Control of skin blood flow and sweating in grafted skin

移植皮肤中皮肤血流量和出汗的控制

• 批准号: 6768764
• 负责人: CRAIG G CRANDALL
• 金额: $ 22.97万
• 依托单位: UT SOUTHWESTERN MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-08-01 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6768764
• 关键词: angiogenesis; blood pressure; body temperature; clinical research; cold temperature; heart rate; heat; human subject; longitudinal human study; microdialysis; nitric oxide; regeneration; skin transplantation; sweat; ultrasound blood flow measurement; vasoconstriction; vasodilatation

DESCRIPTION (provided by applicant): Increases in skin blood flow and sweating are critical responses for humans to appropriately regulate internal temperature during exercise and/or hyperthermic exposure. Wounds, such as burns, can damage the skin requiring removal of the damaged tissue and subsequent skin grafting. Although grafted skin ultimately becomes revascularized, it remains unclear whether this vascular bed will ever contribute to the control of internal temperature through cutaneous vasoconstriction and vasodilation during hypothermic and hyperthermic conditions, respectively. In fact, a limited number of studies showed that individuals with healed burns over 40% of their body had higher rectal temperatures during a hyperthermic challenge relative to non-burned counterparts, suggesting impaired thermal regulatory responses of the burned subjects. However, in those studies the presence or absence of skin grafting, as well as the maturity of the wound/graft, was not controlled. Given the lack of information regarding short and long term consequences of skin grafting with respect to revascularization and reinnervation of the grafted skin, the primary objective of this proposal is to test the hypothesis that autonomic and non-autonomic control of skin blood flow in human split-thickness grafts are initially impaired but return towards normal as the graft matures; while sweating responses remain impaired regardless of graft maturity. Moreover, since the vasculature and sweat ducts of donor sites are disrupted due to skin harvesting, the control of skin blood flow and sweating will also be assessed from these sites. These objectives will be accomplished by performing a series of novel experiments to assess neural and non-neural control of skin blood flow and sweating from subjects with split-thickness skin grafts of varying maturities (i.e. graft procedure performed 5-9, 26-38, 50-62, and 72-86 months prior to study participation). In addition, individuals in the 5-9 month post-graft group will be reassessed yearly throughout the funding period. The information gained from the proposed studies will be valuable to both clinicians and patients towards an understanding of the short and long-term consequences of this surgical procedure. Moreover, this information will provide a benchmark from which responses due to emerging technologies (i.e. synthetic skin, cultured skin, growth factors, etc) could be compared with respect to reinnervation and revascularization of the grafted area.

描述（由申请人提供）：皮肤血流量增加和出汗是人体在运动和/或高温暴露期间适当调节内部温度的关键反应。伤口，例如烧伤，会损伤皮肤，需要去除受损组织并随后进行皮肤移植。虽然移植的皮肤最终实现了血运重建，但仍不清楚该血管床是否会分别在低温和高温条件下通过皮肤血管收缩和血管舒张来控制内部温度。事实上，有限数量的研究表明，相对于未烧伤的受试者，身体愈合超过40%的烧伤个体在高温挑战期间具有更高的直肠温度，这表明烧伤受试者的热调节反应受损。然而，在这些研究中，没有控制是否存在皮肤移植以及伤口/移植物的成熟度。鉴于缺乏有关皮肤移植对移植皮肤血运重建和神经再支配的短期和长期后果的信息，本提案的主要目的是测试以下假设：人体断层移植物中皮肤血流的自主和非自主控制最初受损，但随着移植物成熟而恢复正常;而无论移植物成熟与否，出汗反应仍然受损。此外，由于供体部位的脉管系统和汗管由于皮肤采集而被破坏，因此也将从这些部位评估皮肤血流和出汗的控制。这些目标将通过进行一系列新实验来实现，以评估植入不同成熟度断层皮肤移植物（即，在参与研究前5-9、26-38、50-62和72-86个月进行移植手术）的受试者对皮肤血流和出汗的神经和非神经控制。此外，在整个资助期间，移植后5-9个月组的个人将每年重新评估。从拟议的研究中获得的信息将对临床医生和患者了解这种外科手术的短期和长期后果有价值。此外，这些信息将提供一个基准，根据该基准，可以比较新兴技术（即合成皮肤、培养皮肤、生长因子等）对移植区域神经再支配和血运重建的反应。