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The impact of COVID-19 on clinical outcomes of burn patients COVID-19 对烧伤患者临床疗效的影响
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2023-12-07 DOI: 10.1093/burnst/tkad042
Elliot T Walters, Alen Palackic, Camila Franco-Mesa, Nikhil R Shah, Michael J Erickson, Steven E Wolf
Background Multiple studies have shown the SARS-CoV-2 virus (COVID-19) to be associated with deleterious outcomes in a wide range of patients. The impact of COVID-19 has not been well investigated among burned patients. We suspect that patients will have worsened respiratory and thrombotic complications, ultimately leading to increased mortality. The objective of this study is to determine the impact a concurrent infection of COVID-19 has on clinical outcomes after a burn injury. Methods This is a retrospective, propensity matched, cohort study. We examined a de-identified database of electronic medical records of over 75 million patients across 75 health care associations in the United States for patients treated for thermal burns from 1 January 2020, to 31 July 2021, and those who also were diagnosed with COVID-19 infection within one day before or after injury based on International Classification of Disease, tenth revision (ICD-10) codes. Study participants included adults who were treated for a burn injury during the study period. Results We included 736 patients with burn injury and concomitant COVID-19 infection matched to 736 patients with burn injury and no concurrent COVID-19 infection (total 1472 patients, mean age 36.3 ± 24.3). We found no significant increase in mortality observed for patients with concurrent COVID-19 (OR 1.203, 95% CI 0.517–2.803; p = 0.6675). We did observe significant increase in infections (OR 3.537, 95% CI 2.798–4.471; p = 0.0001), thrombotic complications (OR 2.342, 95% CI 1.351–4.058; p = 0.0018), as was the incidence of hypertrophic scarring (OR 3.368, 95% CI 2.326–4.877; p = 0.0001). Conclusions We observed that concurrent COVID-19 infection was associated with an increase in infections, thrombosis and hypertrophic scarring but no increase in mortality in our cohort of burn patients.
背景多项研究表明,SARS-CoV-2 病毒(COVID-19)与许多患者的不良预后有关。COVID-19 对烧伤患者的影响尚未得到很好的研究。我们怀疑患者的呼吸系统和血栓并发症会恶化,最终导致死亡率上升。本研究的目的是确定 COVID-19 并发感染对烧伤后临床结果的影响。方法 这是一项倾向匹配的回顾性队列研究。我们对美国 75 家医疗保健协会超过 7500 万名患者的电子病历进行了去标识化数据库检查,以了解 2020 年 1 月 1 日至 2021 年 7 月 31 日期间接受热烧伤治疗的患者,以及根据国际疾病分类第十次修订版(ICD-10)代码在受伤前后一天内被诊断出感染 COVID-19 的患者。研究对象包括在研究期间接受过烧伤治疗的成年人。结果 我们纳入了 736 名烧伤并发 COVID-19 感染的患者和 736 名烧伤但未并发 COVID-19 感染的患者(共 1472 名患者,平均年龄为 36.3 ± 24.3)。我们发现并发 COVID-19 感染的患者死亡率没有明显增加(OR 1.203,95% CI 0.517-2.803;P = 0.6675)。但我们观察到感染(OR 3.537,95% CI 2.798-4.471;p = 0.0001)、血栓并发症(OR 2.342,95% CI 1.351-4.058;p = 0.0018)和增生性瘢痕的发生率(OR 3.368,95% CI 2.326-4.877;p = 0.0001)明显增加。结论 我们观察到,在我们的烧伤患者队列中,并发 COVID-19 感染与感染、血栓形成和增生性瘢痕的增加有关,但死亡率没有增加。
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引用次数: 0
Is the surgical community prepared to face patients with SARS-CoV-2-induced cell death and organ injury in the post-pandemic era? 面对由 SARS-CoV-2 引起的细胞死亡和器官损伤的患者,外科界是否做好了后大流行时代的准备?
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2023-11-22 eCollection Date: 2023-01-01 DOI: 10.1093/burnst/tkad049
Sanketh Rampes, Sufia Ruhomaun, Qiang Shu, Daqing Ma
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引用次数: 0
Regulated necrosis pathways: a potential target for ischemic stroke. 受调节的坏死途径:缺血性卒中的潜在靶点。
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2023-11-18 eCollection Date: 2023-01-01 DOI: 10.1093/burnst/tkad016
Kaidi Ren, Jinyan Pei, Yuanyuan Guo, Yuxue Jiao, Han Xing, Yi Xie, Yang Yang, Qi Feng, Jing Yang

