remodeling

重塑
  • 文章类型: Journal Article
    暴露于苯并[α]芘(BaP)会增加过敏性鼻炎(AR)的发生率和严重程度,但潜在的机制仍不清楚。因此,我们在AR大鼠模型中研究了BaP暴露对粘液高分泌和组织重塑的体内影响。
    雌性Sprague-Dawley大鼠随机分为4组:阴性对照组,一组暴露于BaP的健康大鼠,一组卵清蛋白(OVA)诱导的AR大鼠,和一组暴露于BaP的AR模型大鼠。在每只大鼠中测量鼻部症状和OVA特异性血清免疫球蛋白E(IgE)的水平。此外,用高碘酸希夫(PAS)染色和马森三色(MT)染色检查杯状细胞增生和胶原蛋白沉积。通过免疫组织化学评估粘蛋白5AC(MUC5AC)表达。
    BaP显著增加了打喷嚏的次数,AR大鼠的鼻擦次数和OVA特异性血清IgE水平。BaP暴露AR模型组与AR模型组之间杯状细胞增生和胶原沉积差异有统计学意义。免疫组织化学结果显示,BaP暴露后,AR模型大鼠鼻黏膜MUC5AC表达明显升高。
    我们的数据表明,粘液分泌过多和鼻重塑的发展可能是暴露于BaP后对AR易感性增加的病理生理机制。
    UNASSIGNED: Exposure to benzo[α]pyrene (BaP) increases the incidence and severity of allergic rhinitis (AR), but the underlying mechanisms remain unclear. Thus, we investigated the in vivo effects of BaP exposure on mucus hypersecretion and tissue remodeling in a rat model of AR.
    UNASSIGNED: Female Sprague-Dawley rats were randomly divided into 4 groups: a negative control group, a group of healthy rats exposed to BaP, a group of rats with ovalbumin (OVA)-induced AR, and a group of AR model rats exposed to BaP. Nasal symptoms and levels of OVA-specific serum immunoglobulin E (IgE) were measured in each individual rat. Moreover, examination of goblet cell hyperplasia and collagen deposition was carried out with periodic acid-Schiff (PAS) staining and Masson trichrome (MT) staining. Mucin 5AC (MUC5AC) expression was assessed by immunohistochemistry.
    UNASSIGNED: BaP significantly increased the number of sneezes, the number of nasal rubs and the levels of OVA-specific serum IgE in rats with AR. Statistically significant differences in goblet cell hyperplasia and collagen deposition were observed between the BaP-exposed AR model group and the AR model group. Immunohistochemical results showed that the nasal mucosa of AR model rats displayed markedly elevated MUC5AC expression after BaP exposure.
    UNASSIGNED: Our data indicate that mucus hypersecretion and the development of nasal remodeling might be pathophysiologic mechanisms underlying increased susceptibility to AR after exposure to BaP.
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  • 文章类型: Journal Article
    创伤是各种微生物感染和包括事故在内的身体损害的常见命运,手术,和烧伤。作为回应,一个具有强大免疫系统的健康身体通过凝血在最佳时间内治愈特定部位,炎症,扩散,和重塑现象。然而,由于各种疾病,特别是糖尿病和其他生理因素,如年龄,压力,等。,通过各种机制延长伤口愈合的过程,包括Akt,多元醇,和己胺途径。当前的评论彻底解释了伤口类型,正常的伤口愈合机制,和免疫系统的作用。此外,对糖尿病的机制作用也进行了全面阐述。
    Wounds are the common fates in various microbial infections and physical damages including accidents, surgery, and burns. In response, a healthy body with a potent immune system heals that particular site within optimal time by following the coagulation, inflammation, proliferation, and remodeling phenomenon. However, certain malfunctions in the body due to various diseases particularly diabetes and other physiological factors like age, stress, etc., prolong the process of wound healing through various mechanisms including the Akt, Polyol, and Hexosamine pathways. The current review thoroughly explains the wound types, normal wound healing mechanisms, and the immune system\'s role. Moreover, the mechanistic role of diabetes is also elaborated comprehensively.
