Exploring the role of cathelicidin LL-37 and ceragenins in wound healing processes

Wound healing and tissue regeneration are essential for maintaining skin integrity in the face of mechanical, chemical, or thermal damage. In adult mammals, the wound healing process may include complications leading to chronic wounds and hypertrophic scars. Recently, particular attention has been paid to governing wound healing using antimicrobial peptides (AMPs), such as human cathelicidin LL-37, and its synthetic analogs, ceragenins (CSAs). These substances are gaining interest due to their versatile properties that support healing and regeneration. This work reviews literature describing the role of AMPs, particularly LL-37 and synthetic ceragenins, in wound healing. We focus on their complex mechanisms of action, including strong antimicrobial properties preventing infections and the ability to support cell migration and proliferation, highlighting their potential to enhance tissue repair. The interactions of these agents with skin cells and skin homeostasis-associated signaling pathways have been discussed. Ceragenins stand out as non-peptide mimics of AMPs characterized by resistance to proteolysis, anti-biofilm activity, and stability in varying environmental conditions. Additionally, modulation of inflammatory responses by these compounds aids healing and reduces complications associated with excessive inflammation. These properties make ceragenins promising candidates for treating infected wounds and for skin regenerative therapy. As research progresses, the integration of LL-37 and ceragenins into clinical practice could revolutionize current therapeutic strategies, offering new hope to patients with chronic wounds and skin injuries. Continuing research on these compounds will be crucial for understanding their full potential and optimizing their applications in regenerative medicine.