How Might Protein Alteration From NPWT Affect Wound Healing?

Excellent continued efforts in elucidating the role that perturbation of the wound matrix (via negative pressure wound therapy (NPWT)) has on angiogenesis, healing and regeneration. A recent study in Molecular Medicine Reports used label-free quantitative mass spectrometry to analyze differences in granulation tissue protein expression profiles before and after NPWT for patients with diabetic foot ulcers (DFUs).¹ They aimed to take a closer look at how NPWT promotes DFU healing. As such, the study identified multiple novel proteins altered by NPWT, paving the way for future studies in this area.

Researchers looked at three patients hospitalized for Wagner grade 3 DFUs and who underwent NPWT for one week. Granulation tissue samples prior to and following NPWT for that week underwent Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses, along with western blot and ELISA tests. The samples showed 36 proteins with significant differences (P<0.05), 33 with upregulation and three proteins with downregulation. They found that the proteins altered after NPWT mainly associated with the following processes:¹

•  antioxidation and detoxification;
•  the cytoskeleton;
•  regulation of the inflammatory response;
•  complement and coagulation cascades; and
•  lipid metabolism.

Functional validation showed that cathepsin S in peripheral blood and granulation tissue were significantly lower than prior to NPWT. Protein S isoform 1, inter α-trypsin inhibitor heavy chain H4 and peroxiredoxin-2 in peripheral blood and granulation tissue were significantly higher than prior to NPWT.¹

I believe this adds to the growing body of literature that supports a contention that negative pressure wound therapy has profound pro-angiogenic and possibly also anti-inflammatory mechanisms. This further supports the concept that perturbation of the wound matrix through this (and likely other) types of energy/mechanism yields mostly beneficial signals that we are only beginning to understand. 

Dr. Armstrong is Professor of Surgery at the Keck School of Medicine at the University of Southern California. He is the Director of the Southwestern Academic Limb Salvage Alliance (SALSA). 

Editor’s note: This blog originally appeared at: https://diabeticfootonline.com/2021/10/10/proteomics-changes-after-negative-pressure-wound-therapy-in-diabetic-foot-ulcers/. It is adapted with permission from the author.

Reference

1. Jia Z, Liu L, Zhang S, et al. Proteomics changes after negative pressure wound therapy in diabetic foot ulcers. Mol Med Rep. 2021;24(6):834.