Descriptive vs mechanistic scientific approach to study wound healing and its
inhibition: Is there a value of translational research involving human subjects?
Authors Pastar I, Wong LL, Egger AN, Tomic-Canic M
Submitted By Marjana Tomic-Canic on 7/31/2018
Status Published
Journal Experimental dermatology
Year 2018
Date Published 5/1/2018
Volume : Pages 27 : 551 - 562
PubMed Reference 29660181
Abstract The clinical field of wound healing is challenged by numerous hurdles. Not only
are wound-healing disorders complex and multifactorial, but the corresponding
patient population is diverse, often elderly and burdened by multiple
comorbidities such as diabetes and cardiovascular disease. The care of such
patients requires a dedicated, multidisciplinary team of physicians, surgeons,
nurses and scientists. In spite of the critical clinical need, it has been over
15 years since a treatment received approval for efficacy by the FDA in the
United States. Among the reasons contributing to this lack of effective new
treatment modalities is poor understanding of mechanisms that inhibit healing in
patients. Additionally, preclinical models do not fully reflect the disease
complexity of the human condition, which brings us to a paradox: if we are to
use a "mechanistic" approach that favours animal models, we can dissect specific
mechanisms using advanced genetic, molecular and cellular technologies, with the
caveat that it may not be directly applicable to patients. Traditionally,
scientific review panels, for either grant funding or manuscript publication
purposes, favour such "mechanistic" approaches whereby human tissue analyses,
deemed "descriptive" science, are characterized as a "fishing expedition" and
are considered "fatally flawed." However, more emerging evidence supports the
notion that the use of human samples provides significant new knowledge
regarding the molecular and cellular mechanisms that control wound healing and
contribute to inhibition of the process in patients. Here, we discuss the
advances, benefits and challenges of translational research in wound healing
focusing on human subject research.