高低糖環境對糖尿病脂肪幹細胞傷口癒合能力之研究

Abstract

脂肪幹細胞為近年來最容易取得且數量豐富的幹細胞，應用上也越趨多元化。常用於組織修復、燒燙傷、抗衰老、關節保健、軟組織填補。對於有慢性傷口癒合延遲問題的病人，自體幹細胞移植成為除了常規治療以外的另一種治療方式。許多研究指出，糖尿病病人的高血糖症會對器官、組織與細胞造成損害，進而引發糖尿病併發症。再者，長期處於高糖環境下的自體幹細胞也會降低其對傷口修復與組織再生的能力。由於傷口的延遲癒合，在這期間容易造成傷口感染，並增加傷口的發炎程度。 本研究探討經由低糖處理後的自體脂肪幹細胞對糖尿病傷口的治療。藉由改變糖尿病鼠脂肪幹細胞培養的微環境，使自體脂肪幹細胞修復傷口的能力獲得改善。我們發現在體外實驗中，低糖環境能夠促進糖尿病脂肪幹細胞的增殖與減少細胞衰老的現象。對於曾浸潤在高糖環境中的糖尿病鼠脂肪幹細胞，經由低糖環境培養一週後，能夠比沒有經過低糖處理的糖尿病鼠脂肪幹細胞具有更佳的傷口修復能力，並促進血管新生與成纖維細胞的增生。因此，自體脂肪幹細胞經由低糖環境培養後，對於糖尿病傷口修復可能為一種可行的療法。

Adipose-derived stem cells (ASCs) have been the most readily available and abundant stem cells in recent years, and the applications of ASC are becoming more and more diverse, such as tissue repair, burns, anti-aging, joint health, and soft tissue filling. For patients with chronic wound healing delays, autologous stem cell transplantation has become another treatment in addition to conventional treatment. Several studies suggested that hyperglycemia in diabetic patients will damage organs and tissues, and cause diabetes complications. Furthermore, autologous stem cells that have been in a high-glucose environment for a long time will also reduce the ability of repair wounds. Due to the delayed healing of the wound, it is easy to cause wound infection and increase the degree of inflammation of the wound. In order to study the treatment of diabetic wounds with autologous ASCs treated with low-glucose environment, we cultured diabetic murine ASC in low-glucose for a week to improve ASCs to repair wounds. We found that ASCs cultured in low-glucose could promote the cell proliferation and reduce the cell aging in vitro. Moreover, they could have better wound repairing ability than ASCs cultured in high-glucose, and promote angiogenesis and fibroblast proliferation in vivo. Therefore, after autologous ASCs are cultured in a low-sugar environment, it may be a feasible treatment for diabetic wound repair.