Lucas P A, Warejcka D J, Zhang L M, Newman W H, Young H E
Department of Surgery, Mercer University School of Medicine, Macon, Georgia 31207, USA.
J Surg Res. 1996 May;62(2):229-32. doi: 10.1006/jsre.1996.0200.
One of the common and most serious side effects of abdominal surgery is the formation of adhesions within the peritoneal cavity during healing. Efforts to prevent adhesion formation have concentrated on inhibiting the inflammatory response, inhibiting the formation or encouraging the lysis of fibrin, and protection of the damaged serosal surface. We are interested in regenerating the serosal surface by providing a source of mesothelial progenitor cells. Rats were divided into groups of 10 each. Abdominal adhesions were created by removing a circle of peritoneum and suturing it back into place. Two weeks later the rats were euthanized and the adhesions scored on a scale of 0-5. A population of mesenchymal stem cells (MSCs) isolated from the skeletal muscle of neonatal rats was tested. The cells were grown in primary culture to expand the population and then trypsinized and frozen at -80 degrees C. They are then thawed and grown in secondary culture before use. The control group were injected with saline i.p. immediately after surgery. The experimental groups received (1) 1.4 X 10(6) MSCs, (2) 5 X 10(6) MSCs, (3) 7.5 X 10(6) dead MSCs, (4) 5 X 10(6) rat smooth muscle cells immediately post-op, and (5) 5 X 10(6) MSCs 4-6 hours after surgery. Only live MSCs given immediately after surgery by i.p. injection significantly decreased the adhesion scores of the rats (mean score of 3.5 vs 0.9). MSCs injected i.p. 4-6 hours after surgery actually increased the adhesion scores (3.5 vs 4.7), and rat smooth muscle cells injected i.p. immediately after surgery had no effect on adhesions. The exact mechanism of action of the MSCs is unknown at this time. However, we postulate that the MSCs have the capacity to differentiate into mesothelial cells capable of repopulating the injured mesothelium.
腹部手术常见且最严重的副作用之一是愈合过程中腹腔内形成粘连。预防粘连形成的努力主要集中在抑制炎症反应、抑制纤维蛋白形成或促进其溶解以及保护受损的浆膜表面。我们感兴趣的是通过提供间皮祖细胞来源来再生浆膜表面。将大鼠分成每组10只的若干组。通过切除一圈腹膜并将其缝合回原位来制造腹部粘连。两周后对大鼠实施安乐死，并按0 - 5分的标准对粘连情况进行评分。对从新生大鼠骨骼肌中分离出的一群间充质干细胞（MSC）进行了测试。这些细胞在原代培养中生长以扩大数量，然后用胰蛋白酶处理并在 - 80℃下冷冻。使用前将其解冻并在传代培养中生长。对照组在手术后立即经腹腔注射生理盐水。实验组分别接受：（1）1.4×10⁶个MSC；（2）5×10⁶个MSC；（3）7.5×10⁶个死亡的MSC；（4）术后立即经腹腔注射5×10⁶个大鼠平滑肌细胞；（5）术后4 - 6小时经腹腔注射5×10⁶个MSC。只有在手术后立即经腹腔注射活的MSC能显著降低大鼠的粘连评分（平均评分3.5对0.9）。在手术后4 - 6小时经腹腔注射MSC实际上增加了粘连评分（3.5对4.7），而术后立即经腹腔注射大鼠平滑肌细胞对粘连没有影响。目前尚不清楚MSC的确切作用机制。然而，我们推测MSC有能力分化为能够重新填充受损间皮的间皮细胞。
