Department of Human Pathology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russia.
Department of Plastic and Reconstructive Surgery, Cosmetology and Cell Technologies, Pirogov Russian National Research Medical University, Moscow 117997, Russia.
Drug Des Devel Ther. 2020 Nov 12;14:4869-4883. doi: 10.2147/DDDT.S277047. eCollection 2020.
To investigate the comparative effectiveness of certain biological injectable stimulants for the healing of skin wounds and criteria for its assessment.
A comparative study of the effectiveness of mesenchymal stem cells (SC group), collagen (Collagen group), and deproteinized calf blood hemoderivative (DCBH group) was carried out using an acute wound model. Control wounds were injected with isotonic sodium chloride solution (Control group). A total of four groups (28 wounds per group) were included in the study. Aged male Wistar rats were used as experimental animals. A dynamic assessment of the wound areas and edges, microvasculature assessment via laser Doppler flowmetry, histological and morphometric analyses to determine the quantitative and qualitative fibroblasts composition, as well as the degree of newly synthesized collagen maturity, was conducted on days 0, 3, 7, and 14.
The administration of SCs provided a rapid but short-lasting effect, whereas the administration of collagen resulted in a delayed but long-lasting wound-healing effect. DCBH resulted in little to no effect. An increase in the perfusion volume of the wound edges accelerated the regeneration process, while the level of microcirculation did not affect the number and activity of fibroblasts. The wound healing acceleration, as well as the new collagen and stratified epithelium formation and maturation, was associated with the presence of a sufficient pool of mature and active fibroblasts in the wound, and not with the number of fibroblasts.
The present results clarify the action mechanisms of the studied drugs. In addition, the application purposes and different effects of each drug on the different wound healing phases were demonstrated. An assumption on the multi-component treatment advisability under the wound condition objective assessment possibility was made. Findings from this study may assist clinicians in making an informed transition to personalized wound management and achieve better clinical outcomes.
研究某些生物可注射刺激物在皮肤伤口愈合方面的比较疗效及其评估标准。
采用急性伤口模型对间充质干细胞（SC 组）、胶原蛋白（Collagen 组）和脱蛋白小牛血血液衍生物（DCBH 组）的疗效进行了比较研究。对照组注射等渗氯化钠溶液（Control 组）。研究共纳入 4 组（每组 28 个伤口）。实验动物为雄性 Wistar 大鼠。在第 0、3、7 和 14 天，通过激光多普勒血流仪评估伤口面积和边缘的动态变化、微血管评估、组织学和形态计量学分析，以确定定量和定性成纤维细胞组成以及新合成胶原成熟程度。
SC 的给药可提供快速但短暂的效果，而胶原蛋白的给药则导致延迟但持久的伤口愈合效果。DCBH 几乎没有效果。伤口边缘灌流体积的增加加速了再生过程，而微循环水平并不影响成纤维细胞的数量和活性。伤口愈合的加速以及新的胶原和分层上皮的形成和成熟与伤口中成熟和活跃的成纤维细胞的充足池有关，而与成纤维细胞的数量无关。
本研究结果阐明了所研究药物的作用机制。此外，还展示了每种药物在不同伤口愈合阶段的应用目的和不同效果。基于对伤口客观评估可能性下的多成分治疗的合理性提出了假设。本研究的结果可能有助于临床医生做出明智的个性化伤口管理决策，并取得更好的临床效果。
