International Wound Journal最新文献

{"title":"Protein Biomarkers in Venous Leg Ulcer Fluid: A Systematic Review","authors":"Renitha Reddi,&nbsp;Matthew Tan,&nbsp;Alun Huw Davies,&nbsp;Sarah Onida","doi":"10.1111/iwj.70675","DOIUrl":"https://doi.org/10.1111/iwj.70675","url":null,"abstract":"<p>Venous leg ulcers (VLUs) are common and cause significant morbidity and poor quality of life. There is a poor understanding of the biology underlying non-healing VLUs. VLU exudates may reflect the underlying wound microenvironment. This systematic review aims to identify potentially diagnostic and/or prognostic protein biomarkers within VLU fluid/exudates reported in the literature. A systematic review was reported according to PRISMA guidelines. MEDLINE and Embase databases were searched up to 31st March 2024. Full text, primary studies in English reporting on proteins identified in VLU fluid/exudate were included. Two independent reviewers performed the abstract and full-text screen. Additional publications were identified by searching the references of included studies. 46 studies were identified, with nine comparing healing and non-healing VLUs. Cytokines (e.g., IL-1a, IL-1ra, IL-6, eotaxin, GM-CSF, PDGF, VEGF) and proteins involved in extracellular matrix (ECM) homeostasis (e.g., MMP-7, MMP-10, MMP-13, TIMP-4) were significantly increased in non-healing compared to healing VLUs. Collagen subunits (PICP and PIIINP) significantly increased as the VLU healed. Inflammatory proteins (e.g., complement type 6, S100A8, S100A9) and ECM proteins (e.g., fibronectin, lumican) were found to be increased in non-healing VLUs compared to acute surgical wounds. Altered levels of specific proteins in wound exudates may be indicative of healing and non-healing VLUs. Further work is essential to elucidate a comprehensive protein phenotype that may help early identification and prognostication of non-healing VLUs.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"22 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70675","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143919473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wound Management Amongst Doctors in Training: A Cross-Sectional Study of Education and Capability","authors":"Hamza Duffaydar,&nbsp;Octavi Casals-Farre,&nbsp;Jessica Morgan,&nbsp;Harri Jones,&nbsp;Hassan Duffaydar,&nbsp;Amy Smith,&nbsp;Charles Kimberly,&nbsp;James Brock,&nbsp;Rhidian Morgan-Jones,&nbsp;Arwel Poacher","doi":"10.1111/iwj.70674","DOIUrl":"https://doi.org/10.1111/iwj.70674","url":null,"abstract":"<p>Wound care in the UK is a resource-intensive challenge, costing the NHS £8.3 billion annually and growing with an ageing population. However, there is no evidence of whether doctors in training receive adequate teaching to perform wound care competently. Our study aimed to investigate doctors’ confidence when assessing and managing wounds and their preferred learning modality. This cross-sectional study comprised 262 doctors training across the UK. We assessed the correlation between confidence in managing wounds, seniority in training, and trainee speciality. Only 65% of doctors had received teaching on wound healing during medical school, and 25% received further teaching during postgraduate training. Surgical trainees felt more confident in assessing and managing wounds than their medical counterparts (<i>p</i> &lt; 0.01), and surgeons were the only group demonstrating a positive correlation between seniority and confidence in wound management (<i>p</i> = 0.02). All speciality groups favoured bedside teaching and thought wound management was integral to clinical practice. Our study has shown that training is sub optimally delivered and insufficient for trainee requirements. Incorporating dedicated teaching across specialities will be essential to manage the increasing demand for wound care.