Impaired Wound Healing Research Articles

Effect of pomegranate peel with/without autologous bone marrow on healing of acute cutaneous wounds in alloxan-induced diabetic rabbits.

Healing of bum wounds is commonly associated with many complications. Every year various new repair materials are developed and experimentally used for treating burn wounds. Humans with diabetes mellitus usually suffer from chronic wound healing. Vascular, neuropathic, immune function, and biochemical abnormalities each contribute to the altered tissue repair. One underlying factor that accompanies all diabetic ulcerations is poor vascular flow, a circumstance that impedes proper wound healing. Numerous studies have highlighted the importance of adequate vascular sufficiency and vessel proliferation in tissue repair and the lack thereof in diabetic wound healing. Other studies have looked at whether disarrayed capillary remodeling and maturation of vessels might play a role in impaired diabetic wound healing. This investigation has been planned to report the influence of treatment with a mixture of both the powder of pomegranate peel (PP) accompanied with an autologous bone marrow (BM) on the cure of burn injuries in experimentally induced diabetic rabbits. Alloxan monohydrate has been applied to create diabetes in 50 rabbits. Then in each rabbit, two deep second-degree burn wounds were experimentally created. The animals were then divided randomly into 5 treatment sections: non-treatment controls (C1), treated with an available commercial powder for wound (C2), treatment with powder of PP, treatment with alone BM, and the final group treated with PP powder with bone marrow (PPBM). The speed of wound closure and the histopathological changes during healing were measured. The levels of the biomarkers of rabbit platelet-derived growth factor AA (PDGF-AA) and rabbit protease-activated receptor 1 (PAR-1) were measured on days 0, 4, 8, and 12. Wound healing was markedly more rapid in all the treatment groups versus the control non-treated group. Interestingly, a rapid wound cure was significantly observed in the PPBM group versus the other treatment ones. The histological assessment clarified a significant elevation in the fibroblast and collagen scores in the PPBM group versus the other sections. In addition, there were significant increases in the serum levels of the biomarkers PDGF-AA and PAR-1 among groups. Dependent on the results of current research, it can be concluded that both PP powder with BM PPBM significantly accelerate the healing process of burn wounds in experimentally induced diabetic rabbits.

The Negative Impact of Vaping and Electric Cigarettes for Healing of Chronic Wounds: A Literature Review

Non-smokers, particularly adolescents, face significant public health risks from e-cigarette use due to immediate health hazards, the potential for initiating tobacco use, and insufficient data on critical health outcomes, including wound healing. This study investigates vaping's impact on chronic wound healing, emphasizing e-cigarette chemical components. E-cigarettes contain common constituents: 1) Base liquids: Propylene glycol (PG) and vegetable glycerin (VG), 2) Nicotine, 3) Flavoring chemicals and additives, 4) Trace contaminants and toxins. Chronic wounds exhibit persistent inflammation, impaired proliferation, delayed remodeling, and environmental factors (e.g., ischemia, infection, trauma). E-cigarette components impair wound healing: VG induces osmotic effects and cellular toxicity, nicotine causes vasoconstriction, reduced oxygenation, and impaired angiogenesis. Flavoring chemicals contribute to cytotoxicity and modulate inflammatory responses, while contaminants like heavy metals induce oxidative stress and inflammation. Despite e-cigarettes' lower harm compared to traditional cigarettes, their effects on chronic wound healing remain poorly understood. Further research is essential to elucidate smoking's precise impact on chronic wound healing.

Endothelial cells in chronic thromboembolic pulmonary hypertension exhibit cytoskeletal alteration

