Protease Testing Could Change Wound Care Globally

An international work group of wound care specialists has established that protease activity is an essential part of wound healing, and suggests incorporating testing for protease activity into routine practice.

The group of experts met at the Wounds International Conference held in Cape Town (South Africa) during February 2011, to build on the 2008 World Union of Wound Healing Societies (WUWHS) consensus document on diagnostics and wounds. The goal was to explore the importance of protease activity in wound healing and to gain consensus on the value of having an easy to use, point-of-care protease test in clinical practice. The experts agreed that key to success for such a test will be for clinicians to know clearly when, how, and why to use such a test.

The expert consensus opinion reaffirmed increased protease activity as currently the best available marker for impaired wound healing when other causes have been excluded, and that effective use of a protease test kit at the point of care could change wound care world-wide. A proposed algorithm will guide clinicians on how to include protease testing in clinical practice and how to choose protease-modulating therapies where appropriate. In addition, the algorithm suggests a regular follow up with further tests at 2-4 weeks to monitor therapy effectiveness and aid decision making with regard to ceasing or continuing with specific advanced therapies. The international consensus was published in Wounds international 2011.

“The key to success for such a test will be for clinicians to know clearly when, how and why to use such a test,” said Professor Keith Harding, MD, of the Cardiff University (United Kingdom; Cardiff University, UK) School of Medicine. “Effective use of a protease test kit at the point of care has the potential to change wound care globally.”

Proteases are enzymes that act on proteins by breaking them down into peptides and amino acids. In wound healing, the major proteases are the matrix metalloproteinases (MMPs) and the serine proteases, such as elastase. In general, different wound-related proteases act on different proteins; these include extracellular matrix (ECM) and connective tissue proteins, such as collagen, gelatin, proteoglycans, and elastin.

Related Links:
World Union of Wound Healing Societies
Cardiff University