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Wallblom K, Lundgren S, Saleh K, Schmidtchen A, Puthia M. Image-based non-invasive assessment of suction blister wounds for clinical safety and efficacy. Wound Repair Regen 2024; 32:343-359. [PMID: 38511666 DOI: 10.1111/wrr.13172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/07/2024] [Accepted: 02/25/2024] [Indexed: 03/22/2024]
Abstract
Recognising the need for objective imaging-based technologies to assess wound healing in clinical studies, the suction blister wound model offers an easily accessible wound model that creates reproducible epidermal wounds that heal without scarring. This study provides a comprehensive methodology for implementing and evaluating photography-based imaging techniques utilising the suction blister wound model. Our method encompasses a protocol for capturing consistent, high-quality photographs and procedures for quantifying these images via a visual wound healing score and a computer-assisted colour analysis of wound exudation and wound redness. We employed this methodology on 16 suction blister wounds used as controls in a clinical phase-1 trial. Our method enabled us to discern and quantify subtle differences between individual wounds concerning healing progress, erythema and wound exudation. The wound healing score exhibited a high inter-rater agreement. There was a robust correlation between the spectrophotometer-measured erythema index and photography-based wound redness, as well as between dressing protein content and photography-based dressing yellowness. In conclusion, this study equips researchers conducting clinical wound studies with reproducible methods that may support future wound research and aid in the development of new treatments.
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Affiliation(s)
- Karl Wallblom
- Division of Dermatology and Venereology, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Dermatology, Skane University Hospital, Lund, Sweden
| | - Sigrid Lundgren
- Division of Dermatology and Venereology, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Dermatology, Skane University Hospital, Lund, Sweden
| | - Karim Saleh
- Division of Dermatology and Venereology, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Dermatology, Skane University Hospital, Lund, Sweden
| | - Artur Schmidtchen
- Division of Dermatology and Venereology, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Dermatology, Skane University Hospital, Lund, Sweden
| | - Manoj Puthia
- Division of Dermatology and Venereology, Department of Clinical Sciences, Lund University, Lund, Sweden
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Muller DA, Henricson J, Baker SB, Togö T, Jayashi Flores CM, Lemaire PA, Forster A, Anderson CD. Innate local response and tissue recovery following application of high density microarray patches to human skin. Sci Rep 2020; 10:18468. [PMID: 33116241 PMCID: PMC7595201 DOI: 10.1038/s41598-020-75169-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/09/2020] [Indexed: 12/15/2022] Open
Abstract
The development of microarray patches for vaccine application has the potential to revolutionise vaccine delivery. Microarray patches (MAP) reduce risks of needle stick injury, do not require reconstitution and have the potential to enhance immune responses using a fractional vaccine dose. To date, the majority of research has focused on vaccine delivery with little characterisation of local skin response and recovery. Here we study in detail the immediate local skin response and recovery of the skin post high density MAP application in 12 individuals receiving 3 MAPs randomly assigned to the forearm and upper arm. Responses were characterised by clinical scoring, dermatoscopy, evaporimetry and tissue viability imaging (TiVi). MAP application resulted in punctures in the epidermis, a significant transepidermal water loss (TEWL), the peak TEWL being concomitant with peak erythema responses visualised by TiVi. TEWL and TiVi responses reduced over time, with TEWL returning to baseline by 48 h and erythema fading over the course of a 7 day period. As MAPs for vaccination move into larger clinical studies more variation of individual subject phenotypic or disease propensity will be encountered which will require consideration both in regard to reliability of dose delivery and degree of inherent skin response.
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Affiliation(s)
- David A Muller
- School of Chemistry and Molecular Biosciences, The University of Queensland, Building 76 Cooper road, St. Lucia, QLD, 4072, Australia.
| | - Joakim Henricson
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Emergency Medicine, Local Health Care Services in Central Östergötland, Linköping, Sweden
| | - S Ben Baker
- Vaxxas Pty Ltd, Translational Research Institute, 37 Kent Street, Woolloongabba, QLD, 4102, Australia
| | - Totte Togö
- Allergy Center Linköping, Region Östergötland, Sweden
| | - Cesar M Jayashi Flores
- Vaxxas Pty Ltd, Translational Research Institute, 37 Kent Street, Woolloongabba, QLD, 4102, Australia
| | - Pierre A Lemaire
- Vaxxas Pty Ltd, Translational Research Institute, 37 Kent Street, Woolloongabba, QLD, 4102, Australia
| | - Angus Forster
- Vaxxas Pty Ltd, Translational Research Institute, 37 Kent Street, Woolloongabba, QLD, 4102, Australia
| | - Chris D Anderson
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. .,Division of Cell Biology, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
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Hyaluronic Acid Accelerates Re-epithelialization and Alters Protein Expression in a Human Wound Model. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2221. [PMID: 31333952 PMCID: PMC6571313 DOI: 10.1097/gox.0000000000002221] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 02/19/2019] [Indexed: 12/13/2022]
Abstract
Supplemental Digital Content is available in the text. Background: Hyaluronic acid (HA), a large glycosaminoglycan involved in proliferation, migration, and tissue repair, is suggested to be an important factor for keratinocyte activation and re-epithelialization. The experimental hypothesis of this study was that HA accelerates re-epithelialization, and we aimed to investigate the effect of exogenous intradermal HA during deep dermal, incisional wound healing in vivo in humans, the primary endpoint being re-epithelialization. Methods: A total of 8 standardized deep dermal incisional wounds (depth 1.6 mm, width 1.8 mm) per subject were induced in 10 healthy volunteers. Two of the wound sites per subject were pretreated with injections of HA and 2 with saline solution. At 2 time points (24 hours and 14 days), 2 biopsies for each treatment group (one for histology and one for proteomics) were taken. Skin erythema was measured at 24-hour intervals for 14 days as a surrogate measurement of inflammation. Results: At 24 hours, 8 of 9 wounds pretreated with HA showed complete re-epithelization, whereas none of the wounds pretreated with saline had re-epithelized. Wounds pretreated with HA also showed a 10-fold regulation of 8 identified proteins involved in wound healing compared to wounds treated with saline solution. No difference in inflammation, as measured as erythema, could be seen between any of the groups. Conclusions: We conclude that HA accelerates re-epithelialization and stimulates an altered protein expression in vivo in human deep dermal incisional skin wounds, but has no effect on the inflammation process as measured by erythema.
