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Chauhan S, Gulia M, Singh RP, Jhawat V. Diabetic Wound: Pathophysiology, Complications and Treatment Strategies. Curr Protein Pept Sci 2024; 25:200-205. [PMID: 37909438 DOI: 10.2174/0113892037276171231016103320] [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: 08/07/2023] [Revised: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 11/03/2023]
Abstract
Diabetic wound healing is expected to affect 25% of all diabetics, resulting in less severe external factors, economic costs, and less trauma. Topical formulations have been continually improved to achieve a range of amazing properties and have had a significant impact on the management of diabetic wounds. Topical insulin has become one of the most attractive and convenient wound healing techniques due to its excellent biocompatibility, water retention, and therapeutic properties. Multiple versatile topical insulins have been identified and have shown promise over the past few years as they greatly facilitate the management of diabetic wounds as we understand their etiology. The physiological wound healing process repairs damaged tissue and restores skin integrity. For about a century, insulin, a powerful healing agent, and it has been utilized in several clinical and experimental researches research studies to accelerate the healing of various injuries.
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Affiliation(s)
- Sunita Chauhan
- Department of Pharmaceutical Science, School of Medical and Allied Science, GD Goenka University, Gurugram, Haryana, India
| | - Monika Gulia
- Department of Pharmaceutical Science, School of Medical and Allied Science, GD Goenka University, Gurugram, Haryana, India
| | - Rahul Pratap Singh
- Department of Pharmaceutical Science, School of Medical and Allied Science, GD Goenka University, Gurugram, Haryana, India
| | - Vikas Jhawat
- Department of Pharmaceutical Science, School of Medical and Allied Science, GD Goenka University, Gurugram, Haryana, India
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2
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Healy CR, Gethin G, Pandit A, Finn DP. Chronic wound-related pain, wound healing and the therapeutic potential of cannabinoids and endocannabinoid system modulation. Biomed Pharmacother 2023; 168:115714. [PMID: 37865988 DOI: 10.1016/j.biopha.2023.115714] [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: 07/04/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/24/2023] Open
Abstract
Chronic wounds represent a significant burden on the individual, and the healthcare system. Individuals with chronic wounds report pain to be the most challenging aspect of living with a chronic wound, with current therapeutic options deemed insufficient. The cutaneous endocannabinoid system is an important regulator of skin homeostasis, with evidence of system dysregulation in several cutaneous disorders. Herein, we describe the cutaneous endocannabinoid system, chronic wound-related pain, and comorbidities, and review preclinical and clinical evidence investigating endocannabinoid system modulation for wound-related pain and wound healing. Based on the current literature, there is some evidence to suggest efficacy of endocannabinoid system modulation for promotion of wound healing, attenuation of cutaneous disorder-related inflammation, and for the management of chronic wound-related pain. However, there is 1) a paucity of preclinical studies using validated models, specific for the study of chronic wound-related pain and 2) a lack of randomised control trials and strong clinical evidence relating to endocannabinoid system modulation for wound-related pain. In conclusion, while there is some limited evidence of benefit of endocannabinoid system modulation in wound healing and wound-related pain management, further research is required to better realise the potential of targeting the endocannabinoid system for these therapeutic applications.
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Affiliation(s)
- Catherine R Healy
- Pharmacology and Therapeutics, School of Medicine, University of Galway, Galway City, Ireland; Galway Neuroscience Centre, University of Galway, Galway City, Ireland; Centre for Pain Research, University of Galway, Galway City, Ireland; CÚRAM, SFI Research Centre for Medical Devices, University of Galway, Galway City, Ireland
| | - Georgina Gethin
- CÚRAM, SFI Research Centre for Medical Devices, University of Galway, Galway City, Ireland; School of Nursing and Midwifery, University of Galway, Galway City, Ireland; Alliance for Research and Innovation in Wounds, University of Galway, Galway City, Ireland
| | - Abhay Pandit
- CÚRAM, SFI Research Centre for Medical Devices, University of Galway, Galway City, Ireland
| | - David P Finn
- Pharmacology and Therapeutics, School of Medicine, University of Galway, Galway City, Ireland; Galway Neuroscience Centre, University of Galway, Galway City, Ireland; Centre for Pain Research, University of Galway, Galway City, Ireland; CÚRAM, SFI Research Centre for Medical Devices, University of Galway, Galway City, Ireland.
