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Bhatt P, Sharpe A, Staines K, Wallace N, Withers A. Topical desiccating agent (DEBRICHEM): an accessible debridement option for removing biofilm in hard-to-heal wounds. J Wound Care 2024; 33:S4-S11. [PMID: 38752844 DOI: 10.12968/jowc.2024.33.sup5b.s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
It is now assumed that all hard-to-heal wounds contain biofilm. Debridement plays a key role in wound-bed preparation, as it can remove biofilm along with the devitalised tissue, potentially leaving a clean wound bed that is more likely to progress towards healing. The gold standard methods of debridement (surgical and sharp) are the least used, as they require specialist training and are often not readily available at the point of need. Most other methods can be used by generalists but are slower. They all need regular applications. The topical desiccating agent DEBRICHEM is an innovative alternative, as it is fast, effective and can be used in all clinical settings, as well as typically requiring only a single use. This article describes best practice for achieving optimal outcomes with its use.
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Affiliation(s)
- Priti Bhatt
- Community Tissue Viability Lead, Guy's and St Thomas' NHS Foundation Trust
| | - Andrew Sharpe
- Advanced Podiatrist, Salford Care Organisation, Northern Care Alliance NHS Foundation Trust
| | | | - Nicola Wallace
- Leg Ulcer Clinical Nurse specialist, Central London Community Healthcare NHS Trust
| | - Amy Withers
- Lead Tissue Viability Nurse, Acute Services, Manchester University NHS Foundation Trust
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2
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Dissemond J, Chadwick P, Weir D, Alves P, Isoherranen K, Lázaro Martínez JL, Swanson T, Gledhill A, Malone M. M.O.I.S.T. Concept for the Local Therapy of Chronic Wounds: An International Update. INT J LOW EXTR WOUND 2024:15347346241245159. [PMID: 38571403 DOI: 10.1177/15347346241245159] [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: 04/05/2024]
Abstract
Chronic wounds remain a significant clinical challenge both for those affected and for healthcare systems. The treatment is often comprised and complex. All patients should receive wound care that is integrated into a holistic approach involving local management that addresses the underlying etiology and provides for gold standard therapy to support healing, avoid complications and be more cost effective. There have been significant advances in medicine over the last few decades. The development of new technologies and therapeutics for the local treatment of wounds is also constantly increasing. To help standardize clinical practice with regard to the multitude of wound products, the M.O.I.S.T. concept was developed by a multidisciplinary expert group. The M stands for moisture balance, O for oxygen balance, I for infection control, S for supporting strategies, and T for tissue management. Since the M.O.I.S.T. concept, which originated in the German-speaking countries, is now intended to provide healthcare professionals with an adapted instrument to be used in clinical practice, and a recent update to the concept has been undertaken by a group of interdisciplinary experts to align it with international standards. The M.O.I.S.T. concept can now be used internationally both as an educational tool and for the practical implementation of modern local treatment concepts for patients with chronic wounds and can also be used in routine clinical practice.
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Affiliation(s)
- Joachim Dissemond
- Department of Dermatology, Venerology and Allergology, University of Essen, Essen, Germany
| | | | - Dot Weir
- Saratoga Hospital Center for Wound Healing and Hyperbaric Medicine, Saratoga Springs, NY, USA
| | - Paulo Alves
- Universidade Católica Portuguesa, Institute of Health Sciences - Wounds Research Lab, Lisboa, Portugal
| | - Kirsi Isoherranen
- Department of Dermatology and Allergology, University of Helsinki and Inflammation center, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | | | - Terry Swanson
- Wound Education Research Consultancy, Warrnambool, Victoria, Australia
| | - Andrea Gledhill
- Department of Podiatric Surgery, Trauma and Orthopaedics, Great Western Hospital NHSFT, Swindon, UK
| | - Matthew Malone
- Research and Development, Molnlycke Healthcare AB, Gothenburg, Sweden
- Infectious Diseases Microbiology, School of Medicine, Western Sydney University, Sydney, Australia
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3
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Ji W, Zhang Q, Sun Z, Cheng Y. LncRNA H19 Inhibits Keratinocyte Cell Proliferation and Migration by Targeting miR-17-5p/RUNX1 Axis in Chronic Wounds. J Burn Care Res 2024; 45:366-372. [PMID: 37742288 DOI: 10.1093/jbcr/irad145] [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: 07/24/2023] [Indexed: 09/26/2023]
Abstract
The migration and proliferation of keratinocytes are critical for re-epithelization during chronic wound healing. Runt-related transcription factor 1 (RUNX1) has been indicated to repress keratinocyte proliferation. Nonetheless, the potential molecular mechanism of RUNX1 in regulating keratinocyte proliferation and migration remains unclear. Cell counting kit-8 and wound-healing assays were implemented for examining keratinocyte viability and migration, respectively. Western blotting and real-time quantitative polymerase chain reaction were utilized for quantifying protein and RNA levels. Luciferase reporter assay was employed for verifying the interaction between RUNX1, miR-17-5p, and long noncoding RNA H19. The results showed that RUNX1 depletion promoted keratinocyte proliferation and migration and repressed extracellular matrix degradation. Mechanistically, H19 upregulated RUNX1 expression by competitively absorbing miR-17-5p. Rescue experiments revealed that overexpressing RUNX1 reversed H19 silencing-mediated effects on the phenotypes of keratinocytes. In conclusion, H19 knockdown promotes keratinocyte proliferation and migration and suppresses extracellular matrix degradation via the miR-17-5p/RUNX1 axis.
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Affiliation(s)
- Wei Ji
- Department of Plastic Surgery, Tongren Hospital of Wuhan University (Wuhan Third Hospital), Wuhan 430060, China
| | - Qian Zhang
- Department of Plastic Surgery, Tongren Hospital of Wuhan University (Wuhan Third Hospital), Wuhan 430060, China
| | - Zhibo Sun
- Department of Orthopaedic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yanyang Cheng
- Department of Paediatrics, Renmin Hospital of Wuhan University, Wuhan 430060, China
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4
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Wang W, Chen L, Zhang Y, Wang H, Dong D, Zhu J, Fu W, Liu T. Adipose-derived stem cells enriched with therapeutic mRNA TGF-β3 and IL-10 synergistically promote scar-less wound healing in preclinical models. Bioeng Transl Med 2024; 9:e10620. [PMID: 38435824 PMCID: PMC10905533 DOI: 10.1002/btm2.10620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/16/2023] [Accepted: 10/28/2023] [Indexed: 03/05/2024] Open
Abstract
Skin wound healing often leads to scar formation, presenting physical and psychological challenges for patients. Advancements in messenger RNA (mRNA) modifications offer a potential solution for pulsatile cytokine delivery to create a favorable wound-healing microenvironment, thereby preventing cutaneous fibrosis. This study aimed to investigate the effectiveness of human adipose-derived stem cells (hADSCs) enriched with N 1-methylpseudouridine (m1ψ) modified transforming growth factor-β3 (TGF-β3) and interleukin-10 (IL-10) mRNA in promoting scar-free healing in preclinical models. The results demonstrated that the modified mRNA (modRNA)-loaded hADSCs efficiently and temporarily secreted TGF-β3 and IL-10 proteins. In a dorsal injury model, hADSCs loaded with modRNA TGF-β3 and IL-10 exhibited multidimensional therapeutic effects, including improved collagen deposition, extracellular matrix organization, and neovascularization. In vitro experiments confirmed the ability of these cells to markedly inhibit the proliferation and migration of keloid fibroblasts, and reverse the myofibroblast phenotype. Finally, collagen degradation mediated by matrix metalloproteinase upregulation was observed in an ex vivo keloid explant culture model. In conclusion, the synergistic effects of the modRNA TGF-β3, IL-10, and hADSCs hold promise for establishing a scar-free wound-healing microenvironment, representing a robust foundation for the management of wounds in populations susceptible to scar formation.
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Affiliation(s)
- Wei Wang
- Department of Plastic and Aesthetic SurgeryHuadong Hospital, Shanghai Medical College, Fudan UniversityShanghaiChina
| | - Liang Chen
- Department of Plastic and Aesthetic SurgeryHuadong Hospital, Shanghai Medical College, Fudan UniversityShanghaiChina
| | - Yuxin Zhang
- Department of Plastic and Aesthetic SurgeryHuadong Hospital, Shanghai Medical College, Fudan UniversityShanghaiChina
| | - Heng Wang
- Department of Plastic and Aesthetic SurgeryHuadong Hospital, Shanghai Medical College, Fudan UniversityShanghaiChina
| | - Dong Dong
- Department of Plastic and Aesthetic SurgeryHuadong Hospital, Shanghai Medical College, Fudan UniversityShanghaiChina
| | - Jingjing Zhu
- Department of Plastic and Aesthetic SurgeryHuadong Hospital, Shanghai Medical College, Fudan UniversityShanghaiChina
| | - Wei Fu
- Institute of Pediatric Translational Medicine, Shanghai Institute of Pediatric Congenital Heart Disease, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Tianyi Liu
- Department of Plastic and Aesthetic SurgeryHuadong Hospital, Shanghai Medical College, Fudan UniversityShanghaiChina
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5
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Monaghan MG, Borah R, Thomsen C, Browne S. Thou shall not heal: Overcoming the non-healing behaviour of diabetic foot ulcers by engineering the inflammatory microenvironment. Adv Drug Deliv Rev 2023; 203:115120. [PMID: 37884128 DOI: 10.1016/j.addr.2023.115120] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/01/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
Diabetic foot ulcers (DFUs) are a devastating complication for diabetic patients that have debilitating effects and can ultimately lead to limb amputation. Healthy wounds progress through the phases of healing leading to tissue regeneration and restoration of the barrier function of the skin. In contrast, in diabetic patients dysregulation of these phases leads to chronic, non-healing wounds. In particular, unresolved inflammation in the DFU microenvironment has been identified as a key facet of chronic wounds in hyperglyceamic patients, as DFUs fail to progress beyond the inflammatory phase and towards resolution. Thus, control over and modulation of the inflammatory response is a promising therapeutic avenue for DFU treatment. This review discusses the current state-of-the art regarding control of the inflammatory response in the DFU microenvironment, with a specific focus on the development of biomaterials-based delivery strategies and their cargos to direct tissue regeneration in the DFU microenvironment.
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Affiliation(s)
- Michael G Monaghan
- Department of Mechanical, Manufacturing and Biomedical Engineering, Trinity College Dublin, Dublin 2, Ireland; Advanced Materials and BioEngineering Research (AMBER), Centre at Trinity College Dublin and the Royal College of Surgeons in Ireland, Dublin 2, Ireland; CÚRAM, Centre for Research in Medical Devices, National University of Ireland, H91 W2TY Galway, Ireland; Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin 2, Ireland
| | - Rajiv Borah
- Department of Mechanical, Manufacturing and Biomedical Engineering, Trinity College Dublin, Dublin 2, Ireland; Advanced Materials and BioEngineering Research (AMBER), Centre at Trinity College Dublin and the Royal College of Surgeons in Ireland, Dublin 2, Ireland; Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin 2, Ireland
| | - Charlotte Thomsen
- Department of Mechanical, Manufacturing and Biomedical Engineering, Trinity College Dublin, Dublin 2, Ireland; Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Shane Browne
- CÚRAM, Centre for Research in Medical Devices, National University of Ireland, H91 W2TY Galway, Ireland; Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin 2, Ireland; Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
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6
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Casadiego O, Macias O, García L, Sanabria-Chanaga E, Baay-Guzmán GJ, Mantilla JC, Escobar P. In-Silico Selection of Wound-Healing Plant Secondary Molecules and Their Pro-Healing Activities on Experimental Models. Chem Biodivers 2023; 20:e202300961. [PMID: 37966104 DOI: 10.1002/cbdv.202300961] [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: 07/01/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/16/2023]
Abstract
This study explored the potential of plant-derived molecules (PDMs) as a medicinal treatment for skin wounds. To assess their healing properties, 34 potential drug molecules (PDMs) and ten therapeutic targets were subjected to molecular docking and dynamics analysis, with allantoin used as a standard compound. Although aristolochic acid had the most potent inhibitory effect, its toxicity made it unsuitable for testing on cells and mice. Therefore, β-caryophyllene (BC) and caryophyllene oxide (BCoxide) were chosen for further testing. The results showed that BC-treated HaCat cells had significantly improved scratch area closure, and both BC and BCoxide treatment produced positive effects such as reduced dermal cellularity and mast cells, decreased levels of inflammation markers IL-6 and TNF-α, and an increase in collagen deposition in mice tissues. However, these treatments did not accelerate wound healing. This study suggests that the PDMs selected based on in-silico results have significant potential for pro-healing abilities. It is essential to conduct further research to confirm our findings.
