目的 观察感觉神经肽P物质与表皮干细胞(ESC)联合应用对糖尿病大鼠创面愈合与神经再生的作用. 方法 分离培养SD大鼠ESC(经鉴定),接种于羊膜滋养层上构建羊膜-ESC备用.选择48只糖尿病模型大鼠,每只背部制作4个全层皮肤缺损创面.按随机抽签法将此192个创面分为ESC+P物质组、ESC组、P物质组、对照组,每组48个创面.ESC+P物质组和ESC组创面均移植羊膜-ESC,P物质组、对照组创面移植羊膜.移植后,ESC+P物质组、P物质组在创周及创面中央注射1×10-7 mol/L的P物质250μL,ESC组、对照组在创周及创面中央注射PBS 250μL作对照,各组每日注射2次,连用4d.于大鼠伤后4、7、10、14、17、23 d,观察并计算创面愈合率(每时相点8个创面),HE染色观察创面组织结构改变.伤后4、7、10 d,行Masson染色观察创面组织总胶原分布,免疫组织化学染色观察Ⅰ、Ⅲ型胶原沉积量.伤后14、23 d,用免疫组织化学染色法观察创面组织中蛋白基因产物9.5(PGP 9.5)及P物质阳性神经纤维分布情况.对数据行单因素方差分析和t检验. 结果(1)ESC+P物质组伤后14 d创面愈合率达100.0%,明显早于ESC组、P物质组、对照组完全愈合时间(伤后17、17、23 d).HE染色显示ESC+P物质组创面愈合质量明显优于其余3组.(2)伤后10 d,ESC+P物质组与P物质组创面组织中胶原着色深、面积广;其余2组胶原染色较浅、面积较小.随着伤后时间推移,各组创面Ⅰ型胶原沉积量逐渐升高,Ⅲ型胶原沉积量逐渐下降.伤后4、7、10 d,ESC+P物质组Ⅰ型胶原沉积量明显高于ESC组(t值分别为32.72、118.21、26.71,P值均小于0.01)和对照组(t值分别为44.37、22 76、30.32,P值均小于0.01);ESC+P物质组与P物质组水平相对接近.伤后4、7、10d,ESC+P物质组创面Ⅲ型胶原沉积量明显高于ESC组(t值分别为32.27、28 68、14.51,P值均小于0.01)和对照组(t值分别为35 68、22.52、22 24,P值均小于0.01).(3)ESC +P物质组与P物质组创面组织中有大量PGP 9.5和P物质阳性神经纤维再生,创面深层部分神经纤维末梢向表皮延伸.ESC组、对照组仅见创面深层有少量PGP 9.5和P物质阳性神经纤维,且未向表皮延伸.伤后14、23 d,ESC+P物质组创面PGP 9.5阳性神经纤维面积占(3.86±0.25)%、(7 03±0.28)%,明显高于ESC组[(1.48±0.30)%、(3.01±0 43)%,t值分别为23 95、30 27,P值均小于0.01]和对照组[(1 46±0 23)%、(2.84±0.29)%,t值分别为27.35、40.32,P值均小于0.01].伤后14、23 d,ESC+P物质组创面P物质阳性神经纤维面积占(2.01±0 14)%、(1.19±0 11)%,明显高于ESC组[(0.85±0 17)%、(1.34±0 21)%,t值分别为20.50、2.60,P<0.05或P<0.01]和对照组[(0.74 ±0.15)%、( 1.30 ±0.17)%,t值分别为23 98、2.41,P<0.05或P<0.01]. 结论 感觉神经肽P物质和ESC联合应用,可以有效促进糖尿病大鼠创面愈合与神经再生.
