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An easy and reproducible method for a large-zone deep partial-thickness burn model in the mini-pig. 小型猪大区域深部分厚度烧伤模型的简易再现方法。
IF 6.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2025-02-17 eCollection Date: 2025-01-01 DOI: 10.1093/burnst/tkae086
Ugo Lancien, Maria Sbeih, Alexandra Poinas, Pierre Perrot, Selim Aractingi, Amir Khammari, Brigitte Dréno
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引用次数: 0
Flufenamic acid inhibits pyroptosis in ischemic flaps via the AMPK-TRPML1-Calcineurin signaling pathway 氟芬那酸通过ampk - trpml1 -钙调磷酸酶信号通路抑制缺血皮瓣焦亡
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2025-02-17 DOI: 10.1093/burnst/tkaf007
Liang Chen, Ningning Yang, Kongbin Chen, Yingying Huang, Xian Liu, Gaoxiang Yu, Fulin Wang, Yong Gou, Yi Wang, Xiaolang Lu, Yuqi Wang, Lipeng Zhu, Weiyang Gao, Jian Ding
Background Ischemic injury is a primary cause of distal flap necrosis. Previous studies have shown that Flufenamic acid (FFA) can reduce inflammation, decrease oxidative stress (OS), and promote angiogenesis, suggesting its potential role in protecting flaps from ischemic damage. This study investigated the effects and mechanisms of FFA in enhancing the survival of ischemic flaps. Methods The viability of ischemic flaps was evaluated using laser doppler blood flow (LDBF) and survival rates. We examined levels of pyroptosis, OS, transcription factor E3 (TFE3)-induced autophagy, and elements of the AMPK-TRPML1-Calcineurin pathway through western blotting (WB), immunofluorescence (IF), molecular docking (MD), cellular thermal shift assay (CETSA) and surface plasmon resonance (SPR). Results The findings suggest that FFA significantly enhances the viability of ischemic flaps. The improvement in flap survival associated with FFA can be attributed to increased autophagy, diminished OS, and the suppression of pyroptosis. Notably, the promotion of autophagy flux and an augmented resistance to OS are instrumental in curbing pyroptosis in these flaps. Activation of TFE3 by FFA promoted autophagy and diminished oxidative damage. The therapeutic effects of FFA were negated when TFE3 levels were decreased using adeno-associated virus (AAV)-TFE3shRNA. Additionally, FFA modified TFE3 activity through the AMPK-TRPML1-Calcineurin pathway. Conclusions FFA promotes ischemic flap survival via induction of autophagy and suppression of oxidative stress by activation of the AMPK-TRPML1-Calcineurin-TFE3 signaling pathway. These findings could have therapeutic implications.
背景:缺血性损伤是远端皮瓣坏死的主要原因。先前的研究表明,氟芬那酸(FFA)可以减轻炎症,降低氧化应激(OS),促进血管生成,提示其在保护皮瓣免受缺血性损伤方面的潜在作用。本研究旨在探讨FFA对缺血皮瓣存活的促进作用及其机制。方法采用激光多普勒血流法(LDBF)评价缺血皮瓣的生存能力和存活率。我们通过western blotting (WB)、免疫荧光(IF)、分子对接(MD)、细胞热移测定(CETSA)和表面等离子体共振(SPR)检测了焦亡、OS、转录因子E3 (TFE3)诱导的自噬水平和AMPK-TRPML1-Calcineurin通路的元件。结果FFA能明显提高缺血皮瓣的存活率。与FFA相关的皮瓣存活率的提高可归因于自噬增加,OS减少和焦亡抑制。值得注意的是,促进自噬通量和增强对OS的抵抗力有助于抑制这些皮瓣的焦亡。FFA激活TFE3可促进自噬,减少氧化损伤。当使用腺相关病毒(AAV)-TFE3shRNA降低TFE3水平时,FFA的治疗效果被否定。此外,FFA通过AMPK-TRPML1-Calcineurin途径修饰TFE3活性。结论FFA通过激活AMPK-TRPML1-Calcineurin-TFE3信号通路诱导自噬和抑制氧化应激,促进缺血皮瓣存活。这些发现可能具有治疗意义。
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引用次数: 0
Deployable machine learning-based decision support system for tracheostomy in acute burn patients 基于可部署机器学习的急性烧伤气管切开术决策支持系统
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2025-02-17 DOI: 10.1093/burnst/tkaf010
Haisheng Li, Ni Zhen, Shixu Lin, Ning Li, Yumei Zhang, Wei Luo, Zhenzhen Zhang, Xingang Wang, Chunmao Han, Zhiqiang Yuan, Gaoxing Luo
