Option For Wound Healing Research Articles

Efficacy of Honey-Based Wound Dressing Versus Hydrogel-Based Wound Dressing in Wound Healing Process: A Literature Review

Introduction: Wound dressing is a fundamental aspect of modern healthcare, encompassing a diverse range of materials and techniques aimed at optimizing the healing process while safeguarding against infection and further injury. By understanding the specific benefits of different types of wound dressings, healthcare professionals can optimize the healing process and improve patient outcomes Methods: This literature review was compiled using information from various open access online databases. Data were collected and analyzed. Results and Discussions: Honey dressing demonstrates superior efficacy compared to hydrogel dressing in wound management. Its multifaceted properties, such as potent antimicrobial activity, tissue regeneration promotion, and anti-inflammatory effects, render it a superior option for wound healing throughout all stages. Additionally, honey is more cost-effective than hydrogel and more easily accessible. Conclusion: The efficacy of honey dressing surpasses that of hydrogel dressing in wound management. Honey's multifaceted properties, including its potent antimicrobial activity, ability to promote tissue regeneration, and anti-inflammatory effects, make it a superior choice for wound healing across all phases.

Effectiveness of application of Helichrysum italicum essential oil in wound healing: report of 3 cases

Helichrysum italicum (Hi) essential oil is commonly used in wound healing. Hi is an option for treating acute wounds, especially bleeding wounds. Coconut oil has also long been used for various skin disorders including wound healing and microbial infections. The high amount of antioxidants will be useful against free radicals which are considered the main cause of inflammation during the wound healing process. Hi essential oil was chosen because of its antimicrobial, anti-inflammatory, and wound-healing activities, all of which supported the wound-healing process in the three patients in this case report. The purpose of this case report is to determine the effectiveness of using Hi essential oil in healing wounds. We report 3 patients with wounds treated with topical Hi 10% essential oil in virgin coconut oil (VCO) applied three times daily until healed. All cases showed good wound healing without secondary infection. Despite the irritating side effects in patient 2, all three patients were satisfied with the results. The use of Hi 10% essential oil in VCO has advantages in terms of antimicrobial and anti-inflammatory effects on wound healing without secondary infection so it needs to be studied further as an alternative therapy option in wound healing

Regulation of inflammation during wound healing: the function of mesenchymal stem cells and strategies for therapeutic enhancement.

A wound takes a long time to heal and involves several steps. Following tissue injury, inflammation is the primary cause of tissue regeneration and repair processes. As a result, the pathophysiological processes involving skin damage, healing, and remodeling depend critically on the control of inflammation. The fact that it is a feasible target for improving the prognosis of wound healing has lately become clear. Mesenchymal stem cells (MSCs) are an innovative and effective therapeutic option for wound healing due to their immunomodulatory and paracrine properties. By controlling the inflammatory milieu of wounds through immunomodulation, transplanted MSCs have been shown to speed up the healing process. In addition to other immunomodulatory mechanisms, including handling neutrophil activity and modifying macrophage polarization, there may be modifications to the activation of T cells, natural killer (NK) cells, and dendritic cells (DCs). Furthermore, several studies have shown that pretreating MSCs improves their ability to modulate immunity. In this review, we summarize the existing knowledge about how MSCs influence local inflammation in wounds by influencing immunity to facilitate the healing process. We also provide an overview of MSCs optimizing techniques when used to treat wounds.

Enhanced Diabetic Rat Wound Healing by Platelet-Rich Plasma Adhesion Zwitterionic Hydrogel.

