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Publication : Novel mechanisms of Collagenase Santyl Ointment (CSO) in wound macrophage polarization and resolution of wound inflammation.

First Author  Das A Year  2018
Journal  Sci Rep Volume  8
Issue  1 Pages  1696
PubMed ID  29374192 Mgi Jnum  J:260139
Mgi Id  MGI:6148455 Doi  10.1038/s41598-018-19879-w
Citation  Das A, et al. (2018) Novel mechanisms of Collagenase Santyl Ointment (CSO) in wound macrophage polarization and resolution of wound inflammation. Sci Rep 8(1):1696
abstractText  Collagenases are useful in enzymatic wound debridement. Clostridial collagenase, marketed as Collagenase Santyl Ointment (CSO), is FDA approved for such use. Building on the scientific premise that collagenases as well as collagen degradation products may regulate immune cell function, we sought to investigate the potential role of CSO in wound inflammation. We tested the hypothesis that in addition to enacting debridement, CSO contributes to the resolution of persistent wound inflammation. Wound macrophages were isolated from PVA sponges loaded with CSO or petrolatum and implanted in mice. Significant increase in pro-reparative and decrease in pro-inflammatory polarization was noted in macrophages of acute as well as diabetic wounds. Wound macrophages from CSO-treated group displayed increased production of anti-inflammatory cytokines IL-10 and TGF-beta, and decreased levels of pro-inflammatory cytokines TNF-alpha and IL-1beta. The active ingredient of CSO, CS-API, induced the expression of mvarphi(heal) /M(IL-4) polarization markers ex vivo. CS-API treatment attenuated transactivation of NF-kappaB and significantly induced STAT6 phosphorylation. A significant role of a novel PGE2-EP4 pathway in CS-API induced STAT6 activation and the mvarphi(heal) /M(IL-4) polarization was identified. Taken together, findings of this work reposition CSO as a potential agent that may be effective in resolving wound inflammation, including diabetic wounds.
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