目的 觀察感覺神經肽P物質與錶皮榦細胞(ESC)聯閤應用對糖尿病大鼠創麵愈閤與神經再生的作用. 方法 分離培養SD大鼠ESC(經鑒定),接種于羊膜滋養層上構建羊膜-ESC備用.選擇48隻糖尿病模型大鼠,每隻揹部製作4箇全層皮膚缺損創麵.按隨機抽籤法將此192箇創麵分為ESC+P物質組、ESC組、P物質組、對照組,每組48箇創麵.ESC+P物質組和ESC組創麵均移植羊膜-ESC,P物質組、對照組創麵移植羊膜.移植後,ESC+P物質組、P物質組在創週及創麵中央註射1×10-7 mol/L的P物質250μL,ESC組、對照組在創週及創麵中央註射PBS 250μL作對照,各組每日註射2次,連用4d.于大鼠傷後4、7、10、14、17、23 d,觀察併計算創麵愈閤率(每時相點8箇創麵),HE染色觀察創麵組織結構改變.傷後4、7、10 d,行Masson染色觀察創麵組織總膠原分佈,免疫組織化學染色觀察Ⅰ、Ⅲ型膠原沉積量.傷後14、23 d,用免疫組織化學染色法觀察創麵組織中蛋白基因產物9.5(PGP 9.5)及P物質暘性神經纖維分佈情況.對數據行單因素方差分析和t檢驗. 結果(1)ESC+P物質組傷後14 d創麵愈閤率達100.0%,明顯早于ESC組、P物質組、對照組完全愈閤時間(傷後17、17、23 d).HE染色顯示ESC+P物質組創麵愈閤質量明顯優于其餘3組.(2)傷後10 d,ESC+P物質組與P物質組創麵組織中膠原著色深、麵積廣;其餘2組膠原染色較淺、麵積較小.隨著傷後時間推移,各組創麵Ⅰ型膠原沉積量逐漸升高,Ⅲ型膠原沉積量逐漸下降.傷後4、7、10 d,ESC+P物質組Ⅰ型膠原沉積量明顯高于ESC組(t值分彆為32.72、118.21、26.71,P值均小于0.01)和對照組(t值分彆為44.37、22 76、30.32,P值均小于0.01);ESC+P物質組與P物質組水平相對接近.傷後4、7、10d,ESC+P物質組創麵Ⅲ型膠原沉積量明顯高于ESC組(t值分彆為32.27、28 68、14.51,P值均小于0.01)和對照組(t值分彆為35 68、22.52、22 24,P值均小于0.01).(3)ESC +P物質組與P物質組創麵組織中有大量PGP 9.5和P物質暘性神經纖維再生,創麵深層部分神經纖維末梢嚮錶皮延伸.ESC組、對照組僅見創麵深層有少量PGP 9.5和P物質暘性神經纖維,且未嚮錶皮延伸.傷後14、23 d,ESC+P物質組創麵PGP 9.5暘性神經纖維麵積佔(3.86±0.25)%、(7 03±0.28)%,明顯高于ESC組[(1.48±0.30)%、(3.01±0 43)%,t值分彆為23 95、30 27,P值均小于0.01]和對照組[(1 46±0 23)%、(2.84±0.29)%,t值分彆為27.35、40.32,P值均小于0.01].傷後14、23 d,ESC+P物質組創麵P物質暘性神經纖維麵積佔(2.01±0 14)%、(1.19±0 11)%,明顯高于ESC組[(0.85±0 17)%、(1.34±0 21)%,t值分彆為20.50、2.60,P<0.05或P<0.01]和對照組[(0.74 ±0.15)%、( 1.30 ±0.17)%,t值分彆為23 98、2.41,P<0.05或P<0.01]. 結論 感覺神經肽P物質和ESC聯閤應用,可以有效促進糖尿病大鼠創麵愈閤與神經再生.
목적 관찰감각신경태P물질여표피간세포(ESC)연합응용대당뇨병대서창면유합여신경재생적작용. 방법 분리배양SD대서ESC(경감정),접충우양막자양층상구건양막-ESC비용.선택48지당뇨병모형대서,매지배부제작4개전층피부결손창면.안수궤추첨법장차192개창면분위ESC+P물질조、ESC조、P물질조、대조조,매조48개창면.ESC+P물질조화ESC조창면균이식양막-ESC,P물질조、대조조창면이식양막.이식후,ESC+P물질조、P물질조재창주급창면중앙주사1×10-7 mol/L적P물질250μL,ESC조、대조조재창주급창면중앙주사PBS 250μL작대조,각조매일주사2차,련용4d.우대서상후4、7、10、14、17、23 d,관찰병계산창면유합솔(매시상점8개창면),HE염색관찰창면조직결구개변.상후4、7、10 d,행Masson염색관찰창면조직총효원분포,면역조직화학염색관찰Ⅰ、Ⅲ형효원침적량.상후14、23 d,용면역조직화학염색법관찰창면조직중단백기인산물9.5(PGP 9.5)급P물질양성신경섬유분포정황.대수거행단인소방차분석화t검험. 결과(1)ESC+P물질조상후14 d창면유합솔체100.0%,명현조우ESC조、P물질조、대조조완전유합시간(상후17、17、23 d).HE염색현시ESC+P물질조창면유합질량명현우우기여3조.(2)상후10 d,ESC+P물질조여P물질조창면조직중효원착색심、면적엄;기여2조효원염색교천、면적교소.수착상후시간추이,각조창면Ⅰ형효원침적량축점승고,Ⅲ형효원침적량축점하강.상후4、7、10 d,ESC+P물질조Ⅰ형효원침적량명현고우ESC조(t치분별위32.72、118.21、26.71,P치균소우0.01)화대조조(t치분별위44.37、22 76、30.32,P치균소우0.01);ESC+P물질조여P물질조수평상대접근.상후4、7、10d,ESC+P물질조창면Ⅲ형효원침적량명현고우ESC조(t치분별위32.27、28 68、14.51,P치균소우0.01)화대조조(t치분별위35 68、22.52、22 24,P치균소우0.01).(3)ESC +P물질조여P물질조창면조직중유대량PGP 9.5화P물질양성신경섬유재생,창면심층부분신경섬유말소향표피연신.ESC조、대조조부견창면심층유소량PGP 9.5화P물질양성신경섬유,차미향표피연신.상후14、23 d,ESC+P물질조창면PGP 9.5양성신경섬유면적점(3.86±0.25)%、(7 03±0.28)%,명현고우ESC조[(1.48±0.30)%、(3.01±0 43)%,t치분별위23 95、30 27,P치균소우0.01]화대조조[(1 46±0 23)%、(2.84±0.29)%,t치분별위27.35、40.32,P치균소우0.01].상후14、23 d,ESC+P물질조창면P물질양성신경섬유면적점(2.01±0 14)%、(1.19±0 11)%,명현고우ESC조[(0.85±0 17)%、(1.34±0 21)%,t치분별위20.50、2.60,P<0.05혹P<0.01]화대조조[(0.74 ±0.15)%、( 1.30 ±0.17)%,t치분별위23 98、2.41,P<0.05혹P<0.01]. 결론 감각신경태P물질화ESC연합응용,가이유효촉진당뇨병대서창면유합여신경재생.