The skin is the largest organ in the human body and serves as a barrier for protective, immune, and sensory functions. Continuous and permanent exposure to the external environment results in different levels of skin and extracellular matrix damage. During skin wound healing, the use of good dressings and addition of growth factors to the wound site can effectively modulate the rate of wound healing. A dressing containing bioactive substances can absorb wound exudates and reduce adhesion between the wound and dressing, whereas growth factors, cytokines, and signaling factors can promote cell motility and proliferation. We prepared a functional wound dressing by combining platelet-rich plasma (PRP) and zwitterionic hydrogels. Functional wound dressings are rich in various naturally occurring growth factors that can effectively promote the healing process in various types of tissues and absorb wound exudates to reduce adhesion between wounds and dressings. Furthermore, PRP-incorporated zwitterionic hydrogels have been used to repair full-thickness wounds in Sprague-Dawley rats with diabetes (DM SD). Fibroblasts and keratinocytes were cultured with PRP, zwitterionic hydrogels, and PRP-incorporated zwitterionic hydrogels to assess cell proliferation and specific gene expression. Furthermore, PRP-incorporated zwitterionic hydrogels were used to repair full-thickness skin defects in DM SD rats. The swelling ratio of hydrogel, hydrogel + PRP1000 (108 platelets/mL), and hydrogel + PRP1000 (109 platelets/mL) groups were similar (~07.71% ± 1.396%, 700.17% ± 1.901%, 687.48% ± 4.661%, respectively) at 144 hours. The tensile strength and Young modulus of the hydrogel and hydrogel + PRP10000 groups were not significantly different. High concentrations of PRP (approximately 108 and 109 platelets/mL) effectively promoted the proliferation of fibroblasts and keratinocytes. The zwitterionic hydrogels were not cytotoxic to any cell type. High PRP concentration-incorporated zwitterionic hydrogels increased the rate of cell proliferation and significantly increased the expression of characteristic genes such as collagen, fibronectin, involucrin, and keratin. Subsequently, zwitterionic hydrogels with high PRP concentrations were used to repair full-thickness skin defects in DM SD rats, and a wound healing rate of more than 90% was recorded on day 12. PRP contains high concentrations of growth factors that promote cell viability, enhance specific gene expression, and have a high medical value in cell therapy. Zwitterionic hydrogels have a 3-dimensional interconnected microporous structure and can resist cell adhesion without causing cytotoxicity. Platelet-rich plasma-incorporated zwitterionic hydrogels further enhance the cellular properties and provide an effective therapeutic option for wound healing.

Cell-Derived Matrix: Production, Decellularization, and Application of Wound Repair.

Chronic nonhealing wounds significantly reduce patients' quality of life and are a major burden on healthcare systems. Over the past few decades, tissue engineering materials have emerged as a viable option for wound healing, with cell-derived extracellular matrix (CDM) showing remarkable results. The CDM's compatibility and resemblance to the natural tissue microenvironment confer distinct advantages to tissue-engineered scaffolds in wound repair. This review summarizes the current processes for CDM preparation, various cell decellularization protocols, and common characterization methods. Furthermore, it discusses the applications of CDM in wound healing, including skin defect and wound repair, angiogenesis, and engineered vessels, and offers perspectives on future developments.

Yüksek yağlı diyet ile beslenen ve tam kalınlıkta deri defekti modeli oluşturulan sıçanlarda laktoferrinin etkisi

Purpose: Lactoferrin is a member of the milk protein family with a broad spectrum of bioactivities and has therapeutic effects against many microbes, viruses, and other pathogens. This study aims to show the healing effect of lactoferrin against obesity-related wound healing.
 Materials and Methods: In this study, 48 male rats were grouped as the Control (C) (n =8), Full-thickness skin defect model (FT) (n =8), Bovine Lactoferrin (bLf) (200 mg/kg)(n= 8), High Fat Diet (HFD) + Bovine Lactoferrin (bLf) (n = 8), High-Fat Diet (HFD)+Full-thickness skin defect model (FT) (n=8), and HFD+Full-thickness skin defect model (FT) + Bovine Lactoferrin bLf (n=8). High-Fat Diet + bLf and High-Fat Diet + Full-thickness skin defect + bLf group rats were given a high-fat diet and Bovine Lactoferrin orally. IL-6 and VEGF biochemical parameters were examined in serum.
 Results: When the serum IL-6 protein amounts of the groups were examined, it was the highest in the HFD+FT+bLf group on the 21st day, and the lowest in the FT group, when the serum VEGF protein amounts, which were the other biochemical parameters, were evaluated, these amounts were found to be the highest in the HFD+FT+bLf group and the lowest in the FT group on the 21st day.
 Conclusion: Lactoferrin has been shown to accelerate wound healing, and the fact that lactoferrin is readily available and abundant in milk makes it an exciting treatment option for wound healing and inflammation in the future.

