Bulut Turker, Bilsel Yilmaz, Yanar Hakan, Yamaner Sumer, Balik Emre, Solakoglu Seyhun, Koser Murat
Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Turkey.
J Invest Surg. 2004 Jul-Aug;17(4):211-9. doi: 10.1080/08941930490472028.
Wound contraction is a clinically important biological process because it frequently results in contractures, strictures, and stenosis. If collagen synthesis could be altered to minimize the contracture, then the outcome could be improved. Lathyrism produces poorly cross-linked collagen in healing anastomosis, keeping a larger portion of the synthesized collagen soluble. Ultimately, the amount of contracting collagen is reduced, lowering the bulk and lessening the contracture. The aim of this study was to observe the effects of a lathyrogen, beta-aminopropionitrile (BAPN), on the healing of colonic anastomosis. Thirty rats were divided into three groups. Colostomy and anastomosis were performed on all rats. Intraperitoneal saline solution (control) and either intraperitoneal (ip) or oral (po) BAPN were administered. The rats were killed 1 week later. Anastomotic healing was assessed by bursting pressure and the hydroxyproline content of the anastomotic tissues. Granulation tissue thickness, number of fibroblasts, inflammatory cells, and growing capillaries in granulation tissue per unit area were determined. Collagen fibril diameters were estimated, and spatial arrangements of fibrils were examined by an electron microscope. All results were evaluated by Mann-Whitney U-test. The analyses of anastomotic tissues from BAPN-treated rats showed a significantly reduced mean bursting pressure (158.9 +/- 12.3, 171.3 +/- 13.9, ip and po, respectively), hydroxyproline content (8.9 +/- 2.6, 10.1 +/- 2.7), granulation tissue thickness (24.3 +/- 2.6, 16.1 +/- 5.2), number of inflammatory cells (37.8 +/- 4.3, 25 +/- 4.3), fibroblasts (3.2 +/- 1.1, 2.8 +/- 0.7), and a significantly reduced collagen fiber diameter (15 +/- 2, 20 +/- 3) compared with those of control group (236.9 +/- 9, 14 +/- 4.4, 26.8 +/- 4.8, 39 +/- 2.6, 6.9 +/- 1.1, and 35 +/- 5, respectively). As a result, collagen fibers were flimsy, and lost their regular parallel alignment in the BAPN groups. On the other hand, a number of growing capillaries were found to be significantly increased in these groups (16.5 +/- 1.1, 18.2 +/- 0.7) compared to the control (6.7 +/- 1.3). Thus, it is suggested that BAPN may be useful in the prevention of gastrointestinal stricture formation.
伤口收缩是一个临床上重要的生物学过程,因为它常常导致挛缩、狭窄和管腔缩窄。如果能够改变胶原蛋白的合成以尽量减少挛缩,那么结果可能会得到改善。山黧豆中毒会使愈合中的吻合口产生交联不佳的胶原蛋白,使合成的胶原蛋白中有更大比例保持可溶状态。最终,收缩性胶原蛋白的量减少,体积减小,挛缩减轻。本研究的目的是观察一种山黧豆毒素β-氨基丙腈(BAPN)对结肠吻合口愈合的影响。30只大鼠被分为三组。对所有大鼠进行结肠造口术和吻合术。分别腹腔内给予生理盐水(对照组)以及腹腔内(ip)或口服(po)BAPN。1周后处死大鼠。通过破裂压力和吻合口组织的羟脯氨酸含量评估吻合口愈合情况。测定肉芽组织厚度、每单位面积肉芽组织中成纤维细胞、炎症细胞和新生毛细血管的数量。估计胶原纤维直径,并通过电子显微镜检查纤维的空间排列。所有结果采用Mann-Whitney U检验进行评估。对接受BAPN治疗的大鼠的吻合口组织分析显示,与对照组相比,平均破裂压力(分别为ip组158.9±12.3、po组171.3±13.9)、羟脯氨酸含量(8.9±2.6、10.1±2.7)、肉芽组织厚度(24.3±2.6、16.1±5.2)、炎症细胞数量(37.8±4.3、25±4.3)、成纤维细胞数量(3.2±1.1、2.8±0.7)均显著降低,胶原纤维直径也显著减小(分别为15±2、20±3),而对照组分别为236.9±9、14±4.4、26.8±4.8、39±2.6、6.9±1.1和35±5。结果,在BAPN组中胶原纤维脆弱,失去了规则的平行排列。另一方面,与对照组(6.7±1.3)相比,发现这些组中新生毛细血管的数量显著增加(16.5±1.1、18.2±0.7)。因此,提示BAPN可能有助于预防胃肠道狭窄的形成。