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Mariello M, Binetti E, Todaro MT, Qualtieri A, Brunetti V, Siciliano P, De Vittorio M, Blasi L. Eco-Friendly Production of Polyvinyl Alcohol/Carboxymethyl Cellulose Wound Healing Dressing Containing Sericin. Gels 2024; 10:412. [PMID: 38920958 PMCID: PMC11202596 DOI: 10.3390/gels10060412] [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] [Received: 05/16/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024] Open
Abstract
Wound dressing production represents an important segment in the biomedical healthcare field, but finding a simple and eco-friendly method that combines a natural compound and a biocompatible dressing production for biomedical application is still a challenge. Therefore, the aim of this study is to develop wound healing dressings that are environmentally friendly, low cost, and easily produced, using natural agents and a physical crosslinking technique. Hydrogel wound healing dressings were prepared from polyvinyl alcohol/carboxymethyl cellulose and sericin using the freeze-thawing method as a crosslinking method. The morphological characterization was carried out by scanning electron microscopy (SEM), whereas the mechanical analysis was carried out by dynamic mechanical analysis (DMA) to test the tensile strength and compression properties. Then, the healing property of the wound dressing material was tested by in vitro and ex vivo tests. The results show a three-dimensional microporous structure with no cytotoxicity, excellent stretchability with compressive properties similar to those of human skin, and excellent healing properties. The proposed hydrogel dressing was tested in vitro with HaCaT keratinocytes and ex vivo with epidermal tissues, demonstrating an effective advantage on wound healing acceleration. Accordingly, this study was successful in developing wound healing dressings using natural agents and a simple and green crosslinking method.
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Affiliation(s)
- Massimo Mariello
- Center for Biomolecular Nanotechnologies, Italian Institute of Technology, 73100 Lecce, Italy; (M.M.)
- Dipartimento Ingegneria dell’Innovazione, Università del Salento, via Monteroni, 73100 Lecce, Italy
| | - Enrico Binetti
- Center for Biomolecular Nanotechnologies, Italian Institute of Technology, 73100 Lecce, Italy; (M.M.)
- Institute for Microelectronics and Microsystems IMM-CNR, UOS di Lecce Via Monteroni c/o Campus Universitario Ecotekne-Palazzina A3, 73100 Lecce, Italy
| | - Maria Teresa Todaro
- Center for Biomolecular Nanotechnologies, Italian Institute of Technology, 73100 Lecce, Italy; (M.M.)
- Institute of Nanotechnology NANOTEC-CNR, c/o Campus Ecotekne, Via Monteroni, 73100 Lecce, Italy
| | - Antonio Qualtieri
- Center for Biomolecular Nanotechnologies, Italian Institute of Technology, 73100 Lecce, Italy; (M.M.)
| | - Virgilio Brunetti
- Center for Biomolecular Nanotechnologies, Italian Institute of Technology, 73100 Lecce, Italy; (M.M.)
| | - Pietro Siciliano
- Institute for Microelectronics and Microsystems IMM-CNR, UOS di Lecce Via Monteroni c/o Campus Universitario Ecotekne-Palazzina A3, 73100 Lecce, Italy
| | - Massimo De Vittorio
- Center for Biomolecular Nanotechnologies, Italian Institute of Technology, 73100 Lecce, Italy; (M.M.)
- Dipartimento Ingegneria dell’Innovazione, Università del Salento, via Monteroni, 73100 Lecce, Italy
| | - Laura Blasi
- Center for Biomolecular Nanotechnologies, Italian Institute of Technology, 73100 Lecce, Italy; (M.M.)
- Institute for Microelectronics and Microsystems IMM-CNR, UOS di Lecce Via Monteroni c/o Campus Universitario Ecotekne-Palazzina A3, 73100 Lecce, Italy
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Sufiyan M, Kushwaha P, Ahmad M, Mandal P, Vishwakarma KK. Scaffold-Mediated Drug Delivery for Enhanced Wound Healing: A Review. AAPS PharmSciTech 2024; 25:137. [PMID: 38877197 DOI: 10.1208/s12249-024-02855-1] [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: 04/04/2024] [Accepted: 05/28/2024] [Indexed: 06/16/2024] Open
Abstract
Wound healing is a complex physiological process involving coordinated cellular and molecular events aimed at restoring tissue integrity. Acute wounds typically progress through the sequential phases of hemostasis, inflammation, proliferation, and remodeling, while chronic wounds, such as venous leg ulcers and diabetic foot ulcers, often exhibit prolonged inflammation and impaired healing. Traditional wound dressings, while widely used, have limitations such poor moisture retention and biocompatibility. To address these challenges and improve patient outcomes, scaffold-mediated delivery systems have emerged as innovative approaches. They offer advantages in creating a conducive environment for wound healing by facilitating controlled and localized drug delivery. The manuscript explores scaffold-mediated delivery systems for wound healing applications, detailing the use of natural and synthetic polymers in scaffold fabrication. Additionally, various fabrication techniques are discussed for their potential in creating scaffolds with controlled drug release kinetics. Through a synthesis of experimental findings and current literature, this manuscript elucidates the promising potential of scaffold-mediated drug delivery in improving therapeutic outcomes and advancing wound care practices.
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Affiliation(s)
- Mohd Sufiyan
- Faculty of Pharmacy, Integral University, Dasauli-Kursi Road, Lucknow, India
| | - Poonam Kushwaha
- Faculty of Pharmacy, Integral University, Dasauli-Kursi Road, Lucknow, India.
| | - Mohammad Ahmad
- Faculty of Pharmacy, Integral University, Dasauli-Kursi Road, Lucknow, India
| | - Purba Mandal
- Faculty of Pharmacy, Integral University, Dasauli-Kursi Road, Lucknow, India
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Hung CC, Chen CM, Chang YH, Lee SH, Chang CH, Chen YJ. Development and validation of a Chinese version chronic wound health-related quality of life instrument: A methodological study. J Clin Nurs 2024; 33:1820-1829. [PMID: 38054584 DOI: 10.1111/jocn.16948] [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: 04/12/2023] [Revised: 08/12/2023] [Accepted: 11/13/2023] [Indexed: 12/07/2023]
Abstract
AIMS AND OBJECTIVES To develop a Chinese version of a chronic wound health-related quality of life (QoL) instrument and to examine the psychometric properties of this instrument. BACKGROUND Existing QoL instruments are not tailored to the linguistic and cultural characteristics of Chinese-speaking patients; a version addressing this gap will increase clinical understanding of their healthcare experience and may help guide chronic wound care. DESIGN A methodological study. METHODS The method advanced by DeVellis (2017) was used to develop the instrument. An initial pool of 38 items was created. To optimize scale length and test reliability and validity, exploratory and confirmatory factor analyses were conducted. A total of 23 items formed the final pool. After two rounds of expert discussions, the average content validity index of the final 23 items was .89. RESULTS A total of 226 patients completed the instrument and were divided into two groups for further analysis. Exploratory factor analysis revealed that 15 items remained in four factors (social activity restrictions, physical and psychological disturbance, wound burden and daily life limitation), which accounted for 64.87% of the variance. Confirmatory factor analysis revealed an acceptable fit of the hypothesized factor structure and the convergent and discriminant validities were achieved. Cronbach's α coefficients for each factor were .807, .773, .799 and .713, respectively. CONCLUSION The Chinese version of a chronic wound health-related QoL instrument consists of 15 items in four subscales and demonstrates good reliability and validity. RELEVANCE TO CLINICAL PRACTICE This instrument can be used intermittently or continuously to evaluate the treatment effect of chronic wounds by assessing health-related QoL. Scholars in Chinese-speaking regions may find this culturally compatible instrument useful when conducting studies related to chronic wounds. PATIENT OR PUBLIC CONTRIBUTION Two hundred twenty-six participants provided their perspectives on health-related QoL.
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Affiliation(s)
- Chang-Chiao Hung
- School of Nursing & Nursing Department, Chang Gung University of Science and Technology & Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
| | - Chien-Ming Chen
- Burn Center & Department of Plastic Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
| | - Ya-Hui Chang
- Department of Nursing, China Medical University Beigang Hospital, Beigang Township, Taiwan, ROC
| | - Shiao-Haung Lee
- Department of Nursing, China Medical University Beigang Hospital, Beigang Township, Taiwan, ROC
| | - Chia-Hao Chang
- School of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan, ROC
| | - Yea-Jyh Chen
- School of Nursing, University of North Carolina Wilmington, Wilmington, North Carolina, USA
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Kapp D, Pfendler L. Management of post-Mohs surgical wounds with a hypothermically stored amniotic membrane: a case series. J Wound Care 2024; 33:S22-S27. [PMID: 38683816 DOI: 10.12968/jowc.2024.33.sup5.s22] [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] [Indexed: 05/02/2024]
Abstract
OBJECTIVE The aim of this case series is to present an alternative approach to managing post-Mohs Micrographic Surgery (Mohs) wounds with hypothermically stored amniotic membrane (HSAM). METHOD A case series of patients with post-Mohs wounds is presented, with four patients referred for hard-to-heal wounds following a Mohs procedure that was performed 1-3 months previously. All wounds underwent weekly assessment, debridement, and application of HSAM and secondary dressings. Treatment also included management of bioburden, proper skin care and compression therapy for lower extremity wounds. RESULTS This case series of seven wounds consisted of four females and three males with a mean age of 87.6 years. Mean wound size at first application of HSAM was 1.34±1.20cm2. All wounds closed, with an average time to wound closure of 43.7±27.1 days. Patients received an average of 4.6±2.5 HSAM applications. The four post-Mohs wounds with a history of being hard-to-heal had an average time to wound closure of 35.5±16.3 days, with an average duration of 86.5±32.4 days prior to the first HSAM application. CONCLUSION The results of this case series suggest that use of HSAM may provide an alternative approach to managing post-Mohs wounds. In addition, these findings suggest that HSAM may be of greatest benefit when applied early after Mohs surgery.
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Affiliation(s)
- Daniel Kapp
- Daniel L. Kapp M.D. Plastic Surgery and Wound Care, West Palm Beach, FL 33401
| | - Laura Pfendler
- Daniel L. Kapp M.D. Plastic Surgery and Wound Care, West Palm Beach, FL 33401
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Dymarek R, Kuberka I, Walewicz K, Taradaj J, Rosińczuk J, Sopel M. Is Shock Wave Application Effective on Various Chronic Wounds in the Geriatric Population? Preliminary Clinical Study. Clin Interv Aging 2024; 19:665-679. [PMID: 38706636 PMCID: PMC11069372 DOI: 10.2147/cia.s448298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 04/01/2024] [Indexed: 05/07/2024] Open
Abstract
Purpose Extracorporeal shock wave therapy (ESWT) is a beneficial adjunct modality for chronic wounds. Limited research has been conducted on pressure ulcers (PUs), while the majority of studies have focused on diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs). This study aimed to evaluate the short-term effects of radial ESWT in older adults with chronic wounds. Patients and Methods This study involved a total of 31 wounds: PUs (n=22), VLUs (n=7), and DFUs (n=2). A single radial ESWT was performed with 300 + 100 shocks per cm2, pressure of 2.5 bar, energy of 0.15 mJ/mm2, and frequency of 5 Hz. Assessments using digital planimetry and clinical methods, utilizing the Wound Bed Score (WBS) and the Bates-Jansen Wound Assessment Tool (BWAT) were performed before the radial ESWT application (M0) and one week after (M1). Results A significant wound decrease in planimetry was noted (pre-ESWT vs post-ESWT), with wound area from 9.4 cm2 to 6.2 cm2, length from 6.4 cm to 3.9 cm, and width from 2.8 cm to 2.1 cm (p<0.001). Additionally, a substantial clinical improvement was noted in both the WBS with a 31.25% increase and the BWAT with a 20.00% increase (p<0.001). It was also found a significant correlation between the planimetric and clinical outcomes for both tools: WBS (r=-0.446, p=0.012) and BWAT (r=0.327, p=0.073). Conclusion The ESWT application yields substantial immediate clinical effects that support the healing of chronic wounds in older adults. Even a single ESWT session can prove to be clinically effective and beneficial in the management of chronic wounds.
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Affiliation(s)
- Robert Dymarek
- Department of Physiotherapy, Wroclaw Medical University, Wroclaw, Poland
| | - Izabela Kuberka
- Division of Anaesthetic and Surgical Nursing, Wroclaw Medical University, Wroclaw, Poland
| | - Karolina Walewicz
- Medical Institute, Jan Grodek State University in Sanok, Sanok, Poland
| | - Jakub Taradaj
- Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Joanna Rosińczuk
- Division of Internal Medicine Nursing, Wroclaw Medical University, Wroclaw, Poland
| | - Mirosław Sopel
- Faculty of Medicine, Wrocław University of Science and Technology, Wroclaw, Poland
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He Y, Yue J, Teng Y, Fan Z, Jia M, Teng H, Zhuge L. Tryptanthrin promotes pressure ulcers healing in mice by inhibiting macrophage-mediated inflammation via cGAS/STING pathways. Int Immunopharmacol 2024; 130:111687. [PMID: 38382260 DOI: 10.1016/j.intimp.2024.111687] [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: 11/18/2023] [Revised: 01/31/2024] [Accepted: 02/09/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Pressure ulcers (PUs) is ischemic necrosis caused by long-term local tissue pressure, directly affecting postoperative functional recovery. There is evidence that inflammation has an adverse impact on the development of PUs and contributes to unfavorable outcomes, suggesting that blocking the inflammatory response may be a promising therapeutic strategy for PUs. Tryptanthrin (Tryp), a natural product isolated from indigenous plants, has an anti-inflammatory biological function. However, the efficacy of Tryp in PUs remains unclear. METHODS Efficacy of Tryp suppressed inflammation was assessed using magnets-induced PUs model in mice. Hematoxylin-Eosin staining, masson staining and immunohistochemistry were used to evaluate the histologic changes after the formation of PUs. The expression of inflammatory cytokines was detected by qRT-PCR. And we detected the expression of protein by Western blotting. RESULTS Tryp could promote wound healing, such as epidermal thickening, revascularization, and nerve regeneration. Then the treatment of Tryp was able to promote fibroblast migration and collagen deposition. Moreover, Tryp attenuated inflammation through inducing macrophage polarization to M2 phenotype by suppressing the activation of cGAS-STING pathway. CONCLUSION Tryp could reduce the release of inflammatory cytokines, and induce RAW 264.7 polarization to M2 phenotype by targeting cGAS/STING/TBK1 pathways. In summary, Tryp may be a novel medicine for the treatment of PUs in the future.
