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Biomarker in der Wundheilung und Wundbehandlung

Biomarkers in wound healing and treatment

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Gefässchirurgie Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Diagnostische Optionen um das vorherrschende komplexe Milieu chronischer, schwer heilbarer Wunden zu analysieren und die Wundbehandlung zu steuern sind rar. Um moderne Therapieoptionen adäquat zu navigieren, sind Steuerparameter jedoch dringend nötig. Biomarker können hier ein „diagnostisches Fenster“ für die Zukunft der individualisierten, personalisierten Wundmedizin öffnen.

Ziel der Arbeit

Darstellung aktueller Erkenntnisse im Bereich der Biomarker-Entwicklung und Implementation in der Wundheilung und Wundbehandlung.

Material und Methoden

Eine ausführliche Literaturrecherche medizinischer Datenbanken (MEDLINE, EMBASE, Cochrane) wurde durchgeführt. Basierend auf der aktuellen Literatur werden potenzielle Biomarker in der Wundheilung und Wundbehandlung dargestellt, erläutert und bewertet. Des Weiteren wird ein Ausblick auf die zukünftige Entwicklung neuer Ansätze der Biomarker-Detektion gegeben.

Ergebnisse und Schlussfolgerungen

Insbesondere die Themen pH-Wert des Wundmilieus, Proteasen und das proteolytische Milieu der Wunde und die objektive Quantifizierung der mikrobiellen Belastung sowie Marker der Wundinfektion und chronischen Inflammation werden in der aktuellen Forschung bearbeitet. Erste vielversprechende Methoden, „Point-of-care“-Diagnostika und Ergebnisse zeigen das Potenzial der biomarkergesteuerten Wundmedizin auf. Moderne Ansätze wie die Analyse biomolekularer Signaturen via OMICS-Methoden können in Zukunft die Diagnostik und individualisierte Therapiesteuerung noch weiter objektivieren und zur Erzielung bessere Therapieerfolge beitragen.

Abstract

Background

Diagnostic options to analyze the prevailing complex microenvironment of chronic difficult to heal wounds and to guide wound treatment are rare; however, monitoring and steering parameters are urgently needed to adequately navigate modern therapeutic options. Biomarkers can open a diagnostic window for the future of individualized, personalized wound medicine.

Objective

Presentation of current findings in the fields of biomarker development and implementation in wound healing and wound treatment.

Material and methods

An extensive literature search of medical databases (MEDLINE, EMBASE, Cochrane) was performed. Based on the current literature, potential biomarkers in wound healing and wound care are presented, explained and evaluated. Furthermore, an outlook on the future development of new approaches of biomarker detection is given.

Results and conclusion

In particular, the topics of the wound microenvironment pH, proteases and the proteolytic environment of the wound, the objective quantification of microbial burden as well as markers of wound infection and chronic inflammation are addressed in the current research. First promising methods, point of care diagnostics and results show the potential of biomarker-driven wound medicine. Modern approaches, such as the analysis of biomolecular signatures via omics methodology can further objectify diagnostics and individualized treatment management in the future and contribute to the achievement of better therapeutic results.

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Authors and Affiliations

  1. Klinik für Gefäß- und Endovaskularchirurgie, Universitätsklinikum Düsseldorf (UKD), Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    Julian-Dario Rembe

  2. Klinik und Poliklinik für Gefäßmedizin, Universitäres Herz- und Gefäßzentrum, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20251, Hamburg, Deutschland

    Ewa Klara Stürmer

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Correspondence to Julian-Dario Rembe.

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Interessenkonflikt

J.-D. Rembe und E.K. Stürmer geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Rembe, JD., Stürmer, E.K. Biomarker in der Wundheilung und Wundbehandlung. Gefässchirurgie 28, 15–23 (2023). https://doi.org/10.1007/s00772-022-00968-0

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  • DOI: https://doi.org/10.1007/s00772-022-00968-0

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