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Measurements in Wound Healing pp 243–258Cite as

Measurement of Biomarkers for Impaired Healing in Fluids and Tissues

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Abstract

Assessments of the molecular and cellular environment of acute, healing skin wounds demonstrates that healing progresses through four distinct phases of hemostasis, inflammation, repair, and remodeling. Extensive laboratory analyses of wound fluids and biopsies from acute wounds in each of these phases show the actions of cells are tightly regulated by key cytokines, growth factors, proteases, and extracellular matrix components in a process of dynamic reciprocal signaling. In contrast, analyses of fluids and biopsies from delayed healing or dehisced acute wounds or chronic wounds show there are extensive alterations of these key regulatory proteins that disrupt the dynamic reciprocal signaling and results in impaired healing. Typical alterations include elevated levels of planktonic and biofilm bacteria, elevated levels of pro-inflammatory cytokines (TNFa, IL-1), elevated levels of proteases (matrix metalloproteinases (MMPs) and neutrophil elastase (NE)), denatured extracellular matrix proteins (collagen, fibronectin) and cellular receptors (TGFb-RII, integrins). Correlation of these alterations with healing of chronic wounds show that healing only progresses when the abnormal molecular environment is corrected by appropriate clinical interventions and treatments. To help wound care providers assess the molecular status of wounds, rapid, point-of-care detectors for key biomarkers have been developed for measuring levels of MMPs and NE in wound fluids. Comprehensive identification of bacterial and fungal species in wound biopsies are available using rapid, advanced, polymerase chain reaction (PCR) technologies that identify unique genomic nucleotide sequences of micro-organisms. These measurements of molecular biomarkers and microbiological status of wounds enable optimal wound care therapies to be selected for individual patients.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Institute for Wound Research, University of Florida, 1600 SW Archer Rd. M337F, Gainesville, FL, 32610-0294, USA

    Gregory S. Schultz Ph.D.

  2. Department of Biochemistry and Molecular Biology, Institute for Wound Research, University of Florida, 1600 SW Archer Rd. M337F, Gainesville, FL, 32610-0294, USA

    Daniel J. Gibson M.S.

Authors
  1. Gregory S. Schultz Ph.D.
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  2. Daniel J. Gibson M.S.
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Corresponding author

Correspondence to Gregory S. Schultz Ph.D. .

Editor information

Editors and Affiliations

  1. School of Medicine, University of Southampton, Tremona Road, Southampton, SO16 6YD, United Kingdom

    Raj Mani

  2. Centro SERRA, Università di Pisa, Lungarno Pacinotti 43, Pisa, 56100, Italy

    Marco Romanelli

  3. Banaras Hindu University, Varanasi, New F. Jodhpur Colony 6, Varanasi, 221 005, India

    Vijay Shukla

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© 2012 Springer-Verlag London

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Schultz, G.S., Gibson, D.J. (2012). Measurement of Biomarkers for Impaired Healing in Fluids and Tissues. In: Mani, R., Romanelli, M., Shukla, V. (eds) Measurements in Wound Healing. Springer, London. https://doi.org/10.1007/978-1-4471-2987-5_13

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  • DOI: https://doi.org/10.1007/978-1-4471-2987-5_13

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2986-8

  • Online ISBN: 978-1-4471-2987-5

  • eBook Packages: MedicineMedicine (R0)

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