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Titrated Extract from Centella asiatica (TECA) is a drug which has been used for many years in Europe for the treatment of wound healing defects. It is a reconstituted mixture of 3 triterpenes extracted from the plant, asiatic acid, madecassic acid and asiaticoside. In this report, we studied the effects of TECA and its separated components in the wound chamber model described by Schilling et al. Stainless steel wound chambers were surgically inserted under the skin of rats and received serial injections of either TECA or its purified components. Chambers were collected at days 7, 14, 21 or 28 for biochemical analysis or histological examination. TECA-injected wound chambers were characterized by increased dry weight, DNA, total protein, collagen and uronic acid contents. Peptidic hydroproline was also increased, showing an increased remodeling of the collagen matrix in the wound. The 3 purified components of TECA were all able to reproduce the effects of the complete drug, with some differences depending on the product. Asiatic acid and asiaticoside were the most active of the 3 triterpenes. Asiaticoside exerted a preferential stimulation of collagen synthesis and was active at low doses only. In addition to collagen, the 3 components were also able to stimulate glycosaminoglycan synthesis.

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Demographic data, personal and familial characteristics, as well as DSM-III-R-based psychiatric diagnoses were collected in 369 adolescents and young adults aged between 15 and 29 years, referred to an Emergency Department for psychological problems. In total, 60% of them were suicide attempters. Separations before the age of 12 years and depression in the family emerged as the main features distinguishing the suicidal group from the psychiatric control group. Fifty per cent of suicide attempters were repeaters. Fostering during childhood, suicide attempts and depression in the family were found to be risk factors for repeated self-attempts. These results support the view that significant levels of dysfunction, together with increased psychiatric morbidity, especially suicidal behaviour, characterize the families of young self-attempters.

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OBJECTIVE: Since Durkheim, epidemiological studies have revealed a significant, complex association between unemployment and suicidal behaviour. The aim of this study was to analyse the relationship between parasuicide and job instability, including unemployment, French social measures against unemployment and occasional work. METHOD: Demographic data, personal and familial characteristics were collected in 541 suicide attempters. RESULTS: Seventy-seven per cent were socially active, with 61.5% in regular employment, and 38.5% in precarious employment. The female-to-male ratio approached 2 in the securely employed sample, and fell to 1 for those with poor social and professional integration. Depression, parasuicide, and alcohol abuse were more common in the families of repeaters in secure employment. The impact of the familial psychiatric background was no longer significant in the job insecurity group. Fostering in childhood was a risk factor for repeat suicidal behaviour in the group with job insecurity.

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The present study involves a prospective review of all patients who visited the Emergency Psychiatric Service during the period from December, 6, 1993 to June, 5, 1994. A questionnaire was proposed to 1073 subjects (57.2% females; 42.8% males; mean age = 36.6 +/- 0.89). Demographic data, familial and personal characteristics, previous contacts with professional health services, and diagnosis (DSM III-R criteria) were collected. 52% of them were self-attempters, significatively younger (mean age 34.03 +/- 1.14) and more frequently females (61.5%). The parasuicides were more frequent in their families and in their personal past history. The previous contacts with health services (hospitalizations, consultations) were more frequent among patients who were admitted for psychological and/or psychiatric problems. 54% of self-attempters were repeating suicidal patients. There were more depressive disorders, parasuicides and drug/alcohol abuse in their families. A logistic regression analysis (stepwise) revealed the role of these factors in the repetition of parasuicides. This data supports the significance of a better knowledge of the potential significant factors for parasuicide. Preventive measures are necessary.

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The present study involves a review of all patients who visited the Emergency Psychiatric Service during the period from December, 6, 1993 to June, 5, 1994. A questionnaire was proposed to 1073 subjects (57.2% females; 42.8% males; mean age = 36.6). Demographic data, familial and personal characteristics, previous contacts with professional health services, and diagnosis (DSM III R criteria) were collected. 52% of them were self-attempters, younger than the general population and more frequently females (61.5%). The parasuicides were more frequent in their families and in their personal past history. The previous contacts with health services (hospitalizations, consultations) were more frequent among patients who were admitted for psychological and/or psychiatric problems. 54% of self-attempters were repeating suicidal patients. There were more depressive disorders, parasuicides and drug/alcohol abuse in their families. A logistic regression analysis (stepwise) revealed the role of these factors in the repetition of parasuicides. This study supports the significance of a better knowledge of the potential significant factors for parasuicide. Preventive measures are necessary.

