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Fang Y, Li Z, Yang L, Li W, Wang Y, Kong Z, Miao J, Chen Y, Bian Y, Zeng L. Emerging roles of lactate in acute and chronic inflammation. Cell Commun Signal 2024; 22:276. [PMID: 38755659 PMCID: PMC11097486 DOI: 10.1186/s12964-024-01624-8] [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: 01/01/2024] [Accepted: 04/20/2024] [Indexed: 05/18/2024] Open
Abstract
Traditionally, lactate has been considered a 'waste product' of cellular metabolism. Recent findings have shown that lactate is a substance that plays an indispensable role in various physiological cellular functions and contributes to energy metabolism and signal transduction during immune and inflammatory responses. The discovery of lactylation further revealed the role of lactate in regulating inflammatory processes. In this review, we comprehensively summarize the paradoxical characteristics of lactate metabolism in the inflammatory microenvironment and highlight the pivotal roles of lactate homeostasis, the lactate shuttle, and lactylation ('lactate clock') in acute and chronic inflammatory responses from a molecular perspective. We especially focused on lactate and lactate receptors with either proinflammatory or anti-inflammatory effects on complex molecular biological signalling pathways and investigated the dynamic changes in inflammatory immune cells in the lactate-related inflammatory microenvironment. Moreover, we reviewed progress on the use of lactate as a therapeutic target for regulating the inflammatory response, which may provide a new perspective for treating inflammation-related diseases.
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Affiliation(s)
- Yunda Fang
- School of First Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Zhengjun Li
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing, 210023, China
- College of Health Economics Management, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Lili Yang
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing, 210023, China
- Jingwen Library, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Wen Li
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing, 210023, China
- School of Acupuncture-Moxibustion and Tuina, ·School of Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Yutong Wang
- School of Acupuncture-Moxibustion and Tuina, ·School of Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Ziyang Kong
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing, 210023, China
- School of Acupuncture-Moxibustion and Tuina, ·School of Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Jia Miao
- School of First Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Yanqi Chen
- School of First Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Yaoyao Bian
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
- School of Acupuncture-Moxibustion and Tuina, ·School of Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
- TCM Rehabilitation Center, Jiangsu Second Chinese Medicine Hospital, Nanjing, 210023, China.
| | - Li Zeng
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
- Faculty of Chinese Medicine, Macau University of Science and Technology, Taipa, Macau, 999078, China.
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Tricou LP, Al-Hawat ML, Cherifi K, Manrique G, Freedman BR, Matoori S. Wound pH-Modulating Strategies for Diabetic Wound Healing. Adv Wound Care (New Rochelle) 2024. [PMID: 38149883 DOI: 10.1089/wound.2023.0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023] Open
Abstract
Significance: Chronic diabetic wounds on the lower extremities (diabetic foot ulcers, DFU) are one of the most prevalent and life-threatening complications of diabetes, responsible for significant loss of quality of life and cost to the health care system. Available pharmacologic treatments fail to achieve complete healing in many patients. Recent studies and investigational treatments have highlighted the potential of modulating wound pH in DFU. Recent Advances: Data from in vitro, preclinical, and clinical studies highlight the role of pH in the pathophysiology of DFU, and topical administration of pH-lowering agents have shown promise as a therapeutic strategy for diabetic wounds. In this critical review, we describe the role of pH in DFU pathophysiology and present selected low-molecular-weight and hydrogel-based pH-modulating systems for wound healing and infection control in diabetic wounds. Critical Issues: The molecular mechanisms leading to pH alterations in diabetic wounds are complex and may differ between in vitro models, animal models of diabetes, and the human pathophysiology. Wound pH-lowering bandages for DFU therapy must be tested in established animal models of diabetic wound healing and patients with diabetes to establish a comprehensive benefit-risk profile. Future Directions: As our understanding of the role of pH in the pathophysiology of diabetic wounds is deepening, new treatments for this therapeutic target are being developed and will be tested in preclinical and clinical studies. These therapeutic systems will establish a target product profile for pH-lowering treatments such as an optimal pH profile for each wound healing stage. Thus, controlling wound bed pH could become a powerful tool to accelerate chronic diabetic wound healing.
