人脐带胶在豚鼠眼睑原位重建中的应用

Feasibility of in situ eyelid reconstruction in guinea pigs using human umbilical cord jelly

背景:健康新生儿脐带胶是一种无血管的黏液结缔组织,有一定的弹性和韧性,含有溶菌酶、胎盘球蛋白、透明质酸酶、AMP抗体和补体系统,不容易发生感染和排斥反应,还含有较多的间充质干细胞,临床已被用于眼部整形手术。目的:观察脐带胶作为睑板替代物在豚鼠上眼睑重建中的组织相容性和组织病理变化。方法:取健康新生儿脐带中的黏液结缔组织-脐带胶,制备成厚薄相近的组织块;同时制作豚鼠睑板全层缺损模型并植入脐带胶组织块,观察动物大体情况,分别于脐带胶植入后1,2,3周取其交界处眼睑组织,光镜下观察组织学改变。结果与结论:所有动物在植入脐带胶材料后均未发生感染、脱位等情况,所有动物角膜上皮完整,无角膜上皮脱落。脐带胶代替睑板植入后1周时,结膜红润,切口无红肿等排斥反应发生,角膜上皮完整,眼睑运动可;脐带胶与肌肉间的炎性细胞浸润。植入后2周时结膜面红润,切口无红肿,无分泌物增多等排斥反应发生,角膜上皮完整,眼睑及眼球运动良好,无睑球粘连发生;脐带胶有溶解吸收倾向,炎性细胞不明显。植入3周时结膜切口愈合良好,角膜上皮完整,眼睑柔软,形态与对侧眼无明显区别;脐带胶部分吸收,其周边有新的纤维生成,无炎性细胞。说明脐带胶的免疫原性低,可引导新生胶原的生长,是一种良好的睑板替代物。

BACKGROUND：Healthy human umbilical cord jel y is a mucous connective tissue without vessels and has been used in eye plastic operation because of its elasticity and toughness. It contains lysozyme, placental globulin, hyaluronic acid enzyme, AMP antibody and complement, and also contains a lot of mesenchymal stem cells, so it is not prone to infection and rejection. OBJECTIVE：To observe the histocompatibility and histopathological changes of human umbilical cord jel y as a tarsal substitute transplanted for eyelid reconstruction in guinea pigs. METHODS：The mucous connective tissue of healthy neonate umbilical cord jel y was made into tissue blocks at even thickness. Models of tarsal defects were established in guinea pigs, and then the mucous connective tissue of healthy neonate umbilical cord jel y was implanted. Samples of implanted materials were col ected for histological examination at 1, 2, 3 weeks postoperation under light microscope. RESULTS AND CONCLUSION：There were no obvious rejection, infection and eyelid deformation observed, the corneas of al the animals were clear, corneal epithelial shedding did not occur, and the eyelid could move normal y. One week after implantation, there was no infection and rejection on the conjunctiva and the incision of the eyelid, the eyelid could move normal y, and partial inflammatory cells were observed between the human umbilical cord jel y and the muscle of the eyelid with microscopy. Two weeks after implantation, there was no infection and rejection on the conjunctiva and the incision of the eyelid, the cornea was clear, the eyelid and eye could move normal y, and no symblepharon occurred;umbilical cord jel y showed the tendency of absorption, and the inflammatory cells were reduced at 2 weeks after implantation. Three weeks after implantation, the incision of the conjunctiva healed wel , the cornea was clear;there was no difference in the eyelid form and movement between the two eyes;the umbilical cord jel y was absorbed partial y, normal fibrous tissues formed and there were no inflammatory cells. With low immunogenicity, human umbilical cord jel y can guide the growth of new col agen and serve as an ideal tarsal substitute.