外敷氨基胍霜剂对糖尿病大鼠皮肤组织的影响

目的 观察外敷氨基胍霜剂对糖尿病大鼠皮肤组织晚期糖基化终末产物(AGE)形成、KC细胞增殖及氧化应激的影响.方法 将硬脂酸、液状石蜡、凡士林、羊毛脂、肉豆蔻酸异丙酯、甘油、50 g/L尼泊金醇、盐酸氨基胍等试剂按一定比例混合制成氨基胍霜剂,以不含有氨基胍的霜剂为基质.取健康大鼠背部皮肤,分别用5、10 g/L氨基胍霜剂和5 g/L氨基胍+10g/L氮酮霜剂处理,于用药后2、4、7、10、12、24 h测定药物透皮效果.将30只SD大鼠按随机数字表法分为正常对照组6只、糖尿病组8只、氨基胍治疗组8只、基质治疗组8只.后3组大鼠腹腔注射链脲佐菌素65 mg/kg,诱导糖尿病模型;对照组大鼠注射0.05 mmol/L柠檬酸缓冲液.注射1周后,正常对照组与糖尿病组大鼠不行任何治疗,氨基胍治疗组与基质治疗组大鼠背部分别连续外用10 g/L氨基胍霜剂与基质治疗4周.取各组皮肤组织,胶原提取液荧光强度检测法测定AGE含量,流式细胞仪分析表皮KC周期,检测氧化应激相关指标超氧化物歧化酶(SOD)、丙二醛、总抗氧化能力、髓过氧化物酶(MPO)含量.对实验数据行t检验.结果 10 g/L氨基胍霜剂透皮效果优于5g/L氨基胍和5 g/L氨基胍+10 g/L氮酮的霜剂.1只基质治疗组大鼠未诱导成功.建模后4周,糖尿病组与氨基胍治疗组大鼠分别死亡4只和1只.糖尿病组大鼠皮肤组织AGE含量为每毫克羟脯氨酸(OHP)中(36.8±2.6)U,明显高于正常对照组的每毫克OHP中(24.6±2.7)U(t=7.2,P＜0.01);氨基胍治疗组AGE含量为每毫克OHP中(28.6±3.7)U,明显低于糖尿病组(t=-3.9,P＜0.05);基质治疗组AGE含量[每毫克OHP中(32.2±5.2)U]与糖尿病组相近(t=1.6,P＞0.05).糖尿病组大鼠S期KC比例为(5.3±0.6)%,低于正常对照组的(7.6±0.9)%(t=4.50,P＜0.01);氨基胍治疗组大鼠S期和G2/M期KC比例均明显高于糖尿病组(t值分别为6.80、3.17,P值均小于0.01);基质治疗组大鼠S期KC比例[(9.2±1.5)%]显著高于糖尿病组(t=4.90,P＜0.01).糖尿病组大鼠皮肤组织氧化应激指标含量均高于正常对照组,其中SOD和MPO差异有统计学意义(t值分别为4.4、3.7,P值均小于0.05);氨基胍治疗组各氧化应激指标含量均较糖尿病组降低,其中SOD含量显著低于糖尿病组(t=-1.4,P＜0.05);基质治疗组MDA、MPO含量显著低于糖尿病组(t值分别为2.6、2.9,P值均小于0.05).结论 外用氨基胍霜剂可以在一定程度上阻碍糖尿病大鼠皮肤组织中AGE的形成,改善表皮KC细胞增殖能力,适当降低皮肤组织氧化应激状态;单用霜剂基质也可适当降低皮肤组织氧化应激状态.

Abstract：

Objective To investigate the effects of aminoguanidine cream on the proliferation of keratinocytes (KC), content of advanced glycosylation end products (AGE) and oxidative stress in skin tissue of rats with diabetes. Methods Stearic acid, liquid paraffin, vaseline, lanolin, isopropyl myristate fat,glycerol, 50 g/L alcohol paraben, aminoguanidine hydrochloride etc. were mixed in certain proportion to make aminoguanidine cream, and cream without aminoguanidine was used as matrix. The dorsal skin of normal rats were harvested and treated by aminoguanidine cream with dose of 5, 10 g/L, or 5 g/L together with 10 g/L azone. The transdermal effect was respectively measured at post treatment hour 2, 4, 7, 10, 12,24. Thirty SD rats were divided into normal control(NC, n = 6) , diabetes(D, n = 8) , aminoguanidine cream-interfered(AI, n = 8), matrix cream-interfered groups(MI, n = 8) according to the random number table. Diabetes was reproduced by intraperitoneal injection of STZ (65 mg/kg) in rats of D, AI, and MI groups, and rats in NC group were injected with 0. 05 mmol/L citrate buffer as control. One week later, dorsal skin of rats in AI and MI groups were respectively treated with 10 g/L aminoguanidine cream and matrix cream by external use for 4 weeks. AGE content was determined with fluorescence detection from skin collagen extract. KC cell cycle was detected by flow cytometry. Skin tissue specimens were obtained for determination of levels of superoxide dismutase (SOD), malondialdehyde (MDA), myeloperoxidase (MPO), and total antioxidant capacity. Data were processed with t test. Results Transdermal effect of aminoguanidine cream with dose of 10 g/L was better than that with 5 g/L or 5 g/L + 10 g/L azone cream. One rat was not induced successfully in MI group. Four weeks after model reproduction, 4 rats died in D group and 1 rat died in AI group. The AGE content in D group was obviously higher than that in NC group [(36.8 ± 2.6),(24. 6 ±2.7) U per milligram hydroxyproline, respectively, t = 7.2, P ＜0. 01], and that in AI group [(28.6 ±3.7) U per milligram hydroxyproline] was also lower as compared with that in D group(t = -3.9,P ＜ 0.05). There was no significant difference in AGE content between MI [( 32.2 ± 5.2) U per milligram hydroxyproline] and D groups(t = 1.6, P ＞ 0. 05). The percentage of KC in S phase was obviously lower in D group than in NC group [(5.3 ±0.6)%, (7.6±0.9)%, respectively, t =4.50, P ＜0. 01], while that in MI group [(9. 2 ± 1.5) %] was higher as compared with that in D group(t = 4.90, P ＜ 0. 01). It was more higher in AI group than in D group on KC percentage in S and G2/M phase (with t value respectively 6.80, 3.17, P values all below 0. 01). The oxidative stress indexes of skin tissue in D group were all higher than those in NC group, in which levels of MPO and SOD showed statistical difference(with t value respectively 4.4, 3.7, P values all below 0. 05). The oxidative stress indexes were all lower in AI group than in D group, especially in SOD level(t = -1.4, P ＜0. 05). Levels of MAD, MPO in MI group were significantly lower than those in D group(with t value respectively 2.6, 2.9, P values all below 0. 05).Conclusions Aminoguanidine cream can promote KC proliferation and appropriately reduce oxidative stress through inhibiting AGE formation to a certain extent in skin tissue of rats with diabetes. Signal use of matrix cream can also reduce oxidative stress in skin tissue of rats with diabetes.     

