Die Apoptose und ihre Bedeutung in der Plastischen Chirurgie

Zusammenfassung

Die Apoptose ist ein zentraler Mechanismus in der Zellhomöostase. Apoptose und Zellproliferation stehen im multizellularen Organismus in einem fein regulierten Gleichgewicht. Die pathogenetische Ursache für 70 % aller Erkrankungen des Gesamtorganismus ist ein Ungleichgewicht dieses Systems. Die Apoptose stellt daher einen zentralen Schwerpunkt klinischer und biologischer Untersuchungen dar. Um die Bedeutsamkeit der Apoptose für die Plastische Chirurgie zu untersuchen, wurde ihr Einfluss auf Wundheilung und Alterung sowie auf Ischämie und Reperfusionsschäden in mikrochirurgischen Lappenplastiken anhand bisheriger Literatur analysiert, zusätzlich erfolgten Recherchen zur Rolle der Apoptose in der Allotransplantation, in Tumoren und der Angiogenese. In allen dargestellten Teilbereichen der Plastischen Chirurgie wurde in verschiedensten Studien die hohe Bedeutung der Apoptose aufgezeigt. Weitere Untersuchungen zu Einfluss und Regulierbarkeit der Apoptose können ein verbessertes Verständnis plastisch-chirurgischer Krankheitsbilder und der Entwicklung neuer Therapieoptionen, auch in Überschneidung mit anderen Fachgebieten, erwirken. Die Apoptoseforschung stellt somit einen essenziellen Anteil für die Weiterentwicklung des Fachgebietes dar.

Abstract

Apoptosis and cell proliferation are the main mechanisms of cell homeostasis. The pathogenesis of approximately 70 % of all diseases results from an imbalance between these two counterparts. Therefore, research on apoptosis is a main target in biological and clinical fields. Many signalling pathways and proteins involved in their regulation have been characterized. In order to evaluate the relevance of apoptosis in plastic surgery, the literature was reviewed for its impact on ischemia and reperfusion concerning flap surgery as well as wound healing and angiogenesis. Furthermore, the relevance of apoptosis in ageing, allotransplantation and tumors was investigated. In all subsections of plastic surgery, a high impact was identified. More studies on the influence and regulation of apoptosis can bring further understanding on the disease patterns of plastic surgery and other specialties as well as the development of new therapeutic options. Research focusing on apoptosis is therefore an essential means for the advancement of and future trends in plastic surgery.

Schlüsselwörter

Apoptose - Plastische Chirurgie - Transplantation - Wundheilung - Alterung - Lappenplastiken

Key words

Apoptosis - plastic surgery - transplantation - wound healing - ageing - flaps

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