The detrimental impact of extracellular bacterial proteases on wound healing

Lindsay, Sharon; Oates, Angela; Bourdillon, Katie

Abstract

In addition to clinical signs of infection (e.g. inflammation, purulence and pain), a microbial count of ≥105 colony‐forming units/g has historically been used to define wound infection. However, it is increasingly recognised that, rather than a high bioburden level alone being detrimental to wound healing, it is the virulence of the invading microorganism and the host's immune status that can affect clinical outcomes. Bacteria, such as Pseudomonas aeruginosa, Staphylococcus aureus and Staphylococcus epidermidis, have developed a range of virulence factors to help them overcome host defences and proliferate within the underlying soft tissue. More specifically, bacterial proteases are one such virulence factor that has been implicated in promoting the invasion and destruction of the host tissue. Because of the complexities of microorganisms, the proteases can negatively impact the wound environment, leading to delayed wound healing. The aim of the present paper is to describe various extracellular bacterial proteases; review the impact they have on the wound environment, the host immune response and biofilms; and discuss potential wound management strategies against them. The evidence discussed suggests that proteases may play a profound role in wound infections, contribute to the development of an inflammatory response and impede wound healing.

Citation

Lindsay, S., Oates, A., & Bourdillon, K. (2017). The detrimental impact of extracellular bacterial proteases on wound healing. International wound journal, 14(6), 1237-1247. https://doi.org/10.1111/iwj.12790

• Journal Article Type: Article
• Acceptance Date: Jun 15, 2017
• Online Publication Date: Jul 25, 2017
• Publication Date: 2017-12
• Deposit Date: Jan 15, 2019
• Publicly Available Date: Jan 16, 2019
• Journal: International Wound Journal
• Print ISSN: 1742-4801
• Electronic ISSN: 1742-481X
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 14
• Issue: 6
• Pages: 1237-1247
• DOI: https://doi.org/10.1111/iwj.12790
• Keywords: Bacterial protease; Point-of-care diagnostic; Virulence factor; Wound infection
• Public URL: https://hull-repository.worktribe.com/output/1215878
• Publisher URL: https://onlinelibrary.wiley.com/doi/full/10.1111/iwj.12790
• Related Public URLs: http://eprints.whiterose.ac.uk/122599/1/Microbial%20protease%20review%20paper%20FINAL.pdf