A Multicenter Randomized Controlled Trial Evaluating a Cx43-Mimetic Peptide in Cutaneous Scarring.

Abstract

The transmembrane protein Cx43 has key roles in fibrogenic processes including inflammatory signaling and extracellular matrix composition. aCT1 is a Cx43 mimetic peptide that in preclinical studies accelerated wound closure, decreased inflammation and granulation tissue area, and normalized mechanical properties after cutaneous injury. We evaluated the efficacy and safety of aCT1 in the reduction of scar formation in human incisional wounds. In a prospective, multicenter, within-participant controlled trial, patients with bilateral incisional wounds (≥10 mm) after laparoscopic surgery were randomized to receive acute treatment (immediately after wounding and 24 hours later) with an aCT1 gel formulation plus conventional standard of care protocols, involving moisture-retentive occlusive dressing, or standard of care alone. The primary efficacy endpoint was average scarring score using visual analog scales evaluating incision appearance and healing progress over 9 months. There was no significant difference in scar appearance between aCT1- or control-treated incisions after 1 month. At month 9, aCT1-treated incisions showed a 47% improvement in scar scores over controls (Vancouver Scar Scale; P = 0.0045), a significantly higher Global Assessment Scale score (P = 0.0009), and improvements in scar pigmentation, thickness, surface roughness, and mechanical suppleness. Adverse events were similar in both groups. aCT1 has potential to improve scarring outcome after surgery.

• Authors: Christina L Grek, Jade Montgomery, Meenakshi Sharma, A Ravi, J S Rajkumar, Kurtis E Moyer, Robert G Gourdie, Gautam S Ghatnekar
• Journal: The Journal of investigative dermatology (J Invest Dermatol) Vol. 137 Issue 3 Pg. 620-630 (03 2017) ISSN: 1523-1747 [Electronic] United States
• PMID: 27856288 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Chemical References

• Connexin 43
• Peptide Fragments
• Peptides
• aCT1 peptide

Topics

• Adult
• Aged
• Cicatrix (drug therapy, metabolism)
• Connexin 43 (chemistry, therapeutic use)
• Female
• Humans
• Inflammation
• Laparoscopy
• Male
• Middle Aged
• Patient Safety
• Peptide Fragments (therapeutic use)
• Peptides (chemistry)
• Prospective Studies
• Severity of Illness Index
• Skin (drug effects)
• Stress, Mechanical
• Wound Healing
• Young Adult