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瘢痕疙瘩患者瘢痕疙瘩与其周围正常皮肤水屏障功能的差异及其相关机制

于磊 杨雅婷 刘伟

于磊, 杨雅婷, 刘伟. 瘢痕疙瘩患者瘢痕疙瘩与其周围正常皮肤水屏障功能的差异及其相关机制[J]. 中华烧伤与创面修复杂志, 2022, 38(1): 63-68. DOI: 10.3760/cma.j.cn501120-20210427-00156.
引用本文: 于磊, 杨雅婷, 刘伟. 瘢痕疙瘩患者瘢痕疙瘩与其周围正常皮肤水屏障功能的差异及其相关机制[J]. 中华烧伤与创面修复杂志, 2022, 38(1): 63-68. DOI: 10.3760/cma.j.cn501120-20210427-00156.
Herrero DLE, Sanchez-Sanchez M, Cachafeiro FL, et al. Lactate and lactate clearance in critically burned patients: usefulness and limitations as a resuscitation guide and as a prognostic factor[J]. Burns, 2020, 46(8):1839-1847. DOI: 10.1016/j.burns.2020.06.003.
Citation: Herrero DLE, Sanchez-Sanchez M, Cachafeiro FL, et al. Lactate and lactate clearance in critically burned patients: usefulness and limitations as a resuscitation guide and as a prognostic factor[J]. Burns, 2020, 46(8):1839-1847. DOI: 10.1016/j.burns.2020.06.003.

瘢痕疙瘩患者瘢痕疙瘩与其周围正常皮肤水屏障功能的差异及其相关机制

doi: 10.3760/cma.j.cn501120-20210427-00156
基金项目: 

国家自然科学基金面上项目 81671921

详细信息
    通讯作者:

    刘伟,Email:liuwei_md@126.com

Differences of water barrier function between keloid and its surrounding normal skin in patients with keloids and its related mechanism

Funds: 

General Program of National Natural Science Foundation of China 81671921

More Information
  • 摘要:   目的   比较瘢痕疙瘩患者的瘢痕疙瘩与其周围正常皮肤的皮肤水屏障功能的差异并初步探索相关机制。   方法   采用横断面观察性研究方法。2020年10月—2021年3月,上海交通大学医学院附属第九人民医院接诊30例符合入选标准的瘢痕疙瘩患者,其中男12例、女18例,年龄20~48岁。接诊当日采用多功能皮肤测试仪测定30例患者瘢痕疙瘩皮肤及其周围正常皮肤的经皮水分丢失(TEWL)。对5例患者瘢痕疙瘩修复术后的瘢痕疙瘩皮肤及其周围正常皮肤行苏木精-伊红染色观测表皮厚度,取其中3例患者标本采用免疫组织化学法检测瘢痕疙瘩皮肤及正常皮肤细胞角蛋白10、内披蛋白和聚丝蛋白的表达。对数据行配对样本 t检验或独立样本 t检验。   结果   接诊当日,30例患者瘢痕疙瘩皮肤TEWL为9.0(6.9,13.4)g·m -2·h -1,正常皮肤的TEWL为8.1(6.4,18.1)g·m -2·h -1,二者比较差异无统计学意义( t=0.44, P>0.05)。瘢痕疙瘩修复术后,5例患者瘢痕疙瘩皮肤表皮厚度为(194±44)μm,明显厚于正常皮肤的(44±11)μm( t=6.88, P<0.01);且瘢痕疙瘩区域均存在角质形成细胞(KC)数量增多、正常皮肤的表皮脊结构缺乏、表皮明显增厚等现象。瘢痕疙瘩修复术后,3例患者瘢痕疙瘩皮肤细胞角蛋白10表达明显低于正常皮肤( t=8.50, P<0.01),而瘢痕疙瘩皮肤表皮的内披蛋白和聚丝蛋白表达均与正常皮肤相近( t值分别为0.07、0.96, P>0.05)。   结论   瘢痕疙瘩患者瘢痕疙瘩皮肤组织中存在KC增多、表皮增厚的现象,但瘢痕疙瘩区域的水屏障功能与周围正常皮肤组织相近,TEWL可能并不是影响瘢痕疙瘩持续发展的主要机制。

     

  • 参考文献(36)