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Health Research Fund (Fondo de Investigación Sanitaria [FIS]) from the Instituto de Salud Carlos III Introduction Endothelial dysfunction (ED) is pivotal in Chronic Thromboembolic Pulmonary Hypertension (CTEPH) due to structural and functional alterations in endothelial. Previous studies have shown the critical function of cytoskeletal elements, particularly actin microfilaments and microtubules, along with associated cell adhesion complexes, in the endothelial integrity. Nevertheless, precise alterations in the cytoskeletal elements of endothelial cells (ECs) in CTEPH patients remain unclear. Purpose This study aims to investigate the cytoskeleton changes in CTEPH-ECs compared to healthy ECs, characterizing morphological and structural differences. Objectives involve assessing microtubules and microfilaments expression, and their influence on ECs migratory capacity. Finally, our study aims to gain novel insights into the spatial organization of cytoskeleton components in CTEPH patients. Methods CTEPH-ECs were isolated from freshly resected pulmonary endarterectomy specimens of CTEPH patients, while human pulmonary artery ECs (HPAE) were used as healthy controls. Fluorescence immunocytochemistry assessed phenotypic and compositional characteristics of the cytoskeleton. Morphometric analysis described morphology and filament organization of cytoskeletal proteins using a custom-built pipeline. X-ray microscopy examined the phenotype and cytoskeletal components distribution. The migration assay evaluated how these structural differences affected ECs migratory capacity and the cytoskeletal elements expression. Results CTEPH-ECs exhibited larger surface area (1352 vs 662µm2, p<0.01) and a more stellate morphology (0.365 vs 0.289, p<0.01) than HPAE-ECs. Immunostaining indicated altered cytoskeletal composition in CTEPH-ECs with significantly higher tubulin expression, expressed in microtubules, (3327 vs 2238AU, p<0.01) and F-actin microfilaments (2068 vs 1300AU, p<0.01) compared to HPAE. Similarly, CTEPH-ECs showed reduced G-actin expression (3002 vs 7461AU, p<0.01). Morphometric analysis demonstrated that microfilaments were thinner (0.623 vs 0.831AU, p<0.01), more straight (0.135 vs. 0.172, p<0.01) and more aligned (0.132 vs. 0.156, p<0.01) in CTEPH-ECs. Microtubule thickness decreased compared to HPAE-ECs (0.341 vs 1.371AU, p<0.01). CTEPH-ECs showed impaired wound healing (60 vs 89% closure, p<0.05). CTEPH group showed an increase in microtubules and microfilaments expression during wound healing, but with irregular patterns, unlike the constant levels in HPAE. TXM-technology revealed spatial organization differences, especially expansive microtubules distribution in CTEPH-ECs (4.2*10^7 vs. 8.7*10^6 nm³, p<0.05). Conclusion These preliminary findings highlight significant structural and compositional differences in CTEPH-ECs, along with altered wound healing capacity, suggesting dynamic cytoskeletal and cellular changes in CTEPH. Understanding these alterations is crucial for advancing CTEPH knowledge and identifying potential therapeutic targets.

The effects of photobiomodulation therapy plus methacrylate powder dressing (Altrazeal powder) on the bacterial count in diabetic foot ulcer: A case report

Diabetes patients frequently experience a serious complication known as impaired wound healing, which increases the likelihood of foot infection and limb amputation. Investigators have been looking for novel methods to treat Diabetic Foot Ulcers (DFU) recently.

Influence of anesthesia on surgical site infections

Surgical site infections (SSI) are the most frequent cause of impaired perioperative wound healing, lead to increased postoperative morbidity, mortality and length of hospital stay and are therefore arelevant perioperative complication. In addition to numerous measures taken by the surgical departments, there are anesthesiological options that can help to reduce the risk of SSI. In addition to heat, volume and transfusion management these include, for example, the use of antibiotics and the choice of the anesthesia procedure. This article is intended to provide fundamental knowledge on SSI, shows various options for reducing them in the context of anesthesia and evaluates their effectiveness and evidence based on the current state of knowledge.

A multifunctional protein-based hydrogel with Au nanozyme-mediated self generation of H2S for diabetic wound healing

