Опубликовать статью

Информационное партнерство

Инфоресурсы

Контакты

«

Vol. 23, Art. 32 (pp. 573-595)    |    2022       

»

Sanogenetic mechanisms of early correction of local damages of soft tissues in compression injury with hyaluronic acid (experimental study)

Shperling I.A.1, Shulepov A.V.1, Odintsova I.A.2, Shperling N.V.1, Sheladev I.V.1

1Federal State Budgetary Establishment «State Scientific Research Test Institute of the military medicine of the Russian Federation Defense Ministry»

2Military Medical Academy named after S.M. Kirov

Brief summary

Background. In injury surgery, the protective and regenerative properties of hyaluronic acid (HA) gels have become widely used. Despite this, the effectiveness of early local application of HA on the regeneration of skeletal muscles in the area of damage during prolonged static compression of soft tissues has not been sufficiently studied at present. Objective. To study the sanogenetic mechanisms of early correction of local soft tissue injuries with hyaluronic acid in compression injury. Materials and methods. The study was performed on 66 male Wistar rats, which were divided into 3 groups before the experiment: the main group (n=28), the comparison group (n=28) and the intact group (n=10). Animals of the main and comparison groups were subjected to mechanical compression of the soft tissues of the thigh with a compression force of 10-12 kg/cm² and a compression duration of 7 hours. No compression injury was applied to intact animals. After 3 hours, the animals of the main group were injected locally with a 1.75% solution of hyaluronic acid in a volume of 2.0 ml/kg, the animals of the comparison group did not receive local treatment. 3, 7, 14, and 28 days after the end of compression, we measured the femoral circumference, biochemical parameters (myoglobin, potassium), determined the state of microcirculation and soft tissue metabolism, and performed a histomorphological study of skeletal muscles in the area of injury. Results. In the early (3-7 days) and intermediate (14 days) post-compression periods in animals after local administration of HA, a less pronounced swelling of the soft tissues of the thigh was noted, a decrease in myoglobin by 20-69% (p<0.05) and potassium by 34% (p<0.05) was observed, a less significant increase in the level of pro-inflammatory cytokines in the blood, increased perfusion and metabolism in the area of compression (increase in the coefficient of variation of the microcirculation index (Kv) by 25-43% (p<0.05) and the index of oxygen exchange efficiency (ОЕЕ) - by 93-95% (p<0.05). In the late compression period (28 days) after the use of HA, an increase in the profile of anti-inflammatory IL-10 oxygen exchange (increased OEE by 87% (p<0.05), less pronounced post-traumatic atrophy of skeletal muscles in the area of damage. The proportion of necrotic muscle fibers by the end of the observation period was reduced by 30% (p<0.05), and the area of newly formed elements of skeletal muscle tissue increased by almost 1.5 times for (p<0.05) compared with animals without local treatment. Conclusion. Early local correction of soft tissue damage with hyaluronic acid stops microcirculatory and metabolic disorders, which inhibits the progression of the pro-inflammatory reaction, limits tissue necrosis in the area of compression, promotes active neomyogenesis without the formation of a pronounced connective tissue regenerate.


Key words

compression injury, rhabdomyolysis, hyaluronic acid, regeneration

Reference list

Mysseliys, S.G. Okazanie medicinskoi pomoshi postradavshim pri zemletryasenii v Armenii (k 30-letiu tragedii) / S.G. Mysseliys, V.G. Teryaev, V.I. Potapov, L.N. Zimina // Jyrnal im. N.V. Sklifosovskogo «Neotlojnaya medicinskaya pomosh». - 2020. - T.9, 1. - S.123-129. doi: 10.23934/2223-9022-2020-9-1-123-129


2. Genthon, A.L. Crush syndrome: a case report and review of the literature / A.L. Genthon, S.R. Wilcox // J. Emerg. Med. - 2014 - Vol.46, 2. - P.313-319.


3. Abrosimov, D.A. Kolichestvennii analiz mozgovogo natriiyreticheskogo peptida kardiomiocitov kris v rannem postreperfyzionnom periode / D.A. Abrosimov, E.I. Yakovleva, M.L. Bygrova // Citologiya. - 2015. - 4. - S.305-308.


