Amrita Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Amrita University, Kochi-682 041. India.
Curr Pharm Des. 2017;23(24):3529-3537. doi: 10.2174/1381612823666170503145528.
A cut or break on the surface of the skin is usually referred to as a wound. Any wound has a potential to heal by itself through a complex cascade of events. However, some wounds show delayed healing due to their underlying physiology and are referred to as chronic wounds like diabetic ulcers, venous ulcers, pressure ulcers and chronic infected ulcers. Extensive care has to be taken for the management of chronic wounds and these have become a major concern in the current medical scenario. The use of bioactive molecules or in other words the molecules that can actively interact with the wound environment and help in wound healing are gaining much importance. The incorporation of bioactive molecules into a suitable matrix system which not only provide a controlled release of the molecules, but also enable better exudate management is desired to overcome the shortcomings of the conventional treatment modalities. A major problem associated with chronic wounds is that they are easily prone to infections. In such cases, the topical delivery of antibiotics helps eliminate infection. However, the continuous use of high dose of antibiotics has led to the development of multi drug resistant bacterial strains. To overcome these issues, other broad-spectrum antimicrobial agents like antiseptics, metallic nanoparticles and antimicrobial peptides are being adopted nowadays. Growth factors play a major role in the wound healing cascade, thus topical delivery of growth factor from a suitable matrix is an interesting strategy. The delivery of nucleic acids with the aid of suitable vectors for either silencing a particular gene or over expressing a gene of interest is also being investigated nowadays. This review is an attempt to draw light over some of the recent approaches adopted for the treatment of chronic wounds using bioactive molecules like antibiotics, antiseptics, metallic nanoparticles or ions, growth factors and nucleic acids.
皮肤表面的切口或破裂通常被称为伤口。任何伤口都有可能通过一系列复杂的事件自行愈合。然而，由于其潜在的生理学原因，一些伤口显示出愈合延迟，被称为慢性伤口，如糖尿病溃疡、静脉溃疡、压力溃疡和慢性感染性溃疡。慢性伤口的管理需要特别注意，这些伤口在当前的医疗环境中已经成为一个主要问题。生物活性分子的使用，或者换句话说，能够与伤口环境主动相互作用并有助于伤口愈合的分子，正变得越来越重要。将生物活性分子纳入合适的基质系统中，不仅可以提供分子的受控释放，还有助于更好地管理渗出物，这是克服传统治疗方法缺点的理想选择。与慢性伤口相关的一个主要问题是它们很容易感染。在这种情况下，局部给予抗生素有助于消除感染。然而，连续使用高剂量的抗生素导致了多药耐药菌的产生。为了克服这些问题，如今正在采用其他广谱抗菌剂，如防腐剂、金属纳米粒子和抗菌肽。生长因子在伤口愈合级联反应中起着重要作用，因此从合适的基质中局部给予生长因子是一种有趣的策略。利用合适的载体输送核酸，无论是沉默特定基因还是过表达感兴趣的基因，目前也正在研究中。本文综述试图介绍一些最近采用的使用生物活性分子（如抗生素、防腐剂、金属纳米粒子或离子、生长因子和核酸）治疗慢性伤口的方法。
