Laboratory of Experimental Surgery and Research, Surgical Department, University of Athens School of Medicine, 15B Ag. Thoma Str., Athens, Greece.
J Plast Reconstr Aesthet Surg. 2011 Dec;64(12):1647-56. doi: 10.1016/j.bjps.2011.07.009. Epub 2011 Aug 11.
Skin grafts are frequently used for a variety of indications in plastic and reconstructive surgery. Their necrosis is a common complication, while different therapies have been proposed. Currently, adipose-derived stem cells (ASCs) hold great promise for their angiogenic potential and role during tissue repair. In this study, autologous transplantation of ASCs was used in skin grafts in rats to determine if it increases angiogenesis, skin-graft survival and wound healing.
ASCs were isolated, cultured, labelled with fluorescent dye and injected under full-thickness skin grafts in 10 rats (group 1), while 10 others served as controls (group 2). Skin grafts were analysed after 1 week. Collagen's framework was assessed with Masson's trichrome stain and angiogenesis with von Willebrand factor (vWF) immunohistochemistry. In addition, immunohistochemical staining intensity of vascular endothelial growth factor (VEGF) and transforming growth factor b3 (TGFb3) was assessed in all grafts.
Mean area of graft necrosis was significantly less in group 1 than in group 2 (6.12% vs. 32.62%, p<0.01). Statistically significant increase of microvessel density, collagen density, VEGF and TGFb3 expression was noted in group 1 compared with group 2 (all: p<0.01).
These findings suggest that autologous ASCs transplantation increases full-thickness skin-graft survival and shows promise for use in skin-graft surgery. This might be both due to in situ differentiation of ASCs into endothelial cells and increased secretion by ASCs of growth factors, such as VEGF and TGFb3 that enhance angiogenesis and wound healing.
皮片移植常用于整形和重建外科的多种适应证。皮片坏死是常见的并发症,已经提出了不同的治疗方法。目前,脂肪来源的干细胞(ASCs)因其血管生成潜力和在组织修复中的作用而具有广阔的应用前景。在这项研究中,将自体 ASC 移植用于大鼠皮片移植,以确定其是否能增加血管生成、皮片存活率和伤口愈合。
从 10 只大鼠中分离、培养、荧光标记 ASCs,并将其注射到全厚皮片移植下(第 1 组),另 10 只作为对照(第 2 组)。第 1 组和第 2 组皮片在第 1 周后进行分析。用 Masson 三色染色法评估胶原纤维框架,用 von Willebrand 因子(vWF)免疫组化法评估血管生成。此外,还对所有移植皮片中血管内皮生长因子(VEGF)和转化生长因子 b3(TGFb3)的免疫组化染色强度进行了评估。
第 1 组皮片坏死面积明显小于第 2 组(6.12%比 32.62%,p<0.01)。第 1 组与第 2 组相比,微血管密度、胶原密度、VEGF 和 TGFb3 表达均显著增加(均 p<0.01)。
这些发现表明,自体 ASC 移植可增加全厚皮片的存活率,并有望应用于皮片移植手术。这可能是由于 ASCs 原位分化为内皮细胞,以及 ASCs 分泌更多的生长因子(如 VEGF 和 TGFb3),从而增强血管生成和伤口愈合。