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Affiliation(s)
- Omar Casadiego
- Centro de Investigaciones en Enfermedades Tropicales, Escuela de Medicina, Universidad Industrial de Santander, Piedecuesta, Colombia
| | - Oscar Macias
- Centro de Investigaciones en Enfermedades Tropicales, Escuela de Medicina, Universidad Industrial de Santander, Piedecuesta, Colombia
- Semillero de Investigación en Enfermedades Tropicales (SINAT), CINTROP, Escuela de Medicina, Universidad Industrial de Santander, Piedecuesta, Colombia
| | - Laura García
- Centro de Investigaciones en Enfermedades Tropicales, Escuela de Medicina, Universidad Industrial de Santander, Piedecuesta, Colombia
| | - Elkin Sanabria-Chanaga
- Facultad de Ciencias Básicas, Departamento de Química, Universidad de Pamplona, Pamplona, Colombia
| | - Guillermina J Baay-Guzmán
- Unidad de Investigación en Enfermedades Oncológicas, Hospital Infantil de México Federico Gómez, México, México DF
| | - Julio Cesar Mantilla
- Departamento de Patología, Escuela de Medicina, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Patricia Escobar
- Centro de Investigaciones en Enfermedades Tropicales, Escuela de Medicina, Universidad Industrial de Santander, Piedecuesta, Colombia
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7
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Choma P, Bazin I, Cerutti M, Vena A, Sorli B. Capacitive immunosensor based on grafted Anodic Aluminum Oxide for the detection of matrix metalloproteinase 9 found in chronic wounds. Anal Biochem 2023; 678:115282. [PMID: 37572841 DOI: 10.1016/j.ab.2023.115282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/14/2023]
Abstract
Chronic wounds impose a significant burden on healthcare resources, society and more specifically on patients. Preliminary research showed that as of today, there is not a system that can do a precise monitoring of these wounds so that healthcare systems can manage them with efficiency. The overall aim of our project is to produce a capacitive sensor able to detect a specific molecule in chronic wounds, thus giving information concerning its inflammation state. In this article, we present a system that uses nanoporous Anodic Aluminum Oxide (AAO) grafted with a commercially available anti-MMP9 antibody able to interact with Matrix Metalloproteinase 9, an enzyme that works as an indicator of inflammation. In order to produce a proof-of-concept we chose to compare two methods of functionalization followed by a thorough analysis with biological, electrical and optical testing. This study produced reproducible results for each functionalization method, chemisorption being the best choice for the immobilization of conventional antibodies on AAO-based sensors for a detection of MMP9 in pure and complex conditions. This proof-of-concept and its analysis allowed a better understanding of the needs of the overall project and will be helpful to produce a prototype of smart dressing in the near future.
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Affiliation(s)
- Pauline Choma
- Institut d'Electronique et des Systèmes, CNRS UMR5214, Université Montpellier, 860 rue Saint Priest, 34090, Montpellier, France
| | - Ingrid Bazin
- LGEI, IMT Mines Ales, Université de Montpellier, 6 avenue de Clavières, 30319, Ales Cedex, France
| | - Martine Cerutti
- Unité Baculovirus et Thérapie, Station Recherche, CNRS UPS3044, 410 chemin des Boissières, 30380, Saint Christol Lès Alès, France
| | - Arnaud Vena
- Institut d'Electronique et des Systèmes, CNRS UMR5214, Université Montpellier, 860 rue Saint Priest, 34090, Montpellier, France
| | - Brice Sorli
- Institut d'Electronique et des Systèmes, CNRS UMR5214, Université Montpellier, 860 rue Saint Priest, 34090, Montpellier, France.
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8
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Crivello G, Orlandini G, Morena AG, Torchio A, Mattu C, Boffito M, Tzanov T, Ciardelli G. Lignin-Cobalt Nano-Enabled Poly(pseudo)rotaxane Supramolecular Hydrogel for Treating Chronic Wounds. Pharmaceutics 2023; 15:1717. [PMID: 37376166 DOI: 10.3390/pharmaceutics15061717] [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: 03/31/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Chronic wounds (CWs) are a growing issue for the health care system. Their treatment requires a synergic approach to reduce both inflammation and the bacterial burden. In this work, a promising system for treating CWs was developed, comprising cobalt-lignin nanoparticles (NPs) embedded in a supramolecular (SM) hydrogel. First, NPs were obtained through cobalt reduction with phenolated lignin, and their antibacterial properties were tested against both Gram-negative and Gram-positive strains. The anti-inflammatory capacity of the NPs was proven through their ability to inhibit myeloperoxidase (MPO) and matrix metalloproteases (MMPs), which are enzymes involved in the inflammatory process and wound chronicity. Then, the NPs were loaded in an SM hydrogel based on a blend of α-cyclodextrin and custom-made poly(ether urethane)s. The nano-enabled hydrogel showed injectability, self-healing properties, and linear release of the loaded cargo. Moreover, the SM hydrogel's characteristics were optimized to absorb proteins when in contact with liquid, suggesting its capacity to uptake harmful enzymes from the wound exudate. These results render the developed multifunctional SM material an interesting candidate for the management of CWs.
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Affiliation(s)
- Giulia Crivello
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Giuliana Orlandini
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Angela Gala Morena
- Group of Molecular and Industrial Biotechnology, Department of Chemical Engineering, Universitat Politècnica de Catalunya, 08222 Terrassa, Spain
| | - Alessandro Torchio
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Clara Mattu
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Monica Boffito
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Tzanko Tzanov
- Group of Molecular and Industrial Biotechnology, Department of Chemical Engineering, Universitat Politècnica de Catalunya, 08222 Terrassa, Spain
| | - Gianluca Ciardelli
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
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9
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Chappidi S, Buddolla V, Ankireddy SR, Lakshmi BA, Kim YJ. Recent trends in diabetic wound healing with nanofibrous scaffolds. Eur J Pharmacol 2023; 945:175617. [PMID: 36841285 DOI: 10.1016/j.ejphar.2023.175617] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/03/2023] [Accepted: 02/03/2023] [Indexed: 02/26/2023]
Abstract
There is an emphasis in this review on nanofibrous scaffolds (NFSs) in diabetic wound healing, as well as their mechanisms and recent advancements. Diabetes-related complex wounds pose an important problem to humanity, due to the fact that their chronic nature can lead to serious complications including sepsis and amputations. Despite the fact that there are certain therapy options available for diabetic wound healing, these options are either ineffective or intrusive, making clinical intervention difficult. Clinical research is also challenged by the emergence of bacterial resistance to standard antibiotics. However, research into nanotechnology, in particular NFSs, is growing swiftly and has a positive impact on the treatment of diabetic wounds. For instance, SpinCare™, developed by Nanomedic Technologies Ltd, has successfully finished clinical testing and can re-epithelialize second-degree burns and chronic diabetic wounds in 7 and 14 days, respectively. In this review, we discussed homologous studies as well as other recent research studies on diabetic wound healing using NFSs.
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Affiliation(s)
| | - Viswanath Buddolla
- Dr. Buddolla's Institute of Life Sciences, Tirupati, 517503, Andhra Pradesh, India
| | | | - Buddolla Anantha Lakshmi
- Department of Electronic Engineering, Gachon University, 1342 Seongnam-Daero, Seongnam, Gyeonggi-Do, 13120, Republic of Korea.
| | - Young-Joon Kim
- Department of Electronic Engineering, Gachon University, 1342 Seongnam-Daero, Seongnam, Gyeonggi-Do, 13120, Republic of Korea.
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10
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Ead JK, Armstrong DG. Granulocyte-macrophage colony-stimulating factor: Conductor of the wound healing orchestra? Int Wound J 2023; 20:1229-1234. [PMID: 36632762 PMCID: PMC10031218 DOI: 10.1111/iwj.13919] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/25/2022] [Indexed: 01/13/2023] Open
Abstract
Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a glycoprotein and is derived from both hemopoietic and nonhemopoietic sources which exert immunomodulatory properties. Various theories have been proposed to explain why some wounds become chronic and non-healing. Generalized suppression of inflammation locally or systemically may impede the body's physiological healing response by crippling the activity of reparative cells within the wound ecosystem. Thus, highlighting the importance of promoting host-directed therapeutics with immunomodulatory properties. The temporal and spatial expression of GM-CSF and GM-CSF receptors in the integumentary system suggests that epithelial-derived GM-CSF functions in an autocrine/paracrine manner. This may positively affect wound healing physiology via local inflammatory regulation promoting macrophage survival. Although diabetes negatively affects multiple aspects of wound healing GM-CSF activation is particularly impacted. Compared to acute/healthy wounds diabetic foot ulcers (DFU) only partially activate GM-CSF activity. There is a deleterious chain of events associated with this unfortunate sequala. DFUs also have a high proportion of monocytes and an absence of activated macrophages which results in an impaired inflammatory response. This may potentially serve as a vital point for GM-CSF to act as a companion diagnostic/theragnostic modality to help modulate the inflammatory response in wound healing. Correcting macrophage immune dysfunction with exogenous GM-CSF may help restore the immune balance in the wound ecosystem and jumpstart the wound healing cascade. Thus, the recognized beneficial role of GM-CSF in immune regulation across many studies provides a rationale for the initiation of the ongoing randomized controlled trials using GM-CSF.
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Affiliation(s)
- J. Karim Ead
- Department of SurgeryUSC Keck School of MedicineLos AngelesUSA
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11
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Xiao H, Chen X, Liu X, Wen G, Yu Y. Recent advances in decellularized biomaterials for wound healing. Mater Today Bio 2023; 19:100589. [PMID: 36880081 PMCID: PMC9984902 DOI: 10.1016/j.mtbio.2023.100589] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/07/2023] [Accepted: 02/18/2023] [Indexed: 02/24/2023] Open
Abstract
The skin is one of the most essential organs in the human body, interacting with the external environment and shielding the body from diseases and excessive water loss. Thus, the loss of the integrity of large portions of the skin due to injury and illness may lead to significant disabilities and even death. Decellularized biomaterials derived from the extracellular matrix of tissues and organs are natural biomaterials with large quantities of bioactive macromolecules and peptides, which possess excellent physical structures and sophisticated biomolecules, and thus, promote wound healing and skin regeneration. Here, we highlighted the applications of decellularized materials in wound repair. First, the wound-healing process was reviewed. Second, we elucidated the mechanisms of several extracellular matrix constitutes in facilitating wound healing. Third, the major categories of decellularized materials in the treatment of cutaneous wounds in numerous preclinical models and over decades of clinical practice were elaborated. Finally, we discussed the current hurdles in the field and anticipated the future challenges and novel avenues for research on decellularized biomaterials-based wound treatment.
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Affiliation(s)
- Huimin Xiao
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.,College of Fisheries and Life Science, Shanghai Ocean University, Shanghai, 201306, China
| | - Xin Chen
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.,College of Fisheries and Life Science, Shanghai Ocean University, Shanghai, 201306, China
| | - Xuanzhe Liu
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Gen Wen
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.,College of Fisheries and Life Science, Shanghai Ocean University, Shanghai, 201306, China
| | - Yaling Yu
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.,Institute of Microsurgery on Extremities, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
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12
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Danella EB, Costa de Medeiros M, D'Silva NJ. Cytokines secreted by inflamed oral mucosa: implications for oral cancer progression. Oncogene 2023; 42:1159-1165. [PMID: 36879116 DOI: 10.1038/s41388-023-02649-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/10/2023] [Accepted: 02/23/2023] [Indexed: 03/08/2023]
Abstract
The oral mucosa has an essential role in protecting against physical, microbial, and chemical harm. Compromise of this barrier triggers a wound healing response. Key events in this response such as immune infiltration, re-epithelialization, and stroma remodeling are coordinated by cytokines that promote cellular migration, invasion, and proliferation. Cytokine-mediated cellular invasion and migration are also essential features in cancer dissemination. Therefore, exploration of cytokines that regulate each stage of oral wound healing will provide insights about cytokines that are exploited by oral squamous cell carcinoma (SCC) to promote tumor development and progression. This will aid in identifying potential therapeutic targets to constrain SCC recurrence and increase patient survival. In this review, we discuss cytokines that overlap in oral wounds and SCC, emphasizing how these cytokines promote cancer progression.
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Affiliation(s)
- Erika B Danella
- Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1011 N. University Ave, Ann Arbor, MI, USA
| | - Marcell Costa de Medeiros
- Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1011 N. University Ave, Ann Arbor, MI, USA
| | - Nisha J D'Silva
- Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1011 N. University Ave, Ann Arbor, MI, USA. .,Pathology, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI, USA. .,Rogel Cancer Center, 1500 E Medical Center Dr, Ann Arbor, MI, USA.
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13
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Girgis B, Carvalho D, Duarte JA. The effect of high-voltage monophasic pulsed current on diabetic ulcers and their potential pathophysiologic factors: A systematic review and meta-analysis. Wound Repair Regen 2023; 31:171-186. [PMID: 36507861 DOI: 10.1111/wrr.13063] [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: 06/13/2022] [Revised: 10/04/2022] [Accepted: 11/08/2022] [Indexed: 12/15/2022]
Abstract
The present review was conducted to determine the efficacy of high-voltage monophasic pulsed current (HVMPC) in treating diabetic ulcers, assess its effect on skin lesions with each of the pathophysiologic factors potentially contributing to diabetic ulcers, evaluate its safety, and identify treatment parameters. Electronic search of PubMed, Scopus, PEDro and Google Scholar databases was conducted. The revised tool for assessing risk of bias in randomised trials (RoB 2), the risk of bias in non-randomised studies-of interventions (ROBINS-I) and the Joanna Briggs Institute (JBI) critical appraisal tool were used to assess risk of bias and methodological quality. Overall quality of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) principles. Thirty-two studies matched the eligibility criteria, and included 1061 patients with 1103 skin lesions of selected aetiologies; 12 randomised controlled trials were included in quantitative synthesis. HVMPC plus standard wound care (SWC) likely increased the probability of complete wound healing of pressure ulcers (PrUs) compared with sham/no stimulation plus SWC; relative risk (RR) 2.08; 95% CI: [1.42, 3.04], p = 0.0002; I2 = 0%, p = 0.61; eight studies, 358 ulcers. Although conclusive evidence regarding the effect of HVMPC on diabetic ulcers was not found, collateral evidence might suggest a potential benefit. Direct evidence, with moderate certainty, may support its efficacy in treating PrUs, albeit few adverse reactions were reported. Other observations, moreover, might indicate that this efficacy may not be limited to PrUs. Nonetheless, several aspects remain to be clarified for safe and effective application of electrical stimulation for wound healing.
