Eming Sabine A, Smola Hans, Krieg Thomas
Department of Dermatology, University of Cologne, Germany.
Cells Tissues Organs. 2002;172(2):105-17. doi: 10.1159/000065611.
The morbidity and mortality from chronic wounds of varying etiology present a significant health care problem. Multiple local disturbances and systemic disease can impair wound healing. Recently, experiments with tissue cultures and animal models have revolutionized the understanding of wound healing and the pathophysiological processes involved. In cooperation with clinicians and industrial partners novel therapeutic concepts including the topical application of growth factors and cell therapies have been developed. Cytokines that have been tested in clinical studies include epidermal growth factor, platelet-derived growth factor and fibroblast growth factor. These studies showed that an important aspect of the growth factor wound healing paradigm is the effective delivery of these polypeptides to the wound site. Current drug delivery strategies suffer from the inherent loss of drug activity due to the combined effects of physical inhibition and biological degradation. A molecular genetic approach in which genetically modified cells synthesize and deliver the desired growth factor in a time-regulated manner is a powerful means to overcome the limitations associated with the topical application of recombinant growth factor proteins.
不同病因的慢性伤口所导致的发病率和死亡率构成了一个重大的医疗保健问题。多种局部紊乱和全身性疾病会损害伤口愈合。最近，组织培养和动物模型实验彻底改变了人们对伤口愈合及相关病理生理过程的理解。与临床医生和产业合作伙伴合作，已经开发出了包括局部应用生长因子和细胞疗法在内的新型治疗理念。在临床研究中进行过测试的细胞因子包括表皮生长因子、血小板衍生生长因子和成纤维细胞生长因子。这些研究表明，生长因子伤口愈合模式的一个重要方面是将这些多肽有效递送至伤口部位。由于物理抑制和生物降解的综合作用，当前的药物递送策略存在药物活性固有损失的问题。一种分子遗传学方法，即让经过基因改造的细胞以时间调控的方式合成并递送所需的生长因子，是克服与重组生长因子蛋白局部应用相关局限性的有力手段。