Comparative Study of the Efficacy of EHO-85, a Hydrogel Containing Olive Tree (Olea europaea) Leaf Extract, in Skin Wound Healing.

Olive tree (Olea europaea) leaf extract (OELE) has important antioxidant and anti-inflammatory properties, supporting its use in human clinical practice. We recently designed an amorphous hydrogel called EHO-85 (EHO indicates olive leaf extract in Spanish) containing OELE for skin ulcer treatments. Yet, its effectiveness has not been previously compared with other products used in routine clinical practice. This is necessary to evaluate its potential translation to the human clinic. Thus, in this study, the effect of EHO-85 on healing was evaluated in comparison with treatments containing Indian/Asiatic pennywort (Centella asiatica), hyaluronic acid, or dexpanthenol in a rat model. The speed of wound closure and histological parameters after seven and 14 days were analyzed. All treatments accelerated wound closure, but there were differences between them. Dexpanthenol after seven days produced the highest epithelialization and the lowest inflammation and vascularization. EHO-85 also promoted epithelialization and reduced vascularization. After 14 days, wounds treated with EHO-85 showed less inflammation and higher levels of collagen in the extracellular matrix. This indicates a higher degree of maturity in the regenerated tissue. In conclusion, the effect of EHO-85 on healing was equal to or superior to that of other treatments routinely used in human clinical practice. Therefore, these results, together with previous data on the effects of this hydrogel on ulcer healing in humans, indicate that EHO-85 is a suitable, low-cost, and efficient therapeutic option for wound healing.

Sustainable functionalized chitosan based nano-composites for wound dressings applications: A review

Functionalized chitosan nanocomposites have been studied for wound dressing applications due to their excellent antibacterial and anti-fungal properties. Polysaccharides show excellent antibacterial and drug-release properties and can be utilized for wound healing. In this article, we comprise distinct approaches for chitosan functionalization, such as photosensitizers, dendrimers, graft copolymerization, quaternization, acylation, carboxyalkylation, phosphorylation, sulfation, and thiolation. The current review article has also discussed brief insights on chitosan nanoparticle processing for biomedical applications, including wound dressings. The chitosan nanoparticle preparation technologies have been discussed, focusing on wound dressings owing to their targeted and controlled drug release behavior. The future directions of chitosan research include; a) finding an effective solution for chronic wounds, which are unable to heal completely; b) providing effective wound healing solutions for diabetic wounds and venous leg ulcers; c) to better understanding the wound healing mechanism with such materials which can help provide the optimum solution for wound dressing; d) to provide an improved treatment option for wound healing.