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Affiliation(s)
- Yaozhi He
- Department of Orthopedics (Spine Surgery), The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Juanqing Yue
- (Department of Pathology) Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, China
| | - Yiwei Teng
- Renji College, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ziwei Fan
- Department of Orthopedics (Spine Surgery), The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mengxian Jia
- Department of Orthopedics (Spine Surgery), The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Honglin Teng
- Department of Orthopedics (Spine Surgery), The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Linmin Zhuge
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Pun R, Cavanaugh AM, Aldrich E, Tran O, Rudd JC, Hansen LA, North BJ. PKCμ promotes keratinocyte cell migration through Cx43 phosphorylation-mediated suppression of intercellular communication. iScience 2024; 27:109033. [PMID: 38375220 PMCID: PMC10875573 DOI: 10.1016/j.isci.2024.109033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 12/18/2023] [Accepted: 01/23/2024] [Indexed: 02/21/2024] Open
Abstract
Downregulation of intercellular communication through suppression of gap junctional conductance is necessary during wound healing. Connexin 43 (Cx43), a prominent gap junction protein in skin, is downregulated following wounding to restrict communication between keratinocytes. Previous studies found that PKCμ, a novel PKC isozyme, regulates efficient cutaneous wound healing. However, the molecular mechanism by which PKCμ regulates wound healing remains unknown. We have identified that PKCμ suppresses intercellular communication and enhances cell migration in an in vitro wound healing model by regulating Cx43 containing gap junctions. PKCμ can directly interact with and phosphorylate Cx43 at S368, which leads to Cx43 internalization and downregulation. Finally, utilizing phosphomimetic and non-phosphorylatable S368 substitutions and gap junction inhibitors, we confirmed that PKCμ regulates intercellular communication and in vitro wound healing by controlling Cx43-S368 phosphorylation. These results define PKCμ as a critical regulator of Cx43 phosphorylation to control cell migration and wound healing in keratinocytes.
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Affiliation(s)
- Renju Pun
- Biomedical Sciences Department, School of Medicine, Creighton University, Omaha, NE 68178, USA
| | - Ann M. Cavanaugh
- Department of Biology, College of Arts and Sciences, Creighton University, Omaha, NE 68178, USA
| | - Emily Aldrich
- Biomedical Sciences Department, School of Medicine, Creighton University, Omaha, NE 68178, USA
| | - Olivia Tran
- Biomedical Sciences Department, School of Medicine, Creighton University, Omaha, NE 68178, USA
| | - Justin C. Rudd
- Biomedical Sciences Department, School of Medicine, Creighton University, Omaha, NE 68178, USA
| | - Laura A. Hansen
- Biomedical Sciences Department, School of Medicine, Creighton University, Omaha, NE 68178, USA
| | - Brian J. North
- Biomedical Sciences Department, School of Medicine, Creighton University, Omaha, NE 68178, USA
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Laiva AL, O'Brien FJ, Keogh MB. Dual delivery gene-activated scaffold directs fibroblast activity and keratinocyte epithelization. APL Bioeng 2024; 8:016104. [PMID: 38283135 PMCID: PMC10821797 DOI: 10.1063/5.0174122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/12/2024] [Indexed: 01/30/2024] Open
Abstract
Fibroblasts are the most abundant cell type in dermal skin and keratinocytes are the most abundant cell type in the epidermis; both play a crucial role in wound remodeling and maturation. We aim to assess the functionality of a novel dual gene activated scaffold (GAS) on human adult dermal fibroblasts (hDFs) and see how the secretome produced could affect human dermal microvascular endothelial cells (HDMVECs) and human epidermal keratinocyte (hEKs) growth and epithelization. Our GAS is a collagen chondroitin sulfate scaffold loaded with pro-angiogenic stromal derived factor (SDF-1α) and/or an anti-aging β-Klotho plasmids. hDFs were grown on GAS for two weeks and compared to gene-free scaffolds. GAS produced a significantly better healing outcome in the fibroblasts than in the gene-free scaffold group. Among the GAS groups, the dual GAS induced the most potent pro-regenerative maturation in fibroblasts with a downregulation in proliferation (twofold, p < 0.05), fibrotic remodeling regulators TGF-β1 (1.43-fold, p < 0.01) and CTGF (1.4-fold, p < 0.05), fibrotic cellular protein α-SMA (twofold, p < 0.05), and fibronectin matrix deposition (twofold, p < 0.05). The dual GAS secretome also showed enhancements of paracrine keratinocyte pro-epithelializing ability (1.3-fold, p < 0.05); basement membrane regeneration through laminin (6.4-fold, p < 0.005) and collagen IV (8.7-fold, p < 0.005) deposition. Our findings demonstrate enhanced responses in dual GAS containing hDFs by proangiogenic SDF-1α and β-Klotho anti-fibrotic rejuvenating activities. This was demonstrated by activating hDFs on dual GAS to become anti-fibrotic in nature while eliciting wound repair basement membrane proteins; enhancing a proangiogenic HDMVECs paracrine signaling and greater epithelisation of hEKs.
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Affiliation(s)
| | | | - Michael B. Keogh
- Author to whom correspondence should be addressed:. Tel.: +973 17351450
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Dhar A, Needham J, Gibb M, Coyne E. The client and family experience of attending a nurse-led clinic for chronic wounds. Aust J Prim Health 2024; 30:NULL. [PMID: 37925745 DOI: 10.1071/py23081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 10/10/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND The quality of life for individuals with chronic wounds is diminished due to poor health-related outcomes and the financial burden of wound care. The literature has shown nurse-led wound care to have a positive impact on wound healing and psychosocial wellbeing. However, there is minimal research investigating the lived experience of attending a nurse-led clinic for chronic wounds. The purpose of this study was to explore the client and family experience of attending a nurse-led clinic for chronic wounds. METHODS Qualitative descriptive study. Semi-structured telephone interviews were transcribed verbatim and thematic analysis was undertaken. RESULTS Twelve clients and two family members participated, and the average length of interviews was 20min. Three main themes emerged: (1) expecting and managing pain; (2) receiving expert advice and reflecting on previous care; and (3) managing the cost of care. There was an emphasis on the impact of chronic wounds on pain and the ability to complete the activities of daily living. Expert advice, client satisfaction and physical accessibility were highlighted as benefits of the clinic. Cost and minimal client education were identified as challenges of the clinic. CONCLUSIONS The findings demonstrated that chronic wounds have a significant impact on the client and family attending the nurse-led clinic. Comprehensive pain assessment, improved social support, better client education and cost-effective care is required to optimise the experience for people attending the nurse-led clinic.
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Affiliation(s)
- Anusuya Dhar
- Griffith University, School of Nursing and Midwifery, Logan campus, Meadowbrook, Qld 4131, Australia
| | - Judith Needham
- Griffith University, School of Nursing and Midwifery, Logan campus, Meadowbrook, Qld 4131, Australia
| | - Michelle Gibb
- Wound Specialist Services Pty Ltd, Brisbane, Qld 4000, Australia
| | - Elisabeth Coyne
- Griffith University, School of Nursing and Midwifery, Logan campus, Meadowbrook, Qld 4131, Australia
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Dong M, Jin Y, Lin X, Wang S, Shen P. Meta-analysis on the impact of immune senescence: Unravelling the interplay in cutaneous wound healing and lung cancer progression. Int Wound J 2024; 21:e14756. [PMID: 38339818 PMCID: PMC10858335 DOI: 10.1111/iwj.14756] [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: 01/03/2024] [Revised: 01/12/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
The primary objective of this meta-analysis was to provide the comprehensive understanding of the intricate correlation that existed between immune senescence and its effects on the advancement of lung cancer as well as recovery of cutaneous wounds. By conducting this systematic review of six rigorous studies utilizing databases such as PubMed and Web of Science, this research examined the multitude of facets pertaining to immune aging and consequences it bear on the health outcomes. The incorporated studies encompassed wide range of geographical and methodological viewpoints, with the specific emphasis on non-small-cell lung cancer and diverse scenarios related to wound recovery. This analysis synthesized discoveries regarding therapeutic responses, cellular and molecular mechanisms and impact of lifestyle factors on immune senescence. The findings suggested that immune senescence has substantial impact on the effectiveness of treatments for lung cancer and cutaneous wounds healing process; therefore, targeted therapies and holistic approaches may be able to mitigate these effects. By following the revised PRISMA guidelines, this meta-analysis guarantee thorough and ethically sound methodology for amalgamating pre-existing literature. The study concluded by emphasizing the critical nature of comprehending immune senescence in the context of clinical practice and proposed avenues for further investigation to enhance health results among the elderly.
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Affiliation(s)
- Mengqian Dong
- Department of GeriatricsThe first people's hospital of WenlingWenlingChina
| | - Ying Jin
- Department of GeriatricsThe first people's hospital of WenlingWenlingChina
| | - Xiaoyang Lin
- Department of Integrative Traditional Chinese and Western MedicineThe first people's hospital of WenlingWenlingChina
| | - Shuangshuang Wang
- Department of BurnThe first people's hospital of WenlingWenlingChina
| | - Peihong Shen
- Department of Integrative Traditional Chinese and Western MedicineThe first people's hospital of WenlingWenlingChina
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Kremer M, Burkemper N. Aging Skin and Wound Healing. Clin Geriatr Med 2024; 40:1-10. [PMID: 38000854 DOI: 10.1016/j.cger.2023.06.001] [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] [Indexed: 11/26/2023]
Abstract
Responsible for many essential functions of life, human skin is made up of many components, each of which undergoes significant functional changes with aging and photodamage. Wound healing was previously thought to be defective in the elderly given the higher presence of chronic wounds and the longer time required for re-epithelialization of acute wounds. However, these notions have been challenged in recent research, which has shown that wound healing in the elderly is delayed but not defective. Poor healing of chronic wounds in older populations is more often attributable to comorbid conditions rather than age alone.
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Affiliation(s)
- Michael Kremer
- Department of Dermatology, SSM Saint Louis University Hospital, 1225 South Grand Boulevard 3L, St. Louis, MO 63104, USA
| | - Nicole Burkemper
- Department of Dermatology, SSM Saint Louis University Hospital, 1225 South Grand Boulevard 3L, St. Louis, MO 63104, USA.
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12
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Shi HS, Yuan X, Wu FF, Li XY, Fan WJ, Yang X, Hu XM, Liu GB. Research progress and challenges in stem cell therapy for diabetic foot: Bibliometric analysis and perspectives. World J Stem Cells 2024; 16:33-53. [PMID: 38292441 PMCID: PMC10824042 DOI: 10.4252/wjsc.v16.i1.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/06/2023] [Accepted: 12/28/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Stem cell therapy has shown great potential for treating diabetic foot (DF). AIM To conduct a bibliometric analysis of studies on the use of stem cell therapy for DF over the past two decades, with the aim of depicting the current global research landscape, identifying the most influential research hotspots, and providing insights for future research directions. METHODS We searched the Web of Science Core Collection database for all relevant studies on the use of stem cell therapy in DF. Bibliometric analysis was carried out using CiteSpace, VOSviewer, and R (4.3.1) to identify the most notable studies. RESULTS A search was conducted to identify publications related to the use of stem cells for DF treatment. A total of 542 articles published from 2000 to 2023 were identified. The United States had published the most papers on this subject. In this field, Iran's Shahid Beheshti University Medical Sciences demonstrated the highest productivity. Furthermore, Dr. Bayat from the same university has been an outstanding researcher in this field. Stem Cell Research & Therapy is the journal with the highest number of publications in this field. The main keywords were "diabetic foot ulcers," "wound healing," and "angiogenesis." CONCLUSION This study systematically illustrated the advances in the use of stem cell therapy to treat DF over the past 23 years. Current research findings suggested that the hotspots in this field include stem cell dressings, exosomes, wound healing, and adipose-derived stem cells. Future research should also focus on the clinical translation of stem cell therapies for DF.
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Affiliation(s)
- Hong-Shuo Shi
- Department of Peripheral Vascular Surgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 250021, China
| | - Xin Yuan
- Department of Peripheral Vascular Surgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 250021, China
| | - Fang-Fang Wu
- Department of Peripheral Vascular Surgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 250021, China
| | - Xiao-Yu Li
- Department of Peripheral Vascular Surgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 250021, China
| | - Wei-Jing Fan
- Department of Peripheral Vascular Surgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 250021, China
| | - Xiao Yang
- Department of Peripheral Vascular Surgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 250021, China
| | - Xiao-Ming Hu
- Department of Peripheral Vascular Surgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 250021, China
| | - Guo-Bin Liu
- Department of Peripheral Vascular Surgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 250021, China.
