Angiogenesis, the formation of new capillaries from pre-existing vascular network, plays an important role in physiological and pathological processes such as embryonic development, wound healing, and development of atherosclerosis. Extension of the circulatory network is also considered to be one the most important factors during cancerogenesis. Inhibition of angiogenesis may lead to inhibition of tumor growth whereas stimulation may improve wound healing. Research achievements suggest the use of plants and their extracts as potential therapeutic agents with pro- or antiangiogenic activity. Since the anticancer and antiangiogenic properties of many phytomedicines have been amply reviewed elsewhere this paper will focus on the treatment of vascular insufficiency in wound healing. Globally accepted herbal drugs are thought to be safe and effective, however, there is a need for more evidence-based confirmation in controlled and validated trials. Among the most frequently studied proangiogenic phytochemicals are ginsenosides from Panax ginseng, beta-sitosterol from Aloe vera, calycosin from Radix Astragali, and extracts from Hippophae rhamnoides L. and Angelica sinensis.
Colon anastomosis is therapeutically challenging because multiple, usually undetectable factors influence a spectrum of repair mechanisms. We hypothesized that low molecular weight heparins, routinely administered perioperatively, may differentially affect gene expression related to colon healing. Twenty pairs of untreated and enoxaparin-treated rats underwent left-side hemicolectomy with a primary end-to-end anastomosis. Normal colon and anastomotic bowel segments were resected on day 0 and on days 1, 3, 5, and 7 after surgery, respectively. Serial anastomosis transverse cross-sections were evaluated microscopically and by microarray (Rat Genome 230 2.0, Affymetrix). Differentially expressed probe sets were annotated with Gene Ontology. We also examined the influence of enoxaparin on fibroblast proliferation and viability in vitro. Among the 5476 probe sets, we identified differential expression at each healing time point, yielding 79 subcategories. Most indicated genes were involved in wound healing, including multicellular organismal development, locomotory behavior, immune response, cell adhesion, inflammatory response, cell-cell signaling, blood vessel development, and tissue remodeling. Although we found no intensity differences in histological features of healing between enoxaparin-treated and control rats, treatment did induce significant expression changes during early healing. Of these changes, 83 probe sets exhibited at least twofold changes and represented different functional annotations, including inflammatory response, regulation of transcription, regulation of apoptosis, and angiogenesis. Fibroblast culture confirmed an anti-viability effect of enoxaparin. Enoxaparin affects colon wound-related gene expression profiles, but further studies will resolve whether heparin treatment is a risk factor after intestinal surgery, at least in some patients.
Two bio-based polymers have been compared in this study, namely: polylactide (PLA) and polyhydroxyoctanoate (PHO). Due to their properties such as biocompatibility, and biointegrity they are considered to be valuable materials for medical purposes, i.e., creating scaffolds or wound dressings. Presented biopolymers were investigated for their impact on cellular migration strategies of mouse embryonic fibroblasts (MEF) 3T3 cell line. Advanced microscopic techniques, including confocal microscopy and immunofluorescent protocols, enabled the thorough analysis of the cell shape and migration. Application of wound healing assay combined with dedicated software allowed us to perform quantitative analysis of wound closure dynamics. The outcome of the experiments demonstrated that the wound closure dynamics for PLA differs from PHO. Single fibroblasts grown on PLA moved 1.5-fold faster, than those migrating on the PHO surface. However, when a layer of cells was considered, the wound closure was by 4.1 h faster for PHO material. The accomplished work confirms the potential of PLA and PHO as excellent candidates for medical applications, due to their properties that propagate cell migration, vitality, and proliferation—essential cell processes in the healing of damaged tissues
Background: Uremic impairment of wound healing is a well-established phenomenon, however the etiology of this condition continues to be a medical enigma. Carbamylation, posttranslational modification (PTM) occurring with high frequency in uremic milieu, is known to have impact on structural and functional properties of proteins and peptides. Herein we show that carbamylation of the members of kinin-kallikrein system, that play an essential role in wound healing process, results in its aberrant functionality and impedes the complex process of tissue regeneration in uremic patients. Results: Through enzymatic assays we demonstrate that carbamylation of kininogen results in aberrant bradykinin generation. We confirmed that bradykinin is efficiently carbamylated in uremic conditions and, alternatively, by activated neutrophiles. Moreover, this modification affects proteolytic cleavage of the peptide, potentially leading to the accumulation of the carbamylated form. Modified peptide demonstrated lower affinity toward its receptors. Carbamylation diminished bradykinin’s ability to stimulate expression of the $B_{1}$ receptor and cytokines essential in wound healing process. Carbamylated bradykinin was significantly less potent in promoting angiogenesis and keratinocyte motility as compared to the native form. In the in vivo murine model of wound healing, we observed impaired collagen fiber production and delayed re-epithelialisation in the presence of carbamylated form. Conclusions: Carbamylation-driven impairment of wound healing is a mechanistic link to wound persistence in uremia. Importantly, production of carbamylated bradykinin in localized inflammatory milieus could be a significant contributor to delayed wound healing and formation of chronic wounds in diabetes or psoriasis.
The problem of treating chronic wounds is widespread throughout the world and carries a huge cost. Biomaterials engineering tries to solve this problem by creating innovative bioactive dressings dedicated to specific types of wounds. Both synthetic and natural polymers are the main base to produce wound dressings. Biopolymers have the advantage over synthetic polymers by being more biocompatible, non-toxic, biodegradable, and eco-friendly. The aim of this work was to produce a bioactive biomaterial based on natural polymers with potential applications to manage chronic highly exuding and infected wounds. A newly developed method for chemical synthesis of the curdlan/agarose biomaterial at high temperature combined with freeze-drying process resulted in a superabsorbent dressing material with antibiotic immobilized. The obtained biomaterial was subjected to basic microbiological in vitro tests and a cytotoxicity assay according to ISO 10993-5. Moreover, the experimental treatment of the infected wound in a veterinary patient was performed using the developed material. Based on the conducted research, it was proved that the produced dressing is not toxic to normal human skin fibroblasts. An additional advantage of the biomaterial is its ability to inhibit the growth of harmful microorganisms, such as Staphylococcus aureus and Pseudomonas aeruginosa. Furthermore, the experimental treatment confirmed the validity of using the produced biomaterial as a dressing dedicated to the treatment of difficult-to-heal infected wounds. To summarize, the produced biomaterial possesses great potential to be used as a wound dressing for infected wounds.
Aim: This study was undertaken with an aim to assess the feasibility of monitoring of wound healing by replacement of the traditional real-life clinical follow-up with a review of smartphone-captured digital photographs of post-surgical wounds by a clinician.
Method: The postoperative patients who understood the objectives got enrolled in the prospective study and were followed up. They were requested to capture digital photographs of the wounds using smartphones and send them through WhatsApp on postoperative days 3, 5, 7, 15 and 30 or else whenever they felt need for review due to symptoms like fever, pain, redness or swelling.
Results: 24 abdominal, 2 extremity and 1 neck wounds were followed up in 27 patients. Three patients developed complications and all were detected with 100% accuracy. As many as 81% of the patients were satisfied with this mode of postoperative wound assessment.
Conclusion: The experience shows that in the follow-up of postsurgical wounds, there is a good correlation between real-life clinical and remote photographic review. Incorporating photographic wound assessment into the postoperative follow-up care pathway can potentially decrease the number of postoperative hospital visits and decrease the burden on healthcare facilities.
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