Background Airway obstruction is a common emergency in acute burns with high mortality. Tracheostomy is the most effective method to keep patency of airway and start mechanical ventilation. However, the indication of tracheostomy is challenging and controversial. We aimed to develop and validate a deployable machine learning (ML)-based decision support system to predict the necessity of tracheostomy for acute burn patients. Methods We enrolled 1011 burn patients from Southwest Hospital (2018–2020) for model development and feature selection. The final model was validated on an independent internal cross-temporal cohort (2021, n = 274) and an external cross-institutional cohort (Second Affiliated Hospital of Zhejiang University School of Medicine 2020–2021, n = 376). To improve the model’s deployment and interpretability, an ML-based nomogram, an online calculator, and an abbreviated scale were constructed and validated. Results The optimal model was the eXtreme Gradient Boosting classifier (XGB), which achieved an AUROC of 0.973 and AUPRC of 0.879 in training dataset, and AUROCs of greater than 0.95 in both cross-temporal and cross-institutional validation. Moreover, it kept stable discriminatory ability in validation subgroups stratified by sex, age, burn area, and inhalation injury (AUROC ranging 0.903–0.990). The analysis of calibration curve, decision curve, and score distribution proved the feasibility and reliability of the ML-based nomogram, abbreviated scale, and online calculator. Conclusions The developed system has strong predictive ability and generalizability in cross-temporal and cross-institutional evaluations. The nomogram, online calculator, and abbreviated scale based on machine learning show comparable prediction performance and can be deployed in broader application scenarios, especially in resource-limited clinical environments.
背景:气道阻塞是急性烧伤的常见急症,死亡率高。气管切开术是保持气道通畅并开始机械通气的最有效方法。然而,气管切开术的适应症具有挑战性和争议性。我们旨在开发和验证一个可部署的基于机器学习(ML)的决策支持系统,以预测急性烧伤患者气管切开术的必要性。方法选取西南医院2018-2020年收治的1011例烧伤患者进行模型开发和特征选择。最终模型在独立的内部跨时间队列(2021年,n = 274)和外部跨机构队列(浙江大学医学院第二附属医院2020-2021年,n = 376)中进行验证。为了提高模型的可部署性和可解释性,构建并验证了基于ml的nomogram、online calculator和简略量表。结果最优模型为极限梯度增强分类器(eXtreme Gradient Boosting classifier, XGB),在训练数据集上AUROC分别为0.973和0.879,跨时间和跨机构验证的AUROC均大于0.95。在以性别、年龄、烧伤面积、吸入性损伤分层的验证亚组中保持稳定的区分能力(AUROC范围为0.903 ~ 0.990)。通过对标定曲线、决策曲线和评分分布的分析,证明了基于ml的nomogram、简略量表和在线计算器的可行性和可靠性。结论该系统在跨时间、跨机构评价中具有较强的预测能力和通用性。基于机器学习的nomogram、online calculator和缩略scale具有相当的预测性能,可以在更广泛的应用场景中部署,特别是在资源有限的临床环境中。
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引用次数: 0
The emerging role and therapeutical implications of ferroptosis in wound healing 铁下垂在伤口愈合中的新作用和治疗意义
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2025-02-14 DOI: 10.1093/burnst/tkae082
Yanan Zhao, Zhiyang Chen, Shenghao Xie, Feng Xiao, Qian Hu, Zhenyu Ju
Wound healing is a complex biological process involving multiple steps, including hemostasis, inflammation, proliferation, and remodeling. A novel form of regulated cell death, ferroptosis, has garnered attention because of its involvement in these processes. Ferroptosis is characterized by the accumulation of lipid peroxides and is tightly regulated by lipid metabolism, iron metabolism, and the lipid-peroxide repair network, all of which exert a significant influence on wound healing. This review highlights the current findings and emerging concepts regarding the multifaceted roles of ferroptosis throughout the stages of normal and chronic wound healing. Additionally, the potential of targeted interventions aimed at modulating ferroptosis to improve wound-healing outcomes is discussed.