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3
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Bi X, Zhou L, Liu Y, Gu J, Mi QS. MicroRNA-146a Deficiency Delays Wound Healing in Normal and Diabetic Mice. Adv Wound Care (New Rochelle) 2022; 11:19-27. [PMID: 33554730 PMCID: PMC9831247 DOI: 10.1089/wound.2020.1165] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Objective: MiRNAs are important regulators of inflammation and wound healing. However, the mechanisms through which miRNAs regulate wound healing under normal and diabetic conditions are poorly understood. We aimed to determine the effects of miR-146a on the pathogenesis of wound healing in normal and streptozotocin (STZ)-induced diabetic mice. Approach: Wild-type (WT) and miR-146a knockout (KO) mice were induced to develop diabetes with STZ. Next, skin and corneal wounds were produced and measured. Percent wound closure and histology were evaluated. Inflammation at wound sites was analyzed using flow cytometry, reverse-transcription PCR, and western blot. Results: Healing of wounded skin was significantly delayed in miR-146a KO compared with WT mice. However, corneal epithelial wound healing did not differ significantly in the mice with normal blood glucose, whereas corneal and skin wound healing was significantly delayed in KO mice with diabetes. Neutrophil infiltration increased in skin wounds of KO compared with normal mice. The potential mechanisms were associated with dysregulated interleukin 1β, tumor necrosis factor alpha (TNF-α), IRAK1 (interleukin-1 receptor-associated kinase 1), TRAF6 (TNF receptor-associated factor 6), and nuclear factor kappa B (NF-κB) signaling induced by miR-146a KO. Innovation: Skin wound healing was delayed in miR-146a KO mice and enhanced inflammatory responses were mediated by the NF-κB signaling pathway. Conclusions: Deficiency in miR-146a delayed skin wound healing by enhancing inflammatory responses in normal and diabetic mice. Therefore, miR-146a may be a potential target for modulation to accelerate skin wound healing.
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Affiliation(s)
- Xinling Bi
- Department of Dermatology, Changhai Hospital, Naval Medical University, Shanghai, China.,Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA
| | - Li Zhou
- Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA
| | - Yanfang Liu
- Wound Care Center of Outpatient Department, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Jun Gu
- Department of Dermatology, Changhai Hospital, Naval Medical University, Shanghai, China.,Correspondence: Jun Gu, Department of Dermatology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Qing-Sheng Mi
- Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA.,Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA .
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4
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Raffetto JD, Ligi D, Maniscalco R, Khalil RA, Mannello F. Why Venous Leg Ulcers Have Difficulty Healing: Overview on Pathophysiology, Clinical Consequences, and Treatment. J Clin Med 2020; 10:jcm10010029. [PMID: 33374372 PMCID: PMC7795034 DOI: 10.3390/jcm10010029] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/14/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022] Open
Abstract
Venous leg ulcers (VLUs) are one of the most common ulcers of the lower extremity. VLU affects many individuals worldwide, could pose a significant socioeconomic burden to the healthcare system, and has major psychological and physical impacts on the affected individual. VLU often occurs in association with post-thrombotic syndrome, advanced chronic venous disease, varicose veins, and venous hypertension. Several demographic, genetic, and environmental factors could trigger chronic venous disease with venous dilation, incompetent valves, venous reflux, and venous hypertension. Endothelial cell injury and changes in the glycocalyx, venous shear-stress, and adhesion molecules could be initiating events in VLU. Increased endothelial cell permeability and leukocyte infiltration, and increases in inflammatory cytokines, matrix metalloproteinases (MMPs), reactive oxygen and nitrogen species, iron deposition, and tissue metabolites also contribute to the pathogenesis of VLU. Treatment of VLU includes compression therapy and endovenous ablation to occlude the axial reflux. Other interventional approaches such as subfascial endoscopic perforator surgery and iliac venous stent have shown mixed results. With good wound care and compression therapy, VLU usually heals within 6 months. VLU healing involves orchestrated processes including hemostasis, inflammation, proliferation, and remodeling and the contribution of different cells including leukocytes, platelets, fibroblasts, vascular smooth muscle cells, endothelial cells, and keratinocytes as well as the release of various biomolecules including transforming growth factor-β, cytokines, chemokines, MMPs, tissue inhibitors of MMPs (TIMPs), elastase, urokinase plasminogen activator, fibrin, collagen, and albumin. Alterations in any of these physiological wound closure processes could delay VLU healing. Also, these histological and soluble biomarkers can be used for VLU diagnosis and assessment of its progression, responsiveness to healing, and prognosis. If not treated adequately, VLU could progress to non-healed or granulating VLU, causing physical immobility, reduced quality of life, cellulitis, severe infections, osteomyelitis, and neoplastic transformation. Recalcitrant VLU shows prolonged healing time with advanced age, obesity, nutritional deficiencies, colder temperature, preexisting venous disease, deep venous thrombosis, and larger wound area. VLU also has a high, 50-70% recurrence rate, likely due to noncompliance with compression therapy, failure of surgical procedures, incorrect ulcer diagnosis, progression of venous disease, and poorly understood pathophysiology. Understanding the molecular pathways underlying VLU has led to new lines of therapy with significant promise including biologics such as bilayer living skin construct, fibroblast derivatives, and extracellular matrices and non-biologic products such as poly-N-acetyl glucosamine, human placental membranes amnion/chorion allografts, ACT1 peptide inhibitor of connexin 43, sulodexide, growth factors, silver dressings, MMP inhibitors, and modulators of reactive oxygen and nitrogen species, the immune response and tissue metabolites. Preventive measures including compression therapy and venotonics could also reduce the risk of progression to chronic venous insufficiency and VLU in susceptible individuals.
