Background and limitations: Impaired wound healing (WH) and chronic inflammation are hallmarks of non-communicable diseases (NCDs). However, despite WH being a recognized player in NCDs, mainstream therapies focus on (un)targeted damping of the inflammatory response, leaving WH largely unaddressed, owing to three main factors. The first is the complexity of the pathway that links inflammation and wound healing; the second is the dual nature, local and systemic, of WH; and the third is the limited acknowledgement of genetic and contingent causes that disrupt physiologic progression of WH.
Proposed approach: Here, in the frame of Predictive, Preventive, and Personalized Medicine (PPPM), we integrate and revisit current literature to offer a novel systemic view on the cues that can impact on the fate (acute or chronic inflammation) of WH, beyond the compartmentalization of medical disciplines and with the support of advanced computational biology.
Conclusions: This shall open to a broader understanding of the causes for WH going awry, offering new operational criteria for patients' stratification (prediction and personalization). While this may also offer improved options for targeted prevention, we will envisage new therapeutic strategies to reboot and/or boost WH, to enable its progression across its physiological phases, the first of which is a transient acute inflammatory response versus the chronic low-grade inflammation characteristic of NCDs.
Keywords: Autonomic nervous system; Big data analysis; Epigenetics; Genetics; Individualized patient profile; Inflammation; Machine learning; Mechanotransduction; Multi-omics; Network science; Neuro-immuno modulation; Non-communicable diseases; Patient stratification; Phenotyping; Predictive; Risk; Wound healing; and personalized medicine; modifiable; preventable factors; preventive.
© European Association for Predictive, Preventive and Personalised Medicine (EPMA) 2019.