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医药导报, 2017, 36(12): 1363-1366
doi: 10.3870/j.issn.1004-0781.2017.12.007
积雪草苷对博莱霉素诱导小鼠皮肤瘢痕形成的抑制作用*
Inhibitory Effect of Asiaticoside on Bleomycin-induced Skin Cicatrization in Mice
王莎丽1,, 杨琳1, 刘勇2, 姚超然1, 宋爽1, 刘洋1, 袁晓环2, 武艳2,

摘要:

目的 探讨积雪草苷对博莱霉素诱导的小鼠皮肤瘢痕形成的抑制作用及其可能的作用机制。方法 雄性C57BL/6小鼠30只,随机分为阴性对照组、模型对照组以及积雪草苷组,每组10只,模型对照组和积雪草苷组小鼠每日于背部经皮下注射博莱霉素(1 mg·mL-1)1 mL,积雪草苷组于4 h后经皮下注射积雪草苷(20 mg·mL-1)1 mL,模型对照组给予相同剂量的0.9%氯化钠溶液,阴性对照组则在此两个时间点给予相同剂量0.9%氯化钠溶液,21 d后处死全部小鼠。进行皮肤组织形态学观察、肌成纤维细胞增殖以及炎症因子表达的检测。结果 病理组织学显示,积雪草苷组皮肤瘢痕较薄,纤维化程度较模型对照组明显减轻,其真皮层胶原厚度显著小于模型对照组厚度;皮肤纤维化程度指标α-平滑肌肌动蛋白的表达也明显低于模型对照组,并且炎症细胞浸润减少。结论 积雪草苷可抑制博莱霉素诱导的小鼠皮肤瘢痕的形成,其机制可能与调节肌成纤维细胞以及炎症细胞的表达相关。

关键词: 积雪草苷 ; 博来霉素 ; 皮肤瘢痕

Abstract:

Objective To evaluate the inhibitory effect of asiaticoside on bleomycin-induced skin cicatrization. Methods Thirty male C57BL/6 mice were randomly divided into three groups: negative control group,model control group,and asiaticoside group,ten in each group.In model control group and asiaticoside group,1 mg·mL-1 bleomycin was subcutaneously injected into the dorsal skin of mice every day;4 h later,1 mL 0.9% sodium chloride solution 1 mL asiaticoside (20 mg·mL-1) was injected into the lesion skin in the model control group and the asiaticoside group,respectively.In the negative control group,the same volume of 0.9% sodium chloride solution was subcutaneously injected into the dorsal skin of the mice at the two time points every day.After 21 days,skin specimens were harvested to observe the histomorphology and detect myofibroblast proliferation and expression of inflammatory factors. Results The skin scar was significantly attenuated in the asiaticoside group as compared with the model control group,and the dermal thickness measured exhibited a gradual decrease in asiaticoside group.The expression of α-antismooth muscle antisbidy and infiltration of inflammatory cells were significantly lower in the asiaticoside group than in the model control group. Conclusion Asiaticoside inhibits the development of skin scar of mice by regulating proliferation and differentiation of myofibroblasts and down-regulating inflammatory cells.

Key words: Asiaticoside ; Bleomycin ; Skin scar

积雪草苷为伞形科药用植物积雪草中提取的三萜类化合物,具有抗氧化[1],抗炎[2],促进创伤愈合的作用[1],抑制过氧化物形成[1]以及促进肿瘤细胞凋亡[3]等作用。研究发现积雪草苷还具有抗纤维化的作用,其主要是通过抑制成纤维细胞的增殖,减弱胶原蛋白的表达,提高基质金属蛋白酶的含量等达到目的。但在是否具有抑制皮肤瘢痕形成的作用报道较少[1]。因此,本研究拟将积雪草苷作用于博莱霉素诱导的小鼠皮肤瘢痕模型,旨在验证积雪草苷对于皮肤瘢痕形成的作用。

1 材料与方法
1.1 实验动物

选取健康SPF级雄性C57小鼠30只,8~10周龄,体质量(25±3) g,由北京维通利华实验动物技术有限公司提供,实验动物生产许可证号:SCXK(京)2012-0001。饲养于牡丹江医学院医药研究中心SPF级动物房,在(25±2)℃,相对湿度45%~65%,分笼饲养,普通饮食,适应性饲养1周后开始实验[4]