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  • 文章类型: Journal Article
    通过免疫细胞的适当参与的脱细胞细胞外基质(dECM)材料的宿主重塑对于实现功能性器官/组织再生是必不可少的。由于许多研究都集中在巨噬细胞的作用上,只有少数人评估了调节性T细胞(Tregs)在dECM重塑中的作用。在这项研究中,我们使用创伤性肌肉损伤小鼠模型来确定Tregs在血管源性dECM建设性重塑中的作用.根据结果,dECM植入后可募集一定数量的Tregs.值得注意的是,基于M2巨噬细胞数量的显著减少,使用抗CD25来减少由dECM募集的Treg的数量对材料重塑显著有害。此外,胶原蛋白和弹性纤维,保持材料的完整性和机械性能,在植入的早期阶段迅速降解。相比之下,使用CD28-SA抗体来增加dECM招募的Tregs的数量促进了建设性的重塑,导致材料边缘的炎症反应减少,周围纤维结缔组织变薄,宿主细胞的均匀浸润,显著改善组织重塑评分。M2巨噬细胞的数量增加,而M1巨噬细胞的数量减少。此外,Treg条件培养基在体外进一步增强了材料诱导的M2巨噬细胞极化。总的来说,Treg是影响dECM建设性重塑的重要细胞类型。这些发现有助于下一代生物材料的设计,以优化dECM材料的重塑和再生。
    Host remodeling of decellularized extracellular matrix (dECM) material through the appropriate involvement of immune cells is essential for achieving functional organ/tissue regeneration. As many studies have focused on the role of macrophages, only few have evaluated the role of regulatory T cells (Tregs) in dECM remodeling. In this study, we used a mouse model of traumatic muscle injury to determine the role of Tregs in the constructive remodeling of vascular-derived dECM. According to the results, a certain number of Tregs could be recruited after dECM implantation. Notably, using anti-CD25 to reduce the number of Tregs recruited by the dECM was significantly detrimental to material remodeling based on a significant reduction in the number of M2 macrophages. In addition, collagen and elastic fibers, which maintain the integrity and mechanical properties of the material, rapidly degraded during the early stages of implantation. In contrast, the use of CD28-SA antibodies to increase the number of Tregs recruited by dECM promoted constructive remodeling, resulting in a decreased inflammatory response at the material edge, thinning of the surrounding fibrous connective tissue, uniform infiltration of host cells, and significantly improved tissue remodeling scores. The number of M2 macrophages increased whereas that of M1 macrophages decreased. Moreover, Treg-conditioned medium further enhanced material-induced M2 macrophage polarization in vitro. Overall, Treg is an important cell type that influences constructive remodeling of the dECM. Such findings contribute to the design of next-generation biomaterials to optimize the remodeling and regeneration of dECM materials.
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  • 文章类型: Journal Article
    纤维状胶原蛋白分层组装成广泛而有序的超分子蛋白质原纤维对于细胞外基质功能和组织力学至关重要。尽管经过了几十年的研究,我们对纤维形成的复杂过程仍然知之甚少,特别是在观察快速形成的最早阶段,纳米级中间体挑战了大多数现有显微镜方法的空间和时间分辨率。使用视频速率扫描原子力显微镜(VRS-AFM),我们可以在溶液中的云母表面上观察到胶原蛋白原纤维形成和生长的最初几分钟的细节。纤维状胶原蛋白的定义特征是沿着原纤维的67nm周期性条带,这是由单个单体在多个长度尺度上的有序组装所驱动的。VRS-AFM视频显示了小原纤维从初始均匀高度到在几秒钟内显示典型条带的结构的同时生长和成熟。原纤维主要以单向方式生长,生长尖端的磨损末端锁住相邻的原纤维。我们发现,即使在极早的时间点,生长中的原纤维的重塑通过鸟笼中间体进行,并提出这些动力学可能提供成熟的分层组装途径。VRS-AFM提供了对在原纤维形成开始期间胶原的超分子组装的重塑的条带和途径的早期出现的独特一瞥。
    The hierarchic assembly of fibrillar collagen into an extensive and ordered supramolecular protein fibril is critical for extracellular matrix function and tissue mechanics. Despite decades of study, we still know very little about the complex process of fibrillogenesis, particularly at the earliest stages where observation of rapidly forming, nanoscale intermediates challenges the spatial and temporal resolution of most existing microscopy methods. Using video rate scanning atomic force microscopy (VRS-AFM), we can observe details of the first few minutes of collagen fibril formation and growth on a mica surface in solution. A defining feature of fibrillar collagens is a 67-nm periodic banding along the fibril driven by the organized assembly of individual monomers over multiple length scales. VRS-AFM videos show the concurrent growth and maturation of small fibrils from an initial uniform height to structures that display the canonical banding within seconds. Fibrils grow in a primarily unidirectional manner, with frayed ends of the growing tip latching onto adjacent fibrils. We find that, even at extremely early time points, remodeling of growing fibrils proceeds through bird-caging intermediates and propose that these dynamics may provide a pathway to mature hierarchic assembly. VRS-AFM provides a unique glimpse into the early emergence of banding and pathways for remodeling of the supramolecular assembly of collagen during the inception of fibrillogenesis.
