TY - JOUR
T1 - Descriptive vs mechanistic scientific approach to study wound healing and its inhibition
T2 - Is there a value of translational research involving human subjects?
AU - Pastar, Irena
AU - Wong, Lulu L.
AU - Egger, Andjela N.
AU - Tomic-Canic, Marjana
PY - 2018/5
Y1 - 2018/5
N2 - The clinical field of wound healing is challenged by numerous hurdles. Not only are wound-healing disorders complex and multifactorial, but the corresponding patient population is diverse, often elderly and burdened by multiple comorbidities such as diabetes and cardiovascular disease. The care of such patients requires a dedicated, multidisciplinary team of physicians, surgeons, nurses and scientists. In spite of the critical clinical need, it has been over 15 years since a treatment received approval for efficacy by the FDA in the United States. Among the reasons contributing to this lack of effective new treatment modalities is poor understanding of mechanisms that inhibit healing in patients. Additionally, preclinical models do not fully reflect the disease complexity of the human condition, which brings us to a paradox: if we are to use a “mechanistic” approach that favours animal models, we can dissect specific mechanisms using advanced genetic, molecular and cellular technologies, with the caveat that it may not be directly applicable to patients. Traditionally, scientific review panels, for either grant funding or manuscript publication purposes, favour such “mechanistic” approaches whereby human tissue analyses, deemed “descriptive” science, are characterized as a “fishing expedition” and are considered “fatally flawed.” However, more emerging evidence supports the notion that the use of human samples provides significant new knowledge regarding the molecular and cellular mechanisms that control wound healing and contribute to inhibition of the process in patients. Here, we discuss the advances, benefits and challenges of translational research in wound healing focusing on human subject research.
AB - The clinical field of wound healing is challenged by numerous hurdles. Not only are wound-healing disorders complex and multifactorial, but the corresponding patient population is diverse, often elderly and burdened by multiple comorbidities such as diabetes and cardiovascular disease. The care of such patients requires a dedicated, multidisciplinary team of physicians, surgeons, nurses and scientists. In spite of the critical clinical need, it has been over 15 years since a treatment received approval for efficacy by the FDA in the United States. Among the reasons contributing to this lack of effective new treatment modalities is poor understanding of mechanisms that inhibit healing in patients. Additionally, preclinical models do not fully reflect the disease complexity of the human condition, which brings us to a paradox: if we are to use a “mechanistic” approach that favours animal models, we can dissect specific mechanisms using advanced genetic, molecular and cellular technologies, with the caveat that it may not be directly applicable to patients. Traditionally, scientific review panels, for either grant funding or manuscript publication purposes, favour such “mechanistic” approaches whereby human tissue analyses, deemed “descriptive” science, are characterized as a “fishing expedition” and are considered “fatally flawed.” However, more emerging evidence supports the notion that the use of human samples provides significant new knowledge regarding the molecular and cellular mechanisms that control wound healing and contribute to inhibition of the process in patients. Here, we discuss the advances, benefits and challenges of translational research in wound healing focusing on human subject research.
KW - chronic ulcers
KW - human specimens
KW - pre-clinical models
KW - wound healing
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U2 - 10.1111/exd.13663
DO - 10.1111/exd.13663
M3 - Review article
C2 - 29660181
AN - SCOPUS:85048265457
VL - 27
SP - 551
EP - 562
JO - Experimental Dermatology
JF - Experimental Dermatology
SN - 0906-6705
IS - 5
ER -