Hyaluronan-Based Hybrid Systems as Growth Factor Carriers in the Treatment of Chronic Wounds
Aneta Ostróżka-Cieślik, Archana Tanwar, Monika Michalak
Abstract
The treatment of wounds, most of which are complications of chronic diseases, poses a significant clinical challenge. Hybrid systems based on hyaluronic acid containing growth factors are a promising prospect for the treatment of chronic wounds. Hyaluronic acid supports fibroblast proliferation, migration, and adhesion to the wound site, and stimulates collagen production. Growth factors (GF), such as epidermal growth factor (EGF), fibroblast growth factor (FGF), and vascular endothelial growth factor (VEGF), influence the normal proliferation and migration of keratinocytes and fibroblasts. This review aims to summarise the current state of knowledge regarding their therapeutic potential. Google Scholar, Web of Science, and Medline (PubMed) databases were searched. Eighteen studies, including basic, preclinical, and clinical studies, were included in the review. The studies confirm the therapeutic potential of the developed formulations. Collagen/hyaluronic acid and alginate/hyaluronic acid systems are biocompatible and biodegradable matrices that provide a moist wound environment, which promotes cell migration and proliferation. EGF stimulates the proliferation and migration of keratinocytes, which accelerates re-epithelialisation. bFGF supports angiogenesis by stimulating the proliferation and migration of vascular endothelial cells. The effect of these actions indirectly leads to increased production of VEGF and HGF cytokines, which support the formation of granulation tissue. The VEGF-containing dressing stimulated vascularisation and the production of collagen type-1 and fibronectin. Only one clinical study conducted in this field indicates the need for further research in this area.