Ankara, Turkey From the Departments of Plastic Reconstructive and Aesthetic Surgery and Histology and Embryology, Hacettepe University Faculty of Medicine.
Plast Reconstr Surg. 2013 Sep;132(3):361e-371e. doi: 10.1097/PRS.0b013e31829acf0a.
Angiotensin-converting enzyme inhibitors are widely used in medicine because of their antihypertensive and antifibrogenic effects. Angiotensin-converting enzyme activates angiotensin I to angiotensin II, which plays an important regulatory role in wound healing and collagen production. The authors investigated whether systemic administration of angiotensin-converting enzyme inhibitors has any effect on formation of hypertrophic scars using the rabbit ear wound model.
Sixteen New Zealand albino rabbits were divided into four groups, and four punch defects were created on each ear. The first group received oral enalapril immediately after the creation of punch defects. The second group received oral enalapril on day 28 after the formation of scars. The third group received intralesional steroid injections on days 28 and 35. The fourth group was the control group. The rabbits were killed on day 40. The harvested specimens were analyzed histomorphometrically and immunohistochemically.
Early enalapril application decreased the scar elevation index and fibroblast and capillary counts significantly, compared with the values in the control group. Late enalapril application decreased fibroblast counts significantly; however, there was no difference in scar elevation index compared with the control group. There was no difference between early enalapril application and steroid therapy in terms of scar elevation index and capillary and fibroblast counts. However, early and late enalapril groups displayed lower collagen type III immunoreactivity compared with the steroid and control groups.
Early application of enalapril following dermal injury reduces formation of hypertrophic scars, probably because of its down-regulatory effects on type III collagen production.
血管紧张素转换酶抑制剂因其具有降压和抗纤维化作用而被广泛应用于医学领域。血管紧张素转换酶将血管紧张素 I 激活为血管紧张素 II，在伤口愈合和胶原生成中发挥重要的调节作用。作者通过兔耳创伤模型，研究了全身应用血管紧张素转换酶抑制剂对增生性瘢痕形成的影响。
16 只新西兰白兔随机分为 4 组，每组 4 只兔耳。第 1 组在打孔后立即口服依那普利。第 2 组在瘢痕形成 28 天后口服依那普利。第 3 组在第 28 和 35 天给予皮损内皮质类固醇注射。第 4 组为对照组。第 40 天处死兔子，采集标本进行组织形态计量学和免疫组织化学分析。
与对照组相比，早期依那普利应用显著降低了瘢痕隆起指数和纤维母细胞及毛细血管计数。晚期依那普利应用虽可显著降低纤维母细胞计数，但与对照组相比，瘢痕隆起指数无差异。早期依那普利应用与皮质类固醇治疗在瘢痕隆起指数、毛细血管和纤维母细胞计数方面无差异。然而，早期和晚期依那普利组的 III 型胶原免疫反应性较皮质类固醇组和对照组低。
皮肤损伤后早期应用依那普利可减少增生性瘢痕的形成，可能是因为其对 III 型胶原生成的下调作用。