    [1] TanS, KhumaloN, BayatA. Understanding keloid pathobiology from a quasi-neoplastic perspective: less of a scar and more of a chronic inflammatory disease with cancer-like tendencies[J]. Front Immunol,2019, 10:1810.DOI: 10.3389/fimmu.2019.01810.
    [2] AndrewsJP, MarttalaJ, MacarakE, et al. Keloids: the paradigm of skin fibrosis-pathomechanisms and treatment[J]. Matrix Biol,2016,51:37-46.DOI: 10.1016/j.matbio.2016.01.013.
    [3] OgawaR. Keloid and hypertrophic scars: are the result of chronic inflammation in the reticular dermis[J]. Int J Mol Sci,2017,18(3):606.DOI: 10.3390/ijms18030606.
    [4] LimandjajaGC, NiessenFB, ScheperRJ, et al. The keloid disorder: heterogeneity, histopathology, mechanisms and models[J]. Front Cell Dev Biol,2020,8:360.DOI: 10.3389/fcell.2020.00360.
    [5] TsaiCH, OgawaR. Keloid research: current status and future directions[J]. Scars Burn Heal, 2019,5:2059513119868659.DOI: 10.1177/2059513119868659.
    [6] UehaS, ShandFHW, MatsushimaK. Cellular and molecular mechanisms of chronic inflammation-associated organ fibrosis[J]. Front Immunol,2012,3:71.DOI: 10.3389/fimmu.2012.00071.
    [7] WangZC, ZhaoWY, CaoYY, et al. The roles of inflammation in keloid and hypertrophic scars[J]. Front Immunol,2020,11:603187.DOI: 10.3389/fimmu.2020.603187.
    [8] TandaraAA, MustoeTA. The role of the epidermis in the control of scarring:evidence for mechanism of action for silicone gel[J]. J Plast Reconstr Aesthet Surg,2008,61(10):1219-1225.DOI: 10.1016/j.bjps.2008.03.022.
    [9] MustoeTA. Evolution of silicone therapy and mechanism of action in scar management[J]. Aesthetic Plast Surg,2008,32(1):82-92.DOI: 10.1007/s00266-007-9030-9.
    [10] OgawaR, DohiT, TosaM, et al. The latest strategy for keloid and hypertrophic scar prevention and treatment: the Nippon Medical School (NMS) protocol[J]. J Nippon Med Sch,2021,88(1):2-9.DOI: 10.1272/jnms.JNMS.2021_88-106.
    [11] O'BrienL, JonesDJ. Silicone gel sheeting for preventing and treating hypertrophic and keloid scars[J]. Cochrane Database Syst Rev,2013,2013(9):CD003826.DOI: 10.1002/14651858.CD003826.pub3.
    [12] AlexanderH, BrownS, DanbyS, et al. Research techniques made simple: transepidermal water loss measurement as a research tool[J]. J Invest Dermatol,2018,138(11):2295-2300.e1.DOI: 10.1016/j.jid.2018.09.001.
    [13] DiniV, BarbaneraS, RomanelliM. Quantitative evaluation of maceration in venous leg ulcers by transepidermal water loss(TEWL) measurement[J]. Int J Low Extrem Wounds,2014,13(2):116-119.DOI: 10.1177/1534734614536035.
    [14] GardienKLM, BaasDC, de VetHCW, et al. Transepidermal water loss measured with the Tewameter TM300 in burn scars[J]. Burns,2016,42(7):1455-1462.DOI: 10.1016/j.burns.2016.04.018.
    [15] KuniiT, HiraoT, KikuchiK, et al. Stratum corneum lipid profile and maturation pattern of corneocytes in the outermost layer of fresh scars: the presence of immature corneocytes plays a much more important role in the barrier dysfunction than do changes in intercellular lipids[J]. Br J Dermatol,2003, 149(4):749-756.DOI: 10.1046/j.1365-2133.2003.05545.x.
    [16] EhrlichHP, DesmoulièreA, DiegelmannRF, et al. Morphological and immunochemical differences between keloid and hypertrophic scar[J]. Am J Pathol,1994,145(1):105-113.
    [17] BetarbetU, BlalockTW. Keloids: a review of etiology, prevention, and treatment[J]. J Clin Aesthet Dermatol,2020,13(2):33-43.
    [18] BaroniA, BuomminoE, De GregorioV, et al. Structure and function of the epidermis related to barrier properties[J]. Clin Dermatol,2012,30(3):257-262.DOI: 10.1016/j.clindermatol.211.08.007.
    [19] MenonGK, ClearyGW, LaneME. The structure and function of the stratum corneum[J]. Int J Pharm, 2012,435(1):3-9.DOI: 10.1016/j.ijpharm.2012.06.005.
