Division of Plastic Surgery, Laboratory of Bioregenerative Medicine & Surgery, Weill Cornell Medicine, New York, New York, USA.
Department of Surgery, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Skin Pharmacol Physiol. 2022;35(1):31-40. doi: 10.1159/000518015. Epub 2021 Jun 24.
Surgery within radiated tissue is associated with increased complication rates. It is hypothesized that impaired wound healing may result from aberrant inflammatory responses that occur in previously radiated tissues. Previous work has demonstrated that the topical application of naturally occurring antigen α-gal (Galα1-3Galβ1-(3)4GlcNAc-R) nanoparticles (AGNs) within wounds accelerates macrophage recruitment and subsequent healing in both normal and diabetic wounds. Herein, we hypothesize that application of this antigen would similarly enhance wound healing in irradiated tissues.
To simulate human physiology, α-1,3-galactosyltransferase knockout (KO) mice were exposed to the antigen to produce anti-α-gal antibodies (anti-Gal). Ten days prior to wounding, the dorsal skin was irradiated with 1 session of 40 Gy. Bilateral dorsal 6-mm splinted full-thickness wounds were created within the radiated skin and treated with 50 µL of AGNs (50 mg/mL) immediately after wounding and again on postoperative day 1. A control KO group underwent similar irradiation and wounding protocols but was treated with phosphate-buffered saline (PBS) vehicle. Wild-type (WT) mice, which do not produce anti-Gal, went through the same irradiation and wounding.
Histologic analysis demonstrated enhanced epithelial migration in the radiated/AGN-treated KO wounds, which was significantly elevated in comparison to radiated/PBS-treated KO wounds beginning by day 15 and continuing until the end of the study (p < 0.01). In WT mice, treatment with AGNs showed no effect on epithelial migration.
Topical application of AGNs onto irradiated wounds significantly ameliorates the delayed wound healing classically seen in radiated skin and results in faster wound closure with only transient application.
在放射组织内进行手术与增加并发症发生率有关。人们假设,异常的炎症反应可能导致先前放射组织中的伤口愈合受损。先前的工作表明,在伤口内局部应用天然存在的抗原α-半乳糖(Galα1-3Galβ1-(3)4GlcNAc-R)纳米颗粒(AGN)可加速正常和糖尿病伤口中的巨噬细胞募集和随后的愈合。在此,我们假设应用这种抗原也会类似地增强放射组织中的伤口愈合。
为了模拟人体生理学,α-1,3-半乳糖基转移酶敲除(KO)小鼠暴露于抗原中以产生抗-α-半乳糖抗体(抗-Gal)。在受伤前 10 天,用 1 次 40 Gy 照射背部皮肤。在放射皮肤内创建双侧背部 6mm 带夹板的全层伤口,并在受伤后立即和术后第 1 天用 50 µL 的 AGN(50 mg/mL)处理。接受类似照射和创伤方案但用磷酸盐缓冲盐水(PBS)载体处理的 KO 对照组。不产生抗-Gal 的野生型(WT)小鼠也经历了相同的照射和创伤。
组织学分析表明,在放射/AGN 处理的 KO 伤口中上皮迁移增强,与放射/PBS 处理的 KO 伤口相比,从第 15 天开始显著升高,并持续到研究结束(p < 0.01)。在 WT 小鼠中,AGN 的治疗对上皮迁移没有影响。
AGN 局部应用于放射伤口可显著改善放射皮肤中常见的延迟性伤口愈合,并导致更快的伤口闭合,仅需短暂应用。