等离子体活化液对糖尿病大鼠创面的影响及其机制的初步研究

Effects and mechanisms of plasma-activated liquid on diabetic rat wound healing

  • 摘要: 背景 我国糖尿病并发慢性难愈性创面患者逐年增加,因其迁延不愈、反复感染及高截肢率,已成为我国公共卫 生领域的重大挑战。目的 探究等离子体活化液(plasma-activated liquid,PAL)是否具有促进糖尿病大鼠创面愈合的作用。 方法 动物实验:选取40只雄性SD大鼠腹腔注射50 mg/kg 1% STZ构建糖尿病大鼠模型。造模成功的33只大鼠随机均分 为空白对照组、湿敷组、注射组,每组各11只。每组大鼠背部中线两侧制造4个直径为0.8 cm的圆形创面。再将湿敷组与 注射组大鼠一侧创面予以生理盐水治疗,对侧创面予以PAL治疗,最终将创面分为空白对照组,生理盐水湿敷组,PAL湿 敷组,生理盐水注射组,PAL注射组。以单个创面作为本研究的实验单元,定期对创面取材行组织染色,评估创面愈合面 积和质量。体外实验:用无菌棉签蘸取大肠杆菌、金黄色葡萄球菌及铜绿假单胞菌菌液涂布在M-H培养皿,无菌打孔器打 孔后分别加入PAL、生理盐水及蒸馏水,通过抑菌圈大小评估PAL的抑菌能力;采集大鼠抗凝全血后分别加入PAL+CaCl2、 生理盐水+CaCl2及CaCl2,记录凝血时间评估PAL的促凝效果;取对数期生长的L929小鼠成纤维细胞分别予以PAL、生理 盐水处理,采用CCK8法测定细胞增殖率,划痕实验测定细胞迁移率。结果 动物实验发现两种PAL治疗方式均能促进糖 尿病大鼠创面愈合,创面切片普通染色提示PAL治疗的两组肉芽组织成熟度最好,第14天胶原含量PAL湿敷组及PAL注射 组明显多于对照组(64.94%±3.09%,69.93%±2.42% vs 53.69%±0.88%,P<0.001);PAL湿敷组及PAL注射组愈合后期Ⅰ型与 Ⅲ型胶原纤维比值更大。免疫组化提示在第3天时PAL治疗组IL-6表达明显低于对照组(P<0.001),IL-10表达较对照组显 著增多(P<0.001);第10天时PAL治疗的2组创面α-SMA及VEGF表达均明显高于对照组及生理盐水治疗组(P<0.05), CD31免疫荧光染色提示PAL治疗能促进创面由肉芽组织向瘢痕转化。体外实验中,抑菌圈实验表明体PAL能够杀灭三种 常见细菌;体外全血凝结实验及全血凝固时间实验发现PAL明显缩短血液凝固时间(P<0.001);CCK8实验提示PAL能够促 进L929细胞增殖(P<0.05),划痕实验提示PAL可以增强细胞迁移能力(P<0.05)。结论 PAL具有一定抗菌、促凝、促进细 胞迁移和增殖的能力,并能够促进糖尿病创面愈合。

     

    Abstract: Background The increasing prevalence of patients with chronic non-healing wounds complicated by diabetes mellitus in China has become a major public health challenge, owing to persistent disease progression, recurrent infections, and high amputation risks.Objective To investigate whether plasma-activated liquid (PAL) exhibits therapeutic effects in promoting wound healing in diabetic rats.Methods In vivo: Forty male Sprague-Dawley (SD) rats were injected intraperitoneally with 50 mg/kg streptozotocin (STZ) to establish diabetic models. Thirty-three successfully modeled rats were randomly divided into blank control group (n=11), topical saline/PAL treatment (wet dressing) group (n=11), and subcutaneous saline/PAL injection group (n=11). Four full-thickness circular wounds (0.8 cm diameter) were created bilaterally along the dorsal midline, with contralateral wounds in treatment groups receiving saline or PAL. Each wound served as an independent experimental unit. Histological staining, collagen quantification, and immunohistochemistry were performed to assess healing progression. In vitro: PAL's antimicrobial activity against Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa was evaluated via agar diffusion assays. Coagulation time was measured using whole blood clotting assays. L929 fibroblast proliferation and migration were analyzed using CCK-8 and scratch assays. Results In vivo: Both PAL-treated groups exhibited accelerated wound closure and superior granulation tissue maturation. By day 14, collagen content was significantly higher in the topical PAL and subcutaneous PAL groups compared to controls (64.94%± 3.09%, 69.93%±2.42% vs 53.69%±0.88%, P<0.001), with a marked increase in the type I/III collagen ratio. Immunohistochemistry revealed suppressed IL-6 (P < 0.001) and elevated IL-10 (P < 0.001) expression in PAL groups on day 3. By day 10, PAL-treated wounds demonstrated upregulated α-SMA and VEGF (P < 0.05) and enhanced CD31 immunofluorescence, indicating robust angiogenesis and transition to scar formation. In vitro: PAL exhibited potent bactericidal activity (clear inhibition zones), significantly shortened coagulation time (P < 0.001), and stimulated L929 proliferation (P < 0.05) and migration (P < 0.05). Conclusion PAL demonstrates multifunctional properties, including antimicrobial, procoagulant, and pro-regenerative effects, which collectively enhance diabetic wound healing.

     

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