Scientists Discover Why Some Wounds Refuse to Heal
New Research Offers Hope for Faster Healing of Chronic, Antibiotic-Resistant Wounds
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An international research team led by Nanyang Technological University, Singapore (NTU Singapore) discovered a mechanism by which a common bacterium hinders wound healing and identified a way to potentially overcome this obstacle, even in wounds infected with antibiotic-resistant bacteria.
The Growing Problem of Chronic Wounds
Chronic wounds represent a significant and increasing global health challenge. Approximately 18.6 million people worldwide develop diabetic foot ulcers each year, according to data from 2023.[1] Over a lifetime, as many as one in three people with diabetes will experience a foot ulcer.
Thes persistent wounds frequently led to lower limb amputations,and ongoing infections often impede healing,creating a cycle of complications. In Singapore,more than 16,000 cases of chronic wounds – including diabetic foot ulcers,pressure injuries,and venous leg ulcers - are reported annually,notably among older adults and individuals with diabetes.[2]
How Enterococcus faecalis Interferes with healing
The research, published in Science Advances in collaboration with the University of Geneva, Switzerland, details how the bacterium Enterococcus faecalis (E.faecalis) actively disrupts the body’s natural wound-healing processes. The team demonstrated that blocking this interference allows skin cells to recover and close wounds.
E. faecalis is an opportunistic pathogen commonly found in chronic infections like diabetic foot ulcers, which are notoriously tough to treat. Some strains of E. faecalis are resistant to multiple commonly used antibiotics, further complicating treatment.
While the link between infection and delayed healing has long been known, the underlying biological mechanisms remained unclear until now.
The study was jointly led by NTU Associate Professor guillaume Thibault from the School of Biological Sciences and Professor Kimberly Kline from the University of geneva, who also holds a visiting professorship at SCELSE – Singapore Center for Environmental Life sciences and Engineering, at NTU.
Bacterial Metabolism and cell Stress
The researchers found that E. faecalis differs from many other wound-infecting bacteria.Instead of primarily using toxins, it releases reactive oxygen species (ROS), a byproduct of its metabolism. These ROS disrupt the normal function of human skin cells, hindering healing.
“E. faecalis doesn’t kill skin cells directly. Instead, it stresses them, preventing them from doing their job properly, which is to close the wound,”
said Professor Kline.
The team’s findings suggest that targeting the metabolic processes of E. faecalis could offer a new approach to treating chronic wounds and improving patient outcomes.