Stony Brook University School of Medicine, Stony Brook, NY 11794-8165, USA.
Wound Repair Regen. 2013 Jul-Aug;21(4):563-70. doi: 10.1111/wrr.12053. Epub 2013 Apr 29.
Burn injury progression has not been well characterized at the cellular level. To define burn injury progression in terms of cell death, histopathologic spatiotemporal relationships of cellular necrosis and apoptosis were investigated in a validated porcine model of vertical burn injury progression. Cell necrosis was identified by high mobility group box 1 protein and apoptosis by Caspase 3a staining of tissue samples taken 1 hour, 24 hours, and 7 days postburn. Level of endothelial cell necrosis at 1 hour was predictive of level of apoptosis at 24 hours (Pearson's r = 0.87) and of level of tissue necrosis at 7 days (Pearson's r = 0.87). Furthermore, endothelial cell necrosis was deeper than interstitial cell necrosis at 1 hour (p < 0.001). Endothelial cell necrosis at 1 hour divided the zone of injury progression (Jackson's zone of stasis) into an upper subzone with necrotic endothelial cells and initially viable adnexal and interstitial cells at 1 hour that progressed to necrosis by 24 hours and a lower zone with initially viable endothelial cells at 1 hour but necrosis and apoptosis of all cell types by 24 hours. Importantly, this spatiotemporal series of events and rapid progression resembles myocardial infarction and stroke and implicates mechanisms of these injuries, ischemia, ischemia reperfusion, and programmed cell death in burn progression.
烧伤损伤的进展在细胞水平上尚未得到很好的描述。为了从细胞死亡的角度来定义烧伤损伤的进展，我们研究了一个经过验证的猪垂直烧伤进展模型中组织坏死和细胞凋亡的组织病理学时空关系。组织样本在烧伤后 1 小时、24 小时和 7 天时，通过高迁移率族蛋白 1 （HMGB1）和 Caspase 3a 染色来识别细胞坏死，通过 Caspase 3a 染色来识别细胞凋亡。1 小时时内皮细胞坏死的程度可预测 24 小时时的凋亡程度（Pearson r = 0.87）和 7 天时的组织坏死程度（Pearson r = 0.87）。此外，1 小时时内皮细胞坏死比间质细胞坏死深（p < 0.001）。1 小时时内皮细胞坏死将损伤进展区（Jackson 静止区）分为上亚区，该亚区在上 1 小时时内皮细胞坏死，附属细胞和间质细胞最初存活，但在 24 小时时进展为坏死，下亚区在上 1 小时时内皮细胞最初存活，但在 24 小时时所有细胞类型均发生坏死和凋亡。重要的是，这种时空系列事件和快速进展类似于心肌梗死和中风，并暗示了这些损伤、缺血、缺血再灌注和程序性细胞死亡在烧伤进展中的机制。