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Affiliation(s)
- Beshoy Girgis
- CIAFEL, Faculty of Sport, University of Porto, Porto, Portugal
| | - Davide Carvalho
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar S. João, Faculty of Medicine, University of Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
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14
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Liu T, Lu Y, Zhan R, Qian W, Luo G. Nanomaterials and nanomaterials-based drug delivery to promote cutaneous wound healing. Adv Drug Deliv Rev 2023; 193:114670. [PMID: 36538990 DOI: 10.1016/j.addr.2022.114670] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/24/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
Various factors could damage the structure and integrity of skin to cause wounds. Nonhealing or chronic wounds seriously affect the well-being of patients and bring heavy burdens to the society. The past few decades have witnessed application of numerous nanomaterials to promote wound healing. Owing to the unique physicochemical characteristics at nanoscale, nanomaterials-based therapy has been regarded as a potential approach to promote wound healing. In this review, we first overview the wound categories, wound healing process and critical influencing factors. Then applications of nanomaterials with intrinsic therapeutic effect and nanomaterials-based drug delivery systems to promote wound healing are addressed in detail. Finally, current limitations and future perspectives of nanomaterials in wound healing are discussed.
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Affiliation(s)
- Tengfei Liu
- Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Yifei Lu
- Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Rixing Zhan
- Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Wei Qian
- Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Gaoxing Luo
- Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University (Third Military Medical University), Chongqing 400038, China.
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15
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Zhang WQ, Tang W, Hu SQ, Fu XL, Wu H, Shen WQ, Chen HL. Effect of matrix metalloproteinases on the healing of diabetic foot ulcer: A systematic review. J Tissue Viability 2023; 32:51-58. [PMID: 36513539 DOI: 10.1016/j.jtv.2022.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 10/24/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND This study aims to discuss the expression of matrix metalloproteinase in wound healing of diabetic foot ulcers and further summarize the strategies of targeted matrix metalloproteinase and its inhibitors in the treatment of diabetic foot ulcers. METHODS Following PRISMA-SCR guidelines, databases (PubMed, Home-PMC-NCBI, CINAHL, Web of Science) were systematically searched from inception to 19 June 2022. Newcastle-Ottawa Scale (NOS) was used to evaluate the bias risk of the included studies. RESULTS Eight studies are finally eligible for our systematic review. The combined data analysis of 8 studies showed that there were no significant difference in age(p = 0.110), duration of diabetes(p = 0.197), glycosylated hemoglobin content(p = 0.489), size(p = 0.133) and depth(p>0.05) of initial ulcer between the ulcer wound healing group and the non-healing group. MMP-1, 2, 8, 9, and TIMP-1, 2 affected the healing of DFUs. In the DFUs healing group, the concentrations of MMP (MMP-1, 2, 8, 9) decreased, and the concentration of TIMP-1 increased. CONCLUSION Our study showed that high levels of MMP-1, 2, 9 delayed the healing of diabetic foot ulcers, and high expression of MMP-8 in tissues improved wound healing. This study also summarized the effective intervention strategies for the treatment of diabetic foot ulcers.
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Affiliation(s)
| | - Wen Tang
- School of Medicine, Nantong University, Nantong, China
| | - Shi-Qi Hu
- School of Medicine, Nantong University, Nantong, China
| | - Xue-Lei Fu
- School of Medicine, Nantong University, Nantong, China
| | - Hua Wu
- School of Medicine, Nantong University, Nantong, China
| | - Wang-Qin Shen
- School of Medicine, Nantong University, Nantong, China.
| | - Hong-Lin Chen
- School of Public Health, Nantong University, Nantong, China.
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16
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Rai V, Moellmer R, Agrawal DK. Role of fibroblast plasticity and heterogeneity in modulating angiogenesis and healing in the diabetic foot ulcer. Mol Biol Rep 2023; 50:1913-1929. [PMID: 36528662 DOI: 10.1007/s11033-022-08107-4] [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: 08/15/2022] [Accepted: 11/09/2022] [Indexed: 12/23/2022]
Abstract
Chronic diabetic foot ulcers (DFUs) are an important clinical issue faced by clinicians despite the advanced treatment strategies consisting of wound debridement, off-loading, medication, wound dressings, and keeping the ulcer clean. Non-healing DFUs are associated with the risk of amputation, increased morbidity and mortality, and economic stress. Neo-angiogenesis and granulation tissue formation are necessary for physiological DFU healing and acute inflammation play a key role in healing. However, chronic inflammation in association with diabetic complications holds the ulcer in the inflammatory phase without progressing to the resolution phase contributing to non-healing. Fibroblasts acquiring myofibroblasts phenotype contribute to granulation tissue formation and angiogenesis. However, recent studies suggest the presence of five subtypes of fibroblast population and of changing density in non-healing DFUs. Further, the association of fibroblast plasticity and heterogeneity with wound healing suggests that the switch in fibroblast phenotype may affect wound healing. The fibroblast phenotype shift and altered function may be due to the presence of chronic inflammation or a diabetic wound microenvironment. This review focuses on the role of fibroblast plasticity and heterogeneity, the effect of hyperglycemia and inflammatory cytokines on fibroblasts, and the interaction of fibroblasts with other cells in diabetic wound microenvironment in the perspective of DFU healing. Next, we summarize secretory, angiogenic, and angiostatic phenotypes of fibroblast which have been discussed in other organ systems but not in relation to DFUs followed by the perspective on the role of their phenotypes in promoting angiogenesis in DFUs.
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Affiliation(s)
- Vikrant Rai
- Department of Translational Research, Western University of Health Sciences, 91766, Pomona, CA, USA.
| | - Rebecca Moellmer
- College of Podiatric Medicine, Western University of Health Sciences, 91766, Pomona, CA, USA
| | - Devendra K Agrawal
- Department of Translational Research, Western University of Health Sciences, 91766, Pomona, CA, USA
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17
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Häsler Gunnarsdottir S, Sommerauer L, Schnabel T, Oostingh GJ, Schuster A. Antioxidative and Antimicrobial Evaluation of Bark Extracts from Common European Trees in Light of Dermal Applications. Antibiotics (Basel) 2023; 12:antibiotics12010130. [PMID: 36671331 PMCID: PMC9854852 DOI: 10.3390/antibiotics12010130] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/12/2023] Open
Abstract
Plant species have developed effective defense strategies for colonizing diverse habitats and protecting themselves from numerous attacks from a wide range of organisms, including insects, vertebrates, fungi, and bacteria. The bark of trees in particular constitutes a number of components that protect against unwanted intruders. This review focuses on the antioxidative, dermal immunomodulatory, and antimicrobial properties of bark extracts from European common temperate trees in light of various skin pathogens, wound healing, and the maintenance of skin health. The sustainability aspect, achieved by utilizing the bark, which is considered a byproduct in the forest industry, is addressed, as are various extraction methods applied to retrieve extracts from bark.
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Affiliation(s)
| | - Lukas Sommerauer
- Department of Forest Products Technology & Timber Constructions, Salzburg University of Applied Sciences, Markt 136a, 5431 Kuchl, Austria
- Salzburg Center for Smart Materials, c/o Department of Chemistry and Physics of Materials, Paris Lodron University of Salzburg, Jakob-Haringer-Straße 2a, 5020 Salzburg, Austria
- Department of Material Sciences and Process Engineering, Institute of Physics and Materials Science, University of Natural Resources and Life Sciences, Peter-Jordan-Straße 82, 1190 Vienna, Austria
| | - Thomas Schnabel
- Department of Forest Products Technology & Timber Constructions, Salzburg University of Applied Sciences, Markt 136a, 5431 Kuchl, Austria
- Faculty of Furniture Design and Wood Engineering, Transilvania University of Brasov, B-dul. Eroilor nr. 29, 500036 Brasov, Romania
| | - Gertie Janneke Oostingh
- Biomedical Sciences, Salzburg University of Applied Sciences, Urstein Sued 1, 5412 Puch, Austria
| | - Anja Schuster
- Biomedical Sciences, Salzburg University of Applied Sciences, Urstein Sued 1, 5412 Puch, Austria
- Correspondence:
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Kutlu Z, Halici Z, Gedikli S, Diyarbakir B, Civelek MS. A Lead Target Molecule for Excisional Wound Healing: Trypthantrin Compound. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2022; 21:e127665. [PMID: 36945339 PMCID: PMC10024809 DOI: 10.5812/ijpr-127665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 07/10/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022]
Abstract
Objectives We aimed to evaluate the impact of the tryptanthrin (TRP) compound, with antimicrobial and anti-inflammatory effects, on the excisional wound (EW) model. In an EW model in mice, we tried to explain the possible effect of TRP through vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) that contribute significantly to wound healing. Methods A total of 90 BALB-C female mice aged 6 - 8 weeks were used in the present study. Animals were randomly divided into five groups. After creating the EW model, three different doses (1, 2.5, 5 mg/kg) of TRP compound were applied topically for 14 days, and wound closure rates were measured on days 0, 3, and 7. Vascular endothelial growth factor and MMP-9 were evaluated on days 3, 7, and 14 on wound explants and on day 14 on serum samples by enzyme-linked immunosorbent assay. Histopathological analysis was performed on wound explants. Results After the EW model creation, significant healing of the wound areas was observed in the groups for which TRP was applied, especially on the third day. Moreover, in groups that received the third dose of TRP, the wound closure rate was 94%. It was found that the wound areas were closed due to the increase in TRP dose. In line with wound healing, VEGF and MMP-9 levels gradually rose on the third and seventh days and decreased on the 14th day. Conclusions Tryptanthrin compound usage on the EW model increased wound healing and did not leave a scar after 14 days.
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Affiliation(s)
- Zerrin Kutlu
- Department of Biochemistry, Faculty of Pharmacy, Atatürk University, Erzurum, Turkey
- Corresponding Author: Department of Biochemistry, Faculty of Pharmacy, Atatürk University, P.O. Box: 25240, Erzurum, Turkey.
| | - Zekai Halici
- Faculty of Medicine, Department of Pharmacology, Atatürk University, Turkey
- Clinical Research, Development and Design Application and Research Center, Ataturk University, Erzurum, Turkey
| | - Semin Gedikli
- Faculty of Veterinary, Department of Histology and Embryology, Ataturk University, Erzurum, Turkey
| | - Busra Diyarbakir
- Faculty of Medicine, Department of Pharmacology, Atatürk University, Turkey
| | - Maide Sena Civelek
- Department of Biochemistry, Faculty of Pharmacy, Atatürk University, Erzurum, Turkey
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19
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Morena AG, Pérez-Rafael S, Tzanov T. Lignin-Based Nanoparticles as Both Structural and Active Elements in Self-Assembling and Self-Healing Multifunctional Hydrogels for Chronic Wound Management. Pharmaceutics 2022; 14:pharmaceutics14122658. [PMID: 36559153 PMCID: PMC9781249 DOI: 10.3390/pharmaceutics14122658] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 12/02/2022] Open
Abstract
Efficient wound healing is feasible when the dressing materials simultaneously target multiple factors causing wound chronicity, such as deleterious proteolytic and oxidative enzymes and bacterial infection. Herein, entirely bio-based multifunctional self-assembled hydrogels for wound healing were developed by simply mixing two biopolymers, thiolated hyaluronic acid (HA-SH) and silk fibroin (SF), with lignin-based nanoparticles (NPs) as both structural and functional elements. Sono-enzymatic lignin modification with natural phenolic compounds results in antibacterial and antioxidant phenolated lignin nanoparticles (PLN) capable of establishing multiple interactions with both polymers. These strong and dynamic polymer-NP interactions endow the hydrogels with self-healing and shear-thinning properties, and pH-responsive NP release is triggered at neutral to alkaline pH (7-9). Despite being a physically crosslinked hydrogel, the material was stable for at least 7 days, and its mechanical and functional properties can be tuned depending on the polymer and NP concentration. Furthermore, human skin cells in contact with the nanocomposite hydrogels for 7 days showed more than 93% viability, while the viability of clinically relevant Staphylococcus aureus and Pseudomonas aeruginosa was reduced by 99.7 and 99.0%, respectively. The hydrogels inhibited up to 52% of the activity of myeloperoxidase and matrix metalloproteinases, responsible for wound chronicity, and showed a strong antioxidant effect, which are crucial features promoting wound healing.
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20
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Dissemond J, Lobmann R. Evidenzbasierte Lokaltherapie chronischer Wunden. AKTUELLE DERMATOLOGIE 2022. [DOI: 10.1055/a-1904-3302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ZusammenfassungChronische Wunden sind zumeist durch Grunderkrankungen wie Diabetes mellitus oder Gefäßerkrankungen bedingt und stellen eine große Problematik in der zunehmend alternden Gesellschaft dar. Die inadäquate Behandlung geht oftmals mit protrahierter Wundheilung, erhöhten Risiken für Komplikationen, eingeschränkter Lebensqualität der Betroffenen und langwierigen Therapien mit hohen Behandlungskosten einher.Die erfolgreiche Therapie setzt eine frühzeitige adäquate Diagnostik, Kausaltherapie sowie Wundbehandlung möglichst auf Basis evidenzbasierter Medizin voraus. Diese Behandlung sollte dann in qualifizierten Versorgungsstrukturen anhand konkreter Behandlungspfade erfolgen. Somit können in der täglichen Praxis eine verbesserte Wundheilung mit gesteigerter Lebensqualität der Patienten sowie ein medizinökonomischer Vorteil erreicht werden.In diesem Übersichtsartikel wird die evidenzbasierte Lokaltherapie chronischer Wunden mit Schwerpunkt auf Wundverbänden mit TLC-Sucrose-Octasulfat-Beschichtung dargestellt. Leitlinien und Behandlungspfade sowie pharmaökonomische Aspekte werden dabei berücksichtigt.
