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[温度敏感型羟丁基壳聚糖水凝胶对大鼠全层皮肤缺损创面愈合的影响]

[Effects of temperature-sensitive hydroxybutyl chitosan hydrogel on wound healing of full-thickness skin defect in rats].

作者信息

Chen A X, Chen Y B, Jiang Y F, Han Y

机构信息

Department of Plastic and Reconstructive Surgery, the First Medical Center of PLA General Hospital, Beijing 100853, China.

Department of Wound Repair Surgery, Special Medical Center of Strategic Support Force, Beijing 100101, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2021 Dec 20;37(12):1166-1174. doi: 10.3760/cma.j.cn501120-20200927-00424.

Abstract

To investigate the effects of temperature-sensitive hydroxybutyl chitosan hydrogel on wound healing of full-thickness skin defect in rats. The experimental research method was used. Fifty-one no matter male or female Sprague-Dawley rats aged 7-10 weeks were selected, and two round full-thickness skin defect wounds with a diameter of 2 cm were created on the back of each rat at a distance about 1.0 cm to the spine. The rats were divided into temperature-sensitive hydrogel group, gel group, and blank control group according to the random number table, with 17 rats and 34 wounds in each group. Wounds of rats in the first two groups were applied respectively with 0.3 mL temperature-sensitive hydroxybutyl chitosan hydrogel and carboxymethyl chitosan hydrogel immediately after injury, and the wounds of rats in blank control group received no treatment. The wounds of rats in the three groups were all covered with vaseline oil gauze. The states of temperature-sensitive hydroxybutyl chitosan hydrogel in wounds of rats in temperature-sensitive hydrogel group and carboxymethyl chitosan hydrogel in wounds of rats in gel group were observed every day when the dressings were changed, and the difficulty of vaseline oil gauze removal was recorded. On the 3rd, 7th, 10th, 14th, and 21st day after injury, the wound healing of rats in the three groups was observed and the wound healing rates were calculated. On the 3rd, 7th, 10th, 14th, and 21st day after injury, tissue from 4 wounds of 2 rats in each group was collected for the following observation and detection. The infiltration of inflammatory cells, angiogenesis, and re-epithelialization were observed by hematoxylin eosin staining. The regeneration and remodeling of collagen fibers were observed by Masson staining, and the collagen volume fraction was calculated. The expressions of interleukin-6 (IL-6), transforming growth factor β (TGF-β), and matrix metalloproteinase-1 (MMP-1) were detected by enzyme-linked immunosorbent assay method. Data were statistically analyzed with analysis of variance for factorial design, one-way analysis of variance, and Bonferroni test. The carboxymethyl chitosan gel in wounds of rats in gel group was liquid gel and could flow with the body position, while the temperature-sensitive hydroxybutyl chitosan hydrogel in wounds of rats in temperature-sensitive hydrogel group was solid gel and could not flow with the body position, and the distribution of the latter was more uniform. The vaseline oil gauzes were easily removed in wounds of rats in temperature-sensitive hydrogel group, while the vaseline oil gauzes were difficult to remove in the other two groups. On the 3rd, 7th, 10th, 14th, and 21st day after injury, the wound granulation tissue of rats grew well in temperature-sensitive hydrogel group and gel group, with no obvious infection, and two rats in blank control group died of wound infection on the 3rd and 5th day after injury. On the 7th, 10th, 14th, and 21st day after injury, the wound healing rates of rats in temperature-sensitive hydrogel group and gel group were significantly higher than that in blank control group (<0.01). On the 10th day after