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  • 文章类型: Journal Article
    心房颤动(AF)是最常见的心律失常类型。由于全球人口老龄化以及相关危险因素的发病率增加,其患病率增加。我们对AF病理生理学的理解以及与AF促进心房重构有关的淋巴结参与者的识别的最新进展突出了新的治疗方法的潜在机会。
    这篇详细的综述总结了房颤领域抗心律失常药物的最新进展。
    目前的情况远非最佳。尽管在AF治疗领域的药物开发中存在明显的未满足的需求,目前缺乏新药的开发。对短期和长期不存在心脏和非心脏毒性的分子的需要是本领域的限制。提高对AF遗传学的理解,病理生理学,分子改变,以提供个性化AF治疗为目标的大数据和人工智能将是未来几年AF治疗的基石。
    UNASSIGNED: Atrial fibrillation (AF) is the most common type of cardiac arrhythmia. Its prevalence has increased due to worldwide populations that are aging in combination with the growing incidence of risk factors associated. Recent advances in our understanding of AF pathophysiology and the identification of nodal players involved in AF-promoting atrial remodeling highlights potential opportunities for new therapeutic approaches.
    UNASSIGNED: This detailed review summarizes recent developments in the field antiarrhythmic drugs in the field AF.
    UNASSIGNED: The current situation is far than optimal. Despite clear unmet needs in drug development in the field of AF treatment, the current development of new drugs is absent. The need for a molecule with absence of cardiac and non-cardiac toxicity in the short and long term is a limitation in the field. Improvement in the understanding of AF genetics, pathophysiology, molecular alterations, big data and artificial intelligence with the objective to provide a personalized AF treatment will be the cornerstone of AF treatment in the coming years.
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  • 文章类型: Journal Article
    血管周围脂肪组织(PVAT)由于其合成血管活性产物的能力及其机械性能而调节血管功能。PVATs最丰富的细胞是脂肪细胞,它们的种群是由成熟的脂肪细胞祖细胞(APC),可能在心血管疾病的发病机制中起关键作用。然而,APC在PVAT仓库内的分布,它们在空间位置上的潜在变化,性别和年龄对其丰度的影响仍然未知。我们假设PVAT中的APC丰度受位置影响,年龄,性别和APC亚型具有特定的空间分布。来自胸主动脉和腹主动脉的PVAT,和肠系膜动脉,和来自肩胛骨的AT,性腺,分析了来自13周龄和30周龄雌性和雄性Pdgfrα-CreERT2xLSL-td番茄小鼠(n=28)的皮下储库。腹主动脉PVAT的祖细胞少于肠系膜PVAT和性腺AT。衰老降低了胸主动脉中APC的丰度,但增加了肠系膜PVAT中APC的数量。在肠系膜PVAT和性腺AT仓库中,女性的APC比男性多。APC在主动脉和肠系膜PVAT中表现出独特的空间分布,它们定位了邻近的血管和动脉。在所有PVAT储库中鉴定了APC亚型(APC1、APC2、APC3、diffAPC)。胸主动脉PVATAPC3位于外膜,而diffAPC位于实质。这项研究确定了基于仓库的APC种群的变异性,年龄,和性爱。独特的空间分布和不同APC亚型的存在表明,它们可能对心血管疾病诱导的PVAT重塑有不同的贡献。
    Perivascular adipose tissue (PVAT) regulates vascular function due to its capacity to synthesize vasoactive products and its mechanical properties. PVATs most abundant cells are adipocytes, and their populations are maintained by the maturation of adipocyte progenitor cells (APC), which may play a pivotal role in the pathogenesis of cardiovascular diseases. However, the distribution of APC within PVAT depots, their potential variation in spatial location, and the influence of sex and age on their abundance remain unknown. We hypothesize that APC abundance in PVAT is affected by location, age, sex and that APC subtypes have specific spatial distributions. PVAT from thoracic and abdominal aorta, and mesenteric arteries, and AT from interscapular, gonadal, and subcutaneous depots from 13-week and 30-week-old females and males Pdgfrα-CreERT2 x LSL-tdTomato mice (n = 28) were analyzed. Abdominal aorta PVAT had fewer progenitors than mesenteric PVAT and gonadal AT. Aging