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"22 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70674","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143919474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preclinical Evaluation of Closed Incisional Negative Pressure Therapy on Post-Surgical Oedema and Lymphatic Activity","authors":"John C. Rasmussen,&nbsp;Marisa Schmidt,&nbsp;Janelle E. Morton,&nbsp;Samantha Mann,&nbsp;Kristine Kieswetter,&nbsp;Eva M. Sevick-Muraca","doi":"10.1111/iwj.70180","DOIUrl":"https://doi.org/10.1111/iwj.70180","url":null,"abstract":"<p>Closed incisional Negative Pressure Therapy (ciNPT) has demonstrated improved post-surgical healing with reduced oedema and hematoma/seroma formation in patients. The underlying mechanism of action is poorly understood, although evidence indicates that lymphatics play a role. The effects of ciNPT on oedema and lymphatic recovery were assessed following bilateral, surgical undermining of swine mammary tissues. One incision was treated with ciNPT, and the control covered with clear dressing. Near-infrared fluorescence imaging was used to visualise lymphatic activity. Oedema and lymph node size were measured using ultrasound. LYVE-1 and podoplanin were quantified with ELISA. Analysis of lymphatic activity revealed a contralateral effect of ciNPT on control sites. Statistically higher pulsatile rates were observed at both incisions when ciNPT was active, compared with when it was removed. Separate evaluations with dressings off and on showed no differences between treatments. While not significant, lower surgical site oedema, lymph node volume, and incidence/severity of seroma were observed in treated sites along with increased lymphatic vessel markers in lymph draining tissues. Taken together, evidence suggests that ciNPT may influence watersheds outside the treated area. Similar systemic impacts owing to manual lymphatic drainage have previously been reported in healthy individuals and those with cancer-related lymphedema.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"22 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70180","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2-Methoxyestradiol Inhibits the Oxygen-Sensing Pathway in Keloid Fibroblasts by Targeting HIF-1α/PHD","authors":"Ming-Zi Zhang,&nbsp;Zhi-Jin Li,&nbsp;Wen-Bo Xia,&nbsp;Lou-Bin Si,&nbsp;Nanze Yu,&nbsp;Xiao-Jun Wang,&nbsp;Xiao Long","doi":"10.1111/iwj.70373","DOIUrl":"https://doi.org/10.1111/iwj.70373","url":null,"abstract":"<p>Maintaining oxygen homeostasis is a basic cellular process for adapting to physiological oxygen variations in which the oxygen-sensing pathway plays a critical role, especially in tumour progression. Little is known about the activity of the oxygen-sensing pathway in keloid tissue. In this study, key features of the oxygen-sensing pathway and its downstream effects were evaluated and compared between normal skin tissue and keloid tissue. Keloid tissue showed increased oxygen-sensing pathway activation and a higher expression of key downstream factors such as tumour necrosis factor-1α (TNF-α) and vascular endothelial growth factor (VEGF). In addition, the effects of 2-methoxyestradiol on the oxygen-sensing pathway in both hypoxic and normoxic keloid fibroblasts were evaluated. Our results suggest that 2-methoxyestradiol could be used to inhibit keloid fibroblast activity by inhibiting the oxygen-sensing pathway and its downstream effectors.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"22 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity, reliability and dimensionality of the Norwegian version of Wound-QoL","authors":"Monica Maria Schwartz,&nbsp;Tone Marte Ljosaa,&nbsp;Brita Solveig Pukstad,&nbsp;Britt Karin Utvær","doi":"10.1111/iwj.70051","DOIUrl":"https://doi.org/10.1111/iwj.70051","url":null,"abstract":"<p>The aim of the study was to explore the psychometric properties of the Norwegian version of the Wound-quality of life (QoL)-17. We included 204 patients with hard-to-heal wounds on the lower extremity. Patients filled out the Wound-QoL-17, SF-36 and Patients' Global Impression of Change at three time points over 14 weeks. Clinical and demographical data were collected at baseline. Wound severity was collected at baseline and 14 weeks follow-up (T2). Confirmatory factor analyses showed acceptable fit of the hypothesised three-factor model (i.e., body, psyche and everyday life) of the Wound-QoL as long as we accepted two correlated error terms within the Body factor (<i>χ</i>² = 203.14, <i>p</i> = 0.000, df = 99, <i>χ</i>²/df = 2.05, Root Mean Square Error of Approximation = 0.072, Standardised Root Mean Square Residual = 0.059, Comparative Fit Index = 0.943 and Tucker–Lewis Index = 0.930). Correlation showed moderate to strong associations between Wound-QoL and SF-36 (−0.400** to −0.777**), and significant associations between Wound-QoL and Patients' Global Impression of Change (0.199*), general wound pain intensity (0.435**), pain intensity at wound change (0.340**) and infection (0.174*). The intraclass correlations, ranging from 0.578** to 0.782**, suggested strong test–retest reliability. Cronbach's alphas for all subscales and the total score between 0.748 and 0.922, indicated good internal consistency. The Norwegian version of Wound-QoL demonstrates good reliability and construct validity and is suitable for evaluating QoL in patients with hard-to-heal wounds. However, some improvements were performed to achieve an acceptable fit.