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Yang Y, Huang J, Zeng A, Long X, Yu N, Wang X. The role of the skin microbiome in wound healing. BURNS & TRAUMA 2024; 12:tkad059. [PMID: 38444635 PMCID: PMC10914219 DOI: 10.1093/burnst/tkad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/05/2023] [Accepted: 11/21/2023] [Indexed: 03/07/2024]
Abstract
The efficient management of skin wounds for rapid and scarless healing represents a major clinical unmet need. Nonhealing skin wounds and undesired scar formation impair quality of life and result in high healthcare expenditure worldwide. The skin-colonizing microbiota contributes to maintaining an intact skin barrier in homeostasis, but it also participates in the pathogenesis of many skin disorders, including aberrant wound healing, in many respects. This review focuses on the composition of the skin microbiome in cutaneous wounds of different types (i.e. acute and chronic) and with different outcomes (i.e. nonhealing and hypertrophic scarring), mainly based on next-generation sequencing analyses; furthermore, we discuss the mechanistic insights into host-microbe and microbe-microbe interactions during wound healing. Finally, we highlight potential therapeutic strategies that target the skin microbiome to improve healing outcomes.
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Affiliation(s)
- Yuyan Yang
- Department of Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100005, China
| | - Jiuzuo Huang
- Department of Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100005, China
| | - Ang Zeng
- Department of Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100005, China
| | - Xiao Long
- Department of Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100005, China
| | - Nanze Yu
- Department of Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100005, China
| | - Xiaojun Wang
- Department of Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100005, China
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Kennewell TL, Haidari H, Mashtoub S, Howarth GS, Bennett C, Cooksley CM, Wormald PJ, Cowin AJ, Vreugde S, Kopecki Z. Deferiprone-Gallium-Protoporphyrin Chitogel Decreases Pseudomonas aeruginosa Biofilm Infection without Impairing Wound Healing. MATERIALS (BASEL, SWITZERLAND) 2024; 17:793. [PMID: 38399044 PMCID: PMC10889926 DOI: 10.3390/ma17040793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/25/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024]
Abstract
Pseudomonas aeruginosa is one of the most common pathogens encountered in clinical wound infections. Clinical studies have shown that P. aeruginosa infection results in a larger wound area, inhibiting healing, and a high prevalence of antimicrobial resistance. Hydroxypyridinone-derived iron chelator Deferiprone (Def) and heme analogue Gallium-Protoporphyrin (GaPP) in a chitosan-dextran hydrogel (Chitogel) have previously been demonstrated to be effective against PAO1 and clinical isolates of P. aeruginosa in vitro. Moreover, this combination of these two agents has been shown to improve sinus surgery outcomes by quickly reducing bleeding and preventing adhesions. In this study, the efficacy of Def-GaPP Chitogel was investigated in a P. aeruginosa biofilm-infected wound murine model over 6 days. Two concentrations of Def-GaPP Chitogel were investigated: Def-GaPP high dose (10 mM Def + 500 µg/mL GaPP) and Def-GaPP low dose (5 mM Def + 200 µg/mL GaPP). The high-dose Def-GaPP treatment reduced bacterial burden in vivo from day 2, without delaying wound closure. Additionally, Def-GaPP treatment decreased wound inflammation, as demonstrated by reduced neutrophil infiltration and increased anti-inflammatory M2 macrophage presence within the wound bed to drive wound healing progression. Def-GaPP Chitogel treatment shows promising potential in reducing P. aeruginosa cutaneous infection with positive effects observed in the progression of wound healing.
