a Department of Biosciences , Federal University of São Paulo, UNIFESP , SP , Brazil.
b Department of Morphology , Federal University of Espirito Santo, UFES , ES , Brazil.
Connect Tissue Res. 2019 May;60(3):230-239. doi: 10.1080/03008207.2018.1484916. Epub 2018 Jul 11.
Extensive burn may cause acute resistance to insulin, which accentuates hypermetabolism, impairs glucose metabolism, immune dysfunction and risks of sepsis. To minimize these effects, insulin is used as a treatment. The purpose was to analyze the collagen-elastic arrangement effects of insulin on the burned skin. Wistar rats were assigned in groups: control (C); control with insulin (C + I); scald burn injury (SBI); and SBI with insulin (SBI+ I). SBI were submitted to 45% total body surface area burn and the insulin-treated groups received insulin (5 UI/Kg/day) for 4 or 14 days (d). Insulin levels, glucose tolerance test and HOMA index were determined. The skin sections were analyzed for histophatological and morphoquantitative data. Histopathological findings showed increased reepithelization of SBI+ I and formation of a new muscle layer after 14 days. In the collagen-elastic arrangement, insulin for 4 days increased the volume fraction (Vv) of thin collagen and elastic fibers. After 14 days, independently of injury, insulin decreased the elastic fibers. Insulin was able to reverse damages in the collagen-elastic rearrangement and stimulate reepithelization after 4 days. Untreated scald-burned animals showed higher Vv of thick collagen after 4 days, while those treated had a higher Vv of thin collagen. The Vv of elastic fibers was increased in SBI+ I for 4 days. In conclusion, insulin treatment was able to stimulate reepithelization. It also reversed the damages to the collagen-elastic arrangement in the scald-burned group, improving the organization of thin collagen and increasing the Vv of elastic fibers in the injured group treated with insulin for a short time, that is, for 4 days.
大面积烧伤可能导致胰岛素急性抵抗，从而加剧代谢亢进、损害葡萄糖代谢、免疫功能障碍和脓毒症风险。为了尽量减少这些影响，使用胰岛素进行治疗。目的是分析胰岛素对烧伤皮肤的胶原-弹性排列的影响。Wistar 大鼠分为以下几组：对照组（C）；胰岛素对照组（C+I）；烫伤烧伤组（SBI）；胰岛素烫伤烧伤组（SBI+I）。SBI 接受 45%的全身表面积烧伤，胰岛素治疗组在 4 天或 14 天（d）每天接受 5 UI/Kg 的胰岛素治疗。测定胰岛素水平、葡萄糖耐量试验和 HOMA 指数。对皮肤切片进行组织病理学和形态定量数据分析。组织病理学发现，SBI+I 组在 14 天后有更多的再上皮化和新的肌肉层形成。在胶原-弹性排列方面，胰岛素治疗 4 天可增加细胶原和弹性纤维的体积分数（Vv）。14 天后，无论是否有损伤，胰岛素均会减少弹性纤维。胰岛素能够逆转胶原-弹性排列的损伤，并在 4 天后刺激再上皮化。未经治疗的烫伤烧伤动物在 4 天后的厚胶原 Vv 较高，而接受治疗的动物的薄胶原 Vv 较高。SBI+I 在 4 天内弹性纤维 Vv 增加。总之，胰岛素治疗能够刺激再上皮化。它还能逆转烫伤烧伤组胶原-弹性排列的损伤，在接受短期（即 4 天）胰岛素治疗的损伤组中改善薄胶原的组织，并增加弹性纤维的 Vv。