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Affiliation(s)
- Joseph D. Raffetto
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
- Correspondence: (J.D.R.); (F.M.)
| | - Daniela Ligi
- Department of Biomolecular Sciences, Section of Biochemistry and Biotechnology, Unit of Clinical Biochemistry, University Carlo Bo of Urbino, 61029 Urbino, Italy; (D.L.); (R.M.)
| | - Rosanna Maniscalco
- Department of Biomolecular Sciences, Section of Biochemistry and Biotechnology, Unit of Clinical Biochemistry, University Carlo Bo of Urbino, 61029 Urbino, Italy; (D.L.); (R.M.)
| | - Raouf A. Khalil
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Ferdinando Mannello
- Department of Biomolecular Sciences, Section of Biochemistry and Biotechnology, Unit of Clinical Biochemistry, University Carlo Bo of Urbino, 61029 Urbino, Italy; (D.L.); (R.M.)
- Correspondence: (J.D.R.); (F.M.)
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5
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Wound Pain and Wound Healing Biomarkers From Wound Exudate: A Scoping Review. J Wound Ostomy Continence Nurs 2020; 47:559-568. [PMID: 33201141 DOI: 10.1097/won.0000000000000703] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE Effective management of wound pain is essential for optimal wound healing. Nevertheless, the outcomes of wound pain interventions are based on subjective measures, which can prove problematic in patients with cognitive impairment. Identification of biomarkers associated with wound pain and wound healing can be used to more objectively estimate wound pain and contribute to the development of precise management options to reduce wound pain and promote wound healing. This scoping review aimed to identify wound pain and wound healing biomarkers from wound exudates and to describe different wound collection methods to identify these biomarkers. METHODS We searched the literature (PROSPERO database registration number: CRD42018103843) via a scoping review. SEARCH STRATEGY The PubMed database was searched for articles that explored relationships between cutaneous wound pain, wound healing, and biomolecules. Inclusion criteria were articles that reported original data, used adult human samples, and were published in English. FINDINGS Twenty-one articles were retrieved: 17 investigated molecules from wound exudate associated with wound healing status, and 4 reported molecules associated with wound pain. The most frequently observed wound pain biomarkers were proinflammatory cytokines; the most frequently observed wound healing biomarkers were proteases including those in the matrix metalloproteinase family. Six wound exudate collection methods were identified to extract potential wound pain and wound healing biomarkers from wound exudate. IMPLICATIONS The results can guide future wound exudate research to validate these wound pain and wound healing biomarkers and to develop therapies targeting these biomarkers to reduce wound pain and promote wound healing.
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Rodrigues Neves C, Buskermolen J, Roffel S, Waaijman T, Thon M, Veerman E, Gibbs S. Human saliva stimulates skin and oral wound healing in vitro. J Tissue Eng Regen Med 2019; 13:1079-1092. [PMID: 30968584 PMCID: PMC6593997 DOI: 10.1002/term.2865] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 03/25/2019] [Accepted: 04/03/2019] [Indexed: 12/13/2022]
Abstract
Despite continuous exposure to environmental pathogens, injured mucosa within the oral cavity heals faster and almost scar free compared with skin. Saliva is thought to be one of the main contributing factors. Saliva may possibly also stimulate skin wound healing. If so, it would provide a novel therapy for treating skin wounds, for example, burns. This study aims to investigate the therapeutic wound healing potential of human saliva in vitro. Human saliva from healthy volunteers was filter sterilized before use. Two different in vitro wound models were investigated: (a) open wounds represented by 2D skin and gingiva cultures were used to assess fibroblast and keratinocyte migration and proliferation and (b) blister wounds represented by introducing freeze blisters into organotypic reconstructed human skin and gingiva. Re‐epithelialization and differentiation (keratin K10, K13, K17 expression) under the blister and inflammatory wound healing mediator secretion was assessed. Saliva‐stimulated migration of skin and oral mucosa fibroblasts and keratinocytes, but only fibroblast proliferation. Topical saliva application to the blister wound on reconstructed skin did not stimulate re‐epithelization because the blister wound contained a dense impenetrable dead epidermal layer. Saliva did promote an innate inflammatory response (increased CCL20, IL‐6, and CXCL‐8 secretion) when applied topically to the flanking viable areas of both wounded reconstructed human skin and oral mucosa without altering the skin specific keratin differentiation profile. Our results show that human saliva can stimulate oral and skin wound closure and an inflammatory response. Saliva is therefore a potential novel therapeutic for treating open skin wounds.
