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Inflammatory Response and Structural Changes in Human Skin Following Nitrogen Mustard Exposure Using an Ex Vivo Perfusion Model
Mahajan, Naresh PhD; Rivera del Rio Hernandez, Alexa MD; Bosco, Samantha BS; Egro, Francesco M. MBChB, MSc, MRCS; Gusenoff, Jeffrey MD; Rubin, J. Peter MD, FACS, MBA; Ejaz, Asim PhD
Department of Plastic Surgery, University of Pittsburgh, PA USA
2025-01-10
Presenter: Naresh Mahajan
Affidavit:
I certify that this material is not previously presented
Director Name: Vu T Nguyen
Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: Aesthetics
Nitrogen mustard (NM), a potent alkylating agent, causes severe cutaneous damage, including inflammation, immune cell infiltration, and structural disruption. While its vesicant effects are established, the dynamics of NM-induced damage in human skin over time and at varying concentrations remain underexplored. This study utilized an ex vivo human skin perfusion model to investigate the inflammatory and structural changes induced by NM exposure.
Full-thickness human skin flaps were perfused ex vivo and exposed to NM at 10 mg/cm², 30 mg/cm², and 60 mg/cm². Vehicle (acetone:PBS) and untreated control groups were included. Skin biopsies were collected at 0, 2, 6, 24, 125, 200, and 250 hours post-exposure. Histological assessments using Hematoxylin and Eosin (H&E) and Toluidine Blue staining evaluated epidermal and dermal changes, immune cell infiltration, and mast cell degranulation.
H&E staining revealed dose-dependent epidermal thinning, dermal separation, and cellular infiltration. Acute inflammatory changes were evident at 2–6 hours, with immune responses peaking at higher concentrations (30 and 60 mg/cm²) by 24 hours. Mast cell degranulation peaked between 2 and 125 hours. At later time points, lower concentrations (10 mg/cm²) showed recovery, while higher concentrations (60 mg/cm²) exhibited persistent inflammation and disrupted skin architecture.
Nitrogen mustard induces a concentration-dependent inflammatory response and structural damage in human skin. This ex vivo perfusion model provides valuable insights into chemical-induced skin injury and supports the development of therapeutic strategies for managing chemical burns.
