Topical Estrogen/CB Patch for Wound Healing in Elderly

建议开发一种外用雌激素贴片，其中包括一种可生物降解的壳聚糖生物聚合物(CB)，以促进老年患者的伤口愈合。急性皮肤伤口愈合延迟会导致局部感染、伤口裂开，并过渡到慢性、不可愈合的伤口。最近的临床数据表明，使用局部雌激素透皮贴片可以加速老年患者的伤口愈合。雌激素疗法的缺点之一是形成更多的疤痕。皮肤瘢痕形成是临床上的一个主要问题，涉及功能损害和生长受限。初步研究表明，在CB存在的情况下，成纤维细胞增殖增加。此外，已有报道称，CB可减少体内瘢痕的形成。在这项第一阶段的可行性研究中，我们建议：(1)在动物实验中检测外用雌激素/CB贴片对创面愈合的比率和瘢痕形成潜力；(2)用初步的人体实验来证实动物数据。拟议应用的长期目标是开发一种雌激素贴片，加快老年人的修复速度和愈合质量。建议的商业应用：局部雌激素贴片可能是一种可行的、加速老年人伤口愈合的治疗方法。此外，使用以壳聚糖为基础的生物聚合物基质可以减少疤痕的形成，与雌激素一起使用，有望为伤口愈合提供比目前商业雌激素贴片更好的替代方案。

The development of a topical estrogen patch including a biodegradable chitosan-based biopolymer (CB) to accelerate wound healing in the elderly patients is proposed. Delays in acute cutaneous wound healing lead to local infections, wound dehiscence, and a transition toward chronic, nonhealing wound. Recent clinical data have shown the benefit of using a topical estrogen transdermal patch to accelerate wound healing in elderly patients. One of the disadvantages of estrogen therapy is greater scar formation. Cutaneous scarring is a major clinical problem concerning functional impairment and restricted growth. Preliminary studies have shown increased fibroblast proliferation in the presence of CB. In addition, CB has been reported to reduce scar formation in vivo. In this Phase I feasibility study we propose: (1) to examine the rate and scarring potential of the topical estrogen/CB patch for wound healing in animal studies and (2) to confirm the animal data with preliminary human studies. The long-term goal of the proposed application is to develop an estrogen patch which accelerates the rate of repair as well as the quality of healing in the elderly. PROPOSED COMMERCIAL APPLICATIONS: A topical estrogen patch could be a viable, accelerated wound healing treatment in the elderly. In addition, the use of a chitosan-based biopolymer matrix showing reduced scar formation, together with the estrogen, is expected to provide a better alternative than current commercial transdermal estrogen patches for wound healing applications.