Premium
TOPICAL OXYGEN THERAPY INDUCES VASCULAR ENDOTHELIAL GROWTH FACTOR EXPRESSION AND IMPROVES CLOSURE OF CLINICALLY PRESENTED CHRONIC WOUNDS
Author(s) -
Gordillo Gayle M,
Roy Sashwati,
Khanna Savita,
Schlanger Richard,
Khandelwal Sorabh,
Phillips Gary,
Sen Chandan K
Publication year - 2008
Publication title -
clinical and experimental pharmacology and physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 103
eISSN - 1440-1681
pISSN - 0305-1870
DOI - 10.1111/j.1440-1681.2008.04934.x
Subject(s) - medicine , chronic wound , wound healing , diabetes mellitus , vascular endothelial growth factor , population , hyperbaric oxygen , surgery , pharmacology , vegf receptors , endocrinology , environmental health
SUMMARY1 Chronic wounds, especially in diabetics, represent a serious threat to human health. 2 Correcting a compromised state of tissue oxygenation by the administration of supplemental O 2 is known to benefit wound healing. Beyond its role as a nutrient and antibiotic, O 2 supports wound healing by driving redox signaling. 3 Hyperbaric oxygen (HBO) therapy is widely used and approved by Center for Medicare and Medicaid Services to treat specific ulcerations. The current literature supports the notion that approaches to topically oxygenate wounds may be productive. 4 Here, we present the results of two simultaneous studies testing the effects of HBO and portable topical oxygen (TO) therapies. These two therapeutic approaches have several contrasting features. 5 In total, 1854 patients were screened in outpatient wound clinics for non‐randomized enrolments into the HBO ( n = 32; 31% diabetic) and TO ( n = 25; 52% diabetic) studies. 6 Under the conditions of the present study, HBO treatment seemed to benefit some wounds while not benefiting others. Overall, HBO did not result in statistically significant improvements in wound size in the given population over the time monitored in the present study. 7 However, TO significantly improved wound size. Among the three O 2 ‐sensitive genes ( VEGF , TGFb1 and COL1A1 ) studied in wound edge tissue biopsies, TO treatment was associated with higher VEGF165 expression in healing wounds. Expression of the other genes mentioned was not affected by TO. There was no significant change in the expression levels of any of genes studied in patients in the HBO study. This establishes a link between VEGF gene expression and healing outcome for TO therapy. 8 Taken together, the present study provides evidence demonstrating that TO treatment benefits wound healing in patients suffering from chronic wounds. Treatment with TO is associated with an induction of VEGF expression in wound edge tissue and an improvement in wound size.