Zhao Jing-Chun, Zhang Bo-Ru, Shi Kai, Wang Jian, Yu Qing-Hua, Yu Jia-Ao
Burns and Plastic Reconstruction Unit, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China.
Exp Ther Med. 2018 Jan;15(1):933-939. doi: 10.3892/etm.2017.5441. Epub 2017 Nov 6.
The aim of the present study was to investigate the effects of radial extracorporeal shock wave therapy (rESWT) on scar characteristics and transforming growth factor (TGF)-β1/Smad signaling in order to explore a potential modality for the treatment of hypertrophic scars (HS). The HS model was generated in rabbit ears, then rabbits were randomly divided into 3 groups: Lower (L)-ESWT [treated with rESWT with lower energy flux density (EFD) of 0.1 mJ/mm], higher (H)-ESWT (treated with a higher EFD of 0.18 mJ/mm) and the sham ESWT group (S-ESWT; no ESWT treatment). Scar characteristics (wrinkles, texture, diameter, area, volume of elevation, hemoglobin and melanin) were assessed using the Antera 3D system. The protein and mRNA expression of TGF-β1, Smad2, Smad3 and Smad7 was assessed by enzyme-linked immunosorbent assay and reverse transcription-quantitative polymerase chain reaction, respectively. The Antera 3D results indicated that wrinkles and hemoglobin of the HS were significantly improved in both of the rESWT groups when compared with the S-ESWT group. However, these changes appeared much earlier in the L-ESWT group than the H-ESWT. Scar texture was also improved in the L-ESWT group. However, rESWT did not influence HS diameter, area, volume of elevation or melanin levels. rESWT had no effect on TGF-β1 or Smad7 expression in either of rESWT groups. Although no difference was observed in Smad2 mRNA expression in the L-ESWT group, the Smad3 mRNA and protein expression significantly decreased when compared with the H-ESWT and S-ESWT groups. By contrast, Smad2 and Smad3 mRNA expression were upregulated in the H-ESWT group. These results demonstrated that rESWT with 0.1 mJ/mm EFD improved some characteristics of the HS tissue. Downregulation of Smad3 expression may underlie this inhibitory effect. Inhibition of the TGF-β1/Smad signal transduction pathway may be a potential therapeutic target for the management of HS.
本研究的目的是探讨放射状体外冲击波疗法（rESWT）对瘢痕特征及转化生长因子（TGF）-β1/Smad信号通路的影响，以探索一种治疗增生性瘢痕（HS）的潜在方法。在兔耳上建立HS模型，然后将兔子随机分为3组：低能量通量密度（EFD）0.1 mJ/mm的低（L）-ESWT组[接受rESWT治疗]、高EFD 0.18 mJ/mm的高（H）-ESWT组以及假ESWT组（S-ESWT；未接受ESWT治疗）。使用Antera 3D系统评估瘢痕特征（皱纹、质地、直径、面积、隆起体积、血红蛋白和黑色素）。分别通过酶联免疫吸附测定和逆转录-定量聚合酶链反应评估TGF-β1、Smad2、Smad3和Smad7的蛋白质和mRNA表达。Antera 3D结果表明，与S-ESWT组相比，两个rESWT组的HS皱纹和血红蛋白均有显著改善。然而，这些变化在L-ESWT组中比H-ESWT组出现得更早。L-ESWT组的瘢痕质地也有所改善。然而，rESWT对HS直径、面积、隆起体积或黑色素水平没有影响。rESWT对两个rESWT组中的TGF-β1或Smad7表达均无影响。虽然L-ESWT组中Smad2 mRNA表达未观察到差异，但与H-ESWT组和S-ESWT组相比，Smad3 mRNA和蛋白质表达显著降低。相比之下，H-ESWT组中Smad2和Smad3 mRNA表达上调。这些结果表明，EFD为0.1 mJ/mm的rESWT改善了HS组织的一些特征。Smad3表达的下调可能是这种抑制作用的基础。抑制TGF-β1/Smad信号转导通路可能是治疗HS的潜在靶点。
