Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv 69978, Israel.
Med Eng Phys. 2013 May;35(5):601-7. doi: 10.1016/j.medengphy.2012.07.004. Epub 2012 Jul 31.
Deep tissue injury (DTI) is a serious pressure ulcer which onsets in skeletal muscle tissues adjacent to weight-bearing bony prominences. Recent literature points at sustained large deformations in muscle tissue, which translate to static stretching of the plasma membrane (PM) at the cell-scale, as the primary cause of accumulated cell death in DTI. It has been specifically suggested that prolonged exposure to large tensional PM strains interferes with normal cellular homeostasis, primarily by affecting transport through the PM which could become more permeable when stretched. In this context, using confocal imaging and fluorescence-activated cell sorter (FACS), we visualized and quantified here the uptake of fluorescent Dextran dye by myoblasts that were statically stretched uniaxially, up to physiological strains of 3%, 6% and 9%, using two different molecular masses for the Dextran (4kDa and 20kDa). The confocal and FACS studies provided consistent evidence that the permeability of the PM increased at large static deformations. Furthermore, the FACS data indicated that the kinetics of the PM permeability very likely depends on the size of the biomolecular marker. Both results were consistent with reports published in the neurotrauma literature on the kinetics of uptake of fluorescent biomolecules by dynamically stretched neurons; hence there are some analogues in the biomechanical pathways of cellular-level injury between DTI and impact insults. The present work provides additional empirical support to the theory of cell-scale deformation-diffusion damage in the etiology of DTI, and may lead to better understanding of time courses for onset of cellular damage in DTI, by exploring mass transport processes across the PM of the involved cells.
深部组织损伤(DTI)是一种严重的压疮,发生在承重骨突附近的骨骼肌组织中。最近的文献指出,肌肉组织中持续的大变形会导致细胞膜(PM)在细胞尺度上的静态拉伸,这是 DTI 中细胞死亡积累的主要原因。具体地说,长时间暴露于大的拉伸 PM 应变会干扰正常的细胞内稳态,主要是通过影响 PM 的运输,当 PM 被拉伸时,其通透性可能会增加。在这种情况下,我们使用共聚焦成像和荧光激活细胞分选(FACS),在这里可视化和量化了静态拉伸的成肌细胞对荧光葡聚糖染料的摄取,这些细胞被单向静态拉伸至生理应变 3%、6%和 9%,使用两种不同的葡聚糖(4kDa 和 20kDa)的分子质量。共聚焦和 FACS 研究提供了一致的证据,表明 PM 的通透性在大的静态变形时增加。此外,FACS 数据表明,PM 通透性的动力学很可能取决于生物分子标记的大小。这两个结果都与神经创伤文献中关于动态拉伸神经元对荧光生物分子摄取的动力学的报告一致;因此,在 DTI 和冲击损伤的细胞水平损伤的生物力学途径中存在一些类似之处。本工作为 DTI 发病机制中细胞尺度变形-扩散损伤理论提供了额外的经验支持,并可能通过探索涉及细胞的 PM 中的质量传输过程,更好地理解 DTI 中细胞损伤的时间过程。