approach, a plasmid containing the desired insert and marked with antibiotic resistance marker 1 is first fused with the lentiviral vector backbone plasmid marked with antibiotic resistance marker 2 using positive selection of the co-integrate plasmid with two antibiotics. The desired new lentiviral vector backbone plasmid is then obtained by removing the unwanted plasmid sequences from the resultant bi-replicon plasmid using restriction digestion and efficient intra-molecular ligation reaction. Clearly, this strategy for insertions into a lentiviral vector backbone plasmid requires the thoughtful placement of restriction sites conveniently accommodating both the “pop-in” step and the “pop-out” step.
The genome sizes of non-defective wild type HIV-1 isolates are close to 9.5 kb. The lentiviral packaging size constraints are dictated by the geometry of the viral capsid and are thought to be fairly permissive of the smaller than wild type genome versions, but remarkably intolerant of the larger than wild type variants. As lentiviral sequences required for genomic RNA packaging and chromosomal integration constitute about 2 kb, the available gene payload space within HIV-1 based lentiviral vectors should not be much more than 7.5 kb. Thus, the insert size capacity of the lentiviral vectors is completely appropriate for the vast majority of the monogenic applications but can present a challenge in situations where the delivery of several genes by a single vector is required. Therefore, various possible methods of gene cargo reduction have been explored.
The expression of two or more cistrons from a single promoter can be achieved by the employment of internal ribosome entry site (IRES) elements, which are normally borrowed from viral genomes (Fux, Langer et al. 2004). The IRES sequences (about 0.5 kb) are inserted between the coding frames to facilitate translation of the downstream coding frames from the same transcript. IRES efficiency is not absolute and it is a common occurrence for the subsequent gene in the expression cassette to be expressed at a lower level than the preceding gene. As the length of the intercistronic inserts is an important factor in the IRES efficiency, the expression of the downstream genes can be improved by increasing or decreasing the sizes of the IRES inserts (Attal, Theron et al. 1999).
Another common method used to compress the gene expression cassettes is to produce gene products as polyproteins, that is, large polypeptides, which are split into individual proteins by proteases recognizing the appropriate amino acid sequence cleavage motifs between the protein modules. In fact, lentiviruses use the same principle themselves as the Gag polyprotein is proteolytically processed inside the viral particles to form nucleocapsid, capsid, matrix proteins and the GagPol polyprotein is processed to form additionally viral protease, integrase and reverse transcriptase. The usual proteolytic signal, 2A, which is used in recombinant lentiviral gene vectors, is, however, borrowed not from lentiviruses but from the Foot-and-Mouth Disease Virus belonging to the family of picornaviruses. Multiple copies of the 2A sequence can be successfully used to indicate the desired break-up of the polyproteins. The method has its limitations as protein misfolding might occur, which would require some extra chaperone support.
Quite often there is no need to separate several proteins as they can perform several functions remaining as a single polypeptide chain. In general, multifunctional fusion proteins are produced by the fusion of the coding sequences in the same translation frame. Some spacer peptides might be used to intercalate between the fused polypeptides to improve folding and to facilitate the functional activity of the individual protein domains. There are two common methods to achieve protein fusion: 1) the stop codon of the upstream coding unit is deleted and the start codon of the downstream coding unit is retained to obtain alternative translation starts; 2) both the stop codon of the upstream coding unit and the start codon of the downstream coding unit are deleted. It is important to remember that many proteins are naturally proteolytically processed and this processing can be upset by protein fusion or can interfere with the desired fusion. For example, many proteins are secreted into the lumen of the endoplasmic reticulum (ER) with the concomitant cleavage of the leader peptide by the signal peptidase. If incorporated within the downstream portion of the fusion protein, the signal peptide cleavage sequence can cause undesired fission of the fusion protein. Thus, potential problems associated with building of novel fusion proteins include protein misfolding, incorrect intracellular localization and unexpected sensitivity to a protease attack. In addition,
Mimicking wild type lentiviruses, splicing signals can be exploited to generate multiple mRNAs for different proteins from a single primary transcript (Zhu, Chung et al. 2001). However, internal splicing signals reduce the amount of the full size genomic RNA of the lentiviral vectors and, therefore, are bound to be detrimental for the vectors’ titres.
On some occasions several cargo genes within one lentiviral vector can be arranged to be driven by their individual promoters. This option is discussed in the following Section 4.
The most straightforward way to arrange two transcription cassettes within the lentiviral vector is to assemble them in a tandem with the orientation coinciding with the transcription direction for the primary genomic RNA (that is, from 5’-LTR to 3’-LTR). Extreme caution is recommended in the employment of foreign pA signals in both cassettes, as they can interfere with the production of functional genomic RNA of the lentiviral vector. The production of functional genomic RNA and transcription from the two gene expression cassettes can all rely on the pA signal within 3’-LTR and a postranscriptional enhancer, such as WPRE, positioned immediately upstream from the 3’-LTR. Such tandem arrangement of two gene expression units is prone to overriding any regulatory features of the downstream promoter by the topmost upstream promoter. Thus, a regulated promoter (e.g. a tissue specific promoter) should be positioned in the upstream gene expression unit while a constitutive and ubiquitous promoter should be positioned downstream (Gallo, Grimaldi et al. 2008; Kita-Matsuo, Barcova et al. 2009). As the lentiviral promoter in the 5’-LTR can override any regulatory features of the downstream promoters, versions of the lentiviral vectors with a deleted 5’-LTR promoter are preferable for tandem assemblies of expression cassettes, which include a regulated promoter. There are multiple situations, both in gene therapy and in general biomedical research, where an induced transgene expression is required. In particular, heat (Vilaboa and Voellmy 2006), light (Schoenenberger, Gerosa et al. 2009; Deisseroth 2011) and gas-born acetaldehyde (Weber, Rimann et al. 2004) were used for induction of gene expression in mammalian cells (Goverdhana, Puntel et al. 2005).