FROM SEIZURES TO WOUNDS: THE POTENTIAL OF PHENYTOIN IN TRAUMATIC WOUND MANAGEMENT

Objective: Phenytoin is a medication primarily used to treat seizures, but it has been discovered to have the potential for wound healing due to its ability to increase collagen production, promote new blood vessel growth, reduce inflammation, fight infections, and encourage new skin growth. These effects are particularly useful for healing chronic wounds like pressure ulcers, diabetic ulcers, traumatic wounds, and venous ulcers. Methods: This is a two-year prospective study conducted between January 2020 and December 2022 at the Government General Hospital in Kurnool. A study was conducted on 60 patients with traumatic wounds, dividing them into two groups. One group received topical phenytoin dressing, while the other received normal saline dressing. The study compared wound surface area, granulation tissue percentage, pain ratings on the visual analog scale, and healing time between the groups on day 14 and day 21. Results: On day 0, cases and controls had similar wound surface areas (62.17±25.74 cm2 and 62.14±21.57 cm2, respectively) and VAS scores (8.81±1.22 and 8.88±1.52). By day 14, cases had significantly smaller wound surface areas (41±32.32 cm2), a higher percentage of granulation tissue (75.56±7.30%), and lower VAS scores (4.57±1.78) compared to controls (53.28±25.33 cm2, 58.45±7.01%, and 6.32±1.02, respectively). By day 21, cases had even smaller wound surface areas (28.3±31.75 cm2), a higher percentage of granulation tissue (93±3.46%), and lower VAS scores (2.78±0.42) compared to controls (40.34±34.23 cm2, 72.56±5.05%, and 4.82±1.27, respectively). The time for wound healing was significantly shorter for cases (22.76±7.28 d) compared to controls (32.64±9.31 d). On day 21, negative cultures were found in 80% of wounds in the study group and 50% of wounds in the control group, with a statistically significant difference (P-value<0.05). Conclusion: Topical phenytoin dressing had positive effects on wound healing by increasing the rate of granulation tissue formation, providing better pain relief, and shortening the healing time. It was found to be a safe, effective, and cost-effective option for wound healing due to its various mechanisms. The study highlights the significance of phenytoin in treating traumatic wounds, particularly in patients with limited access to expensive wound-healing medications.

Assessment of tissue healing after periodontal and peri-implant surgery

Relevance. In clinical practice, a dentist usually faces surgical wound healing peculiarities. We know that wound healing by primary intention is preferable, but the postoperative period does not always go this way. In practice, doctors observe a variety of wound healing options, which are not always documented correctly and in full. An incomplete and unprecise diagnosis may lead to c omplications, including iatrogenic ones.Material and methods. This study included patients undergoing surgical treatment in the Samara dental outpatient department. The study assessed the healing of periodontal and peri-implant tissues on the 4th-5th day after surgery. One hundred-and-thirty subjects, aged 27 to 65 y.o., participated in the study.Results. The study revealed the criteria for oral surgical wound healing, which included density and quality of the approximation of wound edges, oedema, exudate, hyperemia, fibrin coat amount, and purulent discharge. The study also recorded the subjective sensations of the patients. After analyzing the postoperative wound condition, we divided the patients into groups according to a similar clinical situation. We identified six types of wound healing processes around implants and teeth. Thus, we formed classes and subclasses of our "Classification of periodontal and peri-implant surgical wound healing assessment." This classification will optimize and simplify communication between specialists and speed up medical charting. The analysis helped to develop and implement a decisionmaking algorithm for postoperative surgical site treatment.Conclusion. The method of soft tissue condition classification and treatment after periodontal and peri-implant surgery is easily reproducible and available in routine outpatient surgical practice. The algorithm will allow for the successful treatment of surgical wounds based on the wound-healing process characteristics.

Design and fabrication of Sesamol-loaded transfersomal gel for wound healing: physicochemical characterization and in-vivo evaluation

Objective In the present study, an attempt has been made to develop SL-loaded transfersomal gel for the effective treatment of delayed wound healing. Significance The wound healing process consists of a complex series of biochemical events and changes in cellular activity that restore the integrity of the skin and the subcutaneous tissue. Sesamol (SL), which is a natural phenolic compound, is known for its antioxidant properties, anti-inflammatory properties, and wound-healing abilities. Methods A thin-film hydration method was used to prepare SL-loaded transfersomes. Different formulations containing Tween-80 and Span-80 as edge activators were prepared and optimized. Various characteristics of vesicles were assessed, such as size, shape, loading efficiency, deformability, and in vitro skin penetration. The optimized formulation was then incorporated into 1% carbopol 940 gel. An in vivo wound healing potential of the selected formulation was assessed by an excision wound model. Results The SL-loaded transfersomal gel displayed improved skin penetration and better skin deposition. Wound healing studies showed that the highest wound contraction was observed with SL-loaded transfersomes. Following 21 days of application of the transfersomal gel, a marked improvement in skin histological architecture was found. Conclusion The study findings suggest that transfersomal gel has great potential as a therapeutic option in wound healing.