Diabetics usually suffer from chronic impaired wound healing due to facile infection, excessive inflammation, diabetic neuropathy, and peripheral vascular disease. Hence, the development of effective diabetic wound therapy remains a critical clinical challenge. Hydrogen sulfide (H2S) regulates inflammation, oxidative stress, and angiogenesis, suggesting a potential role in promoting diabetic wound healing. Herein, we propose a first example of fabricating an antibiotic-free antibacterial protein hydrogel with self-generation of H2S gas (H2S-Hydrogel) for diabetic wound healing by simply mixing bovine serum albumin‑gold nanoclusters (BSA-AuNCs) with Bis[tetrakis(hydroxymethyl)phosphonium] sulfate (THPS) at room temperature within a few minutes. In this process, the amino group in BAS and the aldehyde group in THPS are crossed together by Mannich reaction. At the same time, tris(hydroxymethyl) phosphorus (trivalent phosphorus) from THPS hydrolysis could reduce disulfide bonds in BSA to sulfhydryl groups, and then the sulfhydryl group generates H2S gas under the catalysis of BSA-AuNCs. THPS in H2S-Hydrogel can destroy bacterial biofilms, while H2S can inhibit oxidative stress, promote proliferation and migration of epidermal/endothelial cells, increase angiogenesis, and thus significantly increase wound closure. It would open a new perspective on the development of effective diabetic wound dressing.

Antibacterial property of dual-network hydrogel filled with amino functionalized graphene quantum dots

Bacterial infections seriously impair wound healing, so the development of wound dressings with high antimicrobial activity is of critical importance. In this study, amino functionalized graphene quantum dots (His-GQDs) were prepared via thermal pyrolysis of citric acid and histidine, and doped into a dual-network gelatin/sodium alginate (His-GQDs/G/SA) hydrogel to improve the antibacterial activity. The His-GQDs/G/SA hydrogel exhibited excellent antibacterial activity after 6 h of contact with bacteria. Simultaneously, the composite hydrogel could effectively alleviate the cytotoxicity of His-GQDs. The results of antimicrobial and biocompatibility tests demonstrate that the His-GQDs/G/SA dual-network hydrogel is a promising wound dressing to promote healing of infected wounds.

Outcomes of brachial artery transposition in hemodialysis patients

ObjectiveIn hemodialysis patients with a difficult access extremity who are not suitable for an arteriovenous fistula or arteriovenous graft creation, the concept of cannulating a superficialized artery for arterial outflow in dialysis sessions has been adopted as a tertiary alternative. However, its long-term patency and complications have not been recognized widely. We report our 16-year experience with hemodialysis access creation using the brachial artery transposition (BAT) technique. MethodsThis single-center retrospective study included consecutive patients who underwent BAT for hemodialysis vascular access between June 1, 2006, and December 31, 2022. The patency of the whole access circuit and the transposed brachial artery itself was evaluated independently. ResultsIn total, 193 surgical procedures were included. The success rate was 93.2%. The mean operative time was 128 minutes. The median interval from access placement to first cannulation was 21 days. The primary patency rates for BAT were 92.3%, 91.3%, 90.3%, 86.1%, and 71.9% at 1, 2, 3, 5, and 10 years, respectively. The secondary patency rates for BAT were 96.3%, 96.3%, 95.0%, 90.1%, and 74.9% at 1, 2, 3, 5, and 10 years, respectively. The primary patency rates for the whole access circuit were 61.4%, 49.2%, 45.8%, and 26.9% at 1, 2, 3, and 5 years, respectively. The secondary patency rates for the whole access circuit were 85.1%, 83.3%, 82.0%, and 68.6% at 1, 2, 3, and 5 years, respectively. The overall patient survival rates were 79.6%, 69.6%, 54.6%, 36.5%, and 13.4% at 1, 2, 3, 5 and 10 years, respectively. The abandonments of BAT were brachial artery thrombosis (n = 6), pseudoaneurysm (n = 2), aneurysmal change (n = 1), and other reasons (n = 1). The abandonments of the whole access circuit were exhaustion of venous return (n = 26), abandonment of BAT (n = 7), and other reasons (n = 2). Complications were exhaustion of venous return (n = 26), aneurysmal change (n = 12), pseudoaneurysm (n = 6), brachial artery thrombosis (n = 7), impaired wound healing (n = 19), lymphorrhea (n = 9), skin infection (n = 5), hematoma on cannulation (n = 3), and reduced peripheral blood flow (n = 2). ConclusionsThe patency of BAT was excellent, and that of the whole access circuit was adequate, with a few complications. BAT is an effective alternative from a long-term perspective for patients who are unsuitable for conventional hemodialysis access creation.

