WEB106 Inflammation and Oxygen Free Radicals
Released Apr 12, 2017
Expires Apr 12, 2019
The state of wound oxygenation is a key determinant of healing outcomes. Molecular oxygen and its reactive radical as well as non-radical derivatives, collectively referred to as reactive oxygen species (ROS), work in cooperation to enable wound healing. Work during the last couple of decades have recognized ROS as cell signaling agents that are widely implicated in numerous aspects of wound healing. ROS generated by phagocytic cells are directly implicated in the killing of pathogens. Acute inflammation following injury is the site for abundant production of ROS by phagocytic NADPH oxidases. As in?ammation resolves and phagocyte count at the wound site falls, several aspects of healing such as cell proliferation and migration are supported by redox signaling where low-level ROS produced by non-phagocytic oxidases serve as messenger molecules. In phagocytes, such production of ROS is stimulated by the presence of infection by a series of reactions called ‘respiratory burst’. Impairment of the respiratory burst, often seen in diabetes and chronic granuloumatous disease (primarily linked to defective phagocytic NADPH oxidase), results in poor wound healing outcomes. Wound-site macrophages (m?) are key drivers of the healing process. Timely debridement of apoptotic cells by wound-sitef m? (efferocytosis) paves the way to the resolution of inflammation. Under conditions of diabetic complications, efferocytosis is compromised resulting in a persisting pro-inflammatory milieu that complicates healing outcomes. Biofilm infection may subdue respiratory burst too thus derailing wound healing. In this context it should be noted that anti-inflammatory and immune-suppressive drugs may modify ROS production thus delaying wound healing. The objective of this presentation is to address fundamental concepts in oxygen, radicals and their roles in inflammation in the context of wound healing.
Intended AudiencePhysicians, PAs, NPs, Nurses, Discharge Planners, Admissions Coordinators, Social Services.
Learning ObjectivesUpon completion of program:
- Identify the phases of wound healing and the mechanisms of inflammation.
- Recognize the wound which has stalled in healing due to excessive inflammation.
- Describe clinical strategies to treat excessive inflammation.
- Demonstrate that implementation of appropriate management algorithms improves patient healing and clinical outcomes.
- Demonstrate team based communication that will foster implementation of appropriate management algorithms resulting in improved patient healing and clinical outcomes.
Dr. Chandan K. Sen is a tenured John H & Mildred C Lumley Professor of Surgery, Executive Director of The Ohio State University Comprehensive Wound Center and Director of the Ohio State University's Center for Regenerative Medicine & Cell Based Therapies. He is also the Associate Dean for Research at The Ohio State University Wexner Medical Center. Dr. Sen serves as a program director (Innovation & Collaboratory) for The Ohio State University's Center for Clinical and Translational Science. After completing his Masters of Science in Human Physiology from the University of Calcutta, India, Dr. Sen received his PhD in Physiology from the University of Kuopio in Finland. Dr. Sen trained as a postdoctoral fellow at the University of California at Berkeley's Molecular and Cell Biology department. His first faculty appointment was in the Lawrence Berkeley National Laboratory in California. In the fall of 2000, Dr. Sen moved to The Ohio State University where established a program on tissue injury and repair. Currently, Dr. Sen is the Lumley Professor and Vice Chair of Research of Surgery. He is a PI of several projects including multiple clinical trials. His research has been continuously extramurally funded by prestigious agencies such as five different institutes of the National Institutes of Health, US Department of Defense, US Department of Veteran Affairs and the industry. Dr. Sen serves on the editorial board of numerous scientific journals. He is the Editor in Chief of Antioxidants & Redox Signaling (www.liebertpub.com/ars) with a current impact factor of 7.1. He is also the Editor of the Wound Healing Society Publication Advances in Wound Care. Dr. Sen and his team have published over 300 scientific publications. He has a Hindex of 81 and is currently cited over 2000 times every year.
Chandan K. Sen, PhD has no relevant financial relationship to disclose.
Ruchit Parikh, PharmD
Associate Medical Director
Haymarket Medical Education
Dr. Parikh has no relevant financial relationships to disclose
Accredited Provider Disclosure
Haymarket Medical Education staff involved in the planning and content review of this activity have no relevant financial relationships to disclose.
Haymarket Medical Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Haymarket Medical Education designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Disclosure of Unlabeled Use
This CME activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options for a specific patient’s medical condition.
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To obtain credit, a score of 70% or better on the post-test is required. This activity is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a copy of your credit certificate.