Lung Surfactant Accelerates Skin Wound Healing: A Translational Study with a Randomized Clinical Phase I Study.

Abstract

Lung surfactants are used for reducing alveolar surface tension in preterm infants to ease breathing. Phospholipid films with surfactant proteins regulate the activity of alveolar macrophages and reduce inflammation. Aberrant skin wound healing is characterized by persistent inflammation. The aim of the study was to investigate if lung surfactant can promote wound healing. Preclinical wound models, e.g. cell scratch assays and full-thickness excisional wounds in mice, and a randomized, phase I clinical trial in healthy human volunteers using a suction blister model were used to study the effect of the commercially available bovine lung surfactant on skin wound repair. Lung surfactant increased migration of keratinocytes in a concentration-dependent manner with no effect on fibroblasts. Significantly reduced expression levels were found for pro-inflammatory and pro-fibrotic genes in murine wounds. Because of these beneficial effects in preclinical experiments, a clinical phase I study was initiated to monitor safety and tolerability of surfactant when applied topically onto human wounds and normal skin. No adverse effects were observed. Subepidermal wounds healed significantly faster with surfactant compared to control. Our study provides lung surfactant as a strong candidate for innovative treatment of chronic skin wounds and as additive for treatment of burn wounds to reduce inflammation and prevent excessive scarring.

• Authors: Ursula Mirastschijski, Igor Schwab, Vincent Coger, Ulrich Zier, Carmela Rianna, Wei He, Kathrin Maedler, Sørge Kelm, Arlo Radtke, Gazanfer Belge, Patrick Lindner, Frank Stahl, Martin Scharpenberg, Lukas Lasota, Jürgen Timm
• Journal: Scientific reports (Sci Rep) Vol. 10 Issue 1 Pg. 2581 (02 13 2020) ISSN: 2045-2322 [Electronic] England
• PMID: 32054903 (Publication Type: Clinical Trial, Phase I, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Pulmonary Surfactant-Associated Proteins
• Surface-Active Agents

Topics

• Animals
• Blister (drug therapy, pathology)
• Cell Proliferation (drug effects)
• Cicatrix (drug therapy, pathology)
• Female
• Fibroblasts (drug effects)
• Humans
• Inflammation (drug therapy, pathology)
• Keratinocytes (drug effects)
• Mice
• Pulmonary Surfactant-Associated Proteins (pharmacology)
• Skin (drug effects, injuries, pathology)
• Surface-Active Agents
• Wound Healing (drug effects)