Author: Isabel Zhang
From: Chicago, IL, US
Image Source: Pixabay
When we get small wounds, such as cuts or scrapes, it’s no big deal- we just put on a band-aid and go about our daily lives, waiting for our body to heal itself. But serious conditions such as diabetes, vascular disease, and skin disorders don’t heal easily. This can cause chronic wounds that have devastating effects on a person’s life. Here’s the big question we still face today: How and why do some wounds become chronic?
A Tough Obstacle
This question surfaced in a recent study, where researchers were investigating epidermolysis bullosa (EB), a group of skin diseases that severely impair healing. Patients suffer from blisters and lesions that are slow to heal and some become chronic. In turn, these chronic wounds are likely to develop into aggressive skin cancer.
The researchers were trying to predict which wounds in the patients would heal and which ones would stay to become chronic. Sampling the cells in wounds is a key method that can be used to understand the mechanisms behind healing. However, current methods of sampling are approached with hesitation: the researchers studying EB knew that performing a biopsy to sample the wounds would be helpful, but biopsies are extremely painful and might interfere with the healing of the wound. So the researchers wondered if there was another way to sample that was easier and safer, but still effective...
A Breakthrough (Gross but Genius)
We all know that after you’ve used a bandaid, it’s of no use anymore and goes straight to the trash. However, the researchers in the EB study began to think otherwise: What if we took used wound dressings or bandages and looked at what cells were present instead of throwing them out? Collecting these bandages that are just going to be thrown away wouldn’t pose any harm to the patient and would be easy enough to do.
So the researchers collected and analyzed discarded wound dressings from EB patients. Using lab techniques that were frequently used before, they were able to recover hundreds of millions of living cells from the dressings for study. The researchers then characterized the cells to see what type of cells were present at the wound, and ended up detecting a variety of immune cells including lymphocytes, granulocytes or neutrophils, and monocytes or macrophages.
When they compared the dressings from normal-healing and chronic wounds, they found many more neutrophils at chronic wound sites. Neutrophils are the first components of our immune system to arrive at the scene of wound forming. Previous findings from protein analysis of human wound dressings had actually supported the idea that when neutrophils stay for longer than they should, it stalls the healing process and can cause chronic wounds. So the researchers’ findings make that theory more definitive by showing that chronic wounds are characterized by higher levels of neutrophils.
These findings finally gave the insight into wound healing that we need for doctors to treat wounds and prevent them from becoming chronic. For instance, therapies are being developed that promote the healing process by neutralizing excess neutrophils and recruit macrophages (the immune cells that jump in after neutrophils to fight a wound forming).
The researchers plan to continue following the EB patients for a longer period of time so they can observe how a wound’s cellular composition changes as it heals or doesn't heal. Their hope is to analyze the genetic material inside them in order to find genetic markers that can predict healing or chronicity.
And while the current study focuses on EB, the researchers seek to expand their method to other conditions, such as diabetic foot ulcers and vascular leg ulcers. This sampling technique could be an alternative to biopsies and bothersome swabs or blood draws, which are especially hard to do in newborns. The limits to the excitement of this discovery for our future are boundless.
The U.S. spends billions of dollars per year on chronic wound treatment, yet that money could be saved with our newfound knowledge. The field of wound healing has been waiting for a better understanding of what drives a chronic wound, and the new sampling technique could be transformative to helping patients live more comfortable and healthy lives. And, rather surprisingly, it’s all thanks to some used bandages.
About the Author: Isabel Zhang
Isabel is a senior in high school, and is interested in biology and engineering. In her free time, she loves to bake, sketch, and hang out with her family.
T. (2020, September 15). A new approach to understanding the biology of wound healing. Retrieved from https://www.sciencedaily.com/releases/2020/09/200915152443.htm