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      Glucocorticoid-mediated induction of caveolin-1 disrupts cytoskeletal organization, inhibits cell migration and re-epithelialization of non-healing wounds

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          Abstract

          Although impaired keratinocyte migration is a recognized hallmark of chronic wounds, the molecular mechanisms underpinning impaired cell movement are poorly understood. Here, we demonstrate that both diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) exhibit global deregulation of cytoskeletal organization in genomic comparison to normal skin and acute wounds. Interestingly, we found that DFUs and VLUs exhibited downregulation of ArhGAP35, which serves both as an inactivator of RhoA and as a glucocorticoid repressor. Since chronic wounds exhibit elevated levels of cortisol and caveolin-1 (Cav1), we posited that observed elevation of Cav1 expression may contribute to impaired actin-cytoskeletal signaling, manifesting in aberrant keratinocyte migration. We showed that Cav1 indeed antagonizes ArhGAP35, resulting in increased activation of RhoA and diminished activation of Cdc42, which can be rescued by Cav1 disruption. Furthermore, we demonstrate that both inducible keratinocyte specific Cav1 knockout mice, and MβCD treated diabetic mice, exhibit accelerated wound closure. Taken together, our findings provide a previously unreported mechanism by which Cav1-mediated cytoskeletal organization prevents wound closure in patients with chronic wounds.

          Abstract

          Jozic et al observe deregulated cytoskeleton components and elevated levels of cortisol and caveolin-1 in chronic wounds. They also show that inducible-keratinocyte specific Cav1 knockout or drug-induced cholesterol disruption in diabetic mice leads to accelerated wound closure suggesting a therapeutic approach for diabetic foot ulcers.

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          Wound repair and regeneration: mechanisms, signaling, and translation.

          The cellular and molecular mechanisms underpinning tissue repair and its failure to heal are still poorly understood, and current therapies are limited. Poor wound healing after trauma, surgery, acute illness, or chronic disease conditions affects millions of people worldwide each year and is the consequence of poorly regulated elements of the healthy tissue repair response, including inflammation, angiogenesis, matrix deposition, and cell recruitment. Failure of one or several of these cellular processes is generally linked to an underlying clinical condition, such as vascular disease, diabetes, or aging, which are all frequently associated with healing pathologies. The search for clinical strategies that might improve the body's natural repair mechanisms will need to be based on a thorough understanding of the basic biology of repair and regeneration. In this review, we highlight emerging concepts in tissue regeneration and repair, and provide some perspectives on how to translate current knowledge into viable clinical approaches for treating patients with wound-healing pathologies.
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            Challenges in the Treatment of Chronic Wounds

            Significance: Chronic wounds include, but are not limited, to diabetic foot ulcers, venous leg ulcers, and pressure ulcers. They are a challenge to wound care professionals and consume a great deal of healthcare resources around the globe. This review discusses the pathophysiology of complex chronic wounds and the means and modalities currently available to achieve healing in such patients. Recent Advances: Although often difficult to treat, an understanding of the underlying pathophysiology and specific attention toward managing these perturbations can often lead to successful healing. Critical Issues: Overcoming the factors that contribute to delayed healing are key components of a comprehensive approach to wound care and present the primary challenges to the treatment of chronic wounds. When wounds fail to achieve sufficient healing after 4 weeks of standard care, reassessment of underlying pathology and consideration of the need for advanced therapeutic agents should be undertaken. However, selection of an appropriate therapy is often not evidence based. Future Directions: Basic tenets of care need to be routinely followed, and a systematic evaluation of patients and their wounds will also facilitate appropriate care. Underlying pathologies, which result in the failure of these wounds to heal, differ among various types of chronic wounds. A better understanding of the differences between various types of chronic wounds at the molecular and cellular levels should improve our treatment approaches, leading to better healing rates, and facilitate the development of new more effective therapies. More evidence for the efficacy of current and future advanced wound therapies is required for their appropriate use.
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              Human skin wounds: a major and snowballing threat to public health and the economy.