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Affiliation(s)
- Tahlia L. Kennewell
- Future Industries Institute, University of South Australia, Mawson Lakes, SA 5095, Australia; (T.L.K.); (H.H.); (A.J.C.)
| | - Hanif Haidari
- Future Industries Institute, University of South Australia, Mawson Lakes, SA 5095, Australia; (T.L.K.); (H.H.); (A.J.C.)
| | - Suzanne Mashtoub
- School of Biomedicine, The University of Adelaide, Adelaide, SA 5005, Australia;
- Department of Gastroenterology, Women’s and Children’s Hospital, North Adelaide, SA 5006, Australia
| | - Gordon S. Howarth
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA 5371, Australia;
| | - Catherine Bennett
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia; (C.B.); (C.M.C.); (P.J.W.); (S.V.)
- Department of Surgery Otolaryngology Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA 5011, Australia
| | - Clare M. Cooksley
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia; (C.B.); (C.M.C.); (P.J.W.); (S.V.)
- Department of Surgery Otolaryngology Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA 5011, Australia
| | - Peter John Wormald
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia; (C.B.); (C.M.C.); (P.J.W.); (S.V.)
- Department of Surgery Otolaryngology Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA 5011, Australia
| | - Allison J. Cowin
- Future Industries Institute, University of South Australia, Mawson Lakes, SA 5095, Australia; (T.L.K.); (H.H.); (A.J.C.)
| | - Sarah Vreugde
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia; (C.B.); (C.M.C.); (P.J.W.); (S.V.)
- Department of Surgery Otolaryngology Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA 5011, Australia
| | - Zlatko Kopecki
- Future Industries Institute, University of South Australia, Mawson Lakes, SA 5095, Australia; (T.L.K.); (H.H.); (A.J.C.)
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Taheri A, Mansoori P, Sharif M. Wound Debridement in Pyoderma Gangrenosum. Adv Skin Wound Care 2024; 37:107-111. [PMID: 38241454 DOI: 10.1097/asw.0000000000000092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
BACKGROUND Wound debridement improves healing in a variety of acute and chronic ulcers. However, there is concern that debridement may trigger pathergy and worsen pyoderma gangrenosum (PG). OBJECTIVE To determine whether published evidence supports conservative wound debridement for PG. DATA SOURCES The authors reviewed the literature published in MEDLINE through January 2023 using the search germs "pyoderma gangrenosum" and "debridement." STUDY SELECTION Articles reporting sharp surgical debridement or maggot debridement for PG were included in the review. The authors also searched the reference sections of the reviewed articles for additional reports on debridement for PG. DATA EXTRACTION Clinical data regarding patient status, procedures performed, and patient outcomes were extracted from the selected articles. DATA SYNTHESIS There are multiple reports of uncontrolled, active-phase PG wounds worsening after aggressive excisional debridement of viable inflamed tissues. In contrast, there is no evidence indicating that conservative debridement of nonviable necrotic tissue worsens PG wounds, regardless of the disease activity. There are multiple reports of successful debridement and surgical grafting for PG in remission. CONCLUSIONS There is no evidence in favor of or against using conservative debridement of nonviable necrotic tissue for a PG wound. Therefore, it should not be considered contraindicated, even in the active phase of the disease.
