评估壳聚糖-l-DOPA MAP凝胶治疗急性喉损伤的疗效

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中文摘要

目的： 本研究旨在评估一种创新的壳聚糖-l-DOPA修饰微孔退火颗粒（MAP）水凝胶在治疗急性喉损伤（ALgI）中减少纤维化和促进愈合的疗效。
方法： 在经验证的兔急性喉损伤模型中评估四个实验治疗组：未损伤对照组、假治疗对照组（生理盐水）、非生物活性MAP凝胶（sMAP）和壳聚糖-l-DOPA MAP凝胶（dMAP2）。该模型包括后声门黏膜剥离和清创，随后在损伤后14天进行治疗。治疗后第4天和第14天进行组织学评估，通过免疫荧光染色评估后声门厚度（PGT）、后声门内胶原含量和类型，通过阿尔新蓝染色评估糖胺聚糖（GAG）含量，并通过天狼星红染色评估胶原纤维取向。
结果： 第4天时，dMAP2治疗与标准MAP凝胶表现相似，表明炎症特征一致。尽管在第14天时，dMAP2治疗的损伤与未损伤对照组相比显示PGT显著增加（p < 0.001），但愈合伤口中胶原面积显著增加，包括胶原I、胶原III和共定位种类（p < 0.05）。组织内胶原纤维的排列与未损伤样本一致，而未治疗损伤则不然。类似地，与未治疗损伤相比，dMAP2治疗的伤口导致环杓关节内GAG表达与未损伤组织相似，这与关节炎状况减轻一致。
结论： 与未治疗对照组相比，dMAP2凝胶通过伤口愈合的增殖期改善了愈合，并促进了有组织的组织重塑。
证据等级： 3。

英文摘要

OBJECTIVES: This study aimed to evaluate the efficacy of an innovative chitosan-l-DOPA-modified microporous annealed particle (MAP) hydrogel in reducing fibrosis and enhancing healing in the treatment of Acute Laryngeal Injury (ALgI).
METHODS: Four experimental treatment groups: uninjured control, sham treated control (saline), nonbioactive MAP gel (sMAP), and Chitosan-l-DOPA MAP gel (dMAP2) were evaluated in a validated rabbit model of acute laryngeal injury, consisting of posterior glottis mucosal stripping and debridement followed by treatment at 14 days postinjury. At Days 4 and 14 posttreatment, histological evaluations were performed to evaluate the posterior glottic thickness (PGT), collagen content and type within the posterior glottis via immunofluorescence staining, glycosaminoglycan (GAG) content via Alcian blue staining, and collagen fiber orientation through picrosirius red staining.
RESULTS: At Day 4, the dMAP2 treatment performed similarly to the standard MAP gel, indicating a consistent inflammatory profile. Though at Day 14, the dMAP2 treated injuries demonstrated a significant increase in PGT compared to uninjured controls (p < 0.001), the healing wound expressed a significant increase in collagen area, including collagen I, collagen III, and colocalized species (p < 0.05). The alignment of collagen fibers within the tissue was consistent with the uninjured sample compared to the untreated injury. In a similar relationship, dMAP2 treated wounds led to similar GAG expression within the cricoarytenoid joint as the uninjured tissue, compared to the untreated injury consistent with a reduced arthritic condition.
CONCLUSIONS: The dMAP2 gel improved healing with organized tissue remodeling compared to untreated controls through the proliferative phase of wound healing.
LEVEL OF EVIDENCE: 3.