1.2 主要试剂

博莱霉素(批号:91071)购自日本化药株式会社;积雪草苷(16830-15-2)购自南京景竹生物科技有限公司;α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA,批号:ab18147)购自Abcam公司;DAB显色剂(批号:PV-6000-D)购自北京中杉金桥公司;逆转录试剂盒(批号:998897)购自美国 Invitrogen 公司。

1.3 主要仪器

倒置相差显微镜购自日本Olympus公司(型号:IX70-142);PCR仪购自德国Eppendorf公司(型号:5331)。

1.4 动物分组及给药方式

将C57小鼠按体质量随机分为阴性对照组、模型对照组和积雪草苷组,每组10只。模型对照组和积雪草苷组小鼠每日于背部经皮下注射博莱霉素1 mL,浓度选取为1 mg·mL-1(经预实验结果和文献[5]报道显示,博莱霉素浓度过大瘢痕形成不均匀,浓度过小则形成瘢痕不显著),积雪草苷组于4 h后经皮下注射积雪草苷1 mL(20 mg·mL-1,预实验显示此浓度为最适浓度),模型对照组给予相同剂量的0.9%氯化钠溶液,阴性对照组则在此两个时间点给于相同剂量0.9%氯化钠溶液,21 d后处死全部小鼠。

1.5 病理组织学观察

37%甲醛水溶液固定皮肤组织,石蜡包埋,常规切片,厚度为5 μm,行苏木精-伊红(HE)和Masson’s Trichome染色,在光学显微镜下进行观察。

1.6 免疫组化检测

石蜡包埋,常规切片,厚度为5 μm,脱蜡,为灭活内源性过氧化物酶采用3% H2O2室温孵育10 min,加入一抗(抗小鼠α-SMA单克隆抗体),4 ℃过夜,DAB显色,苏木精染核,中性树胶封片,光学显微镜下观察。

1.7 Real-time PCR检测

采用Trizol 法提取组织中的mRNA,在进行cDNA转录及PCR 检测。RT- PCR 的引物序列如下:肿瘤坏死因子(TNF-α)正义: 5'-TGG AAC TGG CAG AAG AGG-3', 反义5'-AGA CAG AAG AGC GTG GTG-3';白细胞介素6(IL-6)正义: 5'-GAG GAT ACC ACT CCC AAC AGA CC-3', 反义: 5'-AAG TGC ATC ATC GTT GTT CAT ACA-3'; IL-10正义5'-GCG GCC GCG GTA CCA TGC CTG GCT CAG CAC TG-3',反义5'-GCT AGC TTA GCT TTT CAT TTT GAT CAT CAT G-3';β-actin正义: 5'-TGG AAT CCT GTG GCA TCC ATG AAA C-3', 反义: 5'-TAA AAC GCA GCT CAG TAA CAG TCC G-3'。

1.8 统计学方法

采用GraphPad Prism软件进行统计分析,数据以均数±标准差( x ¯ ±s)表示,组间均数比较采用单因素方差分析,以P<0.05为差异有统计学意义。

2 结果
2.1 HE染色结果

阴性对照组皮肤组织结构完整,呈波纹状,胶原排列紧密、均匀且纤维较细;模型对照组皮肤组织不仅表皮层明显增厚,其真皮层的厚度也增加很多,镜下可见大量的胶原纤维,粗细不一,排列不规则;与模型对照组比较,积雪草苷组皮肤组织表皮和真皮厚度减少,胶原排列更规则一些。见图1。

图1 3组小鼠皮肤的组织形态学( HE染色,×100)
A.阴性对照组;B.模型对照组;C.积雪草苷组

Fig.1 Cutaneous histomorphology of three groups of mice (HE staining,×100)
A.negative control group;B.model control group;C. asiaticoside group

2.2 Masson’s Trichome 染色结果

模型对照组胶原纤维与阴性对照组比较,明显增多,排列紊乱,成漩涡状或结节状排列,而积雪草苷组胶原纤维与模型对照组比较,排列较为规则,成条索状。见图2。

图2 3组小鼠皮肤的组织形态学 (Masson’s Trichome染色,×100)
A.阴性对照组;B.模型对照组;C.积雪草苷组

Fig.2 Cutaneous histomorphology of three groups of mice(Masson’s Trichome staining,×100)
A.negative control group;B.model control group;C.asiaticoside group