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Affiliation(s)
- Charlotte Rodrigues Neves
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands
| | - Jeroen Buskermolen
- Department of Oral Cell Biology Academic Center For Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Sanne Roffel
- Department of Oral Cell Biology Academic Center For Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Taco Waaijman
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands
| | - Maria Thon
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands
| | - Enno Veerman
- Department of Oral Biochemistry Academic Center For Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Susan Gibbs
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands.,Department of Oral Cell Biology Academic Center For Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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7
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Multi-species oral biofilm promotes reconstructed human gingiva epithelial barrier function. Sci Rep 2018; 8:16061. [PMID: 30375445 PMCID: PMC6207751 DOI: 10.1038/s41598-018-34390-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/16/2018] [Indexed: 02/07/2023] Open
Abstract
Since the oral mucosa is continuously exposed to abundant microbes, one of its most important defense features is a highly proliferative, thick, stratified epithelium. The cellular mechanisms responsible for this are still unknown. The aim of this study was to determine whether multi-species oral biofilm contribute to the extensive stratification and primed antimicrobial defense in epithelium. Two in vitro models were used: 3D reconstructed human gingiva (RHG) and oral bacteria representative of multi-species commensal biofilm. The organotypic RHG consists of a reconstructed stratified gingiva epithelium on a gingiva fibroblast populated hydrogel (lamina propria). Biofilm was cultured from healthy human saliva, and consists of typical commensal genera Granulicatella and major oral microbiota genera Veillonella and Streptococcus. Biofilm was applied topically to RHG and host–microbiome interactions were studied over 7 days. Compared to unexposed RHG, biofilm exposed RHG showed increased epithelial thickness, more organized stratification and increased keratinocyte proliferation. Furthermore biofilm exposure increased production of RHG anti-microbial proteins Elafin, HBD2 and HBD3 but not HBD1, adrenomedullin or cathelicidin LL-37. Inflammatory and antimicrobial cytokine secretion (IL-6, CXCL8, CXCL1, CCL20) showed an immediate and sustained increase. In conclusion, exposure of RHG to commensal oral biofilm actively contributes to RHG epithelial barrier function.
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8
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Lei Z, Singh G, Min Z, Shixuan C, Xu K, Pengcheng X, Xueer W, Yinghua C, Lu Z, Lin Z. Bone marrow-derived mesenchymal stem cells laden novel thermo-sensitive hydrogel for the management of severe skin wound healing. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 90:159-167. [PMID: 29853078 DOI: 10.1016/j.msec.2018.04.045] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/30/2018] [Accepted: 04/16/2018] [Indexed: 01/03/2023]
Abstract
Bone marrow-derived mesenchymal stem cells (BMSCs) are easy to collect and culture, and it is identified that it has multi-directional differentiation potential, moreover it has low immunogenicity, hence it can be used as an allogeneic cell source for skin wound healing. Hydrogel has been widely used in skin wound healing own to it is able to mimic the 3D microenvironment of cells, which supports cell proliferation, migration and secretion. In this study, we created a novel biocompatible thermo-sensitive hydrogel to carry BMSCs for full-thickness skin wound healing. The thermo-sensitive hydrogel loaded with BMSCs can fast achieve sol-gel transition after implanting to the wound. Histological results confirmed that hydrogel-BMSCs combination group showed significant promotion of wound closure, epithelial cells' proliferation and re-epithelialization, and reduced inflammatory responses in the wounds and in the tissues surrounding the wounds. The combination therapy also can promote collagen deposition, TGF-β1 and bFGF secretion and tissue remodeling. The present study provides a promising strategy for the clinical treatment of skin wounds.
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Affiliation(s)
- Zhang Lei
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Guangdong Provincial Key Laboratory of Proteomics and Key Laboratory of Transcriptomics and Proteomics of Ministry of Education of China, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Gurankit Singh
- Department of Mechanical Engineering, Biochemistry and Medical Genetics, University of Manitoba, Manitoba Institute of Child Health, Winnipeg, MB R3T 2N2, Canada
| | - Zhang Min
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Guangdong Provincial Key Laboratory of Proteomics and Key Laboratory of Transcriptomics and Proteomics of Ministry of Education of China, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Chen Shixuan
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Guangdong Provincial Key Laboratory of Proteomics and Key Laboratory of Transcriptomics and Proteomics of Ministry of Education of China, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Kaige Xu
- Department of Mechanical Engineering, Biochemistry and Medical Genetics, University of Manitoba, Manitoba Institute of Child Health, Winnipeg, MB R3T 2N2, Canada
| | - Xu Pengcheng
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Guangdong Provincial Key Laboratory of Proteomics and Key Laboratory of Transcriptomics and Proteomics of Ministry of Education of China, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Wang Xueer
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Guangdong Provincial Key Laboratory of Proteomics and Key Laboratory of Transcriptomics and Proteomics of Ministry of Education of China, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Chen Yinghua
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Guangdong Provincial Key Laboratory of Proteomics and Key Laboratory of Transcriptomics and Proteomics of Ministry of Education of China, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Zhang Lu
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Guangdong Provincial Key Laboratory of Proteomics and Key Laboratory of Transcriptomics and Proteomics of Ministry of Education of China, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China; Elderly Health Services Research Center, Southern Medical University, Guangzhou 510515, China.
| | - Zhang Lin
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Guangdong Provincial Key Laboratory of Proteomics and Key Laboratory of Transcriptomics and Proteomics of Ministry of Education of China, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
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9
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Opdenakker G, Van Damme J, Vranckx JJ. Immunomodulation as Rescue for Chronic Atonic Skin Wounds. Trends Immunol 2018; 39:341-354. [PMID: 29500031 DOI: 10.1016/j.it.2018.01.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 12/08/2017] [Accepted: 01/24/2018] [Indexed: 12/11/2022]
Abstract
Chronic skin wounds, caused by arterial or venous insufficiency or by physical pressure, constitute an increasing medical problem as populations age. Whereas typical wounds are characterized by local inflammation that participates in the healing process, atonic wounds lack inflammatory markers, such as neutrophil infiltration, and generally do not heal. Recently, prominent roles in the immunopathology of chronic wounds were attributed to dysregulations in specific cytokines, chemokines, matrix metalloproteinases (MMPs), and their substrates. Together with the complement system, these molecular players provide necessary defense against infections, initiate angiogenesis, and prepare tissue reconstitution. Here, we review the current state of the field and include the concept that, aside from surgery and stem cell therapy, healing may be enhanced by immunomodulating agents.
