基于转录组测序分析美洲大蠊提取物促进小鼠创面愈合的分子机制

美洲大蠊Periplaneta americana是传统的中药材,其提取物已在临床上广泛用于创面治疗,但对其中的分子机制知之甚少。本文通过构建小鼠皮肤创伤模型,并基于转录组测序(RNA-seq)深入分析美洲大蠊提取物促进小鼠创面愈合的分子机制。首先构建C57小鼠皮肤全层切除模型,并将其分为3组,其中实验组分别以2种美洲大蠊提取物(康复新液、精粉)为敷料,而对照组以75%乙醇为敷料。用药处理3 d后取伤口皮肤组织送样进行RNAseq,然后分析转录组数据找出与伤口愈合相关的差异性表达基因,并利用荧光定量PCR(Q-PCR)对伤口组织中相关基因的表达量进一步验证。实验结果显示,实验组小鼠伤口的结痂速度比对照组快,这表明了小鼠创面模型中,美洲大蠊提取物能促进伤口愈合。经转录组分析,得到显著性差异表达基因数:对照组vs.精粉组为545,对照组vs.康复新液组为938。结合生物信息分析结果和已发表的文献,发现3个可能参与调节伤口愈合的关键基因:表皮调节素(Ereg)、Gli-kruppel家族成员(Gli2)和表皮型转谷氨酰胺酶3(Tgm3)。Q-PCR实验表明,这3个基因在美洲大蠊提取物加药组中均高表达。本文研究结果表明,2种美洲大蠊提取物:康复新液、精粉可能通过诱导Ereg、Tgm3和Gli2的高表达来促进皮肤创面的愈合。     

人脐带间充质干细胞上清凝胶加速小鼠皮肤创面愈合

目的:探讨人脐带间充质干细胞(hUC-MSCs)上清凝胶对小鼠皮肤创面修复的作用,为临床皮肤创伤提供新的修复方法奠定基础。方法:从新生儿脐带分离出hUC-MSCs并培养,经流式细胞仪检测细胞表面标志物、成骨成脂细胞分化实验以及RT-PCR检测干性相关基因的表达证明其干细胞特性;收集上清液,进行粗提纯及总蛋白浓度检测,制成凝胶剂,用于小鼠背部损伤模型中创面的治疗;于第2、3、6、8、15 d取样,伤口及正常皮肤组织样品分别用于制备组织病理切片及愈合组织相关因子表达的Q-PCR检测。结果:从新生儿脐带分离出的hUC-MSCs其形态、表面标志物符合干细胞特性,具有成骨和成脂诱导分化潜能。实验小鼠皮肤创伤后3 d开始可见各组创面逐渐缩小,伤后15 d创面基本愈合;第5、7 d高剂量组创面愈合率大于对照组,其差异有统计学意义(P0.05)。病理切片结果显示高剂量组伤口愈合程度最高,低剂量组次之,两者都优于对照组。愈合组织相关因子检测表明,伤后第2 d,高剂量上清处理的小鼠伤口组织TGF-β1和Col1a1基因表达增加,明显多于对照组(P0.05),伤后第3 d,实验组VEGF的表达量均高于对照组(P0.05);高剂量组从第3 d开始,IL-1β这一炎症因子表达水平显著低于空白对照组(P0.05)。结论:hUC-MSCs上清凝胶能够提高小鼠皮肤创面愈合的速度。     