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Simonsen NV, Klassen AF, Rae C, Dalaei F, Cano S, Poulsen L, Pusic AL, Sørensen JA. Further psychometric validation and test-retest reproducibility of the WOUND-Q. Int Wound J 2024; 21:e14354. [PMID: 37581232 PMCID: PMC10777769 DOI: 10.1111/iwj.14354] [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: 06/29/2023] [Accepted: 08/03/2023] [Indexed: 08/16/2023] Open
Abstract
WOUND-Q is a condition-specific patient-reported outcome measure developed for all types of chronic wounds, located anywhere on the body. To establish reliability and validity of a patient-reported outcome measure, multiple pieces of evidence are required. The purpose of this study was to examine the measurement properties of 9 of the 13 WOUND-Q scales and perform a test-retest reproducibility study in an international sample. In August 2022, we invited members of an international online community (Prolific.com) with any type of chronic wound to complete a survey containing the WOUND-Q scales, the Wound-QoL and EQ-5D. A test-retest survey was performed 7 days after the first survey. It was possible to examine the reliability and validity of eight of the nine WOUND-Q scales by Rasch Measurement Theory (RMT). To examine test-retest reproducibility intraclass correlation coefficients (ICCs), the standard error of the measurement and the smallest detectable change were calculated. In total, 421 patients from 22 different countries with 11 different types of chronic wounds took part in this study. Our analyses provided further evidence of the reliability and validity of the scales measuring wound characteristics (assessment, drainage, smell), health-related quality of life (life impact, psychological, sleep, social) and wound treatment (dressing).
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Affiliation(s)
- Nina Vestergaard Simonsen
- Department of Plastic Surgery, Odense University Hospital, Odense, DenmarkUniversity of Southern DenmarkOdenseDenmark
| | | | - Charlene Rae
- Department of PediatricsMcMaster UniversityHamiltonCanada
| | - Farima Dalaei
- Department of Plastic Surgery, Odense University Hospital, Odense, DenmarkUniversity of Southern DenmarkOdenseDenmark
| | | | - Lotte Poulsen
- Research Unit for Plastic SurgeryOdense University Hospital, Løntoft, Nyhøj and Poulsen Plastic SurgeryOdenseDenmark
| | - Andrea L. Pusic
- Patient‐Reported Outcomes, Value & Experience (PROVE) Center, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Jens Ahm Sørensen
- Department of Plastic Surgery, Odense University Hospital, Odense, DenmarkUniversity of Southern DenmarkOdenseDenmark
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14
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Brent AA, Mancuso E, Smith E. Considerations in geriatric dermatopathology. Int J Dermatol 2023; 62:1458-1474. [PMID: 37807385 DOI: 10.1111/ijd.16852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023]
Abstract
This review provides an overview of considerations in geriatric dermatopathology. The nuances of specimen collection and reporting in this population, including the importance of obtaining adequate tissue, providing detailed clinical information and ethical considerations surrounding specimen collection will be discussed. The histopathologic changes associated with aging and the morphologic features of common lesions related to photoaging are outlined followed by a discussion of common interpretation pitfalls, specifically entities at risk of overinterpretation and those related to hyper- and hypopigmentation. Finally, the recent literature is reviewed regarding special cases and what this implies for future research both in dermatology and dermatopathology.
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Affiliation(s)
- Ashley A Brent
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Elizabeth Mancuso
- Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA
| | - Emily Smith
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
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15
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Chwa ES, Applebaum SA, Khazanchi R, Wester JR, Gosain AK. Racial Disparities Following Reconstructive Flap Procedures. J Craniofac Surg 2023; 34:2004-2007. [PMID: 37582256 DOI: 10.1097/scs.0000000000009595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/30/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Prior reports have highlighted disparities in healthcare access, environmental conditions, and food insecurity between Black and White populations in the United States. However, limited studies have explored racial disparities in postoperative complications, particularly reconstructive flap surgeries. METHODS Cases of flap reconstruction based on named vascular pedicles were identified in the American College of Surgeons National Surgical Quality Improvement Program database and grouped into 3 time periods: 2005 to 2009, 2010 to 2014, and 2015 to 2019. Logistic regression was used to compare rates of postoperative complications between White and Black patients within each time period while controlling for comorbidities. Data for flap failure was only available from 2005 to 2010. RESULTS A total of 56,116 patients were included in the study, and 6293 (11.2%) were Black. Black patients were significantly younger than White patients and had increased rates of hypertension, smoking, and diabetes across all years ( P <0.01). Black patients had significantly higher rates of sepsis compared to White patients in all time periods. From 2005 to 2009, Black patients had a significantly higher incidence of flap failure (aOR=2.58, P <0.01), return to the operating room (aOR=1.53, P =0.01), and having any complication (aOR=1.48, P <0.01). From 2010 to 2019, White patients had a higher incidence of superficial surgical site infection. CONCLUSIONS Surgical complication rates following flap reconstruction based on a named vascular pedicle were higher for Black patients. Limited data on this topic currently exists, indicating that additional research on the drivers of racial disparities is warranted to improve plastic surgery outcomes in Black patients.
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Affiliation(s)
- Emily S Chwa
- Northwestern University Feinberg School of Medicine and the Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital, Chicago, IL
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Popescu V, Cauni V, Petrutescu MS, Rustin MM, Bocai R, Turculet CR, Doran H, Patrascu T, Lazar AM, Cretoiu D, Varlas VN, Mastalier B. Chronic Wound Management: From Gauze to Homologous Cellular Matrix. Biomedicines 2023; 11:2457. [PMID: 37760898 PMCID: PMC10525626 DOI: 10.3390/biomedicines11092457] [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: 07/17/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Chronic wounds are a significant health problem with devastating consequences for patients' physical, social, and mental health, increasing healthcare systems' costs. Their prolonged healing times, economic burden, diminished quality of life, increased infection risk, and impact on patients' mobility and functionality make them a major concern for healthcare professionals. PURPOSE This review offers a multi-perspective analysis of the medical literature focusing on chronic wound management. METHODS USED We evaluated 48 articles from the last 21 years registered in the MEDLINE and Global Health databases. The articles included in our study had a minimum of 20 citations, patients > 18 years old, and focused on chronic, complex, and hard-to-heal wounds. Extracted data were summarized into a narrative synthesis using the same health-related quality of life instrument. RESULTS We evaluated the efficacy of existing wound care therapies from classical methods to modern concepts, and wound care products to regenerative medicine that uses a patient's pluripotent stem cells and growth factors. Regenerative medicine and stem cell therapies, biologic dressings and scaffolds, negative pressure wound therapy (NPWT), electrical stimulation, topical growth factors and cytokines, hyperbaric oxygen therapy (HBOT), advanced wound dressings, artificial intelligence (AI), and digital wound management are all part of the new arsenal of wound healing. CONCLUSION Periodic medical evaluation and proper use of modern wound care therapies, including the use of plasma-derived products [such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF)] combined with proper systemic support (adequate protein levels, blood sugar, vitamins involved in tissue regeneration, etc.) are the key to a faster wound healing, and, with the help of AI, can reach the fastest healing rate possible.
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Affiliation(s)
- Valentin Popescu
- General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania; (V.P.); (M.S.P.); (A.M.L.); (B.M.)
- General Surgery Department, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (M.M.R.); (R.B.); (C.R.T.); (H.D.); (T.P.)
| | - Victor Cauni
- Urology Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania;
| | - Marius Septimiu Petrutescu
- General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania; (V.P.); (M.S.P.); (A.M.L.); (B.M.)
| | - Maria Madalina Rustin
- General Surgery Department, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (M.M.R.); (R.B.); (C.R.T.); (H.D.); (T.P.)
| | - Raluca Bocai
- General Surgery Department, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (M.M.R.); (R.B.); (C.R.T.); (H.D.); (T.P.)
| | - Cristina Rachila Turculet
- General Surgery Department, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (M.M.R.); (R.B.); (C.R.T.); (H.D.); (T.P.)
| | - Horia Doran
- General Surgery Department, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (M.M.R.); (R.B.); (C.R.T.); (H.D.); (T.P.)
- Prof. I. Juvara General Surgery Clinic, Dr. I. Cantacuzino Clinical Hospital, 011437 Bucharest, Romania
| | - Traian Patrascu
- General Surgery Department, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (M.M.R.); (R.B.); (C.R.T.); (H.D.); (T.P.)
- Prof. I. Juvara General Surgery Clinic, Dr. I. Cantacuzino Clinical Hospital, 011437 Bucharest, Romania
| | - Angela Madalina Lazar
- General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania; (V.P.); (M.S.P.); (A.M.L.); (B.M.)
- General Surgery Department, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (M.M.R.); (R.B.); (C.R.T.); (H.D.); (T.P.)
| | - Dragos Cretoiu
- Fetal Medicine Excellence Research Center, Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania
- Department of Genetics, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania
| | - Valentin Nicolae Varlas
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
- Department of Obstetrics and Gynaecology, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu St., 020021 Bucharest, Romania
| | - Bogdan Mastalier
- General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania; (V.P.); (M.S.P.); (A.M.L.); (B.M.)
- General Surgery Department, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (M.M.R.); (R.B.); (C.R.T.); (H.D.); (T.P.)
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Berger AG, Deiss-Yehiely E, Vo C, McCoy MG, Almofty S, Feinberg MW, Hammond PT. Electrostatically assembled wound dressings deliver pro-angiogenic anti-miRs preferentially to endothelial cells. Biomaterials 2023; 300:122188. [PMID: 37329684 PMCID: PMC10424785 DOI: 10.1016/j.biomaterials.2023.122188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 06/19/2023]
Abstract
Chronic non-healing wounds occur frequently in individuals affected by diabetes, yet standard-of-care treatment leaves many patients inadequately treated or with recurring wounds. MicroRNA (miR) expression is dysregulated in diabetic wounds and drives an anti-angiogenic phenotype, but miRs can be inhibited with short, chemically-modified RNA oligonucleotides (anti-miRs). Clinical translation of anti-miRs is hindered by delivery challenges such as rapid clearance and uptake by off-target cells, requiring repeated injections, excessively large doses, and bolus dosing mismatched to the dynamics of the wound healing process. To address these limitations, we engineered electrostatically assembled wound dressings that locally release anti-miR-92a, as miR-92a is implicated in angiogenesis and wound repair. In vitro, anti-miR-92a released from these dressings was taken up by cells and inhibited its target. An in vivo cellular biodistribution study in murine diabetic wounds revealed that endothelial cells, which play a critical role in angiogenesis, exhibit higher uptake of anti-miR eluted from coated dressings than other cell types involved in the wound healing process. In a proof-of-concept efficacy study in the same wound model, anti-miR targeting anti-angiogenic miR-92a de-repressed target genes, increased gross wound closure, and induced a sex-dependent increase in vascularization. Overall, this proof-of-concept study demonstrates a facile, translational materials approach for modulating gene expression in ulcer endothelial cells to promote angiogenesis and wound healing. Furthermore, we highlight the importance of probing cellular interactions between the drug delivery system and the target cells to drive therapeutic efficacy.
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Affiliation(s)
- Adam G Berger
- Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA; Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Institute for Soldier Nanotechnologies, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Elad Deiss-Yehiely
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Chau Vo
- Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA; Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Institute for Soldier Nanotechnologies, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Michael G McCoy
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sarah Almofty
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, 31441, Saudi Arabia
| | - Mark W Feinberg
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Paula T Hammond
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Institute for Soldier Nanotechnologies, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
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Sawaya AP, Vecin NM, Burgess JL, Ojeh N, DiBartolomeo G, Stone RC, Pastar I, Tomic-Canic M. Calreticulin: a multifunctional protein with potential therapeutic applications for chronic wounds. Front Med (Lausanne) 2023; 10:1207538. [PMID: 37692787 PMCID: PMC10484228 DOI: 10.3389/fmed.2023.1207538] [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: 04/17/2023] [Accepted: 08/07/2023] [Indexed: 09/12/2023] Open
Abstract
Calreticulin is recognized as a multifunctional protein that serves an essential role in diverse biological processes that include wound healing, modification and folding of proteins, regulation of the secretory pathway, cell motility, cellular metabolism, protein synthesis, regulation of gene expression, cell cycle regulation and apoptosis. Although the role of calreticulin as an endoplasmic reticulum-chaperone protein has been well described, several studies have demonstrated calreticulin to be a highly versatile protein with an essential role during wound healing. These features make it an ideal molecule for treating a complex, multifactorial diseases that require fine tuning, such as chronic wounds. Indeed, topical application of recombinant calreticulin to wounds in multiple models of wound healing has demonstrated remarkable pro-healing effects. Among them include enhanced keratinocyte and fibroblast migration and proliferation, induction of extracellular matrix proteins, recruitment of macrophages along with increased granulation tissue formation, all of which are important functions in promoting wound healing that are deregulated in chronic wounds. Given the high degree of diverse functions and pro-healing effects, application of exogenous calreticulin warrants further investigation as a potential novel therapeutic option for chronic wound patients. Here, we review and highlight the significant effects of topical application of calreticulin on enhancing wound healing and its potential as a novel therapeutic option to shift chronic wounds into healing, acute-like wounds.
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Affiliation(s)
- Andrew P. Sawaya
- Wound Healing and Regenerative Medicine Research Program, Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Nicole M. Vecin
- Wound Healing and Regenerative Medicine Research Program, Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Jamie L. Burgess
- Wound Healing and Regenerative Medicine Research Program, Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Nkemcho Ojeh
- Wound Healing and Regenerative Medicine Research Program, Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
- Faculty of Medical Sciences, The University of the West Indies, Bridgetown, Barbados
| | - Gabrielle DiBartolomeo
- Wound Healing and Regenerative Medicine Research Program, Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Rivka C. Stone
- Wound Healing and Regenerative Medicine Research Program, Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Irena Pastar
- Wound Healing and Regenerative Medicine Research Program, Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Marjana Tomic-Canic
- Wound Healing and Regenerative Medicine Research Program, Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
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Charoenlux P, Utoomprurkporn N, Seresirikachorn K. Cyanoacrylate Tissue Adhesives Compared With Sutures on Facial and Neck Wounds: A Meta-analysis. OTO Open 2023; 7:e73. [PMID: 37693830 PMCID: PMC10487314 DOI: 10.1002/oto2.73] [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: 05/31/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Objective To compare the effectiveness between cyanoacrylate tissue adhesives (CTAs) and sutures for skin closure on the face and neck. Data Sources Embase, Medline, Scopus, Central, Web of Science. Review Methods Randomized controlled trials comparing CTAs versus sutures for skin closure on the face and neck were included. Primary outcomes were cosmetic outcomes. Secondary outcomes were scar depth, scar width, pain, closure time, cost, and adverse events. Subgroup analyses were performed by wound locations, type of CTAs, type of sutures, age groups, and type of wounds. Physicians and patients evaluated the cosmetic outcomes. Results Eighteen studies (1020 patients) were included. CTAs offered better cosmetic outcomes by Wound Registry Scale at ≤1 month (physician: mean difference [MD]: -1.50, 95% confidence interval, CI: -2.42 to -0.58). The cosmetic outcomes assessed by Visual Analog Scale were comparable at >1 to ≤3 months (physicians: standard mean difference [SMD], -0.01, 95% CI, -0.25 to 0.23, patients: SMD, -0.02, 95% CI, -0.84 to 0.79). The cosmetic outcomes by the Patient and Observer Scar Assessment Scale favored sutures at >3 to 12 months (physician: MD 4.26, 95% CI, 2.02-6.50). Subgroup analyses revealed no differences. CTAs offered less scar depth, scar width, pain, closure time, and total cost of closure. Adverse events were similar. Conclusion Based on the wound healing process, the cosmetic outcomes exhibited a favorable inclination toward CTAs at <1 month while demonstrating comparable results between CTAs and sutures at >1 to ≤3 months. Subsequently, sutures exhibited superior cosmetic outcomes compared to CTAs at >3 to 12 months.
