thymosin-beta(4) and Epidermolysis-Bullosa

Thymosin β4 is a naturally-occurring regenerative protein present in almost all cells and body fluids, including wound fluid. In multiple preclinical injury models, it promotes dermal repair and tissue regeneration. Thymosin β4 acts by increasing keratinocyte/epithelial cell migration, angiogenesis, and cell survival, and by decreasing inflammation, apoptosis, and scarring. It also modulates cytokines, including those that cause itching. Thymosin β4 promotes faster repair in various chronic human wounds, including pressure ulcers, stasis ulcers, and epidermolysis bullosa lesions. The faster healing time with increased keratinocyte migration and angiogenesis and reduction in both inflammation and scarring are especially important for epidermolysis bullosa patients who suffer from slow healing and inflammation that leads to itching, infections, pain, fluid loss, scarring, and tissue damage. These multiple mechanisms of action support thymosin β4's role in accelerating dermal repair and suggest the potential to treat various types of severe wounds, including epidermolysis bullosa patients who suffer from frequent blistering wounds that can be life threatening. There is an urgent need at this time to develop a therapeutic, such as thymosin β4, for epidermolysis bullosa. Despite progress in gene/stem cell therapy, there is no cure for this disease and careful wound management is the standard of care.

Topics: Animals; Epidermolysis Bullosa; Humans; Microfilament Proteins; Models, Animal; Regeneration; Skin; Thymosin; Wound Healing

Thymosin β4 (Tβ4), a multifunctional peptide, has been used successfully in several clinical trials involving tissue repair and regeneration. The review will first update the current information on the common underlying cellular cascades and pathways that are basic to Tβ4's regenerative activity and second, on the current and potential uses of this protein in the clinic.. Significant advances in our understanding of the actions of Tβ4 have occurred in directing stem cell maturation and in regeneration and repair of injuries. Many of its activities directly affect the repair cascade following injury. Using PubMed, we summarize the discovery and isolation of Tβ4 as well as the studies on tissue repair, which have provided the scientific foundation for ongoing and projected trials in the treatment of eye injuries, dermal wounds, repair of the heart following myocardial infarction and healing of the brain following stroke, trauma or neurological diseases.. Based on its multifunctional activities during tissue regeneration in various animal studies, Tβ4 has the potential for new clinical applications such kidney and liver disease, as well as repair of spinal cord, bone and ligament damage. In addition, it may be useful in the treatment of a wide range of other applications, including the consequences of aging and viral infections.

Topics: Amino Acid Sequence; Animals; Epidermolysis Bullosa; Molecular Sequence Data; Pressure Ulcer; Regeneration; Spinal Cord; Thymosin; Varicose Ulcer; Wound Healing; Wounds and Injuries

Inherited epidermolysis bullosa (EB), having an overall incidence of only about 19 in every 1 million live births, encompasses many phenotypically and genotypically distinct diseases characterized by the presence of recurrent blisters, mechanical fragility of the skin and other epithelial structures (most notably the cornea and gastrointestinal tract), and scar formation. Each disease is the result of mutations within any of 10 specific structural proteins (keratins, laminins, collagens, integrins) within the basilar keratinocyte or the skin basement membrane zone. Two of the more severe subtypes, junctional and dystrophic EB, often involve many extracutaneous tissues. If severe, these conditions may be life threatening. Recent studies in wounds that had been artificially induced on normal skin, both in rodents and in human volunteers, have suggested that thymosin beta4 may be effective in promoting epithelial migration across the wounds. A randomized double-blind clinical trial has been recently organized to determine whether this novel biologic agent may be beneficial in promoting wound healing in patients with junctional and dystrophic EB. To do so, a solitary noninfected cutaneous wound of standardized size will be treated topically on a daily basis with either one of three concentrations of thymosin beta4 or a placebo control. Serial wound healing will be quantitated by computerized digital-imaging technique. At the same time, the occurrence of adverse effects will be sought, so as to confirm the safety of thymosin beta4 when applied to EB skin, both in children and in adults. Although as yet unproven, topically applied thymosin beta4 may prove to be an extremely important addition to the overall management of patients with this potentially devastating disease.

Topics: Administration, Topical; Cell Adhesion; Epidermolysis Bullosa; Thymosin; Wound Healing