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Cell salvage in acute and chronic wounds: a potential treatment strategy. Experimental data and early clinical
Dieter Mayer1, David Armstrong2, Greg Schultz3
1HFR Fribourg - Hôpital cantonal.
Abstract:
On 9 May 2018, the authors took part in a closed panel discussion on the impact of cell salvage in acute and chronic wounds. The goal was to deliberate the possible use of plurogel micelle matrix (PMM) as a new treatment strategy for wound healing and the authors openly shared their experiences, thoughts, experimental data and early clinical results. The outcome of the panel discussion has been abridged in this paper. The cell membrane consists of a lipid bilayer, which provides a diffusion barrier separating the inside of a cell from its environment. Cell membrane injury can result in acute cellular necrosis when defects are too large and cannot be resealed. There is a potential hazard to the body when these dying cells release endogenous alarm signals referred to as 'damage (or danger) associated molecular patterns' (DAMPs), which trigger the innate immune system and modulate inflammation. Cell salvage by membrane resealing is a promising target to ensure the survival of the individual cell and prevention of further tissue degeneration by inflammatory processes. Non-ionic surfactants such as poloxamers, poloxamines and PMM have the potential to resuscitate cells by inserting themselves into damaged membranes and stabilising the unstable portions of the lipid bilayers. The amphiphilic properties of these molecules are amenable to insertion into cell wall defects and so can play a crucial, reparative role. This new approach to cell rescue or salvage has gained increasing interest as several clinical conditions have been linked to cell membrane injury via oxidative stress-mediated lipid peroxidation or thermal disruption. The repair of the cell membrane is an important step in salvaging cells from necrosis to prevent further tissue degeneration by inflammatory processes. This is applicable to acute burns and chronic wounds such as diabetic foot ulcers (DFUs), chronic venous leg ulcers (VLUs), and pressure ulcers (PUs). Experimental data shows that PMM is biocompatible and able to insert itself into damaged membranes, salvaging their barrier function and aiding cell survival. Moreover, the six case studies presented in this paper reveal the potential of this treatment strategy.
Insights
Plurogel micelle matrix (PMM) shows promise in cell salvage for wound healing by repairing damaged cell membranes. This approach helps prevent cell death and tissue damage in chronic wounds.
Area of Science:
- Biomaterials Science
- Cell Biology
- Wound Healing Research
Background:
- Cell membrane integrity is crucial for cell survival.
- Damage to cell membranes can trigger inflammatory responses via damage-associated molecular patterns (DAMPs).
- Cell salvage via membrane resealing offers a therapeutic target to prevent tissue degeneration.
Observation:
- Plurogel micelle matrix (PMM) and similar non-ionic surfactants can insert into damaged lipid bilayers.
- These molecules stabilize cell membranes, aiding in cell resuscitation.
- Cell membrane injury is implicated in various clinical conditions, including chronic wounds.
Findings:
- Experimental data confirms PMM's biocompatibility and ability to repair cell membranes.
- PMM effectively salvages the membrane's barrier function, promoting cell survival.
- Early clinical case studies indicate PMM's potential as a wound healing treatment.
Implications:
- PMM represents a novel therapeutic strategy for acute and chronic wound management.
- This cell salvage approach could mitigate inflammation and tissue damage in conditions like diabetic foot ulcers and pressure ulcers.
- Further research into PMM could advance treatments for conditions involving cell membrane injury.
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