Department of Oral and Maxillofacial Surgery, University of Erlangen, Nuremberg, Germany.
Department of Oral and Maxillofacial Surgery, University of Erlangen, Nuremberg, Germany.
J Craniomaxillofac Surg. 2021 May;49(5):422-429. doi: 10.1016/j.jcms.2021.02.006. Epub 2021 Feb 12.
The aim of this study was to investigate intraluminal vessel diameters and endothelial expression levels of pro-inflammatory and -thrombotic mediators in patent and non-patent microvascular anastomoses. Endothelial expression of CD31, VCAM-1, E- and P-Selectin, eNOS, iNOS and PAI-1 was evaluated by immunohistochemistry and compared to non-anastomosed arteries as controls. Intraluminal diameters were determined via H.E.-staining. In 20 human anastomoses (8 patent, 12 non-patent) neither the analysis of endoluminal de-endothelialization (p = 0.966) nor luminal narrowing (p = 0.750) revealed any significant differences between patent and non-patent microanastomoses. Expressions of pro-inflammatory mediators were significantly higher in patent anastomoses compared to controls but did not show any difference compared to non-patent anastomoses (p > 0.050). iNOS was higher in non-patent compared to patent anastomoses (p = 0.030) and controls (p = 0.001), whereas eNOS did not reveal any differences between these groups (p = 0.611 and p = 0.130). In non-patent anastomoses PAI-1 was expressed higher compared to patent anastomoses and controls (p = 0.021 and p < 0.001). Irrespective of their patency, anastomoses are characterized by endothelial dysfunction with a pro-inflammatory and pro-thrombotic milieu. Avoiding endothelial trauma during suturing is essential in order not to aggravate existing endothelial dysfunction in microanastomoses. Additionally, the influence of medication-related changes on anastomoses should be investigated as this is still an indistinctive topic.
本研究旨在探讨通畅和非通畅微血管吻合术中管腔内径和内皮促炎及促血栓形成介质的表达水平。通过免疫组织化学方法评估 CD31、VCAM-1、E-和 P-选择素、eNOS、iNOS 和 PAI-1 的内皮表达，并与非吻合动脉作为对照进行比较。通过 H.E.染色确定管腔内径。在 20 个人吻合术中（8 个通畅，12 个非通畅），通畅和非通畅微血管吻合术之间在内腔去内皮化（p = 0.966）或管腔狭窄（p = 0.750）的分析中均未发现任何显著差异。与对照组相比，通畅吻合术中促炎介质的表达明显升高，但与非通畅吻合术无差异（p > 0.050）。与通畅吻合术和对照组相比，非通畅吻合术的 iNOS 表达更高（p = 0.030 和 p = 0.001），而 eNOS 在这些组之间没有差异（p = 0.611 和 p = 0.130）。在非通畅吻合术中，PAI-1 的表达高于通畅吻合术和对照组（p = 0.021 和 p < 0.001）。无论通畅与否，吻合术都具有内皮功能障碍，伴有促炎和促血栓形成环境。在缝合过程中避免内皮创伤对于不加重微血管吻合术中现有的内皮功能障碍至关重要。此外，应该研究与药物相关的变化对吻合术的影响，因为这仍然是一个不明确的课题。