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Affiliation(s)
- Prapitphan Charoenlux
- Department of OtolaryngologyFaculty of Medicine, Chulalongkorn UniversityBangkokThailand
| | - Nattawan Utoomprurkporn
- Department of OtolaryngologyFaculty of Medicine, Chulalongkorn UniversityBangkokThailand
- Faculty of Brain Science, UCL Ear InstituteUniversity College LondonLondonUK
| | - Kachorn Seresirikachorn
- Department of OtolaryngologyFaculty of Medicine, Chulalongkorn UniversityBangkokThailand
- Endoscopic Nasal and Sinus Surgery Excellence CenterKing Chulalongkorn Memorial HospitalBangkokThailand
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Lan Z, Kar R, Chwatko M, Shoga E, Cosgriff-Hernandez E. High porosity PEG-based hydrogel foams with self-tuning moisture balance as chronic wound dressings. J Biomed Mater Res A 2023; 111:465-477. [PMID: 36606332 DOI: 10.1002/jbm.a.37498] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/21/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023]
Abstract
A major challenge in chronic wound treatment is maintaining an appropriate wound moisture balance throughout the healing process. Wound dehydration hinders wound healing due to impeded molecule transport and cell migration with associated tissue necrosis. In contrast, wounds that produce excess fluid contain high levels of reactive oxygen species and matrix metalloproteases that impede cell recruitment, extracellular matrix reconstruction, and angiogenesis. Dressings are currently selected based on the relative amount of wound exudate with no universal dressing available that can maintain appropriate wound moisture balance to enhance healing. This work aimed to develop a high porosity poly(ethylene glycol) diacrylate hydrogel foam that can both rapidly remove exudate and provide self-tuning moisture control to prevent wound dehydration. A custom foaming device was used to vary hydrogel foam porosity from 25% to 75% by adjusting the initial air-to-solution volume ratio. Hydrogel foams demonstrated substantial improvements in water uptake volume and rate as compared to bulk hydrogels while maintaining similar hydration benefits with slow dehydration rates. The hydrogel foam with the highest porosity (~75%) demonstrated the greatest water uptake and rate, which outperformed commercial dressing products, Curafoam® and Silvercel®, in water absorption, moisture retention, and exudate management. Investigation of the water vapor transmission rates of each dressing at varied hydration levels was characterized and demonstrated the dynamic moisture-controlling capability of the hydrogel foam dressing. Overall, the self-tuning moisture control of this hydrogel foam dressing holds great promise to improve healing outcomes for both dry and exudative chronic wounds.
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Affiliation(s)
- Ziyang Lan
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas, USA
| | - Ronit Kar
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas, USA
| | - Malgorzata Chwatko
- Department of Chemical and Materials Engineering, University of Kentucky, Lexington, Kentucky, USA
| | - Erik Shoga
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas, USA
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Obesity and Wound Healing: Focus on Mesenchymal Stem Cells. Life (Basel) 2023; 13:life13030717. [PMID: 36983872 PMCID: PMC10059997 DOI: 10.3390/life13030717] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/20/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023] Open
Abstract
Chronic wounds represent nowadays a major challenge for both clinicians and researchers in the regenerative setting. Obesity represents one of the major comorbidities in patients affected by chronic ulcers and therefore diverse studies aimed at assessing possible links between these two morbid conditions are currently ongoing. In particular, adipose tissue has recently been described as having metabolic and endocrine functions rather than serving as a mere fat storage deposit. In this setting, adipose-derived stem cells, a peculiar subset of mesenchymal stromal/stem cells (MSCs) located in adipose tissue, have been demonstrated to possess regenerative and immunological functions with a key role in regulating both adipocyte function and skin regeneration. The aim of the present review is to give an overview of the most recent findings on wound healing, with a special focus on adipose tissue biology and obesity.
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22
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Liu Z, Agu E, Pedersen P, Lindsay C, Tulu B, Strong D. Chronic Wound Image Augmentation and Assessment Using Semi-Supervised Progressive Multi-Granularity EfficientNet. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2023; 5:404-420. [PMID: 38899014 PMCID: PMC11186650 DOI: 10.1109/ojemb.2023.3248307] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/06/2023] [Accepted: 02/20/2023] [Indexed: 06/21/2024] Open
Abstract
Goal: Augment a small, imbalanced, wound dataset by using semi-supervised learning with a secondary dataset. Then utilize the augmented wound dataset for deep learning-based wound assessment. Methods: The clinically-validated Photographic Wound Assessment Tool (PWAT) scores eight wound attributes: Size, Depth, Necrotic Tissue Type, Necrotic Tissue Amount, Granulation Tissue type, Granulation Tissue Amount, Edges, Periulcer Skin Viability to comprehensively assess chronic wound images. A small corpus of 1639 wound images labeled with ground truth PWAT scores was used as reference. A Semi-Supervised learning and Progressive Multi-Granularity training mechanism were used to leverage a secondary corpus of 9870 unlabeled wound images. Wound scoring utilized the EfficientNet Convolutional Neural Network on the augmented wound corpus. Results: Our proposed Semi-Supervised PMG EfficientNet (SS-PMG-EfficientNet) approach estimated all 8 PWAT sub-scores with classification accuracies and F1 scores of about 90% on average, and outperformed a comprehensive list of baseline models and had a 7% improvement over the prior state-of-the-art (without data augmentation). We also demonstrate that synthetic wound image generation using Generative Adversarial Networks (GANs) did not improve wound assessment. Conclusions: Semi-supervised learning on unlabeled wound images in a secondary dataset achieved impressive performance for deep learning-based wound grading.
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Affiliation(s)
- Ziyang Liu
- Computer Science DepartmentWorcester Polytechnic InstituteWorcesterMA01609USA
| | - Emmanuel Agu
- Computer Science DepartmentWorcester Polytechnic InstituteWorcesterMA01609USA
| | - Peder Pedersen
- Electrical and Computer Engineering DepartmentWorcester Polytechnic InstituteWorcesterMA01609USA
| | - Clifford Lindsay
- Department of RadiologyUniversity of Massachusetts Medical SchoolWorcesterMA01609USA
| | - Bengisu Tulu
- Foisie Business SchoolWorcester Polytechnic InstituteWorcesterMA01609USA
| | - Diane Strong
- Foisie Business SchoolWorcester Polytechnic InstituteWorcesterMA01609USA
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Smythe P, Wilkinson HN. The Skin Microbiome: Current Landscape and Future Opportunities. Int J Mol Sci 2023; 24:ijms24043950. [PMID: 36835363 PMCID: PMC9963692 DOI: 10.3390/ijms24043950] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/11/2023] [Accepted: 02/12/2023] [Indexed: 02/18/2023] Open
Abstract
Our skin is the largest organ of the body, serving as an important barrier against the harsh extrinsic environment. Alongside preventing desiccation, chemical damage and hypothermia, this barrier protects the body from invading pathogens through a sophisticated innate immune response and co-adapted consortium of commensal microorganisms, collectively termed the microbiota. These microorganisms inhabit distinct biogeographical regions dictated by skin physiology. Thus, it follows that perturbations to normal skin homeostasis, as occurs with ageing, diabetes and skin disease, can cause microbial dysbiosis and increase infection risk. In this review, we discuss emerging concepts in skin microbiome research, highlighting pertinent links between skin ageing, the microbiome and cutaneous repair. Moreover, we address gaps in current knowledge and highlight key areas requiring further exploration. Future advances in this field could revolutionise the way we treat microbial dysbiosis associated with skin ageing and other pathologies.
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Affiliation(s)
- Paisleigh Smythe
- Centre for Biomedicine, Hull York Medical School, University of Hull, Hull HU6 7RX, UK
- Skin Research Centre, Hull York Medical School, University of York, York YO10 5DD, UK
| | - Holly N. Wilkinson
- Centre for Biomedicine, Hull York Medical School, University of Hull, Hull HU6 7RX, UK
- Skin Research Centre, Hull York Medical School, University of York, York YO10 5DD, UK
- Correspondence:
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Razack SA, Lee Y, Shin H, Duraiarasan S, Chun BS, Kang HW. Cellulose nanofibrils reinforced chitosan-gelatin based hydrogel loaded with nanoemulsion of oregano essential oil for diabetic wound healing assisted by low level laser therapy. Int J Biol Macromol 2023; 226:220-239. [PMID: 36509199 DOI: 10.1016/j.ijbiomac.2022.12.003] [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: 09/19/2022] [Revised: 11/27/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022]
Abstract
Diabetic foot ulcers are imperfections in the process of wound healing due to hyperglycemic conditions. Here, a nanoemulgel fabricated with oregano essential oil nanoemulsion, assisted by low-level laser therapy, was investigated for its efficacy in diabetic wound healing. A hydrogel- based healing patch, fabricated using biological polymers namely chitosan and gelatin and, polyvinyl pyrollidone. The hydrogel was reinforced with cellulose nanofibrils for enhanced stability and barrier properties. Nanoemulsion of oregano essential oil, with an average particle size of 293.7 ± 8.3 nm, was prepared via homogenization with chitosan as the coating agent. Nanoemulsion impregnated hydrogel, termed as the nanoemulgel, was assessed for its physio-mechanical properties and healing efficiency. The strong linkages in nanoemulgel demonstrated its large swelling capacity, high mechanical strength, and maximum thermal stability. The optimized conditions for low-level laser therapy using 808 nm were 1 W. cm-2 and 5 min. The optimized drug concentration of 128 μg. mL-1 exhibited viability of NIH/3 T3 fibroblasts as 75.5 ± 1.2 % after 24 h. Cell migration assay demonstrated that dual therapy facilitated wound healing, with a maximum closure rate of 100 % at 48 h. In vivo results revealed the rapid healing effects of the dual therapy in diabetic rat models with foot ulcers: a maximum healing rate of 97.5 %, minimum scar formation, increased granulation, enhanced reepithelialization, and a drastic decrease in inflammation and neutrophil infiltration within the treatment period compared to monotherapy and control. In summary, the combinatorial therapy of nanoemulgel and low-level laser therapy is a promising regimen for managing diabetic foot ulcers with a rapid healing effect.
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Affiliation(s)
- Sirajunnisa Abdul Razack
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan, Republic of Korea
| | - Yeachan Lee
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan, Republic of Korea; Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
| | - Hwarang Shin
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan, Republic of Korea
| | | | - Byung-Soo Chun
- Institute of Food Science, Pukyong National University, Busan, Republic of Korea; Department of Food Science and Technology, Pukyong National University, Busan, Republic of Korea
| | - Hyun Wook Kang
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan, Republic of Korea; Major of Biomedical Engineering, Division of Smart Healthcare, College of Information, Pukyong National University, Busan, Republic of Korea.
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Othman EM, Hamada HA, Mohamed GI, Abdallah GA, Ahmed ZS, Al-Shenqiti AM, Kadry AM. Clinical and histopathological responses to bee venom phonophoresis in treating venous and diabetic ulcers: a single-blind randomized controlled trial. Front Med (Lausanne) 2023; 10:1085544. [PMID: 37153087 PMCID: PMC10157245 DOI: 10.3389/fmed.2023.1085544] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/21/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction Chronic venous and diabetic ulcers are hard to treat that cause patients long time of suffering as well as significant healthcare and financial costs. Purpose The conducted study was to evaluate the efficacy of bee venom (BV) phonophoresis on the healing of chronic unhealed venous and/or diabetic foot ulcers Also, to compare the healing rate of diabetic and venous ulcers. Methodology The study included 100 patients (71 males and 29 females) with an age range of 40-60 years' old who had chronic unhealed venous leg ulcers of grade I, grade II, or diabetic foot ulcers with type II diabetes mellitus. They randomly assigned into four equal groups of 25: Group A (diabetic foot ulcer study group) and group C (venous ulcer study group) who both received conservative treatment of medical ulcer care and phonophoresis with BV gel, in addition to group B (diabetic foot ulcer control group) and group D (venous ulcer control group) who both received conservative treatment of medical ulcer care and received ultrasound sessions only without BV gel. Wound surface area (WSA) and ulcer volume measurement (UVM) were used to assess the ulcer healing pre-application (P0), post-6 weeks of treatment (P1), and after 12 weeks of treatment (P2). In addition to Ki-67 immunohistochemistry was used to evaluate the cell proliferative in the granulation tissue of ulcers pre-application (P0) and after 12 weeks of treatment (P2) for all groups. Results This research revealed a statistical significance improvement (p ≤ 0.0) in the WSA, and UVM with no significant difference between study groups after treatment. Regarding Ki-67 immunohistochemistry showed higher post treatment values in the venous ulcer group in comparison to the diabetic foot ulcer group. Conclusion Bee venom (BV) provided by phonophoresis is effective adjuvant treatment in accelerating venous and diabetic foot ulcer healing with higher proliferative effect on venous ulcer. Clinical trial registration www.ClinicalTrials.gov, identifier: NCT05285930.
