Diegelmann R F, Lindblad W J, Hussey R W, Maygarden S J, Cohen I K
Division of Plastic and Reconstructive Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond.
Plast Reconstr Surg. 1989 Feb;83(2):309-14. doi: 10.1097/00006534-198902000-00019.
To test the hypothesis that altered collagen metabolism is a contributing factor in the apparent delayed wound healing in denervated regions of spinal cord injury (SCI) patients, a tissue implant (PVA) was used to directly measure collagen deposition. Sterile PVA implants were placed subcutaneously in the inner aspect of the upper arm above the cord injury (innervated) and in the inner aspect of the upper leg below the cord injury (denervated) of 20 spinal cord injury patients and compared to eight healthy volunteers. On day 14, the implants were removed and analyzed histologically by trichrome stain and biochemically for hydroxyproline as a measure of collagen deposition. No remarkable histologic differences were observed in the sponge material removed from the upper regions compared to the lower denervated regions of the spinal cord injury patients. Sponges from both areas were infiltrated with fibroblasts containing well-developed rough endoplasmic reticulum and large quantities of trichrome-positive collagen. Likewise, upper and lower histology of controls was identical and nondistinguishable from the corresponding sections obtained from the spinal cord injury patients. Quantitation of the hydroxyproline in the arms of the spinal cord injury patients (n = 20) showed 4.3 +/- 0.7 nmol hydroxyproline per milligram of sponge compared to 4.1 +/- 0.4 nmol/mg in the denervated regions of the lower limb. The hydroxyproline content in the arms of control volunteers was 5.2 +/- 0.7 nmol/mg compared to 3.9 +/- 0.8 nmol/mg in the leg (n = 8). These observations suggest that fibrogenic processes in denervated regions are not reduced significantly compared to innervated regions.
为了验证胶原代谢改变是脊髓损伤（SCI）患者失神经支配区域伤口愈合明显延迟的一个促成因素这一假设，使用了一种组织植入物（聚乙烯醇）来直接测量胶原沉积。将无菌的聚乙烯醇植入物皮下植入20例脊髓损伤患者脊髓损伤上方上臂内侧（有神经支配）和脊髓损伤下方大腿内侧（失神经支配），并与8名健康志愿者进行比较。在第14天，取出植入物，通过三色染色进行组织学分析，并对羟脯氨酸进行生化分析以测量胶原沉积。与脊髓损伤患者失神经支配的下部区域相比，从上部区域取出的海绵材料在组织学上没有观察到明显差异。两个区域的海绵均有含有发育良好的粗面内质网和大量三色阳性胶原的成纤维细胞浸润。同样，对照组的上下组织学相同，与从脊髓损伤患者获得的相应切片无法区分。对脊髓损伤患者（n = 20）上臂羟脯氨酸的定量分析显示，每毫克海绵中羟脯氨酸为4.3±0.7 nmol，而下肢失神经支配区域为4.1±0.4 nmol/mg。对照志愿者上臂的羟脯氨酸含量为5.2±0.7 nmol/mg，而腿部为3.9±0.8 nmol/mg（n = 8）。这些观察结果表明，与有神经支配的区域相比，失神经支配区域的纤维化过程并没有显著减少。
