纳米纤维素蛋白和脱细胞基质修复口腔黏膜

Nano-cellulose protein versus acellular matrix in oral mucosa repair

背景:口腔黏膜的敏感性和分泌黏液的功能等增加了口腔软组织修复难度,患者修复后其形态和功能难以达到预期的修复效果。纳米纤维素蛋白主要由甘氨酸、丙氨酸以及丝氨酸等组成,该材料具有良好的组织相容性。但是,目前临床上对于纳米纤维素蛋白和脱细胞基质在口腔黏膜修复中效果效果比较研究较少,且临床上对于两种材料修复效果尚存在较大争议。目的:观察纳米纤维素蛋白和脱细胞基质在口腔黏膜修复中的应用,比较两种不同修复材料的效果。方法:建立缺口黏膜缺损模型大鼠,建模后随机分为4组,对照组大鼠采用凡士林油修复,纳米纤维素蛋白组大鼠采用纳米纤维素蛋白修复,牛脱细胞基质组采用牛皮肤组织脱细胞基质修复,人脱细胞基质组则利用人皮肤组织脱细胞基质修复。各组大鼠进行2个月观察,比较不同材料下大鼠口腔黏膜中的修复效果。结果与结论:(1)口腔黏膜缺损直径:采用游标卡尺对4组口腔黏膜修复进行测量,各组大鼠术后1 d口腔黏膜缺损直径差异无显著性意义(P>0.05),纳米纤维素蛋白组大鼠术后3,5,7 d口腔黏膜缺损直径显著低于其他3组(P<0.05),牛脱细胞基质组和人脱细胞基质组在术后5,7 d口腔黏膜缺损直径显著低于对照组(P<0.05);(2)口腔黏膜组织形态:光学显微镜下观察显示,纳米纤维素蛋白组、牛脱细胞基质组和人脱细胞基质组在术后1,3,5,7周口腔黏膜缺损部分新生组织中毛细血管内皮数差异无显著性意义(P>0.05);纳米纤维素蛋白组、牛脱细胞基质组和人脱细胞基质组与对照组相比差异有显著性意义(P<0.05);纳米纤维素蛋白组术后21 d新生上皮较厚,排列比较紧密;牛脱细胞基质组术后21 d缺损部位修复良好,新生上皮存在,炎性细胞减少;人脱细胞基质组存在明显炎性细胞,存在新生上皮组织,厚度一般;对照组修复21 d后炎性细胞较多,上皮组织较薄。(3)结果说明,纳米纤维素蛋白材料和脱细胞基质能促进口腔黏膜上皮增生,加快创面愈合。

BACKGROUND： The sensitivity and mucus secretion of the oral mucosa make oral soft tissues difficult to repair, so patients cannot achieve satisfactory outcomes after treatment. Nano-cellulose protein mainly composed of glycine, alanine and serine has good histocompatibility. However, there is a lack of comparative study about the effect of nano-cellulose protein and acellular matrix in oral mucosa repair, and the clinical effects of the two materials are still under discussion. OBJECTIVE： To investigate the effects of nano-cellulose protein versus acellular matrix in oral mucosa repair. METHODS： Oral mucosa defect models were prepared in rats, and these rat models were randomly divided into four groups： oral mucosa defects were repaired by vaseline（control group）, nano-cellulose protein, bovine skin acellular matrix and human skin acellular matrix, respectively. Repair effects were compared among different materials within 2 months after surgery. RESULTS AND CONCLUSION： The diameter of oral mucosa defect measured using a vernier caliper, had no significant differences among groups at 1 day after surgery（P〉0.05）; the diameter of oral mucosa defect in the nano-cellulose protein group was significantly lower than that in the other groups at 3, 5 and 7 days after surgery（P〈0.05）; the diameter of oral mucosa defect in the bovine and human skin acellular matrix groups was significantly lower than that in the control group at 5 and 7 days after surgery（P〈0.05）. Morphological observation of the oral mucosa under light microscope showed： the number of newborn capillary endothelial cells in the defect region had no significant differences among nano-cellulose protein, bovine acellular matrix and human acellular matrix groups at 1, 3, 5 and 7 weeks after surgery（P〉0.05）; but there were significant differences in the number of newborn capillary endothelial cells between the control group and the other three groups（P〈0.05）. Furthermore, at 21 days after surgery, closely aligned and thicker new epithelial tissue could be found in the nano-cellulose protein group; in the bovine acellular matrix group, the defect region was repaired well, new epithelial tissue appeared and the number of inflammatory cells decreased; in the human acellular matrix group, inflammatory cells appeared obviously, and new epithelial tissue formed with the normal thickness. In contrast, abundant inflammatory cells and thinner epithelial tissues appeared in the control group. To conclude, both nano-cellulose protein and acellular matrix can accelerate wound healing by promoting oral mucosal epithelial hyperplasia.