You get a cut, you bandage it. With a little bit of time the wound heals and you take the bandage off. Done and done.
But what if it didn't heal? What if your cut stayed open? What if it wouldn't allow your skin to heal? Believe it or not, 20 to 25 per cent of patients in long-term care facilities, as well as the elderly, people suffering from diabetes, people who are immobile, and those who are obese are highly susceptible to developing skin wounds that do not close and heal properly, according to Providence Health Care, a faith-based private health care organization.
But all that could change in the next two years.
Dr. David Granville, a Port Coquitlam resident, is the principal investigator researching what could be the answer to sealing the wounds that just won't shut.
"Chronic wounds get stuck in the inflammation stage," he explained in an interview with the Tri-Cities NOW. "What happens then is the body releases a lot of enzymes. But the problem with the body doing this is it doesn't get a chance to build the foundation."
It's like rebuilding a wall, Granville said, but while you're constructing it, termites are eating away at the wood. The "Granzyme B" is that termite, degrading the foundations of your skin and leaving your body vulnerable.
"So what we found was when we inhibited the protein genetically, we were able to not only increase the wound closure, but also the strength of the skin," he said.
Granville is professor of pathology and laboratory medicine at the University of British Columbia, as well as principal investigator at the Centre for Heart and Lung Innovation at St. Paul's Hospital in Vancouver.
He said the discovery is extremely important because elderly patients or those suffering from diabetes can have wounds close, but underneath the skin is very fragile.
"That makes them really highly susceptible to re-opening the wound," he said. "It's a huge problem with the elderly, because it's as easy as bumping into a desk and they can tear their skin."
Providence reports that between $4-to-6 billion a year is spent on long-term health care and hospitals in the U.S. alone.
"The degree of morbidity and mortality associated with these wounds is similar to that of many types of cancer," the press release states.
This is the first study to show that inhibiting this protein-degrading enzyme can restore normal wound healing, according to the study.
So far, the research team headed by Granville has worked with mice and has consistently shown promising results.
Given the success of the study, it's possible that human clinical trials could start in about two years after further testing and scrupulous safety procedures.
But if all goes well it could be as easy as applying sun block, a simple ointment to spread over the troubled area, Granville said.
"It would be some kind of a topical ointment or cream" he said. "Topical formulation basically that can be applied underneath the bandages."
Oddly enough, Granville and his team stumbled upon this discovery of the Granzyme B enzyme by accident when he was researching aortic aneurysms.
"I'm a cardiovascular researcher by trade," he said. "We started out studying enzymes in cardiovascular research... We were looking at alleviating these aortic aneurysms, but when we were genetically fitting these enzymes we found they had effects on the skin."
That was more than three years ago, and since then Granville and his team decided to apply this knowledge into sealing chronic non-closing wounds, a field that hasn't attracted much research, he said.
"I think it's looking very promising," he said. "We do have a lot of work still and making sure everything is in place before it becomes commercially available."
The study was published in the medical journal Cell Death and Differentiation, and was funded in part by the Canadian Institutes for Health Research Industry Partnership grant.
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