目的:评价肠内和肠胃外途径细菌发酵产生的外源性透明质酸(HA)在大鼠缺血皮瓣中的作用。使用临床和组织学检查;和白细胞介素(IL)作为组织炎症生物标志物。
方法:将64只雄性Wistar大鼠随机分为4组,基于治疗方案:皮下施用盐水溶液(0.9%)(GI);口服施用蒸馏水(GII);皮下施用HA(0.3%)(GIII);和口服施用HA(1%)(GIV)。所有组的皮瓣在临床和宏观评估方面具有可比性。组织学检查,促炎细胞因子(IL-1β,IL-6和肿瘤坏死因子-α)和抗炎细胞因子IL-10。
结果:在皮下施用HA治疗的皮瓣中发现坏死百分比较低(0.3%)。促炎和抗炎细胞因子,表皮厚度,血管,和炎性细胞在组间和组间差异均有统计学意义(p<0.05)。
结论:通过皮下或口服途径给药的高分子HA(1,400〜2,000kDa)对大鼠缺血皮瓣均具有有益作用。然而,HA(0.3%)的皮下给药在坏死和上皮形成的百分比方面显示出更好的结果。
OBJECTIVE: To evaluate exogenous hyaluronic acid (HA) derived from bacterial fermentation through enteral and parenteral routes in ischemic skin flaps induced in rats, using clinical and histological exams; and interleukins (IL) as tissue inflammatory biomarkers.
METHODS: Sixty-four male adults Wistar rats with ischemic skin flaps on the dorsum were randomized into four groups, based on the treatment protocol: subcutaneous administration of saline solution (0.9%) (GI); oral administration of distilled water (GII); subcutaneous administration of HA (0.3%) (GIII); and oral administration of HA (1%) (GIV). Flaps of all groups were comparable regarding clinical and macroscopic evaluation, histological examination, pro-inflammatory cytokines (IL-1β, IL-6, and tumor necrosis factor-α) and anti-inflammatory cytokine IL-10.
RESULTS: A lower percentage of necrosis was identified in flaps treated with subcutaneous administration of HA (0.3%). The pro- and anti-inflammatory cytokines, epidermis thickness, blood vessels, and inflammatory cells showed statistically significant inter-group and intra-group differences (p < 0.05).
CONCLUSIONS: High molecular HA (1,400 ~ 2,000 kDa) administrated by subcutaneous or oral route exhibited beneficial effects in ischemic skin flaps of rats. However, subcutaneous administration of HA (0.3%) showed better results in terms of the percentage of necrosis and epithelialization.