Lloris-Carsí José Miguel, Barrios Carlos, Prieto-Moure Beatriz, Lloris-Cejalvo José Miguel, Cejalvo-Lapeña Dolores
Department of Surgery, University of Valencia, Valencia, Spain.
Division of Experimental Surgery, Valencia Catholic University, Valencia, Spain.
PLoS One. 2017 May 11;12(5):e0177665. doi: 10.1371/journal.pone.0177665. eCollection 2017.
Renal injuries are relatively common in cases of abdominal trauma. Adhesives and sealants can be used to repair and preserve damaged organs. Using a rat model, this study explores the activity of different matrix metalloproteinases (MMP) during the healing of renal injuries treated by two biological adhesives (TachoSil and GelitaSpon) and a new synthetic elastic cyanoacrylate (Adhflex).
Renal traumatic injuries were experimentally induced in 90 male Wistar rats by a Stiefel Biopsy Punch in the anterior aspect of the left kidney. Animals were divided into five groups: 1, sham non-injured (n = 3); 2, non-treated standard punch injury (n = 6); 3, punch injury treated with TachoSil (n = 27); 4, punch injury treated with GelitaSpon (n = 27); and, 5, punch injury treated with Adhflex (n = 27). Wound healing was evaluated 2, 6, and 18 days after injury by determining the expression of MMPs, and the histopathological evolution of lesions.
Histologically, the wound size at 6 days post-injury was larger in Adhflex-treated samples than in the other treatments, but the scarring tissue was similar at 18 days post-injury. Only the MMPs subtypes 1, 2, 8, 9, and 13 were sufficiently expressed to be quantifiable. Both time since injury and treatment type had a significant influence on MMPs expression. Two days after injury, the expression of MMP8 and MMP9 was predominant. MMP2 expression was greater 6 days after injury. The Adhflex-treated group had a significantly higher MMPs expression than the other treatment groups at all healing stages.
All three sealant treatments induced almost similar expression of MMPs than untreated animals indicating a physiological healing process. Given that all renal trauma injuries must be considered emergencies, both biological and synthetic adhesives, such as Adhflex, should be considered as a treatment options.
肾损伤在腹部创伤病例中相对常见。粘合剂和密封剂可用于修复和保护受损器官。本研究使用大鼠模型，探讨两种生物粘合剂（速即纱和吉利海绵）和一种新型合成弹性氰基丙烯酸酯（Adhflex）治疗肾损伤愈合过程中不同基质金属蛋白酶（MMP）的活性。
采用施泰费尔活检打孔器在90只雄性Wistar大鼠左肾前部实验性诱导肾创伤性损伤。动物分为五组：1，假手术未受伤组（n = 3）；2，未治疗的标准打孔损伤组（n = 6）；3，速即纱治疗的打孔损伤组（n = 27）；4，吉利海绵治疗的打孔损伤组（n = 27）；5，Adhflex治疗的打孔损伤组（n = 27）。在损伤后2、6和18天，通过测定MMPs的表达以及病变的组织病理学演变来评估伤口愈合情况。
组织学上，Adhflex治疗组损伤后6天的伤口大小比其他治疗组大，但损伤后18天的瘢痕组织相似。只有MMPs亚型1、2、8、9和13有足够的表达可进行定量分析。损伤后的时间和治疗类型对MMPs表达均有显著影响。损伤后2天，MMP8和MMP9的表达占主导。损伤后6天MMP2表达更高。在所有愈合阶段，Adhflex治疗组的MMPs表达均显著高于其他治疗组。
所有三种密封剂治疗诱导的MMPs表达与未治疗动物几乎相似，表明是生理性愈合过程。鉴于所有肾创伤损伤都必须被视为紧急情况，生物粘合剂和合成粘合剂，如Adhflex，都应被视为治疗选择。
