Zhang X F, Sun G F, Chen Y F, Ma J Y, Gao C F, Sheng X, Feng D X
Department of General Surgery, Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China.
Zhonghua Shao Shang Za Zhi. 2016 Dec 20;32(12):714-720. doi: 10.3760/cma.j.issn.1009-2587.2016.12.003.
To observe the effects of Huanglian ointment on wound healing of mice with full-thickness skin defect, and to explore the related mechanism. Thirty male C57BL/6J mice were divided into Huanglian ointment group and vehicle group according to the random number table after round wounds of full-thickness skin defect with diameter of 7.5 mm were inflicted on the back of each mouse, with 15 mice in each group. Wounds of mice in Huanglian ointment group and vehicle group were treated with Huanglian ointment and vehicle respectively from post injury day (PID) 1 on, 2 times each day. Five mice from each group were selected to observe wound changes on PID 0, 3, 7, 10, and 14, and wound healing rates were calculated. Five mice out of the 10 mice that hadn't been used for general observation in each group were sacrificed on PID 3 and 7 respectively, and 5 mice after being used for general observation in each group were sacrificed on PID 14. Wound and skin tissue within 2 mm from the edge of wound was collected. Histologic scoring was conducted based on the histomorphological observation with HE staining. The expression of double positive cells of alpha smooth muscle actin (α-SMA) and Ki-67 (myofibroblast) in tissue of wounds of mice was observed by immunofluorescence staining. Protein expressions of transforming growth factor beta (TGF-β) and collagen in tissue of wounds of mice were determined by enzyme-linked immunosorbent assay. Data were processed with analysis of variance for repeated measurement, analysis of variance of factorial design, test of two independent samples, one-way analysis of variance, and Bonferronni test or correction. (1) Wounds of mice in two groups were red and swollen on PID 0, while they were neither red nor swollen with scabs on PID 3 and 7. On PID 10, woundsof mice in Huanglian ointment group contracted obviously, while the contracted wounds of mice in vehicle group were smaller than those in Huanglian ointment group. On PID 14, wounds of most mice in Huanglian ointment group were healed, while wounds of some mice in vehicle group failed to heal. Wound healing rates of mice in two groups were close on PID 3 and 7 (with values respectively 0.64 and 1.90, values above 0.05). Wound healing rates of mice in Huanglian ointment group on PID 10 and 14 were (76±7)% and (93±5)% respectively, significantly higher than those of vehicle group [(48±9)% and (68±11)%, with values respectively 7.44 and 3.89, values below 0.01]. Wound healing rates of mice in two groups on PID 7, 10, and 14 were significantly higher than those on the previous time points of the same group (with values below 0.01). (2) Histologic scores of wounds of mice in two groups were close on PID 3 (=-0.76, >0.05). Histologic scores of wounds of mice in Huanglian ointment group on PID 7 and 14 were (7.0±1.6) and (11.6±2.1) points respectively, significantly higher than those of vehicle group [(4.2±1.3) and (7.2±1.3) points, with values respectively 1.96 and 2.50, <0.05 or <0.01]. Histologic scores of wounds of mice in two groups on PID 7 and 14 were significantly higher than those on the previous time points of the same group (with values below 0.01). (3) Percentages of double positive cells of α-SMA and Ki-67 in tissue of wounds of mice in Huanglian ointment group on PID 3 and 7 were (35±12)% and (62±10)% respectively, significantly higher than those of vehicle group [(17±12)% and (34±6)%, with values respectively -2.48 and -5.25, <0.05 or <0.01]. The percentage of double positive cells of α-SMA and Ki-67 in tissue of wounds of mice in Huanglian ointment group on PID 14 was (25±5)%, significantly lower than that of vehicle group [(44±17)%, =2.50, <0.05]. The percentage of double positive cells of α-SMA and Ki-67 in tissue of wounds of mice on PID 7 was significantly higher than that on PID 3 or 14 in Huanglian ointment group (with values below 0.01). Percentages of double positive cells of α-SMA and Ki-67 in tissue of wounds of mice on PID 7 and 14 were significantly higher than those on the previous time points in vehicle group (with values below 0.05). (4) Protein expressions of TGF-β in tissue of wounds of mice in Huanglian ointment group on PID 3 and 7 were (396±45) and (722±96) pg/mL respectively, significantly higher than those of vehicle group [(290±42) and (382±62) pg/mL, with values respectively -8.17 and -6.65, values below 0.01]. Protein expressions of TGF-β in tissue of wounds of mice in two groups were close on PID 14 (=1.60, >0.05). The protein expression of TGF-β in tissue of wounds of mice in Huanglian ointment group on PID 7 was significantly higher than that on PID 3 or 14 (with values below 0.01). Protein expressions of TGF-β in tissue of wounds of mice in vehicle group on PID 7 and 14 were significantly higher than those on the previous time points (with values below 0.05). Protein expressions of collagen in tissue of wounds of mice in two groups were close on PID 3 (=1.99, >0.05). Protein expressions of collagen in tissue of wounds of mice in Huanglian ointment on PID 7 and 14 were (47±10) and (70±14) ng/mL respectively, significantly higher than those of vehicle group [(34±10) and (42±12) ng/mL, with values respectively 3.15 and 3.52, <0.05 or <0.01]. Protein expressions of collagen in tissue of wounds of mice in two groups on PID 7 and 14 were significantly higher than those on the previous time points of the same group (<0.05 or <0.01). Huanglian ointment can promote wound healing of full-thickness skin defect of mice through increasing production of myofibroblasts and protein expressions of TGF-β and collagen.
观察黄连膏对小鼠全层皮肤缺损创面愈合的影响,并探讨其相关机制。将30只雄性C57BL/6J小鼠背部造成直径7.5 mm的全层皮肤缺损圆形创面后,按随机数字表分为黄连膏组和赋形剂组,每组15只。自伤后第1天起,黄连膏组和赋形剂组小鼠创面分别给予黄连膏和赋形剂治疗,每日2次。每组分别选取5只小鼠,于伤后第0、3、7、10和14天观察创面变化,计算创面愈合率。每组未用于一般观察的10只小鼠中,分别于伤后第3天和第7天处死5只,每组用于一般观察后的5只小鼠于伤后第14天处死。收集创面及创面边缘2 mm内的皮肤组织。采用HE染色进行组织形态学观察并进行组织学评分。通过免疫荧光染色观察小鼠创面组织中α平滑肌肌动蛋白(α-SMA)和Ki-67双阳性细胞(肌成纤维细胞)的表达。采用酶联免疫吸附测定法测定小鼠创面组织中转化生长因子β(TGF-β)和胶原蛋白的蛋白表达。数据采用重复测量方差分析、析因设计方差分析、两独立样本t检验、单因素方差分析及Bonferronni检验或校正。(1)两组小鼠创面在伤后第0天时均红肿,伤后第3天和第7天时均无红肿且结痂。伤后第10天,黄连膏组小鼠创面明显收缩,而赋形剂组小鼠收缩后的创面小于黄连膏组。伤后第14天,黄连膏组多数小鼠创面愈合,而赋形剂组部分小鼠创面未愈合。两组小鼠在伤后第3天和第7天的创面愈合率相近(分别为0.64和1.90,P值均大于0.05)。黄连膏组小鼠在伤后第10天和第14天的创面愈合率分别为(76±7)%和(93±5)%,显著高于赋形剂组[(48±9)%和(68±11)%,P值分别为7.44和3.89,P值均小于0.01]。两组小鼠在伤后第7天、第10天和第14天的创面愈合率均显著高于同组前一时间点(P值均小于0.01)。(2)两组小鼠创面在伤后第3天的组织学评分相近(P=-0.76,P>0.05)。黄连膏组小鼠创面在伤后第7天和第14天的组织学评分分别为(7.0±1.6)分和(11.6±2.1)分,显著高于赋形剂组[(4.2±1.3)分和(7.2±1.3)分,P值分别为1.96和2.50,P<0.05或P<0.01]。两组小鼠创面在伤后第7天和第14天的组织学评分均显著高于同组前一时间点(P值均小于0.01)。(3)黄连膏组小鼠创面组织中α-SMA和Ki-67双阳性细胞在伤后第3天和第7天的百分比分别为(35±12)%和(62±10)%,显著高于赋形剂组[(17±12)%和(34±6)%,P值分别为-2.48和-5.25,P<0.05或P<0.01]。黄连膏组小鼠创面组织中α-SMA和Ki-67双阳性细胞在伤后第14天的百分比为(25±5)%,显著低于赋形剂组[(44±17)%,P=2.50,P<0.05]。黄连膏组小鼠创面组织中α-SMA和Ki-67双阳性细胞在伤后第7天的百分比显著高于伤后第3天或第14天(P值均小于0.01)。赋形剂组小鼠创面组织中α-SMA和Ki-67双阳性细胞在伤后第7天和第14天的百分比显著高于前一时间点(P值均小于0.05)。(4)黄连膏组小鼠创面组织中TGF-β在伤后第3天和第7天的蛋白表达分别为(396±45)和(722±96)pg/mL,显著高于赋形剂组[(290±42)和(382±62)pg/mL,P值分别为-8.17和-6.65,P值均小于0.01]。两组小鼠创面组织中TGF-β在伤后第14天的蛋白表达相近(P=1.60,P>0.05)。黄连膏组小鼠创面组织中TGF-β在伤后第7天的蛋白表达显著高于伤后第3天或第14天(P值均小于0.01)。赋形剂组小鼠创面组织中TGF-β在伤后第7天和第14天的蛋白表达显著高于前一时间点(P值均小于0.05)。两组小鼠创面组织中胶原蛋白在伤后第3天的蛋白表达相近(P=1.99,P>0.05)。黄连膏组小鼠创面组织中胶原蛋白在伤后第7天和第14天的蛋白表达分别为(47±10)和(70±14)ng/mL,显著高于赋形剂组[(34±10)和(42±12)ng/mL,P值分别为3.15和3.52,P<0.05或P<0.01]。两组小鼠创面组织中胶原蛋白在伤后第7天和第14天的蛋白表达均显著高于同组前一时间点(P<0.05或P<0.01)。黄连膏可通过增加肌成纤维细胞的产生及TGF-β和胶原蛋白的蛋白表达促进小鼠全层皮肤缺损创面的愈合。