An alternative solution for the arrangement of two expression cassettes within a lentiviral vector genome is an assembly with the divergent orientation of the transcription. The advantage of the divergent orientation of the promoters is that it excludes any cross-talk between two gene expression units. Therefore, two highly regulated promoters can be employed in the same vector. An expression cassette positioned along the transcription of the genomic RNA can still use pA signal in 3’-LTR while a counter-genomic-transcription unit requires its own pA signal. Care should be taken to use an exclusively unidirectional pA signal and not to use a DNA fragment with two opposing pA signals, which can cause the disruption of the functional genomic RNA production.
Lentiviral vectors with tissue-specific promoters can be used for the long-term expression of transgenes in gene therapy and also as sensors of cell differentiation, an important task in stem-cell-based therapy. There are two principal types of genetic sensors: a “responsive” type with a real-time reaction to the cell’s state and a “fate-mapping” type, which, once activated, can permanently retain the sensor state during any epigenetic changes happening while cells differentiate or react to outside stimuli. As promoters and enhancers are pivotal elements of the gene expression control, the ability of lentiviral vectors to accommodate several transcription cassettes is an important consideration in the gene vector choice.
A flexible way to regulate gene expression is via cistron inversion relative to a promoter (Atasoy, Aponte et al. 2008; Sohal, Zhang et al. 2009). Thus, a site-specific recombinase, such as Cre-recombinase, can react with the cognate recombination sites within lentiviral vector provirus to activate or to block gene expression. Similarly, controlled excision or inversion of a transcription terminator can be used as a regulatory contrivance. The expression of some genes, e.g. cell suicide genes in cancer gene therapy, requires extra tight control, which can be achieved via a parallel or cascade arrangement of two control elements such as an inducible promoter and a cistron-inversion system (Sektas, Hasan et al. 2001). Lentiviral vectors seem to be particularly suited for the assembly of complex gene expression control systems destined for delivery to postmitotic cell populations as their packaging size constraints are less prohibitive than the packaging size constraints of competing Adeno-Associated Virus (AAV) based gene vectors.
One of the current trends in vectorology is for viral vectors to acquire some of the advantageous features of non-viral vectors and for non-viral vectors to borrow attractive bits of the viral machinery. A clear example of that trend is the rapid coming to the fore of non-integrating lentiviral vectors, which are transducing particles still bearing a substantial resemblance to lentiviruses and yet deficient in typical for retroviruses random chromosomal integration of their proviruses (Nightingale, Hollis et al. 2006; Philippe, Sarkis et al. 2006; Yanez-Munoz, Balaggan et al. 2006; Apolonia, Waddington et al. 2007; Philpott and Thrasher 2007; Bayer, Kantor et al. 2008; Sarkis, Philippe et al. 2008; Rahim, Wong et al. 2009). Importantly, non-integrating lentiviral vectors retain the nuclear-penetrating ability, the flexibility of virion envelope engineering and capacity to package nucleic acids of the therapeutically relevant size that are otherwise characteristic of the lentiviral gene vectors (Wanisch and Yanez-Munoz 2009). The benefits of the non-integrative vectors for gene therapy arise from the absence of malignancy provoking insertional mutagenesis, which can occur because of the disruption of the tumour supressor genes or activation of expression of the oncogenes after proviral integration.
Non-integrating lentiviral vectors are prepared with modified lentiviral packaging systems, which employ a modified GagPol polyprotein containing mutations specifically inactivating the lentiviral integrase function. If a regular lentiviral vector backbone plasmid is used in the packaging procedure, the resultant vector virions can deliver transgenes to the nucleoplasm, where the transgenes can stay and be expressed until they are diluted out in cell divisions. Therefore, such vectors are suitable either for transient transduction of dividing cells or for relatively stable transduction of non-dividing cells, where the lentiviral vector genomes can persist. To achieve better maintenance of the transgenes, non-integrating lentiviral vectors have to be supplemented with either site-specific integration machinery (Lombardo, Genovese et al. 2007; Moldt, Staunstrup et al. 2008) or episomal maintenance apparatus (Wong, Argyros et al. 2009; Argyros, Wong et al. 2011).
Provirus integration can be made harmless by its targeting to a benign locus within the target cell genome (Moldt, Staunstrup et al. 2008). The lentiviral integrase itself can be engineered into a site-directed recombination enzyme by its fusion with site-specific “tethering” domains (Ferris, Wu et al. 2010). Robust and error-free site-specific integration into mammalian cells lacking pre-engineered integration sites is, however, difficult to achieve. Thus, compact episomal replicons from SV40, polyoma, papilloma viruses or EBNA1-Rep1 DNA segment of Epstein-Barr virus (EBV) can be used to support maintenance of non-integrating lentiviral vectors in the nucleoplasm of dividing cells. Viral replicons are often completely adequate for research use of gene vectors, however they are rarely acceptable for therapeutic applications. Indeed, expression of the large SV40 T-antigen and, hence, malignant transformation of the recipient host cells is required for SV40-origin-based replication. EBNA1 expression does not result in a typical malignant transformation but can still tilt the cells towards the undesired immortalisation (Humme, Reisbach et al. 2003). Alternative benign episomal replicons are being sought; encouragingly, the scaffold/matrix attachment region (S/MAR) from the human β-interferon gene was reported to support episomal replication (Wong, Argyros et al. 2011).
