title: The role of doxycycline as a matrix metalloproteinase inhibitor for the treatment of chronic wounds.
abstract: Many chronic wounds fail to heal with conventional therapy, resulting in disability and impaired quality of life. New technologies using recombinant growth factors, autologous growth factors, or bioengineered skin-tissue substitutes have been shown to be effective, but these treatments are costly. An effective, low-cost treatment to improve healing of chronic wounds is needed. The molecular environment of chronic wounds, like many other chronic inflammatory diseases, contains abnormally high levels of proinflammatory cytokines (tumor necrosis factor [TNF]-alpha and interleukin [IL]-1beta]) and matrix metalloproteinases (MMPs), which impair normal wound healing. In animal models and clinical studies of ulcerative diseases, doxycycline, an inexpensive and Food and Drug Administration (FDA)-approved antibiotic, appears to inhibit members of the MMP superfamily like MMPs and TNF-alpha-converting enzyme (TACE). This article provides an overview of the roles of MMPs and intrinsic tissue inhibitors of metalloproteinases (TIMPs) in wound healing and the damaging effects of chronically elevated levels of MMPSs in chronic wounds. It also explores the use of topical doxycycline, a synthetic MMP inhibitor (MMPI), to enhance healing of chronic wounds.
authors.affiliation: College of Nursing, University of Florida, Gainesville, FL 32610, USA. stechjk@ufl.edu
authors.forename: Joyce
authors.initials: J
authors.lastname: Stechmiller
authors.forename: Linda
authors.initials: L
authors.lastname: Cowan
authors.forename: Gregory
authors.initials: G
authors.lastname: Schultz
mesh_terms: D002908:Chronic Disease; D004318:Doxycycline / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D061965:Matrix Metalloproteinase Inhibitors; D011480:Protease Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D014947:Wounds and Injuries / Q000188:drug therapy*
chemical_list: D061965:Matrix Metalloproteinase Inhibitors; D011480:Protease Inhibitors; D004318:Doxycycline