中井 彩乃

Persistent and blanchable redness (PBR) is not currently included in category I pressure injury (PI), which is defined as non-blanchable redness (NBR). However, PBR progresses to PI in a clinical setting. Therefore, it should be clinically managed as category I PI, and a method to distinctly identify PBR is needed. This study aimed to examine whether PI-related biomarkers can distinguish PRB from transient redness (TR) and NBR using skin blotting. TR, PBR, and NBR models were established by the different conditions of dorsal skin compression. Redness observation and skin blotting were performed, and the skin tissue samples were subjected to histological and molecular biological analyses. The vascular endothelial growth factor (Vegf) b, heat shock protein (Hsp) 90aa1, tumour necrosis factor, interleukin (Il) 1b, and Il6 messenger ribonucleic acid levels were significantly different between the three models. The VEGF-A, VEGF-B, IL-1β, and IL-6 protein levels were different between the three models. Although the results of skin blot examinations were inconsistent with those of the expression analysis of tissue, HSP90α and IL-1β are suggested to be potential markers to distinguish PBR from TR and NBR.

背景:小児湿疹に対し,紫外線光線療法を長期間行うことは有害である.本研究の目的は紫外線を含まない可視光線療法の小児湿疹への効果を検討することである.方法:シングルケース実験デザイン研究.3週間の非照射期間のあと,30分間の光線療法を週3回,5週間行った.評価項目は,Patient-Oriented Eczema Measure(POEM),経表皮水分蒸散量(TEWL),皮膚表面水分量,pH,TSLP,IL-4,IL-13とした.結果:症例は中等度の湿疹を有する3歳男児で,10ヵ月間の治療を経ても悪化していた.照射・非照射期間を比較しPOEMは臨床的に有意に低下していた.炎症部のTEWLも低下傾向を示した.結論:紫外線を含まない可視光線療法により,かゆみが改善したことで,掻き動作やそれに伴う出血が軽減した.このことから,本療法が小児湿疹の改善に一定の効果をもたらす可能性が示唆された.今後は客観的指標による皮膚バリア機能の改善効果を検証する必要がある.(著者抄録)

Pressure injuries (PIs) are localised skin injuries that result from pressure with or without shear force. Shear force is more destructive than pressure in clinical settings. Therefore, determining the critical external forces is important for selecting the appropriate care to prevent PIs. To quantitatively distinguish pressure and shear loading with high specificity, we focused on microRNAs (miRs). This study aimed to identify the miRs that are distinguishable between pressure with and without shear loading in rat skin. Microarray analysis identified six candidate miRs from the comparisons among the pressure, shear, and unloaded groups. We analysed the expression levels of the candidate miRs in the process of PI development using real-time reverse transcriptase polymerase chain reaction. In the pressure and shear groups, miR-92b expressions at 6 hours after loading were 2.3 ± 1.3 and 2.9 ± 1.0, respectively, which were significantly higher than those in the control group (P = .014 and .004, respectively). miR-877 expression at 6 hours after loading was significantly increased only in the shear group (2.8 ± 0.9) compared with the control group (P = .016). These results indicate that miR-92b and miR-877 are promising biomarkers to determine for which external force healthcare professionals should intervene.