Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Department of Biology, Washington University in St. Louis, St. Louis, Missouri, USA.
Adv Wound Care (New Rochelle). 2023 May;12(5):269-287. doi: 10.1089/wound.2021.0126. Epub 2022 May 26.
The skin is the crucial first-line barrier against foreign pathogens. Compromise of this barrier presents in the context of inflammatory skin conditions and in chronic wounds. Skin conditions arising from dysfunctional inflammatory pathways severely compromise the quality of life of patients and have a high economic impact on the U.S. health care system. The development of a thorough understanding of the mechanisms that can disrupt skin inflammation is imperative to successfully modulate this inflammation with therapies. Many advances in the understanding of skin inflammation have occurred during the past decade, including the development of multiple new pharmaceuticals. Mechanical force application has been greatly advanced clinically. Bioscaffolds also promote healing, while reducing scarring. Various skin inflammatory conditions provide a framework for analysis of our understanding of the phases of successful wound healing. The large burden of chronic wounds on our society continues to focus attention on the chronic inflammatory state induced in many of these skin conditions. Better preclinical models of disease states such as chronic wounds, coupled with enhanced diagnostic abilities of human skin, will allow a better understanding of the mechanism of action. This will lead to improved treatments with biologics and other modalities such as the strategic application of mechanical forces and scaffolds, which ultimately results in better outcomes for our patients.
皮肤是抵御外来病原体的第一道重要防线。这种屏障的破坏表现在炎症性皮肤病和慢性伤口中。由于炎症途径功能失调而导致的皮肤状况严重影响患者的生活质量,并对美国的医疗保健系统造成巨大的经济影响。深入了解可能破坏皮肤炎症的机制对于成功地用治疗方法来调节这种炎症至关重要。在过去十年中,人们对皮肤炎症的理解有了许多进展,包括多种新药物的开发。机械力的应用在临床上得到了极大的推进。生物支架也促进了愈合,同时减少了疤痕。各种皮肤炎症性疾病为我们对成功的伤口愈合各个阶段的理解提供了一个分析框架。慢性伤口给我们的社会带来了巨大的负担,这使得人们继续关注许多皮肤疾病中诱导的慢性炎症状态。更好的慢性伤口等疾病状态的临床前模型,加上对人类皮肤的增强诊断能力,将有助于更好地了解作用机制。这将导致更好的生物制剂和其他治疗方法的治疗效果,例如机械力和支架的策略应用,最终为我们的患者带来更好的结果。