Cutaneous wound healing in aging small mammals: a systematic review
Cutaneous wound healing in aging small mammals: a systematic review
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DOI：
10.1111/wrr.12290
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发表时间：
2015-05-01
影响因子：
2.9
通讯作者：
Clark, Richard A. F.
中科院分区：
文献类型：
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作者：
Kim, Dong Joo;Mustoe, Thomas;Clark, Richard A. F.
随着老年人口的增长，无法愈合的皮肤创伤的临床和社会经济负担也在增加，其中大部分发生在60岁以上的人中。关于衰老如何影响伤口愈合的人体研究将永远是黄金标准，但研究存在伦理和实践障碍。选择动物模型是由成本和动物寿命决定的，这排除了大型动物的使用。在这里，我们回顾了目前关于衰老如何影响小动物模型皮肤伤口愈合的文献，并在可能的情况下，比较不同研究的愈合情况。使用MEDLINE/PubMed数据库的文献搜索，研究仅限于那些使用全层伤口的研究，并比较了年轻和老年队列中伤口闭合、再上皮化、肉芽组织填充和抗张强度等伤口愈合参数。总体而言，在不同品系的小鼠和大鼠中，伤口闭合、再上皮化和肉芽组织填充随着年龄的增长而延迟或减少。在小鼠中，衰老与伤口愈合过程早期的抗张强度较低有关，但在伤口愈合过程的后期与较高的抗张强度有关。类似地，大鼠的衰老与伤口愈合过程早期较低的抗张强度有关，但在愈合伤口的后期，年轻和老年大鼠之间的抗张强度没有显著差异。从对新西兰白兔的研究中，我们发现随着年龄的增长，再上皮化和肉芽组织填充总体上延迟或减少。虽然不同菌株和物种之间的关键伤口愈合参数有相似之处和不同之处，但整个研究的可比性非常值得怀疑，因为实验设计和报告中存在很大的差异。在未来的研究中，标准化的实验设计和报告将有助于建立可比较的研究小组，并推进整体知识库，促进动物数据与人类临床情况的可译性。
As the elderly population grows, so do the clinical and socioeconomic burdens of nonhealing cutaneous wounds, the majority of which are seen among persons over 60 years of age. Human studies on how aging effects wound healing will always be the gold standard, but studies have ethical and practical hurdles. Choosing an animal model is dictated by costs and animal lifespan that preclude large animal use. Here, we review the current literature on how aging effects cutaneous wound healing in small animal models and, when possible, compare healing across studies. Using a literature search of MEDLINE/PubMed databases, studies were limited to those that utilized full-thickness wounds and compared the wound-healing parameters of wound closure, reepithelialization, granulation tissue fill, and tensile strength between young and aged cohorts. Overall, wound closure, reepithelialization, and granulation tissue fill were delayed or decreased with aging across different strains of mice and rats. Aging in mice was associated with lower tensile strength early in the wound healing process, but greater tensile strength later in the wound healing process. Similarly, aging in rats was associated with lower tensile strength early in the wound healing process, but no significant tensile strength difference between young and old rats later in healing wounds. From studies in New Zealand White rabbits, we found that reepithelialization and granulation tissue fill were delayed or decreased overall with aging. While similarities and differences in key wound healing parameters were noted between different strains and species, the comparability across the studies was highly questionable, highlighted by wide variability in experimental design and reporting. In future studies, standardized experimental design and reporting would help to establish comparable study groups, and advance the overall knowledge base, facilitating the translatability of animal data to the human clinical condition.