Orringer Jeffrey S, Kang Sewon, Johnson Timothy M, Karimipour Darius J, Hamilton Ted, Hammerberg Craig, Voorhees John J, Fisher Gary J
Department of Dermatology, University of Michigan Medical School, Ann Arbor, USA.
Arch Dermatol. 2004 Nov;140(11):1326-32. doi: 10.1001/archderm.140.11.1326.
To quantitatively examine the dynamics of molecular alterations involved in dermal remodeling after carbon dioxide (CO(2)) laser resurfacing of photodamaged human skin.
Serial in vivo biochemical analyses after laser therapy.
Academic referral center, Department of Dermatology, University of Michigan, Ann Arbor. Subjects Volunteer sample of 28 adults, 48 to 76 years old, with clinically evident photodamage of the forearms. Intervention Focal CO(2) laser resurfacing of photodamaged forearms and serial biopsies at baseline and various times after treatment.
Reverse transcriptase real-time polymerase chain reaction technology and immunohistochemistry were used to assess levels of type I and type III procollagens; matrix metalloproteinases (MMPs) 1, 3, 9, and 13; tropoelastin; fibrillin; primary cytokines interleukin 1beta and tumor necrosis factor alpha; and profibrotic cytokine transforming growth factor beta1.
Production of type I procollagen and type III procollagen messenger RNA peaked at 7.5 and 8.9 times baseline levels, respectively, 21 days after treatment and remained elevated for at least 6 months. Increases in messenger RNA levels of several cytokines (interleukin 1beta, tumor necrosis factor alpha, and transforming growth factor beta1) preceded and/or accompanied changes in collagen levels. Marked increases in messenger RNA levels of MMP-1 (39 130-fold), MMP-3 (1041-fold), MMP-9 (75-fold), and MMP-13 (767-fold) were noted. Levels of fibrillin and tropoelastin rose in a delayed fashion several weeks after treatment.
The biochemical changes seen after CO(2) laser resurfacing proceed through a well-organized and highly reproducible wound healing response that results in marked alterations in dermal structure. These quantitative changes may serve as a means for comparison as other therapeutic modalities meant to improve the appearance of photodamaged skin are evaluated.
定量研究二氧化碳（CO₂）激光换肤治疗光损伤人体皮肤后真皮重塑过程中分子改变的动态变化。
激光治疗后的系列体内生化分析。
密歇根大学安娜堡分校皮肤科的学术转诊中心。
28名年龄在48至76岁之间、前臂有明显光损伤的成年人志愿者样本。
对光损伤的前臂进行局部CO₂激光换肤，并在基线及治疗后的不同时间进行系列活检。
采用逆转录实时聚合酶链反应技术和免疫组织化学方法评估I型和III型前胶原、基质金属蛋白酶（MMP）1、3、9和13、原弹性蛋白、原纤蛋白、主要细胞因子白细胞介素1β和肿瘤坏死因子α以及促纤维化细胞因子转化生长因子β1的水平。
治疗后21天，I型前胶原和III型前胶原信使核糖核酸的产生分别达到基线水平的7.5倍和8.9倍峰值，并至少持续升高6个月。几种细胞因子（白细胞介素1β、肿瘤坏死因子α和转化生长因子β1）信使核糖核酸水平的增加先于和/或伴随胶原水平的变化。观察到MMP-1（39130倍）、MMP-3（1041倍）、MMP-9（75倍）和MMP-13（767倍）的信使核糖核酸水平显著增加。原纤蛋白和原弹性蛋白的水平在治疗后数周呈延迟上升。
CO₂激光换肤后出现的生化变化通过有序且高度可重复的伤口愈合反应进行，导致真皮结构发生显著改变。这些定量变化可作为一种比较手段，用于评估其他旨在改善光损伤皮肤外观的治疗方式。
