Ferguson P C, Boynton E L, Wunder J S, Hill R P, O'Sullivan B, Sandhu J S, Bell R S
Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.
J Surg Res. 1999 Aug;85(2):331-8. doi: 10.1006/jsre.1999.5664.
Despite its well-recognized benefits in the management of several solid tumors, the use of radiotherapy prior to surgery is associated with a high incidence of significant surgical wound healing complications. Radiation-induced damage to dermal fibroblasts has been proposed as an important cause. We hypothesized that the introduction of normal, unirradiated fibroblasts into previously irradiated skin would enhance healing of the subsequent surgical wound.
Four groups of wounds were examined in female Wistar rats: (1) unirradiated skin (n = 10), (2) irradiated skin injected with tissue culture medium alone (n = 17), (3) irradiated skin injected with autologous dermal fibroblasts (n = 17), and (4) irradiated skin injected with irradiated autologous dermal fibroblasts (n = 7). Wounds were evaluated biomechanically and histologically.
The biomechanical values of breaking load, ultimate tensile strength, elastic modulus, and toughness were significantly greater in the irradiated wounds injected with fibroblasts than those injected with medium only. These cell-injected wounds did not perform as well biomechanically as those in unirradiated skin. Irradiating the cells prior to injection resulted in biomechanical results no better than those in medium-injected wounds.
These results demonstrate that injection of normal, unirradiated fibroblasts significantly improves healing of the irradiated surgical wound. These cells are likely better able to respond to the proliferative, migratory, and synthetic demands of the wound healing environment, as injection of irradiated cells has an equivalent effect on healing as injection of medium alone.
尽管放射疗法在多种实体瘤的治疗中具有公认的益处，但在手术前使用放射疗法会导致严重手术伤口愈合并发症的高发生率。辐射诱导的真皮成纤维细胞损伤被认为是一个重要原因。我们假设将正常的、未受辐射的成纤维细胞引入先前受辐射的皮肤中会增强后续手术伤口的愈合。
在雌性Wistar大鼠中检查了四组伤口：（1）未受辐射的皮肤（n = 10），（2）仅注射组织培养基的受辐射皮肤（n = 17），（3）注射自体真皮成纤维细胞的受辐射皮肤（n = 17），以及（4）注射受辐射自体真皮成纤维细胞的受辐射皮肤（n = 7）。对伤口进行了生物力学和组织学评估。
注射成纤维细胞的受辐射伤口的断裂负荷、极限拉伸强度、弹性模量和韧性的生物力学值明显高于仅注射培养基的伤口。这些注射细胞的伤口在生物力学方面的表现不如未受辐射皮肤中的伤口。在注射前对细胞进行辐射导致生物力学结果并不比注射培养基的伤口更好。
这些结果表明，注射正常的、未受辐射的成纤维细胞可显著改善受辐射手术伤口的愈合。这些细胞可能更能响应伤口愈合环境的增殖、迁移和合成需求，因为注射受辐射细胞对愈合的影响与仅注射培养基相同。