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Affiliation(s)
- Joachim Dissemond
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Essen, Deutschland
| | - Ralf Lobmann
- Klinik für Endokrinologie, Diabetologie und Geriatrie, Klinikum Stuttgart, Stuttgart, Deutschland
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21
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Angelou V, Psalla D, Dovas CI, Kazakos GM, Marouda C, Chatzimisios K, Kyrana Z, Moutou E, Karayannopoulou M, Papazoglou LG. Locally Injected Autologous Platelet-Rich Plasma Improves Cutaneous Wound Healing in Cats. Animals (Basel) 2022; 12:ani12151993. [PMID: 35953982 PMCID: PMC9367528 DOI: 10.3390/ani12151993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
Cutaneous defects in cats are commonly encountered in clinical practice, and healing can be accomplished by first or second intention. Platelet-rich plasma (PRP) is characterized by a plasma concentration containing a large number of platelets in a small volume of plasma. The objective of the present study was to record the efficacy of PRP infiltration in open wounds in laboratory cats. Six wounds were created in the dorsal midline of eight laboratory cats, with the wounds of one side designated as the PRP group and the wounds of the other side as the control group. Wound healing was evaluated by daily clinical examination, planimetry, laser Doppler flowmetry, and histologic examination on days 0, 7, 14, and 25, and by measurement of metalloproteinases (MMPs)-2 and -9 and tissue inhibitor metalloproteinase (TIMP)-1 on days 0, 14, and 25. Based on the results of the present study, the mean time for full coverage with granulation tissue was shorter in the PRP group, the mean contraction and total wound healing percentage were increased compared to the control group, and finally, the perfusion measured with laser Doppler flowmetry was higher in the PRP group during all examination days. In conclusion, this is the first study focusing on the topical application of PRP in the treatment of open wounds in laboratory cats, and our results are encouraging—showing a more rapid healing in the PRP group.
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Affiliation(s)
- Vasileia Angelou
- Unit of Surgery and Obstetrics, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
- Correspondence: ; Tel.:+231-0994408
| | - Dimitra Psalla
- Laboratory of Pathology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Chrysostomos I. Dovas
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 11 S. Voutyra Str., 54627 Thessaloniki, Greece
| | - George M. Kazakos
- Unit of Anaesthesiology and Intensive Care, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Christina Marouda
- Laboratory of Pathology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Kyriakos Chatzimisios
- Unit of Surgery and Obstetrics, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Zacharenia Kyrana
- Laboratory of Agronomy, School of Agriculture, Faculty of Agriculture, Forestry and Natural Environment, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Evangelia Moutou
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 11 S. Voutyra Str., 54627 Thessaloniki, Greece
| | - Maria Karayannopoulou
- Unit of Surgery and Obstetrics, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Lysimachos G. Papazoglou
- Unit of Surgery and Obstetrics, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
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22
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Weigelt MA, Lev-Tov HA, Tomic-Canic M, Lee WD, Williams R, Strasfeld D, Kirsner RS, Herman IM. Advanced Wound Diagnostics: Toward Transforming Wound Care into Precision Medicine. Adv Wound Care (New Rochelle) 2022; 11:330-359. [PMID: 34128387 DOI: 10.1089/wound.2020.1319] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Significance: Nonhealing wounds are an ever-growing global pandemic, with mortality rates and management costs exceeding many common cancers. Although our understanding of the molecular and cellular factors driving wound healing continues to grow, standards for diagnosing and evaluating wounds remain largely subjective and experiential, whereas therapeutic strategies fail to consistently achieve closure and clinicians are challenged to deliver individualized care protocols. There is a need to apply precision medicine practices to wound care by developing evidence-based approaches, which are predictive, prescriptive, and personalized. Recent Advances: Recent developments in "advanced" wound diagnostics, namely biomarkers (proteases, acute phase reactants, volatile emissions, and more) and imaging systems (ultrasound, autofluorescence, spectral imaging, and optical coherence tomography), have begun to revolutionize our understanding of the molecular wound landscape and usher in a modern age of therapeutic strategies. Herein, biomarkers and imaging systems with the greatest evidence to support their potential clinical utility are reviewed. Critical Issues: Although many potential biomarkers have been identified and several imaging systems have been or are being developed, more high-quality randomized controlled trials are necessary to elucidate the currently questionable role that these tools are playing in altering healing dynamics or predicting wound closure within the clinical setting. Future Directions: The literature supports the need for the development of effective point-of-care wound assessment tools, such as a platform diagnostic array that is capable of measuring multiple biomarkers at once. These, along with advances in telemedicine, synthetic biology, and "smart" wearables, will pave the way for the transformation of wound care into a precision medicine. Clinical Trial Registration number: NCT03148977.
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Affiliation(s)
- Maximillian A. Weigelt
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Hadar A. Lev-Tov
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Marjana Tomic-Canic
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - W. David Lee
- Precision Healing, Inc., Newton, Massachusetts, USA
| | | | | | - Robert S. Kirsner
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ira M. Herman
- Precision Healing, Inc., Newton, Massachusetts, USA
- Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
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23
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Darvishi S, Tavakoli S, Kharaziha M, Girault HH, Kaminski CF, Mela I. Advances in the Sensing and Treatment of Wound Biofilms. ANGEWANDTE CHEMIE (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2022; 134:e202112218. [PMID: 38505642 PMCID: PMC10946914 DOI: 10.1002/ange.202112218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Indexed: 03/21/2024]
Abstract
Wound biofilms represent a particularly challenging problem in modern medicine. They are increasingly antibiotic resistant and can prevent the healing of chronic wounds. However, current treatment and diagnostic options are hampered by the complexity of the biofilm environment. In this review, we present new chemical avenues in biofilm sensors and new materials to treat wound biofilms, offering promise for better detection, chemical specificity, and biocompatibility. We briefly discuss existing methods for biofilm detection and focus on novel, sensor-based approaches that show promise for early, accurate detection of biofilm formation on wound sites and that can be translated to point-of-care settings. We then discuss technologies inspired by new materials for efficient biofilm eradication. We focus on ultrasound-induced microbubbles and nanomaterials that can both penetrate the biofilm and simultaneously carry active antimicrobials and discuss the benefits of those approaches in comparison to conventional methods.
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Affiliation(s)
- Sorour Darvishi
- Department of Chemical Engineering and BiotechnologyUniversity of CambridgePhilippa Fawcett DriveCambridgeCB3 0ASUK
- Department of Chemistry and Chemical EngineeringÉcole Polytechnique Fédérale de Lausanne1951SionSwitzerland
| | - Shima Tavakoli
- Department of Chemistry-Ångstrom LaboratoryUppsala UniversitySE75121UppsalaSweden
| | - Mahshid Kharaziha
- Department of Materials EngineeringIsfahan University of TechnologyIsfahan84156-83111Iran
| | - Hubert H. Girault
- Department of Chemistry and Chemical EngineeringÉcole Polytechnique Fédérale de Lausanne1951SionSwitzerland
| | - Clemens F. Kaminski
- Department of Chemical Engineering and BiotechnologyUniversity of CambridgePhilippa Fawcett DriveCambridgeCB3 0ASUK
| | - Ioanna Mela
- Department of Chemical Engineering and BiotechnologyUniversity of CambridgePhilippa Fawcett DriveCambridgeCB3 0ASUK
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24
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Xie J, Wu W, Zheng L, Lin X, Tai Y, Wang Y, Wang L. Roles of MicroRNA-21 in Skin Wound Healing: A Comprehensive Review. Front Pharmacol 2022; 13:828627. [PMID: 35295323 PMCID: PMC8919367 DOI: 10.3389/fphar.2022.828627] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/10/2022] [Indexed: 12/12/2022] Open
Abstract
MicroRNA-21 (miR-21), one of the early mammalian miRNAs identified, has been detected to be upregulated in multiple biological processes. Increasing evidence has demonstrated the potential values of miR-21 in cutaneous damage and skin wound healing, but lack of a review article to summarize the current evidence on this issue. Based on this review, relevant studies demonstrated that miR-21 played an essential role in wound healing by constituting a complex network with its targeted genes (i.e., PTEN, RECK. SPRY1/2, NF-κB, and TIMP3) and the cascaded signaling pathways (i.e., MAPK/ERK, PI3K/Akt, Wnt/β-catenin/MMP-7, and TGF-β/Smad7-Smad2/3). The treatment effectiveness developed by miR-21 might be associated with the promotion of the fibroblast differentiation, the improvement of angiogenesis, anti-inflammatory, enhancement of the collagen synthesis, and the re-epithelialization of the wound. Currently, miRNA nanocarrier systems have been developed, supporting the feasibility clinical feasibility of such miR-21-based therapy. After further investigations, miR-21 may serve as a potential therapeutic target for wound healing.
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Affiliation(s)
- Jie Xie
- Department of Emergency Medicine, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Weizhou Wu
- Department of Urology, Maoming People's Hospital, Guangdong, China
| | - Liying Zheng
- Postgraduate Pepartment, First Affiliated Hospital of Gannan Medical College, Ganzhou, China
| | - Xuesong Lin
- Department of Burn Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Yuncheng Tai
- Department of Burn Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Yajie Wang
- Department of Burn Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Le Wang
- Department of Burn Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
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Bardill JR, Laughter MR, Stager M, Liechty KW, Krebs MD, Zgheib C. Topical gel-based biomaterials for the treatment of diabetic foot ulcers. Acta Biomater 2022; 138:73-91. [PMID: 34728428 PMCID: PMC8738150 DOI: 10.1016/j.actbio.2021.10.045] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/18/2021] [Accepted: 10/25/2021] [Indexed: 01/17/2023]
Abstract
Diabetic foot ulcers (DFUs) are a devastating ailment for many diabetic patients with increasing prevalence and morbidity. The complex pathophysiology of DFU wound environments has made finding effective treatments difficult. Standard wound care treatments have limited efficacy in healing these types of chronic wounds. Topical biomaterial gels have been developed to implement novel treatment approaches to improve therapeutic effects and are advantageous due to their ease of application, tunability, and ability to improve therapeutic release characteristics. Here, we provide an updated, comprehensive review of novel topical biomaterial gels developed for treating chronic DFUs. This review will examine preclinical data for topical gel treatments in diabetic animal models and clinical applications, focusing on gels with protein/peptides, drug, cellular, herbal/antioxidant, and nano/microparticle approaches. STATEMENT OF SIGNIFICANCE: By 2050, 1 in 3 Americans will develop diabetes, and up to 34% of diabetic patients will develop a diabetic foot ulcer (DFU) in their lifetime. Current treatments for DFUs include debridement, infection control, maintaining a moist wound environment, and pressure offloading. Despite these interventions, a large number of DFUs fail to heal and are associated with a cost that exceeds $31 billion annually. Topical biomaterials have been developed to help target specific impairments associated with DFU with the goal to improve healing. A summary of these approaches is needed to help better understand the current state of the research. This review summarizes recent research and advances in topical biomaterials treatments for DFUs.
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Affiliation(s)
- James R Bardill
- Laboratory for Fetal and Regenerative Biology, Department of Surgery, University of Colorado Denver School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
| | | | - Michael Stager
- Department of Chemical and Biological Engineering, Colorado School of Mines, Golden, CO, USA
| | - Kenneth W Liechty
- Laboratory for Fetal and Regenerative Biology, Department of Surgery, University of Colorado Denver School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
| | - Melissa D Krebs
- Department of Chemical and Biological Engineering, Colorado School of Mines, Golden, CO, USA
| | - Carlos Zgheib
- Laboratory for Fetal and Regenerative Biology, Department of Surgery, University of Colorado Denver School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.
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Wilkinson HN, Reubinoff B, Shveiky D, Hardman MJ, Menachem-Zidon OB. Epithelial arginase-1 is a key mediator of age-associated delayed healing in vaginal injury. Front Endocrinol (Lausanne) 2022; 13:927224. [PMID: 36034415 PMCID: PMC9410732 DOI: 10.3389/fendo.2022.927224] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 07/22/2022] [Indexed: 11/30/2022] Open
Abstract
Pelvic organ prolapse is a disorder that substantially affects the quality of life of millions of women worldwide. The greatest risk factors for prolapse are increased parity and older age, with the largest group requiring surgical intervention being post-menopausal women over 65. Due to ineffective healing in the elderly, prolapse recurrence rates following surgery remain high. Therefore, there is an urgent need to elucidate the cellular and molecular drivers of poor healing in pelvic floor dysfunction to allow effective management and even prevention. Recent studies have uncovered the importance of Arginase 1 for modulating effective healing in the skin. We thus employed novel in vitro and in vivo vaginal injury models to determine the specific role of Arginase 1 in age-related vaginal repair. Here we show, for the first time, that aged rat vaginal wounds have reduced Arginase 1 expression and delayed healing. Moreover, direct inhibition of Arginase 1 in human vaginal epithelial cells also led to delayed scratch-wound closure. By contrast, activation of Arginase 1 significantly accelerated healing in aged vaginal wounds in vivo, to rates comparable to those in young animals. Collectively, these findings reveal a new and important role for Arginase 1 in mediating effective vaginal repair. Targeting age-related Arginase 1 deficiency is a potential viable therapeutic strategy to promote vaginal healing and reduce recurrence rate after surgical repair of pelvic organ prolapse.