4. Danilov, R.K. Ranevoi gistogenez: gistogeneticheskie osnovi / R.K. Danilov. - SPb: VMedA, 2008. - 379 s.


5. Shylepov, A.V. Regenerativnie effekti regionarnogo primeneniya mezenhimnih stromalnih kletok cheloveka v gele gialyronovoi kisloti pri eksperimentalnoi kompressionnoi travme myagkih tkanei / A.V. Shylepov, N.V. Shperling, U.V. Urkevich [i dr.] // Mediko-biologicheskie i socialno-psihologicheskie problemi bezopasnosti v chrezvichainih sityaciyah. - 2018. - 1. - S.75-83. doi: 10.25016/2541-7487-2018-0-1-75-83


6. Aya, K.L. Hyaluronan in wound healing: rediscovering a major player / K.L. Aya, R. Stern // Wound Repair Regen. - 2014. - Vol.22, ?5. - P.579-593. doi: 10.1111/wrr.12214


7. Johnson, P. Hyaluronan and its interactions with immune cells in the healthy and inflamed lung / P. Johnson, A.A. Arif, S.S.M. Lee-Sayer, Y. Dong // Front. Immunol. - 2018. - 9. - P.2787-2795. doi: 10.3389/fimmu.2018.02787


8. Petrey, A.C. Hyaluronan, a crucial regulator of inflammation / A.C. Petrey, C.A. Motte // Front. Immunol. - 2014. - Vol.11, 5. - P.101. doi: 10.3389/fimmu.2014.00101


9. Shperling, I.A. Izmeneniya mikrocirkylyacii i metabolicheskoi aktivnosti v myagkih tkanyah posle lokalnogo primeneniya gialyronovoi kisloti v raznih rejimah pri eksperimentalnoi vzrivnoi travme / I.A. Shperling, R.V. Semakin, A.V. Shylepov [i dr.] // Tihookeanskii medicinskii jyrnal. - 2022. - 1. - S.90-97. doi: 10.34215/1609-1175-2022-1-90-97


10. Shperling, I.A. Sanogeneticheskie i farmakologicheskie effekti lokalnogo primeneniya gialyronovoi kisloti pri eksperimentalnoi kompressionnoi travme myagkih tkanei / I.A. Shperling, A.V. Shylepov, N.V. Shperling [i dr.] // Krimskii jyrnal eksperimentalnoi i klinicheskoi medicini. - 2020. - T.10, 2. - S.53-60. doi: 10.37279/2224-6444-2020-10-2-53-60


11. Wang, W. Protective effects of ischemic postconditioning on skeletal muscle following crush syndrome in the rat / W. Wang, Yu. Wang, J. Yang // Acta Cir. Bras. - 2021. - Vol.36, 7. - P.e360701. doi.org/10.1590/ABC360701


12. Yamamoto, T. Detection of ruminant meat and bone meal in feeds by sandwich ELISA with monoclonal antibodies / T. Yamamoto, M. Kato, K. Endo [et al.] // J. Vet. Med. Sci. - 2016. - Vol.77, 12. - P.1605-1609. doi: 10.1292/jvms.15-0078


13. Miziev, I.A. Individyalnii prognoz ostrogo povrejdeniya pochek y bolnih s sochetannoi travmoi / I.A. Miziev, M.H. Mahov, A.K. Jigynov [i dr.] // Medicina katastrof. - 2014. - T.88, 4. - S.18-20.


14. Zimmerman, J.L. Rhabdomyolysis / J.L. Zimmerman, M.C. Shen // Chest. - 2013. - Vol.144, 3. - P.1058-1065. doi: 10.1378/chest.12-2016


15. Harchenko, V.Z. Molekylyarnie mehanizmi razvitiya ekstremalnih sostoyanii i ih korrekciya / V.Z. Harchenko, A.V. Kybishkin, I.I. Fomochkina [i dr.]. - Simferopol: Dolya, 2011. - 155 s.


16. George, M.J. Platelet biomechanics, platelet bioenergetics, and applications to clinical practice and translational research / M.J. George, J. Bynum, P. Nair [et al.] // Platelets. - 2018. - Vol.29. - P.431-439.