The titre of lentiviral vector particles in the cell culture supernatant hardly ever exceeds 1x108 TU/ml and, depending on a particular lentiviral vector backbone, is often much lower. Therefore, the use of concentrated lentiviral vector preparations is a popular, even though relatively involved, approach to achieve high efficiency of transduction with small volumes of the applied viral vector suspension. In addition to increased titres, concentrated lentiviral vector preparations benefit from concomitant purification of viral vector particles from transduction inhibitors, which are commonly present in the cell culture supernatants. Ultracentrifugation is a traditional method to concentrate lentiviral vector virions, however it is often accompanied by the loss of a substantial fraction of the active lentiviral vector particles. The particles are, in part, inactivated because of the contact between the vector pellet and air. To make the pellet more compact, ultracentrifugation is performed in swing-out bucket rotors and conical-bottom tubes supplemented with appropriate adaptors. Centrifugal force can also cause deterioration of sedimenting vector particles, so a bottom layer of dense sucrose solution is recommended as a “cushion” for better survival of the vector virions. The cushion is also important because a considerable portion of the lentiviral vector preparation can be lost due to incomplete wash-off of the viral vector pellet from the tube or its poor re-suspension. VSV-G pseudotyped lentiviral vectors have relatively short half-life of 8-9 hrs at 37 oC and are better stored at -80 oC.
Similarly to other virions, lentiviral vector particles can be precipitated using “molecular crowding” agents such as polyethylene glycol (PEG), which can soak up water molecules and create micro-pockets with an extra-high virion concentration. Thus, precipitation of virions can be achieved by a proprietary reagent “Lenti-XTM concentrator” supplied by Clontech-Takara. Precipitated lentiviral vector particles can be pelleted by low-speed centrifugation and re-suspended in a smaller volume. However, some non-lentiviral material from cell culture supernatants tends to co-precipitate with virions complicating the re-suspension step. Therefore, additional viral vector purification is required, which is often performed by ion exchange chromatography. Lentiviral vector particles are eluted from the ion exchange column in a high salt solution, which can be toxic to cells. Therefore, the medium for lentiviral vector particles should be exchanged to the desired one using dialysis, gel filtration or ultrafiltration. Ultrafiltration also provides a means for additional concentration of the viral vector.
A completely different strategy for the lentiviral vector concentration is to bind the vector particles to a coated plastic surface, which can then be used as a substrate for the cells to be infected. A recombinant derivative of human fibronectin called RetroNectinTM, which was originally used for surface immobilisation of amphotropic retroviral vectors, can be used to trammel VSV-G pseudotyped lentiviral vectors on a plastic surface (Clontech-Takara). Lentiviral vector virions can also be concentrated, including directly at the recipient cell surfaces, after conjugation to paramagnetic particles and attraction by magnet.
Receptors for VSV-G protein are ubiquitous, but still poorly defined. Various types of cells are transduced by VSV-G-pseudotyped lentiviral vectors with different efficiency. A higher efficiency of transduction can often be achieved by a better match of the recipient cells’ type and the type of the envelope protein used to pseudotype lentiviral vector particles. Lentiviral transduction is normally dramatically enhanced by polycations, such as hexadimethrine bromide (Polybrene), presumably because they modify the electrostatic interaction between the cells and the vector particles. The polycations’ transduction enhancer activity is highly cell specific. Alternative polycations, such as positively charged lipid dioctadecylamidoglycylspermine (DOGS), can be more effective than Polybrene for specific cell populations (Tolmachov, Ma et al. 2006). Transduction efficiency can be further increased by a very unusual and poorly understood method called “spinfection”. The recipient cells are overlaid by a viral vector suspension and centrifuged at low speed for 45 min or more. In most circumstances, such a centrifugation step results in a distinct increase in the transduction efficiency, perhaps because of the changes in the trajectories of vector-laden endosomal vesicles due to the centrifugal force.
Lentiviral vectors are able to transduce non-dividing cells. However, higher efficiencies of transduction are achieved with dividing cells, indicating that the nuclear envelope still constitutes a difficult barrier to negotiate for the entering lentiviral vector particles. Therefore, growth factors that stimulate cell division can be applied to increase the efficiency of the lentiviral transduction.
In addition to the measurement of the transduction activity, a lentiviral vector titre can be estimated using physical methods such as electron microscopy or enzyme-linked immunosorbent assay (ELISA) for capsid protein (such as “p24-antigen” of HIV-1). The titre of viral vector particles can be inferred from the concentration of genomic RNA determined by quantitative (real time) PCR. As the proportion of defective viral vector particles can vary depending on the procedures used to isolate and to concentrate the vector, such projections should rely on individually built calibration plots relating the physical titre and the transduction-based titre for a specific set of the viral vector production protocols.
Lentiviral gene vectors are generated by the packaging of the RNA transcribed in mammalian cells from vector backbone plasmids propagated in bacteria. Such plasmids contain bacterial and eukaryotic sets of elements. The bacterial set is comprised of a plasmid origin of replication, a bacterial selection marker, an optional partition region for stable maintenance in bacteria and plasmid DNA manipulation prop-ups like multiple cloning sites and site-specific recombination sites. The eukaryotic set consists of the lentiviral
Enamel and dentin constitute different concentrations of organic, water and mineral contents. This accounts for their specific physical-mechanical properties and their integration allow the tooth to be functionally stable in adverse oral conditions [1]. Dentin tissue underlines the enamel and constitutes the bulk of the tooth. The inorganic to organic ratio is different in various tissues, these variations affect the properties of these tissues. The enamel is tougher and most highly resistant to force in comparison to other hard tissue in the body owing to its high inorganic content. On the other hand the dentin with high organic content serves as a resilient layer under enamel and cementum [2]. Enamel shows higher mineralization than cementum as there is more carbon 49% (wt) in cementum than enamel 3% (wt). Enamel being the hardest tissue and dentin being softer whereas X-ray diffraction (XRD) shows cementum has poorest crystallinity. Following decalcification process for separation of organic and inorganic content the organic components of the dentin are retained thereby maintaining the dentin shape. However due to 90% mineral content of the enamel it is lost after decalcification.
