title: Doxycycline speeds up healing of chronic venous ulcers.
abstract: Venous ulcers are common, with an overall prevalence of up to 2% in the general population of western countries, and have significant socioeconomic impact. Matrix metalloproteinases (MMPs) are involved in the alteration of extracellular matrix that could lead to venous ulceration. Sixty-four patients with venous ulcers were recruited in a 22-month period. All patients were subjected to the most appropriate treatment considering also the patient's wishes (compression therapy followed or not by vein surgery). Patients were randomised into two groups of 32 persons in each (groups A and B). Patients of group A in addition to the basic treatment, described above, received the administration of oral low doses of doxycycline 20 mg b.i.d. for 3 months, whereas patients of group B received basic treatment only. Healing was assessed by means of direct ulcer tracing with computerised planimetry. Group A showed a higher healing rate compared with group B. In group B, the lower healing rate was related to higher levels of MMP-9; neutrophil gelatinase-associated lipocalin and vascular endothelial growth factor, documented in plasma; wound fluid and biopsies executed and compared between both groups. Pharmacological treatments, as doxycycline administration, which by means of its immunomodulatory and anti-inflammatory actions, through the inhibition of MMP, could improve extracellular matrix functioning and represent a possible solution to support wound healing.
authors.affiliation: Department of Medical and Surgical Science, University Magna Graecia of Catanzaro, Catanzaro, Italy; Interuniversity Center of Phlebolymphology, International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Catanzaro, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Serra
authors.forename: Luca
authors.initials: L
authors.lastname: Gallelli
authors.forename: Gianluca
authors.initials: G
authors.lastname: Buffone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Molinari
authors.forename: Domenico M
authors.initials: DM
authors.lastname: Stillitano
authors.forename: Camillo
authors.initials: C
authors.lastname: Palmieri
authors.forename: Stefano
authors.initials: S
authors.lastname: de Franciscis
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D004318:Doxycycline / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000378:metabolism; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000378:metabolism; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D014945:Wound Healing
chemical_list: D000209:Acute-Phase Proteins; D000900:Anti-Bacterial Agents; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D042461:Vascular Endothelial Growth Factor A; D020780:Matrix Metalloproteinase 9; D004318:Doxycycline
keywords: Chronic venous leg ulcers; Doxycycline; Metalloproteinase-9; Neutrophil gelatinase-associated lipocalin; Wound healing
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