Chronic Venous Leg Ulcers - Current and Future Therapies to Target Neutrophil Activity

2.50
Hdl Handle:
http://hdl.handle.net/10755/308638
Category:
Abstract
Type:
Presentation
Title:
Chronic Venous Leg Ulcers - Current and Future Therapies to Target Neutrophil Activity
Author(s):
McDaniel, Jodi
Lead Author STTI Affiliation:
Epsilon
Author Details:
Jodi McDaniel, PhD, MS, RN, mcdaniel.561@osu.edu
Abstract:

Session presented on: Monday, November 18, 2013

Chronic venous leg ulcers (CVLUs) pose significant global healthcare burdens because of high prevalence and recurrence rates.  In the United States alone, CVLUs affect approximately 600,000 people annually and accrue yearly treatment costs of $2.5-5 billion.  Furthermore, it is predicted that as the population ages, demands on healthcare resources for CVLU treatments will drastically increase. Thus, it is critical that factors associated with CVLUs be discerned and adjuvant, evidence-based therapies be identified.  Previous studies have suggested that the pathogenesis of CVLUs involves the prolonged presence of high numbers of activated neutrophils secreting excessive proteases in wound beds that prolong inflammation, and destroy growth factors, receptors and the extracellular matrix that are essential for healing.  However, further evidence is needed before innovative treatments targeting neutrophils are recommended for CVLU care.  Therefore, the primary purpose of this project was to review observational or intervention studies from the past 15 years that characterized neutrophil activity in the microenvironment of human CVLUs for new evidence explicating the relationship between excessive, sustained neutrophil activity and CVLUs. Other principal goals were to review 1) the function of neutrophils in wound healing, and 2) appraise the strength of evidence for current and potential therapeutics that target excessive neutrophil activity.  A literature search was conducted with PubMed, Medline and Cochrane databases. The collective evidence suggests that upregulated neutrophil activity impedes CVLU healing. The evidence also supports using novel wound dressings that sequester proteases or deliver inhibitors of neutrophil-derived proteases directly in the biochemical environment of CVLUs.  In addition to specialized dressings, studies show that two systemic agents, pentoxifylline and micronized purified flavonoid fraction, are effective in modulating neutrophil activity. Therefore, adjunctive therapies that target excessive neutrophil activity may assist with resolving the persistent inflammation associated with CVLUs and improve healing outcomes for patients with these tenacious wounds.

 

Keywords:
Targeted Therapies; Chronic Venous Leg Ulcers; Neutrophils
Repository Posting Date:
19-Dec-2013
Date of Publication:
19-Dec-2013
Conference Date:
2013
Conference Name:
42nd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriott

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleChronic Venous Leg Ulcers - Current and Future Therapies to Target Neutrophil Activityen_GB
dc.contributor.authorMcDaniel, Jodien_GB
dc.contributor.departmentEpsilonen_GB
dc.author.detailsJodi McDaniel, PhD, MS, RN, mcdaniel.561@osu.eduen_GB
dc.identifier.urihttp://hdl.handle.net/10755/308638-
dc.description.abstract<p>Session presented on: Monday, November 18, 2013</p>Chronic venous leg ulcers (CVLUs) pose significant global healthcare burdens because of high prevalence and recurrence rates.  In the United States alone, CVLUs affect approximately 600,000 people annually and accrue yearly treatment costs of $2.5-5 billion.  Furthermore, it is predicted that as the population ages, demands on healthcare resources for CVLU treatments will drastically increase. Thus, it is critical that factors associated with CVLUs be discerned and adjuvant, evidence-based therapies be identified.  Previous studies have suggested that the pathogenesis of CVLUs involves the prolonged presence of high numbers of activated neutrophils secreting excessive proteases in wound beds that prolong inflammation, and destroy growth factors, receptors and the extracellular matrix that are essential for healing.  However, further evidence is needed before innovative treatments targeting neutrophils are recommended for CVLU care.  Therefore, the primary purpose of this project was to review observational or intervention studies from the past 15 years that characterized neutrophil activity in the microenvironment of human CVLUs for new evidence explicating the relationship between excessive, sustained neutrophil activity and CVLUs. Other principal goals were to review 1) the function of neutrophils in wound healing, and 2) appraise the strength of evidence for current and potential therapeutics that target excessive neutrophil activity.  A literature search was conducted with PubMed, Medline and Cochrane databases. The collective evidence suggests that upregulated neutrophil activity impedes CVLU healing. The evidence also supports using novel wound dressings that sequester proteases or deliver inhibitors of neutrophil-derived proteases directly in the biochemical environment of CVLUs.  In addition to specialized dressings, studies show that two systemic agents, pentoxifylline and micronized purified flavonoid fraction, are effective in modulating neutrophil activity. Therefore, adjunctive therapies that target excessive neutrophil activity may assist with resolving the persistent inflammation associated with CVLUs and improve healing outcomes for patients with these tenacious wounds. <p><b> </b>en_GB
dc.subjectTargeted Therapiesen_GB
dc.subjectChronic Venous Leg Ulcersen_GB
dc.subjectNeutrophilsen_GB
dc.date.available2013-12-19T17:33:56Z-
dc.date.issued2013-12-19-
dc.date.accessioned2013-12-19T17:33:56Z-
dc.conference.date2013en_GB
dc.conference.name42nd Biennial Conventionen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationIndianapolis, Indiana, USAen_GB
dc.description42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriotten_GB
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