Wong Sing Wan, Cheung Brian Chun Ho, Pang Bruce Tak Keung, Kwong Ateline, Chung Anna, Lee Kenneth Ka Ho, Mak Arthur Fut Tak
Division of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong.
School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong.
J Biomech. 2017 Apr 11;55:113-120. doi: 10.1016/j.jbiomech.2017.02.023. Epub 2017 Feb 27.
Deep tissue pressure ulcers, a serious clinical challenge originating in the muscle layer, are hardly detectable at the beginning. The challenge apparently occurs in aged subjects more frequently. As the ulcer propagates to the skin surface, it becomes very difficult to manage and can lead to fatal complications. Preventive measures are thus highly desirable. Although the complex pathological mechanisms have not been fully understood, prolonged and excessive physical challenges and oxidative stress are believed to be involved in the ulcer development. Previous reports have demonstrated that oxidative stress could compromise the mechanical properties of muscle cells, making them easier to be damaged when physical challenges are introduced. In this study, we used senescence accelerated (SAMP8) mice and its control breed (SAMR1) to examine the protective effects of intermittent vibration on aged and control muscle tissues during prolonged epidermal compression under 100mmHg for 6h. Results showed that an application of 35Hz, 0.25g intermittent vibration during compression decreased the compression-induced muscle breakdown in SAMP8 mice, as indicated histologically in terms of number of interstitial nuclei. The fact that no significant difference in muscle damage could be established in the corresponding groups in SAMR1 mice suggests that SAMR1 mice could better accommodate the compression insult than SAMP8 mice. Compression-induced oxidative damage was successfully curbed using intermittent vibration in SAMP8 mice, as indicated by 8-OHdG. A possible explanation is that the anti-oxidative defense could be maintained with intermittent vibration during compression. This was supported by the expression level of PGC-1-alpha, catalase, Gpx-1 and SOD1. Our data suggested intermittent vibration could serve as a preventive measure for deep tissue ulcer, particularly in aged subjects.
深部组织压疮是一种起源于肌肉层的严重临床挑战,在初期很难被察觉。这种挑战显然在老年受试者中更频繁地出现。随着溃疡蔓延至皮肤表面,其管理变得非常困难,并可能导致致命的并发症。因此,预防措施非常必要。尽管复杂的病理机制尚未完全明了,但长期和过度的身体挑战以及氧化应激被认为与溃疡的发展有关。先前的报道表明,氧化应激会损害肌肉细胞的机械性能,使其在受到身体挑战时更容易受损。在本研究中,我们使用加速衰老(SAMP8)小鼠及其对照品系(SAMR1),来研究在100mmHg压力下持续6小时的表皮压迫过程中,间歇性振动对老年和对照肌肉组织的保护作用。结果显示,在压迫过程中施加35Hz、0.25g的间歇性振动,可减少SAMP8小鼠中由压迫引起的肌肉分解,从组织学上看,这表现为间质细胞核数量的减少。在SAMR1小鼠的相应组中未发现肌肉损伤有显著差异,这一事实表明,SAMR1小鼠比SAMP8小鼠能更好地适应压迫损伤。在SAMP8小鼠中,使用间歇性振动成功抑制了由压迫引起的氧化损伤,8-羟基脱氧鸟苷(8-OHdG)的检测结果表明了这一点。一种可能的解释是,在压迫过程中,间歇性振动可维持抗氧化防御。这得到了过氧化物酶体增殖物激活受体γ辅激活因子1α(PGC-1-alpha)、过氧化氢酶、谷胱甘肽过氧化物酶1(Gpx-1)和超氧化物歧化酶1(SOD1)表达水平的支持。我们的数据表明,间歇性振动可作为深部组织溃疡的预防措施,特别是对于老年受试者。