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The role of bacterial extracellular vesicles in chronic wound infections: current knowledge and future challenges

Brown, Helen, Clayton, Aled and Stephens, Phil 2021. The role of bacterial extracellular vesicles in chronic wound infections: current knowledge and future challenges. Wound Repair and Regeneration 29 (6) , pp. 864-880. 10.1111/wrr.12949

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Abstract

Chronic wounds are a significant global problem with an increasing economic and patient welfare impact. How wounds move from an acute to chronic, non-healing, state is not well understood although it is likely that it is driven by a poorly regulated local inflammatory state. Opportunistic pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa are well known to stimulate a pro-inflammatory response and so their presence may further drive chronicity. Studies have demonstrated that host cell extracellular vesicles (hEVs), in particular exosomes, have multiple roles in both increasing and decreasing chronicity within wounds; however, the role of bacterial extracellular vesicles (bEVs) is still poorly understood. The aim of this review is to evaluate bEV biogenesis and function within chronic wound relevant bacterial species to determine what, if any, role bEVs may have in driving wound chronicity. We determine that bEVs drive chronicity by both increasing persistence of key pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa and stimulating a pro-inflammatory response by the host. Data also suggest that both bEVs and hEVs show therapeutic promise, providing vaccine candidates, decoy targets for bacterial toxins or modulating the bacterial species within chronic wound biofilms. Caution should, however, be used when interpreting findings to date as the bEV field is still in its infancy and as such lacks consistency in bEV isolation and characterization. It is of primary importance that this is addressed, allowing meaningful conclusions to be drawn and increasing reproducibility within the field.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Dentistry
Medicine
Subjects: Q Science > Q Science (General)
Additional Information: This is an open access article under the terms of the Creative Commons Attribution License
Publisher: Wiley
ISSN: 1067-1927
Date of First Compliant Deposit: 25 June 2021
Date of Acceptance: 26 May 2021
Last Modified: 31 Jan 2022 07:19
URI: https://orca.cardiff.ac.uk/id/eprint/142180

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