Tooth enamel possess remarkable structural and mechanical properties making it an unique tissue. Tooth enamel is a complex mineralized tissue comprising of long and parallel apatite crystals configured into decussating enamel rods [3, 4]. The enamel consists of 96% inorganic and 4% organic and water content and is the most mineralized tissue. The organic content of enamel is less than that of dentin. The organic content consist of some unique proteins present only in enamel and lipids [5]. The enamel is formed only once before the eruption of the tooth. Following eruption the tooth organ permanently loses the ability to form new enamel [3].
Being highly mineralized enamel could be expected to be brittle and have low fracture resistance. However, the experimental studies proved that the fracture toughness of enamel is equivalent to or even better than some tough ceramics [6, 7].
During the development of enamel, ameloblasts secrete enamel matrix protein. Proteins are large complex molecules that are required for the structure, function and regulating body’s tissues and organs. Enamel matrix proteins bind to the hydroxyapatite structuring the enamel and modulating crystal growth [8, 9]. Initial developing enamel matrix constitutes 60-70% water, 20-30% proteins and 15-20% of mineral ions. Mineralization process leads to resorption of enamel proteins and water leaving very little amount of organic content in matured enamel [3]. Major components of the enamel matrix protein (EMP) are the amelogenins constituting greater than 90% of all the organic content in the enamel [10, 11]. The other type of protein group is the non – amelogenin including enamelins, tuftelin and sheathlins. Other than these two enzymes, matrix metalloproteinase (MMP)-20 and enamel matrix serine proteinase (EMSP)-1 are also present in the EMP (Figure 1) [10].
Types of enamel matrix proteins.
Enamel proteins consist of 1-2% of the total composition. These proteins are located mainly at the enamel rods interface. The proteins play a role in modulation of the stress in enamel and contributes to the elastic and viscoelastic behavior [12]. Any kind of damage or denaturation of the enamel or dentin non-collagenous proteins can decrease the durability of the tooth [12]. Tooth whitening procedures or treatment with potassium hydroxide leads to loss of enamel proteins causing enamel to be more prone to fracture [12, 13]. Radiation therapy for treatment of oral cancers is also known to damage the enamel proteins [12]. In a study the enamel proteins were extracted using potassium hydroxide treatment from the enamel sections of the molar cusps. The results showed a 40% reduction in fracture toughness in comparison with a fully proteinized control. The organic content of the enamel is very small, but it is of importance crack growth toughening. This is because it helps in forming unbroken ligament and fortify its efficacy [14].
The synthesis and secretion of the organic extracellular matrix is controlled by ameloblasts and deposited along the dentino-enamel junction which eventually controls enamel biomineralization [15].
Amelogenins are hydrophobic in nature, they are rich in proline (25%), glutamine (14%), leucine (9%) and histidine (7%) amino acid residues [4, 15]. Amelogenin functions in regulating orientation, shape and length of enamel crystals [16]. Tuftelin is suggested to function at the level of ameloblast differentiation, it may play a role in extracellular matrix secretion. Tuftelin is also expressed in different soft tissues, which suggest it may have multifunctional role [17]. Ameloblastin also known as sheathlin and amelin present in Tomes’ processes of the secretory ameloblasts the sheath space between rod and inter-rod enamel suggest that this protein may play a role in biomineralization. Enamelin is also believed to play a role in enamel biomineralization. Enamelin is hydrophilic and an acidic protein rich in glycine, aspartic acid and serine [4]. The enamel proteins with unique properties requires specific proteases for their removal during enamel maturation whose spatiotemporal expression is impeccably regulated. This requirement is met by serine protease kallikrein-4 and MMP20 [18]. Enamel proteases processes secreted amelogenins, ameloblastin and enamelin in the matrix and eventually degrades and remove them from the mineralizing matrix when maturation of amelogenesis occurs. The sulfated enamel proteins are present in very small amount in the enamel matrix [15].
Enamel matrix derivative (EMD) is approved by FDA to be used as a material for periodontal regeneration since 1997 [19]. EMD is commercially obtained by heat treated lyophilized proteins that are isolated from porcine enamel at specific stage of development [20]. Emdogain, a mixture of enamel matrix proteins mainly composed of amelogenin is used for repair of hard and soft periodontal tissues [11, 21, 22, 23]. Emdogain has shown similar results to guided tissue regeneration with added advantage of easy to use with minimal complications [23].
Owing to its unique properties like toughness and relative fracture resistance researchers are focusing on developing an enamel-like biomaterial. Enamel biomimetics hold a great promise as structural components in a wide range of fields for biomedical and engineering applications. Some examples are like tooth repair, restoring a orthopedic defect site, functional insulator components, brakes and exhaust pollutant filters [3, 24]. Enamel proteins and calcium phosphate growth solutions seems to be a convincing formulation for biologically synthesizing tooth enamel. Based on the established role of enamel proteins, using an EMP researchers were successfully grew elongated and parallel apatite crystals within decussating enamel prisms (Figure 2) [3]. The research until now using biochemical approaches can only mimic limited features of apatite and calcium phosphate crystal growth.
Scanning electron micrograph images of engineered enamel. In this study apatite was grown within a decellularized enamel protein matrix, resulting in decussating enamel prisms containing distinct and separated individual enamel crystals. A SEM image overview of the engineered enamel apatite, b depicts parallel bundles of enamel crystals, and c depicts newly formed decussating enamel rods [
The dentin consists of 65% inorganic and 35% organic and water content. The presence of more organic content in dentin than enamel makes it very similar to that of bone. The organic part of dentin is composed of collagenous fibrils embedded in ground substance of mucopolysacchrides [5]. Type I collagen is the principal type of collagen in dentin. It contributes about 90% of the organic content, the remaining 10% contains several proteins and proteoglycans, acidic glycoproteins referred to as non-collagenous proteins [25, 26]. Also type I collagen is abundantly present organic constituent of the bone extracellular matrix [27]. The collagen fibrils form a scaffold network and are densely mineralized. The dentin consists of little amounts of type V and III collagen. The odontoblasts synthesize and secretes the non-collagenous proteins as well collagen fibrils [28].
