Can plantar fibroblast implantation protect amputees from skin injury? A recipe for skin augmentation.
Can plantar fibroblast implantation protect amputees from skin injury? A recipe for skin augmentation.
复制标题
足底成纤维细胞植入可以保护截肢者免受皮肤损伤吗？
DOI：
10.1111/exd.14419
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发表时间：
2021
影响因子：
3.6
通讯作者：
Boyle CJ
中科院分区：
文献类型：
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作者：
Boyle CJ
尽管假肢设计取得了持续的进步，但皮肤损伤仍然是假肢使用者的一个长期问题。限制皮肤损伤预防的一个因素是残肢上的皮肤不适合承担行走的机械负荷。适合这项任务的身体的一个部位是脚底。在这里，我们提出了一种新的策略，积极增加皮肤的负荷耐力，增加其对机械损伤的抵抗力。我们假设，通过将足底成纤维细胞自体移植到残肢真皮中，可以提高皮肤的负荷耐受性。我们预计，引入足底成纤维细胞将诱导覆盖的角质形成细胞表达足底特异性角蛋白，从而导致更坚韧的表皮。使用负重残肢的计算有限元模型，我们估计通过将皮肤重新编程为足底样表型，皮肤变形(压疮损伤的关键驱动因素)可以减半。我们相信，这一策略可以在预防截肢者压疮方面取得新的进展，促进患者的康复，提高患者的生活质量。
Skin injuries remain a persistent problem for users of lower‐limb prostheses despite sustained progress in prosthesis design. One factor limiting the prevention of skin injuries is that skin on the residual limb is not suited to bear the mechanical loads of ambulation. One part of the body that is suited to this task is the sole of the foot. Here, we propose a novel strategy to actively augment skin's tolerance to load, increasing its resistance to mechanically induced injuries. We hypothesise that the load tolerance of skin can be augmented by autologous transplantation of plantar fibroblasts into the residual limb dermis. We expect that introducing plantar fibroblasts will induce the overlying keratinocytes to express plantar‐specific keratins leading to a tougher epidermis. Using a computational finite element model of a weight‐bearing residual limb, we estimate that skin deformation (a key driver of pressure ulcer injuries) could be halved by reprogramming skin to a plantar‐like phenotype. We believe this strategy could yield new progress in pressure ulcer prevention for amputees, facilitating rehabilitation and improving quality of life for patients.