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Angiogenesis is induced and wound size is reduced by electrical stimulation in an acute wound healing model in human skin. PLoS One 2015; 10:e0124502. [PMID: 25928356 PMCID: PMC4415761 DOI: 10.1371/journal.pone.0124502] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 03/03/2015] [Indexed: 11/24/2022] Open
Abstract
Angiogenesis is critical for wound healing. Insufficient angiogenesis can result in impaired wound healing and chronic wound formation. Electrical stimulation (ES) has been shown to enhance angiogenesis. We previously showed that ES enhanced angiogenesis in acute wounds at one time point (day 14). The aim of this study was to further evaluate the role of ES in affecting angiogenesis during the acute phase of cutaneous wound healing over multiple time points. We compared the angiogenic response to wounding in 40 healthy volunteers (divided into two groups and randomised), treated with ES (post-ES) and compared them to secondary intention wound healing (control). Biopsy time points monitored were days 0, 3, 7, 10, 14. Objective non-invasive measures and H&E analysis were performed in addition to immunohistochemistry (IHC) and Western blotting (WB). Wound volume was significantly reduced on D7, 10 and 14 post-ES (p = 0.003, p = 0.002, p<0.001 respectively), surface area was reduced on days 10 (p = 0.001) and 14 (p<0.001) and wound diameter reduced on days 10 (p = 0.009) and 14 (p = 0.002). Blood flow increased significantly post-ES on D10 (p = 0.002) and 14 (p = 0.001). Angiogenic markers were up-regulated following ES application; protein analysis by IHC showed an increase (p<0.05) in VEGF-A expression by ES treatment on days 7, 10 and 14 (39%, 27% and 35% respectively) and PLGF expression on days 3 and 7 (40% on both days), compared to normal healing. Similarly, WB demonstrated an increase (p<0.05) in PLGF on days 7 and 14 (51% and 35% respectively). WB studies showed a significant increase of 30% (p>0.05) on day 14 in VEGF-A expression post-ES compared to controls. Furthermore, organisation of granulation tissue was improved on day 14 post-ES. This randomised controlled trial has shown that ES enhanced wound healing by reduced wound dimensions and increased VEGF-A and PLGF expression in acute cutaneous wounds, which further substantiates the role of ES in up-regulating angiogenesis as observed over multiple time points. This therapeutic approach may have potential application for clinical management of delayed and chronic wounds.
