Pietramaggiori Giorgio, Scherer Saja S, Mathews Jasmine C, Alperovich Michael, Yang Ho-Jik, Neuwalder Jennifer, Czeczuga Joshua M, Chan Rodney K, Wagner Christopher T, Orgill Dennis P
Division of Plastic Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Wound Repair Regen. 2008 Mar-Apr;16(2):218-25. doi: 10.1111/j.1524-475X.2008.00362.x.
The incidence and prevalence of chronic and diabetic wounds are increasing and clinical treatments to tackle these epidemics are still insufficient. In this study, we tested the ability of freeze-dried platelet-rich plasma (PRP) and an allogenic micronized acellular dermal matrix alone and in combination to modulate diabetic wound healing. Therapeutic materials were applied to 1.0 cm(2) excisional wounds on genetically diabetic (db/db) mice. Wound-healing kinetics and new tissue formation were studied at 9 and 21 days posttreatment. Quantitative immunohistochemistry was used to study vascularity and cellular proliferation (days 9 and 21), and collagen deposition was evaluated 21 days postwounding. In vitro, micronized allogenic dermis, when combined with PRP, absorbed nearly 50% of original platelet-derived growth factor, transforming growth factor-beta, vascular endothelial growth factor, and epidermal growth factor from platelets and stimulated fibroblast proliferation. In vivo, micronized dermis increased the formation of vascularized wound tissue by day 9. Freeze-dried PRP alone or in combination with micronized dermis increased wound tissue revascularization and proliferation compared with spontaneous healing. The increase in cell proliferation persisted until day 21 only when freeze-dried PRP was used in combination with micronized dermis. These results indicate that micronized allogenic dermis may be used to provide a dermal matrix to stimulate tissue formation and the combination with PRP may confer additional beneficial growth factors to chronic or diabetic wounds.
慢性伤口和糖尿病伤口的发病率及患病率正在上升，而应对这些流行疾病的临床治疗方法仍显不足。在本研究中，我们测试了冻干富血小板血浆（PRP）和同种异体微粉化脱细胞真皮基质单独及联合使用对糖尿病伤口愈合的调节能力。将治疗材料应用于基因糖尿病（db/db）小鼠的1.0平方厘米切除伤口。在治疗后第9天和第21天研究伤口愈合动力学和新组织形成。采用定量免疫组织化学研究血管生成和细胞增殖（第9天和第21天），并在受伤后21天评估胶原沉积。在体外，微粉化同种异体真皮与PRP联合使用时，可吸收近50%的源自血小板的原始血小板衍生生长因子、转化生长因子-β、血管内皮生长因子和表皮生长因子，并刺激成纤维细胞增殖。在体内，到第9天时微粉化真皮增加了血管化伤口组织的形成。与自然愈合相比，单独使用冻干PRP或与微粉化真皮联合使用均可增加伤口组织的血管再生和增殖。仅当冻干PRP与微粉化真皮联合使用时，细胞增殖的增加持续到第21天。这些结果表明，微粉化同种异体真皮可用于提供真皮基质以刺激组织形成，与PRP联合使用可为慢性或糖尿病伤口提供额外有益的生长因子。
