رئوس مطالب

  • حوزه و اهمیت
  • Translational relevance (ارتباط تبدیلی)
  • ارتباط بالینی (clinical relevance)
  • پس زمینه: ECM به عنوان یک تنظیم کننده ی سیگنالینگ فاکتور رشد
  • مولکول های ECM مهم درگیر در ترمیم زخم
  • عملکردهای تنظیمی فاکتور رشد ECM در طی ترمیم زخم
  • کاهش سیگنالینگ فاکتور رشد به عنوان یک پیامدی از ECM معیوب در زخم های مزمن
  • سیستم های انتقال فاکتور رشد ملهم از ECM برای ترمیم پوست
  • منبع فاکتورهای رشد
  • مهندسی ماتریس های بیومتریال برای بهینه سازی انتقال فاکتور رشد
  • مهندسی فاکتورهای رشد برای برهم کنش با ماتریس های بیومتریال و ECM
  • جهت گیری های آینده
  • خلاصه
  • تقدیر و تشکر و منابع سرمایه گذاری
  • منابع

Abstract

Significance: Growth factors are very promising molecules for the treatment of skin wounds. However, their translation to clinical use has been seriously limited, facing issues related to safety and cost-effectiveness. These problems may derive from the fact that growth factors are used at vastly supra-physiological levels without optimized delivery systems.

Recent Advances: The extracellular matrix (ECM) plays a fundamental role in coordinating growth factor signaling. Therefore, understanding the mechanisms by which the ECM modulates growth factor activity is key for designing efficient growth factor-based therapies. Recently, several growth factor-binding domains have been discovered within various ECM proteins, and growth factor delivery systems integrating these ECM growth factor-binding domains showed promising results in animal models of skin wound healing. Moreover, a novel strategy consisting of engineering growth factors to target endogenous ECM could substantially enhance their efficacy, even when used at low doses.

Critical Issues: Optimal delivery of growth factors often requires complex engineered biomaterial matrices, which can face regulatory issues for clinical translation. To simplify delivery systems and render strategies more applicable, growth factors can be engineered to optimally function with clinically approved biomaterials or with endogenous ECM present at the delivery site.

Future Directions: Further development and clinical trials will reveal whether growth factor-based therapies can be used as main therapeutic approaches for skin wound healing. The future impact of these therapies will depend on our capacity to deliver growth factors more precisely, to improve efficacy, safety, and cost-effectiveness.


SUMMARY

While growth factors are very promising for the treatment of skin wounds, their translation to the clinic has been limited, in part due to the lack of appropriate delivery systems. The ECM is critical in guiding injured skin tissue toward the reparative or regenerative path and it has become evident that one of its main functions is to coordinate and modulate growth factor signaling. Growth factor delivery systems mimicking the ECM’s growth factor regulatory functions are proving to be successful, at least in animal models. Further development and clinical trials will thus reveal if growth factor-based therapies can be used as primary therapeutics for wound healing. Indeed, the future impact of these therapies will most likely depend on our capacity to deliver growth factors precisely, to improve efficacy, safety, and cost-effectiveness. The main challenges are still to control the local delivery, reduce the doses, and to achieve spatiotemporal control of delivery of multiple growth factors.

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