确炎舒松对增生性瘢痕PCNA、bcl-2表达的影响

目的观察局部注射确炎舒松后增生性瘢痕(HS)中增殖细胞核抗原(PCNA)、bcl-2的表达水平变化,探讨糖皮质激素治疗瘢痕的机制.方法用免疫组织化学SP法检测比较42例HS激素注射前后PCNA、bcl-2表达水平变化.结果HS中PCNA、bcl-2阳性细胞均较正常皮肤显著增多,注药组PCNA及bcl-2阳性细胞率均较对照组明显减少,两者差异有显著性(P＜0.05).结论成纤维细胞增殖过度、凋亡不足是HS形成的重要原因,激素可通过抑制PCNA基因的表达来抑制HS成纤维细胞增殖;激素可能通过抑制bcl-2基因的表达而诱导成纤维细胞凋亡.

Effects of triamcinolone acetonide on PCNA and bcl-2 expression in hypertrophic scars

Objective This study aims at observing the effects of local injection of triamcinolone acetonide on PCNA and bcl-2 expression in hypertrophic scars and to investigate the mechanism of steroid in treating abnormal scars. Methods Pre- and post-injection comparison was made to see changes in PCNA and bcl-2 level determined by immunohistochemical technique in 42 hypertrophic scars. Results The densities of PCNA and bcl-2 positive cells were significantly higher in hypertrophic scars than in normal skins (P<0.01), but lower in scars treated with triamcinolone than in the control group (P<0.01). Conclusion Excessive proliferation and lack of apoptosis of cells may cause the formation of hypertrophic scars. Local injection of steroid has the effect of restraining the proliferation of fibroblasts in hypertrophic scars by inhabiting PCNA gene expression in vivo. It also can inhibit bcl-2 gene expression of hypertrophic scars in vivo, which may induce apoptosis of cells.