reduced the abundance of APC in the thoracic aorta but increased their numbers in mesenteric PVAT. Females had more APC than males in mesenteric PVAT and gonadal AT depots. APC exhibited unique spatial distribution in the aorta and mesenteric PVAT where they localized neighboring vasa vasorum and arteries. APC subtypes (APC1, APC2, APC3, diff APC) were identified in all PVAT depots. Thoracic aorta PVAT APC3 were located in the adventitia while diff APC were in the parenchyma. This study identified variability in APC populations based on depot, age, and sex. The distinctive spatial distribution and the presence of diverse APC subtypes suggest that they may contribute differently to cardiovascular diseases-induced PVAT remodeling.
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  • 文章类型: Journal Article
    肌肉骨骼损伤,包括肌腱病,为老龄化人群带来了巨大的临床负担。虽然与年龄相关的肌腱功能下降的生物学驱动因素知之甚少,众所周知,细胞外基质(ECM)重塑的失调在慢性肌腱变性中起作用。衰老细胞,与肌肉骨骼组织中的多种退行性病变有关,分泌具有促进ECM分解潜力的高度促炎衰老相关分泌表型(SASP)。然而,衰老细胞在肌腱ECM稳态失调中的作用尚不清楚.为了直接评估这一点,我们建立了小鼠肌腱外植体诱导细胞衰老的体外模型。这项新技术使我们能够研究衰老细胞及其天然ECM的分离相互作用,而不受年龄相关的系统性变化的干扰。我们记录了诱导肌腱外植体细胞衰老的多种生物标志物,包括细胞周期停滞,凋亡抗性,和持续的炎症反应。然后,我们利用这个体外衰老模型来比较幼体的ECM重塑反应,自然衰老,和诱导衰老的肌腱改变了机械刺激。我们发现衰老和衰老独立地导致ECM相关基因表达的改变,减少蛋白质合成,和组织组成变化。此外,MMP活性持续,从而使衰老和诱导衰老组织的重塑平衡向降解过度生产转移。一起,这表明细胞衰老在衰老肌腱的机械反应改变中起作用,并可能导致衰老人群的不良临床结局.
    Musculoskeletal injuries, including tendinopathies, present a significant clinical burden for aging populations. While the biological drivers of age-related declines in tendon function are poorly understood, it is well accepted that dysregulation of extracellular matrix (ECM) remodeling plays a role in chronic tendon degeneration. Senescent cells, which have been associated with multiple degenerative pathologies in musculoskeletal tissues, secrete a highly pro-inflammatory senescence-associated secretory phenotype (SASP) that has potential to promote ECM breakdown. However, the role of senescent cells in the dysregulation of tendon ECM homeostasis is largely unknown. To assess this directly, we developed an in vitro model of induced cellular senescence in murine tendon explants. This novel technique enables us to study the isolated interactions of senescent cells and their native ECM without interference from age-related systemic changes. We document multiple biomarkers of cellular senescence in induced tendon explants including cell cycle arrest, apoptosis resistance, and sustained inflammatory responses. We then utilize this in vitro senescence model to compare the ECM remodeling response of young, naturally aged, and induced-senescent tendons to an altered mechanical stimulus. We found that both senescence and aging independently led to alterations in ECM-related gene expression, reductions in protein synthesis, and tissue compositional changes. Furthermore, MMP activity was sustained, thus shifting the remodeling balance of aged and induced-senescent tissues towards degradation over production. Together, this demonstrates that cellular senescence plays a role in the altered mechano-response of aged tendons and likely contributes to poor clinical outcomes in aging populations.