Label-free detection of prostaglandin transporter (SLCO2A1) function and inhibition: insights by wound healing and TRACT assays.

The prostaglandin transporter (PGT, SLCO2A1) mediates transport of prostanoids (a.o. prostaglandin E2 (PGE2)) into cells and thereby promotes their degradation. Overexpression of PGT leads to low extracellular PGE2 levels and has been linked to impaired wound healing of diabetic foot ulcers. Inhibition of PGT could thus be beneficial, however, no PGT inhibitors are currently on the market and drug discovery efforts are hampered by lack of high-through screening assays for this transporter. Here we report on a label-free impedance-based assay for PGT that measures transport activity through receptor activation (TRACT) utilizing prostaglandin E2 receptor subtype EP3 and EP4 that are activated by PGE2. We found that induction of PGT expression on HEK293-JumpIn-SLCO2A1 cells that also express EP3 and EP4 leads to an over 10-fold reduction in agonistic potency of PGE2. PGE2 potency could be recovered upon inhibition of PGT-mediated PGE2 uptake with PGT inhibitors olmesartan and T26A, the potency of which could be established as well. Moreover, the TRACT assay enabled the assessment of transport function of PGT natural variants. Lastly, HUVEC cells endogenously expressing prostanoid receptors and PGT were exploited to study wound healing properties of PGE2 and T26A in real-time using a novel impedance-based scratch-induced wound healing assay. These novel impedance-based assays will advance PGT drug discovery efforts and pave the way for the development of PGT-based therapies.

Reconstruction after salvage total laryngectomy

Over recent decades, there has been a trend toward non-surgical or “organ preservation” therapy for advanced staged laryngeal cancers, but up to 1/3 of patients will see a lack of long-term treatment response. As a result of this paradigm shift, total laryngectomy is increasingly performed in the ‘salvage’ setting. Salvage total laryngectomy is associated with high rates of complications from impaired wound healing from prior chemotherapy and/or radiotherapy, and reconstructive techniques aim to decrease these complications. Regional and free tissue flaps are used in contemporary reconstruction of salvage laryngectomy defects. In this article, the pectoralis major myocutaneous flap and the anterolateral thigh fasciocutaneous free flap are discussed in detail. Additionally, specific techniques are described in a defect-based approach with special attention to total laryngectomy with primary closure of the mucosa, as well as defects not amenable to primary closure, such as total laryngectomy with partial or total pharyngectomy and esophagectomy. This defect-based approach allows the author to present surgical scenarios commonly encountered during salvage total laryngectomy and walk the reader through various reconstructive techniques.

YAP/TAZ Drive Agrin–Matrix Metalloproteinase 12–Mediated Diabetic Skin Wound Healing

Macroscopic loss of extracellular matrix (ECM) can lead to chronic defects in skin wound healing, but supplementation of ECM holds promise for facilitating wound closure, particularly in diabetic wound healing. We recently showed that the ECM proteoglycan agrin accelerates cutaneous wound healing by improving mechanoperception of migrating keratinocytes and allowing them to respond to mechanical stresses via matrix metalloproteinase-12 (MMP12). RNA-sequencing analysis revealed that in addition to a disorganized ECM, agrin-depleted skin cells have impaired YAP/TAZ transcriptional outcomes, leading us to hypothesize that YAP/TAZ, as central mechanosensors, drive the functionality of agrin-MMP12 signaling during cutaneous wound repair. Herein, we demonstrate that agrin activates YAP/TAZ during migration of keratinocytes post-wounding in vitro and in vivo. Mechanistically, YAP/TAZ sustain agrin and MMP12 protein expression during migration post-wounding through positive feedback. YAP/TAZ silencing abolishes agrin-MMP12 mediated force-recognition and geometrical constraints. Importantly, soluble agrin (sAgrin) therapy accelerates wound closure in diabetic mouse models by engaging MMP12-YAP. Because patients with diabetic foot ulcers and impaired wound healing have reduced expression of agrin-MMP12 that correlates with YAP/TAZ inactivation, we propose that timely activation of YAP/TAZ by sAgrin therapy can accentuate mechanobiological microenvironments for efficient wound healing, under normal and diabetic conditions.

