Seaman Scott A, Cao Yiqi, Campbell Chris A, Peirce Shayn M
Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.
Department of Plastic Surgery, University of Virginia, Charlottesville, VA, USA.
Microcirculation. 2017 May;24(4). doi: 10.1111/micc.12341.
The surgical transfer of skin, fat, and/or muscle from a donor site to a recipient site within the same patient is a widely performed procedure in reconstructive surgeries. A surgical pretreatment strategy that is intended to increase perfusion in the flap, termed "flap delay," is a commonly employed technique by plastic surgeons prior to flap transplantation. Here, we explored whether CD68 /CD206 macrophages are required for arteriogenesis within the flap by performing gain-of-function and loss-of-function studies in a previously published flap delay murine model.
Local injection of M2-polarized macrophages into the flap resulted in an increase in collateral vessel diameter. Application of a thin biomaterial film loaded with a pharmacological agent (FTY720), which has been previously shown to recruit CD68 /CD206 macrophages to remodeling tissue, increased CD68 /CD206 cell recruitment and collateral vessel enlargement. Conversely, when local macrophage populations were depleted within the inguinal fat pad via clodronate liposome delivery, we observed fewer CD68 cells accompanied by diminished collateral vessel enlargement.
Our study underscores the importance of macrophages during microvascular adaptations that are induced by flap delay. These studies suggest a mechanism for a translatable therapeutic target that may be used to enhance the clinical flap delay procedure.
在同一患者体内将皮肤、脂肪和/或肌肉从供区转移至受区是重建手术中广泛开展的一项操作。一种旨在增加皮瓣灌注的手术预处理策略,即“皮瓣延迟”,是整形外科医生在皮瓣移植前常用的技术。在此,我们通过在先前发表的皮瓣延迟小鼠模型中进行功能获得和功能丧失研究,探讨了皮瓣内动脉生成是否需要CD68/CD206巨噬细胞。
向皮瓣局部注射M2极化巨噬细胞可导致侧支血管直径增加。应用负载有药理剂(FTY720)的薄生物材料膜,先前已证明该药理剂可将CD68/CD206巨噬细胞募集至重塑组织,可增加CD68/CD206细胞募集和侧支血管增粗。相反,当通过氯膦酸盐脂质体递送使腹股沟脂肪垫内的局部巨噬细胞群耗竭时,我们观察到CD68细胞减少,同时侧支血管增粗减弱。
我们的研究强调了巨噬细胞在皮瓣延迟诱导的微血管适应性变化过程中的重要性。这些研究提示了一种可转化治疗靶点的机制,可用于改进临床皮瓣延迟手术。