2.3 α-SMA蛋白的表达

免疫组织化学染色显示,在各组皮肤组织中呈棕黄色的为α-SMA阳性表达。阴性对照组α-SMA阳性表达主要存在于血管平滑肌细胞,每高倍视野为(12±3)个,模型对照组α-SMA阳性表达主要存在于肌成纤维细胞,每高倍视野(87±9)个,积雪草苷组α-SMA阳性表达明显低于模型对照组,每高倍视野为(39 ± 7)个(P<0.01)。见图3。

图3 3组皮肤组织中α-SMA蛋白表达检测(免疫组织化学染色,×100)
A.阴性对照组;B.模型对照组;C.积雪草苷组

Fig.3 Detection on α-SMA protein expression in skin tissue of three groups of mice(immunohistochemical staining,×100)
A.negative control group;B. model control group;C.asiaticoside groups

2.4 炎症因子的表达检测

Real-time PCR检测炎症因子TNF-α、IL-6及IL-10的含量,与模型对照组比较,积雪草苷组明显降低了炎症因子的表达,尤其是对于IL-10表达的影响更为显著(P<0.01)。见图4。

图4 3组小鼠皮肤组织中炎症因子的检测
与阴性对照组比较,*1P<0.01;与模型对照组比较,*2P<0.01

Fig.4 Detection on inflammatory cytokines in skin tissue of three groups of mice
Compared with negative control group,*1P<0.01;compared with model control group,*2P<0.01

3 讨论

皮肤瘢痕是创伤或手术后皮肤组织的纤维化增生,其主要特征是成纤维细胞过度增殖、细胞外基质(extracellular matrixc,ECM)多度沉积以及各种细胞因子和生长因子的不正常激活[6-8]。当皮肤严重创伤或是感染较重时,往往会出现过度修复的现象,造成增生性瘢痕或是瘢痕疙瘩。瘢痕不仅影响患者的外在美观并造成关节、局部器官的功能障碍,还可能引起严重的心理问题,因此研究瘢痕的治疗问题具有重要意义[6-7]。随着中医观念不断深入人心,中医药在瘢痕中的应用越来越收到关注。本研究结果显示,积雪草苷通过减弱胶原的沉积、减少肌成纤维细胞的增殖、抑制炎症因子的表达抑制了博来霉素诱导的小鼠皮肤瘢痕的形成。

瘢痕的产生主要表现为真皮内胶原降解失衡、导致胶原大量沉积[9]。本研究结果还显示,积雪草苷明显抑制了瘢痕的形成,尽管不能完全阻止瘢痕的形成,但与模型对照组相比较,其表皮和真皮的厚度显著减少,胶原纤维排列疏松,更为规则。祁少海等[10]在裸鼠上建立了增生性瘢痕动物模型也发现经过积雪草苷的治疗后,使整块瘢痕组织变软,体积变小,胶原纤维粗细更均匀。另外,在皮肤组织中,肌成纤维细胞是合成ECM(主要是胶原的产生)的主要细胞,在纤维化进程中起到关键的作用[11]。因此笔者在研究中也检测了肌成纤维细胞的表达情况。从结果显示,在模型对照组中有很多成阳性表达的α-SMA,而在积雪草苷组中,这种阳性表达明显较少。可以说积雪草苷在这种纤维化疾病中缓解了基质沉积并且也抑制了肌成纤维细胞的增殖和分化。

在以往的研究中发现,炎症细胞在纤维化的发生发展过程中起到重大作用,它们不仅促进了成纤维细胞的增殖和迁移,并且在炎性环境还会影响成纤维细胞的功能和胶原合成[12-13]。进一步研究发现,在胚胎的无瘢痕修复中几乎没有炎症细胞的参与。实验结果显示,博莱霉素诱导皮肤瘢痕形成后,除了胶原大量沉积、肌成纤维细胞大量增殖外,还有大量的炎症因子的生成。而在瘢痕形成过程中给予积雪草苷后,积雪草苷发挥了显著的抗炎作用,明显降低了炎症细胞的表达,减轻局部炎细胞浸润,可能是其抑制皮肤瘢痕形成的病理机制之一。

综上所述,积雪草苷对博来霉素诱导的小鼠皮肤瘢痕具有抑制其形成的作用,主要是通过调节肌成纤维细胞的增殖和分化、胶原的沉积以及炎症因子的变化来实现,研究结果显示了对于小鼠皮肤瘢痕的预防性治疗是有效的。本研究深入了解积雪草苷在瘢痕发展过程中的调控作用,为临床寻找瘢痕防治手段提供了实验基础,但对于其分子机制还不清楚,值得进一步探讨。

The authors have declared that no competing interests exist.