Dose-response relationship of photobiomodulation therapy and oxidative stress markers in healing dynamics of diabetic neuropathic ulcers in Wistar rats

Purpose:Diabetic foot ulcers are reported to be the most expensive complications of diabetes, with high morbidity and mortality rates. If the necessary care is not provided for the wound to heal, the individual may end up amputating the affected feet. Photobiomodulation therapy is a promising non-pharmacological treatment option for wound healing. The objective of the present study is to establish a dose-response relationship between photobiomodulation therapy and oxidative stress markers in the healing dynamics of diabetic neuropathic ulcers in Wistar rats.Methodology:Diabetic neuropathy was induced in 126 Albino Wistar rats. An excisional wound of an area of 2cm2 was made on the neuropathy-induced leg. Photobiomodulation therapy of dosages 4, 6, 8, 10, 12, and 15 J/cm2 of wavelengths 655 and 808 nm was irradiated. The control group animals were kept un-irradiated. The outcome measures were assessed during wound healing’s inflammatory, proliferative and remodelling phases.Results:In the experimental group, animals treated with photobiomodulation therapy at doses of 4, 6, and 8 J/cm2 showed better wound healing dynamics. Photobiomodulation therapy modulated the reactive oxygen species and antioxidant levels, thereby improving the oxidative status of the wound.Conclusion:Photobiomodulation therapy of dosages 4, 6, and 8 J/cm2 is effective and is a promising adjuvant modality in treating diabetic neuropathic ulcers. There was a strong dose-response relationship in the experimental groups treated with 4, 6 and 8 J/ cm2.

A Prospective Randomized Controlled Multicenter Clinical Trial Comparing Paste-Type Acellular Dermal Matrix to Standard Care for the Treatment of Chronic Wounds.

The treatment of chronic wounds remains challenging. Acellular dermal matrix (ADM) has been shown to be effective for various types of wound healing. This study was designed to compare the wound size reduction rate after 12 weeks between patients receiving paste-type ADM and standard wound care. Patients over 19 years old with chronic wounds, deeper than full-thickness skin defects, more than 4 cm2 in size that did not heal over the 3 weeks before the study were included. After a screening period of 7 days, patients were randomized to receive either paste-type ADM or standard wound care. The wound status was evaluated at baseline, 1, 2, 4, 8, and 12 weeks. A total of 86 patients were enrolled in this study. The wounds continuously and constantly reduced in size from week 1, and the reduction rate was significantly greater in the study group from week 2 until the end (week 12). In the study group, wound healing was achieved in 29 of 38 wounds (76.3%). Paste-type ADM might be a useful option for wound healing and can be applied safely and efficiently for advanced wound care.

Use of Porcine Urinary Bladder Matrix in Socket Reconstruction After Pediatric Orbital Exenteration.

Reconstruction options after orbital exenteration can be challenging, time-consuming, and require intensive postoperative care. Engineered dermal acellular matrices offer a quick and easy option for wound healing that has proven to be successful in various settings. Specifically, the porcine urinary bladder matrix has demonstrated success in periocular and orbital wound healing. This report describes a pediatric patient who underwent repair with porcine urinary bladder matrix after orbital exenteration for recurrent alveolar rhabdomyosarcoma. The patient did not require any additional reconstructive procedures. To our knowledge, this is the youngest patient to receive a porcine urinary bladder matrix after exenteration.

Two-Stage Patterned Cell-Based Treatments for Skin Regeneration.