虫白蜡基复方药膏的制备及促进小鼠皮肤创伤愈合的药效评价

为研制一种以虫白蜡和高级烷醇为基质的促愈复方药膏,以昆明小鼠为实验对象进行创伤造模,通过愈合率计算、组织学观察、体外抗菌试验、二甲苯致炎、热板和冰醋酸致痛等试验对复方药膏的促愈效果、抑菌性、抗炎作用、镇痛作用和皮肤刺激性等进行检测,并与目前治疗创伤常用的西药和中药膏剂进行对照。结果显示,创面形成后第13天,虫白蜡复方药膏组创面几乎痊愈,愈合率为98. 04%,而空白对照组愈合效果不明显,愈合率仅为52. 08%,阳性对照组愈合率分别为80. 28%、85. 98%;虫白蜡复方药膏可促进肉芽组织和胶原纤维增生,减少炎性细胞浸润,对金黄色葡萄球菌和藤黄八叠球菌有抑制作用;虫白蜡复方药膏对二甲苯致炎的抑制率大于30%,其肿胀度与空白对照组相比有极显著性差异(P 0. 01);热板法致痛试验中,给药后30 min,虫白蜡复方药膏组的痛阈值显著高于空白对照组(P 0. 055),注入冰醋酸致痛后,虫白蜡复方药膏组小鼠扭体次数极显著地低于空白对照组(P 0. 01),且低于阳性对照组,对皮肤刺激的平均反应值均0. 400。结果说明虫白蜡复方药膏对小鼠创伤有明显的促愈作用,且愈合速度明显优于阳性对照组,有良好的抗菌性、抗炎和镇痛作用,对皮肤几乎无刺激性,具有较强的安全性,为创伤用药的筛选提供新思路,拓宽了白蜡和高级烷醇的应用范围。     

手指开放性骨折高压氧递增治疗疗效观察

本文对46例手指外伤患者术后行高压氧(HBO)治疗的临床疗效进行分析,25例采用了高压氧递增治疗方案,使其缩短病程,创面的恢复,伤口愈合,降低残缺率等与高压氧常规治疗组的21例患者进行了对照,疗效明显优于常规治疗组,结果报告如下: 1 临床资料 1.1 一般资料 将46例患者从1996年3月至1997年5     

高乳清蛋白的肠内营养对大鼠伤口愈合的影响

探讨高乳清蛋白的肠内营养对大鼠创伤皮肤的促愈合作用.将36只SD大鼠随机分为3组,每组12只,即高乳清蛋白肠内营养组(A)、普通肠内营养组(B)、空白对照组(C),建立大鼠皮肤创伤模型后进行肠内营养支持,肠内营养用量为每天731.5kJ·kg-1,以灌胃的方式提供,分别于术后第7、14天测定血清蛋白、血红蛋白含量并计算创面愈合率.结果显示,术后第7、14天A组的血清蛋白、血红蛋白及伤口皮肤平均愈合率显著高于B、C组,差异具有统计学意义(p＜0.05).表明高乳清蛋白肠内营养具有较好的促进伤口愈合的作用.     

富血小板血浆与贫血小板血浆治疗中华眼镜蛇细胞毒素致小鼠皮肤溃疡的效果比较

目的 比较富血小板血浆(PRP)与贫血小板血浆(PPP)治疗中华眼镜蛇细胞毒素致小鼠皮肤溃疡的效果。方法 将中华眼镜蛇细胞毒素造模成功的30只中小鼠随机分为对照组(n=10)、PRP组(n=10)、PPP组(n=10),造模后第9天各组分别给予单纯生理盐水、PRP、PPP治疗,比较3组小鼠皮肤溃疡面积、溃疡创面愈合率、创面面积差绝对值与HE染色的病理改变。结果 低速组的PRP、PPP符合工作浓度标准。PRP凝胶、PPP凝胶治疗小鼠溃疡愈合时间可缩短3 d。PRP组与PPP组创面愈合率及3 d内面积差绝对值均大于对照组(均P<0.05)。镜下见PRP凝胶、PPP凝胶可减少炎症细胞浸润,促进小鼠上皮细胞再上皮化等病理改变。结论 PRP凝胶、PPP凝胶均可促进中华眼镜蛇伤溃疡皮肤修复,缩短愈合时间。     

