Hashimoto Ichiro, Nakanishi Hideki, Shono Yoshitaka, Toda Maki, Tsuda Hidetaka, Arase Seiji
Department of Plastic and Reconstructive Surgery, University of Tokushima School of Medicine, Kuramoto-cho, Tokushima 770-8503, Japan.
J Med Invest. 2002 Feb;49(1-2):61-6.
Wound healing is a complex biologic process with initial inflammation, granulation tissue formation, and matrix remodeling. We observed the relation between angiostatic effects and corticosteroid administration time in the rabbit ear chamber. Angiogenesis in the chamber was studied using a microscope-television system. Two experiments were undertaken to represent the systemic and the topical administration of steroids. In experiment 1, 10 mg of triamcinolone acetonide was injected three times intramuscularly (on the day of implantation of the chamber, and the 7th and 14th day after implantation). Vascularization in this group was significantly delayed at the 7th, 14th, and 21st days but no difference from controls was observed in the size and density of vessels after its completion. In experiment 2, 3 mg of triamcinolone acetonide was injected once into the skin adjacent to the chamber on the 10th day after installment of chambers or on the day of installment. In the former group, new vascular growth was delayed until the 21st day after installment. The hemorrhagic zone had narrowed and vascular dilation was observed. In the latter group, endothelial budding was delayed and vascular constriction occurred. New vascular growth was severely delayed and granulation filling of the chamber was not completed. These results suggest not only that the topical administration had the stronger inhibitory effect on neovascularization than the systemic administration but that the effect differed depending on the stage of wound healing. In view of this effect of this steroid, we should pay careful attention to the time when steroids are administered to patients.
伤口愈合是一个复杂的生物学过程,包括初始炎症、肉芽组织形成和基质重塑。我们观察了兔耳室中血管生成抑制作用与皮质类固醇给药时间之间的关系。使用显微镜电视系统研究室中的血管生成。进行了两项实验以代表类固醇的全身给药和局部给药。在实验1中,将10mg曲安奈德肌肉注射三次(在植入室的当天以及植入后的第7天和第14天)。该组在第7天、第14天和第21天血管化明显延迟,但在完成后血管的大小和密度与对照组相比没有差异。在实验2中,在安装室后的第10天或安装当天,将3mg曲安奈德注射到室附近的皮肤中一次。在前一组中,新血管生长延迟到安装后的第21天。出血区变窄并观察到血管扩张。在后一组中,内皮芽生延迟且发生血管收缩。新血管生长严重延迟且室的肉芽填充未完成。这些结果不仅表明局部给药对新血管形成的抑制作用比全身给药更强,而且该作用因伤口愈合阶段而异。鉴于这种类固醇的这种作用,我们应该仔细注意给患者使用类固醇的时间。