糖化碱性成纤维细胞生长因子影响人真皮微血管内皮细胞增殖和血管化效应的受体途径

目的:探讨糖化碱性成纤维细胞生长因子(bFGF)影响人真皮微血管内皮细胞(HDMEC)增殖及血管化效应的受体途径。方法:采用实验研究方法。采用葡萄糖、bFGF制备糖化bFGF刺激液。取第3～6代HDMEC进行实验。取细胞,分为小干扰RNA(siRNA)-阳性对照组、siRNA-阴性对照组、siRNA-晚期糖基化终末产物...     

晚期糖基化终末产物与其受体对糖尿病创面氧化应激反应的影响

目的 观察糖尿病患者皮肤和创面中晚期糖基化终末产物(AGE)的蓄积和炎症反应,并结合体外干预实验推测两者之间可能存在的关系. 方法 采集10例2型糖尿病患者(糖尿病组)和12例非糖尿病患者(非糖对照组)的皮肤和创面组织标本,部分于光学显微镜下观察胶原排列、细胞分布(HE染色),AGE及其受体(RAGE)表达(免疫组织化学染色);部分匀浆后采用ELISA法检测丙二醛含量.体外采集、分离健康人外周血中性粒细胞,并分为正常对照组(添加RPMI-1640培养液培养)、低浓度干预组、中浓度干预组和高浓度干预组,3个干预组分别在RPMI-1640培养液中添加AGE修饰的人血清白蛋白,其中AGE的浓度依次为0.315、0.625、1.250 mg/mL;噻唑蓝法检测细胞存活率,荧光探针二氢二氯荧光黄双乙酸钠测定细胞内活性氧水平.对数据进行t检验. 结果 与非糖对照组比较,糖尿病组皮肤组织中胶原萎缩,排列紊乱;创面组织中炎性细胞弥散分布,胶原排列稀疏紊乱.糖尿病组皮肤组织中AGE和RAGE表达均多于非糖对照组;2组创面组织中RAGE呈阳性表达的细胞数量均多于所在组皮肤组织,以糖尿病组更显著,其创面内可见大量RAGE呈阳性表达的炎性细胞.糖尿病组患者皮肤和创面组织中每毫克蛋白丙二醛含量分别为(6 3±1.0)、(7.1±2.4)nmol,均明显高于非糖对照组相应组织[(2.9±1.0)、(3.6±1.4)nmol,t值分别为8.017、4.349,P ＜0.05或P＜0.01].与正常对照组[(34±5)％]比较,低浓度干预组、中浓度干预组、高浓度干预组中性粒细胞存活率均明显上升[(59±8)％、(77±5)％、( 67±6)％,t值分别为7.195、14.890、11.130,P＜0.05或P＜0.01].与正常对照组(0.58±0.06)比较,低浓度干预组、中浓度干预组、高浓度干预组中性粒细胞内活性氧水平均升高(1.67±0.14、2.13±0.17、3 48±0.48,t值分别为20.195、24.905、16.864,P＜0.05或P＜0.01). 结论 异常的氧化应激水平导致糖尿病皮肤具有异常的创伤修复起点,创面愈合过程中AGE-RAGE效应是影响糖尿病创面氧化应激水平的重要因素.     

创面修复门诊患者创面病原微生物分布及耐药性分析

目的 分析创面修复门诊患者创面病原微生物的分布特点及耐药性,为创面专科规范化建设提供依据.方法 采用回顾性病例对照研究分析2017年12月至2019年10月上海交通大学医学院附属瑞金医院收治的365例门诊创面患者临床资料,其中男220例,女145例;年龄18～98岁[(58.8 ±18.9)岁].首诊患者92例,复诊患...