机械张力对兔耳增生性瘢痕的形成及转化生长因子β1/Smad信号通路的影响  

Effects of mechanical tension on the formation of hypertrophic scars in rabbit ears and transforming growth factor-β1/Smad signaling pathway

作　　者：曹鹏 王运帷 官浩 杨云舒 李少珲 陈阳 朱婵 万瑀 任丽颖 姚明[1] Cao Peng;Wang Yunwei;Guan Hao;Yang Yunshu;Li Shaohui;Chen Yang;Zhu Chan;Wan Yu;Ren Liying;Yao Ming(Department of Burns and Plastic Surgery,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Burns and Cutaneous Surgery,Burn Center of PLA,the First Affiliated Hospital of Air Force Medical University,Xi'an 710032,China)

机构地区：[1]宁夏医科大学总医院烧伤整形美容科,银川750004 [2]空军军医大学第一附属医院烧伤与皮肤外科,全军烧伤中心,西安710032

出　　处：《中华烧伤与创面修复杂志》2022年第12期1162-1169,共8页Chinese Journal of Burns And Wounds

基　　金：国家自然科学基金面上项目(82172209)。

摘　　要：目的探讨机械张力对兔耳增生性瘢痕的形成及转化生长因子β1(TGF-β1)/Smad信号通路的影响。方法采用实验研究方法。取6只3~5个月龄雌雄不拘新西兰大白兔, 于每侧兔耳腹面制作5个全层皮肤缺损创面。观察术后0(即刻)、7、14、21、28 d所有兔耳创面外观。术后28 d, 计算瘢痕形成率。将每只兔左耳的3个成熟瘢痕纳入张力组并采用螺旋扩弓器持续扩弓, 将每只兔右耳的3个成熟瘢痕纳入假张力组并仅缝合螺旋扩弓器不扩弓, 每组共18个瘢痕。经机械张力处理(以下简称处理)40 d, 观察2组兔耳瘢痕组织颜色、质地。处理40 d, 观察并计算瘢痕增生指数(SEI), 分别行苏木精-伊红染色观察组织形态、Masson染色观察胶原形态, 采用实时荧光定量反转录PCR法检测瘢痕组织中TGF-β1、Smad3、Ⅰ型胶原、Ⅲ型胶原、α平滑肌肌动蛋白(α-SMA)的mRNA表达, 采用蛋白质印迹法检测瘢痕组织中TGF-β1、Ⅰ型胶原、Ⅲ型胶原、α-SMA的蛋白表达和Smad3磷酸化水平。以上实验各组样本数均为3。对数据行独立样本t检验。结果术后0 d, 所有兔耳均形成5个新鲜创面;术后7 d, 可见创面结痂;术后14 d, 大部分创面已上皮化;术后21 d, 可见全部创面上皮化;术后28 d, 形成明显的增生性瘢痕。术后28 d, 瘢痕形成率为75%(45/60)。处理40 d, 张力组的兔耳瘢痕组织凸起较假张力组明显, 瘢痕组织较硬, 颜色较红润;张力组兔耳瘢痕的SEI为2.02±0.08, 明显高于假张力组的1.70±0.08(t=5.07, P<0.01)。处理40 d, 与假张力组相比, 张力组兔耳瘢痕组织角质层变厚, 真皮层可见大量新生的毛细血管、炎症细胞和成纤维细胞;胶原排列更加紊乱, 呈结节状或旋涡状分布。处理40 d, 张力组兔耳瘢痕组织中TGF-β1、Smad3、Ⅰ型胶原、Ⅲ型胶原、α-SMA的mRNA表达量分别为1.81±0.25、5.71±0.82、7.86±0.56、4.35±0.28、5.89±0.47, 分别明显高于假张力组的Objective To explore the effects of mechanical tension on the formation of hypertrophic scars in rabbit ears and transforming growth factor-β1(TGF-β1)/Smad signaling pathway.Methods The experimental research method was adopted.Six New Zealand white rabbits,male or female,aged 3-5 months were used and 5 full-thickness skin defect wounds were made on the ventral surface of each rabbit ear.The appearance of all rabbit ear wounds was observed on post surgery day(PSD)0(immediately),7,14,21,and 28.On PSD 28,the scar formation rate was calculated.Three mature scars in the left ear of each rabbit were included in tension group and the arch was continuously expanded with a spiral expander.Three mature scars in the right ear of each rabbit were included in sham tension group and only the spiral expander was sutured without expansion.There were 18 scars in each group.After mechanical tension treatment(hereinafter referred to as treatment)for 40 days,the color and texture of scar tissue in the two groups were observed.On treatment day 40,the scar elevation index(SEI)was observed and calculated;the histology was observed after hematoxylin eosin staining,and the collagen morphology was observed after Masson staining;mRNA expressions of TGF-β1,Smad3,collagenⅠ,collagenⅢ,andα-smooth muscle actin(α-SMA)in scar tissue were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction;and the protein expressions of TGF-β1,collagenⅠ,collagenⅢ,andα-SMA,and phosphorylation level of Smad3 in scar tissue were detected by Western blotting.The number of samples of each group in the experiments was 3.Data were statistically analyzed with independent sample t test.Results On PSD 0,5 fresh wounds were formed on all the rabbit ears;on PSD 7,the wounds were scabbed;on PSD 14,most of the wounds were epithelialized;on PSD 21,all the wounds were epithelialized;on PSD 28,obvious hypertrophic scars were formed.The scar formation rate was 75%(45/60)on PSD 28.On treatment day 40,the scar tissue of rabbi

关 键 词：瘢痕 转化生长因子Β1 SMAD蛋白质类 机械张力 

分 类 号：R622[医药卫生—整形外科]