Velander Patrik, Theopold Christoph, Bleiziffer Oliver, Bergmann Juri, Svensson Henry, Feng Yao, Eriksson Elof
Harvard Medical School, Brigham and Woman's Hospital, Boston, Massachusetts 02115, USA.
J Surg Res. 2009 Nov;157(1):14-20. doi: 10.1016/j.jss.2008.10.001. Epub 2008 Nov 4.
Autologous dermal fibroblasts may be useful in the treatment of diabetic skin wounds. We hypothesized that cultured fibroblasts or cultured keratinocytes would not only survive in a hyperglycemic wound environment but also enhance the rate of re-epithelialization. We previously developed a new porcine model of delayed cutaneous wound healing in the diabetic pig. Full thickness wounds were created on the dorsum and dressed with polyurethane chambers to keep the wounds wet and to allow for wound fluid monitoring. Suspensions of either autologous fibroblasts or autologous keratinocytes were injected into full thickness wounds and compared with wounds treated in a wet environment in normal saline. Serum glucose and wound fluid glucose concentrations were monitored daily. Wound contraction was monitored and biopsies taken on day 12. Transplantation of suspensions of autologous fibroblasts or autologous keratinocytes enhanced re-epithelialization of cutaneous full thickness wounds. Wounds treated with autologous fibroblasts showed a re-epithelialization rate of 86.75% and wounds treated with autologous keratinocytes showed a re-epithelialization rate of 91.3%. This is compared with a re-epithelialization rate of 56.8% seen in the normal saline treated wounds. While previous studies have shown fibroblasts suspension to have little effect in the treatment of full thickness wounds in nondiabetic wounds, this study shows a clear beneficial effect in the use of fibroblast or keratinocyte suspensions for the cutaneous healing of diabetic wounds in pigs.
自体真皮成纤维细胞可能对糖尿病皮肤伤口的治疗有用。我们假设培养的成纤维细胞或培养的角质形成细胞不仅能在高血糖伤口环境中存活，还能提高再上皮化的速率。我们之前建立了一种新的糖尿病猪皮肤伤口延迟愈合的猪模型。在猪背部制造全层伤口，并用聚氨酯腔室覆盖以保持伤口湿润并便于监测伤口渗出液。将自体成纤维细胞或自体角质形成细胞的悬液注射到全层伤口中，并与在生理盐水中的湿润环境下处理的伤口进行比较。每天监测血清葡萄糖和伤口渗出液葡萄糖浓度。监测伤口收缩情况，并在第12天进行活检。自体成纤维细胞或自体角质形成细胞悬液的移植增强了皮肤全层伤口的再上皮化。用自体成纤维细胞处理的伤口再上皮化率为86.75%，用自体角质形成细胞处理的伤口再上皮化率为91.3%。相比之下，生理盐水处理的伤口再上皮化率为56.8%。虽然之前的研究表明成纤维细胞悬液在治疗非糖尿病伤口的全层伤口方面效果甚微，但本研究表明，使用成纤维细胞或角质形成细胞悬液对猪糖尿病伤口的皮肤愈合具有明显的有益效果。
