Wethers D L, Ramirez G M, Koshy M, Steinberg M H, Phillips G, Siegel R S, Eckman J R, Prchal J T
St. Lukes/Roosevelt Hospital, Comprehensive Sickle Cell Center, New York, NY 10025.
Blood. 1994 Sep 15;84(6):1775-9.
Leg ulcers are a chronic manifestation of sickle-cell disease (SCD) and are often painful, disabling, and difficult to treat. RGD peptide matrix treatment is a novel therapy designed to provide a topical synthetic extracellular matrix that can act as a temporary substitute for the damaged natural matrix at the ulcer site. In this randomized, placebo-controlled, double-blind, prospective, multicenter investigation, SCD patients with full-thickness leg ulcers were treated with standard therapy plus RGD peptide matrix or saline placebo once weekly for up to 10 weeks. Healing in patients with chronic ulcers (2 months or greater in duration) was significantly accelerated (P = .0085) in RGD peptide matrix recipients compared with the placebo group. In these chronic ulcer cases, the average percent ulcer closure (decrease in ulcer surface area) in the RGD peptide matrix group (54.4% +/- 8.9%) exceeded that in the placebo group (19.0% +/- 24.3%) nearly threefold by study endpoint. Furthermore, RGD peptide matrix was equally effective in promoting healing of long persistent ulcers and ulcers of shorter duration. In contrast, standard therapy plus placebo was significantly less effective (P = .001) in promoting healing for ulcers of progressively greater duration. The results of this study provide preliminary evidence that RGD peptide matrix treatment may significantly accelerate healing of chronic sickle-cell leg ulcers.
腿部溃疡是镰状细胞病(SCD)的一种慢性表现,通常疼痛、致残且难以治疗。RGD肽基质治疗是一种新型疗法,旨在提供一种局部合成的细胞外基质,可作为溃疡部位受损天然基质的临时替代品。在这项随机、安慰剂对照、双盲、前瞻性、多中心研究中,患有全层腿部溃疡的SCD患者接受标准治疗加RGD肽基质或生理盐水安慰剂治疗,每周一次,持续长达10周。与安慰剂组相比,接受RGD肽基质治疗的慢性溃疡(病程2个月或更长)患者的愈合明显加速(P = 0.0085)。在这些慢性溃疡病例中,到研究终点时,RGD肽基质组的平均溃疡闭合百分比(溃疡表面积减少)(54.4%±8.9%)比安慰剂组(19.0%±24.3%)高出近三倍。此外,RGD肽基质在促进长期持续性溃疡和病程较短的溃疡愈合方面同样有效。相比之下,标准治疗加安慰剂在促进病程逐渐延长的溃疡愈合方面效果明显较差(P = 0.001)。这项研究的结果提供了初步证据,表明RGD肽基质治疗可能会显著加速慢性镰状细胞性腿部溃疡的愈合。