近红外线照射与局部氧疗对伤口愈合作用的实验研究

目的:研究近红外照射与局部氧疗相结合对伤口愈合的作用及机理.方法:以新西兰种兔为研究对象,建立创伤模型,并将创伤兔随机分为四组,分别对伤口施加近红外照射、局部氧疗、近红外照射 局部氧疗三种治疗,而对照组不施加任何干预,观察伤口愈合情况30天,记录各组伤口愈合数目和愈合天数并计算平均愈合时间.结果:结合治疗组(即近红外照射 局部氧疗组)的20个伤口全部愈合.平均愈合天数是(20.2±2.1)天,分别与红外线照射组、局部氧疗组、对照组存在显著性差异.结论:近红外照射与局部氧疗相结合能促进伤口愈合,是一种新的治疗创伤的方式.     

枯草芽胞杆菌喷雾剂对家兔皮肤创伤愈合的影响

目的 :观察枯草芽胞杆菌喷雾剂对家兔皮肤创伤愈合的影响。方法 :采用家兔皮肤创伤为模型 ,连续给药 6 d,第 11天测定创面面积 ,并于第 17天记录创面愈合数。结果 :枯草芽胞杆菌喷雾剂高剂量组和磺胺嘧啶银组创面面积显著小于空白对照组 ( P<0 .0 5 ) ;枯草杆菌喷雾剂的愈合率显著高于空白对照组( P<0 .0 5 )。结论 :枯草芽胞杆菌喷雾剂能够缩小家兔创面愈合 ,增加创面愈合率     

护理干预对老年糖尿病伴皮肤病溃疡患者的临床疗效分析

为了探讨强化护理干预对老年糖尿病伴皮肤溃疡患者临床治疗效果的影响,现选取四川大学华西医院与南充市中心医院收治的110例糖尿病伴皮肤溃疡患者,采用随机数字表法分为强化组、对照组各55例,在给予相同的治疗方法的条件下,强化组给予针对性的溃疡护理方案,对照组仅给予常规护理;对比两组护理效果差异。结果显示强化组在治疗7 d、14 d及28 d时,创面愈合率显著高于对照组(p0.05),强化组的溃疡完全愈合时间显著低于对照组患者(p0.05);治疗7 d、14 d时,强化组患者创面TcPO2测定值显著高于对照组患者(p0.05)。强化组治愈率为74.55%、好转率为25.45%,对照组治愈率为54.55%、好转率为43.64%、无效仅为1.82%,两组比较差异具有统计学意义(p0.05)。表明对创面皮肤进行强化护理有利于促进老年糖尿病伴皮肤溃疡创面愈合,值得临床推广应用。     

高压氧对脑缺血再灌注海马CA_1区神经元凋亡作用的研究

目的和方法 :应用TUNEL检测技术 ,对沙土鼠前脑缺血 2 0min后再灌注 3d模型 ,用HBO治疗连续 3d。观察HBO作用下海马CA1区神经元凋亡变化 ,研讨HBO对脑缺血再灌注损伤的疗效及其机理 ,为临床应用HBO治疗疾病提供理论依据。结果 :沙土鼠脑缺血再灌注 3d后海马CA1区大量神经元凋亡 ,HBO治疗组凋亡细胞数明显减少 (P <0 .0 1) ,并以 0 .2 5MPaHBO治疗组为佳。结论 :HBO治疗对海马神经元损伤有保护作用 ,减少神经元凋亡 ,为高压氧治疗缺血性损伤的疗效机理之一     

alpha-Lipoic acid modulates extracellular matrix and angiogenesis gene expression in non-healing wounds treated with hyperbaric oxygen therapy

alpha-Lipoic acid (LA) has been found previously to accelerate wound repair in patients affected by chronic wounds who underwent hyperbaric oxygen (HBO) therapy. Because proteinases are important in wound repair, we hypothesized that LA may regulate matrix metalloproteinase (MMP) expression in cells that are involved in wound repair. Patients undergoing HBO therapy were double-blind randomized into two groups: the LA group and the placebo group. Gene expression profiles for MMPs and for angiogenesis mediators were evaluated in biopsies collected at the first HBO session, at the seventh HBO session, and after 14 days of HBO treatment. ELISA tests were used to validate microarray expression of selected genes. LA supplementation in combination with HBO therapy downregulated the inflammatory cytokines and the growth factors which, in turn, affect MMPs expression. The disruption of the positive autocrine feedback loops that maintain the chronic wound state promotes progression of the healing process.     