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  • 文章类型: Journal Article
    背景:成纤维细胞分化为肌成纤维细胞表型是哮喘气道重塑的一个特征。肺成纤维细胞表达整联蛋白受体α4β7,纤连蛋白通过该受体诱导肌成纤维细胞分化。
    目的:研究β7整合素受体亚基和α4β7整合素复合物在慢性变应原暴露小鼠模型气道重塑和气道高反应性(AHR)中的作用。
    方法:将C57BL/6野生型(WT)和β7整合素缺失小鼠(β7-/-)致敏(第1,10天)并用卵清蛋白(OVA)攻击,每周三次,持续1或4周。在存在或不存在α4β7阻断抗体的情况下,用WT小鼠进行类似的实验。支气管肺泡(BAL)细胞计数,AHR,组织学评估,可溶性胶原蛋白含量,测量转化生长因子-β(TGFβ)和白细胞介素-13(IL13)。评价从WT和β7-/-盐水(SAL)和OVA处理的小鼠培养的成纤维细胞的表型。
    结果:WT与β7-/-小鼠的嗜酸性粒细胞数量相似。β7-/-小鼠OVA暴露时间延长与AHR降低相关,肺胶原含量,支气管周围平滑肌,与WT相比,肺组织TGFβ和IL13表达。在用α4β7阻断抗体处理的WT小鼠中观察到类似的发现。WT中的成纤维细胞迁移响应于OVA而不是β7-/-成纤维细胞而增强。相对于WT,α-SMA和纤连蛋白表达在β7-/-成纤维细胞中降低。
    结论:在变应原暴露的小鼠模型中,β7整合素亚基和α4β7整合素复合物调节AHR和气道重塑。这种效果是,至少在某种程度上,通过抑制成纤维细胞活化来解释,并且独立于嗜酸性粒细胞炎症。
    BACKGROUND: Fibroblast differentiation to a myofibroblast phenotype is a feature of airway remodeling in asthma. Lung fibroblasts express the integrin receptor α4β7 and fibronectin induces myofibroblast differentiation via this receptor.
    OBJECTIVE: To investigate the role of the β7 integrin receptor subunit and α4β7 integrin complex in airway remodeling and airway hyperresponsiveness (AHR) in a murine model of chronic allergen exposure.
    METHODS: C57BL/6 wild type (WT) and β7 integrin null mice (β7 -/-) were sensitized (days 1,10) and challenged with ovalbumin (OVA) three times a week for one or 4 weeks. Similar experiments were performed with WT mice in the presence or absence of α4β7 blocking antibodies. Bronchoalveolar (BAL) cell counts, AHR, histological evaluation, soluble collagen content, Transforming growth factor-β (TGFβ) and Interleukin-13 (IL13) were measured. Phenotype of fibroblasts cultured from WT and β7 -/- saline (SAL) and OVA treated mice was evaluated.
    RESULTS: Eosinophil numbers were similar in WT vs β7-/- mice. Prolonged OVA exposure in β7-/- mice was associated with reduced AHR, lung collagen content, peribronchial smooth muscle, lung tissue TGFβ and IL13 expression as compared to WT. Similar findings were observed in WT mice treated with α4β7 blocking antibodies. Fibroblast migration was enhanced in response to OVA in WT but not β7 -/- fibroblasts. α-SMA and fibronectin expression were reduced in β7-/- fibroblasts relative to WT.
