Bohn Gregory, Liden Brock, Schultz Gregory, Yang Qingping, Gibson Daniel J
Center for Wound Care and Hyperbaric Medicine, Westshore Medical Center , Manistee, Michigan.
Reynoldsburg Podiatry Centre , Reynoldsburg, Ohio.
Adv Wound Care (New Rochelle). 2016 Jan 1;5(1):1-10. doi: 10.1089/wound.2015.0660.
Broad-spectrum metalloproteinase (MMP) reduction along with inherent aspects of an extracellular matrix (ECM) dressing can bring about improved wound healing outcomes and shorter treatment duration. Initial reports of clinical effectiveness of a new ovine-based collagen extracellular matrix (CECM) dressing demonstrate benefits in chronic wound healing. CECM dressings are processed differently than oxidized regenerated cellulose/collagen dressings. CECM dressings consist primarily of collagens I and III arranged as native fibers that retain the three-dimensional architecture present in tissue ECM. As such, ovine-based ECM dressings represent a new generation of collagen dressings capable of impacting a broad spectrum of MMP excess known to be present in chronic wounds. While MMPs are essential in normal healing, elevated presence of MMPs has been linked to wound failure. Collagen has been shown to reduce levels of MMPs, acting as a sacrificial substrate for excessive proteases in a chronic wound. Preserving collagen dressings in a more native state enhances bioactivity in terms of the ability to affect the chronic wound environment. Clinical observation and assessment may not be sufficient to identify a wound with elevated protease activity that can break down ECM, affect wound fibroblasts, and impair growth factor response. Collagen dressings that target broad-spectrum excessive MMP levels and can be applied early in the course of care may positively impact healing rates in difficult wounds. Next-generation collagen dressings offer broader MMP reduction capacity while providing a provisional dermal matrix or ECM.
广谱金属蛋白酶（MMP）的减少以及细胞外基质（ECM）敷料的固有特性可带来更好的伤口愈合效果，并缩短治疗时间。关于一种新型羊源胶原蛋白细胞外基质（CECM）敷料临床有效性的初步报告表明，其对慢性伤口愈合有益。CECM敷料的加工方式与氧化再生纤维素/胶原蛋白敷料不同。CECM敷料主要由I型和III型胶原蛋白组成，排列成天然纤维，保留了组织ECM中存在的三维结构。因此，羊源ECM敷料代表了新一代胶原蛋白敷料，能够影响已知存在于慢性伤口中的多种过量MMP。虽然MMP在正常愈合中至关重要，但MMP水平升高与伤口愈合失败有关。胶原蛋白已被证明可降低MMP水平，在慢性伤口中作为过量蛋白酶的牺牲底物。将胶原蛋白敷料保持在更天然的状态可增强其影响慢性伤口环境的生物活性。临床观察和评估可能不足以识别出蛋白酶活性升高的伤口，这种伤口会分解ECM、影响伤口成纤维细胞并损害生长因子反应。针对广谱过量MMP水平且可在护理过程早期应用的胶原蛋白敷料可能会对难愈合伤口的愈合速度产生积极影响。新一代胶原蛋白敷料在提供临时真皮基质或ECM的同时，具有更强的降低MMP能力。
