Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu Province, China.
J Craniomaxillofac Surg. 2012 Sep;40(6):516-20. doi: 10.1016/j.jcms.2011.09.001. Epub 2011 Oct 12.
The detailed process and underlying mechanism of stenosis following microvascular anastomoses remains unclear. NF-E2-related factor 2 (Nrf2), is a pleiotropic regulator of cell survival and plays a crucial role in modulating acute inflammatory response. An animal experiment was employed to obtain new information on the histomorphological changes and distribution of Nrf2 in anastomoses.
An end-to-end anastomotic model in rat carotid arteries was carried out. The stoma was examined by H&E staining and immunostaining to evaluate histomorphological change as well as the intensity of anti-Nrf2 and а-SMA staining.
Compression, dehiscence and inflammatory cells infiltration were often seen following vessel anastomoses. Inflammatory cells infiltrate was reduced and the granulation tissue fibrosis and endothelium reforming become apparent with times. Marked tunica media hyperplasia consisting of a packed layer of neogenetic smooth muscle cell was present around the anastomosis. Nrf2 expression was upregulated after the operation and was mainly distributed in the neogenetic smooth muscle cells.
Stenosis following the micro-artery anastomoses may be mainly due to the progressive myointimal hyperplasia in the media of the arteries. Nrf2 was involved in the pro-inflammatory stress during the vascular morphogenesis/angiogenesis and can be a valuable tool for studying the process of wound healing.
微血管吻合后狭窄的详细过程和潜在机制仍不清楚。核因子 E2 相关因子 2（Nrf2）是一种细胞存活的多效调节剂，在调节急性炎症反应中起着至关重要的作用。动物实验获得了吻合处 Nrf2 的组织形态变化和分布的新信息。
在大鼠颈动脉进行端端吻合模型。通过 H&E 染色和免疫染色检查吻合口，以评估组织形态变化以及抗 Nrf2 和 а-SMA 染色的强度。
血管吻合后常可见压迫、裂开和炎症细胞浸润。随着时间的推移，炎症细胞浸润减少，肉芽组织纤维化和内皮细胞重建明显。吻合处周围有明显的中膜增生，由一层排列紧密的新生平滑肌细胞组成。手术后 Nrf2 表达上调，主要分布在新生平滑肌细胞中。
微血管吻合后狭窄可能主要是由于动脉中膜的进行性内膜增生所致。Nrf2 参与了血管发生/血管生成过程中的促炎应激反应，可作为研究创伤愈合过程的有价值的工具。
