载红细胞生成素水凝胶与脂肪来源干细胞分泌因子在舌缺损再生中的作用。

BACKGROUND: Tongue defects have several etiologies and significantly affect the quality of life. This study was conducted to compare the regenerative potential of erythropoietin (EPO)-loaded hydrogel and adipose derived stem cell (ADSC) secretome on tongue dorsum defects focusing on the role of anti-inflammatory M2 macrophage phenotype. METHODS: Rats were subjected to induction of mechanical circular defects on the dorsal surface of the tongue, then divided into three groups; Group I (control): received 0.1 ml phosphate buffered saline, Group II (EPO): received 5000 U/kg EPO-hydrogel, and Group III (ADSC-Secretome): received 0.1 ml ADSC-Secretome. Treatments were injected circumferentially around wound margins after induction. Seven and fourteen days after treatment, specimens were obtained and processed for histological and immunohistochemical staining followed by the relevant histomorphometric and statistical analyses. RESULTS: Seven days after treatment, groups II and III presented defects with some epithelial regeneration at the lateral margins, while the center of the defect showed granulation tissue with much inflammatory cells. The base of the defects showed some muscle fibers and new blood vessels, however group III showed more enhanced neovascularization. Fourteen days after therapeutic intervention, group II defects were completely covered with epithelium showing a thin keratin layer with regular rete pegs interdigitating with the underlying connective tissue papillae, but tongue papillae were not restored. Group III expressed much better healing with developing filiform papillae. The connective tissue showed more vascularity and well-arranged muscle bundles. Both treated groups showed a significant decrease in defect depth and significant increase in anti-inflammatory macrophages compared to the control group at both time intervals, however there was no significant difference between the two treated groups. CONCLUSION: Both treatments showed promising and comparable results in the treatment of tongue defects reducing inflammation and restoring tongue histological architecture with significant upregulation of M2 macrophage.

背景：舌缺损有多种病因，严重影响生活质量。本研究旨在比较载红细胞生成素（EPO）水凝胶和脂肪来源干细胞（ADSC）分泌因子对舌背缺损的再生潜能，重点关注抗炎 M2 巨噬细胞表型的作用。

方法：大鼠舌背表面诱导机械性环形缺损，然后分为三组；I 组（对照组）：给予 0.1ml 磷酸盐缓冲液；II 组（EPO 组）：给予 5000U/kg EPO 水凝胶；III 组（ADSC-Secretome 组）：给予 0.1ml ADSC-Secretome。诱导后，在伤口边缘周围进行环形注射治疗。治疗后 7 天和 14 天，取标本进行组织学和免疫组织化学染色，然后进行相关的组织形态计量学和统计学分析。

结果：治疗后 7 天，II 组和 III 组的缺损边缘有一些上皮再生，而缺损中心显示肉芽组织和大量炎症细胞。缺损的基底有一些肌纤维和新血管，但 III 组显示出更强的新生血管化。治疗干预 14 天后，II 组缺损完全被上皮覆盖，表现为具有规则的 rete 突相互交错的薄角化层与下面的结缔组织乳头，但舌乳头未恢复。III 组表现出更好的愈合，形成丝状乳头。结缔组织显示出更多的血管和排列整齐的肌束。与对照组相比，两组治疗组在两个时间点的缺损深度均显著降低，抗炎巨噬细胞数量显著增加，但两组之间无显著差异。

结论：两种治疗方法在治疗舌缺损方面均显示出有希望且相当的结果，可减少炎症，并通过显著上调 M2 巨噬细胞来恢复舌组织学结构。