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Affiliation(s)
- Eman M. Othman
- Department for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Hamada Ahmed Hamada
- Department for Biomechanics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Ghada I. Mohamed
- Department of Basic Science, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Ghada A. Abdallah
- Department of Basic Science, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Zeinab S. Ahmed
- Department of Cardiovascular, Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | | | - Ahmed Mahmoud Kadry
- Faculty of Physical Therapy, Kafrelsheikh University, Kafr el-Sheikh, Egypt
- *Correspondence: Ahmed Mahmoud Kadry
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Carter MJ, DaVanzo J, Haught R, Nusgart M, Cartwright D, Fife CE. Chronic wound prevalence and the associated cost of treatment in Medicare beneficiaries: changes between 2014 and 2019. J Med Econ 2023; 26:894-901. [PMID: 37415496 DOI: 10.1080/13696998.2023.2232256] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE To determine the cost of wound care and prevalence of chronic wounds for Medicare beneficiaries in the aggregate, by wound type, and by setting between the years 2014 and 2019. METHODS This retrospective analysis of Medicare claims data included beneficiaries who experienced episodes of care for diabetic foot ulcers and infections; arterial ulcers; skin disorders and infections; surgical wounds and infections; traumatic wounds; venous ulcers and infections; unspecified chronic ulcers; and others. The 2014 data were based on a Medicare 5% Limited Data Set whereas for 2019 the data used were for all fee-for-service Medicare beneficiaries. Three methods were used to generate expenditure estimates: (a) a low (Medicare provider payments when the wound was a primary diagnosis, excluding any kind of deductible); (b) mid (primary plus secondary diagnosis with weighted attribution); and (c) high (primary or secondary diagnosis). The main outcomes were the prevalence of each wound type, Medicare expenditure for each wound type and aggregate, and expenditure by type of service. RESULTS Over the 5-year period the number of Medicare beneficiaries with a wound increased from 8.2 million to 10.5 million. Wound prevalence increased by 13% from 14.5% to 16.4%. Over the 5-year period, the Medicare beneficiaries with the largest increase in chronic wound prevalence were those aged <65 years (males: 12.5% to 16.3%; females: 13.4% to 17.5%). The largest changes in terms of wound prevalence were increases in arterial ulcers (0.4% to 0.8%), skin disorders (2.6% to 5.3%), and decreases in traumatic wounds (2.7% to 1.6%). Expenditures decreased regardless of the three methods used with a reduction of $29.7 billion to $22.5 billion for the most conservative method. Except for venous ulcers in which costs per Medicare beneficiary increased from $1206 to $1803, cost per wound decreased with surgical wounds remaining the most expensive to treat (2014: $3566; 2019: $2504), and the largest decrease for arterial ulcers ($9651 to $1322). Hospital outpatient fees saw the largest reduction ($10.5 billion to $2.5 billion) although home health agency expenditures decreased from $1.6 billion to $1.1 billion. Physician offices saw an increase from $3.0 billion to $4.1 billion and durable medical equipment increased from $0.3 billion to $0.7 billion. CONCLUSIONS It appears that chronic wound care expenditures have shifted to the physician's office from the hospital-based outpatient department. Given that the prevalence of chronic wounds is increasing, especially among the disabled under 65, it will be important to know whether these shifts have positively or negatively affected outcomes.
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Affiliation(s)
| | - Joan DaVanzo
- Dobson DaVanzo & Associates LLC, Vienna, VA, USA
| | | | | | | | - Caroline E Fife
- Baylor College of Medicine, Houston, TX, USA
- The US Wound Registry, TX, USA
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Wound healing approach based on excretory-secretory product and lysate of liver flukes. Sci Rep 2022; 12:21639. [PMID: 36517588 PMCID: PMC9751068 DOI: 10.1038/s41598-022-26275-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Exogenous bioactive peptides are considered promising for the wound healing therapy in humans. In this regard, parasitic trematodes proteins may potentially become a new perspective agents. Foodborne trematode Opisthorchis felineus is widespread in Europe and has the ability to stimulate proliferation of bile duct epithelium. In this study, we investigated skin wound healing potential of O. felineus proteins in mouse model. C57Bl/6 mice were inflicted with superficial wounds with 8 mm diameter. Experimental groups included several non-specific controls and specific treatment groups (excretory-secretory product and lysate). After 10 days of the experiment, the percentage of wound healing in the specific treatment groups significantly exceeded the control values. We also found that wound treatment with excretory-secretory product and worm lysate resulted in: (i) inflammation reducing, (ii) vascular response modulating, (iii) type 1 collagen deposition promoting dermal ECM remodeling. An additional proteomic analysis of excretory-secretory product and worm lysate samples was revealed 111 common proteins. The obtained data indicate a high wound-healing potential of liver fluke proteins and open prospects for further research as new therapeutic approaches.
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Role of Senescent Cells in Cutaneous Wound Healing. BIOLOGY 2022; 11:biology11121731. [PMID: 36552241 PMCID: PMC9775319 DOI: 10.3390/biology11121731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 11/30/2022]
Abstract
Cellular senescence has gained increasing attention in the field of aging research. Senescent cells have been implicated in biological aging processes, tumorigenesis, development, and wound repair amongst other processes and pathologies. Recent findings reveal that senescent cells can both promote and inhibit cutaneous wound healing processes. Relating senescent cells in acute and chronic wounds will help to clarify their role in wound healing processes and inform our understanding of senescent cell heterogeneity. To clarify this apparent contradiction and guide future research and therapeutic development, we will review the rapidly growing field of cellular senescence and its role in wound healing biology.
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Liu Z, John J, Agu E. Diabetic Foot Ulcer Ischemia and Infection Classification Using EfficientNet Deep Learning Models. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2022; 3:189-201. [PMID: 36660100 PMCID: PMC9842228 DOI: 10.1109/ojemb.2022.3219725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/05/2022] [Accepted: 10/23/2022] [Indexed: 11/23/2022] Open
Abstract
Motivation: Infection (bacteria in the wound) and ischemia (insufficient blood supply) in Diabetic Foot Ulcers (DFUs) increase the risk of limb amputation. Goal: To develop an image-based DFU infection and ischemia detection system that uses deep learning. Methods: The DFU dataset was augmented using geometric and color image operations, after which binary infection and ischemia classification was done using the EfficientNet deep learning model and a comprehensive set of baselines. Results: The EfficientNets model achieved 99% accuracy in ischemia classification and 98% in infection classification, outperforming ResNet and Inception (87% accuracy) and Ensemble CNN, the prior state of the art (Classification accuracy of 90% for ischemia 73% for infection). EfficientNets also classified test images in a fraction (10% to 50%) of the time taken by baseline models. Conclusions: This work demonstrates that EfficientNets is a viable deep learning model for infection and ischemia classification.
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Affiliation(s)
- Ziyang Liu
- Computer Science DepartmentWorcester Polytechnic InstituteWorcesterMA 01609USA
| | - Josvin John
- Computer Science DepartmentWorcester Polytechnic InstituteWorcesterMA 01609USA
| | - Emmanuel Agu
- Computer Science DepartmentWorcester Polytechnic InstituteWorcesterMA 01609USA
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Bousset L, Gil J. Targeting senescence as an anticancer therapy. Mol Oncol 2022; 16:3855-3880. [PMID: 36065138 PMCID: PMC9627790 DOI: 10.1002/1878-0261.13312] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/12/2022] [Accepted: 08/21/2022] [Indexed: 01/10/2023] Open
Abstract
Cellular senescence is a stress response elicited by different molecular insults. Senescence results in cell cycle exit and is characterised by multiple phenotypic changes such as the production of a bioactive secretome. Senescent cells accumulate during ageing and are present in cancerous and fibrotic lesions. Drugs that selectively kill senescent cells (senolytics) have shown great promise for the treatment of age-related diseases. Senescence plays paradoxical roles in cancer. Induction of senescence limits cancer progression and contributes to therapy success, but lingering senescent cells fuel progression, recurrence, and metastasis. In this review, we describe the intricate relation between senescence and cancer. Moreover, we enumerate how current anticancer therapies induce senescence in tumour cells and how senolytic agents could be deployed to complement anticancer therapies. "One-two punch" therapies aim to first induce senescence in the tumour followed by senolytic treatment to target newly exposed vulnerabilities in senescent tumour cells. "One-two punch" represents an emerging and promising new strategy in cancer treatment. Future challenges of "one-two punch" approaches include how to best monitor senescence in cancer patients to effectively survey their efficacy.
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Affiliation(s)
- Laura Bousset
- MRC London Institute of Medical Sciences (LMS)UK
- Faculty of Medicine, Institute of Clinical Sciences (ICS)Imperial College LondonUK
| | - Jesús Gil
- MRC London Institute of Medical Sciences (LMS)UK
- Faculty of Medicine, Institute of Clinical Sciences (ICS)Imperial College LondonUK
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31
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Munteanu AN, Surcel M, Isvoranu G, Constantin C, Neagu M. Healthy Ageing Reflected in Innate and Adaptive Immune Parameters. Clin Interv Aging 2022; 17:1513-1526. [PMID: 36247200 PMCID: PMC9555218 DOI: 10.2147/cia.s375926] [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: 05/23/2022] [Accepted: 09/06/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of the paper is to establish and quantify the relation between healthy ageing and the innate and adaptive immune parameters as indicators of age-related diseases. Patients In order to observe the immunological changes that occur according to age, several humoral and cellular immune parameters were investigated for 288 healthy donors (30-80 years). Subjects' selection was done using clinical, biochemical and immunological parameters of inclusion/exclusion criteria from SENIEUR protocol. Results Age-related changes were observed for both humoral and cellular immune parameters. Lymphocyte immunophenotyping revealed several significant differences in the distribution of cells, both intra- and inter-age groups, namely decreased values of T-CD3+, T-CD8+ and NK cells, and elevated values for T-CD4+, T-CD4+/T-CD8+ ratio and B cells. The percentages of unstimulated neutrophils that show basal oxidative activity and the intensity of this activity had an increasing tendency age-related. The percentage of N-Formyl-Methionyl-Leucyl-Phenylalanine stimulated neutrophils clearly decreases with age, and is associated with an increasing intensity of oxidative activity. Our data also have shown an increased percentage of oxidative neutrophils after phorbol 12-myristate 13-acetate stimulation and an elevated oxidative activity with age. Conclusion Overall healthy ageing is governed by some immune-related deregulations that account for immune exhaustion due to numerous developed immune processes during a life-time and the age-related diseases.
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Affiliation(s)
- Adriana Narcisa Munteanu
- Immunology Laboratory, Victor Babes National Institute of Pathology, Bucharest, 050096, Romania,Doctoral School of Biology, Faculty of Biology, University of Bucharest, Bucharest, 050095, Romania
| | - Mihaela Surcel
- Immunology Laboratory, Victor Babes National Institute of Pathology, Bucharest, 050096, Romania
| | - Gheorghița Isvoranu
- Immunology Laboratory, Victor Babes National Institute of Pathology, Bucharest, 050096, Romania
| | - Carolina Constantin
- Immunology Laboratory, Victor Babes National Institute of Pathology, Bucharest, 050096, Romania,Department of Pathology, Colentina University Hospital, Bucharest, 020125, Romania
| | - Monica Neagu
- Immunology Laboratory, Victor Babes National Institute of Pathology, Bucharest, 050096, Romania,Doctoral School of Biology, Faculty of Biology, University of Bucharest, Bucharest, 050095, Romania,Department of Pathology, Colentina University Hospital, Bucharest, 020125, Romania,Correspondence: Monica Neagu, Immunology Laboratory, Victor Babes National Institute of Pathology, 99-101 Splaiul Independentei, Bucharest, 050096, Romania, Tel/Fax +4021-3194528, Email
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Bhat MJ, Ayed HY, Alrasheed AM, Alghamdi MA, Alsaleh SS, Alrashid YM, Bin-fudhayl S. Public Knowledge About How Common Chronic Diseases Affect Wound Healing Postoperatively in Aseer Region. Cureus 2022; 14:e29790. [PMID: 36340557 PMCID: PMC9618290 DOI: 10.7759/cureus.29790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 11/10/2022] Open
Abstract
Background Wound healing has classically been described to occur in three phases, regardless of the mechanism of injury. These phases are the inflammatory, proliferative, and remodeling phases. Chronic diseases adversely affect the wound healing process, and more needs to be done for different policies, such as adjustment of drug therapy, diet, or behavior to help rapid wound healing. Diabetes, auto-immune diseases, obesity, malnutrition, cardiovascular disease, chronic renal disease, and cancers are the frequent co-morbidities affecting wound healing. Aim To assess the public knowledge about how common chronic diseases affect wound healing postoperatively in Aseer Region. Methodology A descriptive cross-sectional study targeting the general population living in the Aseer region for at least a year. Data were collected using a pre-structured electronic questionnaire initiated by the researchers after an intense literature review and experts’ consultation. The study questionnaire covered participants’ data, smoking and medical history, surgical history, and participant knowledge items. A questionnaire was used as a digital survey and distributed to all participants in a private and anonymous process. Results A total of 502 participants completed the study questionnaire. Participants' ages ranged from 18 to 60 years, with a mean age of 34.6 ± 12.9 years old. A total of 294 (58.6%) participants were males, and 341 (67.9%) were university graduates. Exact 430 (85.7%) know that Supervision and control of Diabetes Mellitus help in wound healing, 369 (73.5%) reported that Chronic diseases delay wound healing, and 449 (89.4%) think that commitment to therapeutic and preventive plans before and after any surgical procedure contributing in rapid wound healing for chronic diseases patients. As for the effect of chronic diseases on a surgical wound, 320 (63.7%) reported delayed wound healing, 241 (48%) knew it may increase the infection, and 186 (37.1%) reported it might Decrease blood supply to the site of a wound. Conclusions In conclusion, the study revealed that more than half of the population in Aseer regions were knowledgeable regarding the effect of chronic diseases on post-optative wound healing, especially for the benefit of a commitment to therapeutic and preventive plans before and after any surgical procedure.