Abstract 2140: The Tgfb-Whsc1 Axis Drives Macrophage To Myofibroblast Transition During Wound Repair

During the proliferative phase of tissue repair macrophages can transition to myofibroblasts, which promote wound contraction and closure. The mechanisms that control this transition remain unknown and are not well studied. Here, using a combination of murine transgenic models of disease, loss of function approaches, pharmacologic inhibition in vivo, and single cell RNA sequencing (scRNA-seq) in human wounds, we identified that a histone methyltransferase, Whsc1, regulates the fibrotic gene program in macrophages during wound repair. Specifically, we identified that Whsc1 was upregulated in wound macrophages (CD3 - CD19 - NK1.1 - Ly6G - CD11b + ) in response to TGFβ. Genetic loss of TGFβ-mediated signaling as well as siRNA knockdown of Whsc1 in bone marrow derived macrophages (BMDMs) decreased TGFβ-dependent expression of Acta2, Col1a1, Col3a1 (p<0.05). Further, TGFβ stimulation resulted in increased Whsc1 and H3K36 dimethylation at fibrotic gene promoters in wound macrophages (p<0.05). Importantly, local pharmacologic inhibition of Whsc1 in vivo significantly impaired wound healing, suggesting that Whsc1 is critical for normal wound repair. We next examined the role of Whsc1 in pathologic healing conditions (i.e. diabetes) where the macrophage-myofibroblast transition is impaired. Whsc1 expression was decreased in human macrophages analyzed by scRNA-seq of diabetic wounds and in murine wound macrophages from a diabetic model (DIO) (p<0.05). Interestingly, in DIO BMDMs, Whsc1 did not traffic to fibrotic promoters after TGFβ treatment, but rather remained at NFkB-regulated inflammatory gene promoters ( Il1b, Il6, Tnf ). On further examination of this, using co-immunoprecipitation and proximity ligation assay in BMDMs, we demonstrated increased physical interaction between RelA and Whsc1 in diabetic macrophages. Knockdown of RelA in DIO macrophages increased Whsc1 enrichment at fibrotic promoters, suggesting RelA sequestered Whsc1 at inflammatory gene promoters (p<0.05). The identification of TGFβ-Whsc1 as a driver of macrophage-myofibroblast transition in normal and pathological tissues allows for development of novel therapies to improve tissue repair, and targeting RelA in macrophages may improve diabetic wound healing.

Analyzing Immune Cell Infiltration and Copper Metabolism in Diabetic Foot Ulcers.

Diabetes impairs wound healing, notably in diabetic foot ulcers (DFU). Stress, marked by the accumulation of lipoylated mitochondrial enzymes and the depletion of Fe-S cluster proteins, triggers cuproptosis-a distinct form of cell death. The involvement of copper in the pathophysiology of DFU has been recognized, and currently, a copper-based therapeutic strategy is emerging as a viable option for enhancing ulcer healing. This study investigates genes linked to copper metabolism in DFU, aiming to uncover potential targets for therapeutic intervention. Two diabetic wound Gene Expression Omnibus (GEO) datasets were analyzed to study immune cell dysregulation in diabetic wounds. Differentially expressed genes related to copper metabolism were identified and analyzed using machine learning methods. Gene ontology, pathway enrichment, and immune infiltration analyses were performed using DFU samples. The expression of identified genes was validated using qRT-PCR and single-cell RNA sequencing. Ten genes associated with copper metabolism were identified. Among these, SLC31A1 and ADNP were found to be significantly differentially expressed in DFU. Notably, SLC31A1 exhibited higher expression in macrophages, whereas ADNP was found to be highly expressed in fibroblasts and chondrocytes. The study indicates a close link between copper metabolism, the infiltration of immune cells, and DFU. It proposes that copper metabolism could influence the progression of DFU through the activation of immune responses. These observations offer fresh perspectives on the underlying mechanisms of DFU and identify potential targets for therapeutic intervention.

Examining the Evidence Regarding Smoking and Patient Outcomes for Isolated Meniscus Pathology: A Comprehensive Systematic Review and Meta-Analysis.

