Sirolimus impairs wound healing

Schäffer, Michael; Schier, Robert; Napirei, Markus; Michalski, Stefan G.; Traska, T; Viebahn, Richard

doi:10.1007/s00423-007-0174-5

Cited by 49 publications

(51 citation statements)

References 42 publications

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“…Based on the fi nding that immunosuppressive therapy affects angiogenesis and collagen synthesis during wound healing (Kelley et al, 1990;Schäffer et al, 2007), a recent study analysed, how the immunosuppressive drugs rapamycin and cyclosporine A infl uence the incorporation of Ultrapro ® meshes (Laschke et al, 2009b). This is an issue of major clinical relevance, considering the fact that the incidence of incisional hernias following orthotopic liver transplantation has markedly increased during the last ten years (Kahn et al, 2007).…”

Section: Surgical Meshesmentioning

confidence: 99%

The dorsal skinfold chamber: window into the dynamic interaction of biomaterials with their surrounding host tissue

Laschke

Vollmar²,

Menger³

2011

eCM

145

128

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The implantation of biomaterials into the human body has become an indispensable part of almost all fi elds of modern medicine. Accordingly, there is an increasing need for appropriate approaches, which can be used to evaluate the suitability of different biomaterials for distinct clinical indications. The dorsal skinfold chamber is a sophisticated experimental model, which has been proven to be extremely valuable for the systematic in vivo analysis of the dynamic interaction of small biomaterial implants with the surrounding host tissue in rats, hamsters and mice. By means of intravital fl uorescence microscopy, this chronic model allows for repeated analyses of various cellular, molecular and microvascular mechanisms, which are involved in the early infl ammatory and angiogenic host tissue response to biomaterials during the initial 2-3 weeks after implantation. Therefore, the dorsal skinfold chamber has been broadly used during the last two decades to assess the in vivo performance of prosthetic vascular grafts, metallic implants, surgical meshes, bone substitutes, scaffolds for tissue engineering, as well as for locally or systemically applied drug delivery systems. These studies have contributed to identify basic material properties determining the biocompatibility of the implants and vascular ingrowth into their surface or internal structures. Thus, the dorsal skinfold chamber model does not only provide deep insights into the complex interactions of biomaterials with the surrounding soft tissues of the host but also represents an important tool for the future development of novel biomaterials aiming at an optimisation of their biofunctionality in clinical practice.

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Section: Surgical Meshesmentioning

confidence: 99%

The dorsal skinfold chamber: window into the dynamic interaction of biomaterials with their surrounding host tissue

Laschke

Vollmar²,

Menger³

2011

eCM

145

128

View full text Add to dashboard Cite

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“…Anti-inflammatory and immunosuppressive drugs have been shown to impair wound healing process (3)(4)(5)(6)(7)(8)(9). Delay of wound healing by systemic corticosteroids is a wellknown phenomenon due to the inhibition of the inflammatory phase of healing by inhibiting leucocyte and macrophage infiltration (10).…”

Section: Introductionmentioning

confidence: 99%

“…Alteration of the healing environment as well as skin atrophy may occur within the first few days of topical steroids use (10,11). Systemic sirolimus and everolimus also show negative effects on wound healing by arresting cell cycle and inhibiting fibroblast proliferation (5,9,12). In a mouse model, TNF-a expression is influenced by cyclosporine A in a way that could explain the downregulation of procollagen a1, which eventually delays wound healing (6,13).…”

Section: Introductionmentioning

confidence: 99%

Topical tacrolimus does not negatively impact acute skin wound healing

Namkoong

Chung

Yoo

et al. 2013

Experimental Dermatology

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Despite the increasing use of topical tacrolimus, there is little information about its effect on skin wound healing. To determine effects on acute cutaneous wound healing, two fullthickness skin wounds were imparted on the backs of 45 hairless mice, which were then divided into vehicle-, topical tacrolimusand topical steroid-treated group. Each drug was topically applied once daily. The wound area was assessed by using dermoscopic images every two days after wounding. At 3, 7 and 11 days after wounding, 10 wounds in each group were collected for semiquantitative analysis of histological features including re-epithelialization, polymorphonuclear leucocytes, fibroblasts and collagen. We also checked the mRNA expression levels of EGF, TGF-b, TNF-a and IL-1a. While topical application of clobetasol propionate was found to delay re-epithelialization and infiltration of polymorphonuclear leucocyte, topical treatment with tacrolimus showed patterns similar to that of the vehicle. In the tacrolimus-treated group, mRNA expression levels of IL-1a and TGF-b were slightly decreased, while the others were similar with the vehicle-treated group. Unlike steroid, topical tacrolimus, therefore, did not disturb the wound healing process in a murine skin wound model.

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“…5 The purpose of this case study is to discuss the effects of sirolimus, an immunosuppressive medication, and its affects on wound healing on a lower extremity wound. 6 …”

mentioning

confidence: 99%

Impaired Lower Extremity Wound Healing Secondary to Sirolimus After Kidney Transplantation

DeVries

Collier

Niezgoda

et al. 2009

The Journal of the American College of Certified Wound Speciali

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PURPOSE: Sirolimus is an immunosuppressive drug used as part of the drug regimen after kidney, liver, and heart transplantation. There have been numerous reports of transplant surgical wound healing complications secondary to sirolimus. The authors present a case of impaired wound healing in the lower extremity after kidney transplantation for a patient on sirolimus. This is one of the few reported cases that we are aware of that demonstrates the effects of sirolimus on wound healing at a nontransplant site.METHODS: A case highlighting aggressive limb-salvage modalities for a kidney transplant patient on sirolimus is presented. The subject was informed that data concerning the case would be submitted for publication. A brief review of the literature shows the wound healing problems previously associated with sirolimus.RESULTS: Despite all salvage techniques employed, including aggressive early debridement, forefoot offloading, IV antibiotics, negative pressure wound therapy, and hyperbaric oxygen therapy, the patient eventually went on to failure and a transtibial amputation.CONCLUSION: Physicians specializing in wound care and limb salvage must be aware of the effects of sirolimus on wound healing and should consider modifications to these patients' immunosuppressive regimens.

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Sirolimus impairs wound healing

Abstract: Experimentally, our data show that sirolimus impairs wound healing, and this is reflected by diminished expression of VEGF and nitric oxide in the wound.

Cited by 49 publications

References 42 publications

The dorsal skinfold chamber: window into the dynamic interaction of biomaterials with their surrounding host tissue

The dorsal skinfold chamber: window into the dynamic interaction of biomaterials with their surrounding host tissue

Topical tacrolimus does not negatively impact acute skin wound healing

Impaired Lower Extremity Wound Healing Secondary to Sirolimus After Kidney Transplantation

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