Dentin constitutes tubules ranging in size of micrometer and surrounded by highly mineralized peritubular dentin, embedded in a matrix rich in collagen called intertubular dentin. Lamina limitans a sheet-like structure divide the peritubular and the intertubular dentin and primarily composed of proteoglycans protein cores. The proteoglycans contribute to mechanical behavior of dentin. They link the collagen fibrils securing the collagenous network together [12]. Peritubular dentin is primarily made of glycosaminoglycans and lacks collagen fibrils [29]. Intertubular matrix chiefly constitutes type I collagen fibrils with non-collagenous proteins and proteoglycans which forms a three-dimensional organic network buttressed by apatite mineral crystallites [30].
The adhesive systems used for dentin bonding rely on formation of a hybrid layer. This hybrid layer is formed by demineralized collagen fibrils reinforced by resin matrix. As the resin monomers are unable to infiltrate the mineralized tissues, so adhesive bonding systems are used which has an acid, primer and an adhesive. The acid helps in removing mineral crystals and exposing the collagen. The primer which is a hydrophilic solution permits the infiltration of resin monomer into the demineralized dentin. Finally, the adhesive consisting of a mixture of monomers penetrates the treated surface thereby forming mechanical adhesion with dentin. Removing the unbound water from hybrid layer and suppressing the endogenous enzymatic activity have helped in increasing biocompatibility by inhibiting degradation of the hybrid layer [31].
The dentin matrix and bone proteins are similar. Type I collagen designs an effective and instructional template for guiding deposition of calcium phosphate polymorphs and subsequently transforming into crystalline hydroxyapatite crystals. The highly complex process of hydroxyapatite nucleation and collagen mineralization is also controlled by non-collagenous proteins. The amount of these non-collagenous proteins in dentin and bone is small, but they play an indispensable role in bone formation and remodeling. Some examples of non-collagenous proteins found in both are osteocalcin, osteopontin and bone sialoprotein. The dentin matrix proteins are of interest because of their calcium binding property in the extracellular matrix which leads to calcification of tissue [32]. Many studies have shown similarities between dentin and bone. Apart from type I collagen being the leading extracellular matrix element, other common proteins and proteoglycans are osteonectin/SPARC, osteocalcin, osteopontin, bone sialoprotein, decorin and biglycan [33].
Dentin proteoglycans plays a key role in mineralization of the dentin and bone, so they perform structural, metabolic, and functional role. The proteoglycans are classified as small leucine-rich proteoglycans (SLRP) and the large aggregating proteoglycans. The SLRP are further divided into 5 classes: decorin; biglycan; fibromodulin; lumican and osteoadherin. Among the large aggregating proteoglycan is only versican has been described well in dentin [25].
Osteocalcin and osteonectin are classified under secretory calcium-binding phosphoprotein a category of non-collagenous proteins. Osteocalcin is a vitamin K-dependent gamma-carboxylated protein. It is a small calcium binding protein consisting of three glutamic acid residues. It is found in dentin in small amounts as compared to the bone [25]. Osteonectin binds collagen, hydroxyapatite and growth factors. It is known to regulate proliferation of cells, prompts angiogenesis and formulation of matrix metalloproteinases [34]. Another subset of the secretory calcium binding phosphoprotein is the Small Integrin-Binding ligand, N-linked Glycoprotein (SIBLING) family. It includes osteopontin, bone sialoprotein, dentin matrix protein 1, dentin sialophosphoprotein, and matrix extracellular phosphoglycoprotein [35].
Dentin phosphoprotein (DPP) and dentin sialoprotein (DSP) were earlier thought to be unique to dentin [5, 33]. Later some immunohistochemical studies established that DSP is also present in the alveolar bone, cellular cementum, osteocytes, cementocytes and their matrices [36]. DPP is rich in aspartic acid and phosphoserine and bind calcium in considerable amounts. DSP is a glycoprotein rich in aspartic acid, serine, glutamic acid, and glycine. Both DPP and DSP are synthesized by odontoblasts and pre-ameloblast cell types. In contrast the bone matrix proteins are not exclusively made by the osteoblasts. This makes dentin unusual based on these dentin specific proteins [33]. DSP has been shown to play a role in prompting differentiation of dental pulp cells in odontoblast-like cells [36].
Growth factors are natural activation signals or substances able to stimulate cellular proliferation, wound healing, and sometimes cellular differentiation. Generally, a growth factor is secreted protein or a steroid hormone [37, 38]. They are necessary for regulating various cellular processes that take part in tissue regeneration procedure [39, 40].
Growth factors are generally acting as signaling molecules between the cells, like cytokines and hormones binding to specific receptors on the target cells surfaces. Examples of growth factors in dentin are TGF-
Promoting tertiary dentinogenesis and in primary odontoblastic differentiation. | |
Upregulated on DPSCs differentiation into a mineralizing phenotype | |
Promotes odontoblastic differentiation | |
Promotes vitro and in vivo odontoblastic differentiation, DSPP induction and increases alkaline phosphatase activity | |
Increases odontoblastic differentiation | |
Promotes DPSCs phenotype mineralization | |
Promotes proliferation and differentiation of DPSCs and SCAP into a mineralizing phenotype | |
Promotes stem cell homing (chemotaxis), angiogenesis, and stemness | |
Promotes angiogenesis, chemotaxis of MSCs modulates the process of odontoblastic differentiation, synergistic act with other growth factors | |
Promotes axonal function and regeneration after injury and plays important role in neuronal maintenance | |
Potent angiogenic factor that promotes blood vessel formation in tooth slices implanted subcutaneously in SCID mice | |
Promotes survival, proliferation, and migration of MSCs | |
Promotes odontoblastic differentiation through activation of p38 | |
Enhances neurogenic differentiation of DPSCs and SCAP | |
Promotes osteogenic and angiogenesis differentiation of MSCs | |
Promotes neuronal growth and axonal targeting | |
Promotes in vivo nerve regeneration and pulp cell proliferation. Increased expression during odontogenic differentiation. |
Growth factors in dentin matrix and their role.