Globally, ischemic stroke causes millions of deaths per year. The outcomes of ischemic stroke are largely determined by the amount of ischemia-related and reperfusion-related neuronal death in the infarct region. In the infarct region, cell injuries follow either the regulated pathway involving precise signaling cascades, such as apoptosis and autophagy, or the nonregulated pathway, which is uncontrolled by any molecularly defined effector mechanisms such as necrosis. However, numerous studies have recently found that a certain type of necrosis can be regulated and potentially modified by drugs and is nonapoptotic; this type of necrosis is referred to as regulated necrosis. Depending on the signaling pathway, various elements of regulated necrosis contribute to the development of ischemic stroke, such as necroptosis, pyroptosis, ferroptosis, pathanatos, mitochondrial permeability transition pore-mediated necrosis and oncosis. In this review, we aim to summarize the underlying molecular mechanisms of regulated necrosis in ischemic stroke and explore the crosstalk and interplay among the diverse types of regulated necrosis. We believe that targeting these regulated necrosis pathways both pharmacologically and genetically in ischemia-induced neuronal death and protection could be an efficient strategy to increase neuronal survival and regeneration in ischemic stroke.

在全球范围内,缺血性中风每年造成数百万人死亡。缺血性脑卒中的预后在很大程度上取决于梗死区缺血相关和再灌注相关神经元死亡的数量。在梗死区,细胞损伤要么遵循包括精确信号级联的调控途径,如凋亡和自噬,要么遵循不受任何分子效应机制(如坏死)控制的非调控途径。然而,最近大量研究发现,某种类型的坏死可以被药物调节和潜在地修饰,并且是非凋亡性的;这种类型的坏死被称为调节性坏死。根据信号通路的不同,各种受调控的坏死因子参与缺血性卒中的发展,如坏死性坏死、焦性坏死、铁性坏死、病理坏死、线粒体通透性转移、孔介导的坏死和肿瘤。在本文中,我们旨在总结缺血性脑卒中中调控性坏死的潜在分子机制,并探讨不同类型的调控性坏死之间的相互作用。我们认为,在缺血诱导的神经元死亡和保护中,从药理学和遗传学上靶向这些受调节的坏死途径可能是增加缺血性卒中中神经元存活和再生的有效策略。
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引用次数: 0
Extracellular vesicles modulate key signalling pathways in refractory wound healing 细胞外囊泡调节难治性伤口愈合的关键信号通路
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2023-11-17 DOI: 10.1093/burnst/tkad039
Bowen Yang, Yumeng Lin, Yibo Huang, Nanxi Zhu, Ying-Qiang Shen
Chronic wounds are wounds that cannot heal properly due to various factors, such as underlying diseases, infection or reinjury, and improper healing of skin wounds and ulcers can cause a serious economic burden. Numerous studies have shown that extracellular vesicles (EVs) derived from stem/progenitor cells promote wound healing, reduce scar formation and have significant advantages over traditional treatment methods. EVs are membranous particles that carry various bioactive molecules from their cellular origins, such as cytokines, nucleic acids, enzymes, lipids and proteins. EVs can mediate cell-to-cell communication and modulate various physiological processes, such as cell differentiation, angiogenesis, immune response and tissue remodelling. In this review, we summarize the recent advances in EV-based wound healing, focusing on the signalling pathways that are regulated by EVs and their cargos. We discuss how EVs derived from different types of stem/progenitor cells can promote wound healing and reduce scar formation by modulating the Wnt/β-catenin, phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin, vascular endothelial growth factor, transforming growth factor β and JAK–STAT pathways. Moreover, we also highlight the challenges and opportunities for engineering or modifying EVs to enhance their efficacy and specificity for wound healing.
慢性伤口是指由于潜在疾病、感染或再损伤等多种因素导致无法正常愈合的伤口,皮肤伤口和溃疡愈合不当会造成严重的经济负担。大量研究表明,来自干细胞/祖细胞的细胞外囊泡(EVs)促进伤口愈合,减少疤痕形成,与传统治疗方法相比具有显著优势。电动汽车是一种膜状颗粒,携带来自细胞起源的各种生物活性分子,如细胞因子、核酸、酶、脂质和蛋白质。电动汽车可以介导细胞间的通讯,调节各种生理过程,如细胞分化、血管生成、免疫反应和组织重塑。在这篇综述中,我们总结了基于电动汽车的伤口愈合的最新进展,重点是由电动汽车及其货物调节的信号通路。我们讨论了来自不同类型的干细胞/祖细胞的ev如何通过调节Wnt/β-连环蛋白、磷酸肌肽3-激酶/蛋白激酶B/雷帕霉素的哺乳动物靶点、血管内皮生长因子、转化生长因子β和JAK-STAT途径促进伤口愈合和减少疤痕形成。此外,我们还强调了工程或改造电动汽车以提高其伤口愈合的功效和特异性的挑战和机遇。
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引用次数: 0
