Abstract:
BACKGROUND:Digestion of collagen with clostridial collagenase (CC) produces peptides that can induce cellular responses consistent with wound healing in vivo. However, nonhealing human wounds are typically in a state of chronic inflammation. We evaluated the effects of CC on markers of inflammation in cell culture and wound fluid from diabetic patients. METHODS:Lipopolysaccharide-induced release of tumor necrosis factor-α and interleukin-6 from interferon-γ-activated THP-1 monocytes was measured in the presence or absence of CC or CC collagen digests. In the clinical study, 17 individuals with mildly inflamed diabetic foot ulcers were randomized to receive CC ointment (CCO) or hydrogel. Weekly assessments included wound appearance and measurements. Wound exudate was collected at baseline and at 2 and 4 weeks of treatment. A multiplex assay was used to measure levels of analytes, including those associated with inflammation and with inflammation resolution. RESULTS:Lower levels of tumor necrosis factor-α and interleukin-6 were found in media of cells cultured with CC or CC digests of collagen type I or III than for untreated lipopolysaccharide controls (P < .05). Clinically, CCO and hydrogel resulted in improvement in wound appearance and a decrease in mean wound area. The CCO, but not the hydrogel, was found to increase the level of analytes associated with resolution of inflammation while decreasing those associated with inflammation. There was a general correlation between resolution of inflammation and healing. CONCLUSIONS:These results support a hypothesis that debridement with CCO is associated with decreased inflammation and greater progress toward healing.
journal_name
J Am Podiatr Med Assocjournal_title
Journal of the American Podiatric Medical Associationauthors
Galperin RC,Lange DL,Ramsay SJ,Shi L,Weedon KA,Hudson NM,Dickerson JE Jr,Cargill DI,Slade HBdoi
10.7547/14-066.1subject
Has Abstractpub_date
2015-11-01 00:00:00pages
509-19issue
6eissn
8750-7315issn
1930-8264journal_volume
105pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Osteochondromas are benign osseous tumors encountered most routinely by physicians responsible for diagnosing musculoskeletal disorders. Often, these osseous lesions are identified following symptoms related to their impingement on adjacent soft tissue or bone. METHODS:This article presents a unique case of...
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