Peptide-coated skin substitutes for the treatment of burn injuries and wounds

描述（由申请人提供）：烧伤和慢性伤口给患者和美国医疗保健系统带来了重大负担。在美国，每年有450，000名烧伤患者需要医疗治疗，45，000名烧伤患者需要住院治疗。与严重烧伤相关的死亡率可高达10%，其中75%的患者死亡是由感染引起的。除了感染的风险外，烧伤伤口闭合延迟会延长疼痛，增加肥厚性瘢痕或移植物排斥的机会，并增加手术次数。与此同时，美国有60万至150万患者发生静脉溃疡，其中35-45%的患者对目前的治疗没有反应。此外，15%至20%的糖尿病患者会遭受慢性足部伤口，其中高达27%的伤口最终需要截肢。干细胞可以通过加速血管化和胶原沉积的速率以及通过减弱炎症反应来解决烧伤和伤口治疗中未满足的需求。脂肪来源的间充质干细胞（ASC）和骨髓来源的间充质干细胞（BMSC）分泌对于新血管形成、细胞外基质（ECM）重塑和减轻炎症反应至关重要的广泛蛋白质。多项临床前和临床报告表明，ASCs和BMSCs可改善烧伤和急性及慢性伤口的愈合。然而，使用扩增和培养的细胞增加了医疗程序的时间和成本，并可能延误治疗。因此，可以在护理点从自体组织中捕获ASC或BMSC的产品将比使用培养的细胞具有显著的优势。在这个项目中，我们建议开发一种用于皮肤替代品的肽涂层，以在护理点捕获和保留ASC。当用于治疗慢性伤口和严重烧伤时，肽涂层皮肤替代品将加速血管化和愈合，并为患者提供更好的结果。

DESCRIPTION (provided by applicant): Burn injuries and chronic wounds present a significant burden to patients and the US healthcare system. Each year in the US, there are 450,000 burns that require medical treatment and 45,000 burn patients that require hospitalization. The mortality rate associated with severe burns can be as high as 10%, with 75% of patient deaths arising from infection. In addition to the risk of infection, delays in burn wound closure prolong pain, increase the chance of hypertrophic scarring or graft rejection, and multiply the number of operative procedures. Meanwhile, venous ulcers occur in 600,000 to 1,500,000 US patients, and 35-45% of these patients will not respond to current treatments. In addition, 15% to 20% of patients with diabetes will suffer a chronic foot wound, and up to 27% of these wounds will eventually require amputation. Stem cells can address the unmet needs in burn and wound therapy by accelerating the rate of vascularization and collagen deposition and by attenuating the inflammatory response. Adipose-derived mesenchymal stem cells (ASCs) and bone marrow-derived mesenchymal stem cells (BMSCs) secrete a broad range of proteins that are crucial for neovascularization, extracellular matrix (ECM) remodeling, and the attenuation of an inflammatory response. Multiple pre-clinical and clinical reports suggest that ASCs and BMSCs improve healing of burn injuries and acute and chronic wounds. However, the use of expanded and cultured cells increases the time and cost of medical procedures and can delay treatment. Therefore, a product that can capture ASCs or BMSCs from autologous tissue at the point-of-care would have significant advantages over the use of cultured cells. In this project, we propose to develop a peptide coating for skin substitutes to capture and retain ASCs at the point-of- care. When used to treat chronic wounds and severe burns, the peptide-coated skin substitute will accelerate vascularization and healing and provide substantially better outcomes for patients.