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Dymarek R, Kuberka I, Rosińczuk J, Walewicz K, Taradaj J, Sopel M. The Immediate Clinical Effects Following a Single Radial Shock Wave Therapy in Pressure Ulcers: A Preliminary Randomized Controlled Trial of The SHOWN Project. Adv Wound Care (New Rochelle) 2022; 12:440-452. [PMID: 35996355 DOI: 10.1089/wound.2021.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Recent preliminary reports indicate that extracorporeal shock wave therapy (ESWT) might be useful for chronic wounds, especially venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs). However, there is limited evidence for the utility and safety of ESWT in pressure ulcers (PUs). Therefore, this randomized controlled trial (RCT) aimed to assess immediate planimetric and clinical effects following a single radial ESWT session in PUs. APPROACH A group of 40 patients with PUs was randomly assigned into two groups: active ESWT (n=20), which underwent a single treatment with radial ESWT (300+100 impulses per 1 cm2, 2.5 bars, 0.15 mJ/mm2, and 5 Hz) and placebo ESWT (n=20) which was exposed to sham-radial ESWT. All patients continued standard wound care procedures. The planimetric assessment and clinical outcomes using Wound Bed Score (WBS) and Bates-Jansen Wound Assessment Tool (BWAT) were assessed before (M0) and after ESWT sessions (M1). RESULTS There was a significant planimetric enhancement observed after active ESWT reported as a reduction in all metric parameters: wound area from 11.51 cm2 to 8.09 cm2 (p<0.001), wound length from 4.97 cm to 4.41 cm (p<0.001), and wound width from 3.15 cm to 2.49 cm (p<0.0001). Also, there was a significant beneficial clinical improvement observed with a WBS as an increased score from 3.85 to 9.65 points (p<0.001) and with the BWAT as a decreased score from 45.45 to 30.70 points (p<0.001). In turn, a regression in the placebo ESWT group was observed in all studied outcomes. INNOVATION This study is the first RCT to provide the positive and immediate clinical effects of radial ESWT in promoting the healing of PUs. CONCLUSION This preliminary RCT showed that even a single session of ESWT is a promising and clinically effective modality in managing PUs. However, there is still limited data regarding the usefulness of ESWT in PUs, and further studies are in demand.
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Affiliation(s)
- Robert Dymarek
- Wroclaw Medical University, Department of Physiotherapy, Wroclaw, Poland;
| | - Izabela Kuberka
- Wroclaw Medical University, Division of Anaesthetic and Surgical Nursing, Wroclaw, Poland;
| | - Joanna Rosińczuk
- Wroclaw Medical University, Division of Internal Medicine Nursing, Wroclaw, Poland;
| | | | - Jakub Taradaj
- Jerzy Kukuczka Academy of Physical Education In Katowice, Institute of Physiotherapy and Health Sciences, Katowice, Poland;
| | - Mirosław Sopel
- Wroclaw Medical University, Department of Basic Sciences, Wroclaw, Poland;
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Wong W, Crane ED, Zhang H, Li J, Day TA, Green AE, Menzies KJ, Crane JD. Pgc-1α controls epidermal stem cell fate and skin repair by sustaining NAD + homeostasis during aging. Mol Metab 2022; 65:101575. [PMID: 35987498 PMCID: PMC9463389 DOI: 10.1016/j.molmet.2022.101575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/30/2022] [Accepted: 08/11/2022] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE The epidermal barrier is renewed by the activation, proliferation, and differentiation of keratinocyte stem cells after injury and aging impedes this repair process through undefined mechanisms. We previously identified a gene signature of metabolic dysfunction in aged murine epidermis, but the precise regulators of epidermal repair and age-related growth defects are not well established. Aged mouse models as well as mice with conditional epidermal loss of the metabolic regulator, peroxisome proliferator-activated receptor gamma coactivator-1 alpha (Pgc-1α) were used to explore the cellular pathways which control skin repair after injury and stress. METHODS Aged mice or those with epidermal Pgc-1α deletion (epiPgc-1α KO) and young or Pgc1afl/fl controls were subjected to wound injury, UVB exposure or the inflammatory agent TPA. In vivo and ex vivo analyses of wound closure, skin structure, cell growth and stem cell differentiation were used to understand changes in epidermal re-growth and repair resulting from aging or Pgc-1α loss. RESULTS Aging impairs epidermal re-growth during wound healing and results in lower expression of Pgc-1α. Mice with conditional deletion of epidermal Pgc-1α exhibit greater inflammation- and UVB-induced cell differentiation, reduced proliferation, and slower wound healing. epiPgc-1α KO mice also displayed reduced keratinocyte NAD+ levels, shorter telomeres, and greater poly ADP-ribosylation, resulting in enhanced stress-stimulated p53 and p21 signaling. When NAD+ was reduced by Pgc-1α loss or pharmacologic inhibition of NAD+ synthesis, there was reduced stress-induced proliferation, increased differentiation, and protection against DNA damage via enhanced epidermal shedding. Similarly, aged mice exhibit disrupted epidermal NAD+ homeostasis and enhanced p53 activation, resulting in p21 growth arrest after wounding. NAD+ precursor treatment restores epidermal growth from old skin to that of young. CONCLUSIONS Our studies identify a novel role for epidermal Pgc-1α in controlling epidermal repair via its regulation of cellular NAD+ and downstream effects on p53-driven growth arrest. We also establish that parallel mechanisms are evident in aged epidermis, showing that NAD+ signaling is an important controller of physiologic skin repair and that dysfunction of this pathway contributes to age-related wound repair defects.
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Affiliation(s)
- Wesley Wong
- Department of Biology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
| | - Elizabeth D Crane
- Department of Biology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
| | - Hui Zhang
- Department of Biology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
| | - Jiahe Li
- Department of Bioengineering, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
| | - Tovah A Day
- Department of Biology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
| | - Alex E Green
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Canada
| | - Keir J Menzies
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Canada
| | - Justin D Crane
- Department of Biology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA.
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Lin Y, Chen Z, Liu Y, Wang J, Lv W, Peng R. Recent Advances in Nano-Formulations for Skin Wound Repair Applications. Drug Des Devel Ther 2022; 16:2707-2728. [PMID: 35996567 PMCID: PMC9392552 DOI: 10.2147/dddt.s375541] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/27/2022] [Indexed: 11/23/2022] Open
Abstract
Skin injuries caused by accidents and acute or chronic diseases place a heavy burden on patients and health care systems. Current treatments mainly depend on preventing infection, debridement, and hemostasis and on supplementing growth factors, but patients will still have scar tissue proliferation or difficulty healing and other problems after treatment. Conventional treatment usually focuses on a single factor or process of wound repair and often ignores the influence of the wound pathological microenvironment on the final healing effect. Therefore, it is of substantial research value to develop multifunctional therapeutic methods that can actively regulate the wound microenvironment and reduce the oxidative stress level at the wound site to promote the repair of skin wounds. In recent years, various bioactive nanomaterials have shown great potential in tissue repair and regeneration due to their properties, including their unique surface interface effect, small size effect, enzyme activity and quantum effect. This review summarizes the mechanisms underlying skin wound repair and the defects in traditional treatment methods. We focus on analyzing the advantages of different types of nanomaterials and comment on their toxicity and side effects when used for skin wound repair.
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Affiliation(s)
- Yue Lin
- Department of Emergency, The Third Affiliated Hospital of Shanghai University & Wenzhou No. 3 Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People’s Hospital, Wenzhou, People’s Republic of China
| | - Zheyan Chen
- Department of Plastic Surgery, The Third Affiliated Hospital of Shanghai University & Wenzhou No. 3 Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People’s Hospital, Wenzhou, People’s Republic of China
| | - Yinai Liu
- Institute of Life Sciences, College of Life and Environmental Science, Wenzhou University, Wenzhou, People’s Republic of China
| | - Jiawen Wang
- Department of Plastic Surgery, The Third Affiliated Hospital of Shanghai University & Wenzhou No. 3 Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People’s Hospital, Wenzhou, People’s Republic of China
| | - Wang Lv
- Department of Emergency, The Third Affiliated Hospital of Shanghai University & Wenzhou No. 3 Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People’s Hospital, Wenzhou, People’s Republic of China
| | - Renyi Peng
- Institute of Life Sciences, College of Life and Environmental Science, Wenzhou University, Wenzhou, People’s Republic of China
- Correspondence: Renyi Peng, Tel +86 159-5771-6937, Email
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OLDER PATIENTS AND PATIENTS WITH SEVERE ARTERIOSCLEROSIS ARE LESS LIKELY TO DEVELOP KELOIDS AND HYPERTROPHIC SCARS AFTER THORACIC MIDLINE INCISION: A SURVEY-BASED ANALYSIS OF 328 CASES. Plast Reconstr Surg 2022; 150:659-669. [PMID: 35787599 DOI: 10.1097/prs.0000000000009451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Surgery is a well-known trigger of keloid and hypertrophic scarring. Sternotomy scars are subject to high skin tension, which is also known to promote pathological scarring. This suggests that sternotomies in adults associate with high pathological-scarring rates, which is also our anecdotal experience. However, this notion has never been formally examined. Therefore, we conducted a survey-based cohort study of patients who had undergone a sternotomy. STUDY DESIGN All consecutive Japanese adults (≥18 years) who underwent cardiovascular surgery with sternotomy in 2014-2017 were identified in 2019 by chart review and sent a questionnaire. Respondents formed the study cohort. The questionnaire presented randomly-ordered photos of representative mature, keloid, and hypertrophic scars and asked the patients to choose the image that best resembled their midline scar when it was particularly noticeable. The incidence of self-reported pathological scarring (keloids and hypertrophic scars were grouped together) and the patient demographic (age and sex) and clinical characteristics (e.g. intima media thickness of the left and right common and internal carotid arteries) that associated with pathological scarring were determined. RESULTS Of the 548 sternotomy patients, 328 (mean age, 67 years; 68.0% male) responded (60% response rate). Of these, 195 (59.5%) reported they had a pathological scar. Compared to mature-scar patients, pathological-scar patients had lower mean age (65 vs. 69 years, p=0.0002) and intima-media thickness (0.92 vs. 1.05 mm, p=0.028). CONCLUSION Sternotomy was associated with a high rate of pathological scarring. An older age and arteriosclerosis were associated with less pathological scarring.
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Lai J, Basford JR, Pittelkow MR. Levels of secretory leukocyte protease inhibitor expression in acute wounds. J Wound Care 2022; 31:S15-S19. [PMID: 35797252 DOI: 10.12968/jowc.2022.31.sup7.s15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Even with our best practices, we are frequently unable to prevent slow and stalled wound healing-particularly in people with impaired circulation and conditions such as diabetes. As a result, greater insight into the nature of wound healing and alternative treatment approaches is needed. An avenue that may be of particular promise is increasing understanding of the role of secretory leukocyte protease inhibitor (SLPI) as there is evidence that it enhances wound healing, its expression increases in response to inflammation and infection, and it exhibits anti-protease, anti-inflammatory, antiviral antibacterial and antifungal activities. METHOD The response of SLPI levels to wounding and skin injury was assessed by taking punch skin biopsies from healthy volunteers and assessing the levels of SLPI at the site of injury at the time of wounding (baseline) as well as one, two, three, four, seven, nine and 12 weeks later. RESULTS A total of 35 volunteers took part in the study. Significant elevations were found: levels of SLPI were greatly increased, 12 times that at baseline, and remained elevated at three weeks despite re-epithelialisation having occurred. CONCLUSION These findings not only suggest that levels of SLPI rise rapidly following wounding, but that these elevations are sustained, and continue to increase even when re-epithelialisation has occurred. These results suggest that the role and potential benefits of this protease inhibitor deserve further exploration.
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Affiliation(s)
- Jengyu Lai
- Department of Dermatology, Mayo Clinic College of Medicine, Rochester, MN, US.,International University of the Health Sciences, St Kitts, West Indies
| | - Jeffrey R Basford
- Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN, US
| | - Mark R Pittelkow
- Department of Dermatology, Mayo Clinic College of Medicine, Rochester, MN, US
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Parikh UM, Mentz J, Collier I, Davis MJ, Abu-Ghname A, Colchado D, Short WD, King A, Buchanan EP, Balaji S. Strategies to Minimize Surgical Scarring: Translation of Lessons Learned from Bedside to Bench and Back. Adv Wound Care (New Rochelle) 2022; 11:311-329. [PMID: 34416825 DOI: 10.1089/wound.2021.0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Significance: An understanding of the physiology of wound healing and scarring is necessary to minimize surgical scar formation. By reducing tension across the healing wound, eliminating excess inflammation and infection, and encouraging perfusion to healing areas, surgeons can support healing and minimize scarring. Recent Advances: Preoperatively, newer techniques focused on incision placement to minimize tension, skin sterilization to minimize infection and inflammation, and control of comorbid factors to promote a healing process with minimal scarring are constantly evolving. Intraoperatively, measures like layered closure, undermining, and tissue expansion can be taken to relieve tension across the healing wound. Appropriate suture technique and selection should be considered, and finally, there are new surgical technologies available to reduce tension across the closure. Postoperatively, the healing process can be supported as proliferation and remodeling take place within the wound. A balance of moisture control, tension reduction, and infection prevention can be achieved with dressings, ointments, and silicone. Vitamins and corticosteroids can also affect the scarring process by modulating the cellular factors involved in healing. Critical Issues: Healing with no or minimal scarring is the ultimate goal of wound healing research. Understanding how mechanical tension, inflammation and infection, and perfusion and hypoxia impact profibrotic pathways allows for the development of therapies that can modulate cytokine response and the wound extracellular microenvironment to reduce fibrosis and scarring. Future Directions: New tension-off loading topical treatments, laser, and dermabrasion devices are under development, and small molecule therapeutics have demonstrated scarless wound healing in animal models, providing a promising new direction for future research aimed to minimize surgical scarring.
