Department of Burn and Plastic Surgery, Third Xiangya Hospital, Central South University, Changsha 410013.
Department of Burn and Skin Repair Surgery, Hainan General Hospital, Haikou 570311.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2022 Jun 28;47(6):698-706. doi: 10.11817/j.issn.1672-7347.2022.220038.
Steroidal anti-inflammatory drugs have certain side effects in the treatment of hypertrophic scar, and the scar recurrence is easy after withdrawal of steroid anti-inflammatory drugs. Finding reliable alternative drugs is an effective means to improve this defect. Aspirin, a traditional non-steroidal anti-inflammatory drug, is safe for topical use and has anti-inflammatory effects similar to those of steroidal anti-inflammatory drugs, which may have similar effects on the treatment of hypertrophic scar. This study aims to investigate the inhibitory effect of aspirin on the proliferation of hypertrophic scar in rabbit ears and the underlying mechanism.
The rabbit ear hypertrophic scar models were prepared. The rabbits were randomly divided into a normal skin group (group A), a blank control group (group B), a 0.9% NaCl group (group C), a 0.2% aspirin group (group D), a 0.5% aspirin group (group E), a 2% aspirin group (group F), and a triamcinolone acetonide group (group G). Macroscopic observation of hyperplasia was performed 8 weeks after local injection of the scar, followed by collecting the scar tissue samples for HE staining, Masson staining, and immunohistochemistry, respectively to assess the proliferation of fibroblasts and collagen fibers, and calculate the hypertrophic index, microvessel density, and immunohistochemical score.
All rabbit ear hypertrophic scar models were successfully constructed. In groups B and C, the hypertrophic scar edge was irregular, with reddish protruding epidermis, significant contracture and hard touch. In group D, E, and F, with the increase of aspirin administration concentration, the scar became thinner and gradually flat, the proliferation of fibrocytes and collagen fibers was weakened, and the hypertrophic index was gradually decreased (<0.05). Immunohistochemistry showed that the expression of β-catenin was decreased in the group D, E and F in turn, and the immunohistochemical score was gradually decreased (<0.05). There was no significant difference in hypertrophic index, microvessel density, and immunohistochemical score (all >0.05).
Local injection of aspirin can reduce the generation of hypertrophic scar in a dose-dependent manner within a certain concentration range; aspirin inhibits the growth of hypertrophic scar in rabbit ears by inhibiting Wnt/β-catenin signal pathway; 2% aspirin and 40 mg/mL triamcinolone acetonide have similar curative efficacy on hypertrophic scar.
甾体类抗炎药在治疗增生性瘢痕时存在一定的副作用,且停药后瘢痕易复发。寻找可靠的替代药物是改善这一缺陷的有效手段。阿司匹林作为一种传统的非甾体类抗炎药,局部使用安全,具有与甾体类抗炎药相似的抗炎作用,可能对增生性瘢痕的治疗具有相似作用。本研究旨在探讨阿司匹林对兔耳增生性瘢痕增殖的抑制作用及其机制。
制备兔耳增生性瘢痕模型。将兔子随机分为正常皮肤组(A 组)、空白对照组(B 组)、0.9%氯化钠组(C 组)、0.2%阿司匹林组(D 组)、0.5%阿司匹林组(E 组)、2%阿司匹林组(F 组)和曲安奈德组(G 组)。局部注射瘢痕 8 周后进行肉眼观察增生情况,随后采集瘢痕组织标本进行 HE 染色、Masson 染色和免疫组化染色,分别评估成纤维细胞和胶原纤维的增殖情况,并计算增生指数、微血管密度和免疫组化评分。
所有兔耳增生性瘢痕模型均成功构建。B 组和 C 组增生性瘢痕边缘不规则,表皮呈红色突出,明显挛缩,质地坚硬。D 组、E 组和 F 组随着阿司匹林给药浓度的增加,瘢痕逐渐变薄变平,成纤维细胞和胶原纤维的增殖减弱,增生指数逐渐降低(<0.05)。免疫组化结果显示,D 组、E 组和 F 组β-catenin 表达依次降低,免疫组化评分逐渐降低(<0.05)。增生指数、微血管密度和免疫组化评分均无明显差异(均>0.05)。
在一定浓度范围内,局部注射阿司匹林可剂量依赖性地减少增生性瘢痕的生成;阿司匹林通过抑制 Wnt/β-catenin 信号通路抑制兔耳增生性瘢痕的生长;2%阿司匹林和 40mg/mL 曲安奈德对增生性瘢痕的疗效相似。