Department of Chemical and Biomolecular Engineering, Johns Hopkins Physical Sciences-Oncology Center, and the Institute for NanoBioTechnology, The Johns Hopkins University, Baltimore, MD 21218, USA.
Proc Natl Acad Sci U S A. 2011 Dec 27;108(52):20976-81. doi: 10.1073/pnas.1115973108. Epub 2011 Dec 14.
Neovascularization is a critical determinant of wound-healing outcomes for deep burn injuries. We hypothesize that dextran-based hydrogels can serve as instructive scaffolds to promote neovascularization and skin regeneration in third-degree burn wounds. Dextran hydrogels are soft and pliable, offering opportunities to improve the management of burn wound treatment. We first developed a procedure to treat burn wounds on mice with dextran hydrogels. In this procedure, we followed clinical practice of wound excision to remove full-thickness burned skin, and then covered the wound with the dextran hydrogel and a dressing layer. Our procedure allows the hydrogel to remain intact and securely in place during the entire healing period, thus offering opportunities to simplify the management of burn wound treatment. A 3-week comparative study indicated that dextran hydrogel promoted dermal regeneration with complete skin appendages. The hydrogel scaffold facilitated early inflammatory cell infiltration that led to its rapid degradation, promoting the infiltration of angiogenic cells into the healing wounds. Endothelial cells homed into the hydrogel scaffolds to enable neovascularization by day 7, resulting in an increased blood flow significantly greater than treated and untreated controls. By day 21, burn wounds treated with hydrogel developed a mature epithelial structure with hair follicles and sebaceous glands. After 5 weeks of treatment, the hydrogel scaffolds promoted new hair growth and epidermal morphology and thickness similar to normal mouse skin. Collectively, our evidence shows that customized dextran-based hydrogel alone, with no additional growth factors, cytokines, or cells, promoted remarkable neovascularization and skin regeneration and may lead to novel treatments for dermal wounds.
血管新生是深度烧伤创面愈合的关键决定因素。我们假设葡聚糖水凝胶可以作为有指导作用的支架,促进三度烧伤创面的血管新生和皮肤再生。葡聚糖水凝胶柔软且有弹性,为改善烧伤创面处理的管理提供了机会。我们首先开发了一种用葡聚糖水凝胶处理小鼠烧伤创面的方法。在该方法中,我们遵循临床实践,通过切除手术去除全层烧伤皮肤,然后用葡聚糖水凝胶和敷料层覆盖创面。我们的方法使水凝胶在整个愈合期内保持完整和固定在位,从而有机会简化烧伤创面处理的管理。为期 3 周的对比研究表明,葡聚糖水凝胶促进了具有完整皮肤附属物的真皮再生。水凝胶支架促进了早期炎症细胞浸润,导致其快速降解,促进了血管生成细胞向愈合创面的浸润。内皮细胞归巢到水凝胶支架中,通过第 7 天实现了血管新生,导致血流增加显著大于治疗组和未治疗对照组。到第 21 天,用水凝胶处理的烧伤创面形成了具有毛囊和皮脂腺的成熟上皮结构。经过 5 周的治疗,水凝胶支架促进了新的毛发生长和表皮形态及厚度,与正常小鼠皮肤相似。总的来说,我们的证据表明,定制的葡聚糖基水凝胶本身,无需额外的生长因子、细胞因子或细胞,即可显著促进血管新生和皮肤再生,可能为皮肤创面提供新的治疗方法。