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Affiliation(s)
- Arash Taheri
- Arash Taheri, MD, is Internal Medicine Physician, JenCare Senior Medical Center, Atlanta, Georgia, United States. Parisa Mansoori, MD, is Dermatopathologist, Atlanta Dermatopathology, Atlanta, Georgia. Mohammad Sharif, DPM, is Podiatrist, Village Podiatry Centers, Atlanta, Georgia
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Zhang XN, Wu CY, Wu ZW, Xu LX, Jiang FT, Chen HW. Association Between the Diabetic Foot Ulcer and the Bacterial Colony of the Skin Based on 16S rRNA Gene Sequencing: An Observational Study. Clin Cosmet Investig Dermatol 2023; 16:2801-2812. [PMID: 37841062 PMCID: PMC10576508 DOI: 10.2147/ccid.s425922] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/19/2023] [Indexed: 10/17/2023]
Abstract
Objective Microorganisms have been the main cause of refractory and high recurrence of diabetic foot ulcer (DFU). This study attempted to observe the skin bacterial colony in healthy skin, diabetic skin and DFU skin. Methods Forty-eight diabetes patients were recruited at Panyu Central Hospital from March 2021 to March 2022 and divided into DFU group (T group, n = 22), diabetes without foot ulcer group (TW group, n = 26). Besides, a healthy control group (H group, n = 10) was recruited at the same time. The swab samples of foot skin in the same position in the three groups were collected. The microorganisms obtained from the skin were analyzed by 16S rRNA gene sequencing. The composition of the skin microorganisms was determined, and the species diversity of the skin microbiota was analyzed by α and β diversity. The species differences in the skin microbiota and the relative abundance of different operational taxonomic units (OUTs) with the most significant abundance were analyzed by linear discriminant analysis effect size (LEfSe). Results Significant changes were found in the composition of the skin microbiota in the T and TW groups relative to the H group. However, the species diversity of the skin microbiota was significantly reduced in the T and TW groups, with the lowest one in the T group. The composition of microbial diversity in the T group was significantly different from that of the TW and H groups. Among the skin bacterial colonies, the abundance of Staphylococcus, Enhydrobacter, and Corynebacterium_1 was obviously reduced, while that of Escherichia coli and Pseudomonas was significantly increased. Conclusion Changes in the abundance of Staphylococcus, Enhydrobacter, Corynebacterium_1, Escherichia coli and Pseudomonas in the skin bacterial colonies can be the main causative factors for DFU. This study indicates that altering the microbiota composition of wounds may help the treatment of DFU.
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Affiliation(s)
- Xiu-Ni Zhang
- Department of Trauma Orthopedics, Panyu Central Hospital, Guangzhou, Guangdong, 511400, People's Republic of China
| | - Cui-Yi Wu
- Department of Outpatient, Panyu Central Hospital, Guangzhou, Guangdong, 511400, People's Republic of China
| | - Zhi-Wei Wu
- Department of Trauma Orthopedics, Panyu Central Hospital, Guangzhou, Guangdong, 511400, People's Republic of China
| | - Li-Xian Xu
- Department of Endocrinology, Panyu Central Hospital, Guangzhou, Guangdong, 511400, People's Republic of China
| | - Feng-Ting Jiang
- Department of Trauma Orthopedics, Panyu Central Hospital, Guangzhou, Guangdong, 511400, People's Republic of China
| | - Han-Wei Chen
- Administrative Office, Panyu District Health Management Center, Guangzhou, Guangdong, 511400, People's Republic of China
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Calum H, Trøstrup H, Laulund AS, Thomsen K, Christophersen L, Høiby N, Moser C. Murine burn lesion model for studying acute and chronic wound infections. APMIS 2022; 130:477-490. [PMID: 35441434 DOI: 10.1111/apm.13228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/13/2022] [Indexed: 02/05/2023]
Abstract
Acute wounds, such as thermal injury, and chronic wounds are challenging for patients and the healthcare system around the world. Thermal injury of considerable size induces immunosuppression, which renders the patient susceptible to wound infections, but also in other foci like the airways and urinary tract. Infected thermal lesions can progress to chronic wounds with biofilm making them more difficult to treat. While animal models have their limitations, murine wound models are still the best tool at the moment to identify strategies to overcome these challenges. Here, we present a murine burn model, which has been developed to study biofilm formation, the significance of wound healing, and for identifying novel treatment candidates. Investigating the effect of a thermal injury in mice, we observed that 48 h after introduction of the injury, the mice showed a reduction in polymorphonuclear neutrophil granulocytes (PMNs) and a reduced capacity for phagocytosis and oxidative burst. Regarding the chronic wound, Pseudomonas aeruginosa biofilm arrested wound healing and kept the wound in an inflammatory state, but suppressing PMN function by means of the PMN factor S100A8/A9, corresponding to observations in human venous leg ulcers. Monotherapy and dual treatment with S100A8/A9 and ciprofloxacin on P. aeruginosa biofilm-infected murine wounds have been investigated. In combination, S100A8/A9 and ciprofloxacin reduced the bacterial quantity, lowered the proinflammatory response, and increased anti-inflammatory cytokines after 4 days of treatment. When the treatment was prolonged, an additional prevention of resistance development was detected in all the dual-treated mice. In the present review, we provide data on using the murine model for research with the aim of better understanding pathophysiology of wounds and for identifying novel treatments for humans suffering from these lesions.
