Center for Engineering in Medicine, Department of Surgery, Massachusetts General Hospital, the Shriners Bruns Hospital, Boston, Massachusetts, USA.
Wound Repair Regen. 2013 Jan-Feb;21(1):35-43. doi: 10.1111/j.1524-475X.2012.00853.x. Epub 2012 Oct 30.
Deep partial thickness burns are subject to delayed necrosis of initially viable tissues surrounding the primary zone of thermally induced coagulation, which results in an expansion of the burn wound, both in area and depth, within 48 hours postburn. Neutrophil sequestration and activation leading to microvascular damage is thought to mediate this secondary tissue damage. Resolvins, a class of endogenous mediators derived from omega-3 polyunsaturated fatty acids, have been shown to regulate the resolution of inflammation. We hypothesized that exogenous resolvins could mitigate the deleterious impact of the inflammatory response in burn wounds. Using two different mouse burn injury models involving significant partial thickness injuries, we found that a systemically administered single dose of resolvin D2 (RvD2) as low as 25 pg/g bw given within an interval of up to 4 hours postburn effectively prevented thrombosis of the deep dermal vascular network and subsequent dermal necrosis. By preserving the microvascular network, RvD2 enhanced neutrophil access to the dermis, but prevented neutrophil-mediated damage through other anti-inflammatory actions, including inhibition of tumor necrosis factor-α, interleukin-1β, and neutrophil platelet-endothelial cell adhesion molecule-1. In a clinical context, RvD2 may be therapeutically useful by reducing the need for surgical debridement and the area requiring skin grafting.
深度部分厚度烧伤会导致最初存活组织的延迟坏死,这些组织环绕着热诱导凝固的主要区域,这会导致烧伤创面在烧伤后 48 小时内的面积和深度都扩大。中性粒细胞的隔离和激活导致微血管损伤被认为介导了这种二次组织损伤。消退素是一类源自ω-3 多不饱和脂肪酸的内源性介质,已被证明可以调节炎症的消退。我们假设外源性消退素可以减轻烧伤创面炎症反应的有害影响。使用两种不同的涉及显著部分厚度损伤的小鼠烧伤损伤模型,我们发现,在烧伤后 4 小时内给予低至 25pg/g bw 的系统给予单一剂量的消退素 D2(RvD2)可以有效预防深部真皮血管网的血栓形成和随后的真皮坏死。通过维持微血管网络,RvD2 增强了中性粒细胞进入真皮的能力,但通过其他抗炎作用,包括抑制肿瘤坏死因子-α、白细胞介素-1β和中性粒细胞血小板内皮细胞黏附分子-1,防止了中性粒细胞介导的损伤。在临床情况下,RvD2 可能通过减少手术清创和需要植皮的面积而具有治疗用途。