Li Fa-cheng, Cui Lei, Sun Yu-xiao, Qian Yun-liang, Chen Shi-shu, Guan Wen-xiang
Department of Plastic Surgery, the Chao Yang Hospital of Capital University of Medical Science, Beijing 100020, China.
Zhonghua Zheng Xing Wai Ke Za Zhi. 2004 Nov;20(6):434-8.
The purpose of this study was to determine the effects of local delivery of vascular endothelial growth factor( VEGF) transferred with adenovirus-mediated gene on the survival of ischemic random skin flap in rats.
The animals were divided into three groups randomly (n = 10) . A 2 cm x 8 cm dorsal skin flap was designed with the pedicle at the level of the iliac crest. In group A (AdCMV-VEGF), each animal received 10(12) PR replication-deficient recombinant adenovirus (AdCMV-VEGF) in the distal two-thirds of the proposed flap by means of the subdermal injection at ten different locations. In group B (AdCMV-GaI), each received 1012 PR AdCMV-Gal. In Group C (Saline), each received 1 ml saline. Three days after the treatment, the flap was elevated as planed way and re-sutured back to its donor site. All the animals were evaluated 7 days after the operation.
The mean percentage of surviving flap area was (85.91 +/- 2.54)% in group A, (59.56 +/- l.18)% in group B, and (61.48 +/- l.09)% in group C. There was a significant increase in the percentage of the survival area in the flaps of the group A, compared with the group B and group C (Group B vs. Group A, P < 0.01; Group C vs.Group A, P < 0.01, Group B vs. Group C, P >0.05). Hybridization in the situ, the immunohistochemical stain showed that the VEGF was expressed in the survival tissue of the flap treated with the AdCMV-VEGF, but it was not found in the control groups. Histological analysis demonstrated qualitatively greater amount of granulation tissue and angiogenesis was found in the group treated with the AdCMV-VEGF than the controls.
The results may indicate that Ad vector carrying VEGF cDNA could be useful in enhancing the survival of the skin flap due to the effect of the local delivery of the VEGF.
本研究旨在确定腺病毒介导基因转移的血管内皮生长因子（VEGF）局部递送对大鼠缺血随意皮瓣存活的影响。
将动物随机分为三组（n = 10）。设计一个2 cm×8 cm的背部皮瓣，蒂位于髂嵴水平。A组（AdCMV-VEGF）中，每只动物通过在拟皮瓣远端三分之二处的十个不同位置进行皮下注射，接受10¹² PFU复制缺陷型重组腺病毒（AdCMV-VEGF）。B组（AdCMV-Gal）中，每只动物接受10¹² PFU AdCMV-Gal。C组（生理盐水组）中，每只动物接受1 ml生理盐水。治疗三天后，按计划掀起皮瓣并重新缝合回供区。所有动物在术后7天进行评估。
A组皮瓣存活面积的平均百分比为（85.91±2.54）%，B组为（59.56±1.18）%，C组为（61.48±1.09）%。与B组和C组相比，A组皮瓣存活面积百分比显著增加（B组与A组比较，P < 0.01；C组与A组比较，P < 0.01，B组与C组比较，P > 0.05）。原位杂交、免疫组织化学染色显示，VEGF在接受AdCMV-VEGF治疗的皮瓣存活组织中表达，但在对照组中未发现。组织学分析定性显示，与对照组相比，接受AdCMV-VEGF治疗的组中肉芽组织和血管生成的量更多。
结果可能表明，携带VEGF cDNA的腺病毒载体由于VEGF的局部递送作用，可有助于提高皮瓣的存活率。