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Keloid scarring, also known as keloid disease (KD), is a common, abnormally raised fibroproliferative cutaneous lesion that can occur following even minor skin trauma. The aetiopathogenesis of KD has remained an enigma todate compounded by an ill-defined clinical management. There is strong evidence suggesting a genetic susceptibility in individuals affected by KD, including familial heritability, common occurrence in twins and high prevalence in certain ethnic populations. This review aims to address the genetic aspects of KD that have been described in present literature that include inheritance patterns, linkage studies, case-揷ontrol association studies, whole genome gene expression microarray studies and gene pathways that were significant in KD. In addition to our clinical and scientific background in KD, we used search engines, Scopus, Scirus and PubMed, which searched for key terms covering various genetic aspects of KD. Additionally, genes reported in seven whole genome gene expression microarray studies were separately compared in detail. Our findings indicate a varied inheritance pattern in KD (predominantly autosomal dominant), linkage loci (chromosomes 2q23 and 7p11), several human leukocyte antigen (HLA) alleles (HLA-DRB1*15, HLA-DQA1*0104, DQ-B1*0501 and DQB1*0503), negative candidate gene case-揷ontrol association studies and at least 25 dysregulated genes reported in multiple microarray studies. The major pathways reportedly proposed to be involved in KD include apoptosis, mitogen-activated protein kinase, transforming growth factor-尾, interleukin-6 and plasminogen activator inhibitor-1. In summary, involvement of more than one gene is likely to be responsible for susceptibility to KD. A better understanding of the genes involved in KD may potentially lead to the development of more effective diagnostic, therapeutic and prognostic measures.
DOI:10.1007/s00403-009-1014-y      PMID:20130896      URL    
[本文引用:1]
[8] 刘漪沦,邓峰美,刘卫华,.大黄素对增生性瘢痕成纤维细胞的作用[J].医药导报,2014,33(12):1566-1570.
目的:探讨大黄素对增生性瘢痕成纤维细胞( HSFs)的作用及其机制。方法分别以终浓度为0,20,40,80μmol·L-1的大黄素处理HSFs,以MTS法检测细胞活力,以Annexin V、碘化丙啶双染法行流式细胞仪检测,以Western blot法检测细胞外信号调节激酶1∕2(ERK1∕2)及其磷酸化蛋白、B淋巴细胞瘤_2(Bcl_2)、髓样细胞白血病_1(Mcl_1)、受体相互 作用蛋白激酶1(RIP1)的表达。结果大黄素对HSFs的增殖活力有抑制作用,且呈剂量依赖性;HSFs在终浓度为40,80μmol·L-1大黄素作 用48 h后死亡率分别为28.6%,68.0%(P<0.01),以泛casPase抑制药Z_VAD_FMK预处理能够部分降低大黄素所致细胞死亡率 (P<0.05);大黄素能够抑制ERK磷酸化、Mcl_1和RIP1的表达。结论大黄素能够抑制HSFs的增殖活力、诱导细胞死亡,其机制可能与 其抑制ERK1∕2磷酸化及Mcl_1、RIP1蛋白表达有关。
DOI:10.3870/yydb.2014.12.007      URL    
[本文引用:1]
[9] JACKSON W M,NESTI L J,TUAN R S.Mesenchymal stem cell therapy for attenuation of scar formation during wound healing[J].Stem Cell Res Ther,2012,3(3):20-22.
Abstract Scars are a consequence of cutaneous wound healing that can be both unsightly and detrimental to the function of the tissue. Scar tissue is generated by excessive deposition of extracellular matrix tissue by wound healing fibroblasts and myofibroblasts, and although it is inferior to the uninjured skin, it is able to restore integrity to the boundary between the body and its environment. Scarring is not a necessary process to repair the dermal tissues. Rather, scar tissue forms due to specific mechanisms that occur during the adult wound healing process and are modulated primarily by the inflammatory response at