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Move Those Electrons — Heal That Wound

Topical agents and systemic drugs can influence the electrical potential of wounded skin to speed or slow healing.

More than 150 years ago, Emil Du Bois Reymond attached a galvanometer to his cut finger and noted that a 1-µ ampere current could be measured flowing outward from the injured area. His intellectual progeny have probed the mechanism behind this phenomenon and have shown that bioelectric currents are essential for keratinocyte migration during wound healing. These authors discuss the possible clinical implications of research by Zhao and colleagues (see Nature 2006; 442:457) concerning electrical signal control in wound healing.

These currents are profoundly influenced by two signaling pathways that regulate PIP3 (phosphatidylinositol 3,4,5-triphosphate) at the leading edge of the migrating cell: The phosphatidylinositol-3-OH kinase- (PI3K) pathway increases electric-field–induced signaling, and the tumor-suppressor phosphatase and tensin homolog (PTEN) pathway decreases signaling and keratinocyte migration. Elegant genetic experiments precisely deleting the function of one or the other pathway support this hypothesis. Especially intriguing are the findings that the commonly used topical agent silver nitrate and systemic drugs such as furosemide can increase or decrease the activity of these pathways.

Comment: An artificial distinction has been made between the interests of those who study molecules — the biochemists — and those who study electricity in living tissues — the physiologists. These findings show how both disciplines are complementary for understanding, and possibly influencing, wound healing. In the past, the proposed use of electric currents to influence wound healing elicited skepticism. These new experiments should open the minds of many to the importance of bioelectric currents in wound repair and possibly to the manipulation of electric fields to enhance healing.

— Lowell A. Goldsmith, MD, MPH

Published in Journal Watch Dermatology January 17, 2007

Citation(s):

Huttenlocher A and Horwitz R. Wound healing with electric potential. N Engl J Med 2007 Jan 18; 356:303-4.

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