Rutger H. Schepers’s research while affiliated with Martini Ziekenhuis and other places

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Publications (5)


Figure 4. HE staining and quantitative immunohistological results. Hematoxylin-eosin-stained (a) and immunohistochemically stained (vWF-vasculature, αSMA-myofibroblasts, perilipin-1-adipocytes). (b) Micrographs and the quantification of ECM-encapsulated tSVF, cultured for 0, 3, 5, and 10 days. Calculated statistical data (c). Insets and arrows depict 'islands' of tSVF inside the skinderived ECM hydrogels. Densitometry was used to determine the percentage of stained area (positive area). Nonparametric data were analyzed with the Kruskal-Wallis test for comparisons among three groups, followed with Dunnett's post hoc test. Mean values are represented by bars and SEM values are represented by the scales. The data are from 3 independent experiments. Five random
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A Versatile Skin-Derived Extracellular Matrix Hydrogel-Based Platform to Investigate the Function of a Mechanically Isolated Adipose Tissue Stromal Vascular Fraction
  • Article
  • Full-text available

November 2024

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10 Reads

Biomolecules

Xue Zhang

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Rutger H. Schepers

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Introduction: To ccelerate cutaneous wound healing and prevent scarring, regenerative approaches such as injecting a mechanically derived tissue stromal vascular fraction (tSVF) are currently under clinical and laboratory investigations. The aim of our study was to investigate a platform to assess the interaction between skin-derived extracellular matrix (ECM) hydrogels and tSVF and their effects on their microenvironment in the first ten days of culture. Material and Methods: A tSVF mixed with ECM hydrogel was cultured for ten days. After 0, 3, 5, and 10 days of culture viability, histology, immunohistochemistry, gene expression, and collagen alignment and organization were assessed. Results: The viability analysis showed that tSVF remained viable during 10 days of culture and seemed to remain within their constitutive ECM. The fiber analysis demonstrated that collagen alignment and organization were not altered. No outgrowth of capillaries was observed in (immuno)histochemical staining. The gene expression analysis revealed that paracrine factors TGFB1 and VEGFA did not change and yet were constitutively expressed. Pro-inflammatory factors IL1B and IL6 were downregulated. Matrix remodeling gene MMP1 was upregulated from day three on, while MMP14 was upregulated at day three and ten. Interestingly, MMP14 was downregulated at day five compared to day three while MMP2 was downregulated after day zero. Conclusions: Skin-derived ECM hydrogels appear to be a versatile platform for investigating the function of a mechanically isolated adipose tissue stromal vascular fraction. In vitro tSVF remained viable for 10 days and sustained the expression of pro-regenerative factors, but is in need of additional triggers to induce vascularization or show signs of remodeling of the surrounding ECM. In the future, ECM-encapsulated tSVF may show promise for clinical administration to improve wound healing.

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Facial Masculinization Surgery Using Polyetheretherketone Alloplasty: Statistical Shape Modeling–based Implant Designs

July 2024

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26 Reads

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1 Citation

The face is the initial feature used to judge gender in public spaces; it is also a source of significant gender dysphoria. Surgical techniques are available for non-cisgender male patients who desire a more masculine face by augmenting certain features to change the bony framework of the skull. Augmentation using virtually designed patient-specific polyetheretherketone implants has now become a more widely applied method in maxillofacial surgery. When designing implants for augmentation, a three-dimensional (3D) reference or template is very useful. Hence, a 3D statistical shape model was developed of a male skull shape from information from a population of 40 male patients containing the mean shape and principal components of shape variation. By overlaying the template and the patient’s 3D skull model, this method identified the regions of gender dimorphism in this case to be the orbital ridge, zygomatic regions, and frontal bossing area. Based on the 3D template overlay, polyetheretherketone augmentation implants were virtually designed in close consultation with a patient to augment the aforementioned regions. The virtual statistical shape modeling template offered an objective reference, and the possibility to fully involve the patient in the treatment planning.


