Lung Surfactant Accelerates Skin Wound Healing: A Translational Study with a Randomized Clinical Phase I Study

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Ursula Mirastschijski # 1, Igor Schwab # 2, Vincent Coger 3, Ulrich Zier 4, Carmela Rianna 5, Wei He 4, Kathrin Maedler 4, Sørge Kelm 4, Arlo Radtke 6, Gazanfer Belge 6, Patrick Lindner 7, Frank Stahl 7, Martin Scharpenberg 8, Lukas Lasota 8, Jürgen Timm

Main idea: This study provides lung surfactant as a strong candidate for innovative treatment of chronic skin wounds and as additive for treatment of burns wounds to reduce inflammation and prevent excessive scarring.

Abstract

Lung surfactants are used for reducing alveolar surface tension in preterm infants to ease breathing. The aim of the study was to investigate if lung surfactant can promote wound healing. Preclinical wound models, e.g. cell scratch assays and full-thickness excisional wounds in mice, and a randomized, phase I clinical trial in healthy human volunteers using a suction blister model were used to study the effect of the commercially available bovine lung surfactant on skin wound repair. Lung surfactant increased migration of keratinocytes in a concentration-dependent manner with no effect on fibroblasts. Significantly reduced expression levels were found for pro-inflammatory and pro-fibrotic genes in murine wounds. Because of these beneficial effects in preclinical experiments, a clinical phase I study was initiated to monitor the safety and tolerability of surfactant when applied topically onto human wounds and normal skin. Subepidermal wounds healed significantly faster with surfactant compared to control wounds. No adverse effects were observed when applied topically to human wounds and normal skin. The study was a phase I clinical trial in healthy human volunteers.

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