局部炎症反应与无细胞异种真皮基质移植物的降解吸收关系

Relationship of the local inflammatory reaction with degradation and resorption of acellular dermal matrix xenograft

目的 探讨不同方法制作的无细胞异种真皮基质(Xeno-ADM)移植物降解吸收与炎症反应之间的关系。方法 猪和兔断层中厚皮片经Trypsin和TritonX-100等脱细胞,分别制成Xe-no-ADM和异体ADM(Allo-ADM),再按不同的预处理因素进行分组:(1)戊二醛交联的Xeno-ADM(A)组;(2)网状交联的Xeno-ADM(B)组;(3)未交联的:Xeno-ADM(C)组,预先被Xeno-ADM蛋白致敏的兔皮下植入;(4)交联的Xeno-ADM(D)组;(5)Allo-ADM(E)组。每组80块ADM分别埋植于兔耳和背部皮下。结果在背部的移植物较耳部炎性反应和降解吸收明显,至术后32wk时,E组以外的其它组移植物解剖学和组织学结构消失,D组和A组炎症反应滞后,可见较多的异物巨细胞,各组ADM炎症反应与降解/吸收的程度依次为:C>B>D>A>E(P<o.05～O.001),二者之间有显著的正相关(n=84,r=0.185,P<0.01)。结论Xeno-ADM生物相容性不及Allo-ADM,其异种蛋白抗原诱导的炎症-免疫反应可能是移植物降解最重要和直接的原因。

Objective To investigate the relationship between the inflammatory reaction and tissue degradation of xenogenic acellular dermal matrix (Xeno-ADM) implants prepared by different methods. Methods The split-thickness skin of swine and rabbits was processed with trypsin and Triton X-100 to make Xeno-ADM or Allo-ADM with glutaraldahyde and punched net(group B)and no conjugated Xeno-ADM(group C) ,in which the ADMs were grafted into the wounds of normal rabbit, and conjugated Xeno-ADM (group D)and allogenic rabbit dermal matrix Allo-ADM (group E,as control) , in which the ADMs were grafted into the rabbit wounds after the rabbits were pre-sensitizated by Xeno-ADM soluble antigen injections. Results There were evident inflammatory cell infiltration and matrix degradation-resorption gradient in Xeno-ADM grafting sites in dorsums. which were much stronger than that in all groups in pinna of ears,and foreign body giant cells were found existing abundantly in Xeno-ADM of A group and D group from 32 wk post-transplantation. The gradients of de-generation-resorption of ADM and inflammatory-immune reaction were as follows:C>B>D>A>E group(P<0. 05~0. 001). Conclusion The bio-compatibility of Xeno-ADM was not as good as that of Allo-ADM. The inflammatory-immune veaetian may be the direct cause of the degradation and absorption of implants.