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胶原蛋白粉在伤口愈合中的作用

Collagen Powder in Wound Healing.

作者信息

Kallis Penelope J, Friedman Adam J

出版信息

J Drugs Dermatol. 2018 Apr 1;17(4):403-408.

PMID:29601617
Abstract

Chronic wounds, such as pressure ulcers, diabetic foot ulcers, and venous leg ulcers, are associated with high costs, poor quality of life, and significant morbidity and mortality. A chronic wound develops when progression through the normal phases of wound healing goes awry, creating a hostile environment with elevated levels of pro-inflammatory cytokines, increased matrix metalloproteinases (MMPs), destruction of extracellular matrix (ECM) components, and diminished activity of growth factors and other soluble mediators. The advent of advanced wound care therapies allows for a targeted approach to the treatment of nonhealing wounds by addressing specific molecular defects in healing. Collagen is an essential building block of the skin that when utilized as an adjunctive wound therapy stimulates and recruits immune cells and fibroblasts and martyrs itself for degradation by MMPs, thereby preserving native ECM structure and promoting healing. Particulate or powdered collagen is processed to minimize covalent cross-linking and is purported to exert its biologic activity immediately upon application. This article critically reviews the current evidence for collagen powder as an adjunctive therapy for chronic wounds and presents indications, limitations, and principles of use. In general, there is a need for high quality studies and randomized control trials to support its use in clinical practice.

J Drugs Dermatol. 2018;17(4):403-408.

.

摘要

慢性伤口,如压疮、糖尿病足溃疡和下肢静脉溃疡,与高成本、生活质量差以及显著的发病率和死亡率相关。当伤口愈合的正常阶段进展出现偏差时,就会形成慢性伤口,从而产生一个充满敌意的环境,其中促炎细胞因子水平升高、基质金属蛋白酶(MMPs)增加、细胞外基质(ECM)成分遭到破坏,以及生长因子和其他可溶性介质的活性降低。先进伤口护理疗法的出现,使得通过解决愈合过程中的特定分子缺陷,对不愈合伤口进行靶向治疗成为可能。胶原蛋白是皮肤的重要组成部分,当用作辅助伤口治疗时,它会刺激并募集免疫细胞和成纤维细胞,并自我牺牲以供MMPs降解,从而保留天然ECM结构并促进愈合。颗粒状或粉末状胶原蛋白经过处理以尽量减少共价交联,据称在应用后能立即发挥其生物活性。本文批判性地回顾了胶原蛋白粉末作为慢性伤口辅助治疗的现有证据,并介绍了其适应证、局限性和使用原则。总体而言,需要高质量的研究和随机对照试验来支持其在临床实践中的应用。

《药物皮肤病学杂志》。2018年;17(4):403 - 408。

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