Deciphering the impaired cytokine cascades in chronic leg ulcers (Review)

Quatresooz, Pascale; Henry, Frédérique; Paquet, Philippe; Piérard-Franchimont, C; Harding, Keith G; Pierard, Gérald

doi:10.3892/ijmm.11.4.411

Cited by 28 publications

(41 citation statements)

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“…[33] Microthrombi in the capillaries cause microinfarctions and micronecrosis. [35] Upregulation of transforming growth factor-b, basic fibroblast growth factor, platelet-derived growth factor, and the associated chronic inflammation, leads to the development of fibrous scar tissue (made up of collagen bundles and loss of cellular components) in the reticular dermis called lipodermatosclerosis. [35] Upregulation of transforming growth factor-b, basic fibroblast growth factor, platelet-derived growth factor, and the associated chronic inflammation, leads to the development of fibrous scar tissue (made up of collagen bundles and loss of cellular components) in the reticular dermis called lipodermatosclerosis.…”

Section: Stasis Dermatitismentioning

confidence: 99%

Clinical Implications of Aging Skin

Farage

Miller

Berardesca

et al. 2009

American Journal of Clinical Dermatology

244

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Aging skin undergoes progressive degenerative change. Structural and physiologic changes that occur as a natural consequence of intrinsic aging combined with the effects of a lifetime of ongoing cumulative extrinsic damage and environment insult (e.g. overexposure to solar radiation) can produce a marked susceptibility to dermatologic disorders in the elderly. As skin ages, the vasculature progressively atrophies. The supporting dermis also deteriorates, with collagen and elastin fibers becoming sparse and increasingly disordered. These changes leave the elderly increasingly susceptible to both vascular disorders such as stasis dermatitis and skin injuries such as pressure ulcers and skin tears, with a steadily decreasing ability to effect skin repair. A parallel erosion of normal immune function produces higher levels of autoimmune skin disorders such as bullous pemphigoid, benign mucous membrane pemphigoid, paraneoplastic pemphigoid, and pemphigus vulgaris. Lichen sclerosus, an autoimmune disorder often occurring in the genital area in older women, is not common but is an important development because of the potential for substantial discomfort as well as serious complications. The prevalence of polypharmacy in this population increases the risk for autoimmune drug reactions, and diagnosis should be undertaken with an awareness that polypharmacy in this population creates a greatly increased susceptibility to drug eruptions that can mimic other cutaneous disorders. Immunologic senescence in the elderly also sets the stage for potential reactivation of the Varicella zoster virus, in which initial dermatologic involvement expands into the major sensory ganglia. Known as shingles, this disorder can be excruciatingly painful with the potential to cause blindness if the optic nerve becomes involved. Dermatoses such as xerosis, pruritus, and eczema are also widespread in the elderly, create substantial suffering in those afflicted, and often prove recalcitrant to treatment. Individual susceptibility to specific types of contact dermatitis changes over the lifetime, and seborrheic dermatitis is substantially more prevalent in the elderly. It is not uncommon for older patients to have multiple impairments, with the potential for cognitive dysfunction as well as impaired vision, hearing, or mobility. In addition, they may not have adequate housing or nutrition, or the financial resources necessary for adequate compliance. Physicians must take into consideration the patient's physical ability to comply with the recommended therapy as well as socioeconomic factors that may impact on compliance. Simple topical regimens are preferable wherever possible in order to maximize compliance and, therefore, efficacy. Extra effort may be necessary to ensure that instructions are accurately followed and that ongoing compliance with the regimen prescribed is actually achieved. Management of dermatologic disorders in the elderly is often less than optimal, due to the fact that the special needs and limitations of this population are no...

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Section: Stasis Dermatitismentioning

confidence: 99%

Clinical Implications of Aging Skin

Farage

Miller

Berardesca

et al. 2009

American Journal of Clinical Dermatology

244

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“…Chronic open foot ulcers are a common problem in diabetes and represent a major concern, from both a quality of life and an economic standpoint (Brem et al 2004;Gallucci et al 2000;Livant et al 2000;Pierce 2001;Quatresooz et al 2003). In these patients, delayed wound healing is characterized by inhibition of the initial inflammatory response, delayed macrophage infiltration, angiogenesis, fibroplasia, and reparative collagen accumulation (Cohen et al 2001;Pierce 2001).…”

Section: Introductionmentioning

confidence: 99%

Differential Evaluation of Excisional Non-occluded Wound Healing in db/db Mice

et al. 2009

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The full-thickness wound in the genetically diabetic (db/db) mouse is a commonly used model of impaired wound healing. We investigated delayed healing of non-occluded, excisional, full-thickness, dermal wounds in db/db mice in comparison to their normal littermate controls and refined methods for monitoring skin wound re-epithelialization, contraction, granulation tissue formation, and inflammation. We have confirmed with a computer-assisted planimetry method the results of previous studies showing that healing of non-occluded full excision wounds in db/db mice does not occur by contraction as much as in healthy mice. In addition, we have developed separate histological methods for the assessment of re-epithelialization, contraction, granulation tissue (mature, immature, fibrosis), and inflammation (lipogranulomas, secondary, nonspecific). Using a new approach to histological assessment, we have shown that wound closure in db/db mice is delayed owing to: (1) delayed granulation tissue maturation; (2) ''laced,'' widely distributed granulation tissue around fat lobules; and (3) obstruction by lipogranulomas, whereas the rate of re-epithelialization seems to be the same as in C57Bl/6 mice. This methodology should permit a more precise differentiation of effects of novel therapeutic agents on the wound healing process in db/db mice.

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“…Multiple studies have demonstrated a beneficial effect of many cytokines and growth factors in the healing process, both in animal models and patients suffering from chronic venous leg ulcer (50). However, functions of most growth factors in chronic diabetic foot ulcers remain rather unconfirmed (51)(52)(53)(54).…”

Section: Molecular Basis Of Ulcer Healing In Diabetesmentioning

confidence: 98%