              ABSTRACT In the United States, chronic wounds affect 6.5 million patients. An estimated excess of US$25 billion is spent annually on treatment of chronic wounds and the burden is rapidly growing due to increasing health care costs, an aging population and a sharp rise in the incidence of diabetes and obesity worldwide. The annual wound care products market is projected to reach $15.3 billion by 2010. Chronic wounds are rarely seen in individuals who are otherwise healthy. In fact, chronic wound patients frequently suffer from "highly branded" diseases such as diabetes and obesity. This seems to have overshadowed the significance of wounds per se as a major health problem. For example, NIH's Research Portfolio Online Reporting Tool (RePORT; http://report.nih.gov/), directed at providing access to estimates of funding for various disease conditions does list several rare diseases but does not list wounds. Forty million inpatient surgical procedures were performed in the United States in 2000, followed closely by 31.5 million outpatient surgeries. The need for post-surgical wound care is sharply on the rise. Emergency wound care in an acute setting has major significance not only in a war setting but also in homeland preparedness against natural disasters as well as against terrorism attacks. An additional burden of wound healing is the problem of skin scarring, a $12 billion annual market. The immense economic and social impact of wounds in our society calls for allocation of a higher level of attention and resources to understand biological mechanisms underlying cutaneous wound complications.
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                Author and article information

                Contributors
                i.jozic@med.miami.edu
                MTCanic@med.miami.edu
                Journal
                Commun Biol
                Commun Biol
                Communications Biology
                Nature Publishing Group UK (London )
                2399-3642
                18 June 2021
                18 June 2021
                2021
                : 4
                : 757
                Affiliations
                [1 ]GRID grid.26790.3a, ISNI 0000 0004 1936 8606, Wound Healing and Regenerative Medicine Research Program, Department of Dermatology and Cutaneous Surgery, , University of Miami Miller School of Medicine, ; Miami, FL USA
                [2 ]GRID grid.266902.9, ISNI 0000 0001 2179 3618, Departments of Ophthalmology, Physiology, and Oklahoma Center for Neuroscience, , University of Oklahoma Health Sciences Center, ; Oklahoma City, OK USA
                [3 ]GRID grid.26790.3a, ISNI 0000 0004 1936 8606, Department of Biomedical Engineering, , University of Miami, ; Coral Gables, FL USA
                [4 ]GRID grid.26790.3a, ISNI 0000 0004 1936 8606, Department of Surgery, , University of Miami Miller School of Medicine, ; Miami, FL USA
                [5 ]GRID grid.26790.3a, ISNI 0000 0004 1936 8606, John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, ; Miami, FL USA
                Author information
                http://orcid.org/0000-0001-5114-9524
                http://orcid.org/0000-0001-6307-7986
                http://orcid.org/0000-0003-0197-6198
                http://orcid.org/0000-0002-9341-0193
                Article
                2298
                10.1038/s42003-021-02298-5
                8213848
                34145387
                8e251ee2-1f7d-4e91-bdbf-b2204b472b4e
                © The Author(s) 2021

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 11 March 2021
                : 28 May 2021
                Funding
                Funded by: FundRef https://doi.org/10.13039/100001797, Pharmaceutical Research and Manufacturers of America Foundation (PhRMA Foundation);
                Funded by: Medline Wound Healing Foundation Innovation Grant; Stanley J. Glaser Research Award
                Funded by: FundRef https://doi.org/10.13039/100000002, U.S. Department of Health & Human Services | National Institutes of Health (NIH);
                Award ID: R01 EY019494
                Award ID: AR073614
                Award ID: U01DK119085
                Award ID: U24DK115255
                Award Recipient :
                Funded by: Oklahoma Center for Adult Stem Cell Research
                Funded by: U.S. Department of Health & Human Services | National Institutes of Health (NIH)
                Funded by: U.S. Department of Health & Human Services | National Institutes of Health (NIH)
                Funded by: U.S. Department of Health & Human Services | National Institutes of Health (NIH)
                Funded by: Organogenesis Inc. Research Grant University of Miami Scientific Awards Committee SAC-2013-19
                Categories
                Article
                Custom metadata
                © The Author(s) 2021

                actin,translational research,skin diseases
                actin, translational research, skin diseases

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