CAJ | 학술논문

背景:治疗由烧伤或疾病等引起的大面积全层皮肤缺失最为常见的和有效的方法就是皮肤移植修复,但目前面临的最大障碍是皮肤供体不足.以自体皮肤细胞作为种子细胞构建的组织工程皮肤是解决这一矛盾的最理想途径.目的:探讨组织工程皮肤动物移植实验的效果.设计:随机对照实验.单位:一所大学再生医学科学研究所及皮肤科.材料:实验于1998-09/2001-07在吉林大学细胞工程研究室完成.选用新生Wistar大鼠20只;8周龄雄性裸鼠24只.方法:应用以壳多糖为基质网架构建的组织工程化复层人工皮肤,对裸鼠大面积(直径20mm)全层皮肤缺损模型进行移植修复.24只8周龄裸鼠分为组织工程皮肤移植(artificial skin,AS)组、壳多糖膜覆盖物(chitosan,CH)组及对照组(control group,CG),术后进行大体观察,并在3,7,14和21 d应用组织学、红外热像扫描分析等手段对修复组织进行动态监测.主要观察指标:①实验动物大体观察情况.②修复区血供情况的红外热像观察.③组织学观察.结果:AS组在移植第3天,移植的组织工程皮肤与自体皮肤能够很好地融合,有少量毛细血管长入移植物,皮肤移植物颜色与自体皮肤颜色接近;随着时间的延长,移植物中毛细血管的数量逐渐增多,表皮层清晰可见基底层、棘细胞层、颗粒层和角质层,角化现象加强,有角化物脱落;真皮层细胞数量增多,网架逐渐降解,分泌的细胞外基质成份增多;第14天,创面基本愈合;修复区皮肤颜色与正常皮肤颜色非常接近,瘢痕很小,无需进行二次植皮.至移植的第14天,CH组结痂未完全脱落,创面未愈合,颜色较AS组深.对照组的结痂脱落,创面大而深,颜色深红.结论:以壳多糖为基质网架构建的组织工程皮肤具有良好的组织相容性,可应用于皮肤缺损的移植修复.
배경:치료유소상혹질병등인기적대면적전층피부결실최위상견적화유효적방법취시피부이식수복,단목전면림적최대장애시피부공체불족.이자체피부세포작위충자세포구건적조직공정피부시해결저일모순적최이상도경.목적:탐토조직공정피부동물이식실험적효과.설계:수궤대조실험.단위:일소대학재생의학과학연구소급피부과.재료:실험우1998-09/2001-07재길림대학세포공정연구실완성.선용신생Wistar대서20지;8주령웅성라서24지.방법:응용이각다당위기질망가구건적조직공정화복층인공피부,대라서대면적(직경20mm)전층피부결손모형진행이식수복.24지8주령라서분위조직공정피부이식(artificial skin,AS)조、각다당막복개물(chitosan,CH)조급대조조(control group,CG),술후진행대체관찰,병재3,7,14화21 d응용조직학、홍외열상소묘분석등수단대수복조직진행동태감측.주요관찰지표:①실험동물대체관찰정황.②수복구혈공정황적홍외열상관찰.③조직학관찰.결과:AS조재이식제3천,이식적조직공정피부여자체피부능구흔호지융합,유소량모세혈관장입이식물,피부이식물안색여자체피부안색접근;수착시간적연장,이식물중모세혈관적수량축점증다,표피층청석가견기저층、극세포층、과립층화각질층,각화현상가강,유각화물탈락;진피층세포수량증다,망가축점강해,분비적세포외기질성빈증다;제14천,창면기본유합;수복구피부안색여정상피부안색비상접근,반흔흔소,무수진행이차식피.지이식적제14천,CH조결가미완전탈락,창면미유합,안색교AS조심.대조조적결가탈락,창면대이심,안색심홍.결론:이각다당위기질망가구건적조직공정피부구유량호적조직상용성,가응용우피부결손적이식수복.
BACKGROUND: Skin transplantation is the most effective conventional method to cure large area full-thickness skin damage caused by empyrosis or some diseases, but present deficiency of skin donator is the largest barrier in front. The most ideal way to solve this problem is to use tissue-engineering skin reconstructed by self-skin cells as seed cells.OBJECTIVE: To investigate the effects of tissue engineered artificial animal skin in animal grafting experiment.DESIGN: A randomized controlled trial SETTING: Institute of frontier medical sciences and department of dermatology in a university.MATERIALS: Study was performed in the Cell-Engineering Institute of Jilin University from September 1998 to July 2001. Totally 20 newborn Wistar rats and 24 8-week old male nude mice were selected into our study.METHODS: Full-thickness wounds(diameter: 20 nn) were made on the backs of twenty-four nude mice to establish full-thickness skin defect animal model for grafting by the tissue-engineered reconstructive artificial skin made by chitosan(CH) as stromal scaffold. Twenty-four 8-week old nude mice were divided into artificial skin (AS) group, chitosan membrane(CH) group and control group (CG). All wounds were covered with AS, CH or petrolatun gauze correspondingly. The wounds of each groups were observed daily,techniques like histology and infrared-ray scan were used for a dynamical surveillance on the 3rd, 7th, 14th and 21st days.MAIN OUTCOME MEASURES: ① general observation; ② blood supply in recipient area under infrared-ray observation; ③ histological observation.RESULTS: Transplanted AS had a favorable fusion between tissue-engineered skin and self-skin on the 3rd day after grafting with a few of ingrowths of capillaries. The color of the AS was closed to self-skin. The capillaries gradually increased in the grafts over time. The new epidermis was clearly consisted of stratum basale, stratum spinosum, stratum granulosum, and stratum corneum. Keratinization enhanced with exfoliation. Cells in dermis increased and the scaffold gradually degraded. The secreted extracellular matrix increased as well. On the 14th day after grafting, the wounds almost recovered.The color of the grafted artificial skin was more similar to the nature skin with very little scaring, which indicated that a second grafting was unnecessary. The scabs did not completely fall off in CH group until the 14th day, and the wound was not healed. The color was darker than that of AS group. The scabs fell off in CG, and the wounds were big and deep with dark red color.CONCLUSION: The new reconstructive tissue-engineered artificial skin with CH as stromal scaffold has good histocompatibility, which can be applied in grafting for full-thickness wounds.