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Affiliation(s)
- Léo-Paul Tricou
- Faculté de Pharmacie, Université de Montréal, Montréal, Canada
- ISPB Faculté de Pharmacie, Université Claude Bernard Lyon 1, Lyon, France
- Chemical Engineering Department, Polytechnique Montreal, Montréal, Canada
| | | | - Katia Cherifi
- Faculté de Pharmacie, Université de Montréal, Montréal, Canada
| | | | - Benjamin R Freedman
- Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Simon Matoori
- Faculté de Pharmacie, Université de Montréal, Montréal, Canada
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The Impact of Antiseptic-Loaded Bacterial Nanocellulose on Different Biofilms-An Effective Treatment for Chronic Wounds? J Clin Med 2022; 11:jcm11226634. [PMID: 36431111 PMCID: PMC9692265 DOI: 10.3390/jcm11226634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction: Pathogenic biofilms are an important factor for impaired wound healing, subsequently leading to chronic wounds. Nonsurgical treatment of chronic wound infections is limited to the use of conventional systemic antibiotics and antiseptics. Wound dressings based on bacterial nanocellulose (BNC) are considered a promising approach as an effective carrier for antiseptics. The aim of the present study was to investigate the antimicrobial activity of antiseptic-loaded BNC against in vitro biofilms. Materials and Methods: BNC was loaded with the commercially available antiseptics Prontosan® and Octenisept®. The silver-based dressing Aquacel®Ag Extra was used as a positive control. The biofilm efficacy of the loaded BNC sheets was tested against an in vitro 24-hour biofilm of Staphylococcus aureus and Candida albicans and a 48-hour biofilm of Pseudomonas aeruginosa. In vivo tests using a porcine excisional wound model was used to analyze the effect of a prolonged treatment with the antiseptics on the healing process. Results: We observed complete eradication of S. aureus biofilm in BNC loaded with Octenisept® and C. albicans biofilm for BNC loaded with Octenisept® or Prontosan®. Treatment with unloaded BNC also resulted in a statistically significant reduction in bacterial cell density of S. aureus compared to untreated biofilm. No difference on the wound healing outcome was observed for the wounds treated for seven days using BNC alone in comparison to BNC combined with Prontosan® or with Octenisept®. Conclusions: Based on these results, antiseptic-loaded BNC represents a promising and effective approach for the treatment of biofilms. Additionally, the prolonged exposure to the antiseptics does not affect the healing outcome. Prevention and treatment of chronic wound infections may be feasible with this novel approach and may even be superior to existing modalities.
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Maria Tottoli E, Chiesa E, Ceccarelli G, Pisani S, Bruni G, Genta I, Conti B, Dorati R. BioFiber: An advanced fibrous textured dressing to manage exudate in severe wounds. Int J Pharm 2022; 625:122073. [PMID: 35931393 DOI: 10.1016/j.ijpharm.2022.122073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 10/16/2022]
Abstract
Biofiber is a new generation of highly absorbent, and textured bandage with patented fiber technology. Biofiber has a sophisticated texture that provides an optimum balance of moisture, flexibility, and conformability, and it has been developed with specific properties to treat complex injuries like burns. The dressing has been designed to be completely adaptable to human anatomy, and it can be fitted to any part of the body, adapting to all curves and jointures, as well as fitting the facial features. Prototypes of PLA-PCL-based textured bandages were developed by electrospinning, characterized, and evaluated for complex wound care. The texture is both esthetic and functional; fibers were uniformly sized (2.2 ± 0.8 and 4.5 ± 0.3 µm) and well interconnected. The texture facilitates vertical absorption of exudate up to 2.5 g/g of bandage, and the high contact angle values (120 - 100°) create an optimum balance of moisture for the healing process. The textured prototypes turned out to be extremely stable; no sign of bandage debris was found by the standard test, BS EN 13726-1.7. In addition, the round texture (3R) showed improvements in tensile strength (0.27 ± 0.019 MPa), ultimate tensile strength (0.83 ± 0.05 MPa) with higher breaking point (0.91 ± 0.05 MPa) compared to control (Mepilex Lite®). The amount of albumin (BSA) and Fibrinogen (Fb) adhered on textured fiber prototypes was calculated by BCA Assay, all prototypes demonstrated strong BSA (ranging from 81.66 ± 8.93 to 182.73 ± 2.07 μg protein/mg dressing) and enhanced Fb shielding (ranging from 108.25 ± 7.3 to 238.12 ± 17.76 μg protein/mg dressing). Their MVTR values ranged from 2313.27 ± 58.86 to 2603.33 ± 50.41 g/m2· day and vertical wicking heights were between 24.6 ± 2.5 and 29.3 ± 4.1 mm; biological tests demonstrated good compatibility of prototypes (cell vitality > 70 %), percentage of cells attachment was in-between 114 and 225 %. The extent of attachment depends on texture, differing topographical patterns presented higher attachment compared with both CTR + and 1P prototype (no texture). Cells were growth on textured fiber prototypes, and the extent of proliferation depend on incubation time.
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Affiliation(s)
| | - Enrica Chiesa
- Department of Fondazione IRCCS Policlinico San Matteo, Department of Surgery, University of Pavia, 27100, Italy
| | - Gabriele Ceccarelli
- Department of Public Health, Experimental Medicine and Forensic, University of Pavia, Pavia 27100, Italy; CHT Center for Health Technologies, University of Pavia, Pavia 27100, Italy
| | - Silvia Pisani
- Department of Otolaryngology, IRCCS Policlinico S. Matteo, Pavia 27100, Italy
| | - Giovanna Bruni
- Department of Chemistry, Physical-Chemistry Section, University of Pavia, Via Taramelli 16, Pavia 27100, Italy
| | - Ida Genta
- Department of Drug Sciences, University of Pavia, Pavia 27100, Italy; CHT Center for Health Technologies, University of Pavia, Pavia 27100, Italy
| | - Bice Conti
- Department of Drug Sciences, University of Pavia, Pavia 27100, Italy; CHT Center for Health Technologies, University of Pavia, Pavia 27100, Italy
| | - Rossella Dorati
- Department of Drug Sciences, University of Pavia, Pavia 27100, Italy.