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Affiliation(s)
- Ghislain Opdenakker
- Laboratory of Immunobiology and Laboratory of Molecular Immunology, Department of Microbiology and Immunology, Rega Institute for Medical Research, University of Leuven, Leuven, Belgium; The Glycobiology Institute, University of Oxford, Oxford, UK.
| | - Jo Van Damme
- Laboratory of Immunobiology and Laboratory of Molecular Immunology, Department of Microbiology and Immunology, Rega Institute for Medical Research, University of Leuven, Leuven, Belgium
| | - Jan Jeroen Vranckx
- Department of Development & Regeneration & Department of Plastic & Reconstructive Surgery, University Hospitals Leuven and KU Leuven, Leuven, Belgium
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10
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Boink MA, Roffel S, Breetveld M, Thon M, Haasjes MSP, Waaijman T, Scheper RJ, Blok CS, Gibbs S. Comparison of advanced therapy medicinal product gingiva and skin substitutes and their in vitro wound healing potentials. J Tissue Eng Regen Med 2017; 12:e1088-e1097. [PMID: 28388010 PMCID: PMC5836907 DOI: 10.1002/term.2438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 01/25/2017] [Accepted: 04/03/2017] [Indexed: 01/23/2023]
Abstract
Skin and oral mucosa substitutes are a therapeutic option for closing hard‐to‐heal skin and oral wounds. Our aim was to develop bi‐layered skin and gingiva substitutes, from 3 mm diameter biopsies, cultured under identical conditions, which are compliant with current European regulations for advanced therapy medicinal products. We present in vitro mode of action methods to (i) determine viability: epithelial expansion, proliferation (Ki‐67), metabolic activity (MTT assay); (ii) characterize skin and gingiva substitutes: histology and immunohistochemistry; and (iii) determine potency: soluble wound healing mediator release (enzyme‐linked immunosorbent assay). Both skin and gingiva substitutes consist of metabolically active autologous reconstructed differentiated epithelium expanding from the original biopsy sheet on a fibroblast populated connective tissue matrix (donor dermis). Gingival epithelium expanded 1.7‐fold more than skin epithelium during the 3 week culture period. The percentage of proliferating Ki‐67‐positive cells located in the basal layer of the gingiva substitute was >1.5‐fold higher than in the skin substitute. Keratins 16 and 17, which are upregulated during normal wound healing, were expressed in both the skin and gingiva substitutes. Notably, the gingiva substitute secreted higher amounts of key cytokines involved in mitogenesis, motogenesis and chemotaxis (interleukin‐6 > 23‐fold, CXCL8 > 2.5‐fold) as well as higher amounts of the anti‐fibrotic growth factor, hepatocyte growth factor (>7‐fold), compared with the skin substitute. In conclusion, while addressing the viability, characterization and potency of the tissue substitutes, important intrinsic differences between skin and gingiva were discovered that may explain in part the superior quality of wound healing observed in the oral mucosa compared with skin.
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Affiliation(s)
- Mireille A Boink
- Department of Oral Biochemistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, the Netherlands.,Department of Dermatology, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Sanne Roffel
- Department of Oral Biochemistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, the Netherlands.,Department of Dermatology, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Melanie Breetveld
- Department of Dermatology, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Maria Thon
- Department of Dermatology, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands.,A-Skin BV, Amsterdam, the Netherlands
| | - Michiel S P Haasjes
- Department of Dermatology, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Taco Waaijman
- Department of Dermatology, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Rik J Scheper
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Chantal S Blok
- Department of Dermatology, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Susan Gibbs
- Department of Dermatology, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands.,Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, the Netherlands
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11
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Bodaan CJ, Wise LM, Wakelin KA, Stuart GS, Real NC, Mercer AA, Riley CB, Theoret C. Short-term treatment of equine wounds with orf virus IL-10 and VEGF-E dampens inflammation and promotes repair processes without accelerating closure. Wound Repair Regen 2016; 24:966-980. [PMID: 27681311 DOI: 10.1111/wrr.12488] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/24/2016] [Indexed: 11/28/2022]
Abstract
Healing is delayed in limb wounds relative to body wounds of horses, partly because of sustained inflammation and inefficient angiogenesis. In laboratory animals, proteins derived from orf virus modulate these processes and enhance healing. We aimed to compare immune cell trafficking and the inflammatory, vascular, and epidermal responses in body and limb wounds of horses and then to investigate the impact of orf virus interleukin-10 and vascular endothelial growth factor-E on these processes. Standardized excisional wounds were created on the body and forelimb of horses and their progression monitored macroscopically until healed. Tissue samples were harvested to measure the expression of genes regulating inflammation and repair (quantitative polymerase chain reaction) and to observe epithelialization (histology), innate immune cell infiltration, and angiogenesis (immunofluorescence). Delayed healing of limb wounds was characterized by intensified and extended pro-inflammatory signaling and exacerbated innate immune response, concomitant with the absence of anti-inflammatory eIL-10. Blood vessels were initially more permeable and then matured belatedly, concomitant with retarded production of angiogenic factors. Epithelial coverage was achieved belatedly in limb wounds. Viral proteins were administered to wounds of one body and one limb site/horse at days 1-3, while wounds at matching sites served as controls. Treatment dampened pro-inflammatory gene expression and the innate immune response in all wounds. It also improved angiogenic gene expression, but primarily in body wounds, where it altered blood vessel density and myofibroblast persistence. Moreover, the viral proteins increased epithelialization of all wounds. The short-term viral protein therapy did not, however, improve the healing rate of wounds in either location, likely due to suboptimal dosing. In conclusion, we have further detailed the processes contributing to protracted healing in limb wounds of horses and shown that short-term administration of viral proteins exerts several promising though transient effects that, if optimized, may positively influence healing.