17. Zavalii, A.A. Dinamika pokazatelei nespecificheskih proteinaz i ih ingibitorov pri lechenii bolnih ostrim gnoinim rinosinysitom mykoaktivnimi preparatami / A.A. Zavalii, A.V. Kybishkin, A.A. Jykova // Bulleten sibirskoi medicini. - 2017. - T.16, 1. - S.27-35. doi: 10.205 38/ 1682-0363-2017-1-27-35


18. Danilov, R.K. Gistogeneticheskii analiz kak osnova mehanizmov reaktivnosti, regeneracii i patologii organov i sistem / R.K. Danilov, I.A. Odincova // Voprosi morfologii HHI veka. - 2018. - 5. - S.8-16.


19. Nikogosyan, V.V. Kletochno-differonnii sostav granylyacionnoi tkani v reparativnom gistogeneze / V.V. Nikogosyan, A.V. Gorbylich // Izvestiya Rossiiskoi Voenno-medicinskoi akademii. - 2020. - T.2, 1. - S.118-120.


20. Shapovalova, E.U. Vliyanie polinykleotidov na soderjanie makrofagov v tkanyah regeneriryushei ishemizirovannoi rani / E.U. Shapovalova, T.A. Boiko, U.G. Baranovskii [i dr.] // Sovremennie problemi nayki i obrazovaniya. - 2017. - ?6. - S.140.


21. Liu, Q. Increased blood flow in keloids and adjacent skin revealed by laser speckle contrast imaging / Q. Liu, X. Wang, Y. Jia [et al.] // Lasers Surg. Med. - 2016. - Vol.48, 4. - P.360-364. doi: 10.1002/lsm.22470


22. Zelenetskii, A.N. Polycomplexes of hyaluronic acid and borates in a solid state and solution: synthesis, characterization and perspectives of application in boron neutron capture therapy / A.N. Zelenetskii, S. Uspenskii, A. Zaboronok [et al.] // Polymers (Basel). - 2018. - Vol.10, 2. - P.181. doi: 10.3390/polym10020181


23. Tavianatou, A.G. Hyaluronan: molecular size-dependent signaling and biological functions in inflammation and cancer / A.G. Tavianatou, I. Caon, M. Franchi [et al.] // FEBS J. - 2019. - Vol.286, ?15. - P.2883-2908. doi: 10.1111/febs.14777


24. Fallacara, A. Hyaluronic acid in the Third Millennium / A. Fallacara, E. Baldini, S. Manfredini [et al.] // Polymers (Basel). - 2018. - Vol.10, 7. - P.701-710. doi: 10.3390/polym10070701


25. Schimizzi, A.L. High-molecular-weight hyaluronan inhibits macrophage proliferation and cytokine release in the early wound of a preclinical postlaminectomy rat model / A.L. Schimizzi, J.B. Massie, M. Murphy [et al.] // Spine J. - 2006. - Vol.6, 5. - P.550-556. doi: 10.1016/j.spinee.2005.12.005


26. Price, Z.K. Differing roles of hyaluronan molecular weight on cancer cell behavior and chemotherapy resistance / Z.K. Price, N.A. Lokman, C.Ricciardelli // Cancers (Basel). - 2018. -Vol.10, 12. - P.482. doi: 10.3390/cancers10120482


27. Wang, Y. CD44 inhibits α-SMA gene expression via a novel G-actin/MRTF-mediated pathway that intersects with TGFβR/p38MAPK signaling in murine skin fibroblasts / Y. Wang, J.A. Mack, E.V. Maytin // J. Biol. Chem. - 2019. - Vol.294, 34. - P.12779-12794. doi: 10.1074/jbc. RA119.007834


28. Patrulea, V. Polyelectrolyte nanocomplexes based on chitosan derivatives for wound healing application / V. Patrulea, L.A. Laurent-Applegate, V. Ostafe [et al.] // Eur. J. Pharm. Biopharm. - 2019. - Vol.140, 7. - P.100-108. doi: 10.1016/j.ejpb.2019.05.009


29. Nyman, E. Hyaluronic acid accelerates re-epithelialization and alters protein expression in a human wound model / E. Nyman, J. Henricson, B. Ghafouri [et al.] // Plast. Reconstr. Surg. Glob. Open. - 2019. - Vol.7, 5. - P.e 2221. doi: 10.1097/GOX.0000000000002221