伤口愈合是一个复杂的生物学过程,涉及多个步骤,包括止血、炎症、增殖和重塑。一种新型的受调控的细胞死亡,铁下垂,已经引起了人们的关注,因为它参与了这些过程。铁下垂的特点是脂质过氧化物的积累,受脂质代谢、铁代谢和脂质-过氧化物修复网络的严格调控,这些都对伤口愈合有重要影响。这篇综述强调了目前的发现和新兴的概念,关于在正常和慢性伤口愈合的各个阶段中,铁下垂的多方面作用。此外,潜在的针对性干预旨在调节铁下垂,以改善伤口愈合的结果进行了讨论。
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引用次数: 0
Microneedles in diabetic wound care: multifunctional solutions for enhanced healing 微针在糖尿病伤口护理:促进愈合的多功能解决方案
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2025-02-14 DOI: 10.1093/burnst/tkae076
Xichao Jian, Yaping Deng, Shune Xiao, Fang Qi, Chengliang Deng
Diabetic wounds present a significant challenge in clinical treatment and are characterized by chronic inflammation, oxidative stress, impaired angiogenesis, peripheral neuropathy, and a heightened risk of infection during the healing process. By creating small channels in the surface of the skin, microneedle technology offers a minimally invasive and efficient approach for drug delivery and treatment. This article begins by outlining the biological foundation of normal skin wound healing and the unique pathophysiological mechanisms of diabetic wounds. It then delves into the various types, materials, and preparation processes of microneedles. The focus is on the application of multifunctional microneedles in diabetic wound treatment, highlighting their antibacterial, anti-inflammatory, immunomodulatory, antioxidant, angiogenic and neural repair properties. These multifunctional microneedles demonstrate synergistic therapeutic effects by directly influencing the wound microenvironment, ultimately accelerating the healing of diabetic wounds. The advancement of microneedle technology not only holds promise for enhancing the treatment outcomes of diabetic wounds but also offers new strategies for addressing other chronic wounds.
糖尿病性伤口在临床治疗中面临着重大挑战,其特点是慢性炎症、氧化应激、血管生成受损、周围神经病变以及愈合过程中感染风险增加。通过在皮肤表面创建小通道,微针技术为药物输送和治疗提供了一种微创和有效的方法。本文首先概述了正常皮肤创面愈合的生物学基础和糖尿病创面独特的病理生理机制。然后深入研究了微针的各种类型、材料和制备过程。重点介绍了多功能微针在糖尿病伤口治疗中的应用,重点介绍了其抗菌、抗炎、免疫调节、抗氧化、血管生成和神经修复等特性。这些多功能微针通过直接影响伤口微环境,最终加速糖尿病伤口的愈合,显示出协同治疗效果。微针技术的进步不仅有望提高糖尿病伤口的治疗效果,也为解决其他慢性伤口提供了新的策略。
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引用次数: 0
Roles of dendritic epidermal T cells in steady and different pathological states 树突状表皮T细胞在稳定和不同病理状态下的作用
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2025-02-12 DOI: 10.1093/burnst/tkae056
Jiaqi Hao, Jie Zhang, Yan Liu
The epidermis is the outermost layer of the skin and acts as the primary barrier to protect the body. Dendritic epidermal T cells (DETCs), which are specifically distributed in epidermal tissues, play a crucial role in skin immune surveillance and wound healing. DETCs are one of the most important components of the epidermis and exert a steady-state monitoring function, facilitating wound healing and tissue regeneration after skin injury. Skin wounds are often linked to other pathological conditions such as ageing, ultraviolet radiation, and metabolic diseases such as diabetes mellitus and obesity. Therefore, it is crucial to investigate how DETCs regulate themselves and the external environment during these pathological states. DETCs interact closely with keratinocytes in the epidermis, and this intercellular interaction may be essential for maintaining health and integrity. In this review, we focus on the characteristics and underlying mechanisms of DETCs in maintaining epidermal homeostasis and re-epithelialization in different pathological states.
