Treatment of Chronic Leg Ulcers With Topical Activated Protein C
Treatment of Chronic Leg Ulcers With Topical Activated Protein C
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DOI：
10.1001/archderm.144.11.1479
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发表时间：
2008-11-01
影响因子：
--
通讯作者：
Jackson, Chris
中科院分区：
文献类型：
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作者：
Whitmont, Kaley;Reid, Ian;Jackson, Chris
背景：皮肤溃疡的治疗经常提出一个管理挑战。对传统伤口管理治疗反应不佳的未愈合伤口是导致残疾的一个重要原因，影响到全球约1%的人口。活化蛋白C是一种丝氨酸蛋白酶，具有抗凝血、血管生成和抗炎特性，在治疗严重脓毒症患者中显示出疗效。我们报告了4例用活化蛋白c治疗的下肢皮肤溃疡未愈合的病例。观察：该研究包括4例患者，尽管标准伤口治疗4个月或更长时间，伤口仍未改善。将活化蛋白C涂抹于创面，每周1次，连续4周。在4个月的随访期间，所有4例患者对治疗均表现出快速的积极反应。治疗耐受性良好，无明显不良反应和并发症。结论：活化蛋白C可促进传统创面愈合治疗难治性皮肤溃疡患者的创面愈合。可能的作用机制是其公认的刺激血管生成和再上皮化以及抑制炎症的能力。活化蛋白C有可能成为慢性皮肤溃疡患者的一种治疗选择。
Background: The treatment of skin ulcers frequently presents a management challenge. Nonhealing wounds with poor response to conventional wound management therapy represent a significant cause of disability, affecting approximately 1% of the global population. Activated protein C is a serine protease with anticoagulant, angiogenic, and anti-inflammatory properties that has shown efficacy in patients for the treatment of severe sepsis. We report 4 cases of nonhealing lower limb skin ulcers that were treated with activated protein C.Observations: The study included 4 patients whose wounds were not improving despite standard wound treatment for 4 months or more. Activated protein C was applied topically to their wounds once weekly for 4 weeks. All 4 patients showed a rapid positive response to treatment that was maintained during a 4-month follow-up period. The treatment was well tolerated, with no remarkable adverse effects or complications.Conclusions: Activated protein C can stimulate wound healing in patients with skin ulcers that are refractory to conventional wound-healing therapies. The likely mechanism of action is its recognized ability to stimulate angiogenesis and reepithelialization and to inhibit inflammation. Activated protein C has potential as a therapeutic option for patients with chronic skin ulcers.