We can group these growth factors by their actions as: Angiogenisis (FGF-2, PDGF, VEGF, NGF); Differentiation (TGF-β, PDGF, FGF-2, BMPs, IGF, NGF); Proliferation (PDGF, FGF-2, IGF, VEGF, TGF-β, SDF-1); Chemotaxis (PDGF, FGF-2, TGF-β, SDF-1) and Neuronal growth (NGF) [41].
The growth factors diffusion into the dentinal-pulpal junction is postulated to activate reactionary dentinogenesis and simultaneous reparative dentinogenesis along with pulp tissue inflammatory reaction [42, 43]. The surviving odontoblasts secrete reactionary dentin as a response to environmental stimuli causing metabolic activity increase in the cells. The inductive molecules determining the success of the pulp healing might be released from damaged dentin and adjacent pulp tissue [44]. Dentin-pulp regeneration process can vary as it depends on the causative agent whether trauma or pathological conditions. An inflammatory reaction is caused by these events, which is supposed to be the beginning of tissue regeneration process [39]. Dentin-pulp defensive and reparative mechanisms mimic the embryonic tooth development stage and growth factors derived from dentin may play a key role in regulating these events [42]. The dentinal matrix constitutes angiogenic growth factors and their release after injury can contribute to overall reparative response of the dentinal-pulpal complex [45].
There are multiple growth factors in dentin that also exist in bone like insulin-like growth factor-1 (IGF-1), insulin-like growth factor-2 (IGF-2), transforming growth factor-beta (TGF-β), fibroblast growth factors (FGFs), platelet-derived growth factor (PDGF), parathyroid bone morphogenetic proteins (BMPs), and certain members of the growth differentiation factor (GDF) group of proteins [46, 47, 48]. That is why recent studies have shown good results after using dentin as a bone graft and stated that dentin has shown to be clinically safe and has good bone-forming capacity [49, 50].
Also known as autogenous tooth biomaterial it is derived from an extracted tooth through demineralization process. It is useful as graft material because of its osteoconductive properties [51]. This biomaterial can be used alone or combined with other materials for example with platelet-rich fibrin [52], bone marrow mesenchymal stem cells [53] or bone morphogenetic protein (BMP-2) [54] for enhanced bone regeneration effects. Recently a dentin derived barrier membrane acting as an osteoinductive collagen membrane showed successful outcome in guided bone regeneration and dental implantation. The membrane was derived from block type autogenous demineralized dentin matrix with advantage of overcoming the mechanical instability of the collagen membrane. It is mostly composed of type I collagen, making it suitable for use in implant procedures [55].
Enamel has 3 essential enamel proteins to build healthy well mineralized enamel which is secreted from ameloblasts “amelogenin, ameloblastin and enamelin” with the help of two enzymes, MMP20 and kallikrein-4 (Klk4) to form the enamel properly and sequent proteolysis of enamel protein [56]. In the event of alteration in the process of protein removal, enamel and dental defects will emerge like for example, amelogenesis imperfecta (AI), Chalky/Molar Hypomolarization (MH), Dentinogenesis Imperfecta (DI) or fluorosis [57]. Figure 3 depicts the protein content in healthy and diseased tooth.
Protein content is compared between healthy and diseased tooth enamel. Different proteins are presented in (rows) as analyzed different tooth conditions (columns). Healthy teeth is presented as reference in light gray, chalky/molar Hypomolarization (MH): Enamel affected by molar hypomineralization, fluorosis and Amelogenesis imperfecta (AI): Hypocalcified and hypomaturation amelogenesis imperfecta enamel; range of percent by weight (wt %) of protein abundance in comparison to healthy enamel show in 4 colors: Healthy range of 0.1–1 wt % (light gray); 2–3 times increase (light teal); 3–30 times increase (dark teal); 0–30 times increase (gray-teal gradient) [
Amelogenesis imperfecta is a rare, inherited enamel development disorder where mutations in the amelogenin gene results in malformation of the enamel layer. It is subdivided to 4 main types hypoplastic (type I), hypomaturation (type II), hypocalcified (type III), hypomaturation/hypoplasia/taurodontism (type IV).
Clinical and radiographical features and enamel thickness, of different subtypes are dependent on mode of inheritance and gene mutation. AI occurs due to mutations in several genes, including enamelin, amelogenin, MMP20, Klk4 and FAM83H [58, 59, 60, 61]. The mutations can lead to hypoplastic, hypomature, or hypocalcified form of the enamel [62]. AI can be easily seen clinically and radiographically as teeth appears in abnormal color like (yellow, brown, or gray). Soft enamel, due to hypo calcification enamel surface are more susceptible to caries, tooth attrition, teeth hypersensitivity, calculus formation, and gingivitis/periodontitis [63].
Type I hypoplastic AI has reduced thickness of enamel and shows pitting and grooves. In radiographs enamel shows normal contrasts from dentine. Type II hypomaturation AI has enamel of normal thickness but appearance is mottled. It is less severe than hypocalcified type. Radiographically it exhibits similar radiodensity as dentine. Type III hypocalcified AI have defect in enamel calcification. The enamel thickness is normal but is weak in structure and appearance is opaque and chalky. In radiographs enamel is less radio-opaque in comparison to dentin. Type IV hypomaturation/hypoplasia/taurodontism AI exhibits mixed hypomaturation and hypoplasia appearance. In taurodontism enlargement of the body and pulp chamber is observed. The pulp chamber floor and furcation moves apically down the root [58].
