title: Healing refractory venous ulcers: new treatments offer hope.
abstract: Non-healing wounds are associated with an inflammatory and proteolytic wound environment, and recent therapeutic strategies have been focused on reversing these changes. Connexins, as members of gap junctions, are important in intercellular signaling and wound repair. Connexin 43 (Cx43) downregulation is associated with normal wound healing, and it has been found to be upregulated in non-healing venous leg ulcers (VLUs). Ghatnekar et al. (2014) report findings of a small phase II trial performed in Indian patients with chronic VLUs, reporting that ACT1, a mimetic peptide of Cx43, accelerates healing in the treatment group. Despite standard care with compression therapy and adjuvant therapy for refractory wounds, at present in clinical practice a significant number of patients remain unhealed. The potential for ACT1 exists to help heal refractory VLUs, but it faces additional regulatory hurdles.
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA. Electronic address: RKirsner@med.miami.edu.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kirsner
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Baquerizo Nole
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Fox
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Sophia N
authors.initials: SN
authors.lastname: Liu
mesh_terms: D018031:Connexin 43 / Q000378:metabolism*; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000188:drug therapy*; D008297:Male; D010455:Peptides / Q000008:administration & dosage*; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D018031:Connexin 43; C500216:GJA1 protein, human; D010455:Peptides