    CONCLUSIONS: The β7 integrin subunit and the α4β7 integrin complex modulate AHR and airway remodeling in a murine model of allergen exposure. This effect is, at least in part, explained by inhibition of fibroblast activation and is independent of eosinophilic inflammation.
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  • 文章类型: Journal Article
    脉络膜血症(CHM)是一种隐性,X连锁疾病影响全球50,000人中的1人。CHM会在青少年时期导致夜盲症,并且在接下来的两到三十年中视力下降。虽然已知CHM会导致视网膜色素上皮(RPE)细胞的进行性丧失,光感受器和脉络膜血管,很少关注CHM患者眼中的视网膜胶质细胞变化。此外,虽然临床上观察到脉络膜损失,尚未对脉络膜丢失进行组织病理学评估.我们调查了两名CHM供体死后眼中的神经胶质重塑和激活以及脉络膜毛细血管变化及其与RPE损失的关系。将眼睛固定并冷冻保存,或将视网膜和脉络膜/RPE加工为扁平的小片,用于透射电子显微镜。致密的神经胶质膜,由波形蛋白和GFAP双阳性细胞组成,RPE区的视网膜下隙和双眼的光感受器丧失。膜没有延伸到远处的外围,其中RPE和光感受器是可行的。在玻璃体视网膜表面也发现了神经胶质膜。透射电子显微镜分析显示神经胶质细胞的突出和解体,其中含有外泌体样的囊泡。UEA凝集素在RPE丧失的区域显示完全没有脉络膜毛细血管,而一些大的脉络膜血管仍然存活。在遥远的外围,其中RPE单层是完整的,脉络膜毛细血管似乎正常。当考虑诸如干细胞替代之类的疗法时,应考虑CHM眼中存在的广泛的神经胶质重塑,因为它可能会阻碍细胞进入视网膜。这种神经胶质增生也需要在一定程度上逆转,以使Müller细胞在视网膜中执行其正常的稳态功能。未来的研究调查供体眼睛以及来自携带者或患有早期CHM的患者的临床成像将证明对了解神经胶质变化有价值。如果早期发生,可能会影响疾病进展。这也将提供对光感受器/RPE/脉络膜毛细血管复合体的疾病进展的见解,这对于确定新的治疗方法和寻找治疗窗口至关重要。
    Choroideremia (CHM) is a recessive, X-linked disease that affects 1 in 50,000 people worldwide. CHM causes night blindness in teenage years with vision loss progressing over the next two to three decades. While CHM is known to cause progressive loss of retinal pigment epithelial (RPE) cells, photoreceptors and choroidal vessels, little attention has been given to retinal glial changes in eyes with CHM. In addition, while choroidal loss has been observed clinically, no histopathologic assessment of choroidal loss has been done. We investigated glial remodeling and activation as well as choriocapillaris changes and their association with RPE loss in postmortem eyes from two donors with CHM. Eyes were fixed and cryopreserved or the retina and choroid/RPE were processed as flatmounts with a small piece cut for transmission electron microscopy. A dense glial membrane, made up of vimentin and GFAP double-positive cells, occupied the subretinal space in the area of RPE and photoreceptor loss of both eyes. The membranes did not extend into the far periphery, where RPE and photoreceptors were viable. A glial membrane was also found on the vitreoretinal surface. Transmission electron microscopy analysis demonstrated prominence and disorganization of glial cells, which contained exosome-like vesicles. UEA lectin demonstrated complete absence of choriocapillaris in areas with RPE loss while some large choroidal vessels remained viable. In the far periphery, where the RPE monolayer was intact, choriocapillaris appeared normal. The extensive glial remodeling present in eyes with CHM should be taken into account when therapies such as stem cell replacement are considered as it could impede cells entering the retina. This gliosis would also need to be reversed to some extent for Müller cells to perform their normal homeostatic functions in the retina. Future studies investigating donor eyes as well as clinical imaging from carriers or those with earlier stages of CHM will prove valuable in understanding the glial changes, which could affect disease progression if they occur early. This would also provide insights into the progression of disease in the photoreceptor/RPE/choriocapillaris complex, which is crucial for identifying new treatments and finding the windows for treatment.
