Cheng E T, Nowak K C, Koch R J
Wound Healing and Tissue Engineering Laboratory, Division of Otolaryngology-Head and Neck Surgery, R-135, Stanford University Medical Center, Stanford, CA 94305-5328, USA.
Arch Facial Plast Surg. 2001 Oct-Dec;3(4):252-7. doi: 10.1001/archfaci.3.4.252.
A serum-free in vitro model was used to determine the effect of combined carbon dioxide (CO2) and erbium (Er):YAG laser (Derma K; ESC/Sharplan Medical Systems, Yokneam, Israel) irradiation on keloid-producing fibroblasts (KFs) from 2 distinct facial sites. Transforming growth factor beta1 (TGF-beta1) and basic fibroblast growth factor (bFGF) play an integral part in wound healing and were assayed using this model. It has always been a clinical impression that fibroblasts from different regions of the face behave differently. This is exemplified by patients prone to lobule keloid formation after ear piercing, who heal normally after a facial incision.
Laboratory-based wound healing.
Human KF cell lines were established from operative specimens using standard explant techniques. At 48 hours after seeding, 20% of each well was exposed to 1.7 J/pulse of Er:YAG laser energy and CO2 delivered at 3 or 5 W and at a duty cycle of 25%, 50%, or 100%. Using a quantitative enzyme-linked immunosorbent assay, TGF-beta1 and bFGF were assayed from collected supernatants.
Laser-treated ear lobule KFs demonstrated decreased TGF-beta1 production when compared with preauricular KFs. Statistical significance (P<.005) was seen in the 3-W CO2 25% duty cycle; a trend was seen in the 3-W CO2 50% duty cycle (P<.08). Preauricular KFs secreted increased bFGF when compared with lobule KFs. Significance was seen in the 3-W CO2 25% and 50% duty cycles (P<.05). Laser-treated preauricular KFs had increased bFGF secretion when compared with non-laser-treated preauricular KFs in the 3-W CO2 25%, 50%, and 100% duty cycles.
Combined CO2 and Er:YAG laser treatment decreases the production of TGF-beta1 in preauricular and ear lobule KFs. This laser may have clinical promise in the treatment of keloids. Finally, the different growth factor profiles obtained suggest that KFs from the ear lobule and preauricular regions are different.
采用无血清体外模型，以确定二氧化碳（CO₂）与铒（Er）：钇铝石榴石激光（Derma K；ESC/Sharplan医疗系统公司，以色列约克奈姆）联合照射对来自面部两个不同部位的瘢痕疙瘩成纤维细胞（KF）的影响。转化生长因子β1（TGF-β1）和碱性成纤维细胞生长因子（bFGF）在伤口愈合中起重要作用，并使用该模型进行检测。临床一直认为，面部不同区域的成纤维细胞表现不同。例如，穿耳洞后易形成耳垂瘢痕疙瘩的患者，面部切口后却能正常愈合。
基于实验室的伤口愈合研究。
采用标准外植技术从手术标本中建立人KF细胞系。接种48小时后，将每个孔的20%暴露于能量为1.7J/脉冲的Er：YAG激光以及以3W或5W、占空比为25%、50%或100%输送的CO₂中。使用定量酶联免疫吸附测定法，从收集的上清液中检测TGF-β1和bFGF。
与耳前KF相比，激光处理后的耳垂KF显示TGF-β1产生减少。在3W CO₂ 25%占空比时具有统计学意义（P<0.005）；在3W CO₂ 50%占空比时可见趋势（P<0.08）。与耳垂KF相比，耳前KF分泌的bFGF增加。在3W CO₂ 25%和50%占空比时具有统计学意义（P<0.05）。在3W CO₂ 25%、50%和100%占空比下，激光处理后的耳前KF与未激光处理的耳前KF相比，bFGF分泌增加。
CO₂与Er：YAG激光联合治疗可降低耳前和耳垂KF中TGF-β1的产生。这种激光在瘢痕疙瘩治疗中可能具有临床应用前景。最后，获得的不同生长因子谱表明耳垂和耳前区域的KF不同。
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