From the Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children; Department of Dermatology, School of Medicine, University of California, Davis; and Department of Pathology, Hebei Medical University.
Plast Reconstr Surg. 2022 Jul 1;150(1):92e-104e. doi: 10.1097/PRS.0000000000009228. Epub 2022 May 10.
Burns are severe injuries often associated with impaired wound healing. Impaired healing is caused by multiple factors, including dysregulated inflammatory responses at the wound site. Interestingly, montelukast, an antagonist for cysteinyl leukotrienes and U.S. Food and Drug Administration approved for treatment of asthma and allergy, was previously shown to enhance healing in excision wounds and to modulate local inflammation.
In this study, the authors examined the effect of montelukast on wound healing in a mouse model of scald burn injury. Burn wound tissues isolated from montelukast- and vehicle-treated mice at various times after burn injury were analyzed for wound areas ( n = 34 to 36), reepithelialization ( n = 14), inflammation ( n = 8 to 9), and immune cell infiltration ( n = 3 to 6) and proliferation ( n = 7 to 8).
In contrast to previously described beneficial effects in excision wounds, this study shows that montelukast delays burn wound healing by impairing the proliferation of keratinocytes and endothelial cells. This occurs largely independently of inflammatory responses at the wound site, suggesting that montelukast impairs specifically the proliferative phase of wound healing in burns. Wound healing rates in mice in which leukotrienes are not produced were not affected by montelukast.
Montelukast delays wound healing mainly by reducing the proliferation of local cells after burn injury.
Although additional and clinical studies are necessary, our study suggests that burn patients who are on montelukast may exhibit delayed healing, necessitating extra observation.
烧伤是一种严重的损伤，常伴有伤口愈合受损。愈合受损是由多种因素引起的，包括伤口部位炎症反应失调。有趣的是，孟鲁司特，半胱氨酰白三烯拮抗剂和美国食品和药物管理局批准用于治疗哮喘和过敏的药物，先前已被证明可增强切除伤口的愈合，并调节局部炎症。
在这项研究中，作者研究了孟鲁司特对烫伤烧伤模型中小鼠伤口愈合的影响。从孟鲁司特和载体处理的小鼠的烧伤伤口组织中分离出烧伤后不同时间的伤口组织，分析伤口面积（n = 34 至 36）、上皮再形成（n = 14）、炎症（n = 8 至 9）和免疫细胞浸润（n = 3 至 6）和增殖（n = 7 至 8）。
与先前描述的切除伤口的有益作用相反，本研究表明孟鲁司特通过损伤角质形成细胞和内皮细胞的增殖来延迟烧伤伤口愈合。这在很大程度上独立于伤口部位的炎症反应，表明孟鲁司特特异性地损伤烧伤中伤口愈合的增殖期。在不产生白三烯的小鼠中，白三烯不产生的小鼠的伤口愈合率不受孟鲁司特的影响。
孟鲁司特主要通过减少烧伤后局部细胞的增殖来延迟伤口愈合。
尽管需要进一步的和临床研究，但我们的研究表明，接受孟鲁司特治疗的烧伤患者可能会出现愈合延迟，需要额外观察。
