The use of large molecular weight compounds to produce local lathyrism in healing wounds

Abstract

Circumferential scar surrounding healing tendons often impairs gliding function. Because mechanistic surgical approaches have been disappointing, the fundamental biology of tendon has been reviewed in search of a new approach to control circumferential scar tissue. One such approach, based upon observation that it is not formation of scar but physical properties of scar which results in loss of gliding function, is control of physical properties of newly synthesized collagen by pharmacological means. Induction of controlled lathyrism is an example of how physical properties of newly synthesized collagen can be controlled with pharmacological agents. Lathyrogenic agents provide an effective method of controlling physical properties of scar tissue in a healing wound by inhibiting formation of interand intramolecular cross-links in newly synthesized collagen [9]. Intramuscular administration of Betaaminopropionitrile (BAPN) has been shown to improve gliding function of scarified flexor tendons in the Lindsay chicken foot tendon model [ 1, 2, 61. Reversible but undesirable systemic reactions were observed, however, when BAPN was administered to human beings undergoing flexor tendon repair [6]. Because of systemic reactions which appeared to be hypersensitivity rather than toxicity, clinical investigation of BAPN was temporarily discontinued.