Amelogenin, an extracellular matrix protein, in the treatment of venous leg ulcers and other hard-to-heal wounds: Experimental and clinical evidence
Amelogenin, an extracellular matrix protein, in the treatment of venous leg ulcers and other hard-to-heal wounds: Experimental and clinical evidence
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釉原蛋白（一种细胞外基质蛋白）用于治疗腿部静脉溃疡和其他难以愈合的伤口：实验和临床证据
DOI：
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发表时间：
2008
影响因子：
3.6
通讯作者：
M. Ågren
中科院分区：
文献类型：
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作者：
M. Romanelli;V. Dini;P. Vowden;M. Ågren
釉原蛋白是细胞外基质蛋白，在生理条件下，自组装成高达微米大小的球状聚集体。对牙周成纤维细胞的研究表明，附着于这些结构增加了多种生长因子的内源性分泌和细胞增殖。临床前和临床研究表明，皮肤伤口受益于用釉原蛋白治疗。一项涉及难以愈合的下肢静脉溃疡（VLU）患者的随机对照试验（RCT）（即，表面积≥10 cm 2且持续时间≥6个月的溃疡）表明，（Xelma®，Molnlycke Health Care，哥德堡，瑞典）作为压迫的辅助治疗导致溃疡尺寸显著减小，溃疡状态改善，疼痛减轻，并且与单独压迫治疗相比，具有低渗液水平的溃疡比例更大。牙釉原蛋白治疗也被证明是安全的，因为在用牙釉原蛋白加压迫治疗的患者和仅用压迫治疗的患者之间观察到的不良事件没有显著差异。病例研究评价表明，在RCT中证实的釉原蛋白治疗的益处在“真实的生活”中得到了重复，并且釉原蛋白治疗也可能在其他伤口类型（如糖尿病足溃疡）的治疗中发挥作用。
Amelogenins are extracellular matrix proteins that, under physiological conditions, self-assemble into globular aggregates up to micron-sizes. Studies with periodontal fibroblasts indicate that attachment to these structures increases the endogenous secretion of multiple growth factors and cell proliferation. Pre-clinical and clinical studies indicate that cutaneous wounds benefit from treatment with amelogenins. A randomized controlled trial (RCT) involving patients with hard-to-heal venous leg ulcers (VLUs) (ie, ulcers with a surface area ≥10 cm2 and duration of ≥6 months) showed that the application of amelogenin (Xelma®, Molnlycke Health Care, Gothenburg, Sweden) as an adjunct treatment to compression results in significant reduction in ulcer size, improvement in the state of ulcers, reduced pain, and a larger proportion of ulcers with low levels of exudate, compared with treatment with compression alone. Amelogenin therapy was also shown to be safe to use in that there were no significant differences in adverse events noted between patients treated with amelogenin plus compression and those treated with compression alone. Case study evaluations indicate that the benefits of amelogenin therapy demonstrated in the RCT are being repeated in “real life” situations and that amelogenin therapy may also have a role to play in the treatment of other wound types such as diabetic foot ulcers.