Chemokines as Therapeutic Targets to Improve Healing Efficiency of Chronic Wounds.

Significance: Impaired wound healing leading to chronic wounds is an important clinical problem that needs immediate attention to develop new effective therapies. Members of the chemokine family seem to be attractive and amenable to stimulate the healing process in chronic wounds. Targeting specific chemokines and/or their receptors has the potential to modify chronic inflammation to acute inflammation, which will hasten the healing process. Recent Advances: Over the years, expression levels of various chemokines and their receptors have been identified as key players in the inflammatory phase of wound healing. In addition, they contribute to regulating other phases of wound healing making them key targets for novel therapies. Understanding the signaling pathways of these chemokines will provide valuable clues for modulating their function to enhance the wound healing process. Critical Issues: Inflammation, an important first-stage process in wound healing, is dysregulated in chronic wounds; emerging studies show that chemokines play a crucial role in regulating inflammation. The knowledge gained so far is still limited in understanding the enormous complexity of the chemokine network during inflammation not just in chronic wounds but also in acute (normal) wounds. A much better understanding of the individual chemokines will pave the way for better targets and therapies to improve the healing efficiency of chronic wounds. Future Directions: Effective understanding of the interaction of chemokines and their receptors during chronic wound healing would facilitate the design of novel therapeutic drugs. Development of chemokine-based drugs targeting specific inflammatory cells will be invaluable in the treatment of chronic wounds, in which inflammation plays a major role.