Limiting burn extension by transient inhibition of Connexin43 expression at the site of injury

Extension of a burn wound over the first 24 h following injury is recognised clinically, and Leads to diagnostic and therapeutic dilemmas. In the central nervous system, a similar spread of damage, beyond the initial injury, can occur via the spread of death signals from injured cells to their healthy neighbours via Connexin43 (Cx43) gap junction channels. In the skin, Cx43 is expressed in the basal epidermis and in fibroblasts and dermal appendages. We have used Cx43 specific antisense oligodeoxynucleotide approach to transiently down-regulate Cx43 protein in the early stages of partial thickness cutaneous burn wound heating. Antisense ODNs reduce the spread of tissue damage and neutrophil infiltration around the wound following injury. Epithetial. cell proliferation is increased and the rate of wound closure is accelerated, compared to controls. Resultant scarring is smaller with less granulation tissue and more dermal appendages than controls. These findings suggest that Cx43 antisense treatment speeds partial thickness burn wound heating and reduces scarring. We suggest that this approach may provide an effective adjunct to managing partial thickness burn wounds. (c) 2005 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved.