Salgado Rosa M, Cruz-Castañeda Otilia, Elizondo-Vázquez Francisco, Pat Lucia, De la Garza Anabel, Cano-Colín Saúl, Baena-Ocampo Leticia, Krötzsch Edgar
Laboratory of Connective Tissue, Centro Nacional de Investigación y Atención de Quemados, Instituto Nacional de Rehabilitación, Mexico City, Mexico.
Wound Care Clinic, Hospital Regional "General Ignacio Zaragoza", Mexico City, Mexico.
J Tissue Viability. 2017 May;26(2):131-137. doi: 10.1016/j.jtv.2017.01.004. Epub 2017 Feb 1.
It has been reported that carbohydrates confer physicochemical properties to the wound environment that improves tissue repair. We evaluated in vitro and in vivo wound healing during maltodextrin/ascorbic acid treatment. In a fibroblast monolayer scratch assay, we demonstrated that maltodextrin/ascorbic acid stimulated monolayer repair by increasing collagen turnover coordinately with TGF-β1 expression (rising TGF-β1 and MMP-1 expression, as well as gelatinase activity, while TIMP-1 was diminished), similar to in vivo trends. On the other hand, we observed that venous leg ulcers treated with maltodextrin/ascorbic acid diminished microorganism population and improved wound repair during a 12 week period. When maltodextrin/ascorbic acid treatment was compared with zinc oxide, almost four fold wound closure was evidenced. Tissue architecture and granulation were improved after the carbohydrate treatment also, since patients that received maltodextrin/ascorbic acid showed lower type I collagen fiber levels and increased extracellular alkaline phosphatase activity and blood vessels than those treated with zinc oxide. We hypothesize that maltodextrin/ascorbic acid treatment stimulated tissue repair of chronic wounds by changing the stage of inflammation and modifying collagen turnover directly through fibroblast response.
据报道,碳水化合物可赋予伤口环境物理化学特性,从而促进组织修复。我们评估了麦芽糖糊精/抗坏血酸治疗期间的体外和体内伤口愈合情况。在成纤维细胞单层划痕试验中,我们证明麦芽糖糊精/抗坏血酸通过与TGF-β1表达协同增加胶原蛋白更新来刺激单层修复(TGF-β1和MMP-1表达升高,以及明胶酶活性升高,而TIMP-1减少),这与体内趋势相似。另一方面,我们观察到用麦芽糖糊精/抗坏血酸治疗的下肢静脉溃疡在12周内微生物数量减少,伤口修复得到改善。当将麦芽糖糊精/抗坏血酸治疗与氧化锌进行比较时,伤口闭合率几乎提高了四倍。碳水化合物治疗后组织结构和肉芽组织也得到改善,因为接受麦芽糖糊精/抗坏血酸治疗的患者与接受氧化锌治疗的患者相比,I型胶原纤维水平较低,细胞外碱性磷酸酶活性和血管增加。我们推测,麦芽糖糊精/抗坏血酸治疗通过改变炎症阶段并直接通过成纤维细胞反应调节胶原蛋白更新来刺激慢性伤口的组织修复。