The Preliminary Study On The Relationship Between The Scar And Substance P, Substance P Receptor

Objective: By measuring the thickness of the scar and the surrounding normal skin, using immunohistochemical method to detect substance P ,the amount of substance P receptor in each group of the scar and the surrounding normal skin, we Initially explore the mechanism of the hyperplasy of scar stimulated by substance P and substance P receptor through the relationship between substance P ,the amount of substance p receptor and the Proliferative index of the scar to provide a theoretical basis for the study of the prevention and treatment of scars.Methods:1 Select 24 patients on cicatrectomy: 9 cases of non-hypertrophic scar, 11 cases of hypertrophic scar, 4 cases of keloid. the scar tissue of each patient was completely cut , and the surrounding normal skin was also cut. paraffin-embed specimens ,measure the thickness of the skin tissue by vernier caliper, calculate Proliferative index of scar=(the thickness of scar - the thickness of normal skin )/ the thickness of normal skin , UNIT: mm.2 Divide the specimens into sections with thickness of 5μm, immunohistochemical stain substance P in the tissue, afterstain nucleus by hematoxylin, dehydration and mounting, progress image acquisition, determine the optical density and gray scale of each specimen.3 Divide the specimens into sections with thickness of 5μm, immunohistochemical stain substance P receptor in the tissue , afterstain nucleus by hematoxylin, dehydration and mounting , progress image acquisition, determine the gray scale of each specimen.4 With sas9 , progress analysis of variance on the proliferation index, gray scale among the groups; proliferation index and gray-scale of scar was progressed linear regression testing .Results:1 The average proliferative index of non-hypertrophic scar, hypertrophic scar and keloid is as follows: -0.025233863, 1.802332415, 1.6184406572 What can be seen under the light microscope is: the structure of the surrounding skin is normal, dermal fibers neatly arranged and paralleled with; we can see the structure of the normal gland, dermal papilla uniformly distributed and arcuation Smoothing,;substance P and substance P receptor are mainly distributed in the epidermal basal layer and papillary layer of dermis;the tissue around nerve fibers and glandular organ was also stained.the full-thickness struncture of non-hypertrophic scars is depauperater than the normal struncture,glandular organ is slightly reduced, the structure of parallel fibers is less tidy,substance P and substance P receptor were mainly stained in the epidermal basal layer; dermisal layer of hypertrophic scar is markedly thickening, glandular organ decreased with tangled fibrous structure and order staggered,curve of dermal papilla layer is flattening ;the dermal fiber structure of keloid is disordered,amounts of vortex structure can be seen, even we can see that the structure of dermal papilla layer and gland is disordered too,curve deepened and annulus structure can be seen, a great number of mast cells are infiltrating, substance P and substance P receptor of hypertrophic scar and keloid were mainly stained in the epidermal basal layer, substance P also expressed in fiber structure and the residual gland,substance P receptor can be seen in fibroblast.3 The substance P average gray-scale in the scar tissue of non-hypertrophic scar group,hypertrophic scar group, keloid group through immunohistochemical image analysis is as follows: 101.2667,131.9636,132.325;the average gray-scale of P substance receptor through immunohistochemical staining image analysis is as follows: 96.2358,130.6271,132.352. the average gray-scale of substance P in the normal skin tissue of non-hypertrophic scar group,hypertrophic scar group, keloid group through immunohistochemical image analysis is as follows:109.0556,122.2182,126.95;the average gray-scale of P substance receptor through immunohistochemical staining image analysis is as follows: 110.1362,121.5738,124.3571. by SAS9, the content of substance P and substance P receptor in the scar tissue among hypertrophic scar and keloid group and non-hypertrophic scar group exist difference, but the content in hypertrophic scar and keloid had no significant difference; substance P and substance P receptor in normal skin of each group had no significant differences in content. Paired t-test showed significant differences between the scar and normal skin in substance P and Substance P receptor through image analysis results,the gray scale of substance P in non-hypertrophic scar by image analysis is lower than that in normal skin, t =- 4.05, P = 0.00185,the Gray-scale of P substance receptor by image analysis is also below the normal skin, t =- 4.5, P = 0.001; the gray scale of substance P in hypertrophic scar by image analysis is higher than normal skin, t = 7.02, P <0.001; the Gray-scale of P substance receptor in hypertrophic scar by image analysis were higher than normal skin, t = 6.93, P <0.001;the gray scale of substance P in keloid by image analysis is higher than normal skin, t = 3.58, P = 0.01865;the Gray-scale of P substance receptor in keloid by image analysis is also higher than normal skin, t = 4.54, P = 0.01.4 Linear regression analysis by SAS9 was progressed among proliferation index of non-hypertrophic scar group, group of hypertrophic scars,keloid group and substance P gray-scale of scar(Table 6),results showed a linear relationship does not exist, (Figure 11); the proliferative index of non-hypertrophic scars group and substance P gray scale carried out linear regression analysis (Table 7) it showed linear relations, the regression equation: y1=-0.1973+ 0.0017x1, F=65.14, P=0.0002(Fig.12); linear regression analysis is carried out on the proliferative index of pathological scar (including hypertrophic scar and keloid) and substance P gray scale(Table 8), it showed linear relation, the regression equation: y2 =- 22.8784 +0.1855 x2, F = 250, P <0.0001 (Figure 13).Conclusion:1 Substance P directly or indirectly stimulate the proliferation of fibroblasts through substance P receptor in fibroblasts and mast cells.2 Substance P and substance P receptor's content in Hypertrophic scars and keloids had no significant difference, but higher than non-hypertrophic scars.3 The proliferation of non-hypertrophic scar (expressed by proliferative index) and its substance P's content present linear correlation; the proliferation of pathological scar and its substance P's content present linear correlation; Proliferative index of pathological scar is more effected by its substance P's content than that of non-hypertrophic scar.