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Affiliation(s)
- Holly N. Wilkinson
- Centre for Biomedicine, Hull York Medical School, University of Hull, Hull, United Kingdom
- *Correspondence: Ofra Ben Menachem-Zidon, ; Holly N. Wilkinson,
| | - Benjamin Reubinoff
- The Hadassah Human Embryonic Stem Cell Research Center and the Goldyne Savad Institute of Gene Therapy, Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Obstetrics and Gynecology, Hadassah – Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel
| | - David Shveiky
- Department of Obstetrics and Gynecology, Hadassah – Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel
- Section of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics & Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Matthew J. Hardman
- Centre for Biomedicine, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Ofra Ben Menachem-Zidon
- The Hadassah Human Embryonic Stem Cell Research Center and the Goldyne Savad Institute of Gene Therapy, Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- *Correspondence: Ofra Ben Menachem-Zidon, ; Holly N. Wilkinson,
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Issa R, Thompson KL, Price BL. CONTROL OF STAPHYLOCOCCAL-MEDIATED ENDOGENOUS PROTEASE ACTIVITY ALTERS WOUND CLOSURE TIME IN A COMPLEX WOUND MODEL. J Dermatol Sci 2022; 105:105-112. [DOI: 10.1016/j.jdermsci.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 10/19/2022]
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Jifar WW, Atnafie SA, Angalaparameswari S. A Review: Matrix Metallopeptidase-9 Nanoparticles Targeted for the Treatment of Diabetic Foot Ulcers. J Multidiscip Healthc 2021; 14:3321-3329. [PMID: 34880623 PMCID: PMC8646228 DOI: 10.2147/jmdh.s343085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/23/2021] [Indexed: 12/14/2022] Open
Abstract
Diabetes foot ulcers are a leading cause of death in diabetic individuals. There are very few medicines and treatments that have received regulatory clearance for this indication, and numerous compounds from various pharmacological classes are now in various stages of clinical studies for diabetic foot ulcers treatment. Multiple risk factors contribute to diabetic foot ulcers, including neuropathy, peripheral artery disease, infection, gender, cigarette smoking, and age. The present difficulties in diabetic foot ulcers treatment are related to bacterial resistance to currently utilized antibiotics. Inhibition of the quorum sensing (QS) system and targeting matrix metallopeptidase-9 (MMP-9) are promising. This study focuses on the difficulties of existing treatment, current treatment technique, and novel pharmacological targets for diabetic foot ulcer. The electronic data base search diabetic for literature on foot ulcers treatment was carried out using Science Direct, PubMed, Google-Scholar, Springer Link, Scopus, and Wiley up to 2021. Becaplermin, a medication that targets MMP-9, glyceryl trinitrate, which inhibits the bacterial quorum sensing system, probiotic therapy, and nano technological solutions are just a few of the novel pharmaceuticals being developed for diabetic foot ulcers treatment. A combination of therapies, rather than one particular agent, will be the best option for treatment of Diabetes foot ulcer since it is multifactorial factors that render occurs of diabetic foot ulcer.
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Affiliation(s)
- Wakuma Wakene Jifar
- Mettu University, College of Health Sciences, Department of Pharmacy, Mettu, Ethiopia
| | - Seyfe Asrade Atnafie
- University of Gondar, College of Medicine and Health Sciences, School of Pharmacy, Department of Pharmacology, Gondar, Ethiopia
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Augustin M, Keuthage W, Lobmann R, Lützkendorf S, Groth H, Möller U, Thomassin L, Bohbot S, Dissemond J, Blome C. Clinical evaluation of UrgoStart Plus dressings in real-life conditions: results of a prospective multicentre study on 961 patients. J Wound Care 2021; 30:966-978. [PMID: 34881999 DOI: 10.12968/jowc.2021.30.12.966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AIMS This study aimed to evaluate the performances of lipid colloid technology with nano-oligosaccharide factor (TLC-NOSF) dressings with polyabsorbent fibres in an unselected population of patients under real-life conditions. METHODS A large, prospective, multicentre, observational study with three polyabsorbent TLC-NOSF dressings (UrgoStart Plus Pad, UrgoStart Plus and UrgoStart Plus Border, Laboratoires Urgo, France) was conducted in Germany between January 2019 and June 2020. Main outcomes included wound healing rate, clinical assessment of wound healing progression, local tolerance and acceptance of dressings, and changes in health-related quality of life (HRQoL) of the patients, assessed with the validated Wound-QoL questionnaire. RESULTS A total of 961 patients with wounds of various aetiologies (leg ulcers (LU), diabetic foot ulcers (DFU), pressure ulcers (PU) and other types of wounds) were treated with the evaluated dressings in 105 centres for a mean duration of 62 days (standard deviation 37 days). By the last visit, a wound closure or an improvement in wound healing was reported in 92.0% of the treated wounds. The highest wound closure rates were achieved when the dressings were used as first-line treatment: 71.3% in DFUs, 52.9% in LUs, 53.6% in PUs and 61.8% in the other wounds. Improvement of the wound healing process was also associated with an 87.5% relative reduction of sloughy tissue, a decrease of the level of exudate in 68.9% of the wounds, and an improvement in the periwound skin condition in 66.4% of the patients at the final visit. The dressings were 'very well' or 'well' tolerated and 'very well' or 'well' accepted by the large majority of patients. The HRQoL questionnaires were completed both at initial and final visits by 337 patients, representative of the total cohort. Despite the relatively short duration of the wounds, the HRQoL of the patients was already impaired at baseline, with 81.6% of the patients being severely affected in at least one aspect of their HRQoL. By the final visit, significant improvements in each dimension of the patients' HRQoL were reported (p<0.001), along with a reduction of the proportion of patients in need of intervention and in the number of actions needed per patient in relation to their HRQoL. CONCLUSIONS These results are consistent with previous clinical evidence on TLC-NOSF dressings. They confirm the good healing properties and safety profile of these dressings, and that a significant improvement in patient HRQoL is achieved in non-selected patients treated in real-life practice. These data support the use of such dressings as a first-line intervention and until wound healing in the management of chronic wounds, in association with appropriate standard of care.
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Affiliation(s)
- Matthias Augustin
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - Ralf Lobmann
- Krankenhaus Bad Cannstatt (kbc) / Klinikum, Stuttgart, Germany
| | | | - Hauke Groth
- Medical Office specialized on Diabetes Relllingen, Hamburg-Rellingen, Germany
| | | | | | - Serge Bohbot
- Medical Affairs Department, Laboratoires URGO Medical, Paris, France
| | - Joachim Dissemond
- Department of Dermatology, Venereology, and Allergology, University Hospital Essen, Essen, Germany
| | - Christine Blome
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Hauck S, Zager P, Halfter N, Wandel E, Torregrossa M, Kakpenova A, Rother S, Ordieres M, Räthel S, Berg A, Möller S, Schnabelrauch M, Simon JC, Hintze V, Franz S. Collagen/hyaluronan based hydrogels releasing sulfated hyaluronan improve dermal wound healing in diabetic mice via reducing inflammatory macrophage activity. Bioact Mater 2021; 6:4342-4359. [PMID: 33997511 PMCID: PMC8105600 DOI: 10.1016/j.bioactmat.2021.04.026] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 12/13/2022] Open
Abstract
Sustained inflammation associated with dysregulated macrophage activation prevents tissue formation and healing of chronic wounds. Control of inflammation and immune cell functions thus represents a promising approach in the development of advanced therapeutic strategies. Here we describe immunomodulatory hyaluronan/collagen (HA-AC/coll)-based hydrogels containing high-sulfated hyaluronan (sHA) as immunoregulatory component for the modulation of inflammatory macrophage activities in disturbed wound healing. Solute sHA downregulates inflammatory activities of bone marrow-derived and tissue-resident macrophages in vitro. This further affects macrophage-mediated pro-inflammatory activation of skin cells as shown in skin ex-vivo cultures. In a mouse model of acute skin inflammation, intradermal injection of sHA downregulates the inflammatory processes in the skin. This is associated with the promotion of an anti-inflammatory gene signature in skin macrophages indicating a shift of their activation profile. For in vivo translation, we designed HA-AC/coll hydrogels allowing delivery of sHA into wounds over a period of at least one week. Their immunoregulatory capacity was analyzed in a translational experimental approach in skin wounds of diabetic db/db mice, an established model for disturbed wound healing. The sHA-releasing hydrogels improved defective tissue repair with reduced inflammation, augmented pro-regenerative macrophage activation, increased vascularization, and accelerated new tissue formation and wound closure.
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Affiliation(s)
- Sophia Hauck
- Department of Dermatology, Venerology und Allergology, Leipzig University, 04103, Leipzig, Germany
| | - Paula Zager
- Department of Dermatology, Venerology und Allergology, Leipzig University, 04103, Leipzig, Germany
| | - Norbert Halfter
- Institute of Materials Science, Max Bergmann Center for Biomaterials, Technische Universität Dresden, 01069, Dresden, Germany
| | - Elke Wandel
- Department of Dermatology, Venerology und Allergology, Leipzig University, 04103, Leipzig, Germany
| | - Marta Torregrossa
- Department of Dermatology, Venerology und Allergology, Leipzig University, 04103, Leipzig, Germany
| | - Ainur Kakpenova
- Department of Dermatology, Venerology und Allergology, Leipzig University, 04103, Leipzig, Germany
| | - Sandra Rother
- Institute of Materials Science, Max Bergmann Center for Biomaterials, Technische Universität Dresden, 01069, Dresden, Germany
| | - Michelle Ordieres
- Department of Dermatology, Venerology und Allergology, Leipzig University, 04103, Leipzig, Germany
| | - Susann Räthel
- Department of Dermatology, Venerology und Allergology, Leipzig University, 04103, Leipzig, Germany
| | - Albrecht Berg
- Biomaterials Department, INNOVENT e.V. Jena, Germany
| | | | | | - Jan C. Simon
- Department of Dermatology, Venerology und Allergology, Leipzig University, 04103, Leipzig, Germany
| | - Vera Hintze
- Institute of Materials Science, Max Bergmann Center for Biomaterials, Technische Universität Dresden, 01069, Dresden, Germany
| | - Sandra Franz
- Department of Dermatology, Venerology und Allergology, Leipzig University, 04103, Leipzig, Germany
- Corresponding author. University Leipzig, Department of Dermatology, Venerology and Allergology, Max Bürger Research Centre, Johannisallee 30, 04103, Leipzig, Germany.
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31
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Darvishi S, Tavakoli S, Kharaziha M, Girault HH, Kaminski CF, Mela I. Advances in the Sensing and Treatment of Wound Biofilms. Angew Chem Int Ed Engl 2021; 61:e202112218. [PMID: 34806284 PMCID: PMC9303468 DOI: 10.1002/anie.202112218] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Indexed: 12/02/2022]
Abstract
Wound biofilms represent a particularly challenging problem in modern medicine. They are increasingly antibiotic resistant and can prevent the healing of chronic wounds. However, current treatment and diagnostic options are hampered by the complexity of the biofilm environment. In this review, we present new chemical avenues in biofilm sensors and new materials to treat wound biofilms, offering promise for better detection, chemical specificity, and biocompatibility. We briefly discuss existing methods for biofilm detection and focus on novel, sensor‐based approaches that show promise for early, accurate detection of biofilm formation on wound sites and that can be translated to point‐of‐care settings. We then discuss technologies inspired by new materials for efficient biofilm eradication. We focus on ultrasound‐induced microbubbles and nanomaterials that can both penetrate the biofilm and simultaneously carry active antimicrobials and discuss the benefits of those approaches in comparison to conventional methods.
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Affiliation(s)
- Sorour Darvishi
- EPFL: Ecole Polytechnique Federale de Lausanne, Chemistry and Chemical Engineering, SWITZERLAND
| | | | - Mahshid Kharaziha
- Isfahan University of Technology, Department of Materials Engineering, IRAN (ISLAMIC REPUBLIC OF)
| | - Hubert H Girault
- EPFL: Ecole Polytechnique Federale de Lausanne, Chemistry and Chemical Engineering, SWITZERLAND
| | - Clemens F Kaminski
- Cambridge University: University of Cambridge, Chemical Engineering and Biotechnology, Department of Chemical Engineering and Biotechnolo, Philippa Fawcett Drive, Cambridge, CB3 0AS, Cambridge, UNITED KINGDOM
| | - Ioanna Mela
- University of Cambridge, Chemical Engineering and Biotechnology, Philippa Fawcett Drive, CB3 0AS, Cambridge, UNITED KINGDOM
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32
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Da LC, Huang YZ, Xie HQ, Zheng BH, Huang YC, Du SR. Membranous Extracellular Matrix-Based Scaffolds for Skin Wound Healing. Pharmaceutics 2021; 13:1796. [PMID: 34834211 PMCID: PMC8620109 DOI: 10.3390/pharmaceutics13111796] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/16/2021] [Accepted: 10/22/2021] [Indexed: 02/05/2023] Open
Abstract
Membranous extracellular matrix (ECM)-based scaffolds are one of the most promising biomaterials for skin wound healing, some of which, such as acellular dermal matrix, small intestinal submucosa, and amniotic membrane, have been clinically applied to treat chronic wounds with acceptable outcomes. Nevertheless, the wide clinical applications are always hindered by the poor mechanical properties, the uncontrollable degradation, and other factors after implantation. To highlight the feasible strategies to overcome the limitations, in this review, we first outline the current clinical use of traditional membranous ECM scaffolds for skin wound healing and briefly introduce the possible repair mechanisms; then, we discuss their potential limitations and further summarize recent advances in the scaffold modification and fabrication technologies that have been applied to engineer new ECM-based membranes. With the development of scaffold modification approaches, nanotechnology and material manufacturing techniques, various types of advanced ECM-based membranes have been reported in the literature. Importantly, they possess much better properties for skin wound healing, and would become promising candidates for future clinical translation.
