督脉隔药灸联合水凝胶多功能复合敷料对压力性损伤大鼠Nrf2/HO-1/NQO1信号通路的影响OACSTPCD

Objective To observe the effects of Du meridian moxibustion on medicines combined with multifunctional composite hydrogel dressing on wound repair and nuclear factor-erythroid 2 related factor 2(Nrf2)/heme oxygenase-1(HO-1)/NADPH quinone oxidoreductase 1(NQO1)signaling pathway in rats with pressure injury.Methods A total of 50 SPF SD rats were randomly divided into sham-operated group,model group,hydrogel dressing group,Du meridian moxibustion on medicines group,and combined intervention group,with ten rats in each group.Except for the sham-operated group,pressure injury rat models were established in the remaining four groups using pressure devices.The intervention was given to each group respectively,and the repair of pressure injury and pathological changes of wound tissue of rats in each group were recorded.ELISA was used to determine the levels of serum inflammatory factors including tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,and IL-6,as well as oxidative stress factors including malondialdehyde(MDA),superoxide dismutase(SOD),and glutathione peroxidase(GSH-Px)in each group.Western blot and RT-PCR were used to check the protein and mRNA expression levels of Nrf2,HO-1,NQO1,and matrix metalloproteinase-9(MMP-9)in wound granulation tissue of rats in each group.Results The HE staining showed that the skin structure of sham-operated group was not damaged;significant cell necrosis,degeneration,and inflammatory cell infiltration of wound granulation tissue were observed in the model group;wound was repaired in all intervention groups,manifested as scattered infiltration of inflammatory cells and a significant reduction in"balloon like"necrosis and degeneration.The Masson staining showed that the collagen fibers in the wound skin tissue of the sham-operated group were relatively neat;large areas of collagen fiber deposition and disorder in wound granulation tissue were observed in the model group;all intervention groups showed varying degrees of wound repair.Compared with sham-operated group,the serum levels of TNF-α,IL-1β,IL-6,and MDA,as well as the protein and mRNA expression levels of Nrf2,HO-1,NQO1,MMP-9 in wound granulation tissue of the model group were higher(P<0.05),while the wound repair rate,serum levels of SOD and GSH-Px were lower(P<0.05).Compared with model group,the serum levels of TNF-α,IL-1β,IL-6,and MDA in hydrogel dressing group,Du meridian moxibustion on medicines group,and combined intervention group decreased(P<0.05),while the wound repair rate,the serum levels of SOD and GSH-Px,and the protein and mRNA expression levels of Nrf2,HO-1,NQO1,and MMP-9 in wound granulation tissue increased(P<0.05),and the combined intervention group showed better results than other intervention groups(P<0.05).Conclusion Du meridian moxibustion on medicines can effectively promote wound repair in pressure injury and the effect is better when combined with multifunctional composite hydrogel dressing.Its mechanism may be related to the inhibition of wound inflammatory reaction and oxidative stress,as well as the activation of Nrf2/HO-1/NQO1 signaling pathway by Du meridian moxibustion on medicines.