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使用肽修饰水凝胶靶向再上皮化促进糖尿病伤口再生。

Diabetic wound regeneration using peptide-modified hydrogels to target re-epithelialization.

作者信息

Xiao Yun, Reis Lewis A, Feric Nicole, Knee Erica J, Gu Junhao, Cao Shuwen, Laschinger Carol, Londono Camila, Antolovich Julia, McGuigan Alison P, Radisic Milica

机构信息

Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, ON M5S 3E5, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada.

Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada.

出版信息

Proc Natl Acad Sci U S A. 2016 Oct 4;113(40):E5792-E5801. doi: 10.1073/pnas.1612277113. Epub 2016 Sep 19.

Abstract

There is a clinical need for new, more effective treatments for chronic wounds in diabetic patients. Lack of epithelial cell migration is a hallmark of nonhealing wounds, and diabetes often involves endothelial dysfunction. Therefore, targeting re-epithelialization, which mainly involves keratinocytes, may improve therapeutic outcomes of current treatments. In this study, we present an integrin-binding prosurvival peptide derived from angiopoietin-1, QHREDGS (glutamine-histidine-arginine-glutamic acid-aspartic acid-glycine-serine), as a therapeutic candidate for diabetic wound treatments by demonstrating its efficacy in promoting the attachment, survival, and collective migration of human primary keratinocytes and the activation of protein kinase B Akt and MAPK The QHREDGS peptide, both as a soluble supplement and when immobilized in a substrate, protected keratinocytes against hydrogen peroxide stress in a dose-dependent manner. Collective migration of both normal and diabetic human keratinocytes was promoted on chitosan-collagen films with the immobilized QHREDGS peptide. The clinical relevance was demonstrated further by assessing the chitosan-collagen hydrogel with immobilized QHREDGS in full-thickness excisional wounds in a db/db diabetic mouse model; QHREDGS showed significantly accelerated and enhanced wound closure compared with a clinically approved collagen wound dressing, peptide-free hydrogel, or blank wound controls. The accelerated wound closure resulted primarily from faster re-epithelialization and increased formation of granulation tissue. There were no observable differences in blood vessel density or size within the wound; however, the total number of blood vessels was greater in the peptide-hydrogel-treated wounds. Together, these findings indicate that QHREDGS is a promising candidate for wound-healing interventions that enhance re-epithelialization and the formation of granulation tissue.

摘要

糖尿病患者慢性伤口需要新的、更有效的治疗方法。上皮细胞迁移缺乏是伤口不愈合的一个标志,而糖尿病常伴有内皮功能障碍。因此,针对主要涉及角质形成细胞的再上皮化过程,可能会改善现有治疗的效果。在本研究中,我们展示了一种源自血管生成素-1的整合素结合促存活肽QHREDGS(谷氨酰胺-组氨酸-精氨酸-谷氨酸-天冬氨酸-甘氨酸-丝氨酸),通过证明其在促进人原代角质形成细胞的附着、存活和集体迁移以及蛋白激酶B Akt和丝裂原活化蛋白激酶(MAPK)激活方面的功效,作为糖尿病伤口治疗的候选药物。QHREDGS肽无论是作为可溶性补充剂还是固定在基质中,都能以剂量依赖的方式保护角质形成细胞免受过氧化氢应激。在固定有QHREDGS肽的壳聚糖-胶原蛋白膜上,正常和糖尿病患者的人角质形成细胞的集体迁移均得到促进。通过在db/db糖尿病小鼠模型的全层切除伤口中评估固定有QHREDGS的壳聚糖-胶原蛋白水凝胶,进一步证明了其临床相关性;与临床批准的胶原蛋白伤口敷料、无肽水凝胶或空白伤口对照相比,QHREDGS显示出伤口闭合显著加速且增强。伤口闭合加速主要源于再上皮化更快和肉芽组织形成增加。伤口内血管密度或大小没有明显差异;然而,肽-水凝胶处理的伤口中血管总数更多。总之,这些发现表明QHREDGS是伤口愈合干预的一个有前景的候选药物,可增强再上皮化和肉芽组织形成。

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