Construction of living skin equivalents using mixed autologous and allogeneic skin cells for repairing scar contracture of the hand in a patient with recessive dystrophic epidermolysis bullosa
10.3760/cma.j.issn.0412-4030.2018.04.002
- VernacularTitle:自体与异体细胞混合构建的活性皮肤替代物修复隐性营养不良型大疱性表皮松解症患者手部瘢痕挛缩一例
- Author:
Lyujun YANG
1
,
2
;
Mingjun ZHANG
;
Sitian XIE
;
Danyan YE
Author Information
1. 510041广东,汕头大学医学院第二附属医院烧伤整形外科
2. 510041广东,汕头大学医学院第二附属医院转化医学研究中心
- Keywords:
Epidermolysis bullosa dystrophica;
Skin,artificial;
Skin transplantation;
Transplantation,homologous;
Contracture;
Living skin equivalent;
Autologous-allogeneic cells
- From:
Chinese Journal of Dermatology
2018;51(4):251-255
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of living skin equivalents (LSE) constructed of mixed autologous and allogeneic skin cells and human amnion which served as a matrix on repairing scar contracture of the hand in a patient with recessive dystrophic epidermolysis bullosa (RDEB).Methods Skin tissues were obtained from a patient with RDEB and her mother,and epidermal keratinocytes and dermal fibroblasts were isolated from these tissues and cultured in vitro separately.Human amnion was obtained from the placenta of an unrelated healthy parturient undergoing cesarean delivery,and served as a matrix of the LSE.The autologous and allogeneic fibroblasts were mixed and seeded on the stromal side of the amnion,and then the autologous and allogeneic keratinocytes were mixed and seeded on the epithelial side of the amnion,so as to construct the human amnion-LSE (AM-LSE).Histological examination was performed to observe the structure of the skin tissues obtained from the patient and her mother,and immunofluorescence staining was conducted to detect the expression of type Ⅶ collagen in the skin tissues of the patient and her mother and in the AM-LSE.The AM-LSE was grafted on the skin defects of the patient after release of scar contracture of the hand.After grafting,the survival status of the AM-LSE graft and repairing effect on the wounds were evaluated.Results The constructed AM-LSE consisted of dermis,multilayered and fully differentiated epidermis and well-developed basement membrane.Immunofluorescence examination revealed that type Ⅶ collagen was linearly distributed along the basement membrane.Half a year after grafting,the AM-LSE survived well,and no obvious rejection reaction was observed.No blisters or ulcers occurred at the recipient sites,and the scar contracture was mild.The grafted area showed normal skin color with soft texture.The patient could grab and hold things,which had met self-care requirements of daily living.Conclusions The AM-LSE constructed of mixed autologous and allogeneic skin cells have good histological structures,and can be grafted on the wounds after resection of the scars in a RDEB patient.After grafting,no obvious rejection reaction was observed,and the skin was not liable to develop blisters,ulcers or scar contracture due to friction.
