Yeo S W, Kim S W, Suh B D, Cho S H
Department of Otolaryngology-Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Am J Otolaryngol. 2000 May-Jun;21(3):153-60. doi: 10.1016/s0196-0709(00)85017-6.
Platelet-derived growth factor basic 30-kD disulfide-bonded dimer of A and B chains (PDGF-AA, PDGF AB, PDGF-BB) and a cytokine, promoting wound healing by its mitogenicity for fibroblast and by stimulating the production of fibronectin and hyaluronic acid. This article investigates the effect of PDGF on the healing process of tympanic membrane (TM) perforation.
The pars tensa of the posterior aspect of the TM of rats was excised and treated with 2 microg of PDGF-AA or placebo. The animals were killed at 3, 5, 7, 9, 11, 15, and 28 days after operation. The healing process of TM perforation was observed with a telescope and light microscope. The temporal bones were also immunohistochemically examined for PDGF-alpha receptor (PDGF-R(alpha)) and fibronectin.
All PDGF-AA-treated TM were completely closed by 5 days after surgery, whereas some of the placebo-treated TM were not closed at 15 postoperative days. PDGF-AA induced the most prominent proliferation of the connective tissue by 9 postoperative days, after which the growth of the connective tissue decreased. By the 4th postoperative week, the PDGF-treated TM were slightly thicker than normal TM. An intense expression of fibronectin was detected in the connective tissue layer of the TM that were treated with PDGF-AA. PDGF-R(alpha) was expressed in the epithelial layer of both the PDGF-treated and control TM.
These results show that PDGF-AA speeds up the healing process of TM defect, improves the rate of healing, and prevents atrophic changes in the healed TM by promoting the connective tissue growth. The use of PDGF-AA can be an effective alternative to surgery for managing TM perforations.
血小板衍生生长因子是由A链和B链组成的30-kD二硫键连接的二聚体（血小板衍生生长因子AA、血小板衍生生长因子AB、血小板衍生生长因子BB），作为一种细胞因子，通过对成纤维细胞的促有丝分裂作用以及刺激纤连蛋白和透明质酸的产生来促进伤口愈合。本文研究血小板衍生生长因子对鼓膜穿孔愈合过程的影响。
切除大鼠鼓膜后份的紧张部，用2微克血小板衍生生长因子AA或安慰剂处理。在术后3、5、7、9、11、15和28天处死动物。用望远镜和光学显微镜观察鼓膜穿孔的愈合过程。对颞骨也进行血小板衍生生长因子α受体（血小板衍生生长因子-R(α)）和纤连蛋白的免疫组织化学检查。
所有接受血小板衍生生长因子AA治疗的鼓膜在术后5天完全闭合，而一些接受安慰剂治疗的鼓膜在术后15天仍未闭合。术后9天，血小板衍生生长因子AA诱导结缔组织最显著的增殖，此后结缔组织生长减少。到术后第4周，接受血小板衍生生长因子治疗的鼓膜比正常鼓膜略厚。在接受血小板衍生生长因子AA治疗的鼓膜结缔组织层中检测到纤连蛋白的强烈表达。血小板衍生生长因子-R(α)在接受血小板衍生生长因子治疗和对照的鼓膜上皮层中均有表达。
这些结果表明，血小板衍生生长因子AA通过促进结缔组织生长加速鼓膜缺损的愈合过程，提高愈合率，并防止愈合后的鼓膜发生萎缩性改变。使用血小板衍生生长因子AA可以成为治疗鼓膜穿孔的一种有效的手术替代方法。
