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采用分子方法研究丝光绿蝇蛆清创疗法及其在创伤愈合中的分泌物。

A molecular approach to maggot debridement therapy with Lucilia sericata and its excretions/secretions in wound healing.

机构信息

Medical Laboratory Techniques, Vocational School of Health Services, Istinye University, Istanbul, Turkey.

Department of Medical Biology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.

出版信息

Wound Repair Regen. 2021 Nov;29(6):1051-1061. doi: 10.1111/wrr.12961. Epub 2021 Aug 3.

Abstract

Chronic wounds caused by underlying physiological causes such as diabetic wounds, pressure ulcers, venous leg ulcers and infected wounds affect a significant portion of the population. In order to treat chronic wounds, a strong debridement, removal of necrotic tissue, elimination of infection and stimulation of granulation tissue are required. Maggot debridement therapy (MDT), which is an alternative treatment method based on history, has been used quite widely. MDT is an efficient, simple, cost-effective and reliable biosurgery method using mostly larvae of Lucilia sericata fly species. Larvae can both physically remove necrotic tissue from the wound site and stimulate wound healing by activating molecular processes in the wound area through the enzymes they secrete. The larvae can stimulate wound healing by activating molecular processes in the wound area through enzymes in their excretions/secretions (ES). Studies have shown that ES has antibacterial, antifungal, anti-inflammatory, angiogenic, proliferative, hemostatic and tissue-regenerating effects both in vivo and in vitro. It is suggested that these effects stimulate wound healing and accelerate wound healing by initiating a direct signal cascade with cells in the wound area. However, the enzymes and peptides in ES are mostly still undefined. Examining the molecular content of ES and the biological effects of these ingredients is quite important to illuminate the molecular mechanism underlying MDT. More importantly, ES has the potential to have positive effects on wound healing and to be used more as a therapeutic agent in the future, so it can be applied as an alternative to MDT in wound healing.

摘要

慢性伤口是由潜在的生理原因引起的,例如糖尿病伤口、压疮、静脉溃疡和感染性伤口,这些伤口影响了相当一部分人群。为了治疗慢性伤口,需要进行强有力的清创、去除坏死组织、消除感染和刺激肉芽组织生长。蝇蛆清创疗法(MDT)是一种基于历史的替代治疗方法,已经得到了广泛的应用。MDT 是一种高效、简单、具有成本效益且可靠的生物外科方法,主要使用丝光绿蝇幼虫。幼虫既能通过物理方式从伤口部位清除坏死组织,又能通过分泌的酶激活伤口区域的分子过程来刺激伤口愈合。幼虫还可以通过其分泌物中的酶来刺激伤口愈合,从而激活伤口区域的分子过程。研究表明,ES 在体内和体外均具有抗菌、抗真菌、抗炎、血管生成、增殖、止血和组织再生作用。这些作用通过与伤口区域的细胞直接发生信号级联反应,从而刺激伤口愈合,加速伤口愈合。然而,ES 中的酶和肽大部分仍未被定义。研究 ES 的分子含量以及这些成分的生物学效应对于阐明 MDT 的分子机制非常重要。更重要的是,ES 有可能对伤口愈合产生积极影响,并在未来更多地用作治疗剂,因此它可以作为伤口愈合的替代方法应用于 MDT。

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