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Local Control of Pyoderma Gangrenosum Using Human Amniotic Membrane and Transcriptome Analysis
Mark A Maier1, Jenna R Dennis2, Cameron J Fontenot3
1Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Abstract:
Pyoderma gangrenosum (PG) is a rare, chronic, ulcerative disease characterized by non-healing wounds that worsen with debridement, a phenomenon called pathergy. No consensus regarding pathogenesis, diagnosis, or treatment exists for PG. A previous pilot study using dehydrated human amniotic/chorionic membrane (dHACM), following excisional debridement, augmented PG wound healing and allowed for subsequent wound closure through split-thickness skin grafting (STSG). In this clinical trial (NCT05120726), four patients with an established PG diagnosis were enrolled to undergo treatment with dHACM and characterize the pre- and post-treatment transcriptome profiles. RNA sequencing was used to isolate the total RNA from specimens. Genes of particular interest were quantified through real-time quantitative reverse transcription polymerase chain reaction. We observed varied changes to the local expression of inflammatory response, positive regulators of cellular proliferation, and extracellular matrix disassembly cytokines. All PG wounds produced granulation tissue following treatment and were closed using split-thickness skin grafts.
Insights
Dehydrated human amniotic/chorionic membrane (dHACM) effectively treats pyoderma gangrenosum (PG) wounds, promoting healing and enabling skin grafting. Transcriptome analysis revealed changes in inflammatory and cellular proliferation genes post-treatment.
Area of Science:
- Dermatology
- Regenerative Medicine
- Molecular Biology
Background:
- Pyoderma gangrenosum (PG) is a rare ulcerative condition with no established treatment consensus.
- Pathergy, or wound worsening with debridement, complicates PG management.
- Previous studies suggest dehydrated human amniotic/chorionic membrane (dHACM) aids PG wound healing.
Purpose of the Study:
- To evaluate dHACM efficacy in treating pyoderma gangrenosum (PG) wounds.
- To analyze transcriptome changes in PG lesions after dHACM treatment.
- To assess the potential for split-thickness skin grafting (STSG) post-treatment.
Main Methods:
- Clinical trial enrolling four PG patients (NCT05120726).
- Treatment with dehydrated human amniotic/chorionic membrane (dHACM) after debridement.
- RNA sequencing and RT-qPCR to analyze gene expression profiles.
Main Results:
- All patients achieved granulation tissue formation post-dHACM treatment.
- Transcriptome analysis showed altered expression of inflammatory, proliferation, and ECM genes.
- Successful wound closure was achieved in all patients via split-thickness skin grafting (STSG).
Conclusions:
- Dehydrated human amniotic/chorionic membrane (dHACM) is a promising therapeutic agent for pyoderma gangrenosum (PG).
- dHACM treatment modulates key molecular pathways involved in wound healing.
- This approach facilitates subsequent wound closure with split-thickness skin grafting (STSG).
