Longaker M T, Chiu E S, Adzick N S, Stern M, Harrison M R, Stern R
Fetal Treatment Program, University of California, San Francisco 94143-0506.
Ann Surg. 1991 Apr;213(4):292-6. doi: 10.1097/00000658-199104000-00003.
Midgestation fetal wound healing is characterized by healing without fibrosis or scar formation. The mechanisms that underlie this remarkable process are mediated in part through a fetal wound extracellular matrix rich in hyaluronic acid. In this study a newly developed assay was used to determine the hyaluronic acid levels in fetal and adult wound fluid. Adult wound fluid had a rapid increase in hyaluronic acid, which peaked at 3 days and decreased to 0 by 7 days. In contrast levels of hyaluronic acid in fetal wound fluid increased rapidly and remained significantly elevated for 3 weeks. This prolonged presence of hyaluronic acid in the matrix of fetal wounds creates a 'permissive' wound environment that promotes fetal fibroblast movement and proliferation and inhibits cytodifferentiation. Such a matrix environment promotes healing by regeneration rather than by scarring. This observation has therapeutic implications. The prolonged application of hyaluronic acid or hyaluronate protein complexes to wounds in children or adults may modulate healing in a manner that makes the wounds more fetal-like.
妊娠中期胎儿伤口愈合的特点是愈合过程中无纤维化或瘢痕形成。这一显著过程背后的机制部分是通过富含透明质酸的胎儿伤口细胞外基质介导的。在本研究中，一种新开发的检测方法被用于测定胎儿和成人伤口液中的透明质酸水平。成人伤口液中的透明质酸迅速增加，在第3天达到峰值，到第7天降至0。相比之下，胎儿伤口液中的透明质酸水平迅速上升，并在3周内保持显著升高。透明质酸在胎儿伤口基质中的这种长期存在创造了一个“宽松”的伤口环境，促进胎儿成纤维细胞的移动和增殖，并抑制细胞分化。这样的基质环境通过再生而非瘢痕形成来促进愈合。这一观察结果具有治疗意义。将透明质酸或透明质酸盐蛋白复合物长期应用于儿童或成人伤口，可能会以一种使伤口更类似胎儿伤口的方式调节愈合。
