增生性瘢痕发生和演变过程中成纤维细胞生物学功能变化及其意义

The study on the fibroblasts biology in the hypertrophic scar formation and progression

目的 探索增生性瘢痕在发生和演变过程中,成纤维细胞生物学功能变化的规律及其意义.方法 选取人不同时期增生性瘢痕组织和正常皮肤组织,进行HE染色观察.另外,分离和培养不同时期瘢痕和正常皮肤中成纤维细胞,RT-PCR分别检测成纤维细胞在转移生长因子（TGF-β1）、血管内皮细胞生长因子（VEGF）、和Ⅰ、Ⅲ胶原mRNA表达水平的变化.结果 HE染色可见正常皮肤细胞和微血管数目较少,早期瘢痕增多,炎症细胞浸润明显.增生期瘢痕成纤维细胞和微血管增多.随病情进展,微血管呈缩窄倾向.消退期瘢痕成纤维细胞减少,微血管狭窄或闭塞.成熟期瘢痕见微血管、成纤维细胞数目进一步减少,微血管管腔小,大部分开放.RT-PCR检测结果发现,正常皮肤来源的成纤维细胞TGF-β1、VEGF和Ⅰ、Ⅲ胶原mRNA有较低表达,早期瘢痕成纤维细胞TGF-β1、VEGF和Ⅰ、Ⅲ胶原mRNA表达水平开始升高,在增生期表达到达高峰,消退期瘢痕的表达开始下降,到成熟期表达最低.结论 增生性瘢痕发生和演变过程中,成纤维细胞功能存在动态改变,这种动态改变与瘢痕的发生和消退成熟的病理变化相关.

Objective To investigate the changes of fibroblast biology in the progression of human hypertrophic scar progression. Methods The human hypertrophic scar of different stage as early, proliferative, regressive and mature scars were harvested and processed for HE staining and cell isolation. The isolated fibroblasts were cultured, and the total RNA was extracted for mRNA detection of TGF-β1, VEGF and collagen I, III. Normal skin as control was included in the analysis. Results HE staining showed that in normal skin there was small amount of fibroblasts and microvessels which increased in early scar, and some inflammatory cells could be seen in this stage. There was a large amount of microvessels and fibroblasts in proliferative scar and decreased in regressive scar with microvessels partially or totally occluded. In mature scar, there was a small amount of microvessels and fibroblasts which was more like normal skin. RT-PCR detection revealed that in normal fibroblasts there was lower expression of TGF-β1, VEGF, collagen I, and collagen III mRNA and increased in early scar. In hypertrophic scar, four cytokines mRNA expression reached a peak, and then decreased significantly in the regressive scar. The lowest level of expression was seen in mature scar. Conclusion The fibroblast biology changed in the scar progression which elevated in scar formation and decreased in scar progression.