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Affiliation(s)
- Lin-Cui Da
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, China; (L.-C.D.); (B.-H.Z.)
| | - Yi-Zhou Huang
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu 610041, China;
| | - Hui-Qi Xie
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu 610041, China;
| | - Bei-Hong Zheng
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, China; (L.-C.D.); (B.-H.Z.)
| | - Yong-Can Huang
- Shenzhen Engineering Laboratory of Orthopaedic Regenerative Technologies, Department of Spine Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, China;
| | - Sheng-Rong Du
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, China; (L.-C.D.); (B.-H.Z.)
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Zheng D, Huang C, Zhu X, Huang H, Xu C. Performance of Polydopamine Complex and Mechanisms in Wound Healing. Int J Mol Sci 2021; 22:10563. [PMID: 34638906 PMCID: PMC8508909 DOI: 10.3390/ijms221910563] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 12/15/2022] Open
Abstract
Polydopamine (PDA) has been gradually applied in wound healing of various types in the last three years. Due to its rich phenol groups and unique structure, it can be combined with a variety of materials to form wound dressings that can be used for chronic infection, tissue repair in vivo and serious wound healing. PDA complex has excellent mechanical properties and self-healing properties, and it is a stable material that can be used for a long period of time. Unlike other dressings, PDA complexes can achieve both photothermal therapy and electro activity. In this paper, wound healing is divided into four stages: antibacterial, anti-inflammatory, cell adhesion and proliferation, and re-epithelialization. Photothermal therapy can improve the bacteriostatic rate and remove reactive oxygen species to inhibit inflammation. Electrical signals can stimulate cell proliferation and directional migration. With low reactive oxygen species (ROS) levels, inflammatory factors are down-regulated and growth factors are up-regulated, forming regular collagen fibers and accelerating wound healing. Finally, five potential development directions are proposed, including increasing drug loading capacity, optimization of drug delivery platforms, improvement of photothermal conversion efficiency, intelligent electroactive materials and combined 3D printing.
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Affiliation(s)
| | - Chongxing Huang
- School of Light Industry & Food Engineering, Guangxi University, Daxue Road 100, Nanning 530000, China; (D.Z.); (X.Z.); (H.H.); (C.X.)
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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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35
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The Insights of Microbes' Roles in Wound Healing: A Comprehensive Review. Pharmaceutics 2021; 13:pharmaceutics13070981. [PMID: 34209654 PMCID: PMC8308956 DOI: 10.3390/pharmaceutics13070981] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/18/2022] Open
Abstract
A diverse range of normal flora populates the human skin and numbers are relatively different between individuals and parts of the skin. Humans and normal flora have formed a symbiotic relationship over a period of time. With numerous disease processes, the interaction between the host and normal flora can be interrupted. Unlike normal wound healing, which is complex and crucial to sustaining the skin’s physical barrier, chronic wounds, especially in diabetes, are wounds that fail to heal in a timely manner. The conditions become favorable for microbes to colonize and establish infections within the skin. These include secretions of various kinds of molecules, substances or even trigger the immune system to attack other cells required for wound healing. Additionally, the healing process can be slowed down by prolonging the inflammatory phase and delaying the wound repair process, which causes further destruction to the tissue. Antibiotics and wound dressings become the targeted therapy to treat chronic wounds. Though healing rates are improved, prolonged usage of these treatments could become ineffective or microbes may become resistant to the treatments. Considering all these factors, more studies are needed to comprehensively elucidate the role of human skin normal flora at the cellular and molecular level in a chronic injury. This article will review wound healing physiology and discuss the role of normal flora in the skin and chronic wounds.
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36
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Laulund ASB, Trøstrup H, Lerche CJ, Thomsen K, Christophersen L, Calum H, Høiby N, Moser C. Synergistic effect of immunomodulatory S100A8/A9 and ciprofloxacin against Pseudomonas aeruginosa biofilm in a murine chronic wound model. Pathog Dis 2021; 78:5497298. [PMID: 31116394 DOI: 10.1093/femspd/ftz027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/29/2019] [Indexed: 12/20/2022] Open
Abstract
The majority of chronic wounds are associated with bacterial biofilms recalcitrant to antibiotics and host responses. Immunomodulatory S100A8/A9 is suppressed in Pseudomonas aeruginosa biofilm infected wounds. We aimed at investigating a possible additive effect between S100A8/A9 and ciprofloxacin against biofilms. MATERIALS/METHODS Thirty-two mice were injected with alginate-embedded P. aeruginosa following a third-degree burn. The mice were randomized into four groups receiving combination ciprofloxacin and S100A8/A9 or monotherapy ciprofloxacin, S100A8/A9 or a placebo and evaluated by host responses and quantitative bacteriology in wounds. In addition, in vitro checkerboard analysis was performed, with P. aeruginosa and ascending S100A8/A9 and ciprofloxacin concentrations. RESULTS S100A8/A9 augmented the effect of ciprofloxacin in vivo by lowering the bacterial quantity compared to the placebo arm and the two monointervention groups (P < 0.0001). S100A8 and 100A9 were increased in the double-treated group as compared to the monointervention groups (P = 0.032, P = 0.0023). Tissue inhibitor of metalloproteinases-1 and keratinocyte\chemokine chemoattractant-1 were increased in the double-intervention group compared to the S100A8/A9 group (P = 0.050, P = 0.050). No in vitro synergism was detected. CONCLUSION The observed ciprofloxacin-augmenting effect of S100A8/A9 in vivo was not confirmed by checkerboard analysis, indicating dependence on host cells for the S100A8/A9 effect. S100A8/A9 and ciprofloxacin is a promising therapy for optimizing chronic wound treatment.
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Affiliation(s)
- Anne Sofie Boe Laulund
- Department of Plastic Surgery, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark
| | - Hannah Trøstrup
- Department of Plastic Surgery, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark
| | - Christian Johann Lerche
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Kim Thomsen
- Department of Plastic Surgery, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark
| | - Lars Christophersen
- Department of Plastic Surgery, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark
| | - Henrik Calum
- Department of Clinical Microbiology, Amager and Hvidovre Hospital, Copenhagen University Hospital, Kettegaard Alle 30, 2650 Copenhagen, Denmark
| | - Niels Høiby
- Institute for Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Claus Moser
- Department of Plastic Surgery, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark
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Nair H, Venkateshwaran N, Seetharaman S S, Deng W, Uthaipaisanwong A, Galea E. Benefits of sucrose octasulfate (TLC-NOSF) dressings in the treatment of chronic wounds: a systematic review. J Wound Care 2021; 30:S42-S52. [PMID: 33856929 DOI: 10.12968/jowc.2021.30.sup4.s42] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Management of chronic wounds remains one of the major challenges for health professionals and patients. An evidence-based decision is important to ensure that patients are receiving the best treatment proven to reduce healing time and improve outcomes, including economic benefits and patients' health-related quality of life (HRQoL). Due to recent restrictions because of the COVID-19 pandemic, including closure of wound care centres within hospitals and a drop in patient volume, chronic wound management needs simple-to-use dressings which are still effective and evidence-based solutions. This systematic review was conducted to identify the clinical evidence available on a sucrose octasulfate dressing (TLC-NOSF, UrgoStart dressing range, Laboratoires Urgo, France) to explore its efficacy in the management of chronic wounds, particularly lower limb ulcers, diabetic foot ulcers and pressure ulcers. METHOD A literature search of PubMed, Cochrane Library and Google Scholar was conducted based on the PICO model (patient/population, intervention, comparison and outcomes) to retrieve publications of different levels of evidence in order to evaluate outcomes of the use of TLC-NOSF dressings. RESULTS A total of 21 publications of different levels, ranging from double-blind randomised control trials to case reports, involving over 12,000 patients, were identified through PubMed, with a further eight publications through Google Scholar and two publications through Cochrane Library. A total of seven results were omitted due to the lack of relevance or repetition. CONCLUSION All the evidence provided suggest that these dressings provide clinicians with an evidence-based option for the management of chronic wounds; that the TLC-NOSF dressings are beneficial in promoting the healing process, reducing healing times, enhancing patients' HRQoL, and in allowing a more cost-effective procedure.
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Affiliation(s)
- Harikrishna Nair
- Head and Consultant, Wound Care Unit, Department of Internal Medicine, Kuala Lumpur Hospital, Malaysia
| | - N Venkateshwaran
- Consultant Plastic and Cosmetic Surgery, Jupiter Hospital, Mumbai, India
| | - Selva Seetharaman S
- Consultant and Head of Department of Plastic and Reconstructive Surgery, Gleneagles Global Hospital, Chennai, India
| | - Wuquan Deng
- Head of Endocrinology Department. Chongqing Emergency Medical Centre, Chongqing University Central Hospital, Chongqing, China
| | - Apinan Uthaipaisanwong
- Department of Surgery, King Chulalongkorn Memorial Hospital, Patumwan, Bangkok, Thailand
| | - Emilio Galea
- International Medical Director, Urgo Education and Training Alliance, Singapore
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Grant JJ, Pillai SC, Hehir S, McAfee M, Breen A. Biomedical Applications of Electrospun Graphene Oxide. ACS Biomater Sci Eng 2021; 7:1278-1301. [PMID: 33729744 DOI: 10.1021/acsbiomaterials.0c01663] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Graphene oxide (GO) has broad potential in the biomedical sector. The oxygen-abundant nature of GO means the material is hydrophilic and readily dispersible in water. GO has also been known to improve cell proliferation, drug loading, and antimicrobial properties of composites. Electrospun composites likewise have great potential for biomedical applications because they are generally biocompatible and bioresorbable, possess low immune rejection risk, and can mimic the structure of the extracellular matrix. In the current review, GO-containing electrospun composites for tissue engineering applications are described in detail. In addition, electrospun GO-containing materials for their use in drug and gene delivery, wound healing, and biomaterials/medical devices have been examined. Good biocompatibility and anionic-exchange properties of GO make it an ideal candidate for drug and gene delivery systems. Drug/gene delivery applications for electrospun GO composites are described with a number of examples. Various systems using electrospun GO-containing therapeutics have been compared for their potential uses in cancer therapy. Micro- to nanosized electrospun fibers for wound healing applications and antimicrobial applications are explained in detail. Applications of various GO-containing electrospun composite materials for medical device applications are listed. It is concluded that the electrospun GO materials will find a broad range of biomedical applications such as cardiac patches, medical device coatings, sensors, and triboelectric nanogenerators for motion sensing and biosensing.
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Affiliation(s)
- Jamie J Grant
- Nanotechnology and Bio-engineering Research Division, Institute of Technology Sligo, Ash Lane, Ballinode, Sligo, Ireland.,The Centre for Precision Engineering, Materials & Manufacturing Research, Institute of Technology Sligo, Ash Lane, Ballinode, Sligo, Ireland
| | - Suresh C Pillai
- Nanotechnology and Bio-engineering Research Division, Institute of Technology Sligo, Ash Lane, Ballinode, Sligo, Ireland.,The Centre for Precision Engineering, Materials & Manufacturing Research, Institute of Technology Sligo, Ash Lane, Ballinode, Sligo, Ireland
| | - Sarah Hehir
- Nanotechnology and Bio-engineering Research Division, Institute of Technology Sligo, Ash Lane, Ballinode, Sligo, Ireland.,The Centre for Precision Engineering, Materials & Manufacturing Research, Institute of Technology Sligo, Ash Lane, Ballinode, Sligo, Ireland
| | - Marion McAfee
- Nanotechnology and Bio-engineering Research Division, Institute of Technology Sligo, Ash Lane, Ballinode, Sligo, Ireland.,The Centre for Precision Engineering, Materials & Manufacturing Research, Institute of Technology Sligo, Ash Lane, Ballinode, Sligo, Ireland
| | - Ailish Breen
- Nanotechnology and Bio-engineering Research Division, Institute of Technology Sligo, Ash Lane, Ballinode, Sligo, Ireland.,The Centre for Precision Engineering, Materials & Manufacturing Research, Institute of Technology Sligo, Ash Lane, Ballinode, Sligo, Ireland
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Johnson JB, Broszczak DA, Mani JS, Anesi J, Naiker M. A cut above the rest: oxidative stress in chronic wounds and the potential role of polyphenols as therapeutics. J Pharm Pharmacol 2021; 74:485-502. [PMID: 33822141 DOI: 10.1093/jpp/rgab038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/11/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The pathophysiology of chronic wounds typically involves redox imbalance and inflammation pathway dysregulation, often with concomitant microbial infection. Endogenous antioxidants such as glutathione and tocopherols are notably reduced or absent, indicative of significant oxidative imbalance. However, emerging evidence suggests that polyphenols could be effective agents for the amelioration of this condition. This review aims to summarise the current state of knowledge surrounding redox imbalance in the chronic wound environment and the potential use of polyphenols for the treatment of chronic wounds. KEY FINDINGS Polyphenols provide a multi-faceted approach towards the treatment of chronic wounds. Firstly, their antioxidant activity allows direct neutralisation of harmful free radicals and reactive oxygen species, assisting in restoring redox balance. Upregulation of pro-healing and anti-inflammatory gene pathways and enzymes by specific polyphenols further acts to reduce redox imbalance and promote wound healing actions, such as proliferation, extracellular matrix deposition and tissue remodelling. Finally, many polyphenols possess antimicrobial activity, which can be beneficial for preventing or resolving infection of the wound site. SUMMARY Exploration of this diverse group of natural compounds may yield effective and economical options for the prevention or treatment of chronic wounds.