Regenerative treatments for scleroderma in cutaneous manifestations of the face: a systematic review

March 2024

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8 Reads

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1 Citation

Clinical and Experimental Rheumatology

Objectives: Scleroderma is a heterogeneous chronic autoimmune disease affecting connective tissue, characterised by chronic inflammation and fibrosis, particularly affecting internal organs and skin. Orofacial involvement is common, leading to facial atrophy, mask-like appearance and difficulties in function that significantly impact patients' quality of life. This systematic review evaluates different autologous regenerative treatments of facial manifestations of scleroderma, aiming to provide comprehensive understanding of their effectiveness in reducing fibrosis, and thereby improving function and skin quality. Methods: A search in PubMed, Embase, Web of Science Core Collection, Cochrane CENTRAL, and CINAHL was conducted. Studies assessing autologous regenerative treatments in cutaneous manifestations of the face in scleroderma patients were included. Outcomes of interest were treatment characteristics, characterisation of biomaterials, outcome measurements and patient satisfaction. Methodological quality was assessed with the Effective Public Health Practice Project tool. Results: In total 18 studies were included. Methodological quality of studies was weak (n=15) and moderate (n=3). Treatments consisted of autologous fat grafting, platelet-rich plasma, stromal vascular fraction, and adipose-derived stem cells. In general, most studies showed improvements of symptoms, but no treatment was considered superior. Conclusions: Autologous regenerative treatments hold potential for alleviating cutaneous manifestations of the face in scleroderma. Further clinical trials should be well-designed to improve the quality of clinical evidence.



Mechanical Fractionation of Adipose Tissue—A Scoping Review of Procedures to Obtain Stromal Vascular Fraction

October 2023

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146 Reads

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10 Citations

Bioengineering

Clinical indications for adipose tissue therapy are expanding towards a regenerative-based approach. Adipose-derived stromal vascular fraction consists of extracellular matrix and all nonadipocyte cells such as connective tissue cells including fibroblasts, adipose-derived stromal cells (ASCs) and vascular cells. Tissue stromal vascular fraction (tSVF) is obtained by mechanical fractionation, forcing adipose tissue through a device with one or more small hole(s) or cutting blades between syringes. The aim of this scoping review was to assess the efficacy of mechanical fractionation procedures to obtain tSVF. In addition, we provide an overview of the clinical, that is, therapeutic, efficacy of tSVF isolated by mechanical fraction on skin rejuvenation, wound healing and osteoarthritis. Procedures to obtain tissue stromal vascular fraction using mechanical fractionation and their associated validation data were included for comparison. For clinical outcome comparison, both animal and human studies that reported results after tSVF injection were included. We categorized mechanical fractionation procedures into filtration (n = 4), centrifugation (n = 8), both filtration and centrifugation (n = 3) and other methods (n = 3). In total, 1465 patients and 410 animals were described in the included clinical studies. tSVF seems to have a more positive clinical outcome in diseases with a high proinflammatory character such as osteoarthritis or (disturbed) wound healing, in comparison with skin rejuvenation of aging skin. Isolation of tSVF is obtained by disruption of adipocytes and therefore volume is reduced. Procedures consisting of centrifugation prior to mechanical fractionation seem to be most effective in volume reduction and thus isolation of tSVF. tSVF injection seems to be especially beneficial in clinical applications such as osteoarthritis or wound healing. Clinical application of tSVF appeared to be independent of the preparation procedure, which indicates that current methods are highly versatile.

Citations (2)


... This includes surgical procedures, such as face lifts and eyelid corrections, but also less invasive procedures, such as injections with neurotoxin in the forehead muscles and fillers in the lips. Minimally invasive procedures in particular have become increasingly popular in recent years in countries such as the United States (American Society of Plastic Surgeons, 2023) and the Netherlands (Decates et al., 2024). Changing ones appearance to project a positive first impression is an important motivation for pursuing these treatments: When asked about why they were pursuing aesthetic treatment, many named the desire to make a better first impression on others (74%), to look more attractive as a romantic partner (74%), and to look more sexually appealing (48%; Maisel et al., 2018). ...

Reference:

Face value: The effect of facial aesthetic treatment on first impressions and partner preferences
An Amazing Trend in the Number of Injectable Treatments in the Netherlands From 2016 to 2022

Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery

... Mechanical methods such as Lipogems ® yield tissue derived SVF (tSVF), which still contains a residual extracellular matrix, offering an additional scaffold that can be beneficial for regenerative applications. The extracellular matrix in tSVF serves as a structural framework for the cells and a reservoir for paracrine factors, which can enhance tissue regeneration in vitro and in vivo [55][56][57][58]. While mechanical digestion typically results in a lower total cell yield compared to enzymatic methods, studies have shown that SVF-derived cells obtained through mechanical dissociation maintain similar morphological and functional characteristics as those isolated using enzymatic protocols [59]. ...

Mechanical Fractionation of Adipose Tissue—A Scoping Review of Procedures to Obtain Stromal Vascular Fraction

Bioengineering