Karimipour Mojtaba, Hassanzadeh Morteza, Zirak Javanmard Masoumeh, Farjah Gholamhossein
Department of Anatomy, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
Neurophysiology Research Center, Department of Anatomy, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
Iran J Basic Med Sci. 2018 Aug;21(8):842-847. doi: 10.22038/IJBMS.2018.29629.7153.
Skin flap necrosis is the most common postoperative side effect in reconstructive surgeries. Glutamine (GLN) has been shown to accelerate wound healing process. The purpose of this study was to evaluate the effects of GLN either in free form or in the dipeptide form along with L- alanyl (Ala-GLN) on random skin flaps survival in rats.
Dorsal skin flaps with caudal bases (8 ×2 cm) were established in 24 adult male Wistar rats. Then, the animals were randomly assigned into 3 groups (n=8). Control, GLN (0.75 g/kg) and Ala-GLN (0.75 g/kg). All groups administrated orally 24 and 6 hr before flap elevation and continued repeatedly daily until 7 days postoperation. The flap survival rate and vascular density using histological analysis were evaluated. Vascular endothelial growth factor (VEGF) by immunohistochemical method was determined.
Seven days after surgery, the mean surviving area in the GLN and Ala-GLN groups were significantly greater than in the untreated control group (<0.001). Furthermore, in comparison with the control group, the number of blood vessels and VEGF-positive cells in treated groups with GLN and Ala-GLN were significantly higher. However, no significant differences were observed between treated groups with GLN and Ala-GLN.
The findings from this study indicate that oral administration of GLN in free form or in the dipeptide (Ala-GLN) could promote neovascularization and improve skin flap survival in rats.
皮瓣坏死是重建手术中最常见的术后副作用。谷氨酰胺(GLN)已被证明可加速伤口愈合过程。本研究的目的是评估游离形式或与L-丙氨酰(丙氨酰-谷氨酰胺)结合的二肽形式的谷氨酰胺对大鼠随意皮瓣存活的影响。
在24只成年雄性Wistar大鼠身上建立带尾基的背部皮瓣(8×2厘米)。然后,将动物随机分为3组(n = 8)。对照组、谷氨酰胺组(0.75克/千克)和丙氨酰-谷氨酰胺组(0.75克/千克)。所有组在皮瓣掀起前24小时和6小时口服给药,并在术后每天重复给药,直至术后7天。通过组织学分析评估皮瓣存活率和血管密度。采用免疫组织化学方法测定血管内皮生长因子(VEGF)。
术后7天,谷氨酰胺组和丙氨酰-谷氨酰胺组的平均存活面积显著大于未治疗的对照组(<0.001)。此外,与对照组相比,谷氨酰胺组和丙氨酰-谷氨酰胺组治疗组的血管数量和VEGF阳性细胞显著更高。然而,谷氨酰胺组和丙氨酰-谷氨酰胺组治疗组之间未观察到显著差异。
本研究结果表明,口服游离形式或二肽(丙氨酰-谷氨酰胺)形式的谷氨酰胺可促进大鼠新生血管形成并提高皮瓣存活率。