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"22 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective, Controlled, Randomised, Clinical Study of Negative Pressure Device Without Foam or Gauze for Skin and Soft Tissue Defects","authors":"Kristo Nuutila,&nbsp;Victoria Diaz,&nbsp;Kristin Anselmo,&nbsp;Michael Broomhead,&nbsp;Elof Eriksson,&nbsp;Rodney K. Chan","doi":"10.1111/iwj.70144","DOIUrl":"https://doi.org/10.1111/iwj.70144","url":null,"abstract":"<p>All common negative pressure wound therapy (NPWT) systems include a filler material usually foam or gauze at the wound/device interface. The filler material distributes the negative pressure evenly to all parts of the wound. The foam or gauze may fragment contributing to foreign material being retained in the wound, becoming colonised with bacteria over time, and painful dressing changes. To mitigate these, negative aspects, an impermeable embossed single-layer NPWT membrane dressing has been developed. The dressing has been coined Negative Pressure—Platform Wound Device (NP-PWD) and a foam or gauze is not required to deliver negative pressure. Rather, the pressure is permeated via the spaces between the embossed pyramids and the wrinkles in the membrane. The purpose of this study was to compare the NP-PWD to the standard of care (SOC) NPWT system in the treatment of skin and soft tissue defects. This was a prospective, randomised, controlled clinical trial. The wounds were treated with the NP-PWD or SOC NPWT system. The randomised treatment was applied for 2 days to up to 9 days after the initial application. Follow-up data were collected at each dressing change/removal and included photographs, and assessments for wound healing, infection, and adverse events. In total 24 subjects (12 NP-PWD and 12 SOC) completed the study. The NP-PWD was easy to use and fast to apply and the patients tolerated it well. The transparency of the NP-PWD allowed the provider to see the wound without removing the dressing which is an improvement over traditional NPWT. In terms of wound healing, inflammation, pain, and infection, no differences were observed between the NP-PWD and the SOC NPWT system. The NP-PWD is a simplified, single component NPWT system eliminating the use of the filler material that commonly causes challenges during treatment.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"22 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cold Atmospheric Pressure Plasma in the Treatment of Diabetic Foot Ulcers: A Systematic Review","authors":"Wassim Hassan,&nbsp;Jabra Mustafa,&nbsp;Ahmad Hassan,&nbsp;Lauren Yaeger,&nbsp;Ibrahim S Al-Busaidi","doi":"10.1111/iwj.70517","DOIUrl":"https://doi.org/10.1111/iwj.70517","url":null,"abstract":"<p>Cold atmospheric pressure plasma (CAPP) is an innovative energy-based therapy which has gained momentum in recent years for its wide array of therapeutic applications. This systematic review aims to evaluate the effectiveness and safety of CAPPs in treating diabetic foot ulcers. We conducted systematic literature searches on Embase, Ovid Medline, Scopus, Cochrane Central Register of Controlled Trials, The Cochrane Database of Systematic Reviews and Clinicaltrials.gov using PRISMA guidelines. We searched for randomised controlled trials (RCTs) and observational studies conducted on patients with diabetic foot ulcers in which CAPP therapy was compared with a control treatment. The risk of bias was assessed using the Cochrane Collaboration tool. Four RCTs from two countries analysing a total of 153 patients were included in the review. Three studies reported a significant reduction in ulcer area in the CAPP group, one study reported a significant decrease in inflammatory markers, and mixed results were reported regarding the reduction of bacterial load. All studies reported no adverse side effects or concerns with the safety profile of CAPP. Current evidence supports CAPP's potential as safe and effective adjunctive therapy that may accelerate wound healing, reduce wound size, promote tissue regeneration and lower infection risks. However, the limited number and size of trials, variability in treatment protocols and short follow-up periods highlight the preliminary nature of these findings. Further large-scale, well-designed studies with standardised protocols and long-term follow-up are needed to confirm CAPP's efficacy and safety, as well as to determine its cost-effectiveness in diverse healthcare settings.