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Affiliation(s)
- Christa J Bodaan
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North
| | - Lyn M Wise
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | - Kirsty A Wakelin
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | - Gabriella S Stuart
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | - Nicola C Real
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | - Andrew A Mercer
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | - Christopher B Riley
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North
| | - Christine Theoret
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North.,Comparative Tissue Healing Laboratory, Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine, University of Montreal, Montreal, Canada
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12
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Methods to study differences in cell mobility during skin wound healing in vitro. J Biomech 2016; 49:1381-1387. [DOI: 10.1016/j.jbiomech.2016.01.040] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 01/19/2016] [Accepted: 01/28/2016] [Indexed: 01/19/2023]
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13
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Boink MA, Roffel S, Nazmi K, van Montfrans C, Bolscher JGM, Gefen A, Veerman ECI, Gibbs S. The Influence of Chronic Wound Extracts on Inflammatory Cytokine and Histatin Stability. PLoS One 2016; 11:e0152613. [PMID: 27018788 PMCID: PMC4809600 DOI: 10.1371/journal.pone.0152613] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 03/16/2016] [Indexed: 12/26/2022] Open
Abstract
Chronic ulcers represent a major health burden in our society. Despite many available therapies, a large number of ulcers do not heal. Protein based therapies fail in part due to proteolytic activity in the chronic wound bed. The aim of this in vitro study was to determine whether typical inflammatory cytokines and human salivary histatins remain stable when incubated with chronic wound extracts. Furthermore we determined whether a short exposure of histatins or cytokines was sufficient to exert long term effects on fibroblast migration. Stability of human recombinant cytokines IL-6 and CXCL8, and histatin variants (Hst1, Hst2, cyclic Hst1, minimal active domain of Hst1) in the presence of chronic wound extracts isolated from non-healing ulcers, was monitored by capillary zone electrophoresis. Migration-stimulating activity was assessed using a dermal fibroblast wound healing scratch assay. Histatins and cytokines stayed stable in saline for > 24 h at 37°C, making them ideal as an off-the-shelf product. However, incubation with chronic wound extracts resulted in serious breakdown of Hst1 and Hst2 (~50% in 8 h) and to lesser extent cyclic Hst1 and the minimal active domain of Hst1 (~20% in 8 h). The cytokines IL-6 and CXCL8 were more stable in chronic wound extracts (~40% degradation in 96 h). An initial 8-hour pulse of histatins or cytokines during a 96-hour study period was sufficient to stimulate fibroblast migration equally well as a continuous 96-hour exposure, indicating that they may possibly be used as novel bioactive therapeutics, exerting their activity for up to four days after a single exposure.
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Affiliation(s)
- Mireille A. Boink
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
- Department of Dermatology, VU University medical center, Amsterdam, The Netherlands
| | - Sanne Roffel
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
- Department of Dermatology, VU University medical center, Amsterdam, The Netherlands
| | - Kamran Nazmi
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | | | - Jan G. M. Bolscher
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Amit Gefen
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Enno C. I. Veerman
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Susan Gibbs
- Department of Dermatology, VU University medical center, Amsterdam, The Netherlands
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
- * E-mail:
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14
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Kisch T, Klemens JM, Hofmann K, Liodaki E, Gierloff M, Moellmeier D, Stang F, Mailaender P, Habermann J, Brandenburger M. Collection of Wound Exudate From Human Digit Tip Amputations Does Not Impair Regenerative Healing: A Randomized Trial. Medicine (Baltimore) 2015; 94:e1764. [PMID: 26469916 PMCID: PMC4616794 DOI: 10.1097/md.0000000000001764] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The regrowth of amputated digit tips represents a unique regenerative healing in mammals with subcutaneous volume regrowth, restoration of dactylogram, and suppression of scar formation. Although factor analysis in amphibians and even in mice is easy to obtain, safety of harvesting biomaterial from human digit tip amputations for analysis has not yet been described.The aim of this study was to evaluate if recovering wound exudate does hamper clinical outcome or influence microbiologic or inflammation status.A predefined cohort of 18 patients with fresh digit tip amputations was randomly assigned to receive standard therapy (debridement, occlusive dressing) with (n = 9) or without (n = 9) collection of the whole wound exudate in every dressing change. Primary endpoint (lengthening) and secondary endpoints (regeneration of dactylogram, nail bed and bone healing, time to complete wound closure, scar formation, 2-point discrimination, microbiologic analysis, inflammatory factors interleukin (IL)-1α, tumor necrosis factor-α, IL-4, and IL-6) were determined by an independent, blinded observer.Patients' characteristics showed no significant differences between the groups. All patients completed the study to the end of 3 months follow-up. Exudate collection did not influence primary and secondary endpoints. Furthermore, positive microbiologic findings as well as pus- and necrosis-like appearance neither impaired tissue restoration nor influenced inflammatory factor release.Here, the authors developed an easy and safe protocol for harvesting wound exudate from human digit tip amputations. For the first time, it was shown that harvesting does not impair regenerative healing. Using this method, further studies can be conducted to analyze regeneration associated factors in the human digit tip.DRKS.de Identifier: DRKS00006882 (UTN: U1111-1166-5723).
