Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospital, NHS Trust, Norwich NR4 7UJ, UK.
J Plast Reconstr Aesthet Surg. 2012 Apr;65(4):e80-6. doi: 10.1016/j.bjps.2011.12.013. Epub 2012 Jan 10.
Wounds deprived of innervation fail to heal normally, and hypertrophic scars may be abnormally innervated. Manipulation of wounds alters the subsequent degree of scarring, and isoforms of transforming growth factor beta (TGFβ) are well established in this role, whilst TGFβ3 is undergoing clinical trials as an antiscarring agent for clinical use. It is unclear if treated wounds show changes in their innervation patterns as they mature into scars.
Mice underwent 1cm(2) full thickness skin excisions which were treated with TGFβ1 or TGFβ3. Wounds were harvested between 5 and 84 days (n=6 at each time point). Sections underwent histological scar assessment and immunohistochemical staining for protein gene product 9.5 (PGP9.5), a pan-neuronal marker, and the sensory neuropeptides calcitonin gene related peptide (CGRP) and substance P (SP).
There was no difference in the reinnervation pattern between the peripheral and central parts of the wounds. Wounds treated with TGFβ3 healed with dermal collagen organised more like normal skin, whereas TGFβ1 treated wounds had abnormally orientated collagen within the scar compared to control treated wounds. Nerve fibre growth into the wounds followed a similar pattern in control and treated wounds, with only one significant difference during the healing process- at 42 days, the density of nerve fibres immunostained with PGP9.5 within the scar was greater than in control wounds. By 84 days, the density of PGP9.5, CGRP and SP immunopositive fibres were similar in control wounds and those treated with TGFβ isoforms.
Changes in reinnervation patterns of wounds treated with TGFβ isoforms were only slightly different from those of control wounds, and by 84 days, the patterns were similar.
失去神经支配的伤口无法正常愈合,而增生性瘢痕可能会异常神经支配。对伤口的处理会改变随后瘢痕形成的程度,转化生长因子β(TGFβ)的同工型在这方面得到了很好的证实,而 TGFβ3 正在临床试验中作为一种抗瘢痕药物用于临床。目前尚不清楚治疗后的伤口在成熟为瘢痕的过程中其神经支配模式是否会发生变化。
小鼠接受 1cm(2)全层皮肤切除术,并用 TGFβ1 或 TGFβ3 处理。在 5 至 84 天(每个时间点 n=6)收获伤口。对切片进行组织学瘢痕评估,并进行蛋白基因产物 9.5(PGP9.5)的免疫组织化学染色,PGP9.5 是一种全神经元标志物,以及感觉神经肽降钙素基因相关肽(CGRP)和 P 物质(SP)。
伤口外周和中央部分的再神经支配模式没有差异。用 TGFβ3 处理的伤口愈合后,真皮胶原排列更像正常皮肤,而 TGFβ1 处理的伤口与对照处理的伤口相比,瘢痕内胶原排列异常。神经纤维向伤口内生长的模式在对照和处理的伤口中相似,只有一个愈合过程中的显著差异-在 42 天,PGP9.5 免疫染色的神经纤维密度在瘢痕内大于对照伤口。到 84 天,对照伤口和 TGFβ 同工型处理的伤口中 PGP9.5、CGRP 和 SP 免疫阳性纤维的密度相似。
TGFβ 同工型处理的伤口再神经支配模式的变化与对照伤口仅略有不同,到 84 天,这些模式相似。