表皮是皮肤的最外层,是保护身体的主要屏障。树突状表皮T细胞(Dendritic epidermal T cells, DETCs)特异分布于表皮组织,在皮肤免疫监测和创面愈合中起着至关重要的作用。detc是表皮最重要的成分之一,发挥稳态监测功能,促进皮肤损伤后伤口愈合和组织再生。皮肤伤口通常与其他病理状况有关,如衰老、紫外线辐射和代谢疾病,如糖尿病和肥胖。因此,研究detc在这些病理状态下如何调节自身和外部环境是至关重要的。detc与表皮中的角质形成细胞密切相互作用,这种细胞间相互作用可能对维持健康和完整性至关重要。本文就detc在不同病理状态下维持表皮稳态和再上皮化的作用特点及机制进行综述。
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引用次数: 0
Engineered Extracellular Vesicles Derived from Pluripotent Stem Cells: A Cell-Free Approach to Regenerative Medicine 来自多能干细胞的工程化细胞外囊泡:一种无细胞再生医学方法
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2025-02-11 DOI: 10.1093/burnst/tkaf013
Aline Yen Ling Wang, Huang-Kai Kao, Yen-Yu Liu, Charles Yuen Yung Loh
The engineered extracellular vesicles (EVs) derived from pluripotent stem cells are a new concept in regenerative medicine. These vesicles are secreted from the embryonic stem cells as well as the induced pluripotent stem cells (iPSCs) and are involved in the transfer of bioactive molecules required for cell signaling. This review describes the possibilities for their use in the modification of therapeutic approaches in regenerative medicine and targeted therapies. Pluripotent stem cells can differentiate into various cell types which can be useful for tissue engineering or to generate models of diseases in a dish. Compared to cell therapies, engineered EVs are characterized by lower immunogenicity, higher targetability, and improved stability. Some of the applications are angiogenic, tissue restorative, immunomodulatory, and gene therapies for the treatment of certain diseases. iPSC-derived engineered EVs find application in regenerative medicine, drug delivery systems, diagnostics of diseases, and hydrogel systems. In regenerative medicine, they can promote the restoration of cardiac, bone, cartilage, and corneal tissues. Engineered EVs are also employed in drug targeting to particular sites as well as in the diagnosis of diseases based on biomarkers and improving image contrast. Hydrogels that contain EVs provide a depot-based delivery system to slowly release drugs in a controlled manner which enhances tissue repair. Thus, the results described above demonstrate the potential of engineered PSC-EVs for various biomedical applications. Future work will be directed toward expanding the knowledge of engineered PSC-EVs and their possibilities to create new therapeutic approaches based on the functions of these vesicles.
