Boyce D E, Jones W D, Ruge F, Harding K G, Moore K
West Midlands Regional Plastic, Cardiff, UK.
Br J Dermatol. 2000 Jul;143(1):59-65. doi: 10.1046/j.1365-2133.2000.03591.x.
Animal experimental data indicate a requirement for functionally active T lymphocytes to allow optimal healing of dermal wounds. Little evidence exists to confirm that this is the case in humans. Lymphocyte involvement in regulation of healing is probably mediated by release of secreted cytokines/growth factors, and we hypothesize that the cytokine profile requirement will be modulated as healing progresses.
As this is likely to be reflected in lymphocyte subset changes over the course of normal healing, we investigated the immunophenotype of lymphocyte subpopulations during wound healing.
Sequential biopsies were taken over 42 days from the margin of 12 wounds healing by secondary intention after pilonidal sinus excision. Serial biopsy sections were analysed by immunohistochemistry using lymphocyte-specific monoclonal antibodies, and lymphocytes were counted microscopically.
Within 42 days, the mean decrease in wound volume was 87.5%. This was accompanied by significant changes in the wound margin lymphocyte population. Total numbers (mean +/- SEM) of T lymphocytes decreased from 36.8 +/- 9.8 cells per field at inclusion in the study to 25.9 +/- 3.0 immediately prior to wound closure, with a concomitant increase in B lymphocytes from 1 +/- 0.4 to 9.5 +/- 3.6 cells per field. The CD4/CD8 T-lymphocyte ratio fell from an initial level of 3.6 +/- 0.3 to 2.1 +/- 0.3 (mean +/- SEM) prior to closure.
These data indicate that human wound-associated lymphocyte populations are modulated during healing; the increase in numbers of CD8+ T-suppressor lymphocytes is in accordance with previous animal data, indicating a role for these cells in downregulating healing as the wound closes. This study also documents an associated increase in B lymphocytes and healing of human wounds, with an as yet undefined role.
动物实验数据表明，功能性活跃的T淋巴细胞是真皮伤口实现最佳愈合所必需的。但几乎没有证据证实人类也是如此。淋巴细胞参与愈合调节可能是通过分泌细胞因子/生长因子来介导的，我们推测随着愈合进程的推进，对细胞因子谱的需求会发生变化。
由于这可能会在正常愈合过程中通过淋巴细胞亚群的变化体现出来，我们研究了伤口愈合过程中淋巴细胞亚群的免疫表型。
在42天内，从12例因藏毛窦切除术后二期愈合的伤口边缘进行连续活检。使用淋巴细胞特异性单克隆抗体通过免疫组织化学对连续活检切片进行分析，并在显微镜下对淋巴细胞进行计数。
在42天内，伤口体积平均减少了87.5%。这伴随着伤口边缘淋巴细胞群体的显著变化。T淋巴细胞总数（平均值±标准误）从纳入研究时的每视野36.8±9.8个细胞降至伤口闭合前的25.9±3.0个细胞，同时B淋巴细胞从每视野1±0.4个细胞增加至9.5±3.6个细胞。CD4/CD8 T淋巴细胞比值从初始水平的3.6±0.3降至闭合前的2.1±0.3（平均值±标准误）。
这些数据表明，人类伤口相关淋巴细胞群体在愈合过程中会发生变化；CD8 + T抑制淋巴细胞数量的增加与先前的动物数据一致，表明这些细胞在伤口闭合时下调愈合过程中发挥作用。本研究还记录了人类伤口愈合过程中B淋巴细胞数量的增加，但其作用尚不清楚。
