Cross-sectional analysis of wound-associated soluble factors in early, established, and chronic wounds of recessive dystrophic epidermolysis bullosa patients

Background Poorly healing wounds represent the primary health-related burden for hereditary recessive dystrophic epidermolysis bullosa (RDEB) patients. Contribution of wound-associated soluble constituents to wound progression remains not well defined. Objective To conduct cross-sectional analysis of cytokine, chemokine, and growth factor in exudates from RDEB wounds and define changes associated with wound progression. Methods Concentrations of selected cytokines, chemokines, and growth factors were evaluated by multiplex ELISA in eight blister fluids and 76 exudates from early, established, and chronic RDEB and five chronic venous ulcers. A cross-sectional analysis was performed. Results Our data demonstrated that accumulation of IL-1β, IL-17, TNF alpha as well as HGF, G-CSF, and VEGF is associated with progression of RDEB wounds to poorly healing state. The levels of these molecules were significantly higher in RDEB wounds than in venous ulcers. High levels of neutrophil-recruiting CCR2, CXCR1/2 ligands and T cell-recruiting CCR4 ligands were also detected in all RDEB wounds. Conclusion Although this study is limited to cross-sectional analysis of wound exudates, detected high levels of specific pro-inflammatory, pro-angiogenic, and neutrophil-recruiting factors, such as IL1b, CXCL8, and VEGF, define progression of RDEB wounds to chronic state and offer potential pharmacological targets to improve wound healing in the patients.