Peptide RL-QN15 promotes wound healing of diabetic foot ulcers through p38 mitogen-activated protein kinase and smad3/miR-4482-3p/vascular endothelial growth factor B axis 肽RL-QN15通过p38丝裂原活化蛋白激酶和smad3/miR-4482-3p/血管内皮生长因子B轴促进糖尿病足溃疡创面愈合
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2023-11-17 DOI: 10.1093/burnst/tkad035
Dandan Sun, Kun Guo, Naixin Liu, Yilin Li, Yuansheng Li, Yan Hu, Shanshan Li, Zhe Fu, Yinglei Wang, Yutong Wu, Yingxuan Zhang, Jiayi Li, Chao Li, Zhuo Wang, Zijian Kang, Jun Sun, Ying Wang, Xinwang Yang
Background Wound management of diabetic foot ulcers (DFUs) is a complex and challenging task, and existing strategies fail to meet clinical needs. Therefore, it is important to develop novel drug candidates and discover new therapeutic targets. However, reports on peptides as molecular probes for resolving issues related to DFUs remain rare. This study utilized peptide RL-QN15 as an exogenous molecular probe to investigate the underlying mechanism of endogenous non-coding RNA in DFU wound healing. The aim was to generate novel insights for the clinical management of DFUs and identify potential drug targets. Methods We investigated the wound-healing efficiency of peptide RL-QN15 under diabetic conditions using in vitro and in vivo experimental models. RNA sequencing, in vitro transfection, quantitative real-time polymerase chain reaction, western blotting, dual luciferase reporter gene detection, in vitro cell scratches, and cell proliferation and migration assays were performed to explore the potential mechanism underlying the promoting effects of RL-QN15 on DFU repair. Results Peptide RL-QN15 enhanced the migration and proliferation of human immortalized keratinocytes (HaCaT cells) in a high-glucose environment and accelerated wound healing in a DFU rat model. Based on results from RNA sequencing, we defined a new microRNA (miR-4482-3p) related to the promotion of wound healing. The bioactivity of miR-4482-3p was verified by inhibiting and overexpressing miR-4482-3p. Inhibition of miR-4482-3p enhanced the migration and proliferation ability of HaCaT cells as well as the expression of vascular endothelial growth factor B (VEGFB). RL-QN15 also promoted the migration and proliferation ability of HaCaT cells, and VEGFB expression was mediated via inhibition of miR-4482-3p expression by the p38 mitogen-activated protein kinase (p38MAPK) and smad3 signaling pathways. Conclusions RL-QN15 is an effective molecule for the treatment of DFUs, with the underlying mechanism related to the inhibition of miR-4482-3p expression via the p38MAPK and smad3 signaling pathways, ultimately promoting re-epithelialization, angiogenesis and wound healing. This study provides a theoretical basis for the clinical application of RL-QN15 as a molecular probe in promoting DFU wound healing.
背景:糖尿病足溃疡(DFUs)的伤口管理是一项复杂而具有挑战性的任务,现有的策略不能满足临床需要。因此,开发新的候选药物和发现新的治疗靶点非常重要。然而,关于多肽作为分子探针解决dfu相关问题的报道仍然很少。本研究利用肽RL-QN15作为外源性分子探针,探讨内源性非编码RNA在DFU创面愈合中的潜在机制。目的是为DFUs的临床管理产生新的见解,并确定潜在的药物靶点。方法采用体外和体内实验模型,研究肽RL-QN15对糖尿病患者创面愈合的影响。通过RNA测序、体外转染、实时定量聚合酶链反应、western blotting、双荧光素酶报告基因检测、体外细胞划痕、细胞增殖和迁移等实验,探讨RL-QN15促进DFU修复的可能机制。结果肽RL-QN15增强了人永生化角质形成细胞(HaCaT细胞)在高糖环境下的迁移和增殖,加速了DFU大鼠模型的伤口愈合。根据RNA测序结果,我们定义了一种新的与促进伤口愈合相关的microRNA (miR-4482-3p)。通过抑制和过表达miR-4482-3p来验证miR-4482-3p的生物活性。抑制miR-4482-3p可增强HaCaT细胞的迁移和增殖能力以及血管内皮生长因子B (VEGFB)的表达。RL-QN15还能促进HaCaT细胞的迁移和增殖能力,通过p38丝裂原活化蛋白激酶(p38MAPK)和smad3信号通路抑制miR-4482-3p表达介导VEGFB的表达。结论RL-QN15是治疗DFUs的有效分子,其机制可能与通过p38MAPK和smad3信号通路抑制miR-4482-3p的表达有关,最终促进再上皮化、血管生成和伤口愈合。本研究为RL-QN15作为分子探针促进DFU创面愈合的临床应用提供了理论依据。
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引用次数: 0
Chinese expert consensus on the Management of Pediatric Deep Partial-Thickness Burn Wounds (2023 edition). 中国儿科深部偏厚烧伤创面管理专家共识(2023年版)。
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2023-10-31 eCollection Date: 2023-01-01 DOI: 10.1093/burnst/tkad053
Yan Liu