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"22 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70517","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The infected diabetic foot: Bacteraemia and endocarditis complicating moderate and severe foot infections","authors":"Mario C. Reyes,&nbsp;Arthur N. Tarricone,&nbsp;Mathew J. Sideman,&nbsp;Michael C. Siah,&nbsp;Bijan Najafi,&nbsp;Edgar J. G. Peters,&nbsp;Lawrence A. Lavery","doi":"10.1111/iwj.70102","DOIUrl":"https://doi.org/10.1111/iwj.70102","url":null,"abstract":"<p>To identify the incidence of blood stream infections (BSIs) and endocarditis in patients with diabetic foot infections (DFIs), risk factors and clinical outcomes. A post hoc analysis of 280 patients using pooled patient level data from three RTCs. Blood cultures were drawn at time of admission for DFI. Deep intraoperative cultures were obtained from infected foot wounds. Data from the 12-month follow-up were used to determine clinical outcomes. 77.1% (<i>N</i> = 216) had blood cultures of which 15.7% (<i>n</i> = 34) had BSI. One patient (3.3%) had endocarditis. Risk factors for BSI included Charcot Neuroarthropathy history (20.6% vs. 7.1%, <i>p</i> = 0.03), low systolic blood pressure (128.3 ± 21.0 vs. 140.8 ± 22.2 <i>p</i> = 0.003), low diastolic blood pressure (71.6 ± 9.4 vs. 79.3 ± 11.5 <i>p</i> &lt;0.001), leucocytosis &gt;12 000 (55.9% vs. 29.1%, <i>p</i> = 0.002) and elevated C-reactive protein (CRP) (26.8 ± 31.2 vs. 12.0 ± 19.6, <i>p</i> &lt;0.001). During the index hospitalization, BSI patients had longer median hospitalizations (14.0, 11.3–18.0 vs. 12.0, 9.0–16.0, <i>p</i> = 0.04). At 12-months, BSI patients were more likely to be admitted to the hospital (all cause hospital admissions 35.3% vs. 18.6%, <i>p</i> = 0.03). There was no difference in re-infection (20.6% vs. 32.9%, <i>p</i> = 0.21), foot-specific hospitalizations (17.6% vs. 22.5%, <i>p</i> = 0.65), wounds healing (64.7% vs. 67.5%, <i>p</i> = 0.88), time to heal (221.0, 74.0–365 vs. 109.5, 46.8–365, <i>p</i> = 0.16) or antibiotic duration (46.0, 39.3–76.5 vs. 45.0, 22.3–67.0, <i>p</i> = 0.09). The most common BSI pathogens were <i>Staphylococcus aureus</i> (79.4%) and <i>Streptococcus</i> spp. (50.0%) species. BSI is common in DFIs. Patients have longer hospitalizations and were more likely to be hospitalized after their initial discharge.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"22 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for surgical site infections after orthopaedic surgery: A meta-analysis and systematic review","authors":"Huan Liu,&nbsp;Hao Xing,&nbsp;Ge Zhang,&nbsp;An Wei,&nbsp;Zhengqi Chang","doi":"10.1111/iwj.70068","DOIUrl":"https://doi.org/10.1111/iwj.70068","url":null,"abstract":"<p>The objective of this meta-analysis was to investigate the occurrence and determinants of surgical site infections (SSIs) in individuals following orthopaedic surgical procedures. A systematic exploration of articles concerning factors predisposing individuals to SSIs after orthopaedic surgery was conducted across multiple databases, including PubMed, Embase, Cochrane Library and Web of Science, up to March 20, 2024. The Stata 15.0 software was employed to estimate combined odds ratios (ORs) utilizing either a random-effects model or a fixed-effects model based on the degree of heterogeneity among the included studies. Egger's test was used to assess publication bias. Among the 1248 records retrieved, 45 articles were deemed eligible after screening for studies incorporating multivariate analyses of risk factors associated with SSIs. These comprised four case–control studies and 41 cohort studies, collectively involving 1 572 160 patients, among whom 43 971 cases of SSIs were reported postoperatively. Meta-analysis outcomes indicated significant associations between SSIs