Objective: The use of noncultured autologous stromal vascular fraction or clinical grade adipose-derived regenerative cells (ADRCs) is a promising strategy to promote wound healing and tissue repair. Nevertheless, issues regarding the optimal mode of administration remain unclear. The purpose of this study was to compare the effects of local injection and topical spray delivery of ADRCs in a porcine model of thermal burns. Approach: Full-thickness thermal burns were created on the dorsum of 10 Gottingen minipigs. Two days following injury, wounds underwent fascial excision and were randomized to receive control vehicle or freshly isolated autologous ADRCs delivered by either multiple injections into or surrounding the wound bed, or by spray onto the wound surface (0.25 × 106 viable cells/cm2). Healing was evaluated by planimetry, histopathology, and immunohistochemistry at day 7, 12, 16, 21, and 28 posttreatment. Results:In vitro analysis demonstrated that there was no substantial loss of cell number or viability attributable to the spray procedure. Planimetric assessment revealed that delivery of ADRCs by either local injection or topical spray increased wound reepithelialization relative to control at day 14. No significant difference in wound reepithelialization was observed between both delivery approaches. In addition, on day 7 posttreatment, blood vessel density was greater in wounds receiving local or topical spray ADRCs than in the wounds treated with vehicle control. Histopathologic analysis suggests that ADRC treatment may modulate the inflammatory response by reducing neutrophil infiltration at day 7 and 12 posttreatment, irrespective of the route of administration. Conclusions: These data demonstrate that local injection and spray delivery of ADRCs modulate inflammation and improve wound angiogenesis and epithelialization. Importantly, both delivery routes exhibited similar effects on wound healing. Given the greater ease-of-use associated with topical spray delivery, these data support the use of a spray system for autologous ADRC delivery.

译文

目的: 使用未培养的自体基质血管部分或临床级脂肪源性再生细胞 (ADRCs) 是促进伤口愈合和组织修复的一种有前途的策略。然而,关于最佳管理模式的问题仍然不清楚。这项研究的目的是比较局部注射和局部喷雾递送ADRCs在猪热烧伤模型中的效果。方法: 在10个Gottingen minipigs的背部产生了全层热烧伤。受伤后两天,伤口进行筋膜切除,并随机接受对照载体或新鲜分离的自体ADRCs,通过多次注射进入或围绕伤口床,或通过喷洒到伤口表面 (0.25  ×   106活细胞/cm2)。在治疗后第7、12、16、21和28天,通过平面测定法,组织病理学和免疫组织化学评估愈合情况。结果: 体外分析表明,喷雾过程没有造成细胞数量或活力的实质性损失。平面评估显示,与第14天的对照相比,通过局部注射或局部喷雾递送adrc会增加伤口上皮再形成。在两种递送方法之间,伤口再上皮化均未观察到显着差异。此外,在治疗后的第7天,接受局部或局部喷雾ADRCs的伤口的血管密度比接受媒介物控制的伤口要大。组织病理学分析表明,ADRC治疗可以通过减少治疗后第7天和第12天的中性粒细胞浸润来调节炎症反应,而与给药途径无关。结论: 这些数据表明ADRCs的局部注射和喷雾递送可调节炎症并改善伤口血管生成和上皮形成。重要的是,两种递送途径对伤口愈合均表现出相似的效果。鉴于与局部喷雾递送相关的更大的易用性,这些数据支持使用喷雾系统进行自体ADRC递送。

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