Department of Pathology, Guizhou Provincial People's Hospital, Guiyang, 550002, Guizhou, China.
Department of Pathology, Guizhou Medical University, Guiyang, 550002, Guizhou, China.
Int Urol Nephrol. 2020 Jan;52(1):97-106. doi: 10.1007/s11255-019-02286-z. Epub 2019 Sep 21.
There are less scar formations in some wounds after wound repair. Our earlier study had shown that the amount of collagen fibers in canine prostatic urethra wound were less than in bladder neck wound after 2-μm laser resection of the prostate (TmLRP) and partial bladder neck mucosa at 4 weeks. The purpose of this study was to observe the amount of scar tissue and characterize the probable causes of "less scar healing" in prostatic urethra wound.
A total of 12 healthy adult male crossbred canines underwent resection of prostate and partial bladder neck mucosa using 2-μm laser. The prostatic urethra and bladder neck wound specimens were harvested at 3, 4, 8 and 12 weeks after operation, respectively. The histopathologic characteristics were observed by hematoxylin and eosin(HE)staining, and the expression of transforming growth factor-β (TGF-β) and casein kinase-2 interacting protein-1 (CKIP-1) were examined by immunohistochemistry in prostatic urethra and bladder neck wound, respectively. Overexpressed CKIP-1 human prostate epithelial cells (BPH-1 cells) were established and the expression of TGF-β was detected by Western blotting. Furthermore, a non-contact co-culture system of BPH-1 cells and human fibroblast (HFF-1) cells was used to observe the effects of BPH-1 cell and their high CKIP-1 levels on the expression of TGF-β in HFF-1 in vitro.
The histology showed that there were a large number of prostatic epithelium and a small amount of scar tissue in prostatic urethra wound, while no epithelial cells and more scar tissue in bladder neck wound at 4, 8 and 12 weeks after repair. There were a higher expression level of TGF-β in prostate epithelial cells and fibroblasts and a lower expression level of CKIP-1 in prostate epithelial cells at 3 weeks after surgery in prostatic urethral wound. Compared to week 3, the TGF-β expression decreased both in prostate epithelial cells and fibroblasts at 4, 8 and 12 weeks in prostatic urethral wound (p < 0.05 or p < 0.01). The CKIP-1 expression increased in prostate epithelial cells at 4, 8 and 12 weeks compared to 3 weeks in prostatic urethra wound (p < 0.01). A higher TGF-β1 expression level of fibroblasts was observed in bladder neck wound at 3 weeks. And there was no significant change in the expression of TGF-β of fibroblasts in 3, 4, 8 and 12 weeks after operation in bladder neck wound. Both the prostate urethra and bladder neck wound fibroblasts showed weak expression of CKIP-1 and there was no significant change in 3, 4, 8 and 12 weeks. The vitro experiments showed that the TGF-β expression in BPH-1 cells with CKIP-1 overexpression decreased 25% compared with control group (p < 0.05). Furthermore, the expression of TGF-β in HFF-1 cells of co-cultured group decreased by 20% compared with Control group (p < 0.05); the expression of TGF-β in HFF-1 cells of overexpression co-culture group were reduced by 15% compared with co-cultured group (p < 0.01).
A large number of prostate epithelial cells in prostatic urethra wound may be one of the causes of less formation of scar tissue after repair. The prostate epithelial cells might reduce expression level of TGF-β by raising CKIP-1 expression and inhibit expression of TGF-β in peripheral fibroblasts at remodeling stage to reduce the excessive proliferation of fibrous cells and the excessive scar formation.
一些伤口在修复后形成的疤痕较少。我们之前的研究表明,在前列腺 2μm 激光切除(TmLRP)和部分膀胱颈黏膜后 4 周,犬前列腺尿道伤口的胶原纤维量比膀胱颈伤口少。本研究旨在观察疤痕组织的数量,并探讨前列腺尿道伤口“愈合疤痕较少”的可能原因。
12 只健康成年雄性杂种犬接受 2μm 激光前列腺和部分膀胱颈黏膜切除术。分别于术后 3、4、8 和 12 周采集前列腺尿道和膀胱颈伤口标本。通过苏木精-伊红(HE)染色观察组织病理学特征,通过免疫组织化学法分别检测前列腺尿道和膀胱颈伤口中转化生长因子-β(TGF-β)和酪蛋白激酶-2 相互作用蛋白-1(CKIP-1)的表达。建立 CKIP-1 过表达的人前列腺上皮细胞(BPH-1 细胞),通过 Western blot 检测 TGF-β的表达。此外,还建立了 BPH-1 细胞与人成纤维细胞(HFF-1)的非接触共培养体系,观察 BPH-1 细胞及其高 CKIP-1 水平对 HFF-1 中 TGF-β表达的影响。
组织学显示,前列腺尿道伤口中有大量前列腺上皮细胞和少量疤痕组织,而在修复后 4、8 和 12 周的膀胱颈伤口中没有上皮细胞和更多的疤痕组织。前列腺尿道伤口中前列腺上皮细胞和成纤维细胞 TGF-β表达水平较高,而前列腺上皮细胞 CKIP-1 表达水平较低。与术后 3 周相比,前列腺尿道伤口中 TGF-β的表达在术后 4、8 和 12 周时在前列腺上皮细胞和成纤维细胞中均降低(p<0.05 或 p<0.01)。与术后 3 周相比,前列腺尿道伤口中前列腺上皮细胞 CKIP-1 的表达在术后 4、8 和 12 周时均增加(p<0.01)。膀胱颈伤口中术后 3 周时成纤维细胞 TGF-β1 的表达水平较高。膀胱颈伤口中术后 3、4、8 和 12 周成纤维细胞 TGF-β 的表达无明显变化。前列腺尿道和膀胱颈伤口的成纤维细胞均表现出 CKIP-1 的弱表达,术后 3、4、8 和 12 周无明显变化。体外实验显示,CKIP-1 过表达的 BPH-1 细胞中 TGF-β的表达减少了 25%(p<0.05)。此外,与对照组相比,共培养组 HFF-1 细胞中 TGF-β的表达降低了 20%(p<0.05);与共培养组相比,过表达共培养组 HFF-1 细胞中 TGF-β的表达降低了 15%(p<0.01)。
前列腺尿道伤口中大量的前列腺上皮细胞可能是修复后疤痕形成较少的原因之一。前列腺上皮细胞可能通过提高 CKIP-1 的表达,降低 TGF-β的表达,从而抑制周围成纤维细胞的 TGF-β表达,减少纤维细胞的过度增殖和过度疤痕形成,从而在重塑阶段降低 TGF-β的表达水平。