Burns are a main cause of accidental injuries among children in China. Because of the unique wound repair capacity and demand for growth in pediatric patients, the management of pediatric deep partial-thickness burn wounds involves a broader range of treatment options and controversy. We assembled experts from relevant fields in China to reach a consensus on the key points of thermal-induced pediatric deep partial-thickness burn-wound management, including definition and diagnosis, surgical treatments, nonsurgical treatment, choice of wound dressings, growth factor applications, infectious wound treatment, scar prevention and treatment. The committee members hope that the Expert Consensus will provide help and guiding recommendations for the treatment of pediatric deep partial-thickness burn wounds.

烧伤是中国儿童意外伤害的主要原因。由于儿科患者独特的伤口修复能力和成长需求,儿科深部部分厚度烧伤伤口的管理涉及更广泛的治疗选择和争议。我们汇集了国内相关领域的专家,就热致儿童深部偏厚烧伤创面管理的关键点达成共识,包括定义和诊断、手术治疗、非手术治疗、创面敷料的选择、生长因子的应用、感染性创面治疗、瘢痕预防和治疗。委员会成员希望《专家共识》将为儿科深部部分厚度烧伤的治疗提供帮助和指导性建议。
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引用次数: 0
S100 calcium-binding protein A9 promotes skin regeneration through toll-like receptor 4 during tissue expansion. S100钙结合蛋白A9在组织扩张过程中通过toll样受体4促进皮肤再生。
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2023-10-31 eCollection Date: 2023-01-01 DOI: 10.1093/burnst/tkad030
Yu Zhang, Yajuan Song, Jing Du, Wei Liu, Chen Dong, Zhaosong Huang, Zhe Zhang, Liu Yang, Tong Wang, Shaoheng Xiong, Liwei Dong, Yaotao Guo, Juanli Dang, Qiang He, Zhou Yu, Xianjie Ma

Background: In plastic surgery, tissue expansion is widely used for repairing skin defects. However, low expansion efficiency and skin rupture caused by thin, expanded skin remain significant challenges in promoting skin regeneration during expansion. S100 calcium-binding protein A9 (S100A9) is essential in promoting wound healing; however, its effects on skin regeneration during tissue expansion remain unclear. The aim of the present study was to explore the role of S100A9 in skin regeneration, particularly collagen production to investigate its importance in skin regeneration during tissue expansion.

