Department of Hand Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, The Second Clinical College of Wenzhou Medical University, Wenzhou 325027, China.
Exp Biol Med (Maywood). 2020 Dec;245(18):1672-1682. doi: 10.1177/1535370220951896. Epub 2020 Aug 31.
Random skin flaps are widely used to repair tissue defects. However, the distal flap regions are prone to ischemic necrosis, limiting clinical applications. Azadirachtin A, a fruit extract from the neem, improves tissue blood supply and metabolism, reduces cell swelling, promotes tissue healing, and prevents venous thrombosis. We explored whether it enhances random skin flap survival. Fifty-four Sprague-Dawley rats were divided into control, low-dose, and high-dose Azadirachtin A-treated groups using a random number table. We used an improved version of the McFarlane technique to create flaps. On day 2, superoxide dismutase and malondialdehyde levels were measured. Tissue slices prepared on day 7 were stained with hematoxylin and eosin. The expression levels of vascular endothelial growth factor (VEGF), toll-like receptor 4 (TLR4), nuclear factor kappa-B (NF-kB), interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were immunohistochemically assayed. Microcirculatory blood flow was measured via laser Doppler blood flowmetry. Flap angiography was performed using the lead-oxide gelatin injection technique. And the azadirachtin A groups exhibited a greater mean flap survival area, an improved mean blood vessel density, a greater blood flow, and higher superoxide dismutase and VEGF levels, especially at the high dose. Azadirachtin A markedly reduced the levels of TNF-α, IL-6, IL-1β, TLR4, and NF-kB. These findings suggest that azadirachtin A promotes random skin flap survival by improving the blood supply, reducing tissue inflammation, and inhibiting flap ischemia reperfusion injury.
随意皮瓣被广泛用于修复组织缺损。然而，皮瓣的远端区域容易发生缺血性坏死，限制了其临床应用。印楝素 A 是从印楝果实中提取的一种物质，可改善组织血液供应和代谢，减轻细胞肿胀，促进组织愈合，防止静脉血栓形成。我们探讨了它是否能提高随意皮瓣的成活率。我们使用随机数字表将 54 只 Sprague-Dawley 大鼠分为对照组、低剂量印楝素 A 组和高剂量印楝素 A 组。我们使用改良的 McFarlane 技术制作皮瓣。在第 2 天，测量超氧化物歧化酶和丙二醛的水平。在第 7 天制备组织切片，并用苏木精和伊红染色。用免疫组化法检测血管内皮生长因子 (VEGF)、 toll 样受体 4 (TLR4)、核因子 kappa-B (NF-kB)、白细胞介素-1β (IL-1β)、白细胞介素-6 (IL-6)和肿瘤坏死因子-α (TNF-α)的表达水平。使用激光多普勒血流仪测量微循环血流。用氧化铅明胶注射技术进行皮瓣血管造影。与对照组相比，印楝素 A 组的皮瓣成活率更高，平均血管密度更高，血流更大，超氧化物歧化酶和 VEGF 水平更高，尤其是在高剂量组。印楝素 A 显著降低了 TNF-α、IL-6、IL-1β、TLR4 和 NF-kB 的水平。这些结果表明，印楝素 A 通过改善血液供应、减轻组织炎症和抑制皮瓣缺血再灌注损伤来促进随意皮瓣的存活。
