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采用断层皮片移植和骨髓源干细胞抑制三度烧伤收缩的模型。

Model to Inhibit Contraction in Third-Degree Burns Employing Split-Thickness Skin Graft and Administered Bone Marrow-Derived Stem Cells.

机构信息

Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery/Interdisciplinary/Stem Cell Institute, University of Miami School of Medicine, Miami, Florida, USA.

Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida, USA.

出版信息

J Burn Care Res. 2023 Mar 2;44(2):302-310. doi: 10.1093/jbcr/irac119.

Abstract

Third-degree burns typically result in pronounced scarring and contraction in superficial and deep tissues. Established techniques such as debridement and grafting provide benefit in the acute phase of burn therapy, nevertheless, scar and contraction remain a challenge in deep burns management. Our ambition is to evaluate the effectiveness of novel cell-based therapies, which can be implemented into the standard of care debridement and grafting procedures. Twenty-seven third-degree burn wounds were created on the dorsal area of Red Duroc pig. After 72 h, burns are surgically debrided using a Weck knife. Split-thickness skin grafts (STSGs) were then taken after debridement and placed on burn scars combined with bone marrow stem cells (BM-MSCs). Biopsy samples were taken on days 17, 21, and 45 posttreatment for evaluation. Histological analysis revealed that untreated control scars at 17 days are more raised than burns treated with STSGs alone and/or STSGs with BM-MSCs. Wounds treated with skin grafts plus BM-MSCs appeared thinner and longer, indicative of reduced contraction. qPCR revealed some elevation of α-SMA expression at day 21 and Collagen Iα2 in cells derived from wounds treated with skin grafts alone compared to wounds treated with STSGs + BM-MSCs. We observed a reduction level of TGFβ-1 expression at days 17, 21, and 45 in cells derived from wounds treated compared to controls. These results, where the combined use of stem cells and skin grafts stimulate healing and reduce contraction following third-degree burn injury, have a potential as a novel therapy in the clinic.

摘要

三度烧伤通常会导致浅表和深层组织明显的瘢痕和挛缩。清创和植皮等既定技术在烧伤治疗的急性期提供了益处,但在深度烧伤的管理中,瘢痕和挛缩仍然是一个挑战。我们的目标是评估新型基于细胞的疗法的有效性,这些疗法可以纳入标准的清创和植皮程序中。在 Red Duroc 猪的背部区域创建了 27 个三度烧伤创面。72 小时后,使用 Weck 刀进行烧伤清创。清创后,取部分厚度皮片(STSG),然后将其置于烧伤瘢痕上,同时结合骨髓间充质干细胞(BM-MSCs)。在治疗后第 17、21 和 45 天取活检样本进行评估。组织学分析显示,未经处理的对照瘢痕在第 17 天比单独用 STSG 治疗和/或用 STSG 加 BM-MSCs 治疗的烧伤更凸起。用皮片加 BM-MSCs 治疗的伤口看起来更薄、更长,表明收缩减少。qPCR 显示,与用 STSG 加 BM-MSCs 治疗的伤口相比,单独用皮片治疗的伤口中α-SMA 表达在第 21 天和胶原 Iα2 升高。与对照相比,用皮片治疗的伤口中 TGFβ-1 的表达在第 17、21 和 45 天降低。这些结果表明,干细胞和皮片的联合使用可刺激三度烧伤后愈合并减少收缩,具有在临床上作为一种新疗法的潜力。

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