Ginestal Ricardo, Pérez-Köhler Bárbara, Pérez-López Paloma, Rodríguez Marta, Pascual Gemma, Cebrián David, Bellón Juan M, García-Moreno Francisca
Neurology Department, Hospital Clínico San Carlos, Madrid, Spain.
Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Madrid, Spain.
Wound Repair Regen. 2019 Jan;27(1):59-68. doi: 10.1111/wrr.12685. Epub 2018 Nov 18.
In this study, rat models of wound closure by first and second intention were developed to evaluate the influence that two immunosuppressants for treating multiple sclerosis (fingolimod, azathioprine) have on wound healing. Sixty-three Sprague-Dawley rats were daily treated with fingolimod (0.6 mg/kg), azathioprine (2.5 mg/kg), or placebo (saline). Following 6 weeks of treatment, a linear incision (1.5 cm) or a circular excisional defect (diameter 1.5 cm) was made on the dorsal skin. The treatments were uninterrupted and after 7 days (incisional) or 21 days (incisional, excisional), animals were euthanized (n = 7 per group and time-point). Morphometric (wound closure), histological (stainings), and immunofluorescent studies (macrophages) were performed to evaluate the healing process. For both the incisional and excisional defects, animals treated with fingolimod exhibited a healing process equivalent to that of placebo in terms of collagenization, wound closure, and macrophage response. By comparison, groups treated with azathioprine displayed a delay in healing times which was especially evident in the excisional defect, where inflammatory reaction and collagen deposition in the repair tissue remained active by day 21. These results show that immunosuppressants with a selective mechanism of action (fingolimod) can have less impact on wound healing than their classical nonselective counterparts (azathioprine).
在本研究中,构建了一期和二期伤口愈合的大鼠模型,以评估两种用于治疗多发性硬化症的免疫抑制剂(芬戈莫德、硫唑嘌呤)对伤口愈合的影响。63只Sprague-Dawley大鼠每日接受芬戈莫德(0.6 mg/kg)、硫唑嘌呤(2.5 mg/kg)或安慰剂(生理盐水)治疗。治疗6周后,在背部皮肤制作一条线性切口(1.5 cm)或一个圆形切除缺损(直径1.5 cm)。治疗持续进行,在7天(切口)或21天(切口、切除)后,对动物实施安乐死(每组和每个时间点n = 7)。进行形态测量(伤口闭合)、组织学(染色)和免疫荧光研究(巨噬细胞)以评估愈合过程。对于切口和切除缺损,接受芬戈莫德治疗的动物在胶原化、伤口闭合和巨噬细胞反应方面表现出与安慰剂相当的愈合过程。相比之下,接受硫唑嘌呤治疗的组愈合时间延迟,这在切除缺损中尤为明显,在第21天时修复组织中的炎症反应和胶原沉积仍然活跃。这些结果表明,具有选择性作用机制的免疫抑制剂(芬戈莫德)对伤口愈合的影响可能小于传统的非选择性免疫抑制剂(硫唑嘌呤)。