the site of injury. Adult tissue-derived mesenchymal stem cells, which participate in normal wound healing, are trophic mediators of tissue repair. These cells participate in attenuating inflammation in the wound and reprogramming the resident immune and wound healing cells to favor tissue regeneration and inhibit fibrotic tissue formation. As a result, these cells have been considered and tested as a likely candidate for a cellular therapy to promote scar-less wound healing. This review identifies specific mechanisms by which mesenchymal stem cells can limit tissue fibrosis and summarizes recent in vivo studies where these cells have been used successfully to limit scar formation.
DOI:10.1186/scrt111      PMID:22668751      URL    
[本文引用:1]
[10] 祁少海,谢举临,利天增,.积雪草甙对烧伤增生性瘢痕作用的实验研究[J].中华烧伤杂志,2000,16(1):53-56.
Magsci    
[本文引用:1]
[11] WANG Q,DONG Y,GENG S,et al.Photodynamic therapy inhibits the formation of hypertrophic scars in rabbit ears by regulating metalloproteinases and tissue inhibitor of metalloproteinase-1[J].Clin Exp Dermatol,2014,39(2):196-201.
BACKGROUND: scarring (HS) is a chronic skin condition, and inhibition of normal fibroblast plays an important role in its . Photodynamic therapy () is known to inhibit of proliferation in blood vessels and fibroblasts in scar tissue, with no significant adverse reactions reported. AIM: To investigate the effect of in the ear model of HS, and the specific mechanism of action of .: We assessed the clinical and histopathological appearance of ears with HS with and without . In addition, mRNA levels of matrix metalloproteinase (MMP)-2, , and tissue inhibitor of metalloproteinase ()-1, and concentration of-were all measured to confirm senescence.: Our data indicate that can accelerate fibroblast by increasing the ratio of MMPs to , in addition to promoting of and , thereby inhibiting HS . These effects lasted for up to 60 days, and induced no significant adverse local or systemic reactions. The efficacy of the treatment can be maximized by applying an appropriately high concentration of aminolaevulinic acid. CONCLUSIONS: can induce senescence in fibroblasts, and may constitute a useful treatment for pathological scarring.
DOI:10.1111/ced.12265      PMID:24475901      URL    
[本文引用:1]
[12] 张密霞,王景文,张德生,.京万红软膏对烫伤及创伤大鼠创面愈合、瘢痕形成的影响[J].中华中医药杂志,2015,30(8):3007-3010.
目的:探讨京万红软膏对烫伤及创伤大鼠创面愈合、瘢痕形成的影响。方法:SD大鼠分为正常组、模型组、京万红基质组、京万红软膏组,每组60只。除正常组外,每组取30只,在脊柱两旁剪去全层皮肤形成两个直径1.5cm的开放圆形创面,另30只100℃水烫伤15s,在脊柱两旁造成两个直径2.3cm的烫伤创面。万红软膏组、京万红基质组分别于创面每日敷药1次,正常组及模型组不用药。造模后第7、14、28天分别取各组大鼠10只,测量创面面积及皮肤组织病理组织形态。结果:与模型组比较,创伤后第7、14天京万红软膏组创面残留面积小于模型组,第28天无显著差异,烫伤后第14天京万红软膏组创面残留面积小于模型组,第7、28天无显著差异。病理组织学显示,与模型组比较,京万红软膏组创伤后大鼠皮肤创面坏死组织少,烫伤后表面坏死组织脱落早;京万红软膏组创伤和烫伤后创面愈合快,愈合过程中炎细胞浸润少,瘢痕较薄,新生上皮形成快,新生皮肤附属器较多。京万红基质组介于京万红软膏组与模型组之间。结论:京万红软膏能促进大鼠皮肤创伤及烫伤后创面愈合,抑制瘢痕形成,促进皮肤附属器新生。
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[本文引用:1]
[13] ALVES C C,TORRINHAS R S,GIORGI R,et al.TGF-β1 expression in wound healing is acutely affected by experimental malnutrition and early enteral feeding[J].Int Wound J,2014,11(5):533-539.
DOI:10.1111/iwj.2014.11.issue-5      URL    
[本文引用:1]
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关键词(key words)
积雪草苷
博来霉素
皮肤瘢痕

Asiaticoside
Bleomycin
Skin scar

作者
王莎丽
杨琳
刘勇
姚超然
宋爽
刘洋
袁晓环
武艳

WANG Shali
YANG Lin
LIU Yong
YAO Chaoran
SONG Shuang
LIU Yang
YUAN Xiaohuan
WU Yan