Division of Plastic and Reconstructive Surgery, Department of Developmental and Reconstructive Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Wound Repair Regen. 2012 Jan-Feb;20(1):91-102. doi: 10.1111/j.1524-475X.2011.00758.x.
A high dose of ionizing external radiation damage to the skin and soft tissue results in changes in function as well as in the general body condition. Once radiation surpasses the tissue safety or survival level, progressive alteration in the damaged tissue results in tissue loss and then flap loss. Local expression and action of stem cells or local growth factors in the irradiated tissue is mitigated, and external administration is sought to investigate the possibility of skin and soft tissue survival after an elevating flap. Basic fibroblast growth factor (bFGF) is primarily considered as a potent angiogenic growth factor. In burns, resurfacing with a dermal component is required, and bFGF stimulates wound healing and enhances human skin-derived mesenchymal stem cells under serum-free conditions in a dose-dependent manner. Thirty-five male, 4- to 8-week-old CLAWN miniature pigs received radiation exposure to assess the effectiveness of bFGF in terms of the progressive clinical course relevant to human skin and soft tissue. At 2 weeks following 10-Gy irradiation, tissue was preserved in the group receiving subcutaneous placement of a round-type tissue expander and bFGF. The expander plus bFGF group demonstrated significantly greater dermo-epidermal proliferation than the radiation alone, radiation plus bFGF, or expander plus radiation plus vehicle-solution groups, and new blood vessel formation was significantly increased in the expander tissue with bFGF after irradiation (p < 0.01). Electron microscopy revealed that tissue with expander and bFGF maintained more stable skin adnexae with preserved intact epidermis and dermis. Thus, bFGF improved and maintained the tissue viability after immediate irradiation in the skin and soft tissue.
高剂量的电离外部辐射会对皮肤和软组织造成损伤,导致功能和整体身体状况发生变化。一旦辐射超过组织安全或生存水平,受损组织的进行性改变会导致组织损失,然后皮瓣损失。辐照组织中干细胞或局部生长因子的局部表达和作用减弱,寻求外部给药以研究提高皮瓣后皮肤和软组织存活的可能性。碱性成纤维细胞生长因子 (bFGF) 主要被认为是一种有效的血管生成生长因子。在烧伤中,需要用真皮成分进行覆盖,bFGF 可刺激伤口愈合,并在无血清条件下以剂量依赖的方式增强人类皮肤源性间充质干细胞。35 只雄性,4-8 周龄 CLAWN 小型猪接受辐射暴露,以评估 bFGF 在与人类皮肤和软组织相关的渐进临床过程中的有效性。在接受 10Gy 照射后 2 周,在接受皮下放置圆形组织扩张器和 bFGF 的组中保存组织。与单独辐射、单独辐射加 bFGF 或扩张器加辐射加载体溶液组相比,扩张器加 bFGF 组的真皮-表皮增殖显著更大,并且在照射后 bFGF 的扩张器组织中,新血管形成显著增加(p<0.01)。电子显微镜显示,带有扩张器和 bFGF 的组织保持更稳定的皮肤附属物,具有完整的表皮和真皮。因此,bFGF 改善并维持了皮肤和软组织立即照射后的组织活力。