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Affiliation(s)
- Henrik Calum
- Department of Clinical Microbiology, Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hannah Trøstrup
- Department of Plastic Surgery and Burns Treatment, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Sofie Laulund
- Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kim Thomsen
- Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lars Christophersen
- Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Niels Høiby
- Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Immunology and Microbiology (ISIM), University of Copenhagen, Copenhagen, Denmark
| | - Claus Moser
- Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark
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Safak AS, Bulut F, Cumbul A. Histopathological role of vitamin D deficiency in recurrent/chronic tonsillitis pathogenesis: Vascular epithelial growth factor-mediated angiogenesis in tonsil. Clin Exp Dent Res 2022; 8:699-706. [PMID: 35213796 PMCID: PMC9209805 DOI: 10.1002/cre2.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives Our aim in this study is to reveal the role of vitamin D deficiency in the pathogenesis of recurrent/chronic tonsillitis and to determine the expression of vascular epithelial growth factor (VEGF). Material and Methods This study was conducted between September and February. Thirty‐two patients between the ages of 3 and 35 (mean age 9.71) with recurrent episodes of chronic tonsillitis were selected. Patients were divided into four groups according to their 25OHD levels. Patients with 25OHD levels 0–10 ng/ml were determined as Group 1, 11–20 ng/ml Group 2, 21–30 ng/ml Group 3, and 31–50 ng/ml control Group 4. Routine histological tissue sampling was performed for histopathological evaluation of the tonsillar tissues under light microscope (LM). Five micron sections were taken from the paraffin blocks and stained with Hematoxylin Eosin (HE) and Trichrome Masson (TCM). VEGF expression was examined immunohistochemically for each group. Results Our analysis showed VEGF expression in all study groups (32 tonsillar tissues). Group 1 and Group 2 histopathological scores were significantly higher than the other groups (p < .001). There were significant differences in VEGF expressions between the four groups (p < .001). 25OHD levels of the patients in Groups 1 and 2 with strong VEGF expression were significantly lower than the other groups (p < .001). Conclusions In conclusion, this study showed an increased angiogenesis in tonsil and an increase in VEGF expression of the tonsillar surface epithelium when blood serum 25OHD levels <20 ng/ml.
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Affiliation(s)
- Ayse S Safak
- Department of Otorhinolaryngology, Istanbul Yeni Yüzyıl University, Özel Merkez Prime Hastanesi, Gebze, Turkey
| | - Fuat Bulut
- Department of Otorhinolaryngology, Private Corlu REYAP Hospital, Istanbul Rumeli University, Istanbul, Turkey
| | - Alev Cumbul
- Histology and Embryology, Istanbul Yeditepe University Faculty of Medicine, Istanbul, Turkey
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Aswathanarayan JB, Rao P, HM S, GS S, Rai RV. Biofilm-Associated Infections in Chronic Wounds and Their Management. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022. [DOI: 10.1007/5584_2022_738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Abstract
A diabetic foot ulcer (DFU) is a serious complication in patients with diabetes mellitus (DM). A DFU is the most common cause of non-traumatic limb amputation, and patients with DFUs have increased mortality rates within 5 years after amputation. DFUs also increase the risk of cardiovascular and cerebrovascular diseases; therefore, with the increasing incidence and prevalence of diabetic foot wounds, DFUs are gradually becoming a major public health problem. The pathophysiology of DFUs is complicated and remains unclear. In recent years, many studies have demonstrated that the pathophysiology of DFUs is especially associated with neuropeptides, inflammation, and biofilms. Neuropeptides, especially substance P (SP) and calcitonin gene-related peptide (CGRP), play an important role in wound healing. SP and CGRP accelerate the healing of cutaneous wounds by promoting neovascularization, inhibiting the release of certain proinflammatory chemokines, regulating macrophage polarization, and so on. However, the expression of SP and CGRP was downregulated in DM and DFUs. DFUs are characterized by a sustained inflammatory phase. Immune cells such as neutrophils and macrophages are involved in the sustained inflammatory phase in DFUs by extracellular traps (NETs) and dysregulated macrophage polarization, which delays wound healing. Furthermore, DFUs are at increased risk of biofilm formation. Biofilms disturb wound healing by inducing a chronic inflammatory response, inhibiting macrophage phagocytosis and keratinocyte proliferation migration, and transferring antimicrobial resistance genes. To understand the relationships among neuropeptides, inflammation, biofilms, and DFUs, this review highlights the recent scientific advances that provide possible pathophysiological insights into the delayed healing of DFUs.