    [20] RawlingsAV, HardingCR. Moisturization and skin barrier function[J]. Dermatol Ther,2004,17 (Suppl 1):S43-48.DOI: 10.1111/j.1396-0296.2004.04s1005.x.
    [21] SuetakeT, SasaiS, ZhenYX, et al. Functional analyses of the stratum corneum in scars. Sequential studies after injury and comparison among keloids, hypertrophic scars, and atrophic scars[J]. Arch Dermatol,1996,132(12):1453-1458.
    [22] LimandjajaGC, van den BroekLJ, WaaijmanT, et al. Increased epidermal thickness and abnormal epidermal differentiation in keloid scars[J]. Br J Dermatol,2017,176(1):116-126. DOI: 10.1111/bjd.14844.
    [23] OuseyK, CuttingKF, RogersAA, et al. The importance of hydration in wound healing: reinvigorating the clinical perspective[J]. J Wound Care,2016,25(3):122,124-130.DOI: 10.12968/jowc.2016.25.3.122.
    [24] SawadaY, SoneK. Hydration and occlusion treatment for hypertrophic scars and keloids[J]. Br J Plast Surg,1992,45(8):599-603.DOI: 10.1016/0007-1226(92)90027-u.
    [25] SuetakT, SasaiS, ZhenYX, et al. Effects of silicone gel sheet on the stratum corneum hydration[J]. Br J Plast Surg,2000,53(6):503-507.DOI: 10.1054/bjps.2000.3388.
    [26] KumarAS, KamalasananK. Drug delivery to optimize angiogenesis imbalance in keloid: a review[J]. J Control Release,2021,329:1066-1076.DOI: 10.1016/j.jconrel.2020.10.035.
    [27] MariW, AlsabriSG, TabalN, et al. Novel insights on understanding of keloid scar: article review[J]. J Am Coll Clin Wound Spec,2016,7(1/2/3):1-7.DOI: 10.1016/j.jccw.2016.10.001.
    [28] LeeHJ, JangYJ. Recent understandings of biology, prophylaxis and treatment strategies for hypertrophic scars and keloids[J]. Int J Mol Sci,2018,19(3):711.DOI: 10.3390/ijms19030711.
    [29] SogabeY, AkimotoS, AbeM, et al. Functions of the stratum corneum in systemic sclerosis as distinct from hypertrophic scar and keloid functions[J]. J Dermatol Sci,2002,29(1):49-53.DOI: 10.1016/s0923-1811(02)00006-3.
    [30] SandlandsA, SutherlandC, IrvineAD, et al. Filaggrin in the frontline: role in skin barrier function and disease[J]. J Cell Sci,2009,122(Pt 9):1285-1294.DOI: 10.1242/jcs.033969.
    [31] BrettmannEA, de Guzman StrongC. Recent evolution of the human skin barrier[J]. Exp Dermatol, 2018,27(8):859-866.DOI: 10.1111/exd.13689.
    [32] AnS, ChaHJ, KoJM, et al. Kinetin improves barrier function of the skin by modulating keratinocyte differentiation markers[J]. Ann Dermatol,2017,29(1):6-12.DOI: 10.5021/ad.2017.29.1.6.
    [33] VisscherMO, SaidD, WickettR. Stratum corneum cytokines, structural proteins, and transepidermal water loss: effect of hand hygiene[J]. Skin Res Technol,2010,16(2):229-236.DOI: 10.1111/j.1600-0846.2009.00411.x.
    [34] MollR, DivoM, LangbeinL. The human keratins: biology and pathology[J]. Histochem Cell Biol, 2008,129(6):705-733.DOI: 10.1007/s00418-008-0435-6.
    [35] JumperN, PausR, BayatA. Functional histopathology of keloid disease[J]. Histol Histopathol,2015, 30(9):1033-1057. DOI: 10.14670/HH-11-624.
    [36] LeeJYY, YangCC, ChaoSC, et al. Histopathological differential diagnosis of keloid and hypertrophic scar[J]. Am J Dermatopathol,2004,26(5): 379-384.DOI: 10.1097/00000372-200410000-00006.
  • 1  1例瘢痕疙瘩患者瘢痕疙瘩皮肤和正常皮肤的组织形态学观察 苏木精-伊红×100,图中标尺为200 µm。1A.正常皮肤;1B.瘢痕疙瘩皮肤,较图1A表皮增厚,细胞层数增多

    2  免疫组织化学法检测瘢痕疙瘩患者瘢痕疙瘩皮肤与正常皮肤细胞角蛋白10、内披蛋白、聚丝蛋白的表达情况 二氨基联苯胺-苏木精×100,图中标尺为100 μm。2A、2B、2C.分别为正常皮肤细胞角蛋白10、内披蛋白、聚丝蛋白阳性表达;2D、2E、2F.分别为瘢痕疙瘩皮肤细胞角蛋白10、内披蛋白、聚丝蛋白阳性表达,其中图2D染色明显较图2A浅,图2E的棕色区域较图2B分布更广,图2F与图2C阳性表达相近

    注:细胞角蛋白10、内披蛋白、聚丝蛋白阳性染色均为棕色

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  • 收稿日期:  2021-04-27

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