Dinh Thanh, Braunagel Shawn, Rosenblum Barry I
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Beth Israel Deaconess Medical Center, Boston, MA, USA.
Clin Podiatr Med Surg. 2015 Jan;32(1):109-19. doi: 10.1016/j.cpm.2014.09.010.
Numerous clinical studies have confirmed the pivotal role growth factors play in wound healing and their diminished levels in the chronic wound. Despite promising early studies treating chronic wounds with growth factors, results with traditional bolus dosing of a single growth factor have yielded insignificant results. Disappointing results have been theorized to be the result of growth factors inherent short half-life, a hostile microenvironment rich in protease activity, and poor delivery mechanisms failing to deliver effective dosages in an appropriate temporal manner. Advances in tissue engineering and regenerative medicine have provided technologies capable of delivering multiple growth factors in a spatially oriented approach. These technologies include polymer systems, scaffolds, and hydrogels that have demonstrated improved response by target tissues when growth factors are delivered in this biomimetic fashion. With improved delivery systems, treatment of chronic wounds with growth factors has the potential to accelerate healing in a manner not previously realized with traditional delivery approaches.
众多临床研究已证实生长因子在伤口愈合中发挥的关键作用,以及它们在慢性伤口中的水平降低。尽管早期用生长因子治疗慢性伤口的研究前景乐观,但传统的单次生长因子大剂量给药效果并不显著。令人失望的结果被认为是由于生长因子固有的半衰期短、富含蛋白酶活性的恶劣微环境以及未能以适当的时间方式递送有效剂量的不良递送机制。组织工程和再生医学的进展提供了能够以空间定向方式递送多种生长因子的技术。这些技术包括聚合物系统、支架和水凝胶,当以这种仿生方式递送生长因子时,已证明靶组织的反应有所改善。随着递送系统的改进,用生长因子治疗慢性伤口有可能以传统递送方法以前未实现的方式加速愈合。