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Versey Z, da Cruz Nizer WS, Russell E, Zigic S, DeZeeuw KG, Marek JE, Overhage J, Cassol E. Biofilm-Innate Immune Interface: Contribution to Chronic Wound Formation. Front Immunol 2021; 12:648554. [PMID: 33897696 PMCID: PMC8062706 DOI: 10.3389/fimmu.2021.648554] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/17/2021] [Indexed: 12/19/2022] Open
Abstract
Delayed wound healing can cause significant issues for immobile and ageing individuals as well as those living with co-morbid conditions such as diabetes, cardiovascular disease, and cancer. These delays increase a patient’s risk for infection and, in severe cases, can result in the formation of chronic, non-healing ulcers (e.g., diabetic foot ulcers, surgical site infections, pressure ulcers and venous leg ulcers). Chronic wounds are very difficult and expensive to treat and there is an urgent need to develop more effective therapeutics that restore healing processes. Sustained innate immune activation and inflammation are common features observed across most chronic wound types. However, the factors driving this activation remain incompletely understood. Emerging evidence suggests that the composition and structure of the wound microbiome may play a central role in driving this dysregulated activation but the cellular and molecular mechanisms underlying these processes require further investigation. In this review, we will discuss the current literature on: 1) how bacterial populations and biofilms contribute to chronic wound formation, 2) the role of bacteria and biofilms in driving dysfunctional innate immune responses in chronic wounds, and 3) therapeutics currently available (or underdevelopment) that target bacteria-innate immune interactions to improve healing. We will also discuss potential issues in studying the complexity of immune-biofilm interactions in chronic wounds and explore future areas of investigation for the field.
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Affiliation(s)
- Zoya Versey
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | | | - Emily Russell
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | - Sandra Zigic
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | - Katrina G DeZeeuw
- Department of Complex Continuing Care, Saint Vincent Hospital, Ottawa, ON, Canada
| | - Jonah E Marek
- Department of Complex Continuing Care, Saint Vincent Hospital, Ottawa, ON, Canada
| | - Joerg Overhage
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | - Edana Cassol
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada.,Centre for Infection, Immunity and Inflammation, University of Ottawa, Ottawa, ON, Canada
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Zhou M, Lin F, Li W, Shi L, Li Y, Shan G. Development of nanosilver doped carboxymethyl chitosan-polyamideamine alginate composite dressing for wound treatment. Int J Biol Macromol 2020; 166:1335-1351. [PMID: 33171183 DOI: 10.1016/j.ijbiomac.2020.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/20/2020] [Accepted: 11/03/2020] [Indexed: 10/23/2022]
Abstract
Nowadays, treatment to the infected wounds caused by bacterial even multi-resistant bacterial strains and subsequently complete skin regeneration remain a critical clinical challenge. Herein, a novel multi-functional platform (Alg/1.0Ag@CMC-PAMAM/PRP) was prepared as wound dressings by mixing platelet rich plasma (PRP) with the sodium alginate (Alg) based dressing containing nano silver (Ag)-doped carboxymethyl chitosan grafted polyamideamine (Ag@CMC-PAMAM) cationic polymers. The present dressings exhibited high swelling, suitable water vapor transmission rate (WVTR), and good mechanical properties and degradability, as well as sustained release of PRP. Besides, the component of Ag@CMC-PAMAM nanoparticles endow them with excellent antibacterial performance, while the incorporation of PRP promotes the effect of anti-inflammatory and angiogenesis by up-regulating relative activity factor expression of TGF-β1, CD31 and α-SMA and down-regulating the inflammatory-relative genes including TNF-α, IL-6 and IL-1β, all of which promote the closure of wound and produce a superior healing effect to the commercial Aquacel Ag group. This work indicates that the prepared Alg/1.0Ag@CMC-PAMAM/PRP wound dressing is a promising biomaterial with synergistic effect of antibacterial property and wound healing.
