Protease modulators

摘要

Chronic wound healing is characterised by a protracted inflammatory phase. Integral to this 'chronicity' are elevated levels of tissue-degrading enzymes and matrix metalloproteases (MMPs), and the subsequent denaturing of growth factors. Modulation (toning down) of wound proteases is thus an important consideration in chronic wound management. In acute wounds, protease activity is kept in check by tissue inhibitors of metalloproteases (TIMPs), but this function is reduced in chronic wounds.Chronic wound tissue - and therefore exudate - contains metalloproteases, elastases and other destructive compounds capable of degrading soft tissue. Chronic wound exudate should therefore be regarded as a wounding agent in its own right.Protease activity not only prolongs the inflammatory phase, but also adversely affects cell migration, granulation tissue formation and wound contraction. We also know that MMP activity in chronic wounds is related to the severity of the ulcer.