Changes in inflammatory gene expression induced by hyperbaric oxygen treatment in human endothelial cells under chronic wound conditions

Hyperbaric oxygen (HBO) therapy involves the inhalation of 100% oxygen, whilst inside a chamber at greater than atmospheric pressure. It is an effective treatment for chronic diabetic wounds, although the molecular mechanisms involved remain unclear. We hypothesised that HBO could alter inflammatory gene expression in human endothelial cells via a reactive oxygen/nitrogen species-mediated pathway. Endothelial cells were exposed to a chronic wound model comprising hypoxia (2% O(2) at 1 atmosphere absolute (ATA); PO(2) ~2 kPa) in the presence of lipopolysaccharide and TNF-α for 24h, then treated with HBO for 90 min (97.5% O(2) at 2.4 ATA; PO(2) ~237 kPa). 5h post-HBO, 19 genes involved in adhesion, angiogenesis, inflammation and oxidative stress were downregulated. Notably, only angiogenin gene expression, which promotes both angiogenesis and nitric oxide production (reflected by increased eNOS protein expression in this study), was upregulated. This led to a decrease in endothelial IL-8 mRNA and protein, which could help alleviate inflammatory processes during chronic wound healing. This was no longer evident 22.5h post-HBO, demonstrating the importance of daily exposures in HBO treatment protocols. These studies indicate that elevated oxygen transiently regulates inflammatory gene expression in endothelial cells, which may enhance chronic wound healing.     

Response of blood vessels in vitro to hyperbaric oxygen (HBO): Modulation of VEGF and NOx release by external lactate or arginine

Hyperbaric oxygen therapy (HBO) is suggested to promote angiogenesis during wound healing, but the mechanisms involved are not understood. This study used a novel isolated blood vessel preparation to explore the effects of air, normobaric oxygen or hyperbaric oxygen (2.2 ATA for 90 min) on the angiogenesis factor, vascular endothelial growth factor (VEGF), nitrite and nitrate (NO_x), lactate dehydrogenase (LDH) and lactate release from the tissue in normal Krebs Ringer, and the Ringer supplemented with either l-arginine, or 15 mM lactate to mimic a wound environment, or both (l-arginine + lactate). The in vitro blood vessel preparation remained viable during all experiments. There were no effects of HBO treatment on any of the parameters measured in normal Krebs Ringer, but some treatment-dependent effects were observed in supplemented Krebs Ringer. In the lactate supplemented Krebs Ringer, medium LDH levels increased in response to either normobaric oxygen (NBO) or HBO, compared to air alone. There were also small, but statistically significant increases in total glutathione due to HBO treatment, compared to NBO or air in the lactate supplemented medium, and in the combined supplement. There were no effects of HBO on NO_x, changes in external medium lactate levels, or tissue VEGF in any of the Krebs Ringers tested. However, post treatment increases in VEGF were observed in the lactate supplemented medium, and for lactate release into the medium for the combined supplement. We conclude that HBO does not cause NO or VEGF production from the blood vessel in normal Krebs Ringer, but the data from supplemented medium show that the response of the tissue is subtly affected by the chemical environment around the blood vessel, and the tissue is more responsive to HBO when wound conditions are mimicked.     