A proper diagnosis identifying the different phenotypes is essential to determine molecular etiology. The treatment plan aims at early diagnosis, managing the pain and restoring the defects with regular follow ups [58]. Mild variations can be treated adequately with facial veneers, whereas in severe cases full coverage is mandatory. For young patients milled acetal resin overlays can be used until fully erupted [64].
It is discolored white patches in one or more molars, porous dental enamel leads to hypersensitivity and risk of caries. Chalky enamel opacities contained unusually high amounts of protein, including serum albumin and other derivatives of blood and saliva [65]. Moderate and severe cases with opacities having a chalky texture exhibit failure of enamel surface soon after the eruption of tooth, it provides a hygiene-resistant nidus for dental plaque accumulation. The porous chalky enamel is invaded by accelerated decay which arises the need for restoration, extraction, or orthodontic treatment. It is observed that MH affects the 2-year molars or 6-year molars, a better understanding of its etiology is necessary [66]. Earlier systemic disturbance of enamel-forming cells (ameloblasts) during the hardening (maturation) stage of enamel formation was thought to be the cause [67]. A different pathomechanism indicating localized exposure of enamel to serum albumin was recently identified [68]. In a recent study the dose–response relationship between albumin and the enamel chalkiness was established. This supports the new pathomechanism also termed as “mineralization poisoning” [66].
MH is a complex problem requiring combinational treatment modalities. The treatment aim may be preventive or symptom control. Various treatment modalities can be adhesive and sealant restoration, composite restoration, glass ionomer restoration, preformed metal crown, microabrasion, bleach or orthodontic extraction [69].
Dental fluorosis is a very common developmental disturbance that is caused by repeated exposures to high concentrations of fluoride during tooth or enamel formation. This leads to disturbance in enamel formation as the fluoride decreases calcium concentration in the matrix. This interferes with protease activity and delays or inhibit enamel matrix protein degradation. An abnormal apatite crystals growth occurs which leads to physical tooth surface changes [70]. It differs from white striations to stained pitting of the enamel depending on case severity [71]. The use of topical fluoride dentifrices in young children may increase the risk of dental fluorosis. In case of concern for fluorosis, in children under 6 years of age toothpaste with fluoride concentration less than 1000 parts per million should be used [70].
Treatment of the case depends on the severity and the esthetics concerns. Mild cases can be treated by bleaching if the tooth. For moderate cases enamel microabrasion with acids can be done. Composite fillings, veneers and crowns can be used for treating cases with severe forms of the disease [72].
The best solution for this condition is to control the fluoride intake for prevention of dental fluorosis [71].
DI is also an inherited condition also called “dentin dysplasia” with discolored teeth but most often blue-gray or yellow-brown which leads to wear, breakage, and loss of teeth. This damage can include teeth fractures or small holes (pitting) in the enamel. The enamel may have hypoplastic or hypocalcified defect in nearly one-third of patients and has tendency to crack away from defective dentin. It is a localized mesodermal dysplasia which affects both primary and permanent dentition. It is inherited in simple autosomal dominant mode exhibiting high penetrance and low mutation rate [73].
DI has 3 types: Type I: occurs in people who have osteogenesis imperfecta so, it appears to have other health concern (mutation in COL1A1/A2 gene). Type II: the most common type occurs in people without another inherited disorder (mutation in DSPP). Radiographically it shows complete obliteration of the pulp cavity by dentin. Type II and type III, are actually similar conditions but in different forms but DI type III shows enlarged pulp cavities [63].
In histological findings although enamel is normal in structure it tends to crack. Scalloping is absent in dentino-enamel junction. Mostly mantle dentin structure is normal. However dentinal tubules of the circumferential dentin are found to be coarse and branched. The tubules are reduced in quantity. An atubular area is present in the dentin with reduction in mineralization and decreased number of odontoblasts. Another common finding is pulpal inclusions and much interglobular dentin [73].
Treatment differs from case to case depend on its severity and presenting pain, also the patient age. Mostly treatments are targeted at maintaining oral hygiene and esthetics. Early diagnosis and treatment can prevent deterioration of teeth and occlusion. In severe cases two treatment stages for primary teeth under general anesthesia is recommended. At the age of 18-20 months the stage 1 treatment involves composite restorations covering for incisors and preformed crowns for first primary molars. At the age of 28-30 months stage 2 aims at protecting second primary molars and canines. For moderate cases one-stage treatment for primary teeth at 30 months of age is optimal. In severe cases composite restoration may not be helpful. A long term follow-up is necessary to adjust treatment according to change in dentition and occlusion [73].
The enamel and dentin organic content varies in amount and its constituents. The enamel proteins help in imparting the elastic and visco-elastic properties to the enamel. The clinical significance of the non-collagenous proteins may be in relation with dentinal growth factor release by calcium hydroxide or mineral trioxide aggregate. The dentin organic matrix constitutes similarity with that of bone, makes it a desirable bone graft material. Demineralized dentin autogenous bone grafts have already been used for dental implant surgeries and provides an easy to prepare and use bone graft material. Any imbalance in the organic content can manifest as developmental disease of the tooth.
The authors declare no conflict of interest.
