脉冲染料激光调节TGF-β1/Smad3信号通路促进成纤维细胞凋亡改善瘢痕增生的机制研究

Mechanism of Pulsed Dye Laser Modulation of TGF-β1/Smad3 Signaling Pathway to Promote Fibroblast Apoptosis and Improve Scar Hyperplasia

目的:观察脉冲染料激光(PDL)对增生性瘢痕的预防及治疗的有效性,比较治疗前后的瘢痕组织中转化生长因子-β1(TGF-β1)、Smad3基因的表达情况,探讨PDL治疗增生性瘢痕的机制。方法:以兔耳增生性瘢痕模型为研究对象,检查上皮化后和增生性瘢痕形成后PDL治疗对瘢痕的瘢痕增生指数(SEI)、瘢痕内成纤维细胞密度、胶原纤维面积、细胞凋亡、胶原蛋白Ⅰ/Ⅲ比值以及TGF-β1、Smad3表达的改变情况。结果:上皮化后创面接受PDL治疗后,SEI、成纤维密度指标、胶原纤维面积均保持平稳低水平(P>0.05);细胞凋亡率随天数增加明显上升(P<0.05);胶原蛋白Ⅰ/Ⅲ比值、TGF-β1、Smad3表达均无明显改变(P>0.05)。瘢痕形成后接受PDL治疗,SEI、成纤维密度指标、胶原纤维面积、胶原蛋白Ⅰ/Ⅲ比值、TGF-β1、Smad3表达随天数增加均呈下降趋势(P<0.05);细胞凋亡率随天数增加明显上升(P<0.05)。结论:PDL治疗通过下调TGF-β1/Smad3信号通路表达,促进瘢痕内成纤维细胞凋亡,从而预防及改善瘢痕增生。

Objective:To observe the effectiveness of pulsed dye laser(PDL)in the prevention and treatment of hypertrophic scar,compare the expression of transformed growth factor-β1(TGF-β1)and Smad3 genes in scar tissue before and after treatment,and explore the mechanism of PDL in the treatment of hypertrophic scar.Method:The rabbit ear hypertrophic scar model was studied,check after the epithelium and hyperplastic scar formation after PDL to treat the scar of scar elevation index(SEI),fibroblast density in scar,collagen fiber area,cell apoptosis,and collagen Ⅰ/Ⅲ ratio and TGF-β1,Smad3 expression change.Result:After PDL treatment,SEI,fibroblast density index and collagen fiber area remained stable and low(P>0.05),apoptosis rate increased significantly with the number of days(P<0.05),and there were no significant change in collagen Ⅰ/Ⅲ ratio,TGF-β1 and Smad3 expression(P>0.05).After receiving PDL treatment after scar formation,SEI,fibroblast density index,collagen fiber area,collagen Ⅰ/Ⅲ ratio,TGF-β1 and Smad3 expression showed a decreasing trend with the number of days(P<0.05),and apoptosis rate increased significantly with the number of days(P<0.05).Conclusion:Pulsed dye laser therapy can down-regulate the expression of TGF-β1/Smad3 signaling pathway and promote the apoptosis of fibroblasts in scar,thereby preventing and improving scar hyperplasia.