injury, the wound healing rate of rats in temperature-sensitive hydrogel group was significantly higher than that in gel group (<0.05). A large number of neutrophils and lymphocytes infiltrated into the wounds of rats in the three groups on the 3rd day after injury. The infiltration of inflammatory cells was gradually reduced and the wound healed gradually in rats of temperature-sensitive hydrogel group and gel group from the 7th to 21st day after injury, and the epidermis and dermis could be seen, without hair follicles and other skin appendages. The wounds of rats in blank control group did not heal completely on 21st day after injury. From the 3rd to 10th day after injury, the newly formed collagen fibers increased gradually in the wounds of rats in the three groups. On the 14th and 21st day after injury, the collagen fibers in the wounds of rats in temperature-sensitive hydrogel group and gel group were denser and more orderly than those in blank control group. On the 10th, 14th, and 21st day after injury, the collagen volume fraction of wounds of rats in temperature-sensitive hydrogel group and gel group was significantly higher than that in blank control group (<0.01). On the 14th day after injury, the collagen volume fraction of wounds of rats in temperature-sensitive hydrogel group was significantly higher than that in gel group (<0.01). On the 3rd, 7th, and 10th day after injury, the expressions of IL-6 in wounds of rats in temperature-sensitive hydrogel group were significantly higher than those in gel group and blank control group (<0.01), and the expressions of IL-6 in wounds of rats in gel group were significantly lower than those in blank control group (<0.01). On the 3rd, 7th, and 10th day after injury, the expressions of TGF-β in wounds of rats in temperature-sensitive hydrogel group were significantly higher than those in gel group and blank control group (<0.01). The expressions of TGF-β in wounds of rats in gel group were significantly lower than those in blank control group on the 3rd and 7th day after injury (<0.01), and the expression of TGF-β in wounds of rats in gel group was significantly higher than that in blank control group on the 10th day after injury (<0.01). On the 14th day after injury, the expression of TGF-β in wounds of rats in gel group was significantly higher than that in temperature-sensitive hydrogel group and blank control group (<0.01). On the 21st day after injury, the expression of TGF-β in wounds of rats in temperature-sensitive hydrogel group was significantly lower than that in gel group and blank control group (<0.01), and the expression of TGF-β in wounds of rats in gel group was significantly lower than that in blank control group (<0.01). On the 7th day after injury, the expression of MMP-1 in wounds of rats in gel group was significantly higher than that in temperature-sensitive hydrogel group and blank control group (<0.01). On the 10th, 14th, and 21st day after injury, the expressions of MMP-1 in wounds of rats in temperature-sensitive hydrogel group were significantly higher than those in gel group and blank control group (<0.01). On the 10th day after injury, the expression of MMP-1 in wounds of rats in gel group was significantly lower than that in blank control group (<0.01). On the 14th and 21st day after injury, the expressions of MMP-1 in wounds of rats in gel group were significantly higher than those in blank control group (<0.01). Temperature-sensitive hydroxybutyl chitosan hydrogel can promote the healing of full-thickness skin defect wounds in rats by increasing the expressions of IL-6, TGF-β, and MMP-1, regulating the wound healing environment, inhibiting inflammatory reaction, improving the strength of tissue repair, and promoting collagen synthesis or decomposition.