and the following factors: low Albumin levels (&lt;35 g/L; OR = 2.29, 95% confidence interval [CI]: 1.45–3.62, <i>p</i> = 0.0001), ASA score &gt;2 (OR = 2.32, 95% CI: 1.86–2.89, <i>p</i> = 0.0001), elevated body mass index (BMI) (&gt;24 kg/m²) (OR = 2.15, 95% CI: 1.60–2.90, <i>p</i> = 0.0001), diabetes (OR = 2.25, 95% CI: 1.66–3.05, <i>p</i> = 0.0001), prolonged surgical duration (&gt;60 min) (OR = 2.06, 95% CI: 1.52–2.80, <i>p</i> = 0.001), undergoing multiple surgeries/procedures (OR = 2.38, 95% CI: 1.29–4.41, <i>p</i> = 0.006), presence of an open fracture (OR = 3.35, 95% CI: 2.51–4.46, <i>p</i> = 0.001), current smoking (OR = 2.87, 95% CI: 1.88–4.37, <i>p</i> = 0.0001), higher wound class (&gt;2; OR = 3.59, 95% CI: 1.68–7.66, <i>p</i> = 0.001) and utilization of implants (OR = 1.89, 95% CI: 1.15–3.11, <i>p</i> = 0.0012). The present study identified a number of risk factors for the development of SSIs following orthopaedic surgery. It is therefore recommended that clinicians closely monitor these indicators in order to prevent the development of postoperative SSIs. Furthermore, our interpretation of diabetes mellitus was not adequate. It is therefore recommended that future studies refine the effect of diabetes mellitus on SSIs in different situations.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"22 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Skin Wound Healing Through Chemically Modified Messenger RNA Encoding Epidermal Growth Factor (EGF)","authors":"Haiyang Hu,&nbsp;Qianglong Sheng,&nbsp;Fan Yang,&nbsp;Xinyi Wu,&nbsp;Youlai Zhang,&nbsp;Shuling Wu,&nbsp;Yihu Liu,&nbsp;Ningyan Hu,&nbsp;Chenhong Fu,&nbsp;Jialin Leong,&nbsp;Rufei Deng,&nbsp;Zhenyu Jiang,&nbsp;Jiaxin Chen,&nbsp;Zhenxing Wang,&nbsp;Chunyuan Chen,&nbsp;Fei Chen,&nbsp;Yixuan Luo,&nbsp;Yuanlin Zeng,&nbsp;Yin Yu,&nbsp;Hui Xie,&nbsp;Gang Wang,&nbsp;Lijin Zou","doi":"10.1111/iwj.70143","DOIUrl":"https://doi.org/10.1111/iwj.70143","url":null,"abstract":"<p>Efficient wound healing remains a formidable medical challenge in clinical practice, due to the prevalence of skin defects arising from diverse etiological factors. It is indisputable that epidermal growth factor (EGF) plays a pivotal role in wound repair. However, its clinical application through recombinant proteins encounters challenges, including a short half-life in vivo and high production costs. Addressing these limitations, recent advancements in chemically modified mRNA (cmRNA) technologies offer a promising alternative. This study explores the utilisation of cmRNA in a biocompatible citrate-saline formulation to encode EGF for therapeutic purposes, capitalising on the advantages of cmRNA's inherent stability and the formulation's compatibility with biological systems. CmRNA demonstrated high transfection efficiency in human immortalised keratinocyte (HaCaT) and normal human dermal fibroblasts (NHDF) cells (93.97% ± 1.25% and 90.37% ± 0.97%, respectively), resulting in efficient production of biologically active EGF protein. In vitro, EGF cmRNA significantly promoted HaCaT and NHDF cell cycle, proliferation and migration. In vivo, in vivo imaging system (IVIS) imaging of murine skin confirmed localised and sustained expression of Luciferase cmRNA, with signals detectable up to 11 days post-injection. Immunohistochemistry revealed protein expression in both epidermal and dermal layers as early as 1 h post-injection, peaking at 48 h, further corroborated by enzyme-linked immunosorbent assay (ELISA). In a full-thickness skin defect mouse model, EGF cmRNA significantly accelerated wound healing, with superior re-epithelialisation observed compared to controls by Day 6. Mitogen-activated protein kinase (MEK)/Extracellular signal-regulated kinase (ERK) and Ki67 mRNA expression levels were markedly increased, both in vitro and in vivo. By Day 14, histological and immunohistochemical analyses revealed that EGF cmRNA outperformed recombinant human EGF (rhEGF), as indicated by enhanced formation of hair follicles and cutaneous glands, better-organised collagen fibres, and a reduced collagen Type I/III ratio. No adverse effects were observed in major organs, confirming cmRNA's biosafety. These results highlight the therapeutic potential of EGF-encoding cmRNA as an effective and safe alternative for enhancing wound healing.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"22 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}