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Affiliation(s)
- Tobias Kisch
- From the Department of Plastic Surgery and Hand Surgery, University Hospital Schleswig-Holstein Campus Lübeck, University of Lübeck (TK, EL, MG, DM, FS, PM); Fraunhofer Research Institution for Marine Biotechnology EMB (JMK, KH, MB); and Department of Surgery, Section for Translational Surgical Oncology and Biobanking, University Hospital Schleswig-Holstein Campus Lübeck, University of Lübeck, Lübeck, Germany (JH)
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15
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Chen S, Shi J, Xu X, Ding J, Zhong W, Zhang L, Xing M, Zhang L. Study of stiffness effects of poly(amidoamine)-poly(n-isopropyl acrylamide) hydrogel on wound healing. Colloids Surf B Biointerfaces 2015; 140:574-582. [PMID: 26628331 DOI: 10.1016/j.colsurfb.2015.08.041] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 08/21/2015] [Accepted: 08/24/2015] [Indexed: 12/17/2022]
Abstract
The mechanical miss-match between the host and an implanted foreign body is one of the primary causes for implantation failure. To enhance the efficacy in wound repair, we developed stiffness-tunable temperature-sensitive hydrogels composed of poly(amidoamine) (PAA)-based poly(n-isopropyl acrylamide) (PNIPAM). PNIPAM-PAA hydrogels with three different stiffness fabricated by varying the concentrations of poly(amidoamine) were chosen for morphology and rheology tests. The degradation rate and cell compatibility of gels were also characterized. The PAA-PNIPAM hydrogels were then tested in a wound healing model of mice with full-thickness skin loss. We found that the stiffness of hydrogels has an impact on the wound healing process mainly by regulating the cell activities in the proliferation phase. PNIPAM-PAA hydrogels with appropriate stiffness reduce scar formation and improve wound healing by promoting myofibroblast transformation, keratinocytes proliferation, extracellular matrix synthesis and remodeling. Moreover, the stiffness of hydrogels impact on the secretion of TGF-β1 and bFGF, which play an important role in skin wound healing. These results suggest that the therapeutic effects of hydrogels in skin wound healing can by regulated by hydrogels' stiffness.
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Affiliation(s)
- Shixuan Chen
- Department of Histology and Embryology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China; Departments of Mechanical Engineering, Biochemistry and Medical Genetics, University of Manitoba, and Manitoba Institute of Child Health, Winnipeg, MB R3T 2N2, Canada
| | - Junbin Shi
- Departments of Mechanical Engineering, Biochemistry and Medical Genetics, University of Manitoba, and Manitoba Institute of Child Health, Winnipeg, MB R3T 2N2, Canada
| | - Xiaolin Xu
- Department of Histology and Embryology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Jianyang Ding
- Department of Histology and Embryology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Wen Zhong
- Department of Biosystem Engineering, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Lu Zhang
- Key Laboratory of Functional Proteomics of Guangdong Province, Department of Pathophysiology, Southern Medical University, Guangzhou 510515, China.
| | - Malcolm Xing
- Departments of Mechanical Engineering, Biochemistry and Medical Genetics, University of Manitoba, and Manitoba Institute of Child Health, Winnipeg, MB R3T 2N2, Canada.
| | - Lin Zhang
- Department of Histology and Embryology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou 510515, China.
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16
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Hedayati N, Carson JG, Chi YW, Link D. Management of mixed arterial venous lower extremity ulceration: A review. Vasc Med 2015. [DOI: 10.1177/1358863x15594683] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mixed arterial venous disease is estimated to affect up to 26% of patients with lower extremity ulcerations. However, its clinical significance and pathophysiology are incompletely understood. Furthermore, there is no consensus on the optimal treatment modality, whether conservative or operative. In this review paper, we describe the current understanding of the pathophysiology of mixed arterial venous lower extremity ulcers. Guidelines for diagnostic tests for patients with mixed arterial venous diseases are discussed. We review some of the newer biological skin substitutes for conservative wound care. Finally, we propose a treatment algorithm based on current available data.