Smoking is a well-known cause of impairment in wound healing and postoperative outcomes; however, its effects on treating meniscus issues remain unclear. This study assesses the relationship between smoking and meniscus treatment outcomes. PubMed, Scopus, Cochrane, and CINAHL were searched from inception to 24 December 2023. Inclusion criteria encompassed studies examining smoking's impact on patient outcomes regarding meniscus pathology. A secondary PubMed search targeted randomized controlled trials (RCTs) in the top ten orthopedic journals focusing on meniscus pathology and smoking as a demographic variable. Meta-analysis of six studies (n = 528) assessed meniscus failure rate based on smoking status. Eighteen observational studies (n = 8353 patients; 53.25% male; mean age: 51.35 ± 11.53 years; follow-up: 184.11 ± 117.34 months) were analyzed, covering meniscus repair, meniscectomy, allograft transplant, conservative care, and arthroscopy. Results showed four studies (36.36%) linked smoking with worse meniscus repair outcomes, while seven studies (63.64%) did not find significant associations. Meta-analysis from six studies showed no significant impact of smoking on repair failure (p = 0.118). Regarding meniscectomy, one study (33.33%) identified a significant association with smoking, but two did not. Only one (3.8%) of the RCTs in leading orthopedic journals included smoking as a factor. The evidence on smoking's effect on meniscus treatment is mixed, necessitating further investigation.

Granzyme serine proteases in inflammation and rheumatic diseases.

Granzymes (granule-secreted enzymes) are a family of serine proteases that have been viewed as redundant cytotoxic enzymes since their discovery more than 30 years ago. Predominantly produced by cytotoxic lymphocytes and natural killer cells, granzymes are delivered into the cytoplasm of target cells through immunological synapses in cooperation with the pore-forming protein perforin. After internalization, granzymes can initiate cell death through the cleavage of intracellular substrates. However, evidence now also demonstrates the existence of non-cytotoxic, pro-inflammatory, intracellular and extracellular functions that are granzyme specific. Under pathological conditions, granzymes can be produced and secreted extracellularly by immune cells as well as by non-immune cells. Depending on the granzyme, accumulation in the extracellular milieu might contribute to inflammation, tissue injury, impaired wound healing, barrier dysfunction, osteoclastogenesis and/or autoantigen generation.

Periodontal granulation tissue - To remove or not to remove, that is the question.

Formation of granulation tissue is a fundamental phase in periodontal wound healing with subsequent maturation leading to regeneration or repair. However, persistently inflamed granulation tissue presents in osseous defects as a result of periodontitis and is routinely disrupted and discarded with non-surgical and surgical therapy to facilitate wound healing or improve chances of regeneration. Histological assessment suggests that granulation tissue from periodontitis-affected sites is effectively a chronic inflammatory tissue resulting from impaired wound healing due to persistence of bacterial dysbiotic bioflim. Nevertheless, the immunomodulatory potential and stem cell characteristics in granulation tissue have also raised speculation about the tissue's regenerative potential. This has led to the conception and recent implementation of surgical techniques which preserve granulation tissue with the intention of enhancing innate regenerative potential and improve clinical outcomes. As knowledge of fundamental cellular and molecular functions regulating periodontitis-affected granulation tissue is still scarce, this review aimed to provide a summary of current understanding of granulation tissue in the context of periodontal wound healing. This may provide new insights into clinical practice related to the management of granulation tissue and stimulate further investigation.

Formulation & Evaluation of Poly-Herbal Ointment

Abstract: Wound healing is a complex process of recovering the forms & functions of injured tissues. The process is tightly regulated by multiple growth factors & cytokines released at the wound site. Any alternations that disrupt the healing process would worsen the tissue damage and prolong repair process. Various conditions may contribute to impaired wound healing including infections underlying diseases and medications. Salves, or ointments, are topical products in which the herbs are extracted into vegetable oils by maceration at either room temperature for a specified length of time, in a low heat infusion or in a higher heat decoction. Numerous studies on the potential of natural products with anti-inflammatory, anti-bacterial, anti-fungal properties as wound healing agents have been performed .Their medicinal properties can be contributed by the content of phytochemical constituents such as Azadirachta indica (Neem leaves),Triticum (wheats), Vitis vinifera(Grape seeds),Helianthus annus (sunflower seeds), Oryza sativa (brown rice)

Combined use of hydrogen-rich water and enzyme-digested edible bird's nest improves PMA/LPS-impaired wound healing in human inflammatory gingival tissue equivalents.