Exposure to Hyperbaric Oxygen Intensified Vancomycin-Induced Nephrotoxicity in Rats

It has been suggested that oxidative stress is a potential mechanism for vancomycin-induced nephrotoxicity and hyperbaric oxygen therapy (HBO) has been shown to be effective in treating renal toxicity that has been pharmacologically induced in animal models. The aim of this study was to investigate the effect of HBO therapy on vancomycin-induced nephrotoxicity in rats. The study group comprised 36 Sprague Dawley male rats. We treated 30 with 500 mg/kg of intraperitoneal vancomycin once a day for 7 days. Half of these rats received a daily 1-hour treatment with HBO at 2 Atmospheres (ATM) on the same 7 days and formed the HBO+ group. The other 15 subjects received no HBO treatment (HBO- group). The remaining six rats served as the control group, three received HBO treatments alone and no treatment was administered to the other three rats. Laboratory results were obtained on day 8 and the intervention and control groups were compared. Rats in the HBO+ group gained less weight than the HBO- group (11.6 grams vs 22.6 grams; P = 0,008) and had significantly higher serum blood urea nitrogen (99.6 vs 52.6 mg/dL; P<0.001), serum creatinine (0.42 vs 0.16 mg/dL; P = 0.001) and magnesium (3.6 vs 3.1mg/dL; P = 0.014). The vancomycin blood levels were also higher in the HBO+ group (27.8 vs 6.7 μg/mL; P = 0.078). There were no pathological kidney changes in the control group. All the kidneys from the treated groups (vancomycin +HBO and vancomycin HBO-) showed moderate to severe histopathological changes with no statistical significance between them. This study demonstrated that exposure to hyperbaric oxygen intensified vancomycin-induced nephrotoxicity in rats.     

Short duration hyperbaric oxygen treatment effects blood flow in rats: pilot observations

Hyperbaric oxygen (HBO) treatment has been found to improve healing in living tissues, especially those poor in oxygen. The effects of HBO have also been tested in rat experiments. However, oxygen partial pressure in rat's arterial blood is normally about twice that in humans. Disregarding this, a human HBO protocol has been applied in previous rat experiments with HBO. Laser Doppler flowmetry (LDF) is a non-invasive means for measuring blood flow. Using LDF, we measured the blood perfusion rate in rats receiving HBO, according to a modified protocol, in a region of healing soft tissue with bone defect. The results indicate that, in rats, shorter HBO treatment with high O2 pressure can significantly improve the blood flow of healing tissues. In this study, an elevated blood perfusion rate was still evident 2 weeks after the ending of HBO therapy, which indicates improved revascularization in the wound area. A short HBO protocol would save time and effort in future HBO experiments on rats.     

Microbiological evaluation of the effects of hyperbaric oxygen on periodontal disease

The term periodontitis indicates a variety of clinical manifestations of infectious disorders in which the supporting tissues of the teeth are attacked. The initiation and progression of periodontal disease are attributed to the presence of elevated levels of pathogenic bacteria within the gingival crevice. Approaches to periodontal treatment range from surgical to regenerative therapy and anti-infective chemotherapy. Anti-infective drug therapy should be rationally based on the composition of the pathogenic microbiota. It is also important to recognize that the periodontopathic plaque constitutes a bacterial biofilm infection that may render the resident microorganisms more resistant than the same organisms grown planktonically. Hyperbaric oxygen (HBO) has been successfully used in several medical applications. The therapeutic effect is related to elevated partial oxygen pressure in the tissues. The aim of this study was to evaluate the effects of HBO on a selected number of patients suffering from adult chronic periodontitis in comparison with surgical intervention (scaling and root planning, SRP), as well as the effects of a combination of both therapies on the evolution over time of the microflora of the periodontal pockets. Bacteria were detected either by culture or by a molecular method (PCR). Microbiological data indicate that the combination of HBO and SRP substantially reduced (by up to 99.9%) the gram-negative anaerobe loads of the subgingival microflora. The low values of pathogens persisted for at least two months after the therapy. HBO or SRP alone produced a temporarily more limited effect on periodontal anaerobes. Additional experimental confirmation of these results was provided by molecular detection of the main periodontopathogenic bacteria with a significant reduction in the number of dental sites which harboured them. It is also shown that HBO both alone and in combination with SRP reduced the Gingival Index value to zero and gingival health persisted for 3 months at least. Thus, in parallel with the loss of periodontopathogenic bacteria, a substantial improvement in oral health was observed. In conclusion, this study has shown that HBO may represent a useful aid, especially in combination with SRP, as far as non-surgical periodontal therapy is concerned.     

