中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (7): 1699-1710.doi: 10.12307/2026.582

• 脂肪干细胞 adipose-derived stem cells • 上一篇    下一篇

脱细胞真皮基质联合脂肪干细胞外泌体促进烧伤创面愈合

何家乐1，2，黄  茜2，董鸿斐2，陈  朗1，钟方宇1，李先慧1，2   

  1. 1川北医学院临床医学院，四川省南充市  637002；2西部战区总医院烧伤整形外科，四川省成都市  610083
  • 收稿日期:2024-10-17 修回日期:2025-04-30 接受日期:2025-05-29 出版日期:2026-03-08 发布日期:2025-08-19
  • 通讯作者: 李先慧，博士，副教授，川北医学院临床医学院，四川省南充市 637002；西部战区总医院烧伤整形外科，四川省成都市 610083
  • 作者简介:何家乐，男，1996年生，四川省成都市人，川北医学院在读硕士，主要从事创面修复研究。 共同第一作者：黄茜，女，1991年生，四川省成都市人，主治医师，主要从事烧伤、急慢性创面研究。
  • 基金资助:
    西部战区总医院院管课题孵化项目(2021-XZYG-C36)，项目负责人：黄茜

Acellular dermal matrix combined with adipose-derived stem cell exosomes promotes burn wound healing 

He Jiale1, 2, Huang Xi2, Dong Hongfei2, Chen Lang1, Zhong Fangyu1, Li Xianhui1, 2   

  1. 1School of Clinical Medicine, North Sichuan Medical College, Nanchong 637002, Sichuan Province, China; 2Department of Burn and Plastic Surgery, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
  • Received:2024-10-17 Revised:2025-04-30 Accepted:2025-05-29 Online:2026-03-08 Published:2025-08-19
  • Contact: Li Xianhui, PhD, Associate professor, School of Clinical Medicine, North Sichuan Medical College, Nanchong 637002, Sichuan Province, China; Department of Burn and Plastic Surgery, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
  • About author:He Jiale, Master candidate, School of Clinical Medicine, North Sichuan Medical College, Nanchong 637002, Sichuan Province, China; Department of Burn and Plastic Surgery, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China Huang Xi, Attending physician, Department of Burn and Plastic Surgery, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China He Jiale and Huang Xi contributed equally to this article.
  • Supported by:
    Incubation Project of Hospital Management Project of General Hospital of Western Theater Command, No. 2021-XZYG-C36 (to HX)

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摘要：

文题释义：

脱细胞真皮基质：通常采用猪皮作为原料，通过物理、化学或生物方法去除皮肤内的细胞成分，保留真皮细胞外基质和三维空间框架结构，具有低免疫原性、良好生物活性、空间支撑以及促进细胞迁移、增殖的作用。
脂肪间充质干细胞外泌体：是从成人脂肪组织中分离培养出脂肪间充质干细胞，将脂肪间充质干细胞上清液经过超速离心获得的微小囊泡，具有低免疫原性、无细胞毒性、易于保存运输等优势。

摘要
背景：脱细胞真皮基质、脂肪间充质干细胞外泌体均可促进创面修复，但二者联合应用于烧伤创面是否有治疗效果目前尚缺乏研究。
目的：探讨脱细胞真皮基质联合脂肪间充质干细胞外泌体对深Ⅱ度烧伤创面愈合的促进作用。
方法：取40只SD大鼠，制作深Ⅱ度烧伤创面，随机分为对照组、脱细胞真皮基质组、脂肪间充质干细胞外泌体组、脱细胞真皮基质+脂肪间充质干细胞外泌体组(以下简称为联合组)，每组10只。给予相应治疗后，观察创面愈合情况，治疗2，8，14 d取创面组织行病理组织学观察及免疫组织化学染色，治疗2 d行免疫荧光染色及TUNEL染色观察细胞凋亡情况。

结果与结论：①治疗14 d，联合组创面愈合率及愈合面积均高于其他3组(P < 0.05)；②苏木精-伊红染色显示，与其他3组比较，联合组创面上皮化更完整，胶原纤维排列更整齐；Masson染色显示，与其他3组比较，联合组胶原纤维含量增多(P < 0.01)；③免疫组化显示，联合组促炎症因子表达低于其他3组(P < 0.01)；抗炎症因子表达高于其他3组(P < 0.01)；联合组新生血管多于其他3组(P < 0.01)；④免疫荧光显示，联合组BAX和Caspase3平均荧光强度低于其他3组(P < 0.01)；而BCL-2平均荧光强度高于其他3组(P < 0.01)；⑤TUNEL染色显示，联合组凋亡指数低于其他3组(P < 0.01)。结果表明，脱细胞真皮基质+脂肪间充质干细胞外泌体联合治疗可促进胶原纤维再生，抑制炎症反应及细胞凋亡，加快烧伤创面的愈合。

https://orcid.org/0009-0009-5374-1666(何家乐)


中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 脱细胞真皮基质, 脂肪间充质干细胞, 外泌体, 烧伤, 皮肤, 炎症, 凋亡, 创面愈合

Abstract: BACKGROUND: Both acellular dermal matrix and adipose mesenchymal stem cell exosomes can promote wound repair, but whether the combination of the two has therapeutic effect on burn wounds is still lacking.
OBJECTIVE: To investigate the promoting effect of acellular dermal matrix combined with adipose mesenchymal stem cell exosomes on wound healing of deep second-degree burn.
METHODS: 40 SD rats were selected to make deep second-degree burn wounds and randomly divided into control group, acellular dermal matrix group, adipose mesenchymal stem cell exosome group, and acellular dermal matrix + adipose mesenchymal stem cell exosome group (hereinafter referred to as the combined group), with 10 rats in each group. After treatment, the wound healing was observed. Histopathological observation and immunohistochemical staining were performed on the wound tissue at 2, 8, and 14 days after treatment. Apoptosis was observed by immunofluorescence staining and TUNEL staining at 2 days after treatment. 
RESULTS AND CONCLUSION: (1) After 14 days of treatment, the wound healing rate and healing area of combined group were higher than those of other three groups (P < 0.05). (2) Hematoxylin-eosin staining showed that compared with the other three groups, the wound epithelization was more complete and the collagen fibers were arranged more neatly in the combined group. Masson staining showed that compared with the other three groups, the collagen fiber content in the combined group was increased (P < 0.01). (3) Immunohistochemistry showed that the expression of pro-inflammatory factors in the combined group was lower than that in the other three groups (P < 0.01). The expression of anti-inflammatory factor was higher than that of the other three groups 
(P < 0.01). The number of new blood vessels in the combined group was higher than that in the other three groups (P < 0.01). (4) Immunofluorescence showed that the average fluorescence intensity of BAX and Caspase-3 in the combined group was lower than that in the other three groups (P < 0.01). The average fluorescence intensity of BCL-2 was higher than that of the other three groups (P < 0.01). (5) TUNEL staining showed that the apoptosis index of the combined group was lower than that of the other three groups (P < 0.01). The results showed that combined therapy could promote the regeneration of collagen fibers, inhibit inflammation and apoptosis, and accelerate the healing of burn wounds.

Key words: acellular dermal matrix, adipose-derived mesenchymal stem cell, exosome, burn, skin, inflammation, apoptosis, wound healing 

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