During the process of wound healing, avoiding the formation of aligned collagen fibrils and subsequent scarring has become the focus of numerous research efforts. However, the goal of regeneration of native or scar-free skin remains a challenge. The complex and equivocal connection between inflammation and regeneration within the process of healing contributes to unsatisfactory treatment outcomes. Inspired by the scarless repair observed in fetal wound healing, we create a two-stage treatment combining the hydrocolloid dressing to attenuate the immune response in the initial three days, and the biomimetic cell-laden hydrogel to improve skin regeneration, which meet the specific needs of each stage in the healing process. To further accelerate the skin regeneration, the patterned cell-laden hydrogels were fabricated by photo-mask based photolithography technique. The efficacy and possible mechanisms of skin regeneration using this patterned cell-laden hydrogel therapy was investigated. Results show that these two-stage patterned cell-laden treatments were able to promote vascular network formation, accelerate wound closure, decrease scar formation, increase tissue regeneration and restore structure and mechanical properties of the skin in a full-thickness murine wound model. These data suggest that our patterned cell-based two-stage treatments can be used as a promising therapeutic option for wound healing by accelerating skin tissue regeneration.

The Effects of Lavender Essential Oil on Wound Healing: A Review of the Current Evidence.

Background: The commercialization of essential oils has expanded their presence in the United States, and emerging studies demonstrate that they may have a place in Western medicine. One oil with a significant body of evidence is lavender essential oil, which may have benefits in wound healing. Objectives: This review aims to present the scientific literature on therapeutic lavender essential oil with the goal of expanding the current repertoire of cost-effective wound healing options available to physicians and patients. Methods: A review was conducted according to PRISMA guidelines in PubMed, Cochrane Library, and Embase from June 2018 through March 2019 to identify articles related to lavender essential oil in the context of wound healing. Results: This search yielded 36 unique studies, 20 of which remained after screening. This review utilizes human clinical trials (n = 7), animal trials (n = 5), in vitro studies (n = 2), and previously conducted reviews (n = 6). Overall, these studies demonstrated a faster rate of wound healing, increased expression of collagen, and enhanced activity of proteins involved in the tissue remodeling process in wounds treated with lavender essential oil. Conclusions: The current body of literature suggests a potential therapeutic benefit of lavender essential oil in wound healing. However, standardization of the chemical composition and additional high-quality human clinical trials are needed to further evaluate the safety and efficacy of lavender essential oil in clinical practice.

Efficacy of Maggot Debridement Therapy on Refractory Atypical Diabetic Foot Ulcers: An Open-Label Study.

Atypical or refractory diabetic foot ulcers (DFUs) are still a major health problem. Maggot debridement therapy (MDT) by larva of Lucilia sericata is an ancient and a modern option for wound healing. It works by debridement, stimulation of wound healing, and disinfection. In this study, we aimed to evaluate the efficacy of MDT for healing atypical and refractory DFUs. Patients with atypical DFUs were selected and further evaluated for some predefined differential diagnoses like atypical fungal, parasitic, or bacterial infections, malignancy, trauma, and so on. Multiple MDT sessions were carried out. Ulcer size was measured before every MDT session. Complete wound healing, time to heal, and adverse effects were recorded as well. Forty-two DFU patients (26 men, 16 women) with 42 nonhealing atypical ulcers participated in this study. Complete wound healing was achieved in 35 patients (83.3%) by MDT. Complete debridement and then healing of the wounds happened in less than 1.79 ± 0.8 months. Four ulcers persisted, and 3 (7.1%) were eventually amputated. MDT may be considered as an effective treatment for atypical DFUs, which are unresponsive to conventional therapies.

Human Gingival Fibroblasts Exposed to Extremely Low-Frequency Electromagnetic Fields: In Vitro Model of Wound-Healing Improvement.