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Remodeling of the extracellular matrix by fibroblasts is an important step in the process of wound healing and tissue repair. We compared the behavior of fibroblasts from two different tissues, dermis and gingiva, in three-dimensional lattices made of two different extracellular matrix macromolecules, collagen and fibrin. Cells were grown in monolayer cultures from normal skin or gingiva and seeded in three-dimensional lattices made of either collagen of fibrin. Photonic and scanning electron microscopy did not reveal any morphological differences between the two types of fibroblasts in both sets of lattices. Both types of fibroblasts retracted collagen lattices similarly and caused only a slight degradation of the collagen substratum. By contrast, when seeded in fibrin lattices, gingival fibroblasts completely digested their substratum in less than 8 days, whereas only a slight fibrin degradation was observed with dermal fibroblasts. The ability of gingival but not dermal fibroblasts to express high levels of tissue plasminogen activators (tPA) when cultured in fibrin lattices was assessed on an immunological basis. Also, deprivation of plasminogen-contaminating fibrinogen preparations or use of tPA inhibitors markedly inhibited both fibrinolysis and retraction rates of fibrin lattices by gingival fibroblasts. Casein-zymography confirmed the intense proteolytic activity induced by fibrin in gingival fibroblasts. It was inhibited by aprotinin and phenyl methylsulfonyl fluoride (PMSF), two non-specific inhibitors of serine proteinases, and by epsilon-amino-caproic acid (epsilon ACA), an inhibitor of plasminogen activators. Monolayer cultures exhibited only trace amounts of caseinolytic activity. Our results demonstrate that the expression of proteinases by fibroblasts is dependent not only on their tissue origin but also on the surrounding extracellular matrix. The intense fibrinolytic activity of gingival fibroblasts in fibrin lattices may explain partially the high rate of healing clinically observed in gingiva.

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The tripeptide-copper complex glycyl-L-histidyl-L-lysine-Cu2+ (GHK-Cu) was first described as a growth factor for differentiated cells. Recent in vitro data showed that it possesses several properties of a potential activator of wound repair. We investigated the effects of GHK-Cu in vivo, using the wound chamber model described previously (Schilling, J.A., W. Joel, and M.T. Shurley, 1959. Surgery [St. Louis]. 46:702-710). Stainless steel wire mesh cylinders were implanted subcutaneously on the back of rats. The animals were divided into groups that received sequential injections into the wound chamber of either saline (control group) or various concentrations of GHK-Cu. At the end of the experiments, rats were killed, wound chambers were collected, and their content was analyzed for dry weight, total proteins, collagen, DNA, elastin, glycosaminoglycans, and specific mRNAs for collagens and TGF beta. In the GHK-Cu-injected wound chambers, a concentration-dependent increase of dry weight, DNA, total protein, collagen, and glycosaminoglycan contents was found. The stimulation of collagen synthesis was twice that of noncollagen proteins. Type I and type III collagen mRNAs were increased but not TGF beta mRNAs. An increase of the relative amount of dermatan sulfate was also found. A control tripeptide, L-glutamyl-L-histidyl-L-proline, had no significant effect. These results demonstrate that GHK-Cu is able to increase extracellular matrix accumulation in wounds in vivo.

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A role for the cytokines produced by tissue-infiltrated inflammatory cells (mainly T-lymphocytes and mast cells) in the pathophysiology of fibrosis has been suggested by several groups. Among the products of these cells, interleukin-4 (IL-4) might be one of the factors involved in the initiation of the fibrotic process. We studied the effects of recombinant human IL-4 on human fibroblast monolayer cultures. IL-4 (10 and 100 U/ml) induced a dose-dependent increase of collagen production. Non-collagen protein synthesis was not significantly altered. A concomitant increase of pro-alpha 1(I) collagen mRNAs was observed, showing that IL-4 acts at a pre-translational level.

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A method of extraction of the collagen and noncollagen proteins from deep dermis of young adult rabbits using a 0.1 M tartaric acid solution was set up. The tartaric acid extraction, together with the preliminary neutral salt extraction, solubilized 95% of the total collagen and 98% of the noncollagen proteins, far more than the 6 M guanidinium Cl solution used for comparison. Elastin was not extracted. Studies on the fibrillation of the extracted collagen in neutral solution at 25 degrees C or on the results of pepsin digestion in acidic solution at +4 degrees C showed that the tartaric acid-extracted collagen was in a nondenatured form, whereas that extracted by guanidinium Cl was largely denatured. Polyacrylamide gel electrophoresis (PAGE) indicated that most of the collagen was of type I and that many noncollagen proteins were present, mostly in the molecular weight range of 40 kDa. Bidimensional PAGE gave a reproducible pattern of these noncollagen proteins, showing that several additional proteins were present in tartaric acid extracts and not in guanidinium chloride extracts.

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A procedure has been developed which can detect the hydroxyproline isomers trans-4-hydroxyproline (Hyp), trans-3-hydroxyproline, cis-4-hydroxyproline, and cis-3-hydroxyproline present in hydrolysates of collagens. The method involves hydrolyzing collagen, and reacting the primary amino acids with o-phthaladehyde (OPA) and the hydroxyprolines and proline with 7-chloro-4-nitrobenzo-2-oxa-1,3-diazole (NBD-Cl) which combines specifically with secondary amino acids. The proline and hydroxyprolines are then separated by thin-layer chromatography and quantified by using a scanning spectrofluorometer. The method was used to show that both trans-4-L-hydroxyproline and trans-3-L-hydroxyproline were epimerized as a function of hydrolysis time to the cis isomers. An appreciable amount of trans-3-Hyp was degraded. Hydrolysis with 6 N HCl in the presence of 6% trichloroacetic acid gave greater epimerization than the 6 N HCl alone. Alkaline hydrolysis in 0.2 M Ba(OH)2 caused more epimerization of trans-4-Hyp and trans-3-Hyp compared with acid hydrolysis but less degradation, so that alkaline hydrolysis is proposed for the evaluation of trans-3-Hyp, provided that the total of the cis and trans isomers be considered in this case.

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