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Affiliation(s)
- Nasim Hedayati
- Division of Vascular and Endovascular Surgery, University of California, Davis Medical Center, Sacramento, California, USA
| | - John G Carson
- Division of Vascular and Endovascular Surgery, University of California, Davis Medical Center, Sacramento, California, USA
| | - Yung-Wei Chi
- Department of Internal Medicine, University of California, Davis Medical Center, Sacramento, California, USA
| | - Daniel Link
- Department of Radiology, University of California, Davis Medical Center, Sacramento, California, USA
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17
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Effects of weekly LED therapy at 625 nm on the treatment of chronic lower ulcers. Lasers Med Sci 2014; 30:367-73. [DOI: 10.1007/s10103-014-1666-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 09/22/2014] [Indexed: 12/17/2022]
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18
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van den Broek LJ, Kroeze KL, Waaijman T, Breetveld M, Sampat-Sardjoepersad SC, Niessen FB, Middelkoop E, Scheper RJ, Gibbs S. Differential response of human adipose tissue-derived mesenchymal stem cells, dermal fibroblasts, and keratinocytes to burn wound exudates: potential role of skin-specific chemokine CCL27. Tissue Eng Part A 2013; 20:197-209. [PMID: 23980822 DOI: 10.1089/ten.tea.2013.0123] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Many cell-based regenerative medicine strategies toward tissue-engineered constructs are currently being explored. Cell-cell interactions and interactions with different biomaterials are extensively investigated, whereas very few studies address how cultured cells will interact with soluble wound-healing mediators that are present within the wound bed after transplantation. The aim of this study was to determine how adipose tissue-derived mesenchymal stem cells (ASC), dermal fibroblasts, and keratinocytes will react when they come in contact with the deep cutaneous burn wound bed. Burn wound exudates isolated from deep burn wounds were found to contain many cytokines, including chemokines and growth factors related to inflammation and wound healing. Seventeen mediators were identified by ELISA (concentration range 0.0006-9 ng/mg total protein), including the skin-specific chemokine CCL27. Burn wound exudates activated both ASC and dermal fibroblasts, but not keratinocytes, to increase secretion of CXCL1, CXCL8, CCL2, and CCL20. Notably, ASC but not fibroblasts or keratinocytes showed significant increased secretion of vascular endothelial growth factor (5-fold) and interleukin-6 (253-fold), although when the cells were incorporated in bi-layered skin substitute (SS) these differences were less pronounced. A similar discrepancy between ASC and dermal fibroblast mono-cultures was observed when recombinant human-CCL27 was used instead of burn wound exudates. Although CCL27 did not stimulate the secretion of any of the wound-healing mediators by keratinocytes, these cells, in contrast to ASC or dermal fibroblasts, showed increased proliferation and migration. Taken together, these results indicate that on transplantation, keratinocytes are primarily activated to promote wound closure. In contrast, dermal fibroblasts and, in particular, ASC respond vigorously to factors present in the wound bed, leading to increased secretion of angiogenesis/granulation tissue formation factors. Our findings have implications for the choice of cell type (ASC or dermal fibroblast) to be used in regenerative medicine strategies and indicate the importance of taking into account interactions with the wound bed when developing advanced therapies for difficult-to-close cutaneous wounds.
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Affiliation(s)
- Lenie J van den Broek
- 1 Department of Dermatology, VU University Medical Center , Amsterdam, The Netherlands
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19
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Minematsu T, Nakagami G, Yamamoto Y, Kanazawa T, Huang L, Koyanagi H, Sasaki S, Uchida G, Fujita H, Haga N, Yoshimura K, Nagase T, Sanada H. Wound blotting: A convenient biochemical assessment tool for protein components in exudate of chronic wounds. Wound Repair Regen 2013; 21:329-34. [DOI: 10.1111/wrr.12017] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 11/27/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Takeo Minematsu
- Department of Gerontological Nursing/Wound Care Management; Graduate School of Medicine; The University of Tokyo; Tokyo; Japan
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management; Graduate School of Medicine; The University of Tokyo; Tokyo; Japan
| | - Yuko Yamamoto
- Department of Gerontological Nursing/Wound Care Management; Graduate School of Medicine; The University of Tokyo; Tokyo; Japan
| | - Toshiki Kanazawa
- Department of Gerontological Nursing/Wound Care Management; Graduate School of Medicine; The University of Tokyo; Tokyo; Japan
| | - Lijuan Huang
- Department of Gerontological Nursing/Wound Care Management; Graduate School of Medicine; The University of Tokyo; Tokyo; Japan
| | - Hiroe Koyanagi
- Department of Nursing; The University of Tokyo Hospital; Tokyo; Japan
| | - Sanae Sasaki
- Department of Nursing; The University of Tokyo Hospital; Tokyo; Japan
| | - Gentaro Uchida
- Department of Plastic Surgery; The University of Tokyo; Tokyo; Japan
| | - Hideki Fujita
- Department of Dermatology; The University of Tokyo; Tokyo; Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine; The University of Tokyo; Tokyo; Japan
| | - Kotaro Yoshimura
- Department of Plastic Surgery; The University of Tokyo; Tokyo; Japan
| | - Takashi Nagase
- Department of Gerontological Nursing/Wound Care Management; Graduate School of Medicine; The University of Tokyo; Tokyo; Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management; Graduate School of Medicine; The University of Tokyo; Tokyo; Japan
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