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Affiliation(s)
- Joel B Johnson
- School of Health, Medical and Applied Science, CQUniversity, Bruce Hwy, North Rockhampton, Queensland, Australia.,Centre for Indigenous Health Equity Research, CQUniversity, Bruce Hwy, North Rockhampton, Queensland, Australia
| | - Daniel A Broszczak
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Tissue Repair and Translational Physiology Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Janice S Mani
- School of Health, Medical and Applied Science, CQUniversity, Bruce Hwy, North Rockhampton, Queensland, Australia.,Centre for Indigenous Health Equity Research, CQUniversity, Bruce Hwy, North Rockhampton, Queensland, Australia
| | - Jack Anesi
- School of Science, Psychology and Sport, Federation University Australia, Ballarat, Victoria, Australia
| | - Mani Naiker
- School of Health, Medical and Applied Science, CQUniversity, Bruce Hwy, North Rockhampton, Queensland, Australia.,Centre for Indigenous Health Equity Research, CQUniversity, Bruce Hwy, North Rockhampton, Queensland, Australia
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Hamed S, Ullmann Y, Belokopytov M, Shoufani A, Kabha H, Masri S, Feldbrin Z, Kogan L, Kruchevsky D, Najjar R, Liu PY, Kerihuel JC, Akita S, Teot L. Topical Erythropoietin Accelerates Wound Closure in Patients with Diabetic Foot Ulcers: A Prospective, Multicenter, Single-Blind, Randomized, Controlled Trial. Rejuvenation Res 2021; 24:251-261. [PMID: 33504262 DOI: 10.1089/rej.2020.2397] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The diabetic foot ulcer (DFU) is a major disabling complication of diabetes mellitus. Growing evidence suggests that topical erythropoietin (EPO) can promote wound healing. The aim of this study is to clinically assess the efficacy of a proprietary topical EPO-containing hydrogel for treating DFUs. We conducted a randomized, controlled trial in 20 patients with DFUs. After a 14-day screening period, the DFUs of 20 eligible participants who fulfilled the inclusion criteria were randomly assigned (1:1) to either a 12-week of daily treatment with topical EPO and standard-of-care (SOC) or SOC treatment alone. The DFUs were assessed weekly until week 12. The primary outcome was 75% ulcer closure or higher. After 12 weeks of treatment, 75% ulcer closure was achieved in 6 of the 10 patients whose DFUs were treated with topical EPO and in one of the 8 patients whose DFUs were treated with SOC alone. The mean area of the DFUs that were treated with topical EPO and SOC was significantly smaller than those treated with SOC alone (1.2 ± 1.4 cm2 vs. 4.2 ± 3.4 cm2; p = 0.023). Re-epithelialization was faster in the topically EPO-treated DFUs than in the SOC-treated DFUs. There were no treatment-related adverse events. We conclude that topical EPO is a promising treatment for promoting the healing of DFUs. Clinical Trial Registration number: NCT02361931.
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Affiliation(s)
- Saher Hamed
- Department of Research and Development, Remedor Biomed Ltd., Nazareth Illit, Israel
| | - Yehuda Ullmann
- Department of Plastic and Reconstructive Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Mark Belokopytov
- Department of Research and Development, Remedor Biomed Ltd., Nazareth Illit, Israel
| | - Aziz Shoufani
- Department of Plastic Surgery and General Surgery, Emek Medical Center, Afula, Israel
| | - Hoda Kabha
- Department of Research and Development, Remedor Biomed Ltd., Nazareth Illit, Israel
| | - Suher Masri
- Department of Research and Development, Remedor Biomed Ltd., Nazareth Illit, Israel
| | - Zeev Feldbrin
- Diabetes Foot Care Unit, Wolfson Medical Center, Holon, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Leonid Kogan
- Department of Plastic Surgery, Western Galilee Medical Center, Nahariya, Israel
| | - Danny Kruchevsky
- Department of Plastic and Reconstructive Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Roger Najjar
- Department of Plastic Surgery, Western Galilee Medical Center, Nahariya, Israel
| | - Paul Y Liu
- Department of Plastic Surgery, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | | | - Sadanori Akita
- Department Wound Care and Plastic and Reconstructive Surgery, Fukuoka University, Fukuoka, Japan
| | - Luc Teot
- Department of Plastic and Reconstructive Surgery and Wound Healing, Montpellier University Hospital, Lapeyronie, Montpellier, France
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Jia Z, Gong J, Zeng Y, Ran J, Liu J, Wang K, Xie C, Lu X, Wang J. Bioinspired Conductive Silk Microfiber Integrated Bioelectronic for Diagnosis and Wound Healing in Diabetes. ADVANCED FUNCTIONAL MATERIALS 2021. [DOI: 10.1002/adfm.202010461] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Zhanrong Jia
- Key Lab of Advanced Technologies of Materials Ministry of Education School of Materials Science and Engineering Southwest Jiaotong University Chengdu Sichuan 610031 China
| | - Jinglei Gong
- State Key Laboratory of Oral Diseases National Clinical Research Center for Oral Diseases Department of Orthodontics West China Hospital of Stomatology Sichuan University Chengdu Sichuan 610041 China
| | - Yan Zeng
- Key Lab of Advanced Technologies of Materials Ministry of Education School of Materials Science and Engineering Southwest Jiaotong University Chengdu Sichuan 610031 China
| | - Jinhui Ran
- Key Lab of Advanced Technologies of Materials Ministry of Education School of Materials Science and Engineering Southwest Jiaotong University Chengdu Sichuan 610031 China
| | - Jin Liu
- Lab for Aging Research and National Clinical Research Center for Geriatrics West China Hospital Sichuan University Chengdu Sichuan 610041 China
| | - Kefeng Wang
- National Engineering Research Center for Biomaterials Sichuan University Chengdu Sichuan 610064 China
| | - Chaoming Xie
- Key Lab of Advanced Technologies of Materials Ministry of Education School of Materials Science and Engineering Southwest Jiaotong University Chengdu Sichuan 610031 China
| | - Xiong Lu
- Key Lab of Advanced Technologies of Materials Ministry of Education School of Materials Science and Engineering Southwest Jiaotong University Chengdu Sichuan 610031 China
| | - Jun Wang
- State Key Laboratory of Oral Diseases National Clinical Research Center for Oral Diseases Department of Orthodontics West China Hospital of Stomatology Sichuan University Chengdu Sichuan 610041 China
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Wang Q, Jiang J, Gao L. Nanozyme-based medicine for enzymatic therapy: progress and challenges. Biomed Mater 2021; 16. [PMID: 33601365 DOI: 10.1088/1748-605x/abe7b4] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/18/2021] [Indexed: 12/17/2022]
Abstract
Nanozymes are nanomaterials with enzyme-like characteristics. As a new generation of artificial enzymes, nanozymes have the advantages of low cost, good stability, simple preparation, and easy storage, allowing them to overcome many of the limitations of natural enzymes in enzymatic therapy. Currently, most reported nanozymes exhibit oxidoreductase-like activities and can regulate redox balance in cells. Nanozymes with superoxide dismutase and catalase activity can be used to scavenge reactive oxygen species (ROS) for cell protection, while those with peroxidase and oxidase activity can generate ROS to kill harmful cells, such as tumor cells and bacteria. In this review, we summarize recent progress in nanozyme-based medicine for enzymatic therapy and highlight the opportunities and challenges in this field for future study.
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Affiliation(s)
- Qian Wang
- Institute of Biophysics Chinese Academy of Sciences, 15 Datun Road, Beijing, Beijing, 100101, CHINA
| | - Jing Jiang
- Institute of Biophysics Chinese Academy of Sciences, 15 Datun Road, Beijing, 100101, CHINA
| | - Lizeng Gao
- Institute of Biophysics Chinese Academy of Sciences, 15 Datun Road, Beijing, Beijing, 100101, CHINA
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Interplay between ESKAPE Pathogens and Immunity in Skin Infections: An Overview of the Major Determinants of Virulence and Antibiotic Resistance. Pathogens 2021; 10:pathogens10020148. [PMID: 33540588 PMCID: PMC7912840 DOI: 10.3390/pathogens10020148] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/16/2022] Open
Abstract
The skin is the largest organ in the human body, acting as a physical and immunological barrier against pathogenic microorganisms. The cutaneous lesions constitute a gateway for microbial contamination that can lead to chronic wounds and other invasive infections. Chronic wounds are considered as serious public health problems due the related social, psychological and economic consequences. The group of bacteria known as ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter sp.) are among the most prevalent bacteria in cutaneous infections. These pathogens have a high level of incidence in hospital environments and several strains present phenotypes of multidrug resistance. In this review, we discuss some important aspects of skin immunology and the involvement of ESKAPE in wound infections. First, we introduce some fundamental aspects of skin physiology and immunology related to cutaneous infections. Following this, the major virulence factors involved in colonization and tissue damage are highlighted, as well as the most frequently detected antimicrobial resistance genes. ESKAPE pathogens express several virulence determinants that overcome the skin's physical and immunological barriers, enabling them to cause severe wound infections. The high ability these bacteria to acquire resistance is alarming, particularly in the hospital settings where immunocompromised individuals are exposed to these pathogens. Knowledge about the virulence and resistance markers of these species is important in order to develop new strategies to detect and treat their associated infections.
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Lu YE, Chen YJ. Resveratrol inhibits matrix metalloproteinase-1 and -3 expression by suppressing of p300/NFκB acetylation in TNF-α-treated human dermal fibroblasts. Chem Biol Interact 2021; 337:109395. [PMID: 33515544 DOI: 10.1016/j.cbi.2021.109395] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/22/2020] [Accepted: 01/22/2021] [Indexed: 12/31/2022]
Abstract
The aim of this study was to explore the signaling pathways associated with the effects of tumor necrosis factor alpha (TNF-α) on matrix metalloproteinase-1 (MMP-1) and MMP-3 expression in the human dermal fibroblast cell line CCD-966SK. TNF-α upregulated MMP-1 and MMP-3 mRNA and protein expression, and NFκB/p65 activation was found to be involved in TNF-α-induced MMP-1 and MMP-3 upregulation. TNF-α induced p65 phosphorylation at Ser536 and acetylation at Lys310. p300 knockdown suppressed TNF-α-induced p65 acetylation and reduced MMP-1 and MMP-3 expression in TNF-α-treated cells, but did not greatly restore MMP-1 and MMP-3 expression when p65 phosphorylation was inhibited by Bay11-7082 (IκBα inhibitor). NF-κB/luciferase reporter assay revealed that p300-mediated p65 acetylation was crucial for TNF-α-induced nuclear factor-kappa B (NF-κB) transcriptional activity. The chromatin immunoprecipitation (ChIP) assay indicated that TNF-α increased p300 recruitment to the MMP-1 and MMP-3 promoter regions surrounding the NFκB-binding site. Resveratrol notably inhibited TNF-α-induced MMP-1 and MMP-3 upregulation and abrogated TNF-α-induced p65 acetylation, leading to the downregulation of MMP-1 and MMP-3 expression in TNF-α-treated cells. Our data indicate that TNF-α-induced p300-mediated p65 acetylation leads to the upregulation of MMP-1 and MMP-3 expression in dermal fibroblasts, whereas resveratrol reduces this TNF-α-induced upregulation by downregulating p300 expression.
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Affiliation(s)
- Yi-En Lu
- Department of Fragrance and Cosmetic Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Jung Chen
- Department of Fragrance and Cosmetic Science, Kaohsiung Medical University, Kaohsiung, Taiwan; Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Maunoury F, Oury A, Fortin S, Thomassin L, Bohbot S. Cost-effectiveness of TLC-NOSF dressings versus neutral dressings for the treatment of diabetic foot ulcers in France. PLoS One 2021; 16:e0245652. [PMID: 33481840 PMCID: PMC7822547 DOI: 10.1371/journal.pone.0245652] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 01/04/2021] [Indexed: 01/22/2023] Open
Abstract
This study assesses the cost-effectiveness of Technology Lipido-Colloid with Nano Oligo Saccharide Factor (TLC-NOSF) wound dressings versus neutral dressings in the management of diabetic foot ulcers (DFUs) from a French collective perspective. We used a Markov microsimulation cohort model to simulate the DFU monthly progression over the lifetime horizon. Our study employed a mixed method design with model inputs including data from interventional and observational studies, French databases and expert opinion. The demographic characteristics of the simulated population and clinical efficacy were based on the EXPLORER double-blind randomized controlled trial. Health-related quality of life, costs, and resource use inputs were taken from the literature relevant to the French context. The main outcomes included life-years without DFU (LYsw/DFU), quality-adjusted life-years (QALYs), amputations, and lifetime costs. To assess the robustness of the results, sensitivity and subgroup analyses based on the wound duration at treatment initiation were performed. Treatment with the TLC-NOSF dressing led to total cost savings per patient of EUR 35,489, associated with gains of 0.50 LYw/DFU and 0.16 QALY. TLC-NOSF dressings were established as the dominant strategy in the base case and all sensitivity analyses. Furthermore, the model revealed that, for every 100 patients treated with TLC-NOSF dressings, two amputations could be avoided. According to the subgroup analysis results, the sooner the TLC-NOSF treatment was initiated, the better were the outcomes, with the highest benefits for ulcers with a duration of two months or less (+0.65 LYw/DFU, +0.23 QALY, and cost savings of EUR 55,710). The results from the French perspective are consistent with the ones from the German and British perspectives. TLC-NOSF dressings are cost-saving compared to neutral dressings, leading to an increase in patients' health benefits and a decrease in the associated treatment costs. These results can thus be used to guide healthcare decisionmakers. The potential savings could represent EUR 3,345 per treated patient per year and even reach EUR 4,771 when TLC-NOSF dressings are used as first line treatment. The EXPLORER trial is registered with ClinicalTrials.gov, number NCT01717183.
