Zhang Ting, Huang Qing, Gan Kaifeng, Zhou Ke, Hu Keqi, Ding Wei, Jin Jiale, Li Jin
Department of Orthopaedics, Li Huili Hospital Affiliated to Ningbo University, Ningbo, China.
The Second School of Medicine, Wenzhou Medical University, Wenzhou, China.
Front Surg. 2023 Jan 6;9:1043239. doi: 10.3389/fsurg.2022.1043239. eCollection 2022.
Random skin flap is commonly used in plastic and reconstructive surgery, however, distal part of skin flap often occurs ischemia and necrosis. Limonin, with bioactivities of anti-inflammation, anti-apoptosis and anti-oxidative stress, may be effective for skin flap survival. In our study, random flap model was performed in mice to explore the role of limonin in the survival of skin flap. On postoperative day 7, the necrosis of skin flaps was observed, while visualization of blood flow below the tissue surface was detected through Laser Doppler blood flow imaging (LDBFI). Then flap tissues were acquired to assess and levels of angiogenesis, apoptosis and oxidative stress. The results showed that limonin decreased necrosis and edema of skin flaps compared with the control group, with more blood flow in the flap under LDBFI detection. Limonin treatment also increased the mean vessels density, elevated the expression levels of angiogenic proteins (matrix metallopeptidase 9, vascular endothelial growth factor, Cadherin5) and antioxidant proteins [superoxide dismutase 1 (SOD1), endothelial nitric oxide synthase, heme oxygenase], and reduced the expression of apoptotic factors (BAX, CYC, Caspase3). In summary, limonin could effectively enhance the survival of random skin flap, the potential mechanism may attribute to the induction of angiogenesis, and inhibition of apoptosis and oxidative stress.
随意皮瓣常用于整形与重建外科手术，然而，皮瓣远端部分常发生缺血坏死。柠檬苦素具有抗炎、抗凋亡及抗氧化应激的生物活性，可能对皮瓣存活有效。在我们的研究中，在小鼠身上构建了随意皮瓣模型，以探究柠檬苦素在皮瓣存活中的作用。术后第7天，观察皮瓣坏死情况，同时通过激光多普勒血流成像（LDBFI）检测组织表面以下的血流情况。然后获取皮瓣组织以评估血管生成、凋亡及氧化应激水平。结果显示，与对照组相比，柠檬苦素减少了皮瓣的坏死和水肿，在LDBFI检测下皮瓣内血流更多。柠檬苦素治疗还增加了平均血管密度，提高了血管生成蛋白（基质金属蛋白酶9、血管内皮生长因子、钙黏蛋白5）和抗氧化蛋白[超氧化物歧化酶1（SOD1）、内皮型一氧化氮合酶、血红素加氧酶]的表达水平，并降低了凋亡因子（BAX、CYC、半胱天冬酶3）的表达。综上所述，柠檬苦素可有效提高随意皮瓣的存活率，其潜在机制可能归因于诱导血管生成以及抑制凋亡和氧化应激。
