脱细胞真皮基质移植后组织学转归的实验研究

摘要

Objective To demonstrate the histology in acellular dermal matrix(ADM)after being transplanted in vivo over time. Methods Forty male SD rats were recruited for the experiment. Subcutaneous implantation of an 1 cm × 1 cm ADM was given in the left sides on the back of the rat for the experimental group, while only dissection and suturing were performed in right side of the back for the control group. All the animals will be sacrificed at appointed time after operation, Five ADM samples were harvested in each time point. The content and proportion of collagen type were examined with HE staining, Picrosirius staining, Masson′s trichrome staining, and Immunohistochemical staining (targets: pan macrophage, M1 macrophage and M2 macrophage). Results All rats survived after operative without any complications. Significant differences of thickness were not observed at the end of 5 months; HE scores suggested that ADM increased in cell infiltration scores in 2 weeks before the plateau , vascularity also showed a similar trend; Collagen trichrome staining showed a substantial increase in density of collagen bundles with time. The comparison of the proportion of collagen among days showed significant differences (P < 0.05). Immunohistochemical staining of M1 and M2 showed that macrophages had distinct polarization profiles in materials. Furthermore, the comparison of M1 vs M2 response associated with different materials showed significant differences in all time points (P < 0.05). Conclusions The chemically cross-linked ADM could keep long time in the body; ADM significantly stimulated proinflammatory of M2 differentiation from M1 in constructive remodeling.%目的：：研究脱细胞真皮基质（acellular dermal matrix，ADM）植入体内后的长期组织学转归规律。方法：取成年雄性SD 大鼠40只于脊柱双侧分别形成1．5 cm ×1．5 cm大小U形切口，左侧（试验组）植入ADM，右侧（阴性对照组）切断后仅原位缝合。于术后相应时间点随机处死5只大鼠取材行组织学观察，包括常规HE 染色，Masson′s染色和天狼星红苦味酸特殊染色，免疫组织化学染色标记巨噬细胞M0及M1、M2分型。结果：ADM 5个月后体积未见明显变化；HE观察2周内以炎性细胞浸润为主，之后逐渐消退；Masson′s 染色及苦味酸天狼星红染色显示ADM植入后胶原排列逐渐规则致密，Ⅰ／Ⅲ型胶原数值与未植入前相比差异均有统计学意义（P ＜0．05）；巨噬细胞免疫组化染色提示，不同时期ADM组M2／M1值显著高于对照组（P ＜0．05）。结论：交联ADM植入后可长期维持稳定的体积，胶原排列逐渐规则致密；胶原亚型不同时期呈现规律性升降；ADM具有促进促炎性M1巨噬细胞向修复重建作用的M2巨噬细胞极化的作用。