A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响  

Effect of botulinum toxin type A injection on hypertrophic scar in rabbit ear model

作　　者：王琳[1] 邰宁正[1] 范志宏[1] 

机构地区：[1]上海交通大学医学院附属仁济医院整形外科,上海200001

出　　处：《中华整形外科杂志》2009年第4期284-287,共4页Chinese Journal of Plastic Surgery

基　　金：上海市科委资助项目（07JC14038）

摘　　要：目的 研究A型肉毒毒素对兔耳增生性瘢痕组织的影响。方法8只日本大耳白兔，体重3kg，建立兔耳增生性瘢痕模型。将兔耳创面分为A型肉毒毒素治疗组（T组）和瘢痕组（S组），每组48个创面。大体观察创面愈合时间和瘢痕增生情况。术后28d，同法另取4只兔子的兔耳腹面健康皮肤为空白组（B组），收集标本。测量S、T组标本HE切片的瘢痕增生指数HI，流式细胞仪分析2组标本中成纤维细胞的细胞周期，western．blot检测S、T、B组标本中Ⅰ、Ⅲ型胶原的蛋白表达。结果①T组标本的瘢痕增生指数H1较S组显著降低，P〈0．01；②蛋白水平上，T组的胶原Ⅰ、Ⅲ蛋白表达和胶原Ⅰ／Ⅲ比值均较S组显著降低，P〈0．01；③S组分布于G2-M期和S期的成纤维细胞较T组显著增多，而静止期G0—G1的细胞则显著减少，P〈0．05。结论A型肉毒毒素局部应用能抑制兔耳增生瘢痕的形成，抑制成纤维细胞的增殖活性，减少瘢痕组织中Ⅰ、Ⅲ型胶原的合成，降低胶原Ⅰ，Ⅲ比值，为其治疗增生性瘢痕的临床应用提供了一定的理论依据。Objective To investigate the effect of botulinum toxin type A （Botox A） injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits＇ ears. These wounds were divided into two groups as group T（treated with Botox A, n = 48） and group S （not treated, n = 48）. The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index（ HI）. The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The HI was significantly lower in group T than in group S（ P 〈 0. 01 ）. The expression of collagen Ⅰ and Ⅲ , as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T （ P 〈 0. 01 ）. Compared with group T, more fibroblasts were in G2-M in group S and fewer in G0-G1 （ P 〈 0.05） . Conclusions Local injection of Botox A can inhibite the formation of hypertrophic scar and the activity of fibroblasts in rabbit ear model. It can significantly decrease the expression of collagen Ⅰ and Ⅲ in hypertrophic scar, as well as the ratio of collagen Ⅰ to Ⅲ It serves as the basis for the treatment of hypertrophic scar with Botox A.

关 键 词：A型肉毒毒素 增生性瘢痕 成纤维细胞 细胞周期 

分 类 号：R622[医药卫生—整形外科]