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Researchers discover the nature of diabetic wounds

EMMA BORNE | Wednesday, November 6, 2013

Notre Dame researchers led by Mayland Chang, Notre Dame research professor and director of the Chemistry-Biochemistry-Biology Interface (CBBI) Program, have identified the enzymes responsible for diabetic wounds, as well as those that are remedial.

Chang said diabetic wound research is important today due to the harm these wounds inflict on patients and the lack of treatment for them.

“We focus on diseases of the extracellular matrix for which there [are] unmet medical needs. The refractory nature of diabetic wounds result in 66,000 lower-limb amputations every year in the U.S.,” Chang said. “There are no therapeutics for the treatment of diabetic wounds and currently treatment is mostly … to remove dead tissue and keep [the wound] clean from infection.”

Chang said the lab group working on the problem consists of about 30 people, mostly postdoctoral students and senior scientists with a few graduate students.

The research group’s biggest success has been reaching an understanding of the behavior of the enzymes active in diabetic wounds, Chang said.

“[The key was] understanding the basis of diabetic wound healing, the enzymes involved in why wounds do not heal … the enzymes that play a role in repairing the wounds, [and also] the discovery and development of inhibitors that selectively target the detrimental enzyme while sparing the beneficial one.”

Chang said, in a Notre Dame press release on the research, this new discovery would help improve treatment.

“Currently, advanced wound dressings containing collagen are used for diabetic wound healing,” Chang said. “The collagen provides a substrate so that the unregulated [harmful enzyme] chews on the collagen in the dressing, rather than on the wound. It would be better to treat the diabetic wounds with a … [harmful enzyme] inhibitor to inhibit the culprit enzyme that is impeding wound healing while leaving the beneficial [enzyme] uninhibited to help repair the wound.”

According to the press release, the team has done most their work using mice, but Chang said they want to move the project forward in the wake of their latest discovery.

“We plan to study chronic wounds in diabetic patients,” Chang said. “The standard of care is debridement of the wounds. We want to analyze this wound tissue in diabetic patients to determine which [enzymes] are present. This will support that the animal model is relevant to the clinical situation and gives us confidence that what works in animals will work in humans.”

Contact Emma Borne at eborne@nd.edu