Maturo Maria Giovanna, Soligo Marzia, Gibson Greg, Manni Luigi, Nardini Christine
1Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
2Institute of Translational Pharmacology, Consiglio Nazionale delle Ricerche (CNR), Rome, Italy.
EPMA J. 2019 Dec 10;11(1):1-16. doi: 10.1007/s13167-019-00195-w. eCollection 2020 Mar.
Impaired wound healing (WH) and chronic inflammation are hallmarks of non-communicable diseases (NCDs). However, despite WH being a recognized player in NCDs, mainstream therapies focus on (un)targeted damping of the inflammatory response, leaving WH largely unaddressed, owing to three main factors. The first is the complexity of the pathway that links inflammation and wound healing; the second is the dual nature, local and systemic, of WH; and the third is the limited acknowledgement of genetic and contingent causes that disrupt physiologic progression of WH.
Here, in the frame of Predictive, Preventive, and Personalized Medicine (PPPM), we integrate and revisit current literature to offer a novel systemic view on the cues that can impact on the fate (acute or chronic inflammation) of WH, beyond the compartmentalization of medical disciplines and with the support of advanced computational biology.
This shall open to a broader understanding of the causes for WH going awry, offering new operational criteria for patients' stratification (prediction and personalization). While this may also offer improved options for targeted prevention, we will envisage new therapeutic strategies to reboot and/or boost WH, to enable its progression across its physiological phases, the first of which is a transient acute inflammatory response versus the chronic low-grade inflammation characteristic of NCDs.
伤口愈合受损（WH）和慢性炎症是非传染性疾病（NCDs）的标志。然而，尽管伤口愈合在非传染性疾病中是一个公认的因素，但主流疗法主要集中于对炎症反应进行（非）靶向性抑制，由于三个主要因素，伤口愈合在很大程度上未得到解决。第一个因素是连接炎症和伤口愈合的途径的复杂性；第二个因素是伤口愈合的局部和全身双重性质；第三个因素是对破坏伤口愈合生理进程的遗传和偶然原因的认识有限。
在此，在预测、预防和个性化医学（PPPM）的框架内，我们整合并重新审视当前文献，以提供一种新颖的系统观点，探讨在超越医学学科划分并借助先进计算生物学支持的情况下，哪些线索会影响伤口愈合的结局（急性或慢性炎症）。
这将有助于更广泛地理解伤口愈合出现问题的原因，为患者分层（预测和个性化）提供新的操作标准。虽然这也可能为靶向预防提供更好的选择，但我们将设想新的治疗策略来重启和/或促进伤口愈合，使其在生理阶段中进展，其中第一个阶段是短暂的急性炎症反应，与非传染性疾病的慢性低度炎症特征相对。
