SkinChronicles, No 1, October 2024, by Maria Sanz-Codina
 

Paper: Doerfler P, Schoefmann N, Cabral G, Bauer W, Berli MC, Binder B, et al. Development of a Cellular Assay as a Personalized Model for Testing Chronic Wound  Therapeutics. J Invest Dermatol. 2024 Jul

Chronic, non-healing wounds present a significant clinical challenge, as the standard of care currently is largely symptomatic (1)(2). Non-healing wounds can transition into a healing state, and vice versa, making it essential to monitor these changes to predict healing outcomes and assess treatment efficacy. Although we are tracking these changes, we currently lack the tools to reliably determine which wounds will heal and which will not. While studies have identified potential biomarkers in wound exudates, none have yet been clinically implemented (3).

This study by Doerfler et al. (4) introduces an ex-vivo assay, which focuses on the effect of wound exudates on fibroblast proliferation to predict outcomes for healing. The authors studied the effect of more than 800 wound exudates, from healing and non-healing wounds of diverse etiologies (diabetic foot ulcer, venous/arterial ulcer or trauma/surgery) on the proliferative capacity of fibroblasts. The assay demonstrated a sensitivity of 76-90% in predicting wound-healing outcomes. Non-healing wound exudates induced inflammatory chemokine pathways, whereas these pathways were downregulated in wounds transitioning to a healing phenotype. In the healing cases, fibroblast proliferation and extracellular matrix formation was restored. Finally, the authors also demonstrate the assay’s ability to assess the efficacy of chronic wounds treatments, such as PDGF and silver sulfadiazine.

I chose this paper because it aligns with my passion for advancing personalised treatment strategies to improve therapy effectiveness, monitor healing progress, and predict clinical outcomes. A real-time cellular response assay compared to WE-isolated biomarker analysis offers new possibilities for understanding the complex biology of chronic wounds. This assay offers a practical tool for a clinician to predict wound healing outcomes and tailor treatment strategies for patients with chronic wounds. For a researcher, it represents a shift towards more patient-specific dynamic models, which can further be validated using other cell types and cellular responses. In conclusion, this assay provides a direct link between the laboratory and the clinic, accelerating translational research in wound care.

1. Carter MJ, DaVanzo J, Haught R, Nusgart M, Cartwright D, Fife CE. Chronic wound prevalence and the associated cost of treatment in Medicare beneficiaries: changes between 2014 and 2019. J Med Econ. 2023;26(1):894–901.
2. Falanga V, Isseroff RR, Soulika AM, Romanelli M, Margolis D, Kapp S, et al. Chronic wounds. Nat Rev Dis Prim. 2022 Jul;8(1):50.
3. Bosanquet DC, Harding KG. Wound healing: potential therapeutic options. Br J Dermatol. 2022 Aug;187(2):149–58.
4. Doerfler P, Schoefmann N, Cabral G, Bauer W, Berli MC, Binder B, et al. Development of a Cellular Assay as a Personalized Model for Testing Chronic Wound Therapeutics. J Invest Dermatol. 2024 Jul;