Journal
CLINICAL INTERVENTIONS IN AGING
Volume 3, Issue 2, Pages 263-272Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/CIA.S1846
Keywords
extracellular matrix; amelogenin; venous leg ulcers; diabetic foot ulcers; pyoderma gangrenosum
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Amelogenins are extracellular matrix proteins that, under physiological conditions, self-assemble into globular aggregates up to micron-sizes. Studies with periodontal fibroblasts indicate that attachment to these structures increases the endogenous secretion of multiple growth factors and cell proliferation. Pre-clinical and clinical studies indicate that cutaneous wounds benefit from treatment with amelogenins. A randomized controlled trial (RCT) involving patients with hard-to-heal venous leg ulcers (VLUs) (ie, ulcers with a surface area >= 10 cm(2) and duration of >= 6 months) showed that the application of amelogenin (Xelma (R), Molnlycke Health Care, Gothenburg, Sweden) as an adjunct treatment to compression results in significant reduction in ulcer size, improvement in the state of ulcers, reduced pain, and a larger proportion of ulcers with low levels of exudate, compared with treatment with compression alone. Amelogenin therapy was also shown to be safe to use in that there were no significant differences in adverse events noted between patients treated with amelogenin plus compression and those treated with compression alone. Case study evaluations indicate that the benefits of amelogenin therapy demonstrated in the RCT are being repeated in real life situations and that amelogenin therapy may also have a role to play in the treatment of other wound types such as diabetic foot ulcers.
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