Neural Control of Blood Flow in Grafted Skin

描述（由申请人提供）：增加皮肤血流量对于人类至关重要， 在运动和/或高温暴露期间适当调节内部温度。伤口，如烧伤，可能会损害皮肤，需要去除受损组织和随后的皮肤移植。虽然移植的皮肤变得血管化，但仍不清楚该血管床是否有助于通过神经介导的皮肤血管舒张和收缩来控制内部温度。烧伤/移植皮肤的温度控制受损的证据已经被提出，因为研究结果表明，烧伤超过40%的个体在热挑战期间相对于非烧伤受试者具有更高的直肠温度。然而，在这些研究中，没有控制皮肤移植的存在或不存在，以及移植物的成熟度。由于缺乏关于 皮肤移植对移植皮肤的自主控制的短期和长期后果，该建议的主要目的是检验以下假设：人的断层移植物中皮肤血流的神经控制最初受损，但随着移植物成熟而恢复正常。这些目标将通过进行新的实验来实现，以评估测试前5-9、26-38、50-62和72-86个月接受断层皮肤移植的受试者的皮肤血流神经控制。从拟议的研究中获得的信息将是有价值的，了解这种外科手术的短期和长期后果。此外，这些信息将提供一个有价值的基准，从该基准中，作为新兴技术（即合成皮肤、培养皮肤、生长因子等）的结果的生理反应将被评估。可以进行比较，以确定这些技术是否对移植皮肤的神经再生和血管重建有益。

DESCRIPTION (provided by applicant): Increasing skin blood flow is critical for humans to appropriately regulate internal temperature during exercise and/or hyperthermic exposure. Wounds, such as burns, can damage skin, requiring removal of damaged tissue and subsequent skin grafting. Although grafted skin becomes revascularized, it remains unclear whether this vascular bed contributes to the control of internal temperature through neurally mediated cutaneous vasodilation and constriction. Evidence of impaired temperature control in burned/grafted skin has been suggested given findings that individuals with burns over 40 percent of their body have higher rectal temperatures during a thermal challenge relative to non-burned subjects. However, the presence or absence of skin grafting, as well as the maturity of the graft, was not controlled in those studies. Given the lack of information regarding the short and long term consequences of skin grafting on autonomic control of grafted skin, the primary objective of this proposal is to test the hypothesis that neural control of skin blood flow in human split-thickness grafts is initially impaired, but returns towards normal as the graft matures. These objectives will be accomplished by performing novel experiments to assess neural control of skin blood flow from subjects who had split-thickness skin grafts 5-9, 26-38, 50-62, and 72-86 months prior to testing. The information gained from the proposed studies will be valuable in understanding the short and long-term ramifications of this surgical procedure. Moreover, this information will provide a valuable benchmark from which physiological responses as a result of emerging technologies (i.e. synthetic skin, cultured skin, growth factors, etc.) could be compared, to identify if those technologies are beneficial to the patient with respect to reinnervation and revascularization of the grafted skin.