Researchers at Uppsala University and SLU have found a new
way of accelerating wound healing. The technology and the mode of action method
published in the highly ranked journal PNAS involves using lactic acid bacteria
as vectors to produce and deliver a human chemokine on site in the wounds. The
research group is the first in the world to have developed the concept for
topical use and the technology could turn out to be disruptive to the field of
biologic drugs.
Treatment of large and chronic wounds are a high cost burden
to the health care system since effective tools to accelerate healing are
lacking. Wound care is today limited to mechanical debridement, use of
different dressings and significant amounts of antibiotics preventing or
treating wound infections. With the aging population, occurrence of chronic
diseases such as diabetes and the alarming global spread of antibiotic
resistance, a treatment that kick-starts and accelerates wound healing will
have a significant impact. There have been many attempts to solve the problem
of chronic wounds that have failed. Drug candidates currently in late stage
clinical trials comprise of growth factors, which are traditional protein-based
biological drugs associated with high costs, and some trials have been prematurely
terminated.
"We have developed a drug candidate, a next-generation
biologic medical product, and are now publishing the fantastic results from the
preclinical part where wound healing was strongly accelerated in mice,"
says Mia Phillipson, Professor at the Department of Medical Cell Biology,
Division of Integrative Physiology, Uppsala University.
The acceleration of the healing process occurs due to
changes in the microenvironment in the wound, which change the behaviour of
specific immune cells. With the newly developed technology, the researchers can
increase the level of a chemokine, CXCL12, for a sufficient time period through
continuous delivery directly to the wound surface. In addition, bioavailability
of CXCL12 is synergistically increased within the wound as the bacterial
produced lactic acid causes a slight pH drop that inhibits degradation.
"The chemokine, CXCL12, is endogenously upregulated in
injured tissue and by increasing the levels further, more immune cells are
recruited and are more specialised to heal the wound, which accelerates the
whole process," says Professor Phillipson.
The potent effect on acceleration of wound healing is
demonstrated in healthy mice but also in two models of diabetes, one model of
peripheral ischemia as well as in a model using human skin biopsies.
There were clear differences in the composition of immune
cells in the wounds and the immune cells present produced higher levels of TGFß
at earlier time points. The treatment was local without systemic exposure.