Several clinical studies have suggested the impact of sinusoidal and pulsed electromagnetic fields in quickening wound repair processes and tissue regeneration. The clinical use of extremely low-frequency electromagnetic fields could represent a novel frontier in tissue repair and oral health, with an interesting clinical perspective. The present study aimed to evaluate the effect of an extremely low-frequency sinusoidal electromagnetic field (SEMF) and an extremely low-frequency pulsed electromagnetic field (PEMF) with flux densities of 1 mT on a model of oral healing process using gingival fibroblasts. An in vitro mechanical injury was produced to evaluate wound healing, migration, viability, metabolism, and the expression of selected cytokines and protease genes in fibroblasts exposed to or not exposed to the SEMF and the PEMF. Interleukin 6 (IL-6), transforming growth factor beta 1 (TGF-β), metalloproteinase 2 (MMP-2), monocyte chemoattractant protein 1 (MCP-1), inducible nitric oxide synthase (iNOS), and heme oxygenase 1 (HO-1) are involved in wound healing and tissue regeneration, favoring fibroblast proliferation, chemotaxis, and activation. Our results show that the exposure to each type of electromagnetic field increases the early expression of IL-6, TGF-β, and iNOS, driving a shift from an inflammatory to a proliferative phase of wound repair. Additionally, a later induction of MMP-2, MCP-1, and HO-1 was observed after electromagnetic field exposure, which quickened the wound-healing process. Moreover, electromagnetic field exposure influenced the proliferation, migration, and metabolism of human gingival fibroblasts compared to sham-exposed cells. This study suggests that exposure to SEMF and PEMF could be an interesting new non-invasive treatment option for wound healing. However, additional studies are needed to elucidate the best exposure conditions to provide the desired in vivo treatment efficacy.

The use of nanoparticles in wound treatment: a systematic review.

To analyze the effects of nanoparticle-based dressings on the wound healing process in in vitro animals and human cells based on scientific evidence. A systematic review of the literature in LILACS, PubMed and Science Direct databases. The articles were selected and evaluated for the level of evidence by the application of STROBE. The sample consisted of 12 articles. The application of the products occurred in surgical wounds, burns, infected wounds and gingival ulcers in laboratory animals, as well as in vitro tests, demonstrating that among other advantages, the nanoparticle-based dressings increased the healing speed, had good antibacterial capacity and were non cytotoxic agents. Based on the analyzed articles, it can be affirmed that dressings containing nanocomposites are quite promising and are shown as a great therapeutic option in wound healing.

Chronic Venous Insufficiency: Transforming Growth Factor-β Isoforms and Soluble Endoglin Concentration in Different States of Wound Healing.

Venous leg ulcer (VLU) is a huge healthcare problem with poorly understood pathophysiology. Transforming growth factor-β (TGF-β) and endoglin (Eng), are inflammatory and wound healing mediators. Eng, co-receptor for TGF-β type-II receptors, may be cleaved forming soluble Eng (sEng), antagonizing TGF-β signaling, a crucial process in vascular pathologies. We evaluated the accumulation in wound fluid (WF) of TGF-β isoforms and sEng in healing stages, showing the effects of sulodexide treatments, a glycosaminoglycan with clinical efficacy in VLU healing. Patients with inflammatory (Infl) and granulating (Gran) VLU were recruited. WFs and THP-1 monocytes exposed to Infl and Gran WF (treated/untreated with sulodexide) were analyzed for TGF-β isoforms and sEng by multiplex immunoassay. In both Infl and Gran WF, TGF-β1 and β2 were similar; TGF-β3 was significantly increased in Infl compared to Gran WFs (p = 0.033). sEng was significantly elevated in Gran compared to Infl WFs (p = 0.002). In THP-1 monocytes there was a significant increase in sEng after co-treatment of WF and sulodexide. The increase in TGF-β3 found in Infl WF highlights its negative effect on wound healing, while the increased levels of sEng in Gran WF affects the leukocyte adhesion/transmigration through the endothelium, reducing the inflammatory response and favoring the wound healing. Glycosaminoglycan sulodexide potentiates the effects of sEng release from monocyte, representing an important therapeutic option for wound healing.