We recently developed a bioresponsive
dextrin-recombinant human
epidermal growth factor (rhEGF) conjugate as a
polymer therapeutic with potential for use in the promotion of tissue repair. The aim of these studies was to use patient-derived
wound fluid and fibroblasts to evaluate its potential for further development as a treatment for chronic
wounds, such as venous leg ulceration, a growing clinical challenge in the aging population. First, the levels of
EGF (ELISA assay),
alpha-amylase and
elastase (
enzyme assays) were measured in patient-derived acute and chronic
wound fluid.
EGF was detected in acute, but not in chronic
wound fluid.
alpha-Amylase concentrations were higher in acute (188 IU/L), compared to chronic
wound fluid (52 IU/L), but both were in the range of human serum levels. Although
elastase was present in chronic
wound fluid (2.1 +/- 1.2 RFU/min), none was detected in acute
wound fluid.
Dextrin-rhEGF incubation in chronic
wound fluid led to endogenous
alpha-amylase-mediated release of rhEGF (ELISA) that was maximal at 48 h. When the migration of HaCaT keratinocytes and of human fibroblasts (isolated from patient-matched, normal skin and chronic dermal
wounds) was studied in vitro using the scratch
wound assay, enhanced cell migration was observed in response to both free rhEGF and
alpha-amylase-activated
dextrin-rhEGF conjugate compared to controls. In addition, fibroblasts displayed increased proliferation (normal dermal fibroblasts approximately 160%; chronic
wound fibroblasts approximately 140%) following incubation (72 h) with
dextrin-rhEGF that had been exposed to physiological levels of
alpha-amylase (93 IU/L). These results suggest further preclinical in vivo evaluation of
dextrin-rhEGF is warranted to determine whether conjugate pharmacokinetics and rhEGF liberation into such a complex and aggressive environment can still lead to bioactivity.