Methods: The expression and distribution of S100A9 and its receptors-toll-like receptor 4 (TLR-4) and receptor for advanced glycation end products were studied in expanded skin. These characteristics were investigated in skin samples of rats and patients. Moreover, the expression of S100A9 was investigated in stretched keratinocytes in vitro. The effects of S100A9 on the proliferation and migration of skin fibroblasts were also observed. TAK-242 was used to inhibit the binding of S100A9 to TLR-4; the levels of collagen I (COL I), transforming growth factor beta (TGF-β), TLR-4 and phospho-extracellular signal-related kinase 1/2 (p-ERK1/2) in fibroblasts were determined. Furthermore, fibroblasts were co-cultured with stretched S100A9-knockout keratinocytes by siRNA transfection and the levels of COL I, TGF-β, TLR-4 and p-ERK1/2 in fibroblasts were investigated. Additionally, the area of expanded skin, thickness of the dermis, and synthesis of COL I, TGF-β, TLR-4 and p-ERK1/2 were analysed to determine the effects of S100A9 on expanded skin.

Results: Increased expression of S100A9 and TLR-4 was associated with decreased extracellular matrix (ECM) in the expanded dermis. Furthermore, S100A9 facilitated the proliferation and migration of human skin fibroblasts as well as the expression of COL I and TGF-β in fibroblasts via the TLR-4/ERK1/2 pathway. We found that mechanical stretch-induced S100A9 expression and secretion of keratinocytes stimulated COL I, TGF-β, TLR-4 and p-ERK1/2 expression in skin fibroblasts. Recombined S100A9 protein aided expanded skin regeneration and rescued dermal thinning in rats in vivo as well as increasing ECM deposition during expansion.

Conclusions: These findings demonstrate that mechanical stretch promoted expanded skin regeneration by upregulating S100A9 expression. Our study laid the foundation for clinically improving tissue expansion using S100A9.

背景:在整形外科中,组织扩张被广泛用于修复皮肤缺陷。然而,低膨胀效率和由薄而膨胀的皮肤引起的皮肤破裂仍然是在膨胀过程中促进皮肤再生的重大挑战。S100钙结合蛋白A9(S100A9)在促进伤口愈合中是必需的;然而,它在组织扩张过程中对皮肤再生的影响尚不清楚。本研究的目的是探索S100A9在皮肤再生中的作用,特别是胶原蛋白的产生,以研究其在组织扩张过程中皮肤再生的重要性。方法:研究S100A9及其受体toll样受体4(TLR-4)和晚期糖基化终产物受体在扩张皮肤中的表达和分布。在大鼠和患者的皮肤样本中研究了这些特征。此外,还研究了S100A9在体外拉伸角质形成细胞中的表达。还观察了S100A9对皮肤成纤维细胞增殖和迁移的影响。TAK-242用于抑制S100A9与TLR-4的结合;测定成纤维细胞中I型胶原(COL I)、转化生长因子β(TGF-β)、TLR-4和磷酸化细胞外信号相关激酶1/2(p-ERK1/2)的水平。此外,通过siRNA转染将成纤维细胞与拉伸的S100A9敲除角质形成细胞共培养,并研究成纤维细胞中COL I、TGF-β、TLR-4和p-ERK1/2的水平。此外,还分析了扩张皮肤的面积、真皮厚度以及COL I、TGF-β、TLR-4和p-ERK1/2的合成,以确定S100A9对扩张皮肤的影响。结果:S100A9和TLR-4的表达增加与扩张真皮中细胞外基质(ECM)的减少有关。此外,S100A9通过TLR-4/ERK1/2途径促进人皮肤成纤维细胞的增殖和迁移以及成纤维细胞中COL I和TGF-β的表达。我们发现,机械拉伸诱导的S100A9表达和角质形成细胞的分泌刺激了皮肤成纤维细胞中COL I、TGF-β、TLR-4和p-ERK1/2的表达。重组S100A9蛋白有助于大鼠体内扩大皮肤再生,挽救真皮变薄,并增加扩张过程中ECM的沉积。结论:这些发现表明,机械拉伸通过上调S100A9的表达来促进扩张的皮肤再生。我们的研究为S100A9在临床上改善组织扩张奠定了基础。
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引用次数: 0
Extracellular vesicles from 3D cultured dermal papilla cells improve wound healing via Krüppel-like factor 4/vascular endothelial growth factor A -driven angiogenesis. 来自3D培养的真皮乳头细胞的细胞外小泡通过Krüppel样因子4/血管内皮生长因子A驱动的血管生成改善伤口愈合。
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2023-10-30 eCollection Date: 2023-01-01 DOI: 10.1093/burnst/tkad034
Yunwei Wang, Kuo Shen, Yulin Sun, Peng Cao, Jia Zhang, Wanfu Zhang, Yang Liu, Hao Zhang, Yang Chen, Shaohui Li, Chaolei Xu, Chao Han, Yating Qiao, Qingyi Zhang, Bin Wang, Liang Luo, Yunshu Yang, Hao Guan

