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中华临床医师杂志(电子版) ›› 2024, Vol. 18 ›› Issue (10) : 955 -960. doi: 10.3877/cma.j.issn.1674-0785.2024.10.012

综述

创面病原体在创面愈合与瘢痕形成中的作用进展
石珊1, 徐志刚1, 魏双1, 官浩1, 石继红1,()   
  1. 1.710032 西安,空军军医大学第一附属医院烧伤与皮肤外科
  • 收稿日期:2024-10-21 出版日期:2024-10-15
  • 通信作者: 石继红
  • 基金资助:
    国家自然科学基金面上项目(82172209)

Advances in understanding of role of wound pathogens in wound healing and scar formation

Shan Shi1, Zhigang Xu1, Shuang Wei1, Hao Guan1, Jihong Shi1,()   

  1. 1.Department of Burns and Cutaneous Surgery, the First Affiliated Hospital of Air Force Medical University, Xi’an 710032, China
  • Received:2024-10-21 Published:2024-10-15
  • Corresponding author: Jihong Shi
引用本文:

石珊, 徐志刚, 魏双, 官浩, 石继红. 创面病原体在创面愈合与瘢痕形成中的作用进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(10): 955-960.

Shan Shi, Zhigang Xu, Shuang Wei, Hao Guan, Jihong Shi. Advances in understanding of role of wound pathogens in wound healing and scar formation[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(10): 955-960.

皮肤创伤后受到病原体入侵的污染,加重、延长炎症反应,造成慢性或难愈合创面,导致创面愈合延迟和瘢痕形成。研究发现革兰氏阴性(G-)菌感染的创面是造成创面慢性炎症、愈合延迟及瘢痕形成的主要病原体,而G-菌特有的毒素脂多糖是造成创面慢性炎症的主要炎性介质。因此,降低创面病原体感染与慢性炎症反应在极大程度上能够改善创面愈合质量,预防瘢痕的形成。本文阐述创面病原体在创面愈合与瘢痕形成过程中的功能作用、致病特性及作用机制;明确控制创面病原体感染是促进创面愈合、预防瘢痕形成行之有效的策略;同时也为病理性瘢痕的预防及治疗奠定理论基础,提供临床指导。

Human skin wounds are contaminated by pathogens, which aggravate and prolong the inflammatory response.This can cause chronic or difficult wound healing, resulting in delayed wound healing and scar formation.Studies have found that Gram-negative (G-) bacteria are the main pathogens causing chronic wound inflammation, delayed wound healing, and scar formation in chronic wound and burn wound infection.Lipopolysaccharide, a unique endotoxin of G- bacteria, is the main inflammatory medium causing chronic wound inflammation.Therefore, reducing wound pathogen infection and chronic inflammatory response can greatly improve wound healing quality and prevent scar formation.This review describes the function, pathogenic characteristics, and mechanism of wound pathogens in wound healing and scar formation, and proposes that the control of pathogen infection in wounds is an effective strategy to promote wound healing and protect against scar formation, with an aim to lay a theoretical foundation and provide clinical guidance for the prevention and treatment of pathological scar.

图1 创面病原体激活成纤维细胞炎症反应示意图 注:PAMPs 为病原体相关分子模式;DAMPs 为损伤相关分子模式;LPS 为脂多糖;TLR4 为Toll 样受体4;Myd88 为髓样分化因子88;TRAF6 为肿瘤坏死因子受体相关因子6;NF-κB 为核因子κB;M 为巨噬细胞;NLRP3 为NOD-样受体热蛋白结构域相关蛋白3;STAT3 为信号转导和转录激活因子3;FAK 为局部粘着斑激酶
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