Galperin RC, Lange DL, Ramsay SJ, Shi L, Weedon KA, Hudson NM, Dickerson JE Jr, Cargill DI, Slade HB, et al.
Journal of the American Podiatric Medical Association. Date of publication 2015 Nov 1;volume 105(6):509-19.
1. J Am Podiatr Med Assoc. 2015 Nov;105(6):509-19. doi: 10.7547/14-066.1. Epub 2015
Oct 5.
Anti-inflammatory Effects of Clostridial Collagenase Results from In Vitro and
Clinical Studies.
Galperin RC, Lange DL, Ramsay SJ, Shi L, Weedon KA, Hudson NM, Dickerson JE Jr,
Cargill DI, Slade HB.
BACKGROUND: Digestion of collagen with clostridial collagenase (CC) produces
peptides that can induce cellular responses consistent with wound healing in
vivo. However, nonhealing human wounds are typically in a state of chronic
inflammation. We evaluated the effects of CC on markers of inflammation in cell
culture and wound fluid from diabetic patients.
METHODS: Lipopolysaccharide-induced release of tumor necrosis factor-α and
interleukin-6 from interferon-γ-activated THP-1 monocytes was measured in the
presence or absence of CC or CC collagen digests. In the clinical study, 17
individuals with mildly inflamed diabetic foot ulcers were randomized to receive
CC ointment (CCO) or hydrogel. Weekly assessments included wound appearance and
measurements. Wound exudate was collected at baseline and at 2 and 4 weeks of
treatment. A multiplex assay was used to measure levels of analytes, including
those associated with inflammation and with inflammation resolution.
RESULTS: Lower levels of tumor necrosis factor-α and interleukin-6 were found in
media of cells cultured with CC or CC digests of collagen type I or III than for
untreated lipopolysaccharide controls (P < .05). Clinically, CCO and hydrogel
resulted in improvement in wound appearance and a decrease in mean wound area.
The CCO, but not the hydrogel, was found to increase the level of analytes
associated with resolution of inflammation while decreasing those associated with
inflammation. There was a general correlation between resolution of inflammation
and healing.
CONCLUSIONS: These results support a hypothesis that debridement with CCO is
associated with decreased inflammation and greater progress toward healing.
DOI: 10.7547/14-066.1
PMID: 26437320 [Indexed for MEDLINE]
