Could A Small Molecule Revolutionize Wound Care?: Thoughts From A Colleague And Current Pioneer

We at the Southwestern Academic Limb Salvage Alliance (SALSA) at the University of Southern California couldn’t be more enthusiastic about deferoxamine (DFO)! Efforts on this small molecule in wound healing are gaining speed. A recent article in ACS Biomaterials, Science and Engineering is one example where, in-vitro and in-vivo studies showed potential clinical applications of DFO-laden hydrogels in diabetic ulcers.¹

I personally do not yet have any clinical experience with DFO, however, in my observation, there is a great deal of very plausible potential for it to be the first small molecule solution for treating chronic wounds. Let’s hear more from my friend and colleague, Geoffrey C. Gurtner, MD, FACS, at the Stanford University School of Medicine, as I feel there is likely no one in the world with more experience on this topic.

Dr. Gurtner and team are currently conducting human Phase II trials on DFO (although not currently for diabetic wounds), but have been investigating DFO in the lab for some time.

“It is a very interesting molecule that works by stabilizing a transcription factor called HIF-1a (for which a Nobel prize was awarded two years ago),” he explains. “By stabilizing HIF-1a, DFO increases angiogenesis and blood vessel growth and appears to be effective in a lot of different types of non-healing wounds.”

The first clinical indication for DFO is the orphan indication of sickle cell ulcers, says Dr. Gurtner.

“We have received orphan designation from the U.S. Food and Drug Administration (FDA), have an open investigational new drug (IND) designation and are enrolling in our phase II clinical trial at four sites in the U.S.,” he shares. “We are starting in this space because of the well-known challenges of drug trials for diabetic foot ulcers (need for offloading, standardizing debridement, etc.).”

Dr. Gurtner adds that DFO is unique because it is a small molecule (otherwise known as a “drug”), adding that wound healing, in his observation, is the largest medical area that has NEVER had a small molecule drug approved by the FDA.

“Small molecule drugs are ideal for wound healing because they are chemicals and thus more resistant to the hostile environment of a wound where you have lots of proteases, biofilm and inflammatory cells around that tend to chew up cells and matrices and even growth factors,” he says. “DFO would be the first small molecule EVER in the entire field of wound healing. We are pretty excited by this.”

It certainly is an exciting development worth following in the literature. Thank you to Dr. Gurtner, a Johnson and Johnson Distinguished Professor of Surgery and Inaugural Vice Chairman of Surgery for Innovation at his institution, for his input.

Dr. Armstrong is Professor of Surgery at the Keck School of Medicine at the University of Southern California. He is the Director of the Southwestern Academic Limb Salvage Alliance (SALSA). 

Editor’s note: This blog originally appeared at: https://diabeticfootonline.com/2021/05/16/injectable-desferrioxamine-laden-silk-nanofiber-hydrogels-for-accelerating-diabetic-wound-healing/ . It is adapted with permission from the author.

Disclaimer: The views and opinions expressed are those of the author(s) and do not necessarily reflect the official policy or position of Podiatry Today or HMP Global, their employees and affiliates. Any content provided by our bloggers or authors are of their opinion and are not intended to malign any religion, ethnic group, club, association, organization, company, individual, anyone or anything.

Reference

1. Ding A, Zhang Y, Guo P, et al. Injectable desferrioxamine-laden silk nanofiber hydrogels for accelerating diabetic wound healing. ACS Biomater Sci Eng. 2021;7(3):1147-1158.