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Kamolz LP, Kotzbeck P, Schintler M, Spendel S. Skin regeneration, repair, and reconstruction: present and future. Eur Surg 2022. [DOI: 10.1007/s10353-022-00757-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Summary
Background
Large skin defects caused by trauma (e.g., burns) or due to other reasons (e.g., tumor-related skin resections) require sufficient skin replacement. The constant improvement of innovative methods of skin replacement and skin expansion mean that even burn victims with more than 80% body surface burned have a realistic chance of survival. Due to these new developments, not only has survival rate increased, but also quality of life has increased tremendously over the past decades.
Methods
The aim of this review is to present an overview of current standards and future trends concerning the treatment of skin defects. The main focus is placed on the most important technologies and future trends.
Results
Autologous skin grafting was developed more than 3500 years ago. Several approaches and techniques have been discovered and established in burn care and plastic surgery since then. Great achievements were made during the 19th and 20th centuries. Many of these old and new techniques are still part of modern burn and plastic surgery. Today, autologous skin grafting is still considered to be the gold standard for many wounds, but new technologies have been developed, ranging from biological to synthetic skin replacement materials.
Conclusion
Today, old and new technologies are available which allow us new treatment concepts. All this has led to the reconstructive clockwork for reconstructive surgery of the 21st century.
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Haller HL, Sander F, Popp D, Rapp M, Hartmann B, Demircan M, Nischwitz SP, Kamolz LP. Oxygen, pH, Lactate, and Metabolism-How Old Knowledge and New Insights Might Be Combined for New Wound Treatment. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111190. [PMID: 34833408 PMCID: PMC8617754 DOI: 10.3390/medicina57111190] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/23/2021] [Accepted: 10/26/2021] [Indexed: 12/23/2022]
Abstract
Over time, we have come to recognize a very complex network of physiological changes enabling wound healing. An immunological process enables the body to distinguish damaged cells and begin a cleaning mechanism by separating damaged proteins and cells with matrix metalloproteinases, a complement reaction, and free radicals. A wide variety of cell functions help to rebuild new tissue, dependent on energy provision and oxygen supply. Like in an optimized “bio-reactor,” disturbance can lead to prolonged healing. One of the earliest investigated local factors is the pH of wounds, studied in close relation to the local perfusion, oxygen tension, and lactate concentration. Granulation tissue with the wrong pH can hinder fibroblast and keratinocyte division and proliferation, as well as skin graft takes. Methods for influencing the pH have been tested, such as occlusion and acidification by the topical application of acidic media. In most trials, this has not changed the wound’s pH to an acidic one, but it has reduced the strong alkalinity of deeper or chronic wounds. Energy provision is essential for all repair processes. New insights into the metabolism of cells have changed the definition of lactate from a waste product to an indispensable energy provider in normoxic and hypoxic conditions. Neovascularization depends on oxygen provision and lactate, signaling hypoxic conditions even under normoxic conditions. An appropriate pH is necessary for successful skin grafting; hypoxia can change the pH of wounds. This review describes the close interconnections between the local lactate levels, metabolism, healing mechanisms, and pH. Furthermore, it analyzes and evaluates the different possible ways to support metabolism, such as lactate enhancement and pH adjustment. The aim of wound treatment must be the optimization of all these components. Therefore, the role of lactate and its influence on wound healing in acute and chronic wounds will be assessed.
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Affiliation(s)
| | - Frank Sander
- Burn Center, Plastic Surgery of Trauma Hospital Berlin, Warener Strasse 7, 12683 Berlin, Germany; (F.S.); (B.H.)
| | - Daniel Popp
- Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University Graz, Auenbruggerplatz 29, 8036 Graz, Austria; (D.P.); (S.P.N.); (L.P.K.)
| | - Matthias Rapp
- Clinic for Orthopedics, Trauma Surgery and Sports Traumatology, Burn Center, Marienhospital Stuttgart, Böheimstraße 37, 70199 Stuttgart, Germany;
| | - Bernd Hartmann
- Burn Center, Plastic Surgery of Trauma Hospital Berlin, Warener Strasse 7, 12683 Berlin, Germany; (F.S.); (B.H.)
| | - Mehmet Demircan
- Pediatric Intensive Burn Care Unit, Department of Pediatric Surgery, Faculty of Medicine, İnönü University, 44315 Malatya, Turkey;
| | - Sebastian Philipp Nischwitz
- Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University Graz, Auenbruggerplatz 29, 8036 Graz, Austria; (D.P.); (S.P.N.); (L.P.K.)
- COREMED—Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgsellschaft mbH, 8036 Graz, Austria
| | - Lars Peter Kamolz
- Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University Graz, Auenbruggerplatz 29, 8036 Graz, Austria; (D.P.); (S.P.N.); (L.P.K.)
- COREMED—Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgsellschaft mbH, 8036 Graz, Austria
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