多能干细胞衍生的工程化细胞外囊泡(EVs)是再生医学的一个新概念。这些囊泡由胚胎干细胞和诱导多能干细胞分泌,并参与细胞信号传递所需的生物活性分子的转移。本文综述了它们在改进再生医学和靶向治疗中的应用。多能干细胞可以分化成各种细胞类型,可用于组织工程或在培养皿中产生疾病模型。与细胞疗法相比,工程化ev具有较低的免疫原性、更高的靶向性和更好的稳定性。其中一些应用是血管生成、组织修复、免疫调节和某些疾病的基因治疗。ipsc衍生的工程化电动汽车在再生医学、药物输送系统、疾病诊断和水凝胶系统中得到了应用。在再生医学中,它们可以促进心脏、骨骼、软骨和角膜组织的修复。工程ev也用于药物靶向特定位点,以及基于生物标志物的疾病诊断和改善图像对比度。含有ev的水凝胶提供了一种基于仓库的递送系统,以受控的方式缓慢释放药物,从而增强组织修复。因此,上述结果证明了工程化psc - ev在各种生物医学应用中的潜力。未来的工作将针对扩展工程psc - ev的知识及其基于这些囊泡功能创造新的治疗方法的可能性。
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引用次数: 0
AT-rich interaction domain 5A facilitates axon regeneration through docking protein 6 in the peripheral nervous system 富含at的相互作用域5A通过对接蛋白6在周围神经系统促进轴突再生
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2025-02-10 DOI: 10.1093/burnst/tkaf012
Zhixian Ren, Weixiao Huang, Xiaosong Gu, Lili Zhao
Background Peripheral nerves are easily damaged in accidental trauma due to their shallow location. Compared to the limited regeneration of the central nerve, the peripheral nerve has a certain regenerative ability after injury. However, this ability is not sufficient to achieve functional recovery. To increase the rate of regeneration after nerve injury, increasing regeneration-associated genes (RAGs) expression by transcription factors in neurons is necessary. Methods Sciatic nerve crush (SNC) animal models were generated in Sprague–Dawley (SD) rats. Bioinformatics analysis and real-time polymerase chain reaction (qPCR) were applied to detect genes expression; immunofluorescence staining and western blotting were applied to detect protein expression. The neurites outgrowth of cultured DRG neurons was performed to evaluate axon regeneration in vitro. Intrathecal injection of adeno-associated virus (AAV) was applied to suppress or overexpress the target in vivo. Following transfection, immunofluorescence staining of newborn axons’ marker (SCG10) in sciatic nerve after crush was used to evaluate the function of AT-rich interaction domain 5A (Arid5a) or docking protein 6 (Dok6) on axon regeneration. The binding between TF and the promoter of target genes was verified by chromatin immunoprecipitation (ChIP). Result has high activity in specific regenerating clusters and it accumulates specifically in the nucleus of DRG neurons after sciatic nerve injury. Upon Arid5a inhibition by siRNA, the outgrowth of neurites in vitro and the regeneration of axons in vivo were inhibited. In contrast, after Arid5a overexpression in rats, axon regeneration was significantly accelerated. In addition, Arid5a promotes the expression of Dok6 by binding to its promoter in DRG neurons. Suppression of Dok6 represses the neurites outgrowth of cultured DRG neurons, while its overexpression enhances axon regeneration in vivo. Furthermore, overexpression of Dok6 restored the impaired effect of Arid5a suppression on axon regeneration. Conclusions These findings indicate that axonal injury induced nucleus accumulation of Arid5a in neurons. Through Dok6, Arid5a accelerates axon regeneration of DRG neurons both in vitro and in vivo. This study enriched our understanding the function of Arid5a in the peripheral nervous system and the transcriptional regulatory network involved in neural regeneration.
