Browsing by Subject "Chronic wounds"

Now showing 1 - 4 of 4
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    Detection of galectin-3 and localization of advanced glycation end products (AGE) in human chronic skin wounds
    (F. Hernández y Juan F. Madrid. Universidad de Murcia. Departamento de Biología Celular e Histología, 2014) Pepe, Daniel; Elliott, Christopher G.; Forbes, Thomas L.; Hamilton, Douglas W.
    The matricellular protein galectin-3 (Gal-3) is upregulated in excisional skin repair in rats where it has been shown to modulate the inflammatory phase of repair. Recent research into kidney pathology has implicated Gal-3 as a receptor for advanced glycation end products (AGE), resulting in the binding and clearance of these molecules. AGEs are thought to contribute to defective skin repair in diabetic patients as well as a result of the normal aging process. However, the distribution and localization of Gal-3 and AGEs has never been performed in human chronic skin wound tissue. Using immunohistochemistry, the localization of Gal-3 and AGEs in tissue isolated from chronic wounds and non-involved skin from the same patient was investigated. Of the 16 patients from which tissue was isolated, 13 had type II diabetes, one had type I diabetes and 2 patients without diabetes were also examined. In non-involved dermis, Gal-3 was detected strongly in the epidermis and in the vasculature. However, at the wound edge and in the wound bed, the level of Gal-3 labelling was greatly reduced in both the epidermis and vasculature. Labelling of serial sections for Gal-3 and AGE demonstrated that where Gal-3 immunoreactivity is reduced in the epidermis and vasculature, there is a concomitant increase in the level of AGE staining. Interestingly, similar labelling patterns were evident in diabetic and non-diabetic patients. The results from our study demonstrate an inverse correlation between Gal-3 and AGEs localization, suggesting that Gal-3 may protect against accumulation of AGEs in wound healing.
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    Heridas crónicas atendidas en un servicio de urgencias
    (Murcia: Servicio de Publicaciones de la Universidad de Murcia, 2014) Lorenzo Hernández, Mª Piedad; Hernández Cano, Rosa Mª; Soria Suárez, Mª Isabel
    Una herida crónica se define como una pérdida de continuidad de la superficie epitelial con pérdida de sustancia con escasa o nula tendencia a la curación espontánea y que requiere períodos muy prolongados para su cicatrización por segunda intención. Constituye un importante problema asistencial que afecta al sistema de salud por la disminución de la calidad de vida, su elevado coste económico y por la dedicación de mucho tiempo de los profesionales de Enfermería. El objetivo de este estudio consiste en describir la prevalencia y tipo de heridas que padecen los pacientes atendidos en el Servicio de Urgencias, programados para fines de semana por su enfermero del centro de salud. Los resultados obtenidos evidencian que casi la mitad de los pacientes acudían por presentar heridas crónicas, y que el 30% no traían indicaciones de su enfermero referente de la realización de la cura
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    Molecular insights into the interaction of cathepsin D and iron in chronic wound healing: exploring therapeutic potential and mechanisms
    (MDPI, 2025-02-21) Rodríguez-Moreno, María; Legaz Pérez, Isabel; Ciencias Sociosanitarias; Facultad de Química
    Background: Chronic wounds, such as diabetic ulcers, often fail to progress through healing due to persistent inflammation, infections, and extracellular matrix (ECM) imbalances. Cathepsin D, an aspartate protease active in acidic environments, plays a pivotal role in wound healing by mediating inflammatory responses, ECM remodeling, and macrophage phenotype transitions. Its dysregulation, however, can impair healing, highlighting the need for targeted modulation of its activity. The aim of this study was to investigate the molecular interaction between Fe2+ and cathepsin D’s catalytic core and ionic zipper under physiological and acidic conditions to identify strategies to enhance tissue repair and accelerate the healing of chronic wounds. Methods: The molecular structure of active cathepsin D was obtained from the Protein Data Bank (PDB) and analyzed using UCSF Chimera. Molecular interactions between cathepsin D and ferrous ions (Fe2+) were studied, focusing on key residues (D33 and D231) and ionic zipper residues (E5, E180, and D187). Results: Our results showed that the active form of cathepsin D, a 96 kDa dimer, consisted of heterodimers with distinct amino acid chains, where residues D33 and D231 formed the active site, and E5, E180, and D187 constituted the ionic zipper. A functional pocket containing the conserved residues D33 and D231, essential for proteolytic activity, was identified. At physiological pH (~7.5), D33 exhibited the most potent interactions with Fe2+, with interaction energies of −7 × 1017 J at oxygen atoms of the carboxylate group (OD1) and α-carbon (CA) atoms, whereas D231 showed slightly lower energies of −6 × 1017 J at γ-carbon atom (CG) and CA atoms. At acidic pH (~4), E5 was the primary interacting residue, with the shortest distance to Fe2+ (2.69 Å), and showed stable interactions across several atoms, emphasizing its role in metal binding. Conclusions: pH conditions strongly influence the interaction of cathepsin D with Fe2. At physiological pH, residues D33 and D231 demonstrate robust and energetically efficient binding with Fe2+. At the same time, under acidic conditions, E5 emerges as the primary residue involved, potentially affecting the ionic zipper of cathepsin D. These insights provide a molecular foundation for targeting specific residues to modulate cathepsin D activity, presenting promising opportunities for therapeutic strategies aimed at improving chronic wound healing.