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    引言术后伤口愈合是任何外科手术结果的最重要因素。伤口愈合是一个涉及炎症的动态过程,新生血管形成,造粒,成纤维细胞增殖,上皮再生,和重塑。它修复组织完整性,恢复身体的自然防御屏障。加速伤口愈合将有助于更快地重建身体的稳态。番木瓜包括重要的营养物质和生物活性物质,如矿物质,维生素,和抗氧化剂。其主要活性成分木瓜蛋白酶引起伤口的酶清创。血凝酶是一种凝血酶样丝氨酸蛋白酶,主要用于其促凝血和伤口愈合特性。它来自蛇蛇的蛇毒。本研究旨在比较拔牙后局部番木瓜叶提取物和血凝酶的伤口愈合特性。材料与方法48例需要双侧治疗性拔牙进行正畸治疗的患者,将番木瓜叶提取物(Caripill275mg/5ml)局部涂在一侧的提取槽上,将血凝酶0.2CU溶液(Botroclot)应用于另一侧的提取槽。在局部麻醉下拔除双侧前磨牙进行正畸治疗。要求患者每天两次局部施用该溶液,持续七天,并在第七天被要求复查。评估两种溶液在术后伤口愈合中的功效是研究的目的。使用Landry的愈合指数对所有患者使用盲法单观察者评估愈合情况。结果48名受试者共96个研究中心完成研究,平均年龄15.4岁.研究人群由24名男性和24名女性组成,在两个研究组中均匀分布。使用Wilcoxon符号秩检验比较两组之间的伤口愈合指数(WHI)评分,就伤口愈合指数评分而言,A组的平均排名明显高于B组,结果有统计学意义(p=0.037)。结论番木瓜叶提取物与血凝酶相比,在拔牙后的切口愈合更好。这项研究提出了有希望的天然提取物,如番木瓜在伤口愈合中的应用,因为它们很容易被患者获得,更经济,且无不良反应。未来需要更多专注于天然提取物促进伤口愈合的研究。
    Introduction Postoperative wound healing is the most important factor in the outcome of any surgical procedure. Wound healing is a dynamic process involving inflammation, neovascularization, granulation, fibroblast proliferation, re-epithelization, and remodeling. It repairs tissue integrity, restoring the body\'s natural defense barrier. A hastened wound healing will help in the quicker re-establishment of the body\'s homeostasis. Carica papaya includes vital nutrients and bioactive substances such as minerals, vitamins, and antioxidants. Its primary active ingredient papain causes the enzymatic debridement of wounds. Hemocoagulase is a thrombin-like serine protease that is mostly employed for its procoagulant and wound-healing characteristics. It is derived from the venom of Bothrops species of snakes. This study aims to compare the wound-healing properties of topical Carica papaya leaf extract and Hemocoagulase after dental extractions. Materials & Methods For 48 patients requiring bilateral therapeutic dental extraction for orthodontic intervention, Carica papaya leaf extract (Caripill 275mg/5ml) was topically applied to the extraction socket on one side, and Hemocoagulase 0.2 CU solution (Botroclot) was applied to the extraction socket on the other side. The bilateral premolars were extracted for orthodontic treatment under local anesthesia. Patients were asked to apply the solution topically twice daily for seven days and were called for review on the seventh day. The assessment of the efficacy of both solutions in post-operative wound healing was the objective of the study. Healing was assessed by using a blinded single observer for all patients using Landry\'s healing index. Results A total of 48 subjects with 96 sites completed the study, with a mean age of 15.4 years. The study population consisted of 24 males and 24 females, which were evenly distributed among the two study groups. On comparison of wound healing index (WHI) scores between the two groups using the Wilcoxon signed rank test, Group A had a significantly higher mean rank than Group B with regards to the wound healing index score, and the results were statistically significant (p = 0.037). Conclusion It can be concluded from the study that Carica papaya leaf extract showed better wound healing in post-extraction sockets compared to Hemocoagulase. This study presents the promising use of natural extracts such as Carica papaya in wound healing because they are easily accessible to patients, more economical, and have no adverse reactions. More studies that focus on natural extracts to promote wound healing are required in the future.
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