When healthy, skin can regenerate and repair itself. However, chronic disease and cancer can attack the skin, creating long-term, life-threatening conditions. Research now underway in the Laboratory of Molecular Dermatology could offer hope to millions of people who currently have few treatment options.
Housed in Cleveland Clinic’s Lerner Research Institute Department of Biomedical Engineering, the lab is headed by Edward V. Maytin MD, PhD, whose team is studying delayed wound healing. This can be a serious, even life-threatening problem, especially in people with obesity and adult-onset diabetes. The lab also is investigating a more effective, nonsurgical treatment for skin cancer that won’t leave scars.
Delayed Wound Healing
Today, over 6 million Americans have chronic ulcers on their feet or legs. These wounds may not heal for months or years, leading to amputations for nearly 100,000 people each year.
“Even today’s creams and wound dressings may still fail to improve wound healing, which only shows how little is known about how healing works,” Dr. Maytin says.
In people with diabetes, high blood sugar levels seem to slow or prevent healing, but scientists aren’t sure why this happens. Researchers in Dr. Maytin’s lab are examining how hyaluronan (HA), a molecule composed entirely of sugars, helps to regulate wound healing.
In the skin, the amount and size of HA (which is affected by sugar availability) is thought to be a major contributor to abnormal inflammation, buildup of fibrous tissue or scarring, and delayed healing under high-sugar conditions. The research team is working to better understand these processes and perhaps develop new therapies for leg ulcers and other wounds, especially for people with obesity and diabetes.
Skin cancers, including basal cell and squamous cell carcinoma, are collectively the most common human cancers. More than 3 million cases are diagnosed each year in the U.S., far more than breast and colon cancer combined. A study by the Skin Cancer Foundation predicts that nearly 1 in 5 Americans will develop skin cancer in their lifetime.
While basal cell and squamous cell carcinomas rarely are deadly, the process of removing them often leaves disfiguring scars.
Dr. Maytin’s lab is investigating a new technique, Photodynamic Therapy (PDT), which can treat skin cancers without leaving a scar. PDT combines two elements: A sensitizing drug, usually delivered as a topical cream, and a strong laser light that activates the drug inside the cancer cells and destroys them. After several treatments, skin tumors can dissolve without leaving any trace.
The researchers already have discovered that when a skin cancer is pre-treated with certain drugs, including methotrexate and Vitamin D, it becomes much more sensitive to PDT. Early research shows that this combination therapy works better than PDT alone.
Dr. Maytin is encouraged by the findings. “PDT works well for cancers close to the surface, but we hope to make PDT work even for thicker and more serious skin cancers. Future clinical trials are planned.”