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Affiliation(s)
- Umang M. Parikh
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - James Mentz
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Ian Collier
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Matthew J. Davis
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Amjed Abu-Ghname
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Daniel Colchado
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Walker D. Short
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Alice King
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Edward P. Buchanan
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Swathi Balaji
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
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Tie-Over Bolster Pressure Dressing Improves Outcomes of Skin Substitutes Xenografts on Athymic Mice. Int J Mol Sci 2022; 23:ijms23105507. [PMID: 35628318 PMCID: PMC9141235 DOI: 10.3390/ijms23105507] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/20/2022] [Accepted: 05/09/2022] [Indexed: 12/10/2022] Open
Abstract
The efficacy of skin substitutes is established for the treatment of burn injuries, but its use is not limited to this condition. This technology has the potential to improve the treatment of various conditions by offering highly advanced and personalized treatments. In vivo studies are challenging but essential to move to clinical use in humans. Mice are the most widely used species in preclinical studies, but the main drawback of this model is the limited surface area of the graft in long-term transplantation studies caused by the displacement and the contraction of the graft. We improved the conventional surgical procedures by stabilizing the chamber covering the graft with intramuscular sutures and by adding a tie-over bolster dressing. The current study was therefore performed to compare outcomes of skin grafts between the conventional and optimized skin graft model. Human self-assembled skin substitutes (SASSs) were prepared and grafted to athymic mice either by the conventional method or by the new grafting method. Graft healing and complications were assessed using digital photographs on postoperative days 7, 14, and 21. Similar structure and organization were observed by histological staining. The new grafting method reduced medium and large displacement events by 1.26-fold and medium and large contraction events by 1.8-fold, leading to a 1.6-fold increase in graft surface area compared to skin substitutes grafted with the usual method. This innovation ensures better reproducibility and consistency of skin substitute transplants on mice.
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Hurlow J, Bowler PG. Acute and chronic wound infections: microbiological, immunological, clinical and therapeutic distinctions. J Wound Care 2022; 31:436-445. [PMID: 35579319 DOI: 10.12968/jowc.2022.31.5.436] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Wound infection is a complex pathology that may manifest either as a rapid onset acute condition, or as a prolonged chronic condition. Although systemic antibiotic therapy is often appropriate and necessary for acute wound infections, it is often used inappropriately, excessively and unsuccessfully in chronic wound infections. Overuse of antibiotics in chronic (hard-to-heal) wound management contributes to antibiotic resistance. This literature review confirms that acute and chronic wound infections are significantly differentiated by their cause (microbial phenotype), the subsequent host immune response and by the resulting clinical manifestations. Consequently, recognition of the type of wound infection followed by appropriate and timely therapy is required to improve wound healing outcomes while encouraging more judicious and responsible use of antibiotics.
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Advanced drug delivery systems containing herbal components for wound healing. Int J Pharm 2022; 617:121617. [PMID: 35218900 DOI: 10.1016/j.ijpharm.2022.121617] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/12/2022] [Accepted: 02/21/2022] [Indexed: 12/18/2022]
Abstract
Management of chronic wound has an immense impact on social and economic conditions in the world. Healthcare costs, aging population, physical trauma, and comorbidities of diabetes and obesity seem to be the major factors of this increasing incidence of chronic wounds. Conditions of chronic wound could not restore functional epidermis; thus, delaying the closure of the wound opening in an expected manner. Failures in restoration of skin integrity delay healing due to changes in skin pathology, such as chronic ulceration or nonhealing. The role of different traditional medicines has been explored for use in the healing of cutaneous wounds, where several phytochemicals, such as flavonoids, alkaloids, phenolic acids, tannins are known to provide potential wound healing properties. However, the delivery of plant-based therapeutics could be improved by the novel platform of nanotechnology. Thus, the objectives of novel delivery strategies of principal bioactive from plant sources are to accelerate the wound healing process, avoid wound complications and enhance patient compliance. Therefore, the opportunities of nanotechnology-based drug delivery of natural wound healing therapeutics have been included in the present discussion with special emphasis on nanofibers, vesicular structures, nanoparticles, nanoemulsion, and nanogels.
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Lamotte S, Rappl A, Freiberger E, Sieber CC, Gehr TJ. [Functional status and quality of life of geriatric patients with wounds in acute hospitals : A comparison between patients with acute and chronic wounds: a cross-sectional study]. Z Gerontol Geriatr 2022; 55:32-37. [PMID: 34609632 PMCID: PMC8789624 DOI: 10.1007/s00391-021-01975-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/02/2021] [Indexed: 12/05/2022]
Abstract
BACKGROUND Geriatric patients are more predisposed to the occurrence of wounds due to age and disease, affecting functional status and quality of life. This aspect has rarely been researched in this population. OBJECTIVE The aim of this study was to investigate the influence of chronic (cW) and acute wounds (aW) on the objective functional status and wound-related subjective quality of life in hospitalized geriatric patients. METHODS In this exploratory cross-sectional analysis, data from 41 patients with wounds were examined. Patients were participating and recruited in the TIGER study (n = 244). Depending on the type of wound, patients were assigned to the aW (n = 19) or cW (n = 22) group. The two groups were compared in terms of physical function, hand strength, activities of daily living, depression, cognition, nutrition, quality of life (Wound-QoL) and sociodemographic data. RESULTS There was a significant difference between the aW and cW groups in terms of gender (p = 0.045) and living conditions (p = 0.047). The type of wound was associated with the Barthel index (p = 0.010) and the Wound-QoL (p = 0.022). CONCLUSION Compared to aW patients, cW patients were more limited in the physical and social dimensions and reported a lower quality of live. Living alone seems to play a relevant role. Among the patients of the TIGER study, men living alone were particularly more affected by cW. The care for these specific patients population should follow a holistic approach.
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Affiliation(s)
- Sylvie Lamotte
- Institut für Biomedizin des Alterns (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg, Deutschland
| | - Anja Rappl
- Institut für Medizininformatik, Biometrie und Epidemiologie (IMBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
| | - Ellen Freiberger
- Institut für Biomedizin des Alterns (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg, Deutschland
| | - Cornel Christian Sieber
- Institut für Biomedizin des Alterns (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg, Deutschland
- Klinik für Innere Medizin, Kantonsspital Winterthur, Winterthur, Schweiz
| | - Thomas Johann Gehr
- Institut für Biomedizin des Alterns (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg, Deutschland.
- Stabstelle Pflegeentwicklung, Pflegedirektion, Krankenhaus Barmherzige Brüder Regensburg, Prüfeninger Straße 86, 93049, Regensburg, Deutschland.
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Espaulella-Ferrer M, Espaulella-Panicot J, Noell-Boix R, Casals-Zorita M, Ferrer-Sola M, Puigoriol-Juvanteny E, Cullell-Dalmau M, Otero-Viñas M. Assessment of frailty in elderly patients attending a multidisciplinary wound care centre: a cohort study. BMC Geriatr 2021; 21:727. [PMID: 34922487 PMCID: PMC8684133 DOI: 10.1186/s12877-021-02676-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/25/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The incidence of frailty and non-healing wounds increases with patients' age. Knowledge of the relationship between frailty and wound healing progress is greatly lacking. METHODS The aim of this study is to characterize the degree of frailty in elderly patients attending a multidisciplinary wound care centres (MWCC). Additionally, we seek to assess the impact of frailty on the wound healing rate and wound healing time. An open cohort study was conducted on 51 consecutive patients aged > 70 years treated for wounds at an MWCC of an intermediate care hospital. The frailty score was determined according to the Frail-VIG index. Data were collected through patient questionnaires at the beginning of the study, and at 6 months or upon wound healing. Wounds were followed up every 2 weeks. To analyse the relationship between two variables was used the Chi-square test and Student's or the ANOVA model. The t-test for paired data was used to analyse the evolution of the frailty index during follow-up. RESULTS A total of 51 consecutive patients were included (aged 81.1 ± 6.1 years). Frailty prevalence was 74.5% according to the Frail-VIG index (47.1% mildly frail, 19.6% moderately frail, and 7.8% severely frail). Wounds healed in 69.6% of cases at 6 months. The frailty index (FI) was higher in patients with non-healing wounds in comparison with patients with healing wounds (IF 0.31 ± 0.15 vs IF 0.24 ± 0.11, p = 0.043). A strong correlation between FI and wound healing results was observed in patients with non-venous ulcers (FI 0.37 ± 0.13 vs FI 0.27 ± 0.10, p = 0.015). However, no correlation was observed in patients with venous ulcers (FI 0.17 ± 0.09 vs FI 0.19 ± 0.09, p = 0.637). Wound healing rate is statically significantly higher in non-frail patients (8.9% wound reduction/day, P25-P75 3.34-18.3%/day;AQ6 p = 0.044) in comparison with frail patients (3.26% wound reduction/day, P25-P75 0.8-8.8%/day). CONCLUSION Frailty is prevalent in elderly patients treated at an MWCC. Frailty degree is correlated with wound healing results and wound healing time.
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Affiliation(s)
- Mariona Espaulella-Ferrer
- Tissue Repair and Regeneration Laboratory (TR2Lab), Centre for Health and Social Care Research (CESS), University of Vic - Central University of Catalonia (UVIC-UCC), Fundació Hospital Universitari de la Santa Creu de Vic, and Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain.,Hospital Universitari de la Santa Creu de Vic, 08500, Vic, Barcelona, Spain
| | - Joan Espaulella-Panicot
- Hospital Universitari de la Santa Creu de Vic, 08500, Vic, Barcelona, Spain.,Central Catalonia Chronicity Research Group (C3RG), Fundació Hospital Universitari de la Santa Creu de Vic, and Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain
| | - Rosa Noell-Boix
- Hospital Universitari de la Santa Creu de Vic, 08500, Vic, Barcelona, Spain.,Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, Barcelona, 08500, Vic, Spain
| | - Marta Casals-Zorita
- Tissue Repair and Regeneration Laboratory (TR2Lab), Centre for Health and Social Care Research (CESS), University of Vic - Central University of Catalonia (UVIC-UCC), Fundació Hospital Universitari de la Santa Creu de Vic, and Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain.,Hospital Universitari de la Santa Creu de Vic, 08500, Vic, Barcelona, Spain
| | - Marta Ferrer-Sola
- Tissue Repair and Regeneration Laboratory (TR2Lab), Centre for Health and Social Care Research (CESS), University of Vic - Central University of Catalonia (UVIC-UCC), Fundació Hospital Universitari de la Santa Creu de Vic, and Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain.,Hospital Universitari de la Santa Creu de Vic, 08500, Vic, Barcelona, Spain
| | - Emma Puigoriol-Juvanteny
- Tissue Repair and Regeneration Laboratory (TR2Lab), Centre for Health and Social Care Research (CESS), University of Vic - Central University of Catalonia (UVIC-UCC), Fundació Hospital Universitari de la Santa Creu de Vic, and Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain.,Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain
| | - Marta Cullell-Dalmau
- Quantitative BioImaging (QuBI) Lab, University of Vic - Central University of Catalonia (UVIC-UCC), 08500, Vic, Barcelona, Spain.,Faculty of Sciences and Technology, University of Vic - Central University of Catalonia (UVIC-UCC), C. de la Laura, 13, 08500, Vic, Barcelona, Spain
| | - Marta Otero-Viñas
- Tissue Repair and Regeneration Laboratory (TR2Lab), Centre for Health and Social Care Research (CESS), University of Vic - Central University of Catalonia (UVIC-UCC), Fundació Hospital Universitari de la Santa Creu de Vic, and Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain. .,Faculty of Sciences and Technology, University of Vic - Central University of Catalonia (UVIC-UCC), C. de la Laura, 13, 08500, Vic, Barcelona, Spain.
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Tsai WH, Chou CH, Huang TY, Wang HL, Chien PJ, Chang WW, Lee HT. Heat-Killed Lactobacilli Preparations Promote Healing in the Experimental Cutaneous Wounds. Cells 2021; 10:3264. [PMID: 34831486 PMCID: PMC8625647 DOI: 10.3390/cells10113264] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/16/2021] [Accepted: 11/19/2021] [Indexed: 12/19/2022] Open
Abstract
Probiotics are defined as microorganisms with beneficial health effects when consumed by humans, being applied mainly to improve allergic or intestinal diseases. Due to the increasing resistance of pathogens to antibiotics, the abuse of antibiotics becomes inefficient in the skin and in systemic infections, and probiotics may also provide the protective effect for repairing the healing of infected cutaneous wounds. Here we selected two Lactobacillus strains, L. plantarum GMNL-6 and L. paracasei GMNL-653, in heat-killed format to examine the beneficial effect in skin wound repair through the selection by promoting collagen synthesis in Hs68 fibroblast cells. The coverage of gels containing heat-killed GMNL-6 or GMNL-653 on the mouse tail with experimental wounds displayed healing promoting effects with promoting of metalloproteinase-1 expression at the early phase and reduced excessive fibrosis accumulation and deposition in the later tail-skin recovery stage. More importantly, lipoteichoic acid, the major component of Lactobacillus cell wall, from GMNL-6/GMNL-653 could achieve the anti-fibrogenic benefit similar to the heat-killed bacteria cells in the TGF-β stimulated Hs68 fibroblast cell model. Our study offers a new therapeutic potential of the heat-killed format of Lactobacillus as an alternative approach to treating skin healing disorders.
