Int Wound J · 2017
Changes in the extracellular matrix surrounding human chronic wounds revealed by 2-photon imaging
Sutcliffe, J.E.S., Thrasivoulou, C., Serena, T.E., Madden, L., Richards, T., Phillips, A.R.J., & Becker, D.L.
International Wound Journal, 2017
In brief
This laboratory study used 2-photon (second harmonic generation) imaging alongside standard histology to examine wound-edge biopsies from 19 patients with venous leg ulcers and 11 with diabetic foot ulcers, compared with normal skin. Collagen was significantly reduced in venous leg ulcer tissue (for example, a 48% decrease in the lower dermis, P < 0.001), elastin was reduced in both wound types, and loss of the tissue matrix went along with higher numbers of CD68- and CD18-positive immune cells. The authors suggest that handheld 2-photon imaging could in future help show whether a chronic wound is healing without taking a biopsy.
Co-authored by Dr. Thomas Serena, SerenaGroup's founder.
Plain-language summary by SerenaGroup. See the full text for complete methods and results.
Abstract
Chronic wounds are a growing problem worldwide with no effective therapeutic treatments available. Our objective was to understand the composition of the dermal tissue surrounding venous leg ulcers and diabetic foot ulcers (DFU). We used novel 2-photon imaging techniques alongside classical histology to examine biopsies from the edges of two common types of chronic wound, venous leg ulcers and DFU. Compared to normal intact skin, we found that collagen levels are significantly reduced throughout the dermis of venous leg ulcer biopsies and DFU, with a reduction in both fibril thickness and abundance. Both wound types showed a significant reduction in elastin in the upper dermis, but in DFU, the loss was throughout the dermis. Loss of extracellular matrix correlated with high levels of CD68- and CD18-positive leukocytes. 2-photon imaging of the extracellular matrix in the intact tissue surrounding a chronic wound with a hand-held device may provide a useful clinical indicator on the healing progression or deterioration of these wounds.
Related in Fluorescence Imaging & Diagnostic Tools