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Affiliation(s)
- Mou Zhou
- Department of Blood Transfusion, General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Fang Lin
- Department of Blood Transfusion, General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Wendan Li
- Department of Blood Transfusion, General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Linying Shi
- Department of Blood Transfusion, General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Yanhui Li
- Department of Blood Transfusion, General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Guiqiu Shan
- Department of Blood Transfusion, General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China.
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Trøstrup H, Laulund ASB, Moser C. Insights into Host-Pathogen Interactions in Biofilm-Infected Wounds Reveal Possibilities for New Treatment Strategies. Antibiotics (Basel) 2020; 9:E396. [PMID: 32664205 PMCID: PMC7400121 DOI: 10.3390/antibiotics9070396] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/04/2020] [Accepted: 07/07/2020] [Indexed: 12/26/2022] Open
Abstract
Normal wound healing occurs in three phases-the inflammatory, the proliferative, and the remodeling phase. Chronic wounds are, for unknown reasons, arrested in the inflammatory phase. Bacterial biofilms may cause chronicity by arresting healing in the inflammatory state by mechanisms not fully understood. Pseudomonas aeruginosa, a common wound pathogen with remarkable abilities in avoiding host defense and developing microbial resistance by biofilm formation, is detrimental to wound healing in clinical studies. The host response towards P. aeruginosa biofilm-infection in chronic wounds and impact on wound healing is discussed and compared to our own results in a chronic murine wound model. The impact of P. aeruginosa biofilms can be described by determining alterations in the inflammatory response, growth factor profile, and count of leukocytes in blood. P. aeruginosa biofilms are capable of reducing the host response to the infection, despite a continuously sustained inflammatory reaction and resulting local tissue damage. A recent observation of in vivo synergism between immunomodulatory and antimicrobial S100A8/A9 and ciprofloxacin suggests its possible future therapeutic potential.
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Affiliation(s)
- Hannah Trøstrup
- Department of Plastic Surgery and Breast Surgery, Zealand University Hospital, 4000 Roskilde, Denmark
| | - Anne Sofie Boe Laulund
- Department of Clinical Microbiology, Copenhagen University Hospital, 2200 Copenhagen, Denmark; (A.S.B.L.); (C.M.)
| | - Claus Moser
- Department of Clinical Microbiology, Copenhagen University Hospital, 2200 Copenhagen, Denmark; (A.S.B.L.); (C.M.)
