Albertson S, Hummel R P, Breeden M, Greenhalgh D G
Shriners Burn Institute, Cincinnati, OH 45229.
Surgery. 1993 Aug;114(2):368-72; discussion 372-3.
Growth factors have been shown to improve healing in impaired models but not after malnutrition. The effects of growth factors on altered tissue repair caused by malnutrition were examined.
Nondiabetic and diabetic mice fed a 1% protein diet received full-thickness skin wounds. Wounds were treated topically with vehicle, platelet-derived growth factor (PDGF, 10 micrograms) or basic fibroblast growth factor (bFGF, 1 microgram), for 5 days.
Malnourished animals developed significantly impaired wound closure. PDGF or bFGF did not enhance closure in nondiabetic C57BL/KsJ-db/m mice, whether fed normal or restricted diets. The same treatment regimen was effective in reversing the delayed wound closure in their genetically diabetic C57BL/KsJ-db/db littermates. The growth factors significantly enhanced tissue repair in diabetic mice fed a 1% protein diet starting as early as day 15 and continuing until day 21. Protein-depleted diabetic wounds had significantly decreased cellularity and granulation tissue formation. These deficiencies were reversed with growth factor treatment.
Despite the lack of effects in nondiabetic animals, growth factors improve healing in diabetic mice with restricted protein intake. The differential effects may result from different healing mechanisms: nondiabetic animals heal mainly by contraction; diabetic animals require granulation tissue formation and reepithelialization.
生长因子已被证明可改善受损模型中的愈合情况,但在营养不良后则不然。本研究检测了生长因子对由营养不良引起的组织修复改变的影响。
喂食1%蛋白质饮食的非糖尿病和糖尿病小鼠接受全层皮肤伤口。伤口局部用赋形剂、血小板衍生生长因子(PDGF,10微克)或碱性成纤维细胞生长因子(bFGF,1微克)处理5天。
营养不良的动物伤口愈合明显受损。PDGF或bFGF对非糖尿病C57BL/KsJ-db/m小鼠的伤口闭合没有促进作用,无论其饮食是正常还是受限。相同的治疗方案对其遗传性糖尿病C57BL/KsJ-db/db同窝小鼠的伤口闭合延迟有逆转作用。生长因子从第15天开始,一直持续到第21天,能显著促进喂食1%蛋白质饮食的糖尿病小鼠的组织修复。蛋白质缺乏的糖尿病伤口的细胞数量和肉芽组织形成明显减少。生长因子治疗可逆转这些缺陷。
尽管生长因子对非糖尿病动物没有作用,但它能改善蛋白质摄入受限的糖尿病小鼠的愈合情况。这种差异效应可能源于不同的愈合机制:非糖尿病动物主要通过收缩愈合;糖尿病动物需要肉芽组织形成和上皮再形成。