Medicine Course, University Center of Mineiros, Mineiros, Goiás, Brazil; School of Veterinary and Zootechnics, Federal University of Goiás, Goiânia, Goiás, Brazil.
Health Sciences Academic Unit, Federal University of Jataí, Jataí, Goiás, Brazil.
Burns. 2024 Feb;50(1):132-145. doi: 10.1016/j.burns.2023.08.018. Epub 2023 Sep 9.
Burns are defined as a traumatic injury, usually of thermal origin, that affects the epithelial and adjacent tissue and is classified according to the depth reached. Tissue repair involved in this type of injury is often a challenge both due to its severity and the multiplicity of complications. Regenerative medicine has focused on the use of low-level laser photobiomodulation therapy (LLLT) and adipose-derived stem cells (ADSC), especially in the early stages of the process, to promote better healing and shorten repair time. Therefore, aim of this study was to evaluate the action of LLLT (660 nm) and ADSC in the repair process of burned skin tissue and investigate the association of the techniques (LLLT and ADSC).
An in vivo study was carried out using 96 rats (Wister) with a scald burn model at a temperature of 95ºC, exposing the animal's back for 14 s. Animals were randomized into seven groups and three periods, five, 14 and 21 days. The groups included GC: Control group, ADSC-: Group treated with CD49d negative cells, ADSC+ : Group treated with positive CD49d cells, CULT: Group treated with conventional isolation cells, LLLT: Group treated only with LLLT Low Power Laser, ADSC-LLLT: Group treated with CD49d negative cells and LLLT. ADSC+LLLT: Group treated with positive CD49d cells and LLLT. The groups treated with LLLT (660 nm; 5 J/cm2) received irradiation three times a week, on alternate days for five, 14 and 21 days, according to the time of biopsy. ADSC-treated groups received one to three applications of the cells in a total volume of 1000 μL starting soon after the surgical debridement of the burn. Photographic monitoring was carried out at 5, 14 and 21 days after the beginning of the experiment to assess the degree of lesion contraction. Macroscopic, morphometric and histopathological analyzes were performed.
We showed significant re-epithelialization as well as an improvement in the healing process in the ADSC+, LLLT and ADSC+LLLT groups. We observed effects in the reduction of the inflammatory phase, increase in angiogenesis, decrease in oedema, greater collagen deposition, and better organization of the extracellular matrix compared to the other treatments. Moreover, the immunomagnetic separation of ADSC cells through the expression of the CD49d protein proved to be a useful means to obtain a more homogeneous population of cells with a role in tissue regeneration compared to the ADSC- and CULT groups.
In conclusion, the association of ADSC+ with LLLT was effective in accelerating the burn repair process, stimulating cell proliferation and formation of more normal skin tissue.
烧伤被定义为一种创伤性损伤，通常源于热，影响上皮和相邻组织，并根据所达到的深度进行分类。由于其严重程度和多种并发症，此类损伤的组织修复常常是一个挑战。再生医学专注于使用低水平激光光生物调节疗法（LLLT）和脂肪来源的干细胞（ADSC），特别是在该过程的早期阶段，以促进更好的愈合并缩短修复时间。因此，本研究的目的是评估 LLLT（660nm）和 ADSC 在烧伤皮肤组织修复过程中的作用，并研究这些技术（LLLT 和 ADSC）的联合作用。
使用 96 只（Wister）大鼠进行了一项体内研究，使用 95°C 的烫伤烧伤模型，将动物背部暴露 14 秒。动物被随机分为七组和三个时期，即 5、14 和 21 天。各组包括 GC：对照组、ADSC-：用 CD49d 阴性细胞治疗组、ADSC+：用 CD49d 阳性细胞治疗组、CULT：用常规分离细胞治疗组、LLLT：仅用低功率激光 LLLT 治疗组、ADSC-LLLT：用 CD49d 阴性细胞和 LLLT 治疗组。ADSC+LLLT：用 CD49d 阳性细胞和 LLLT 治疗组。接受 LLLT（660nm；5J/cm2）治疗的组每周照射三次，在第 5、14 和 21 天根据活检时间交替进行，以治疗五天、14 天和 21 天。ADSC 治疗组在烧伤手术清创后不久开始接受一次至三次共 1000μL 细胞的治疗。在实验开始后 5、14 和 21 天进行照相监测，以评估病变收缩程度。进行了宏观、形态计量和组织病理学分析。
我们显示出明显的再上皮化，以及 ADSC+、LLLT 和 ADSC+LLLT 组愈合过程的改善。与其他治疗方法相比，我们观察到在炎症期的减少、血管生成的增加、水肿的减少、胶原沉积的增加以及细胞外基质的更好组织方面有效果。此外，通过表达 CD49d 蛋白对 ADSC 细胞进行免疫磁分离证明是一种有用的手段，可以获得具有组织再生作用的更均匀的细胞群体，与 ADSC-和 CULT 组相比。
总之，ADSC+与 LLLT 的联合使用可有效加速烧伤修复过程，刺激细胞增殖并形成更正常的皮肤组织。
