RESUMO
The skin is the largest organ in the human body, and due to its barrier function, it is susceptible to multiple injuries. The appearance of infections during the wound healing process is a complication that represents a formidable hospital challenge. The presence of opportunistic bacteria with sophisticated resistance mechanisms is difficult to eradicate and compromises patients' lives. Therefore, the search for new efficacious treatments from natural sources that prevent and counteract infections, in addition to promoting the healing process, has increased in recent years. In this respect, films with the capability to protect wounds and release drugs are the presentation that predominates commercially in the hospital environment. Those films can offer several mechanical advantages such as physical protection to prevent opportunistic bacteria's entry, regulation of gas exchange, and capture of exudate through a swelling process. Wound dressings are generally curative materials easily adaptable to different anatomical regions, with high strength and elasticity, and some are even bioabsorbable. Additionally, the components of the films can actively participate in promoting the healing process. Even more, the film can be made up of carriers with other active participants to prevent and eradicate infections. Therefore, the extensive versatility, practicality, and usefulness of films from natural sources to address infectious processes during wound healing are relevant and recurrent themes. This work presents an analysis of the state-of-the-art of films with natural products focused on preventing and eradicating infections in wound healing.
Assuntos
Produtos Biológicos/farmacologia , Infecções Oportunistas/prevenção & controle , Cicatrização/efeitos dos fármacos , Infecção dos Ferimentos/prevenção & controle , Ferimentos e Lesões/prevenção & controle , Produtos Biológicos/química , Humanos , Hidrogéis/química , Hidrogéis/farmacologia , Membranas Artificiais , Infecções Oportunistas/microbiologia , Plastificantes/química , Plastificantes/farmacologia , Substâncias Protetoras/química , Substâncias Protetoras/farmacologia , Infecção dos Ferimentos/microbiologia , Ferimentos e Lesões/microbiologiaRESUMO
Lamellar ichthyosis (LI) is a genetic skin disorder characterized by dark brown scales, palmoplantar hyperkeratosis, pain, and itching. LI severity could have implications in psychological aspects, causing depression and impairment in the quality of life (QoL) of patients. In this study, we used the Congenital Ichthyosis Severity Index, the Depression Beck Inventory-II (DBI-II), and the Dermatologic Life Quality Index (DLQI) to assess severity, level of depression, and impairment in QoL in a group of patients with LI. We observed that the majority of the patients presented a high severity level concerning the presence of scales (57.7%), while for erythema and alopecia, the severity was less 80% of the analyzed patients presented depression, while only 20.8% of individuals of the control group presented it (P < .001, OR = 15.2). While for QoL, only 4.3% of the patients did not exhibit any impairment. Finally, the increase in the score obtained in DBI-II was correlated with the DLQI score (rs = 0.663, P = .0014). Our results suggest that patients with LI have an increased risk of suffering depression and impairment in their QoL; thus, the management of their disease should be performed from a multidisciplinary perspective to improve the global aspects of their lives.
Assuntos
Ictiose Lamelar , Qualidade de Vida , Alopecia , Depressão/diagnóstico , Depressão/epidemiologia , Eritema , Humanos , Ictiose Lamelar/diagnóstico , Ictiose Lamelar/epidemiologiaRESUMO
BACKGROUND: Autosomal recessive congenital ichthyoses (ARCI) are inherited disorders produced by mutations in essential genes for the skin function. A low prevalence of this disease has been resported worldwide; however, in a recent study, we identified a large cluster of ARCI families who resided in the High Mountains Region from the Veracruz State, Mexico. Thus, we aimed to identify the causative mutation of ARCI and describe the high prevalence of this disease in this region. METHODS: We selected seven familiar trios and performed whole-exome sequencing to identify the mutation associated with ARCI. To validate the identified mutation, we performed Sanger sequencing in 62 patients, 30 unaffected relatives, and 100 healthy volunteers. Finally, we performed molecular modeling to investigate the possible functional consequences produced by the mutation. RESULTS: We identified a novel homozygous mutation (c.1054C>G [p.Pro352Ala]) in the exon 7 of the TGM1 gene in all the patients. We calculated a prevalence rate of ARCI of 74:100,000 (1:1,348) in the studied communities. Molecular modeling revealed that the mutation leads to a nonconservative amino acid substitution, which is very probably damaging to the protein structure/function. CONCLUSIONS: We report a novel mutation in the TGM1 gene in 62 Mexican patients. The unusually high frequency of this mutation suggests a founder effect; however, further haplotype analysis is necessary to corroborate this hypothesis. In this respect, to our knowledge, the prevalence of ARCI found in the studied communities is the highest observed worldwide.