肌成纤维细胞在创伤愈合中的地位和作用

Status and role of myofibroblast in wound healing

目的:认识肌成纤维细胞的生物学特性、与创面收缩及病理性瘢痕的关系、表达及调控机制,有助于深入开展肌成纤维细胞在创伤愈合过程中作用的研究及机制探讨。资料来源:应用计算机检索Pubmed数据库1994-02/2005-02有关肌成纤维细胞在创伤愈合过程中作用的文章,检索词“Myofibroblast,woundhealing”,限定文章语言种类为English;同时应用计算机检索CNKI中文期刊全文数据库,检索词“肌成纤维细胞,创伤愈合”,检索年份“2001/2005”,限定文章语言为中文。资料选择:对检索到的资料进行初审,选取有关肌成纤维细胞的生物学特性、与创面收缩及病理性瘢痕的关系、表达调控机制的文献,选取标准为随机对照实验的研究,排除重复性研究。资料提炼:收集到16篇符合标准的文献,英文文献10篇,中文文献6篇,其中与肌成纤维细胞分子生物学特性有关的6篇,肌成纤维细胞在创口收缩及病理性瘢痕形成中作用有关的6篇,肌成纤维细胞在病理性瘢痕治疗中作用相关的文献4篇。资料综合:16篇文献论述了肌成纤维细胞的生物学特性、与创面收缩及病理性瘢痕的关系、表达调控机制。人们最初在伤口愈合处的肉芽组织中经显微镜检查发现肌成纤维细胞,作为成纤维细胞和平滑肌细胞的中间细胞,它具有成纤维细胞和平滑肌细胞的双重特性,存在于增生性瘢痕、纤维化疾病等病理状态下以及多处正常组织中。肌成纤维细胞的分化是一个复杂的过程,受细胞因子、细胞外基质复合物及机械拉力的影响。肌成纤维细胞是伤口愈合及纤维化过程中组织塑形的关键细胞,它与创伤愈合关系的研究作为一个崭新的领域正受到关注。试验证据来源于细胞培养、动物、人体。结论:越来越多的证据表明,肌成纤维细胞在创伤愈合过程中有着不可低估的地位和重要的作用,今后的研究应主要面向大规模的临床试验。

OBJECTIVE： To know the biological characters of myofibroblast, its correlation with wound healing and pathological scar, its expression and regulative mechanism, which are good for the further exploration on the study and mechanism of myofibroblast in wound healing. DATA SOURCES： A computer-based online search of Pubmed database was undertaken to identify articles about the role of myofibroblast in wound healing published in English between February 1994 and February 2005 by using the keywords of ＂myofibroblast, wound healing＂. Meanwhile, Chinese articles published between 2001 and 2005 were also searched with the same keywords in Chinese in China National Knowledge Infrastructure （CNKI） database. STUDY SELECTION： All the articles were selected firstly. Articles about the biological properts of myofibroblast, the relation to contraction of wound and pathological scar and mechanisms involved in myofibroblastic differentiation were accepted. The randomized controlled trials （RCT） were accepted as inclusive criteria. The excluded articles were repetitive studies. DATA EXTRACTION： Totally 16 literatures were collected according to the inclusive criteria. IO articles were English, and 6 articles were Chinese. Among them 6 articles were related to the biological propert of myofibroblast, 6 articles related to role of myofibroblast in wound contraction and pathological scar formation, and 4 articles about the role of myofib.roblast in the treatment of pathological scar. DATA SYNTHESIS： The collected I6 articles involved the biological properts of myofibroblast, the relation to wound contraction and pathological scar and mechanisms involved in myofibroblastic differentiation were discussed. After the first description of the myofibroblast in granulation tissue of an open wound by means of electron microscopy, as an intermediate cell between the fibroblast and the smooth muscle cell, the myofibroblast is a cell that possesses all the morphologic and biochemical characteristics of both a fibroblast and a smooth muscle cell. It has been identified both in normal tissues, and in pathological tissues, in relation with hypertrophic scarring, fibromatoses and fibrocontractive diseases. Myofibroblast differentiation is a complex process, regulated by cytokines, an extracellular matrix component, as well as the presence of mechanical tension. The myofibroblast is a key cell for the connective tissue remodeling that takes place during wound healing and fibrosis development. Researches on myofibroblast and wound healing,as a new investigation, obtain more and more attention. Trial evidences come from cell culture, animals and human body. CONCLUSION ：More and more evidences indicate that the effect of myofibroblast on the wound healing cannot be underestimated, and clinical trials of large scale were the main direction for the study in future.