Ability of chronic wound fluids to degrade peptide growth factors is associated with increased levels of elastase activity and diminished levels of proteinase inhibitors

Authors

  • Dorne R. Yager PhD,

    Corresponding author
    1. From The Wound Healing Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, Va.
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  • Stephen M. Chen BS,

    1. From The Wound Healing Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, Va.
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  • Susan I. Ward BS,

    1. From The Wound Healing Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, Va.
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  • Oluyinka O. Olutoye MD, PhD,

    1. From The Wound Healing Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, Va.
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  • Robert F. Diegelmann PhD,

    1. From The Wound Healing Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, Va.
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  • I. Kelman Cohen MD

    1. From The Wound Healing Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, Va.
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Reprint requests: Dorne R. Yager, PhD, The Wound Healing Center, PO Box 980117, Richmond, VA 23298-0117.

Abstract

The stability of peptide growth factors exposed to fluids from healing surgical wounds and from nonhealing chronic wounds was examined in vitro. 125I-Labeled transforming growth factor-β1 or platelet-derived growth factor-BB was incubated with fluids from healing surgical wounds and fluids from venous stasis or pressure ulcers. Fluids from healing surgical wounds had no appreciable effect on the level of 125I corresponding to intact growth factor. In contrast, incubation with fluids from several venous stasis or pressure ulcers resulted in significant degradation of these growth factors. Degradation was blocked by broad-spectrum serine proteinase inhibitors and by specific inhibitors of neutrophil elastase. Levels of elastase activity in wound fluids correlated with the ability to degrade peptide growth factors. Further comparisons showed qualitative and quantitative differences in the endogenous proteinase inhibitors, α2-macroglobulin and α1-antiproteinase. These results could explain, in part, the variable growth factor levels which have been found in chronic wounds. More importantly, the ability of some chronic nonhealing wounds to rapidly degrade exogenously added growth factors has important implications with regard to past and future clinical attempts to use peptide growth factors to treat these types of problem wounds.

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