Gingival wound healing plays a critical role in maintaining oral health. However, this process can be delayed by oxidative stress and excessive inflammatory responses. In this study, we established a human inflammatory gingival tissue equivalent (iGTE) to investigate the inhibitory effects of hydrogen-rich water (HW), enzyme-digested edible bird's nest (EBND) and sialic acid (SA) on PMA (an inducer of oxidative free radicals)- and LPS (an inflammatory stimulus)-impaired wound healing. The iGTE was constructed by human gingival fibroblasts (hGFs), keratinocytes and macrophages under three-dimensional conditions. Wounds in the iGTE and hGF/keratinocyte monolayers were created by mechanical injury. Tissues and cells were pretreated with HW, EBND, and SA, and then exposed to the inflammatory and oxidative environment induced by PMA (10ng/mL) and LPS (250ng/mL). The inflammatory cytokines IL-6 and IL-8 were quantitatively analyzed by ELISA. Histopathological image analysis was performed by HE and immunofluorescence staining. In the iGTE, PMA/LPS significantly reduced the epithelial thickness while causing a decrease in K8/18, E-cadherin, laminin and elastin expression and an increase in COX-2 expression along with ulcer-like lesions. In mechanically scratched hGFs and keratinocyte monolayers, PMA/LPS significantly impaired wound healing, and promoted the secretion of IL-6 and IL-8. Pretreatment of HW, EBND, and SA significantly suppressed PMA/LPS-induced wound healing delay and inflammatory responses in cell monolayers, as well as in the iGTE. Remarkably, the combined use of HW and EBND exhibited particularly robust results. Combined use of HW and EBND may be applied for the prevention and treatment of wound healing delay.

Topical Application of TT-10 Ameliorates Impaired Wound Healing.

In recent decades, chronic wounds have become an increasingly significant clinical concern due to their increasing morbidity and socioeconomic toll. However, there is currently no product available on the market that specifically targets this intricate process. One clear indicator of delayed wound repair is the inhibition of re-epithelialization. Yes-associated protein (YAP), which is a potential focal point for tissue repair and regeneration, has been shown to be prominent in several studies. In this context, we have identified the pharmacological product TT-10, which is a YAP activator, as a potential candidate for the treatment of various forms of chronic wounds. The role of TT-10 in regulating YAP activity and subcellular localization was determined by western blotting and immunofluorescence staining. The effect of TT-10 on the biological functions of keratinocytes was assessed by proliferation, wound healing, and apoptosis assays. The impairment of YAP activity in chronic wounds was measured in human and mouse tissues. The in vivo efficacy of TT-10 was examined by gross examination, H&E staining, and measuring wound areas and gaps in normal, diabetic, and ischemic wounds. Our findings suggest that TT-10 facilitates the nuclear transport of YAP, consequently increasing YAP activity, which in turn increases the proliferation and migration of keratinocytes. Moreover, we showed that intracutaneous injection of TT-10 along the wound periphery promoted re-epithelization via YAP activation in the epidermis, culminating in accelerated wound closure in several chronic wound healing models. Our research highlights the potential of TT-10 to treat chronic wounds, which is a persistent challenge in tissue repair.

Lymphatic Interventional Radiology for Postoperative Lymphatic Leakage

AbstractLymphatic leakage is a relatively rare complication following various surgical procedures. Occasionally, conservative treatments fail to control postoperative lymphatic leakage. Refractory lymphatic leakage causes severe morbidities, including malnutrition, immunodeficiency, and impaired wound healing. Lymphangiography is a useful method for identifying various types of lymphatic leakage. Recently, lipiodol lymphangiography has been popular for its potential therapeutic effects on refractory lymphatic leakage, but this technique remains underdeveloped. This review discusses lymphatic interventional radiology for postoperative lymphatic leakage.