Genotoxicity of hyperbaric oxygen

Hyperbaric oxygen (HBO) treatment is applied as a therapy for a wide variety of diseases with symptoms caused by lack of oxygen in the target tissues. However, it is known that exposure to high concentrations of oxygen may lead to oxidative stress and cause cell and tissue damage. Oxygen toxicity and possible cancer-promoting effects of HBO therapy have been a matter of serious concern. Although a cancer-inducing effect of HBO was not found to date, recent studies clearly indicated an induction of oxidative DNA damage in blood cells of healthy subjects after HBO under therapeutic conditions. The biological significance of this finding has been investigated in a series of in vitro and in vivo tests. This review summarizes these studies and critically discusses potential adverse genetic effects of HBO therapy. Furthermore, since an induction of anti-oxidative defense mechanisms has been determined after HBO exposure, a modified treatment regimen of HBO therapy is proposed which avoids genotoxic effects.     

Hyperbaric oxygen therapy suppresses hypoxia and reoxygenation injury to retinal pigment epithelial cells through activating peroxisome proliferator activator receptor-alpha signalling

Retinal ischemia followed by reperfusion (IR) is a common cause of many ocular disorders, such as age-related macular degeneration (AMD), which leads to blindness in the elderly population, and proper therapies remain unavailable. Retinal pigment epithelial (RPE) cell death is a hallmark of AMD. Hyperbaric oxygen (HBO) therapy can improve IR tissue survival by inducing ischemic preconditioning responses. We conducted an in vitro study to examine the effects of HBO preconditioning on oxygen–glucose deprivation (OGD)-induced IR-injured RPE cells. RPE cells were treated with HBO (100% O₂ at 3 atmospheres absolute for 90 min) once a day for three consecutive days before retinal IR onset. Compared with normal cells, the IR-injured RPE cells had lower cell viability, lower peroxisome proliferator activator receptor-alpha (PPAR-α) expression, more severe oxidation status, higher blood-retinal barrier disruption and more elevated apoptosis and autophagy rates. HBO preconditioning increased PPAR-α expression, improved cell viability, decreased oxidative stress, blood-retinal barrier disruption and cellular apoptosis and autophagy. A specific PPAR-α antagonist, GW6471, antagonized all the protective effects of HBO preconditioning in IR-injured RPE cells. Combining these observations, HBO therapy can reverse OGD-induced RPE cell injury by activating PPAR-α signalling.     

Effects of hyperbaric oxygen on Leishmania amazonensis promastigotes and amastigotes

In the present study, we evaluated the effects of hyperbaric oxygen (HBO) exposure in both Leishmania amazonensis life stages (promastigotes and amastigotes) and on macrophage cultures infected with the parasite. HBO treatment protocols, which can be tolerated by humans and animals, induced irreversible metabolic damage and affected parasite morphology, growth and ability to transform. The observation that the antioxidant N-acetylcysteine (NAC) prevents some of these deleterious effects indicated an involvement of oxidative stress during parasite HBO exposure. In addition, HBO exposed L. amazonensis-infected macrophage cultures showed reduction of the percentage of infected cells and of the number of intracellular parasites per cell. Thus, the demonstration that HBO, a therapy used in the management of different diseases, is toxic for both L. amazonensis life stages and can alter macrophage susceptibility to the infection encourages further studies of this therapy in animal models of Leishmania infection.