Background: Non-healing wounds are an intractable problem of major clinical relevance. Evidence has shown that dermal papilla cells (DPCs) may regulate the wound-healing process by secreting extracellular vesicles (EVs). However, low isolation efficiency and restricted cell viability hinder the applications of DPC-EVs in wound healing. In this study, we aimed to develop novel 3D-DPC spheroids (tdDPCs) based on self-feeder 3D culture and to evaluate the roles of tdDPC-EVs in stimulating angiogenesis and skin wound healing.

Methods: To address the current limitations of DPC-EVs, we previously developed a self-feeder 3D culture method to construct tdDPCs. DPCs and tdDPCs were identified using immunofluorescence staining and flow cytometry. Subsequently, we extracted EVs from the cells and compared the effects of DPC-EVs and tdDPC-EVs on human umbilical vein endothelial cells (HUVECs) in vitro using immunofluorescence staining, a scratch-wound assay and a Transwell assay. We simultaneously established a murine model of full-thickness skin injury and evaluated the effects of DPC-EVs and tdDPC-EVs on wound-healing efficiency in vivo using laser Doppler, as well as hematoxylin and eosin, Masson, CD31 and α-SMA staining. To elucidate the underlying mechanism, we conducted RNA sequencing (RNA-seq) of tdDPC-EV- and phosphate-buffered saline-treated HUVECs. To validate the RNA-seq data, we constructed knockdown and overexpression vectors of Krüppel-like factor 4 (KLF4). Western blotting, a scratch-wound assay, a Transwell assay and a tubule-formation test were performed to detect the protein expression, cell migration and lumen-formation ability of KLF4 and vascular endothelial growth factor A (VEGFA) in HUVECs incubated with tdDPC-EVs after KLF4 knockdown or overexpression. Dual-luciferase reporter gene assays were conducted to verify the activation effect of KLF4 on VEGFA.

Results: We successfully cultured tdDPCs and extracted EVs from DPCs and tdDPCs. The tdDPC-EVs significantly promoted the proliferation, lumen formation and migration of HUVECs. Unlike DPC-EVs, tdDPC-EVs exhibited significant advantages in terms of promoting angiogenesis, accelerating wound healing and enhancing wound-healing efficiency both in vitro and in vivo. Bioinformatics analysis and further functional experiments verified that the tdDPC-EV-regulated KLF4/VEGFA axis is pivotal in accelerating wound healing.

Conclusions: 3D cultivation can be utilized as an innovative optimization strategy to effectively develop DPC-derived EVs for the treatment of skin wounds. tdDPC-EVs significantly enhance wound healing via KLF4/VEGFA-driven angiogenesis.

