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异种间充质基质细胞改善大面积烧伤模型中的伤口愈合并调节免疫反应。

Xenogeneic Mesenchymal Stromal Cells Improve Wound Healing and Modulate the Immune Response in an Extensive Burn Model.

作者信息

Caliari-Oliveira Carolina, Yaochite Juliana Navarro Ueda, Ramalho Leandra Náira Zambelli, Palma Patrícia Vianna Bonini, Carlos Daniela, Cunha Fernando de Queiróz, De Souza Daurea Abadia, Frade Marco Andrey Cipriani, Covas Dimas Tadeu, Malmegrim Kelen Cristina Ribeiro, Oliveira Maria Carolina, Voltarelli Julio César

机构信息

Department of Biochemistry and Immunology, Basic and Applied Immunology Program, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.

出版信息

Cell Transplant. 2016;25(2):201-15. doi: 10.3727/096368915X688128. Epub 2015 May 7.

Abstract

Major skin burns are difficult to treat. Patients often require special care and long-term hospitalization. Besides specific complications associated with the wounds themselves, there may be impairment of the immune system and of other organs. Mesenchymal stromal cells (MSCs) are a recent therapeutic alternative to treat burns, mainly aiming to accelerate the healing process. Several MSC properties favor their use as therapeutic approach, as they promote angiogenesis, stimulate regeneration, and enhance the immunoregulatory function. Moreover, since patients with extensive burns require urgent treatment and because the expansion of autologous MSCs is a time-consuming process, in this present study we chose to evaluate the therapeutic potential of xenogeneic MSCs in the treatment of severe burns in rats. MSCs were isolated from mouse bone marrow, expanded in vitro, and intradermally injected in the periphery of burn wounds. MSC-treated rats presented higher survival rates (76.19%) than control animals treated with PBS (60.86%, p < 0.05). In addition, 60 days after the thermal injury, the MSC-treated group showed larger proportion of healed areas within the burn wounds (90.81 ± 5.05%) than the PBS-treated group (76.11 ± 3.46%, p = 0.03). We also observed that CD4(+) and CD8(+) T cells in spleens and in damaged skin, as well as the percentage of neutrophils in the burned area, were modulated by MSC treatment. Plasma cytokine (TGF-β, IL-10, IL-6, and CINC-1) levels were also altered in the MSC-treated rats, when compared to controls. Number of injected GFP(+) MSCs progressively decreased over time, and 60 days after injection, few MSCs were still detected in the skin of treated animals. This study demonstrates the therapeutic effectiveness of intradermal application of MSCs in a rat model of deep burns, providing basis for future regenerative therapies in patients suffering from deep burn injuries.

摘要

大面积皮肤烧伤难以治疗。患者通常需要特殊护理和长期住院治疗。除了与伤口本身相关的特定并发症外,免疫系统和其他器官可能也会受到损害。间充质基质细胞(MSCs)是近年来用于治疗烧伤的一种替代疗法,主要目的是加速愈合过程。MSCs的多种特性使其适合作为治疗手段,因为它们能促进血管生成、刺激再生并增强免疫调节功能。此外,由于大面积烧伤患者需要紧急治疗,且自体MSCs的扩增过程耗时较长,因此在本研究中,我们选择评估异种MSCs在治疗大鼠重度烧伤中的治疗潜力。从小鼠骨髓中分离出MSCs,在体外进行扩增,然后皮内注射到烧伤创面周边。接受MSCs治疗的大鼠存活率(76.19%)高于接受PBS治疗的对照动物(60.86%,p<0.05)。此外,热损伤60天后,接受MSCs治疗的组在烧伤创面内愈合区域的比例(90.81±5.05%)大于接受PBS治疗的组(76.11±3.46%,p = 0.03)。我们还观察到,MSCs治疗可调节脾脏和受损皮肤中的CD4(+)和CD8(+) T细胞,以及烧伤区域中性粒细胞的百分比。与对照组相比,接受MSCs治疗的大鼠血浆细胞因子(TGF-β、IL-10、IL-6和CINC-1)水平也发生了变化。随着时间的推移,注射的绿色荧光蛋白(GFP)(+) MSCs数量逐渐减少,注射60天后,在接受治疗动物的皮肤中仍能检测到少量MSCs。本研究证明了在大鼠深度烧伤模型中皮内应用MSCs的治疗效果,为未来治疗深度烧伤患者的再生疗法提供了依据。

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