Many patients will develop an ulcer or pressure ulcer during their lifetime, for which the path to recovery is often difficult. Despite numerous treatments available, the care remains uncomfortable for the patient, sometimes with limited effectiveness. Scientific research has made it possible to better understand the healing process and to hope for an improvement in care. The Naturveda laboratory, which has been studying chronic wounds for several years, published its first results in 2014 on metalloproteases (MMP), proteins involved in the degradation of the extracellular matrix (ECM). 8 years later, the laboratory is launching a liquid dressing in pharmacies using new polymer-based technology. On this occasion, 2000 products are being offered to nurses. Interview with Dr Shrivastava participating in the development of the “AntiScar” liquid dressing:
Why is a chronic wound so difficult to heal?
The wound healing process is a complex mechanism that involves many cells, growth factors and multiple proteins. During this process, the cells will regenerate and multiply on a support : the ECM. Among the proteins found within the wound, MMPs will cut and degrade debris and impurities. Physiologically, there is a natural balance between MMPs and their inhibitors (TIMPs). For unknown reasons, in bedsores or ulcers, this balance is disrupted . MMPs are excessively released within the wound and destroy the ECM more than necessary. Without this matrix, cells can no longer multiply and regenerate. Healing is therefore considerably slowed down and difficult .
What treatment would be ideal?
An ideal treatment should be able to clean the wound and limit the concentration of MMP to allow the ECM to regenerate. It is also necessary to have an antiseptic, antibacterial , moisturizing action without opposing oxygenation .
What were the objectives of your research?
The first objective was to determine which MMPs were involved in the degradation of the MEC. There are more than twenty of them and only 3 participate in this degradation. Once identified, we used natural polymers to specifically block these MM Ps. Polymers are large, inert molecules from plants that can make bonds. We tested several dozen to finally select 2, capable of binding to the target MMPs.
How did you develop your Antiscar liquid dressing?
Once the step of identifying natural polymers targeting MMPs had been completed, it was then necessary to develop a product capable of responding to all points of the ideal treatment. First, we included the polymers in a film-forming glycerol, that is, capable of creating a stable protective film . Glycerol has a very significant osmotic action, up to 7 times that of sea water. Its application immediately attracts contaminants and helps clean the wound . As the glycerol has been made film-forming, it remains effective up to 6 hours after application. Also, glycerol has a protective effect for cells, it is non-irritating and allows the passage of oxygen . This is why it is the only substance that allows organs to be transported during transplants. Secondly, we opted for honey . Its healing action has been demonstrated several times. Polymers + film-forming glycerol + honey together meet the needs for optimal healing.
What were the main clinical results?
We tested Antiscar in a randomized, double-blind, placebo-controlled clinical study. The placebo was glycerol with honey. The study was carried out in 101 patients with bedsores or ulcers. The results were very rapid with a significant difference after 7 days between the groups. In 21 days, the surface area of the wounds had decreased by 67% . Pain and wound moisture scores were also significantly improved.