褥瘡創面における細胞外マトリックス分解産物の解析

Analysis of Specific Distribution of ECM Degraded-Product in Wound Surface of Pressure Ulcer

要旨

　本研究の目的は，褥瘡創面の細胞外マトリックス（以下ECMとする）分子の構築状態と，褥瘡創面の関連性を明らかにすることである．褥瘡と診断された8名に使用していたガーゼに付着した滲出液から抽出したタンパク質を対象とし，抗体を用いてECM構築分子の存在について検索し，酵素交代測定法（ELISA）によりMMP3の発現量を測定した．その結果，ⅰ）褥瘡創面の状態によって抗体反応のパターンが違うこと，ⅱ）一つの褥瘡創面でも部位により抗体反応が違う，ⅲ）MMP3の発現量が対象によって違いがあることが明らかになった．このことから，対象によって褥瘡創面のECM分子の構築状態が違うことが考えられ，褥瘡創面の状態に応じた看護介入を考慮することが重要である．また，褥瘡創面から MMP3が検出されたことから，MMP3が褥瘡に何らかの関連性があることが示唆された．

Abstract

　The aim of this study was to investigate the relationship between the molecular structure of the extracellular matrix (ECM) and the wound surface of pressure ulcers. Protein samples of excreted tissue fluid attached to the gauze surface of gauze from eight patients were extracted and subjected to examine for the presence of ECM-related molecules by utilizing specific antibody and ELISA to measure the enzymatic level of MMP3. It was revealed that i) western blot profiles differed from one another depending on the surface condition of the pressure ulcer; ii) a distinct immuno-staining profile was observed even in samples isolated from the same pressure ulcer; and iii) the MMP3 expression level also differed among protein samples. These results suggest that the molecular construction of the ECM around the wound surface of a pressure ulcer might differ from patient to patient. Therefore, it is important that nurses consider the nursing intervention based on the surface condition of pressure ulcers. In addition, MMP3-involvement in pressure ulcers is also suggested this enzyme has been detected in protein samples from the wound surface of pressure ulcers.