Objective To observe the effect of sensory neuropeptide substance P combined with epidermal stem cells(ESC)on wound healing and nerve regeneration in diabetic rats. Methods ESC that had been isolated from SD rats were identified and cultured in vitro,and they were inoculated onto nourishing layer of amniotic membrane to construct amniotic membrane-ESC.Four full-thickness skin wounds were produced on the back of each of 48 diabetic rats.The resulted 192 wounds were randomly divided into ESC + substance P group,ESC group,substance P group,and control group according to the lottery method,with 48 wounds in each group.Wounds in ESC + substance P group and ESC group were transplanted with amniotic membrane-ESC,and those in substance P group and control group were transplanted with amniotic membrane.After transplantation,250 μL substance P in the concentration of 1 × 10-7 mol/L was injected around and into the middle of the wounds in ESC + substance P group and substance P group,2 times a day,and continued for 4 days,while 250 μL PBS solution was injected in the above-mentioned position in ESC group and control group as control,2 times a day,and continued for 4 days.On post injury day(PID)4,7,10,14,17,and 23,the wound healing rate(with 8 wounds at each time point)was observed and determined,and changes in wound tissue structure were observed with HE staining.On PID 4,7,and 10,collagen distribution in wound tissue was observed with Masson staining,and type Ⅰ and type Ⅲ collagen deposition in wound tissue was respectively observed after immunohistochemical staining.The distribution of protein gene product 9.5( PGP 9.5)and regeneration of substance P positive nerve fibers in wound tissue were observed with immunohistochemical staining on PID 14 and 23.Data were processed with one-way analysis of variance and t test. Results ( 1 )The wound healing rate in ESC + substance P group reached 100.0% on PID 14,which was obviously earlier than that in ESC group,substance P group,and control group,healing was respectively observed on PID 17,17,and 23.The wound healing quality in ESC + substance P group was better than that in the other three groups as shown by HE staining.(2)On PID 10,collagen that was darkly stained and widely distributed was observed in wound tissue of ESC + substance P group and substance P group,while collagen in the other two groups was lightly stained and narrowly distributed.Deposition quantity of type Ⅰ collagen gradually increased,and that of type Ⅲ collagen gradually decreased in the wounds of each group over time.On PID 4,7,and 10,distribution amount of type Ⅰ collagen in wound tissue of ESC + substance P group was significantly higher than that in ESC group( with t value respectively 32.72,118.21,26.71,P values all below 0.01 )and control group( with t value respectively 44.37,22.76,30.32,P values all below 0.0l ),while there was no significance between ESC + substance P group and substance P group.On PID 4,7,and 10,distribution amount of type Ⅲ collagen in wound tissue of ESC + substance P group was significantly higher than that in ESC group( with t value respectively 32.27,28.68,14.51,P values all below 0.01 )and control group( with t value respectively 35.68,22.52,22.24,P values all below 0.01 ).(3)A large amount of PGP 9.5 and regeneration of substance P positive nerve fibers,and some peripheral nerve fibers in deep wound extending to epidermis were observed in wound tissue of ESC + substance P group and substance P group.A small amount of PGP 9.5 and regeneration of substance P positive nerve fibers without peripheral nerve fibers extending to epidermis were observed in deep wound tissue of ESC group and control group.On PID 14,23,ratios of area of PGP 9.5 positive nerve fiber in the wounds of ESC + substance P group were(3.86 ± 0.25 )% and( 7.03 ± 0.28 )%,and they were significantly higher than those of ESC group [(1.48 ±0.30)%,( 3.01 ±0.43)%,with t value respectively 23.95,30.27,Pvalues all below0.01] and control group [(1.46±0.23)%,(2.84±0.29)%,with t value respectively 27.35,40.32,P values all below 0.01 ].On PID 14,23,ratios of substance P positive nerve fiber area in the wounds ofESC+substance P group were(2.01 ±0.14)% and(1.19 ±0.11)%,which were obviously higher than those of ESC group[(0.85 ± 0.17 )%,( 1.34 ± 0.21 )%,with t value respectively 20.50,2.60,P <0.05 orP <0.01 ] and control group[(0.74 ±0.15)%,(1.30 ±0.17)%,with t value respectively 23.98,2.41,P <0.05 orP <0.01]. Conclusions Joint application of substance P and ESC can effectively promote healing of wound and nerve regeneration in diabetic rats.