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背景:目前认为转化生长因子β与瘢痕形成关系最密切,是关键的活性分子,可影响瘢痕形成的各个阶段。抑制转化生长因子β的生物学作用,在理论上可减少瘢痕的形成。目的:探讨反义转化生长因子β1脱氧寡核苷酸对增生性瘢痕动物模型伤口愈合中瘢痕生成的抑制作用,观察使用反义转化生长因子β1的有效给药途径。设计:自身对照,动物实验。单位:解放军兰州军区总医院安宁分院整形科。材料:实验于2002-09/2003-07在兰州医学院解剖实验室完成。选择日本大耳白兔20只。方法:在每只兔耳腹侧面沿长轴避开可见血管,作两个1.0cm×2.5cm的长方形全层皮肤缺损创面,创面间隔1.5cm,深达软骨表面,共80个,建立兔耳腹侧面增生性瘢痕模型。待兔耳创面上皮化后(平均20d),在每只白兔左耳每个创面的上皮下用微量注射器局部封闭注射反义转化生长因子β1脱氧寡核苷酸5μL(1g/L),为转化生长因子β1组;右耳每个创面下注射生理盐水5μL,为生理盐水对照组。注药后3,7,11,20,30d5个时相点切取瘢痕组织,每个时相点4只。采用苏木精-伊红染色、Masson染色及转化生长因子β1mRNA、Ⅰ、Ⅲ型胶原mRNA的原位杂交组织化学染色。主要观察指标:苏木精-伊红染色、Masson染色和原位杂交组织化学染色结果。结果:纳入动物20只,均进入结果分析。①苏木精-伊红染色显示各组中的右耳增生性瘢痕内均可见有炎性细胞浸润并有明显的白细胞浸润带,而左耳的增生性瘢痕经反义转化生长因子β1干预后虽也有炎性细胞浸润,但未见白细胞浸润带。②Masson染色见右侧耳的增生性瘢痕从伤后3周起均可见蓝染较深的胶原纤维,至第7周时仍可见蓝染的胶原纤维,外形粗大(宽度约为8～10μm),排列杂乱无章。而左耳经反义转化生长因子β1干预的兔耳增生性瘢痕在伤后3周时,虽然亦可见蓝染的胶原纤维,但到第6,7周时胶原纤维蓝染变浅并且纤细(宽度为3～5μm),排列整齐有序。③原位杂交显示转化生长因子β1mRNA、Ⅰ型胶原mRNA、Ⅲ型胶原mRNA阳性细胞表达率明显降低。结论:反义转化生长因子β1能抑制兔耳增生性瘢痕的增殖过程,使瘢痕组织纤维化程度明显减轻。局部注射裸DNA治疗瘢痕的给药途径是可行的。
BACKGROUND: Transforming growth factor beta is currently considered to be most closely related to scar formation and is a key active molecule that affects all stages of scar formation. Inhibition of the biological role of transforming growth factor beta, in theory, can reduce scar formation. OBJECTIVE: To investigate the inhibitory effect of antisense transforming growth factor-β1-deoxy-oligodeoxynucleotide on scar formation in wound healing of hypertrophic scar animal model and to observe the effective route of administration of antisense transforming growth factor-β1. Design: self-control, animal experiments. Unit: People’s Liberation Army General Hospital of Lanzhou Military Hospital Branch Anning Branch. MATERIALS: The experiment was performed in the Anatomy Laboratory of Lanzhou Medical College from September 2002 to July 2003. Choose Japanese white rabbits 20. Methods: The ventral side of each rabbit along the long axis to avoid visible blood vessels, making two 1.0cm × 2.5cm rectangular full-thickness skin defect wounds, 1.5cm intervals between the wound, the depth of cartilage surface, a total of 80, the establishment of rabbit ears Ventral hypertrophic scar model. After the ear wounds were epithelized (average 20 days), 5 μL (1 g / L) antisense transforming growth factor β1-deoxyribonucleoside (5 μg) was injected into each wound on the left ear of each rabbit with a microinjector Transforming growth factor β1 group; the right ear injection of saline under each 5μL, saline control group. At 3, 7, 11, 20 and 30 days after injection, scar tissue was excised at 5 points each time point, 4 points each. The hematoxylin-eosin staining, Masson staining, transforming growth factor β1 mRNA, type Ⅰ and Ⅲ collagen mRNA were detected by in situ hybridization staining. MAIN OUTCOME MEASURES: Hematoxylin-eosin staining, Masson staining and in situ hybridization histochemical staining results. Results: Twenty animals were included in the results analysis. ① hematoxylin-eosin staining showed inflammatory cell infiltration and obvious infiltration of leukocytes in the right ear hypertrophic scars in each group, while hypertrophic scars in the left ear were inhibited by anti-sense transforming growth factor β1 Although there are inflammatory cell infiltration, but no leukocyte infiltration zone. (2) Masson staining showed hypertrophic scars of the right ear from the 3 weeks after injury are visible deep blue collagen fibers, to the first 7 weeks can still be seen blue dye collagen fibers, thick shape (width of about 8 ~ 10μm), disorganized . While the left ear via the antisense transforming growth factor β1 intervention in rabbit ear hypertrophic scars 3 weeks after injury, although also visible blue dye collagen fibers, but by the 6th and 7th week when the blue dye collagen fibers become shallow and thin Width of 3 ~ 5μm), arranged in an orderly manner. ③ In situ hybridization showed that the expression rates of TGF-β1 mRNA, type Ⅰ collagen mRNA and type Ⅲ collagen mRNA were significantly decreased. CONCLUSION: Antisense transforming growth factor β1 can inhibit the proliferation of hypertrophic scars in rabbit ear and significantly reduce the degree of scar tissue fibrosis. Local injection of naked DNA scar treatment route is feasible.