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Lee KT, Muller DA, Coffey JW, Robinson KJ, McCarthy JS, Kendall MAF, Corrie SR. Capture of the Circulating Plasmodium falciparum Biomarker HRP2 in a Multiplexed Format, via a Wearable Skin Patch. Anal Chem 2014; 86:10474-83. [DOI: 10.1021/ac5031682] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Khai Tuck Lee
- The University of Queensland, Australian Institute
for Bioengineering and Nanotechnology, Delivery of Drugs and Genes
Group (D2G2), St. Lucia, Queensland 4072, Australia
- ARC
Centre of Excellence in Convergent Bio-Nano Science and Technology, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - David A. Muller
- The University of Queensland, Australian Institute
for Bioengineering and Nanotechnology, Delivery of Drugs and Genes
Group (D2G2), St. Lucia, Queensland 4072, Australia
- Australian Infectious Diseases Research Centre, St. Lucia, Queensland 4067, Australia
- ARC
Centre of Excellence in Convergent Bio-Nano Science and Technology, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Jacob W. Coffey
- The University of Queensland, Australian Institute
for Bioengineering and Nanotechnology, Delivery of Drugs and Genes
Group (D2G2), St. Lucia, Queensland 4072, Australia
- ARC
Centre of Excellence in Convergent Bio-Nano Science and Technology, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Kye J. Robinson
- The University of Queensland, Australian Institute
for Bioengineering and Nanotechnology, Delivery of Drugs and Genes
Group (D2G2), St. Lucia, Queensland 4072, Australia
- ARC
Centre of Excellence in Convergent Bio-Nano Science and Technology, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - James S. McCarthy
- Australian Infectious Diseases Research Centre, St. Lucia, Queensland 4067, Australia
- QIMR Berghofer Medical Research Institute, Herston, Queensland 4006, Australia
| | - Mark A. F. Kendall
- The University of Queensland, Australian Institute
for Bioengineering and Nanotechnology, Delivery of Drugs and Genes
Group (D2G2), St. Lucia, Queensland 4072, Australia
- Australian Infectious Diseases Research Centre, St. Lucia, Queensland 4067, Australia
- The University of Queensland, Faculty of Health
Sciences, St. Lucia, Queensland 4072, Australia
- ARC
Centre of Excellence in Convergent Bio-Nano Science and Technology, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Simon R. Corrie
- The University of Queensland, Australian Institute
for Bioengineering and Nanotechnology, Delivery of Drugs and Genes
Group (D2G2), St. Lucia, Queensland 4072, Australia
- Australian Infectious Diseases Research Centre, St. Lucia, Queensland 4067, Australia
- ARC
Centre of Excellence in Convergent Bio-Nano Science and Technology, The University of Queensland, St Lucia, Queensland 4072, Australia
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Ferraq Y, Black DR, Theunis J, Mordon S. Superficial wounding model for epidermal barrier repair studies: comparison of Erbium:YAG laser and the suction blister method. Lasers Surg Med 2012; 44:525-32. [PMID: 22865469 DOI: 10.1002/lsm.22054] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2012] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES Wound-healing studies use mainly mechanical methods for wound induction, which are laborious and difficult to standardize. Objective of this study was to evaluate the Erbium:Yttrium-Aluminium-Garnet (Er:YAG) laser method as a model of epidermis ablation on human skin in vivo and to compare the quality and healing rates of Er:YAG laser and suction blister (SB) wounds. MATERIALS AND METHODS Er:YAG laser and SB wounds were made on the forearms of 10 healthy volunteers. Post-wounding measurements including wound surface area (WSA) from photographs, wound depth from 3D volume analysis, trans-epidermal water loss (TEWL), laser doppler blood flow (LDBF), and optical coherence tomography (OCT) imaging were made daily over 7 days. Biopsies were taken on Days 4 and 7. RESULTS 3D analysis showed laser wounds to be shallower and more uniform in depth than SB: 54 ± 14 µm versus 140 ± 102 µm, respectively, with histology demonstrating complete epidermal removal using SB. SB wounds were more variable in size with a WSA of 0.47 ± 0.24 cm(2) compared to 1.17 ± 0.14 cm(2) for laser wounds. Healing rates were similar in both groups, as measured by TEWL, LDBF, and WSA. OCT imaging on Days 3-4 revealed new epidermis below the fibrin clot, similar to histology, and a visible stratum corneum on Day 7, but no apparent epidermal hyperplasia in contrast to histology. CONCLUSION Compared to the SB model, Er:YAG laser achieved rapid standardized epidermal ablation, which despite morphological differences, was similar in terms of epidermal regeneration/barrier formation.
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Affiliation(s)
- Younes Ferraq
- Skin Research Centre, Pierre Fabre Dermocosmétique, Hotel Dieu, Toulouse, France
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Sjögren F, Anderson CD. Are cutaneous microdialysis cytokine findings supported by end point biopsy immunohistochemistry findings? AAPS J 2010; 12:741-9. [PMID: 20967522 PMCID: PMC2976991 DOI: 10.1208/s12248-010-9235-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 09/24/2010] [Indexed: 12/30/2022] Open
Abstract
Insertion of a cutaneous microdialysis catheter into normal dermis has been shown to induce the production of IL1b, IL6 and IL8 in an innate response to minimal trauma. In the present study, skin biopsy for immunohistochemistry has been performed at the site of the microdialysis catheter to compare the findings with that of the microdialysis findings 24 h after insertion. Of the three named cytokines, concordance between the two investigated technologies was highest for IL8 (100%) followed by IL6 (70%) and IL1b (50%). For seven other pro-inflammatory and T cell-relevant cytokines studied, concordance ranged between 50% and 80%. The total number of positive (microdialysis or immunofluorescence) findings was similar between the two methodologies. Technical and biological phenomenon can explain the differences. We conclude that both methodologies illustrate important features of tissue biology and that a combination of the two methods in clinical research can provide the chronology of soluble mediator participation and the more classic, but also more invasive, biopsy-based methodology at a point which constitutes the end of the observation period. We conclude further that at the 24-h time period here studied, microdialysis catheters are still functional and thus capable of producing relevant data which can be corroborated and extended by the "end point biopsy".
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Affiliation(s)
- Florence Sjögren
- />Department of Clinical and Experimental Medicine, Division of Dermatology, Linköping University, Linköping, Sweden
| | - Chris D. Anderson
- />Department of Clinical and Experimental Medicine, Division of Dermatology, Linköping University, Linköping, Sweden
- />Department of Dermatology, University Hospital, 581 85 Linköping, Sweden
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