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12
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Brandenburg KS, Weaver AJ, Karna SLR, You T, Chen P, Stryk SV, Qian L, Pineda U, Abercrombie JJ, Leung KP. Formation of Pseudomonas aeruginosa Biofilms in Full-thickness Scald Burn Wounds in Rats. Sci Rep 2019; 9:13627. [PMID: 31541159 PMCID: PMC6754504 DOI: 10.1038/s41598-019-50003-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/31/2019] [Indexed: 12/14/2022] Open
Abstract
Using Sprague-Dawley rats (350-450 g; n = 61) and the recently updated Walker-Mason rat scald burn model, we demonstrated that Pseudomonas aeruginosa readily formed biofilms within full-thickness burn wounds. Following the burn, wounds were surface-inoculated with P. aeruginosa in phosphate-buffered saline (PBS), while sterile PBS was used for controls. On post-burn days 1, 3, 7, and 11, animals were euthanized and samples collected for quantitative bacteriology, bacterial gene expression, complete blood cell counts, histology, and myeloperoxidase activity. Robust biofilm infections developed in the full-thickness burn wounds inoculated with 1 × 104 CFU of P. aeruginosa. Both histology and scanning electron microscopy showed the pathogen throughout the histologic cross-sections of burned skin. Quantigene analysis revealed significant upregulation of alginate and pellicle biofilm matrix genes of P. aeruginosa within the burn eschar. Additionally, expression of P. aeruginosa proteases and siderophores increased significantly in the burn wound environment. Interestingly, the host's neutrophil response to the pathogen was not elevated in either the eschar or circulating blood when compared to the control burn. This new full-thickness burn biofilm infection model will be used to test new anti-biofilm therapies that may be deployed with soldiers in combat for immediate use at the site of burn injury on the battlefield.
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Affiliation(s)
- Kenneth S Brandenburg
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Alan J Weaver
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - S L Rajasekhar Karna
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Tao You
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Ping Chen
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Shaina Van Stryk
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Liwu Qian
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Uzziel Pineda
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Johnathan J Abercrombie
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Kai P Leung
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA.
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13
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Wei Q, Zhang Z, Luo J, Kong J, Ding Y, Chen Y, Wang K. Insulin treatment enhances pseudomonas aeruginosa biofilm formation by increasing intracellular cyclic di-GMP levels, leading to chronic wound infection and delayed wound healing. Am J Transl Res 2019; 11:3261-3279. [PMID: 31312343 PMCID: PMC6614630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 05/31/2019] [Indexed: 06/10/2023]
Abstract
Diabetes-related infections have become challenging and important public health problems in China and around the world. P. aeruginosa plays an important role in diabetic foot infections. As a gram-negative opportunistic pathogen, P. aeruginosa causes recurrent and refractory infections that are characterized by biofilm formation. Previous studies have demonstrated that biofilm-challenged wounds typically take longer to heal than non-biofilm-challenged normal wounds in diabetic mouse models. In the present study, we sought to explore the mechanism via which insulin treatment affects cyclic di-GMP signaling in P. aeruginosa-infected chronic wounds in db/db diabetic mice. We found that the wounds of diabetic mice healed more slowly than those of nondiabetic mice. Moreover, wound healing in diabetic mice treated with insulin exhibited a considerable delay. Peptide nucleic acid-fluorescence in situ hybridization (PNA-FISH) was used to detect biofilms on P. aeruginosa-infected wound tissues. Increased intracellular c-di-GMP levels promoted biofilm formation in wound tissues from nondiabetic mice. Greater biofilm formation was observed in the wounds of insulin-treated diabetic mice than in the wounds of untreated diabetic mice or nondiabetic mice, in both the PAO1/plac-yhjH- and PAO1-infected groups. Quantitative RT-PCR indicated that upon infection with PAO1/Plac-yhjH (the low c-di-GMP expression strain), the expression of IL-4 RNA was significantly higher in diabetic mice treated with insulin than in untreated diabetic mice or nondiabetic mice at each observation time point. Peak expression of IFN-γ occurred earlier in diabetic mice treated with insulin than in untreated diabetic mice with each of the experimental strains. Finally, P. aeruginosa harboring the plasmid pCdrA: gfp s was used as a reporter strain to monitor c-di-GMP levels. We found that insulin could promote biofilm formation by increasing intracellular c-di-GMP levels in vitro. Taken together, these data demonstrate that insulin treatment increases intracellular c-di-GMP levels, promotes biofilm formation and prolongs the inflammation period during the healing of infected wounds, resulting in delayed wound healing.