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    Plasma rico en plaquetas en el tratamiento de las heridas crónicas
    (Universidad de Murcia. Facultad de Ciencias Socio-Sanitarias de Lorca., ) Dato Vidal, Mercedes; Romera Guirado, Francisco José; Ciencias Sociosanitarias (Lorca)
    Las heridas crónicas continúan siendo un importante problema de salud pública, tanto en España como en otros países de nuestro entorno afectando a pacientes de todos los niveles asistenciales. Ello plantea a los profesionales de la salud un desafío en la curación de las mismas. Se ha experimentado un notable avance en la aplicación el plasma rico en plaquetas y sus derivados, aunque existen ciertas controversias en cuanto a la mejora de la cicatrización de estas heridas. Objetivo: analizar la efectividad del uso de plasma rico en plaquetas en pacientes adultos para promover la cicatrización de las heridas crónicas. Metodología: se realiza una revisión bibliográfica de la literatura científica mediante búsqueda en diferentes bases de datos y limitándose esta búsqueda a artículos publicados en los últimos 10 años, en idiomas en inglés y español. Resultados: se incluyeron 8 estudios que proporcionan información científica sobre la eficacia del uso de plasma rico en plaquetas en la mejora de la cicatrización de las heridas crónicas. En total se seleccionaros 2 revisiones sistemáticas, una de ellas con meta-análisis y 3 ensayos clínicos aleatorizados, así como 3 Guías de Práctica Clínica. Conclusiones: el plasma rico en plaquetas puede mejorar la cicatrización de las heridas crónicas, disminuyendo el área, el tiempo de curación y la mínima aparición de efectos adversos. Es necesario protocolizar la producción del PRP, su cantidad y composición y la frecuencia de aplicación, a la vez que se recomienda la elaboración de trabajos con alta evidencia científica para poder discernir más fehacientemente la efectividad de dicho tratamiento. Palabras clave: Heridas crónicas, Úlceras, Plasma rico en plaquetas y Cicatrización de heridas.Chronic wounds continue to be an important public health problem, both in Spain and in other countries of our environment affecting patients of all levels of care. This is a challenge for health professionals in order to cure them. Significant progress has been made in the application of platelet-rich plasma and its derivatives, although there are some controversies regarding the improvement of the healing of these wounds. Objective: to analyze the effectiveness of the use of platelet-rich plasma in adult patients to promote the healing of chronic wounds. Methodology: a bibliographical review of the scientific literature has been carried out through a search in different databases and this search has been limited to articles published in the last 10 years, in English or Spanish languages. Results: eight studies providing scientific information on the efficacy of the use of platelet-rich plasma in improving healing of chronic wounds were included. In total, 2 systematic reviews were selected, one with meta-analysis and 3 randomized clinical trials, as well as 3 clinical practice guidelines. Conclusions: platelet-rich plasma can improve the healing of chronic wounds, decreasing the area, healing time and minimal occurrence of adverse effects. It is necessary to record platelet-rich plasma production, its quantity and composition and frequency of application. It is also recommended the elaboration of works with high scientific evidence to be able to discern more reliably the effectiveness of this treatment. Key words: Chronic wounds, Ulcer, Platelet-rich plasma and Wound healing.