TY - JOUR
T1 - The Effect of Growth Factors on Vaginal Wound Healing
T2 - A Systematic Review and Meta-analysis
AU - van Velthoven, Melissa J. J.
AU - Gudde, Aksel N.
AU - Struijs, Frederique
AU - Oosterwijk, Egbert
AU - Roovers, Jan-Paul
AU - Guler, Zeliha
AU - Hooijmans, Carlijn R.
AU - Kouwer, Paul H. J.
N1 - Funding Information: This project has received public funding from ZonMw for the project “Synthesis of Evidence, more evidence with less animals” (project number: 114024158) and the TOP project (grant number: 91218030). Publisher Copyright: Melissa J.J. van Velthoven et al., 2023; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - Surgical outcomes of pelvic organ prolapse (POP) surgery are poor, resulting in a 20% recurrence risk. Following the hypothesis that impaired wound healing is the main determinant of recurrent POP, growth factors have the potential to promote wound healing and may improve surgical outcomes. In this study, we systematically reviewed the effect of growth factors on vaginal wound healing in both in vitro and animal studies. For each independent comparison, the standardized mean difference and 95% CI were calculated using the Hedges' g correction. Of the 3858 retrieved studies, seven studies were included, of which six were included in meta-analysis (three in vitro studies and four in vivo studies). In vitro, basic fibroblast growth factor (bFGF) promotes proliferation, differentiation, and collagen types I and III production. Epidermal growth factor stimulates proliferation and connective tissue growth factor promotes Tenascin-C expression. These effects, however, are less pronounced in vivo; only bFGF slightly promotes collagen production. The review shows that growth factors, particularly bFGF, are able to promote vaginal wound healing in vitro. The uncertain in vivo findings suggest that preclinical models should be improved. The ultimate goal is to develop effective growth factor-supplemented therapies that improve surgical outcomes for POP.
AB - Surgical outcomes of pelvic organ prolapse (POP) surgery are poor, resulting in a 20% recurrence risk. Following the hypothesis that impaired wound healing is the main determinant of recurrent POP, growth factors have the potential to promote wound healing and may improve surgical outcomes. In this study, we systematically reviewed the effect of growth factors on vaginal wound healing in both in vitro and animal studies. For each independent comparison, the standardized mean difference and 95% CI were calculated using the Hedges' g correction. Of the 3858 retrieved studies, seven studies were included, of which six were included in meta-analysis (three in vitro studies and four in vivo studies). In vitro, basic fibroblast growth factor (bFGF) promotes proliferation, differentiation, and collagen types I and III production. Epidermal growth factor stimulates proliferation and connective tissue growth factor promotes Tenascin-C expression. These effects, however, are less pronounced in vivo; only bFGF slightly promotes collagen production. The review shows that growth factors, particularly bFGF, are able to promote vaginal wound healing in vitro. The uncertain in vivo findings suggest that preclinical models should be improved. The ultimate goal is to develop effective growth factor-supplemented therapies that improve surgical outcomes for POP.
KW - basic fibroblast growth factor
KW - connective tissue growth factor
KW - epidermal growth factor
KW - growth factors
KW - pelvic organ prolapse
KW - wound healing
UR - http://www.scopus.com/inward/record.url?scp=85167481122&partnerID=8YFLogxK
U2 - https://doi.org/10.1089/ten.TEB.2022.0225
DO - https://doi.org/10.1089/ten.TEB.2022.0225
M3 - Review article
C2 - 37051705
SN - 1937-3368
VL - 29
SP - 429
EP - 440
JO - Tissue Engineering. Part B, Reviews
JF - Tissue Engineering. Part B, Reviews
IS - 4
ER -