β射线敷贴照射治疗增生性瘢痕机制及与肿瘤坏死因子-α关系研究进展

Mechanisms of β-ray application therapy for hypertrophic scars and relationship between β-ray and Tumour Necrosis Factor-α

瘢痕形成是高等哺乳动物特有的创伤愈合形式。在创伤的愈合过程中,如果成纤维细胞合成与分解代谢紊乱,将会导致细胞外基质合成增多和过度沉积,形成增生性瘢痕。目前,增生性瘢痕发病机制及病变基础仍不完全清楚,其影响因素包括:遗传因素、自身免疫因素、内分泌因素、癌基因、细胞凋亡、细胞因子、组织缺氧及细胞间缝隙连接等,治疗上也仍然十分棘手。β射线敷贴照射治疗是一种非常有效的治疗方法 ,通过敷贴器上的放射性核素在衰变过程中释放出的β射线,作用于瘢痕组织中的成纤维细胞。瘢痕组织中含有许多细胞因子,其中肿瘤坏死因子-α(TNF-α)主要由激活的单核/巨噬细胞细胞与T淋巴细胞产生,对成纤维细胞胶原合成与分解代谢发挥着重要作用。在β射线敷贴照射治疗过程中,组织中的TNF-α水平也会发生变化,这些错综复杂的因素共同影响着增生性瘢痕的发生与发展。

Scarring is the characteristic healing mode of high-mammal. During wound healing, if fibroblasts disorder in constructive and destructive metabolism, excessive extracellular matrix will be produced and deposite , and scar formed. Pathogensy of the hypertrophic scars is not clear. there are many factors affecting the pathogenesy of the hypertrophic scars, such as genetic factor, antoimmunity factor, endocrine secretion factor, oncogenes, apoptosis, cytokines, hypoxia, gap junction and so on. Treatment of hypertrophic scars is still very hard now. The β-ray application therapy is a very effective treatment. Radionuclide on application can emit β-ray that affects fibroblast. There are many cytokines in tissue of hypertrophic scars. Tumour necrosis factor-α, mainly secreted by macrophages and T cell, plays an important role. During β-ray application therapy, the level of tumour necrosis factor-α can make change. All these complicated factors have great effects on the development of hypertrophic scars together.