他莫昔芬软膏对兔耳增生性瘢痕中TGF-β2表达的影响

摘要

目的 观察不同浓度他莫昔芬软膏对兔耳增生性瘢痕成纤维细胞和转化生长因子的影响,并探讨其防治增生性瘢痕的可行性.方法 采用兔耳增生性瘢痕模型,将96只新西兰长耳兔共576个耳创面随机分为实验A、B、C组和对照组D组,每组创面144个,实验A、B、C组分别外涂不同浓度(0.5%,1%,2%)的他莫昔芬软膏,D组则涂以空白软膏,分别于术后30、60、90 d切取增生的瘢痕组织,测量瘢痕厚度、观察瘢痕组织形态学变化,并检测成纤维细胞密度及瘢痕组织中TGFβ2 含量变化.结果 ①30 d时,A、D组与B、C组瘢痕厚度差异有统计学意义(P＜0.05),A、D组＜B组＜C组;成纤维细胞密度与TGF-β2 含量则相反,A、D组＞B组＞C组(P＜0.05).② 60、90 d时,4组瘢痕厚度、成纤维细胞密度及TGF-β2 含量差异有统计学意义(P＜0.05),A、B、C、D组TGF-β2含量60 d时分别为:(43.97±3.63)μg/L、(41.92±3.91)μg/L、(36.69±4.15)μg/L、(54.90±4.71)μg/L,90 d时分别为:(45.69 ±2.63)μg//L、(40.43±3.87)μg/L、(38.76±3.24)μg//L、(52.59±4.92)μg/L;成纤维细胞密度60 d时A、B、C、D组分别为:(4 392.07±327.84)个/mm2、(4 208.57±329.76)个/mm2、(4 033.44±427.91)个/mm2、(4 863.03±387.98)个/mm2,90 d时分别为:(4 418.41 ±432.52)个/mm2、(4 077.65 ±386.70)个/mm2、(3 844.53 ±354.29)个/mm2、(4 838.64±390.52)个/mm2,D组＞A组＞B组＞C组(P＜0.05).结论 外用他莫昔芬可降低TGF-β2,减少成纤维细胞数目,引起瘢痕萎缩,从而防治瘢痕增生.%Objective To observe the effect of different concentration of Tamoxifen ointment on the fibroblasts and transforming growth factor (TGF-β2) of hypertrophic scar at rabbit ears, so as to explore the possibility of treatment of hypertrophic scar with Tamoxifen. Methods The hypertrophic scar model was established in 96 New Zealand rabbits' ears. The wounds were divided into four groups (A, B, C and D) , with 144 wounds in each group. Different concentration of tamoxifen ointment(0. 5% ,1% ,2% ) was topically administered in groups A, B and C respectively, and blank ointment in group D. On postoperative (54. 90 ±4. 71) μg/L, respectively, on 60th day; and (45. 69 ±2.63) μg/L, (40. 43 ±3.87) μg/L, (38. 76 ±3. 24) μg/L, (52. 59 ±4. 92) μg/L, respectively, on 90th day. The fibroblasts density of scar in groups A, B, C, D was (4 392. 07 ± 327. 84 ) point/mm2, ( 4 208. 57 ± 329. 76 ) point/mm2, (4 033.44 ±427.91) point/mm2, (4 863.03 ±387.98) point/mm2, respectively, on 60 th day; and (4 418. 41 ±432. 52) point/mm2, (4 077. 65 ±386. 70) point/mm2, (3 844. 53 ±354. 29) point/mm2,(4 838.64 ±390.52) point/mm2, respectively, on 90th day. The content of TGF-β2 and fibroblasts density of scar were lined up as group D ＞ group A ＞ group B ＞ group C ( P ＜ 0. 05 ) . Conclusions Topical Tamoxifen'can reduce the content of TGF-β2 and fibroblast, decrease fibroblasts density and the formation of hypertrophic scar at rabbit ears. It offers a new way for the treatment of the hypertrophic scar.