From the Department of Plastic and Reconstructive Surgery, and the Advanced Medical Research Center, School of Medicine, Nihon University.
Plast Reconstr Surg. 2019 May;143(5):983e-992e. doi: 10.1097/PRS.0000000000005514.
Artificial dermis is an important option for preparing full-thickness wounds for cultured epithelial autografting. Long-term fragility after cultured epithelial autografting remains a problem, probably because of the lack of basement membrane proteins. The authors hypothesized that treating artificial dermis with mesenchymal stem cells would promote basement membrane protein production. The authors tested this using dedifferentiated fat cells in a porcine experimental model.
This study used four male crossbred (Landrace, Large White, and Duroc) swine. Cultured epithelium and dedifferentiated fat cells were prepared from skin and subcutaneous fat tissue harvested from the cervical region. Full-thickness open dorsal wounds were created and treated with artificial dermis to prepare a graft bed for cultured epithelial autograft. Two groups were established: the control group (artificial dermis treated with 0.5 ml of normal saline solution applied to the wounds) and the dedifferentiated fat group (artificial dermis treated with 0.5 × 10 dedifferentiated fat cells suspended in 0.5 ml of normal saline solution sprayed onto the wounds). On postoperative day 10, the prepared cultured epithelium was grafted onto the generated dermis-like tissue. Fourteen days later, tissue specimens were harvested and evaluated histologically.
Light microscopy of hematoxylin and eosin-stained sections revealed the beginning of rete ridge formation in the dedifferentiated fat group. Synthesis of both collagen IV and laminin-5 was significantly enhanced in the dedifferentiated fat group. Transmission electron microscopy revealed a nearly mature basement membrane, including anchoring fibrils in the dedifferentiated fat group.
Combined use of artificial dermis and dedifferentiated fat cells promotes post-cultured epithelial autograft production and deposition of basement membrane proteins at the dermal-epidermal junction and basement membrane development, including anchoring fibrils.
人工真皮是为培养上皮自体移植准备全厚创面的重要选择。培养上皮自体移植后长期脆弱仍然是一个问题，可能是因为缺乏基底膜蛋白。作者假设用间充质干细胞处理人工真皮会促进基底膜蛋白的产生。作者在猪实验模型中用去分化脂肪细胞对此进行了测试。
本研究使用了 4 头雄性杂交（长白、大白和杜洛克）猪。从颈部采集的皮肤和皮下脂肪组织中制备培养上皮和去分化脂肪细胞。制作全厚开放性背部创面，并用人工真皮处理，为培养上皮自体移植制备移植物床。建立了两组：对照组（人工真皮用 0.5ml 生理盐水溶液处理，应用于创面）和去分化脂肪组（人工真皮用 0.5×10 个去分化脂肪细胞悬浮在 0.5ml 生理盐水溶液中喷洒到创面）。术后第 10 天，将准备好的培养上皮移植到生成的真皮样组织上。14 天后，采集组织标本进行组织学评估。
苏木精-伊红染色切片的光学显微镜观察显示，去分化脂肪组开始形成 rete 嵴。去分化脂肪组中胶原 IV 和层粘连蛋白-5 的合成明显增强。透射电镜显示，去分化脂肪组基底膜几乎成熟，包括锚定纤维。
人工真皮与去分化脂肪细胞联合使用可促进培养上皮自体移植后的合成和沉积，并在真皮-表皮交界处和基底膜发育中沉积基底膜蛋白，包括锚定纤维。