外周神经的位置较浅,容易在意外外伤中受到损伤。与中枢神经的有限再生相比,损伤后周围神经具有一定的再生能力。然而,这种能力不足以实现功能恢复。为了提高神经损伤后的再生率,必须通过转录因子增加神经元中再生相关基因(regeneration associated genes, rag)的表达。方法建立SD大鼠坐骨神经压迫(SNC)动物模型。应用生物信息学分析和实时聚合酶链反应(qPCR)检测基因表达;应用免疫荧光染色和western blotting检测蛋白表达。体外培养DRG神经元,观察其轴突生长情况。鞘内注射腺相关病毒(AAV)在体内抑制或过表达靶标。转染后,采用坐骨神经挤压后新生轴突标记物(SCG10)的免疫荧光染色,评价富含at的相互作用结构域5A (Arid5a)或对接蛋白6 (Dok6)对轴突再生的作用。通过染色质免疫沉淀(ChIP)验证了TF与靶基因启动子的结合。结果在坐骨神经损伤后DRG神经元核内特异性聚集,在特定再生簇中具有较高的活性。siRNA抑制Arid5a后,体外神经突的生长和体内轴突的再生均受到抑制。相比之下,Arid5a在大鼠中过表达后,轴突再生明显加快。此外,Arid5a通过结合DRG神经元的启动子来促进Dok6的表达。抑制Dok6可抑制培养DRG神经元的神经突生长,而其过表达可促进体内轴突再生。此外,Dok6的过表达恢复了Arid5a抑制对轴突再生的受损作用。结论轴突损伤诱导神经元Arid5a核聚集。Arid5a通过Dok6在体外和体内加速DRG神经元的轴突再生。本研究丰富了我们对Arid5a在外周神经系统中的功能和参与神经再生的转录调控网络的认识。
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引用次数: 0
High early incidence of sepsis and its impact on organ dysfunction in burn trauma patients: a detailed and hypothesis generating study. 烧伤患者脓毒症的高早期发生率及其对器官功能障碍的影响:一项详细的假设生成研究。
IF 6.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2025-02-10 eCollection Date: 2025-01-01 DOI: 10.1093/burnst/tkae085
Folke Sjoberg, David Greenhalgh, Moustafa Elmasry, Islam Abdelrahman, Ahmed T El-Serafi, Ingrid Steinvall
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引用次数: 0
Nanomedicine-based immunotherapy for tissue regeneration 基于纳米医学的组织再生免疫疗法
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2025-02-09 DOI: 10.1093/burnst/tkaf015
Song Li, Li Lu, Yuan Xiong, Jun Xiao
Tissue regeneration is essential for repairing and restoring damaged tissues, which has significant implications for clinical outcomes. Understanding the cellular mechanisms and the role of the immune system in this process provides a basis for improved regenerative techniques. The emergence of nanomedicine has advanced this field by introducing nanoscale technology that offer precise control over therapeutic delivery and cellular interactions. By modulating immune responses, various immunotherapeutic approaches, including cytokine therapy and immune checkpoint inhibitors, can establish an optimal environment for tissue repair. This review summarizes recent findings and applications of nanomedicine-based immunotherapy in tissue regeneration. It highlights the properties and advantages of nanomedicine in immunotherapy, discusses recent progress in using nanocomposite biomaterials for tissue engineering, and addresses the challenges and future directions in this evolving field. This review aims to emphasize the promising potential of nanomedicine-based immunotherapy in tissue engineering, thereby contributing to the functional design and strategic development of next-generation nanomedicine for regenerative medicine.
组织再生是修复和恢复受损组织的必要条件,对临床结果具有重要意义。了解细胞机制和免疫系统在这一过程中的作用为改进再生技术提供了基础。纳米医学的出现通过引入纳米级技术,提供对治疗递送和细胞相互作用的精确控制,推动了这一领域的发展。通过调节免疫应答,各种免疫治疗方法,包括细胞因子治疗和免疫检查点抑制剂,可以建立组织修复的最佳环境。本文综述了纳米医学免疫治疗在组织再生中的研究进展及应用。重点介绍了纳米医学在免疫治疗中的特性和优势,讨论了纳米复合生物材料用于组织工程的最新进展,并提出了这一领域的挑战和未来发展方向。本文综述了纳米医学免疫治疗在组织工程中的应用前景,为下一代纳米医学在再生医学中的功能设计和战略发展提供参考。
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引用次数: 0
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Burns & Trauma
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