背景:不愈合的伤口是一个棘手的问题,具有重要的临床意义。有证据表明,毛乳头细胞(DPCs)可能通过分泌细胞外小泡(EVs)来调节伤口愈合过程。然而,低的分离效率和有限的细胞活力阻碍了DPC-EVs在伤口愈合中的应用。在本研究中,我们旨在开发基于自饲养3D培养的新型3D-DPC球体(tdDPCs),并评估tdDPC-EVs在刺激血管生成和皮肤伤口愈合中的作用。方法:为了解决目前DPC-EVs的局限性,我们之前开发了一种自饲养三维培养方法来构建TDDPC。用免疫荧光染色和流式细胞术鉴定DPCs和tdDPCs。随后,我们从细胞中提取EVs,并使用免疫荧光染色、划痕试验和Transwell试验在体外比较DPC-EVs和tdDPC-EVs对人脐静脉内皮细胞(HUVECs)的影响。我们同时建立了全层皮肤损伤的小鼠模型,并使用激光多普勒以及苏木精和伊红、Masson、CD31和α-SMA染色评估了DPC-EVs和tdDPC-EVs对体内伤口愈合效率的影响。为了阐明潜在的机制,我们对tdDPC EV和磷酸盐缓冲盐水处理的HUVECs进行了RNA测序(RNA-seq)。为了验证RNA-seq数据,我们构建了Krüppel样因子4(KLF4)的敲除和过表达载体。进行蛋白质印迹、划痕试验、Transwell试验和小管形成试验,以检测KLF4和血管内皮生长因子a(VEGFA)在敲低或过表达后与tdDPC-EVs孵育的HUVECs中的蛋白质表达、细胞迁移和管腔形成能力。进行双荧光素酶报告基因测定以验证KLF4对VEGFA的激活作用。结果:我们成功地培养了tdDPCs,并从DPCs和tdDPCs中提取了EVs。tdDPC-EVs显著促进HUVECs的增殖、管腔形成和迁移。与DPC-EVs不同,tdDPC-EVs在体外和体内都表现出促进血管生成、加速伤口愈合和提高伤口愈合效率的显著优势。生物信息学分析和进一步的功能实验证实,tdDPC-EV调节的KLF4/VEGFA轴在加速伤口愈合方面至关重要。结论:3D培养可作为一种创新的优化策略,有效开发用于治疗皮肤伤口的DPC衍生EVs。tdDPC-EVs通过KLF4/VEGFA驱动的血管生成显著增强伤口愈合。
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引用次数: 0
In vitro comparison of human plasma-based and self-assembled tissue-engineered skin substitutes: two different manufacturing processes for the treatment of deep and difficult to heal injuries. 基于人血浆和自组装组织工程皮肤替代品的体外比较:两种不同的制造工艺,用于治疗深度和难以愈合的损伤。
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2023-10-30 eCollection Date: 2023-01-01 DOI: 10.1093/burnst/tkad043
Álvaro Sierra-Sánchez, Brice Magne, Etienne Savard, Christian Martel, Karel Ferland, Martin A Barbier, Anabelle Demers, Danielle Larouche, Salvador Arias-Santiago, Lucie Germain

Background: The aim of this in vitro study was to compare side-by-side two models of human bilayered tissue-engineered skin substitutes (hbTESSs) designed for the treatment of severely burned patients. These are the scaffold-free self-assembled skin substitute (SASS) and the human plasma-based skin substitute (HPSS).

Methods: Fibroblasts and keratinocytes from three humans were extracted from skin biopsies (N = 3) and cells from the same donor were used to produce both hbTESS models. For SASS manufacture, keratinocytes were seeded over three self-assembled dermal sheets comprising fibroblasts and the extracellular matrix they produced (n = 12), while for HPSS production, keratinocytes were cultured over hydrogels composed of fibroblasts embedded in either plasma as unique biomaterial (Fibrin), plasma combined with hyaluronic acid (Fibrin-HA) or plasma combined with collagen (Fibrin-Col) (n/biomaterial = 9). The production time was 46-55 days for SASSs and 32-39 days for HPSSs. Substitutes were characterized by histology, mechanical testing, PrestoBlue™-assay, immunofluorescence (Ki67, Keratin (K) 10, K15, K19, Loricrin, type IV collagen) and Western blot (type I and IV collagens).