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Affiliation(s)
| | - Anaïs Oury
- Global Regulatory Affairs & Market Access, URGO Medical, Chenôve, France
| | - Sophie Fortin
- Global Regulatory Affairs & Market Access, URGO Medical, Chenôve, France
| | | | - Serge Bohbot
- Global Medical Affairs, URGO Medical, Paris, France
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Dissemond J, Augustin M, Dietlein M, Faust U, Keuthage W, Lobmann R, Münter KC, Strohal R, Stücker M, Traber J, Vanscheidt W, Läuchli S. Efficacy of MMP-inhibiting wound dressings in the treatment of chronic wounds: a systematic review. J Wound Care 2020; 29:102-118. [PMID: 32058850 DOI: 10.12968/jowc.2020.29.2.102] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Matrix metalloproteinases (MMPs) substantially contribute to the development of chronicity in wounds. Thus, MMP-inhibiting dressings may support healing. A systematic review was performed to determine the existing evidence base for the treatment of hard-to-heal wounds with these dressings. METHODS A systematic literature search in databases and clinical trial registers was conducted to identify randomised controlled trials (RCTs) investigating the efficacy of MMP-inhibiting dressings. Studies were analysed regarding their quality and clinical evidence. RESULTS Of 721 hits, 16 relevant studies were assessed. There were 13 studies performed with collagen and three with technology lipido-colloid nano oligosaccharide factor (TLC-NOSF) dressings. Indications included diabetic foot ulcers, venous leg ulcers, pressure ulcers or wounds of mixed origin. Patient-relevant endpoints comprised wound size reduction, complete wound closure, healing time and rate. Considerable differences in the quality and subsequent clinical evidence exist between the studies identified. Substantial evidence for significant improvement in healing was identified only for some dressings. CONCLUSION Evidence for the superiority of some MMP-inhibiting wound dressings exists regarding wound closure, wound size reduction, healing time and healing rate. More research is required to substantiate the existing evidence for different types of hard-to-heal wounds and to generate evidence for some of the different types of MMP-inhibiting wound dressings.
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Affiliation(s)
- Joachim Dissemond
- Department of Dermatology, Venerology and Allergology, University of Essen, Essen, Germany
| | | | | | - Uta Faust
- MEDAHCON GmbH, HealthCare Communication, Bonn, Germany
| | - Winfried Keuthage
- Specialist Practice for Diabetology and Nutritional Medicine, Münster, Germany
| | - Ralf Lobmann
- Department of Endocrinology, Diabetology and Geriatrics, Stuttgart General Hospital, Bad Cannstatt, Stuttgart, Germany
| | | | - Robert Strohal
- Department of Dermatology and Venerology, State Hospital and Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Markus Stücker
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Jürg Traber
- Department of Surgery, Venenklinik Bellevue, Kreuzlingen, Switzerland
| | | | - Severin Läuchli
- University Hospital Zurich, Department of Dermatology, Zurich, Switzerland
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Conde-Montero E, Bohbot S, Grado Sanz R, Peral Vázquez A, Recarte-Marín L, Pérez-Jerónimo L, Galán Sánchez JL, de la Cueva Dobao P. Association of autologous punch grafting, TLC-NOSF dressing and multitype compression therapy to rapidly achieve wound closure in hard-to-heal venous leg ulcers. JOURNAL DE MEDECINE VASCULAIRE 2020; 45:316-325. [PMID: 33248534 DOI: 10.1016/j.jdmv.2020.10.123] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/02/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To document the efficacy of a combined therapeutic strategy in achieving rapid wound healing in patients with long-standing ulcers. MATERIALS AND METHODS Outpatients with hard-to-heal venous leg ulcers were included in an interventional, prospective, single-arm, mono-centre study and treated with autologous punch grafting, TLC-NOSF dressing and multi-type compression therapy. The primary outcome was the percentage of healed wounds by week 12. Secondary outcomes included time-to-reach wound closure, wound area reduction, treatment acceptability and safety. RESULTS From November 2018 to October 2019, 42 patients with 51 ulcers were included (23 males, 70.6±40.8 years old, with multiple comorbidities). Despite poor wound healing prognosis at baseline (47% of recurrent ulcers, with a mean duration of 15 months and a mean area of 12.6cm2), wound healing was achieved in 47 ulcers (92%) after a mean period of treatment of 25±13 days. A relative wound area reduction>75% was also reached in three additional ulcers by the last evaluation visit. No adverse event related to the procedure was reported throughout the study period. The associated treatment were very well tolerated and accepted by the patients. CONCLUSIONS The evaluated procedure induced fast re-epithelisation of the treated ulcers. Based on our experience, this simple and successful reparative strategy may be considered as an interesting option in the treatment of venous leg ulcers of poor prognosis.
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Affiliation(s)
- E Conde-Montero
- Department of dermatology, Hospital Universitario Infanta Leonor and Hospital Virgen-de-la-Torre, avenida Gran Via de Este 80, 28031 Madrid, Spain.
| | - S Bohbot
- Medical affairs department, Laboratoires URGO Medical, 15, avenue de Iena, 75116 Paris, France
| | - R Grado Sanz
- Centro de salud cervantes, Hospital Universitario de Guadalajara, calle Miguel-Cervantes, 16, 19001 Guadalajara, Spain
| | - A Peral Vázquez
- Centro de especialidades Vicente-Soldevilla, calle Sierra-de-Alquife, 8, 28053 Madrid, Spain
| | - L Recarte-Marín
- Centro de especialidades Vicente-Soldevilla, calle Sierra-de-Alquife, 8, 28053 Madrid, Spain
| | - L Pérez-Jerónimo
- Centro de especialidades Vicente-Soldevilla, calle Sierra-de-Alquife, 8, 28053 Madrid, Spain
| | - J-L Galán Sánchez
- Department of dermatology, Hospital Universitario Infanta Leonor and Hospital Virgen-de-la-Torre, avenida Gran Via de Este 80, 28031 Madrid, Spain
| | - P de la Cueva Dobao
- Department of dermatology, Hospital Universitario Infanta Leonor and Hospital Virgen-de-la-Torre, avenida Gran Via de Este 80, 28031 Madrid, Spain
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Coindre VF, Hu Y, Sefton MV. Poly-Methacrylic Acid Cross-Linked with Collagen Accelerates Diabetic Wound Closure. ACS Biomater Sci Eng 2020; 6:6368-6377. [DOI: 10.1021/acsbiomaterials.0c01222] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Virginie F. Coindre
- Institute of Biomedical Engineering, University of Toronto, 164 College St Room 407, Toronto, Ontario M5S 3G9, Canada
| | - Yangshuo Hu
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, 164 College St Room 407, Toronto, Ontario M5S 3G9, Canada
| | - Michael V. Sefton
- Institute of Biomedical Engineering, University of Toronto, 164 College St Room 407, Toronto, Ontario M5S 3G9, Canada
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, 164 College St Room 407, Toronto, Ontario M5S 3G9, Canada
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49
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Lobmann R, Grünerbel A, Lawall H, Lüdemann C, Morbach S, Tigges W, Völkel L, Rychlik RP. Impact of wound duration on diabetic foot ulcer healing: evaluation of a new sucrose octasulfate wound dressing. J Wound Care 2020; 29:543-551. [PMID: 33052796 DOI: 10.12968/jowc.2020.29.10.543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE A common and frequent complication of diabetes is diabetic foot ulcers (DFU), which can have high treatment costs and severe adverse events. This study aims to evaluate the effects of wound duration on wound healing and the impact on costs, including treatment with a new sucrose octasulfate dressing compared with a control dressing. METHOD Based on the Explorer study (a two-armed randomised double-blind clinical trial), a cost-effectiveness analysis compared four different patient groups distinguished by their wound duration and additionally two DFU treatment options: a sucrose octasulfate dressing and a neutral dressing (as control). Clinical outcomes and total direct costs of wound dressings were evaluated over 20 weeks from the perspective of the Social Health Insurance in Germany. Simulation of long-term outcomes and costs were demonstrated by a five cycle Markov model. RESULTS The results show total wound healing rates between 71% and 14.8%, and direct treatment costs for DFU in the range of €2482-3278 (sucrose octasulfate dressing) and €2768-3194 (control dressing). Patients with a wound duration of ≤2 months revealed the highest wound healing rates for both the sucrose octasulfate dressing and control dressing (71% and 41%, respectively) and had the lowest direct treatment costs of €2482 and €2768, respectively. The 100-week Markov model amplified the results. Patients with ≤2 months' wound duration achieved wound healing rates of 98% and 88%, respectively and costs of €3450 and €6054, respectively (CE=€3520, €6864). Sensitivity analysis revealed that the dressing changes per week were the most significant uncertainty factor. CONCLUSION Based on the findings of this study, early treatment of DFU with a sucrose octasulfate dressing is recommended from a health economic view due to lower treatment costs, greater cost-effectiveness and higher wound healing rates.
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Affiliation(s)
- Ralf Lobmann
- Klinikum Stuttgart - Krankenhaus Bad Cannstatt, Stuttgart
| | | | - Holger Lawall
- Gemeinschaftspraxis Prof. Dr. med. Curt Diehm, Dr. med. Holger Lawall, Ettlingen
| | - Claas Lüdemann
- Evangelisches Waldkrankenhaus Spandau, Ein Unternehmen der Paul Gerhardt Diakonie, Berlin
| | | | | | - Lukas Völkel
- Institute of Empirical Health Economics, Burscheid, Germany
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50
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Dissemond J, Augustin M, Dietlein M, Keuthage W, Läuchli S, Lobmann R, Münter KC, Stücker M, Traber J, Vanscheidt W, Strohal R. [Sucrose octasulfate-evidence in the treatment of chronic wounds]. Hautarzt 2020; 71:791-801. [PMID: 32638031 DOI: 10.1007/s00105-020-04637-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Patients with chronic wounds should receive wound treatment in addition to causative therapy. In this context, the lack of adequate evidence for wound healing products has been repeatedly discussed. Using the example of TLC-sucrose octasulfate (TLC: technology lipido-colloid), the present review shows that there is significant data with good evidence and comparability in this area. One therapeutic approach to promote wound healing is the inhibition of matrix-metalloproteinases, for example by sucrose octasulfate. For wound products containing TLC-sucrose octasulfate, several sequential clinical studies have been conducted in recent years. The WHAT study was an open randomized controlled trial (RCT) with 117 patients with venous leg ulcers (VLU). The CHALLENGE study was a double-blind RCT with 187 patients with VLU. The SPID study was a pilot study with 33 patients with diabetic foot ulcers (DFU). The two prospective, multicenter clinical pilot studies NEREIDES and CASSIOPEE examined a total of 88 patients with VLU in different phases of healing. In the REALITY study, a pooled data analysis was performed on eight observational studies with 10,220 patients with chronic wounds of different genesis. In the double-blind, two-armed EXPLORER RCT, 240 patients with neuro-ischemic DFU were followed from first presentation until complete healing. In all studies, a significant promotion of wound healing could be shown by the use of wound healing products with TLC-sucrose octasulfate.
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Affiliation(s)
- Joachim Dissemond
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
| | - Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - Michael Dietlein
- Diabetesschwerpunktpraxis Dietlein, Bauernstr. 50, 86391, Stadtbergen, Deutschland
| | - Winfried Keuthage
- Schwerpunktpraxis Diabetes und Ernährungsmedizin, MedicalCenter am Clemenshospital, Düesbergweg 128, 48153, Münster, Deutschland
| | - Severin Läuchli
- Dermatologische Klinik, Universitätsspital Zürich, Gloriastr. 31, 8091, Zürich, Schweiz
| | - Ralf Lobmann
- Klinik für Endokrinologie, Diabetologie und Geriatrie, Klinikum Stuttgart - Krankenhaus Bad Cannstatt, Prießnitzweg 24, 70374, Stuttgart, Deutschland
| | | | - Markus Stücker
- Abteilung für Dermatologie und Venerologie, LKH Feldkirch, Akademisches Lehrspital, Carinagasse 45-47, 6800, Feldkirch, Österreich
| | - Jürg Traber
- Abteilung für Dermatologie Venerologie und Allergologie am St. Josef-Hospital, Klinikum der Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland
| | | | - Robert Strohal
- Dermatologische Gemeinschaftspraxis, Paula-Modersohn-Platz 3, 79100, Freiburg, Deutschland
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