ヒト培養組織における加圧が細胞外マトリックスに及ぼす影響―褥瘡発生時の体圧との関連

Effect of Compressive Stress on the Extracellular Matrix in Human Fibroblasts and Endothelial Cells：Relation to Body Pressure When Pressure Ulcers Develop

要旨

　本研究の目的は，褥瘡の発生につながる細胞外マトリックス（以下ECMとする）の破壊に対する体圧の影響を明らかにすることである．

　材料は，ヒト線維芽細胞，血管内皮細胞である．培養した細胞に加圧（50 mmHg）を行った後，細胞形態とECMの変化，MMPのようなECMの分解酵素と合成成分の発現を分析した．50 mmHgの加圧で線維芽細胞の形態は変化を起こし，フィブロネクチンの発現の減少，バーシカン，コラーゲンとMMP3，ADAMTS4の発現の増加を確認し，血管内皮細胞の形態は変化を認めなかった．結果から，約50 mmHg値を体圧分散の目安としていることは有効ではないかと考える．しかし，圧力が組織全体へ影響を与え，組織を支持しているECM構築に変化を引き起こしている可能性もある．よって，体圧のみではなく組織全体への影響も考えた看護介入を検討する必要性があることが示唆された．

Abstract

　The aim of this study was to elucidate the effect of physical body pressure on the destruction of the extracellular matrix (ECM) leading to pressure ulcers. Materials used were human normal skin fibroblast and umbilical endothelial cells. Following cultivation of both fibroblasts and endothelial cells in the presence or absence of physical pressure (50 mmHg), the change in cell morphology and ECM, levels of the degradation enzyme of ECM, such as MMPs, and alteration of gene expression were examined. In fibroblasts, in addition to the morphological change, down-regulation of fibronectin, up-regulation of versican, collagen, MMP3, and ADAMTS4 were observed, however, no prominent alteration was detected in endothelial cell morphology under the experimental conditions used. Therefore, it is suggested that physical body pressure of around 50 mmHg could be critical for dispersion of body pressure. However, physical pressure might also affect over all tissue, resulting in alteration of the ECM structure. It was suggested that nursing intervention based on not only the physical pressure but also the total over all tissue structure should be investigated.