Patenall Bethany L, Carter Kristyn A, Ramsey Matthew R
Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Int J Mol Sci. 2024 Jan 21;25(2):1304. doi: 10.3390/ijms25021304.
Cutaneous wound healing consists of four stages: hemostasis, inflammation, proliferation/repair, and remodeling. While healthy wounds normally heal in four to six weeks, a variety of underlying medical conditions can impair the progression through the stages of wound healing, resulting in the development of chronic, non-healing wounds. Great progress has been made in developing wound dressings and improving surgical techniques, yet challenges remain in finding effective therapeutics that directly promote healing. This review examines the current understanding of the pro-healing effects of targeted pharmaceuticals, re-purposed drugs, natural products, and cell-based therapies on the various cell types present in normal and chronic wounds. Overall, despite several promising studies, there remains only one therapeutic approved by the United States Food and Drug Administration (FDA), Becaplermin, shown to significantly improve wound closure in the clinic. This highlights the need for new approaches aimed at understanding and targeting the underlying mechanisms impeding wound closure and moving the field from the management of chronic wounds towards resolving wounds.
止血、炎症、增殖/修复和重塑。虽然健康的伤口通常在四到六周内愈合,但多种潜在的医疗状况会损害伤口愈合各阶段的进程,导致慢性、不愈合伤口的形成。在开发伤口敷料和改进手术技术方面已经取得了很大进展,但在寻找直接促进愈合的有效疗法方面仍然存在挑战。这篇综述探讨了目前对靶向药物、重新利用的药物、天然产物和基于细胞的疗法对正常和慢性伤口中各种细胞类型的促愈合作用的理解。总体而言,尽管有几项很有前景的研究,但美国食品药品监督管理局(FDA)仅批准了一种疗法——贝卡普勒明,在临床上显示能显著改善伤口闭合。这凸显了需要新的方法来理解和针对阻碍伤口闭合的潜在机制,并推动该领域从慢性伤口的管理转向伤口的解决。