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Singh",profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"8018",title:"Extracellular Matrix",subtitle:"Developments and Therapeutics",coverURL:"https://cdn.intechopen.com/books/images_new/8018.jpg",slug:"extracellular-matrix-developments-and-therapeutics",publishedDate:"October 27th 2021",editedByType:"Edited by",bookSignature:"Rama Sashank Madhurapantula, Joseph Orgel P.R.O. and Zvi Loewy",hash:"c85e82851e80b40282ff9be99ddf2046",volumeInSeries:23,fullTitle:"Extracellular Matrix - Developments and Therapeutics",editors:[{id:"212416",title:"Dr.",name:"Rama Sashank",middleName:null,surname:"Madhurapantula",slug:"rama-sashank-madhurapantula",fullName:"Rama Sashank Madhurapantula",profilePictureURL:"https://mts.intechopen.com/storage/users/212416/images/system/212416.jpg",institutionString:"Illinois Institute of Technology",institution:{name:"Illinois Institute of Technology",institutionURL:null,country:{name:"United States of America"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"9759",title:"Vitamin E in Health and Disease",subtitle:"Interactions, Diseases and Health Aspects",coverURL:"https://cdn.intechopen.com/books/images_new/9759.jpg",slug:"vitamin-e-in-health-and-disease-interactions-diseases-and-health-aspects",publishedDate:"October 6th 2021",editedByType:"Edited by",bookSignature:"Pınar Erkekoglu and Júlia Scherer Santos",hash:"6c3ddcc13626110de289b57f2516ac8f",volumeInSeries:22,fullTitle:"Vitamin E in Health and Disease - Interactions, Diseases and Health Aspects",editors:[{id:"109978",title:"Prof.",name:"Pınar",middleName:null,surname:"Erkekoğlu",slug:"pinar-erkekoglu",fullName:"Pınar Erkekoğlu",profilePictureURL:"https://mts.intechopen.com/storage/users/109978/images/system/109978.jpg",institutionString:"Hacettepe University",institution:{name:"Hacettepe University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Proteomics",value:18,count:4},{group:"subseries",caption:"Metabolism",value:17,count:6},{group:"subseries",caption:"Cell and Molecular Biology",value:14,count:9},{group:"subseries",caption:"Chemical Biology",value:15,count:13}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:8},{group:"publicationYear",caption:"2021",value:2021,count:7},{group:"publicationYear",caption:"2020",value:2020,count:12},{group:"publicationYear",caption:"2019",value:2019,count:3},{group:"publicationYear",caption:"2018",value:2018,count:2}],authors:{paginationCount:250,paginationItems:[{id:"274452",title:"Dr.",name:"Yousif",middleName:"Mohamed",surname:"Abdallah",slug:"yousif-abdallah",fullName:"Yousif Abdallah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274452/images/8324_n.jpg",biography:"I certainly enjoyed my experience in Radiotherapy and Nuclear Medicine, particularly it has been in different institutions and hospitals with different Medical Cultures and allocated resources. Radiotherapy and Nuclear Medicine Technology has always been my aspiration and my life. As years passed I accumulated a tremendous amount of skills and knowledge in Radiotherapy and Nuclear Medicine, Conventional Radiology, Radiation Protection, Bioinformatics Technology, PACS, Image processing, clinically and lecturing that will enable me to provide a valuable service to the community as a Researcher and Consultant in this field. My method of translating this into day to day in clinical practice is non-exhaustible and my habit of exchanging knowledge and expertise with others in those fields is the code and secret of success.",institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"313277",title:"Dr.",name:"Bartłomiej",middleName:null,surname:"Płaczek",slug:"bartlomiej-placzek",fullName:"Bartłomiej Płaczek",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/313277/images/system/313277.jpg",biography:"Bartłomiej Płaczek, MSc (2002), Ph.D. (2005), Habilitation (2016), is a professor at the University of Silesia, Institute of Computer Science, Poland, and an expert from the National Centre for Research and Development. His research interests include sensor networks, smart sensors, intelligent systems, and image processing with applications in healthcare and medicine. He is the author or co-author of more than seventy papers in peer-reviewed journals and conferences as well as the co-author of several books. He serves as a reviewer for many scientific journals, international conferences, and research foundations. Since 2010, Dr. Placzek has been a reviewer of grants and projects (including EU projects) in the field of information technologies.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"35000",title:"Prof.",name:"Ulrich H.P",middleName:"H.P.",surname:"Fischer",slug:"ulrich-h.p-fischer",fullName:"Ulrich H.P Fischer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/35000/images/3052_n.jpg",biography:"Academic and Professional Background\nUlrich H. P. has Diploma and PhD degrees in Physics from the Free University Berlin, Germany. He has been working on research positions in the Heinrich-Hertz-Institute in Germany. Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University. His research interests include computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, intelligent systems, information technology, and information systems. Prof. Sarfraz has been a keynote/invited speaker on various platforms around the globe. He has advised various students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He is a member of various professional societies and a chair and member of the International Advisory Committees and Organizing Committees of various international conferences. Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:null},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. RELACION DE PONENCIAS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGIA. 10/2014.",institutionString:null,institution:null},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:null},{id:"243698",title:"Dr.",name:"Xiaogang",middleName:null,surname:"Wang",slug:"xiaogang-wang",fullName:"Xiaogang Wang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243698/images/system/243698.png",biography:"Dr. Xiaogang Wang, a faculty member of Shanxi Eye Hospital specializing in the treatment of cataract and retinal disease and a tutor for postgraduate students of Shanxi Medical University, worked in the COOL Lab as an international visiting scholar under the supervision of Dr. David Huang and Yali Jia from October 2012 through November 2013. Dr. Wang earned an MD from Shanxi Medical University and a Ph.D. from Shanghai Jiao Tong University. Dr. Wang was awarded two research project grants focused on multimodal optical coherence tomography imaging and deep learning in cataract and retinal disease, from the National Natural Science Foundation of China. 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\r\n\tSustainable approaches to health and wellbeing in our COVID 19 recovery needs to focus on ecological approaches that prioritize our relationships with each other, and include engagement with nature, the arts and our heritage. This will ensure that we discover ways to live in our world that allows us and other beings to flourish. We can no longer rely on medicalized approaches to health that wait for people to become ill before attempting to treat them. We need to live in harmony with nature and rediscover the beauty and balance in our everyday lives and surroundings, which contribute to our well-being and that of all other creatures on the planet. This topic will provide insights and knowledge into how to achieve this change in health care that is based on ecologically sustainable practices.
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