Wound Healing and Regenerative Medicine Research Program, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Division of Wound Healing and Regenerative Medicine, Newark Beth Israel Medical Center, RWJBarnabas Health, Newark, NJ 07112, USA.
Mol Ther. 2019 Nov 6;27(11):1992-2004. doi: 10.1016/j.ymthe.2019.07.016. Epub 2019 Jul 30.
Chronic wounds-including diabetic foot ulcers, venous leg ulcers, and pressure ulcers-represent a major health problem that demands an urgent solution and new therapies. Despite major burden to patients, health care professionals, and health care systems worldwide, there are no efficacious therapies approved for treatment of chronic wounds. One of the major obstacles in achieving wound closure in patients is the lack of epithelial migration. Here, we used multiple pre-clinical wound models to show that Caveolin-1 (Cav1) impedes healing and that targeting Cav1 accelerates wound closure. We found that Cav1 expression is significantly upregulated in wound edge biopsies of patients with non-healing wounds, confirming its healing-inhibitory role. Conversely, Cav1 was absent from the migrating epithelium and is downregulated in acutely healing wounds. Specifically, Cav1 interacted with membranous glucocorticoid receptor (mbGR) and epidermal growth factor receptor (EGFR) in a glucocorticoid-dependent manner to inhibit cutaneous healing. However, pharmacological disruption of caveolae by MβCD or CRISPR/Cas9-mediated Cav1 knockdown resulted in disruption of Cav1-mbGR and Cav1-EGFR complexes and promoted epithelialization and wound healing. Our data reveal a novel mechanism of inhibition of epithelialization and wound closure, providing a rationale for pharmacological targeting of Cav1 as potential therapy for patients with non-healing chronic wounds.
慢性伤口——包括糖尿病足溃疡、静脉性腿部溃疡和压力性溃疡——是一个重大的健康问题,需要紧急解决和新的治疗方法。尽管给患者、医疗保健专业人员和全球医疗保健系统带来了巨大负担,但目前还没有批准用于治疗慢性伤口的有效疗法。患者伤口无法闭合的主要障碍之一是缺乏上皮细胞迁移。在这里,我们使用多种临床前伤口模型表明,窖蛋白-1(Cav1)会阻碍愈合,而靶向 Cav1 则可以加速伤口闭合。我们发现,非愈合性伤口边缘活检中的 Cav1 表达显著上调,证实了其抑制愈合的作用。相反,Cav1 不存在于迁移的上皮细胞中,并且在急性愈合的伤口中下调。具体而言,Cav1 以糖皮质激素依赖性方式与膜糖皮质激素受体(mbGR)和表皮生长因子受体(EGFR)相互作用,抑制皮肤愈合。然而,用 MβCD 或 CRISPR/Cas9 介导的 Cav1 敲低破坏小窝会导致 Cav1-mbGR 和 Cav1-EGFR 复合物的破坏,并促进上皮化和伤口愈合。我们的数据揭示了上皮化和伤口闭合抑制的新机制,为 Cav1 的药理学靶向作为非愈合性慢性伤口患者的潜在治疗方法提供了依据。