Kenneth N. Broadley

Particle-mediated gene transfer with transforming growth factor-beta1 cDNAs enhances wound repair in rat skin.

Based on preliminary but variable results with direct DNA transfer into wounds, we evaluated in vivo gene transfer by particle-mediated DNA delivery to rat skin to determine whether overexpression of TGF-beta1 at the site of skin incisions would result in a significant improvement in repair. Optimization of the method with viral promoter-luciferase reporter constructs indicated that expression of luciferase activity persisted up to 5 d and was promoter, pressure, and site dependent (ventral > dorsal). Using cytomegalovirus (CMV)-driven human alpha1-antitrypsin, transgene expression was immunolocalized within keratinocytes of the stratum granulosum at 24 h. We measured tensile strength of skin incisions at 11-21 d in both normal and diabetic rats transfected with TGF-beta1 expression vectors at surgery. Native murine TGF-beta1 under an SV40 promoter produced positive effects, while wound strengthening was more pronounced in diabetic animals using a CMV-driven construct. Transfection of rat skin with constitutively active, mutant porcine TGF-beta1 under the control of the CMV and Moloney murine leukemia virus promoters significantly increased tensile strength up to 80% for 14-21 d after surgery. Transfection 24 h before surgery was more effective. Particle-mediated gene delivery can be used to deliver viral promoter-cytokine expression constructs into rat skin in a safe, efficient, and reproducible fashion. The extent of wound repair, as evidenced by enhanced tensile strength, can be markedly improved in tissues transfected with TGF-beta1 expression constructs.

Hyaluronate derivatives and their application to wound healing: Preliminary observations

Hyaluronic acid and its derivatives show promise as biomaterials in wound healing applications. Studies of cutaneous wound repair were carried out in two animal models to compare the biological effects of hyaluronic acid and hyaluronic acid ethyl ester, a new semisynthetic derivative. The two compounds were tested in partial-thickness excisional wounds in 40-kg pigs and full-thickness excisional wounds in the rabbit ear as 0.2% (w/w) formulations in a neutral Na alginate vehicle. All compounds were administered daily under an occlusive, polyurethane dressing. Neither hyaluronic acid nor the hyaluronic acid ethyl ester showed toxic or inflammatory influences over the observation period of about 2 weeks. Morphometric analysis of porcine wounds revealed small differences among treatment groups which may have been masked by the effect of the vehicle. The rabbit ear model data suggested a very slight inhibition of wound closure. Biochemical analysis of ear wounds showed this injury model to be a sensitive system for evaluation of vulnerary agents. The hyaluronate-treated wounds tended to accumulate collagen more slowly, which may reflect the capacity of these compounds to modify the scarring process. Given the ability to fabricate hyaluronate esters into films and fibers, these data suggest that such biomaterials will not, by themselves, exert a negative influence on the repair process and may improve healing, either alone or in combination with other soluble agents.

Reversal of the wound healing deficit in diabetic rats by combined basic fibroblast growth factor and transforming growth factor‐β1 therapy

Wound healing is impaired in the diabetic state because of, at least in part, low expression of growth factors. Individual growth factors can partially activate healing, yet the actual wound environment presents a dynamic continuum of multiple cellular signals. Complex interactions among growth factors and target cells can have synergistic effects, and several examples of combinatorial, in vivo activity are evident in the literature. In this study, the implantation of a combination of basic fibroblast growth factor and transforming growth factor‐β in rats induced fivefold to sevenfold increases in granulation tissue formation in comparison with implantation of each growth factor alone. Diabetes was induced in adult, male Sprague‐Dawley rats with streptozotocin. Incisional wounds and sponge granulation tissue were produced in separate groups and then treated with an injection of 2 µg transforming growth factor‐β1 combined with 10 µg basic fibroblast growth factor on day 3. DNA, collagen, and protein were analyzed in granulation tissue on days 7 and 9, and biomechanical properties of incisions were tested on days 7, 14, and 21. The combination of transforming growth factor‐β1 and basic fibroblast growth factor had marked, positive effects on biochemical parameters of wound healing and reversed the tensile strength deficit of diabetic wounds. Nonradioactive in situ hybridization showed increased expression of messenger RNA for type I and III procollagen and transforming growth factor‐β1 in normal and diabetic wounds, whereas ultrastructural examination showed a marked reorganization of collagen fibrils. These findings reinforce the concept that appropriate mixtures of cytokines rather than individual cytokines may more adequately stimulate tissues in cases of impaired wound healing.

Low-energy helium-neon laser irradiation and the tensile strength of incisional wounds in the rat.

Low‐level laser energy has been reported to modulate the wound healing process in some but not all studies. To examine this hypothesis, we investigated incisional wounds made on the dorsal pelt of rats for changes in the healing produced by low‐level irradiation with a helium‐neon laser. The incisions were made with a scalpel and closed with sutures. The rats were irradiated daily for 12 days with four levels of laser light (0.0, 0.47, 0.93, and 1.73 J/cm2). Analysis of wound tensile strength indicated a possible strengthening of fresh wounds at the highest levels of irradiation (1.73 J/cm2). No change was observed in the tensile strength of formalin‐fixed wounds. The distribution of measured tensile strengths did not follow normal statistics; instead they showed a platykurtic distribution. Using resampling statistics, where no assumption is made as to the nature of the distribution, we found that the results were contrary to other studies: no biostimulatory effect was seen.