血管内皮生长因子基因感染对大鼠创面移植复合皮的影响

The effects of the grafting of Ad-VEGF gene-infected composite skin on rat wounds

目的观察血管内皮生长因子（VEGF）基因感染的复合皮移植大鼠创面后的愈合效果。方法培养自体表皮细胞和异体成纤维细胞，用腺病毒介导的血管内皮生长因子（Ad-VEGF）感染大鼠成纤维细胞。分别构建感染的复合皮（自体表皮细胞＋人脱细胞真皮基质＋Ad-VEGF基因感染的成纤维细胞）和未感染的复合皮（自体表皮细胞＋人脱细胞真皮基质＋未感染的成纤维细胞），移植于大鼠背部皮肤缺损创面。术后2周观察大鼠创面移植皮片存活情况。术后2、4、6周观察大鼠复合皮大体情况，并取创面组织标本进行组织学观察。结果（1）术后2周，感染组复合皮成活面积大于未感染组复合皮成活面积；（2）术后2周，未感染组创面部分结痂。术后6周感染组复合皮表面光滑，有弹性，抗摩擦性强，愈合效果优于未感染组；（3）术后2周感染组皮片内可见较多的毛细血管分布；6周时表皮细胞分化达5-7层，纤维排列致密整齐，毛细血管分布均匀。结论用Ad-VEGF基因感染复合皮，可以刺激新生血管形成，明显提高皮片愈合质量。

Objective To observe the effects of the grafting of Ad-VEGF gene-infected composite skin on rat wounds with full thickness defect. Methods To culture auto-epidermal cells and allo-fibro- blasts, the fibroblasts were infected with Ad-VEGF. Two types of composite skin were constructed respectively. The infected composite skin was composed of auto-epidermal cells, human acellular dermal matrix and Ad-VEGF gene-infected fibroblasts, while the uninfected composite skin contained auto-epidermal cells, hu-man acellular dermal matrix and fibroblasts. The two kinds of composite skin were grafted onto wounds. The survival rate of the composite skin was observed at 2 post-operative weeks. The rat wounds were examined grossly on 2、4 and 6 weeks . Wound tissue samples were harvested for histological examination . Results （1） At 2 weeks, the survival area of infected composite skin was bigger than that of uninfected composite skin. （2） A scab was formed in the wound at 2 weeks in uninfected group. The surface of the grafted skin in infected group was smooth, elastic, and showed good anti-friction properly, and it was better in quality compared with that in another group at 6 weeks. （3） Capillary formation was more intense in the grafted skins in infected group at 2 weeks, and a normally proliferating keratinocyte layer of 5 to 7 layers of epithelial cells with orderly arrangement and evenly distributed fibrous tissue was seen at 6 weeks. Conclusions Repair of the wound with composite skin containing Ad-VEGF gene could promote angiogenesis,improve the quality of wound healing.