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Affiliation(s)
- Qiu Wei
- Pulmonary and Critical Care Medicine Ward, The First Affiliated Hospital of Guangxi Medical University Nanning 530021, Guangxi, P. R. China
| | - Zhenqiang Zhang
- Pulmonary and Critical Care Medicine Ward, The First Affiliated Hospital of Guangxi Medical University Nanning 530021, Guangxi, P. R. China
| | - Jing Luo
- Pulmonary and Critical Care Medicine Ward, The First Affiliated Hospital of Guangxi Medical University Nanning 530021, Guangxi, P. R. China
| | - Jinliang Kong
- Pulmonary and Critical Care Medicine Ward, The First Affiliated Hospital of Guangxi Medical University Nanning 530021, Guangxi, P. R. China
| | - Yudi Ding
- Pulmonary and Critical Care Medicine Ward, The First Affiliated Hospital of Guangxi Medical University Nanning 530021, Guangxi, P. R. China
| | - Yiqiang Chen
- Pulmonary and Critical Care Medicine Ward, The First Affiliated Hospital of Guangxi Medical University Nanning 530021, Guangxi, P. R. China
| | - Ke Wang
- Pulmonary and Critical Care Medicine Ward, The First Affiliated Hospital of Guangxi Medical University Nanning 530021, Guangxi, P. R. China
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14
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Davis SC, Li J, Gil J, Head C, Valdes J, Glinos GD, Solis M, Higa A, Pastar I. Preclinical evaluation of a novel silver gelling fiber dressing on
Pseudomonas aeruginosa
in a porcine wound infection model. Wound Repair Regen 2019; 27:360-365. [DOI: 10.1111/wrr.12718] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/07/2019] [Accepted: 03/21/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Stephen C. Davis
- Dr. Phillip Frost Department of Dermatology & Cutaneous SurgeryUniversity of Miami Miller School of Medicine P.O. Box 016250 (R 250) Miami Florida, 33136
| | - Jie Li
- Dr. Phillip Frost Department of Dermatology & Cutaneous SurgeryUniversity of Miami Miller School of Medicine P.O. Box 016250 (R 250) Miami Florida, 33136
| | - Joel Gil
- Dr. Phillip Frost Department of Dermatology & Cutaneous SurgeryUniversity of Miami Miller School of Medicine P.O. Box 016250 (R 250) Miami Florida, 33136
| | - Cheyanne Head
- Dr. Phillip Frost Department of Dermatology & Cutaneous SurgeryUniversity of Miami Miller School of Medicine P.O. Box 016250 (R 250) Miami Florida, 33136
| | - Jose Valdes
- Dr. Phillip Frost Department of Dermatology & Cutaneous SurgeryUniversity of Miami Miller School of Medicine P.O. Box 016250 (R 250) Miami Florida, 33136
| | - George D. Glinos
- Dr. Phillip Frost Department of Dermatology & Cutaneous SurgeryUniversity of Miami Miller School of Medicine P.O. Box 016250 (R 250) Miami Florida, 33136
| | - Michael Solis
- Dr. Phillip Frost Department of Dermatology & Cutaneous SurgeryUniversity of Miami Miller School of Medicine P.O. Box 016250 (R 250) Miami Florida, 33136
| | - Alexander Higa
- Dr. Phillip Frost Department of Dermatology & Cutaneous SurgeryUniversity of Miami Miller School of Medicine P.O. Box 016250 (R 250) Miami Florida, 33136
| | - Irena Pastar
- Dr. Phillip Frost Department of Dermatology & Cutaneous SurgeryUniversity of Miami Miller School of Medicine P.O. Box 016250 (R 250) Miami Florida, 33136
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