Suh D Y, Hunt T K, Spencer E M
Laboratory of Growth and Development, California Pacific Medical Center, San Francisco 94118.
Endocrinology. 1992 Nov;131(5):2399-403. doi: 10.1210/endo.131.5.1425438.
Corticosteroids are widely used therapeutic agents that have as a major side-effect the impairment of wound healing. Two hypotheses were tested: 1) that antiinflammatory corticosteroids decrease the local insulin-like growth factor-I (IGF-I) response to injury; and 2) that locally administered IGF-I would overcome methylprednisolone-mediated suppression of healing. The IGF-I concentration was measured in fluid from wire mesh cylinder wounds in rats given saline or methylprednisolone im. Rats receiving 8 and 16 mg had decreased wound IGF-I levels of 32% and 56%, respectively, compared to the saline-injected controls. IGF-I was infused (15 micrograms/day) by osmotic minipumps into wire mesh cylinder wound chambers of methylprednisolone (8 mg)-treated rats for 7 and 14 days. Methylprednisolone decreased wound DNA to 21%, hydroxyproline to 30%, and total protein to 5% of the values found in saline-infused controls. A 14-day treatment with IGF-I completely reversed the effect of methylprednisolone and increased DNA, hydroxyproline, and total protein to 216%, 109%, and 96% of saline control values, respectively. In conclusion, corticosteroids depressed wound IGF-I concentrations in rats, and an infusion of IGF-I into wound chambers reversed the corticosteroid-induced impairment of wound healing, as determined by the DNA, hydroxyproline, and total protein contents in wound chambers.
皮质类固醇是广泛使用的治疗药物,其主要副作用是损害伤口愈合。我们检验了两种假设:1)抗炎皮质类固醇会降低局部胰岛素样生长因子-I(IGF-I)对损伤的反应;2)局部给予IGF-I可克服甲基强的松龙介导的愈合抑制作用。对给予生理盐水或甲基强的松龙腹腔注射的大鼠,测量其金属丝网圆筒伤口渗出液中的IGF-I浓度。与注射生理盐水的对照组相比,接受8毫克和16毫克甲基强的松龙的大鼠伤口IGF-I水平分别降低了32%和56%。通过渗透微型泵将IGF-I(15微克/天)注入接受甲基强的松龙(8毫克)治疗的大鼠的金属丝网圆筒伤口腔室中,持续7天和14天。甲基强的松龙使伤口DNA降至生理盐水注入对照组的21%,羟脯氨酸降至30%,总蛋白降至5%。用IGF-I进行14天的治疗完全逆转了甲基强的松龙的作用,使DNA、羟脯氨酸和总蛋白分别增至生理盐水对照组值的216%、109%和96%。总之,皮质类固醇降低了大鼠伤口的IGF-I浓度,向伤口腔室注入IGF-I可逆转皮质类固醇诱导的伤口愈合损伤,这由伤口腔室中的DNA、羟脯氨酸和总蛋白含量来确定。