COVID-19 NEWS
Heals All Wounds
Can a fetal surgeon ’ s treatment for diabetic wounds reduce mortality in severe COVID-19 ?
Fetuses don ’ t scar . That insight — and its implications for wound healing in adults — led fetal and pediatric surgeon Kenneth Liechty , MD , and his research team deep into an investigation of the inflammatory response . The result : an ingenious two-pronged treatment that could potentially apply to any disease process hinging on inflammation , including acute respiratory distress syndrome , the leading cause of death in COVID-19 .
Acute respiratory distress syndrome , or ARDS , has devastating consequences . A massive inflammatory response floods the alveolar sacs with fluid . Tissues scar and fibrose . Mechanical ventilation can keep patients alive until the response subsides , but there ’ s no treatment .
Mortality approaches 50 %. Even when patients survive , quality of life is significantly impacted .
“ The fetus is unique in that it ’ s able to regenerate a number of organs following injury , and it heals with minimal inflammation and oxidative stress ,” says Dr . Liechty . “ That ’ s a key pathology feature in a lot of disease processes , including ARDS .
“ So the question was ,” he continues , “ how to fetalize the adult .”
THE TWO PRONGS OF INFLAMMATION
When injury occurs , the body ’ s first priority is to kill pathogens and close the wound . Immune cells crowd to the site and crank out proinflammatory proteins .
“ MicroRNA are the biggest regulators of pro-inflammatory gene expression ,” says Dr . Leichty , “ so we developed a strategy to target them .”
That strategy was a microRNA known as miR146a , a regulator of immune function that ’ s recently played a role in studies ranging from cancer to cystic fibrosis . It binds and neutralizes messenger RNA before it can reach the ribosome to produce proteins , interrupting the inflammatory pathway .
The problem was that it didn ’ t treat the other arm of inflammation : reactive oxygen species , volatile compounds that mangle the big , fragile molecules of life . Dr . Liechty ’ s team had a treatment for that , too : a nanoparticle called cerium oxide , which could bind and neutralize reactive oxygen species — but without gene regulation , the immune system would just crank out more .
The key was to combine the two .
10 | CHILDREN ’ S HOSPITAL COLORADO