Results: The SASSs were more resistant to tensile forces (p-value < 0.01) but less elastic (p-value < 0.001) compared to HPSSs. A higher number of proliferative Ki67+ cells were found in SASSs although their metabolic activity was lower. After epidermal differentiation, no significant difference was observed in the expression of K10, K15, K19 and Loricrin. Overall, the production of type I and type IV collagens and the adhesive strength of the dermal-epidermal junction was higher in SASSs.

Conclusions: This study demonstrates, for the first time, that both hbTESS models present similar in vitro biological characteristics. However, mechanical properties differ and future in vivo experiments will aim to compare their wound healing potential.

背景:这项体外研究的目的是比较用于治疗严重烧伤患者的两种并排的人类双层组织工程皮肤替代品(hbTESS)模型。这些是无支架的自组装皮肤替代品(SASS)和基于人血浆的皮肤替代物(HPSS) = 3) 并且使用来自同一供体的细胞来产生两种hbTESS模型。对于SASS的制造,将角质形成细胞接种在包括成纤维细胞和它们产生的细胞外基质(n = 12) ,而对于HPSS的生产,角质形成细胞是在水凝胶上培养的,水凝胶由成纤维细胞组成,成纤维细胞包埋在血浆中作为独特的生物材料(纤维蛋白),血浆与透明质酸结合(纤维蛋白HA)或血浆与胶原结合(纤维素Col)(n/生物材料 = 9) 。SASS的生产时间为46-55天,HPSS的生产时间则为32-39天。通过组织学、机械测试、PrestoBlue对替代品进行了表征™-免疫荧光(Ki67,Keratin(K)10,K15,K19,Loricrin,IV型胶原)和Western印迹(I型和IV型胶原蛋白) p值 + 在SASS中发现了细胞,尽管它们的代谢活性较低。表皮分化后,K10、K15、K19和Loricrin的表达没有显著差异。总的来说,SASS中I型和IV型胶原的产生以及真皮-表皮连接处的粘附强度更高。结论:本研究首次证明,两种hbTESS模型都具有相似的体外生物学特性。然而,机械性能各不相同,未来的体内实验将旨在比较它们的伤口愈合潜力。
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引用次数: 0
Tailored biomedical materials for wound healing. 为伤口愈合量身定制的生物医学材料。
IF 6.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2023-10-26 eCollection Date: 2023-01-01 DOI: 10.1093/burnst/tkad040
Wenhui Liu, Lihua Zu, Shanzheng Wang, Jingyao Li, Xiaoyuan Fei, Meng Geng, Chunlei Zhu, Hui Shi

Wound healing is a long-term, multi-stage biological process that mainly includes haemostatic, inflammatory, proliferative and tissue remodelling phases. Controlling infection and inflammation and promoting tissue regeneration can contribute well to wound healing. Smart biomaterials offer significant advantages in wound healing because of their ability to control wound healing in time and space. Understanding how biomaterials are designed for different stages of wound healing will facilitate future personalized material tailoring for different wounds, making them beneficial for wound therapy. This review summarizes the design approaches of biomaterials in the field of anti-inflammatory, antimicrobial and tissue regeneration, highlights the advanced precise control achieved by biomaterials in different stages of wound healing and outlines the clinical and practical applications of biomaterials in wound healing.

伤口愈合是一个长期、多阶段的生物学过程,主要包括止血、炎症、增殖和组织重塑阶段。控制感染和炎症以及促进组织再生可以很好地促进伤口愈合。智能生物材料在伤口愈合方面具有显著优势,因为它们能够在时间和空间上控制伤口愈合。了解生物材料是如何为伤口愈合的不同阶段设计的,将有助于未来为不同伤口定制个性化材料,使其对伤口治疗有益。本文综述了生物材料在抗炎、抗菌和组织再生领域的设计方法,重点介绍了生物材料对伤口愈合不同阶段实现的先进精确控制,并概述了生物材料的临床和实际应用。
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引用次数: 0
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Burns & Trauma
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