Editors' ChoiceWound Healing

Small spice for big wounds: Can curcumin close the gap?

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Science Translational Medicine  12 Apr 2017:
Vol. 9, Issue 385, eaan2776
DOI: 10.1126/scitranslmed.aan2776

Abstract

Nanoformulation of curcumin may be the key to unlocking its wound healing potential.

Curcumin, the active compound in the plant turmeric, possesses anti-inflammatory, antioxidant, antineoplastic, and antimicrobial properties. Previous data from multiple experiments demonstrated beneficial effects of curcumin on main events in the process of wound healing, including induction of fibroblast proliferation with granulation tissue deposition and improved collagen remodeling. However, curcumin’s bioavailability is low due to its hydrophobicity, poor absorption, and rapid elimination, limiting its translation to clinical practice.

In an effort to overcome this problem, Dai et al. developed a nanoformulation of curcumin. Using electrospinning technology, they embedded curcumin into gelatin-based nanofibers. In a series of in vitro experiments, they demonstrated the sustained release of curcumin from the nanofibers, induction of human fibroblast migration and proliferation, and reduced human peripheral blood mononuclear cell and macrophage chemotaxis. Curcumin-embedded disks (6 mm round) promoted faster healing in a rodent model of acute skin wounding, with well-formed collagen bundles in the healed wounds suggesting long-term benefit for the scarring process. Mechanistically, they demonstrated that curcumin’s positive effects on healing may be mediated by activation of the Wnt pathway via modulation of Dickkopf related protein 1 (Dkk-1). Simultaneously, curcumin’s inhibition of monocytes and macrophage chemotaxis appeared to be mediated by monocyte chemoattractant protein-1 (MCP-1).

Although curcumin’s effects on acute wound healing are exciting, it is important to note that rodent models of wound healing differ considerably from human skin wound healing. For example, the rat experiments failed to account for the fact that rodent wounds heal by contraction, whereas human wounds heal by reepithelialization. The researchers did not address the effect of nanoformulated curcumin treatment on keratinocytes, which are key players in the reepithelialization of wounds. In addition, this study focused only on acute wounds, not chronic wounds. Healing of chronic (nonhealing) wounds, such as venous ulcers and diabetic foot ulcers, represents the Holy Grail of wound healing because chronic wound healing is a major burden on society. Therefore, although the work by Dai et al. is a paramount first step, additional studies are warranted to fully characterize the effects of nanoformulated curcumin on nonhealing wounds.

Innovatively, Dai et al. combined known materials and technology to produce a potentially successful new formulation for wound healing. Gelatin and curcumin have long track records of safety, and both materials are affordable, therefore representing great promise as a potential wound healing therapy. Should human studies—especially in chronic wounds—bear fruit, it may demonstrate what every good chef knows: that a little spice makes a big difference.

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