The effect of thioredoxin-1 on different layers of skin flap during the early stage of ischemia-reperfusion injury
10.3760/cma.j.issn.1009-4598.2019.05.015
- VernacularTitle: 硫氧还蛋白-1对皮瓣缺血再灌注早期不同组织层次损伤的影响
- Author:
Bin GAO
1
,
2
,
3
,
4
,
5
;
Huiwen REN
6
;
Jian YIN
1
,
2
,
3
,
4
,
7
;
Jingyan SUN
1
,
2
,
3
,
4
,
7
;
Jincai FAN
8
;
Zhuming YIN
1
,
2
,
3
,
4
,
7
,
9
Author Information
1. National Clinical Research Center for Cancer
2. Key Laboratory of Cancer Prevention and Therapy, Tianjin
3. Tianjin′s Clinical Research Center for Cancer
4. Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin 300060, China
5. Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
6. Department of Pharmacology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
7. Department of Breast Oncoplastic Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
8. 9th Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China
9. 9th Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China
- Publication Type:Journal Article
- Keywords:
Surgical flap;
Free Flap;
Ischemia-reperfusion injury;
Thioredoxin;
Cell Apoptosis;
Stratum basale;
Dermal papilla of dermis
- From:
Chinese Journal of Plastic Surgery
2019;35(5):489-496
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Ischemia-reperfusion (IR) injury is a leading cause of flap compromise and organ dysfunction during free-tissue transfer, and remains a great challenge for plastic surgeons. Thioredoxin-1 (Trx-1) was proved to protect the IR flap by mitigating the oxidative stress, and inhibiting the activation of apoptosis signal-regulating kinase-1 (ASK-1) and mitogen-activated protein kinase (MAPK) pathway. The aim of this study is to investigate the distinction of Trx-1 expression, apoptosis indices in different layers of IR flaps, and the feasibility of tissue-layer-specific administration of Trx-1.
Methods:Ten patients′ specimens of IR flaps for DIEP breast reconstruction were collected and assessed for apoptosis and Trx-1 expression. Twenty mice were used to establish the IR flap model. The mice were sacrificed twenty-four hours after reperfusion. The flap tissues were harvested and tested by immunohistochemistry staining and TUNEL assay. The tissue-layer-specific dermoprotective effect of Trx-1 and the molecular mechanisms were assessed by an in vitro epithelial skin cell hypoxia-reoxygenation model. The statistics were conducted by t test and ANOVA using SPSS 20.0.
Results:Trx-1 expression and apoptotic cells were observed mainly located in the basal layer of epidermis and the papillary layer of dermis in human IR flaps and mice models. Trx-1 depletion was 24.19 %± 2.23% in the basal layer of epidermis and the papillary layer of dermis of patient IR flaps, decreasing significantly compared with 70.71% ± 6.38% in control group (t = 27.54, P< 0.001). Similar tissue-layer-specific down regulation of Trx-1 also displayed in mice IR flap models (19.83% ± 2.34% vs. 76.59% ± 4.88%; t = 34.71, P<0.001). The apoptotic index in human samples significantly increased from 1.32% ± 1.52% in control group to 43.71 %± 3.17% in IR group (t =38.23, P<0.001); while it was proved to be dramatically raised in mice models from 0.86% ± 1.15% in control group to 41.14 %± 4.21% in IR group (t= 36.96, P < 0.001). Western Blot analysis revealed Trx-1 down regulation and a significant increase in ASK-1, p-p38, and c-PARP abundance in the hypoxia-reoxygenation-treated HaCaT cells (P < 0.01). Supplementation of recombinant human Trx-1 significantly reduced the apoptosis-related protein expression.
Conclusions:The basal layer of epidermis and the papillary layer of dermis are the main damaged tissue layers in the early stage of skin flap ischemia-reperfusion injury. The IR flap can be protected by precisely replenishing the vulnerable layers with Trx-1.
