Ayyildiz Ali, Nuhoglu Baris, Gülerkaya Bülent, Caydere Muzaffer, Ustün Hüseyin, Germiyanoglu Cankon, Erol Demokan
Ankara Training and Education Hospital, 2nd Urology Clinic, Turkey.
Int J Urol. 2004 Dec;11(12):1122-6. doi: 10.1111/j.1442-2042.2004.00959.x.
In the pathogenesis of urethral stricture, fibrosis is associated with an excessive collagen increase. After the recognition that topical application of Mitomycin-C (MMC) inhibits fibroblast proliferation and is effective in preventing scar formation, many studies have been carried out on this subject outside the scope of urology. The aim of the present study is to observe the intraurethral impact of the employment of low doses of MMC on scar formation and fibrosis in experimental rat model.
Urethral injuries were made by internal urethrotomy knife. The study was carried out with 35 adult male Wistar albino rats. Five rats were allocated to the control group (group 1), 10 to a group that was administered 2 mg/L MMC (group 2) and 20 to a group that was administered 10 mg/L MMC (group 3). Mitomycin-C was administered to the injured urethra in the form of irrigation for 5 min. The rats were sacrificed 14 days later in order to evaluate chronic inflammation and fibrosis and their penises were histopathologically examined under light microscopy with hematoxilen eosin and trichrom stains.
When group 2 was compared with control group, the differences in hemosiderin-laden macrophages (HLM), mononuclear cell infiltration (MCI) and fibrosis were found to be statistically significant (P < 0.01, P < 0.05, P < 0.005, respectively). When group 3 was compared with control group, the differences in HLM, MCI and fibrosis were also found to be statistically significant (P < 0.05, P < 0.05, P < 0.005, respectively). In the comparison of group 2 with group 3, no statistically significant differences were found in terms of the these parameters.
Although MMC is toxic at high doses, the antifibrotic effect of the intraurethral low dose MMC may be useful in combination therapy for internal urethrotomy.
在尿道狭窄的发病机制中,纤维化与胶原蛋白过度增加有关。在认识到局部应用丝裂霉素-C(MMC)可抑制成纤维细胞增殖并有效预防瘢痕形成后,泌尿外科领域之外的许多研究都围绕这一主题展开。本研究的目的是观察在实验大鼠模型中低剂量MMC尿道内应用对瘢痕形成和纤维化的影响。
采用尿道内切开刀造成尿道损伤。对35只成年雄性Wistar白化大鼠进行研究。5只大鼠分配至对照组(第1组),10只分配至给予2 mg/L MMC的组(第2组),20只分配至给予10 mg/L MMC的组(第3组)。丝裂霉素-C以冲洗的形式给予受伤尿道5分钟。14天后处死大鼠以评估慢性炎症和纤维化,并对其阴茎进行苏木精-伊红和三色染色,在光学显微镜下进行组织病理学检查。
将第2组与对照组比较时,发现含铁血黄素巨噬细胞(HLM)、单核细胞浸润(MCI)和纤维化方面的差异具有统计学意义(分别为P < 0.01、P < 0.05、P < 0.005)。将第3组与对照组比较时,HLM、MCI和纤维化方面的差异也具有统计学意义(分别为P < 0.05、P < 0.05、P < 0.005)。在第2组与第3组的比较中,这些参数方面未发现统计学显著差异。
尽管高剂量MMC具有毒性,但尿道内低剂量MMC的抗纤维化作用可能对尿道内切开术的联合治疗有用。