摘要

探讨温度敏感型羟丁基壳聚糖水凝胶对大鼠全层皮肤缺损创面愈合的影响。采用实验研究方法。选取51只7 - 10周龄的Sprague-Dawley大鼠,雌雄不限,在每只大鼠背部距脊柱约1.0 cm处制作两个直径为2 cm的圆形全层皮肤缺损创面。根据随机数字表将大鼠分为温度敏感水凝胶组、凝胶组和空白对照组,每组17只大鼠,34个创面。前两组大鼠创面在伤后立即分别涂抹0.3 mL温度敏感型羟丁基壳聚糖水凝胶和羧甲基壳聚糖水凝胶,空白对照组大鼠创面不做处理。三组大鼠创面均覆盖凡士林油纱布。换药时每天观察温度敏感水凝胶组大鼠创面温度敏感型羟丁基壳聚糖水凝胶及凝胶组大鼠创面羧甲基壳聚糖水凝胶的状态,并记录凡士林油纱布去除的难易程度。于伤后第3、7、10、14和21天观察三组大鼠创面愈合情况并计算创面愈合率。于伤后第3、7、10、14和21天,每组取2只大鼠的4个创面组织进行如下观察与检测。采用苏木精-伊红染色观察炎性细胞浸润、血管生成及再上皮化情况。采用Masson染色观察胶原纤维的再生与重塑情况,并计算胶原体积分数。采用酶联免疫吸附测定法检测白细胞介素-6(IL-6)、转化生长因子β(TGF-β)和基质金属蛋白酶-1(MMP-1)的表达。数据采用析因设计方差分析、单因素方差分析和Bonferroni检验进行统计学分析。凝胶组大鼠创面的羧甲基壳聚糖凝胶为液体凝胶,可随体位流动,而温度敏感水凝胶组大鼠创面的温度敏感型羟丁基壳聚糖水凝胶为固体凝胶,不随体位流动,且后者分布更均匀。温度敏感水凝胶组大鼠创面的凡士林油纱布易于去除,而其他两组大鼠创面的凡士林油纱布难以去除。伤后第3、7、10、14和21天,温度敏感水凝胶组和凝胶组大鼠创面肉芽组织生长良好,无明显感染,空白对照组有2只大鼠分别于伤后第3天和第5天因创面感染死亡。伤后第7、10、14和21天,温度敏感水凝胶组和凝胶组大鼠创面愈合率显著高于空白对照组(P<0.01)。伤后第10天,温度敏感水凝胶组大鼠创面愈合率显著高于凝胶组(P<0.05)。伤后第3天,三组大鼠创面均有大量中性粒细胞和淋巴细胞浸润。伤后第7至21天,温度敏感水凝胶组和凝胶组大鼠炎性细胞浸润逐渐减少,创面逐渐愈合,可见表皮和真皮,无毛囊等皮肤附属器。空白对照组大鼠创面在伤后第21天未完全愈合。伤后第3至10天,三组大鼠创面新生胶原纤维逐渐增多。伤后第14和21天,温度敏感水凝胶组和凝胶组大鼠创面胶原纤维比空白对照组更致密、更有序。伤后第10、14和21天,温度敏感水凝胶组和凝胶组大鼠创面胶原体积分数显著高于空白对照组(P<0.01)。伤后第14天,温度敏感水凝胶组大鼠创面胶原体积分数显著高于凝胶组(P<0.01)。伤后第3、7和10天,温度敏感水凝胶组大鼠创面IL-6表达显著高于凝胶组和空白对照组(P<0.01),凝胶组大鼠创面IL-6表达显著低于空白对照组(P<0.01)。伤后第3、7和10天,温度敏感水凝胶组大鼠创面TGF-β表达显著高于凝胶组和空白对照组(P<0.01)。伤后第3和7天,凝胶组大鼠创面TGF-β表达显著低于空白对照组(P<0.01),伤后第10天,凝胶组大鼠创面TGF-β表达显著高于空白对照组(P<0.01)。伤后第14天,凝胶组大鼠创面TGF-β表达显著高于温度敏感水凝胶组和空白对照组(P<0.01)。伤后第21天,温度敏感水凝胶组大鼠创面TGF-β表达显著低于凝胶组和空白对照组(P<0.01),凝胶组大鼠创面TGF-β表达显著低于空白对照组(P<0.01)。伤后第第7天,凝胶组大鼠创面MMP-1表达显著高于温度敏感水凝胶组和空白对照组(P<0.01)。伤后第10、14和21天,温度敏感水凝胶组大鼠创面MMP-1表达显著高于凝胶组和空白对照组(P<0.01)。伤后第10天,凝胶组大鼠创面MMP-1表达显著低于空白对照组(P<0.01)。伤后第14和21天,凝胶组大鼠创面MMP-1表达显著高于空白对照组(P<0.01)。温度敏感型羟丁基壳聚糖水凝胶可通过上调IL-6、TGF-β和MMP-1的表达,调节创面愈合环境,抑制炎症反应,提高组织修复强度,促进胶原合成或分解,从而促进大鼠全层皮肤缺损创面的愈合。

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