Growth factors and chronic wound healing: past, present, and future.
Growth substances (cytokines and growth factors) are soluble signaling proteins affecting the process of normal wound healing. Cytokines govern the inflammatory phase that clears cellular and extracellular matrix debris. Wound repair is controlled by growth factors (platelet-derived growth factor [PDGF], keratinocyte growth factor, and transforming growth factor beta). Endogenous growth factors communicate across the dermal-epidermal interface. PDGF is important for most phases of wound healing. Becaplermin (PDGF-BB), the only growth factor approved by the Food and Drug Administration, requires daily application for neuropathic wound healing. Gene therapy is under development for more efficient growth factor delivery; a single application will induce constitutive growth factor expression for weeks. Based on dramatic preclinical animal studies, a phase 1 clinical trial planned on a PDGF genetic construct appears promising.
Goldman
Robert
R
Department of Rehabilitation Medicine, University of Pennsylvania, Philadelphia, USA.
D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use; D000077214:Becaplermin; D002908:Chronic Disease; D017321:Clinical Trials, Phase I as Topic; D016207:Cytokines / Q000494:pharmacology / Q000502:physiology* / Q000627:therapeutic use*; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D015316:Genetic Therapy / Q000379:methods; D006097:Granulation Tissue / Q000187:drug effects / Q000502:physiology; D006133:Growth Substances / Q000494:pharmacology / Q000502:physiology* / Q000627:therapeutic use*; D006801:Humans; D007249:Inflammation; D018919:Neovascularization, Physiologic / Q000187:drug effects / Q000502:physiology; D010982:Platelet-Derived Growth Factor / Q000494:pharmacology / Q000627:therapeutic use; D020574:Proto-Oncogene Proteins c-sis; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects / Q000502:physiology*; D014947:Wounds and Injuries / Q000503:physiopathology* / Q000628:therapy*
D000925:Anticoagulants; D016207:Cytokines; D006133:Growth Substances; D010982:Platelet-Derived Growth Factor; D020574:Proto-Oncogene Proteins c-sis; D000077214:Becaplermin