Hepatocyte growth factor may accelerate healing in chronic leg ulcers: a pilot study.
BACKGROUND
Hepatocyte growth factor (HGF) is a heparin-binding protein with mitogenic, motogenic and morphogenic activities for various cell types. The regenerative properties of HGF have been the object of several animal and in vitro studies in recent years.


OBJECTIVE
To investigate the physiological and therapeutic effects of HGF on chronic leg ulcers.


METHODS
HGF in gel form was locally applied, once daily for 7 days, to 15 of 19 chronic leg ulcers in 11 elderly patients. All patients had previously been treated by conventional methods and their leg ulcers had been in stable conditions for between 1 and 14 years. Any signs of allergy, discomfort or pain were reported daily. Microcirculation perfusion in the ulcers, compared to the intact contiguous skin, was determined by laser Doppler at the beginning of the study, after 1 week and again after 3 months (in seven patients). Ulcer size and characteristics were also documented.


RESULTS
It was observed that microcirculatory perfusion, which might reflect the angiogenic effect of HGF, was statistically significantly correlated (r = 0.94, p < 0.002) to ulcer area reduction in the treated ulcers. Excellent (84-100% area reduction) or partial healing (58-59%) was seen in eight out of 11 patients. No control group was included in this pilot study, which must be completed by proper control studies.


CONCLUSIONS
This study suggests that HGF may heal chronic leg ulcers, possibly by improving the microcirculation. Proper control studies need to be performed.
Nayeri
F
F
Department of Infectious Diseases, University Hospital, Linköping, Sweden. fariba_nayeri@hotmail.com
Strömberg
T
T
Larsson
M
M
Brudin
L
L
Söderström
C
C
Forsberg
P
P
D000368:Aged; D002908:Chronic Disease; D005260:Female; D005782:Gels; D017228:Hepatocyte Growth Factor / Q000627:therapeutic use*; D006801:Humans; D007866:Leg / Q000098:blood supply; D007871:Leg Ulcer / Q000188:drug therapy* / Q000503:physiopathology; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D010865:Pilot Projects; D014945:Wound Healing / Q000187:drug effects*
D005782:Gels; D017228:Hepatocyte Growth Factor