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Affiliation(s)
- Wan-Hua Tsai
- Research and Development Department, GenMont Biotech Incorporation, Tainan 741014, Taiwan; (W.-H.T.); (C.-H.C.); (T.-Y.H.)
| | - Chia-Hsuan Chou
- Research and Development Department, GenMont Biotech Incorporation, Tainan 741014, Taiwan; (W.-H.T.); (C.-H.C.); (T.-Y.H.)
| | - Tsuei-Yin Huang
- Research and Development Department, GenMont Biotech Incorporation, Tainan 741014, Taiwan; (W.-H.T.); (C.-H.C.); (T.-Y.H.)
| | - Hui-Ling Wang
- School of Biomedical Sciences, Chung Shan Medical University, Taichung 402306, Taiwan; (H.-L.W.); (P.-J.C.)
| | - Peng-Ju Chien
- School of Biomedical Sciences, Chung Shan Medical University, Taichung 402306, Taiwan; (H.-L.W.); (P.-J.C.)
| | - Wen-Wei Chang
- School of Biomedical Sciences, Chung Shan Medical University, Taichung 402306, Taiwan; (H.-L.W.); (P.-J.C.)
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402306, Taiwan
| | - Hsueh-Te Lee
- Institute of Anatomy & Cell Biology, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Taiwan International Graduate Program in Molecular Medicine, National Yang Ming Chiao Tung University and Academia Sinica, Taipei 115024, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
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Pils V, Ring N, Valdivieso K, Lämmermann I, Gruber F, Schosserer M, Grillari J, Ogrodnik M. Promises and challenges of senolytics in skin regeneration, pathology and ageing. Mech Ageing Dev 2021; 200:111588. [PMID: 34678388 DOI: 10.1016/j.mad.2021.111588] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/11/2022]
Abstract
The research of the last two decades has defined a crucial role of cellular senescence in both the physiology and pathology of skin, and senescent cells have been detected in conditions including development, regeneration, aging, and disease. The pathophysiology of cellular senescence in skin is complex as the phenotype of senescence pertains to several different cell types including fibroblasts, keratinocytes and melanocytes, among others. Paradoxically, the transient presence of senescent cells is believed to be beneficial in the context of development and wound healing, while the chronic presence of senescent cells is detrimental in the context of aging, diseases, and chronic wounds, which afflict predominantly the elderly. Identifying strategies to prevent senescence induction or reduce senescent burden in the skin could broadly benefit the aging population. Senolytics, drugs known to specifically eliminate senescent cells while preserving non-senescent cells, are being intensively studied for use in the clinical setting. Here, we review recent research on skin senescence, on the methods for the detection of senescent cells and describe promises and challenges related to the application of senolytic drugs. This article is part of the Special Issue - Senolytics - Edited by Joao Passos and Diana Jurk.
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Affiliation(s)
- Vera Pils
- Christian Doppler Laboratory for the Biotechnology of Skin Aging, Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria; Christian Doppler Laboratory for Skin Multimodal Imaging of Aging and Senescence - SKINMAGINE, Vienna, Austria; Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Nadja Ring
- Ludwig Boltzmann Research Group Senescence and Healing of Wounds, Vienna, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in AUVA Research Center, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Karla Valdivieso
- Christian Doppler Laboratory for the Biotechnology of Skin Aging, Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria; Ludwig Boltzmann Research Group Senescence and Healing of Wounds, Vienna, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in AUVA Research Center, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Ingo Lämmermann
- Christian Doppler Laboratory for the Biotechnology of Skin Aging, Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria; Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Florian Gruber
- Christian Doppler Laboratory for the Biotechnology of Skin Aging, Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria; Christian Doppler Laboratory for Skin Multimodal Imaging of Aging and Senescence - SKINMAGINE, Vienna, Austria; Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Markus Schosserer
- Christian Doppler Laboratory for Skin Multimodal Imaging of Aging and Senescence - SKINMAGINE, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria; Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Johannnes Grillari
- Christian Doppler Laboratory for the Biotechnology of Skin Aging, Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in AUVA Research Center, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria; Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Mikolaj Ogrodnik
- Ludwig Boltzmann Research Group Senescence and Healing of Wounds, Vienna, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in AUVA Research Center, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria.
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Kharaziha M, Baidya A, Annabi N. Rational Design of Immunomodulatory Hydrogels for Chronic Wound Healing. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2021; 33:e2100176. [PMID: 34251690 PMCID: PMC8489436 DOI: 10.1002/adma.202100176] [Citation(s) in RCA: 235] [Impact Index Per Article: 78.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/03/2021] [Indexed: 05/03/2023]
Abstract
With all the advances in tissue engineering for construction of fully functional skin tissue, complete regeneration of chronic wounds is still challenging. Since immune reaction to the tissue damage is critical in regulating both the quality and duration of chronic wound healing cascade, strategies to modulate the immune system are of importance. Generally, in response to an injury, macrophages switch from pro-inflammatory to an anti-inflammatory phenotype. Therefore, controlling macrophages' polarization has become an appealing approach in regenerative medicine. Recently, hydrogels-based constructs, incorporated with various cellular and molecular signals, have been developed and utilized to adjust immune cell functions in various stages of wound healing. Here, the current state of knowledge on immune cell functions during skin tissue regeneration is first discussed. Recent advanced technologies used to design immunomodulatory hydrogels for controlling macrophages' polarization are then summarized. Rational design of hydrogels for providing controlled immune stimulation via hydrogel chemistry and surface modification, as well as incorporation of cell and molecules, are also dicussed. In addition, the effects of hydrogels' properties on immunogenic features and the wound healing process are summarized. Finally, future directions and upcoming research strategies to control immune responses during chronic wound healing are highlighted.
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Affiliation(s)
- Mahshid Kharaziha
- Department of Materials Engineering, Isfahan University of Technology, Isfahan, 84156-83111, Iran
| | - Avijit Baidya
- Chemical and Biomolecular Engineering, University of California - Los Angeles, Los Angeles, CA, 90095, USA
| | - Nasim Annabi
- Chemical and Biomolecular Engineering, University of California - Los Angeles, Los Angeles, CA, 90095, USA
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Liu Z, Agu E, Pedersen P, Lindsay C, Tulu B, Strong D. Comprehensive Assessment of Fine-Grained Wound Images Using a Patch-Based CNN With Context-Preserving Attention. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2021; 2:224-234. [PMID: 34532712 PMCID: PMC8442961 DOI: 10.1109/ojemb.2021.3092207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Goal: Chronic wounds affect 6.5 million Americans. Wound assessment via algorithmic analysis of smartphone images has emerged as a viable option for remote assessment. Methods: We comprehensively score wounds based on the clinically-validated Photographic Wound Assessment Tool (PWAT), which comprehensively assesses clinically important ranges of eight wound attributes: Size, Depth, Necrotic Tissue Type, Necrotic Tissue Amount, Granulation Tissue type, Granulation Tissue Amount, Edges, Periulcer Skin Viability. We proposed a DenseNet Convolutional Neural Network (CNN) framework with patch-based context-preserving attention to assess the 8 PWAT attributes of four wound types: diabetic ulcers, pressure ulcers, vascular ulcers and surgical wounds. Results: In an evaluation on our dataset of 1639 wound images, our model estimated all 8 PWAT sub-scores with classification accuracies and F1 scores of over 80%. Conclusions: Our work is the first intelligent system that autonomously grades wounds comprehensively based on criteria in the PWAT rubric, alleviating the significant burden that manual wound grading imposes on wound care nurses.
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Affiliation(s)
- Ziyang Liu
- Computer Science Department, Worcester Polytechnic Institute, Worcester, MA 01609 USA
| | - Emmanuel Agu
- Computer Science Department, Worcester Polytechnic Institute, Worcester, MA 01609 USA
| | - Peder Pedersen
- Electrical and Computer Engineering Department, Worcester Polytechnic Institute, Worcester, MA 01609 USA
| | - Clifford Lindsay
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA 01655 USA
| | - Bengisu Tulu
- Foisie Business School, Worcester Polytechnic Institute, Worcester, MA 01609 USA
| | - Diane Strong
- Foisie Business School, Worcester Polytechnic Institute, Worcester, MA 01609 USA
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48
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Davies E, Vaghela D, Convery C, Walker L, Murray G. Guideline for the Prevention, Diagnosis, and Management of Acute Bacterial Soft Tissue Infections Following Nonsurgical Cosmetic Procedures. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2021; 14:S29-S35. [PMID: 34980965 PMCID: PMC8562943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The Complications in Medical Aesthetics Collaborative (CMAC) is a nonprofit organization established to promote best patient outcomes through educating clinicians in the prevention, diagnosis, and management of complications that can arise following nonsurgical cosmetic procedures. The organization is a global community sharing information, learning, experience, and data to promote best practices. There is no reliable data on the risk or incidence of acute infection following a nonsurgical cosmetic procedure, but it is considered to be a rare complication. This article explores the evidence base for precautions and best practice standards, including an examination of the rational for standard aftercare advice and guidance on prevention, diagnosis, and management protocols.
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Affiliation(s)
- Emma Davies
- Ms. Davies is the clinical director of Save Face UK
- Dr. Vaghela is with the Department of Microbiology at the Norfolk and Norwich University Hospitals United Kingdom and with V&A Aesthetics Clinic in London United Kingdom
- Dr. Convery is with the Ever Clinic Glasgow in Glasgow, Scotland
- Ms. Murray is with the Clinical Academic Kings College London in London, England
- Dr. Walker is with B City Clinic in Liverpool, England. All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC)
| | - Devan Vaghela
- Ms. Davies is the clinical director of Save Face UK
- Dr. Vaghela is with the Department of Microbiology at the Norfolk and Norwich University Hospitals United Kingdom and with V&A Aesthetics Clinic in London United Kingdom
- Dr. Convery is with the Ever Clinic Glasgow in Glasgow, Scotland
- Ms. Murray is with the Clinical Academic Kings College London in London, England
- Dr. Walker is with B City Clinic in Liverpool, England. All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC)
| | - Cormac Convery
- Ms. Davies is the clinical director of Save Face UK
- Dr. Vaghela is with the Department of Microbiology at the Norfolk and Norwich University Hospitals United Kingdom and with V&A Aesthetics Clinic in London United Kingdom
- Dr. Convery is with the Ever Clinic Glasgow in Glasgow, Scotland
- Ms. Murray is with the Clinical Academic Kings College London in London, England
- Dr. Walker is with B City Clinic in Liverpool, England. All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC)
| | - Lee Walker
- Ms. Davies is the clinical director of Save Face UK
- Dr. Vaghela is with the Department of Microbiology at the Norfolk and Norwich University Hospitals United Kingdom and with V&A Aesthetics Clinic in London United Kingdom
- Dr. Convery is with the Ever Clinic Glasgow in Glasgow, Scotland
- Ms. Murray is with the Clinical Academic Kings College London in London, England
- Dr. Walker is with B City Clinic in Liverpool, England. All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC)
| | - Gillian Murray
- Ms. Davies is the clinical director of Save Face UK
- Dr. Vaghela is with the Department of Microbiology at the Norfolk and Norwich University Hospitals United Kingdom and with V&A Aesthetics Clinic in London United Kingdom
- Dr. Convery is with the Ever Clinic Glasgow in Glasgow, Scotland
- Ms. Murray is with the Clinical Academic Kings College London in London, England
- Dr. Walker is with B City Clinic in Liverpool, England. All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC)
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Abstract
ABSTRACT Burn injuries are a common form of traumatic injury that leads to significant morbidity and mortality worldwide. Burn injuries are characterized by inflammatory processes and alterations in numerous organ systems and functions. Recently, it has become apparent that the gastrointestinal bacterial microbiome is a key component of regulating the immune response and recovery from burn and can also contribute to significant detrimental sequelae after injury, such as sepsis and multiple organ failure. Microbial dysbiosis has been linked to multiple disease states; however, its role in exacerbating acute traumatic injuries, such as burn, is poorly understood. In this article, we review studies that document changes in the intestinal microbiome after burn injury, assess the implications in post-burn pathogenesis, and the potential for further discovery and research.
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Affiliation(s)
- Marisa E. Luck
- Burn & Shock Trauma Research Institute, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, IL 60153, USA
- Alcohol Research Program, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, IL 60153, USA
- Integrative Cell Biology Program, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, IL 60153, USA
| | - Caroline J. Herrnreiter
- Burn & Shock Trauma Research Institute, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, IL 60153, USA
- Alcohol Research Program, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, IL 60153, USA
- Biochemistry and Molecular Biology Program, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, IL 60153, USA
| | - Mashkoor A. Choudhry
- Burn & Shock Trauma Research Institute, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, IL 60153, USA
- Alcohol Research Program, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, IL 60153, USA
- Department of Surgery, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, IL 60153, USA
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, IL 60153, USA
- Integrative Cell Biology Program, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, IL 60153, USA
- Biochemistry and Molecular Biology Program, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, IL 60153, USA
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Pulido T, Velarde MC, Alimirah F. The senescence-associated secretory phenotype: Fueling a wound that never heals. Mech Ageing Dev 2021; 199:111561. [PMID: 34411604 DOI: 10.1016/j.mad.2021.111561] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/29/2021] [Accepted: 08/12/2021] [Indexed: 12/15/2022]
Abstract
Wound healing is impaired with advanced age and certain chronic conditions, such as diabetes and obesity. Moreover, common cancer treatments, including chemotherapy and radiation, can cause unintended tissue damage and impair wound healing. Available wound care treatments are not always effective, as some wounds fail to heal or recur after treatment. Hence, a more thorough understanding of the pathophysiology of chronic, nonhealing wounds may offer new ideas for the development of effective wound care treatments. Cancers are sometimes referred to as wounds that never heal, sharing mechanisms similar to wound healing. We describe in this review how cellular senescence and the senescence-associated secretory phenotype (SASP) contribute to chronic wounds versus cancer.
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Affiliation(s)
- Tanya Pulido
- Buck Institute for Research on Aging, Novato, CA, 94945, USA
| | - Michael C Velarde
- Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City, 1101, Philippines.
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