Evidence map›Paper›PMID 33225583›Full record

ArticleInternational wound journal2021

Endoplasmic reticulum stress in human chronic wound healing: Rescue by 4-phenylbutyrate.

Etty Bachar-Wikstrom, Mansi Manchanda, Ritu Bansal, Magnus Karlsson, Paula Kelly-Pettersson, Olof Sköldenberg, Jakob D Wikstrom

Open access · hybridAbstract read
In one paragraph

Article in International wound journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
1.6field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 48 citations in OpenAlex.

  1. Article
  2. Science advances · 2026
    Article
  3. Article
  4. Article
  5. Review
  6. Collaborative Duality of CircGLIS3(2) RNA and Protein in human Wound Repair.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025
    Article
  7. Review
  8. Review
  9. Review
  10. Review
  11. Article
  12. Article
  13. Review
  14. Review
  15. Article
  16. Review
  17. Review
  18. Review
  19. Review
  20. Collagen's enigmatic, highly conservedProceedings of the National Academy of Sciences of the United States of America · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Etty Bachar-WikstromDermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden.
Mansi ManchandaDermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden.
Ritu BansalDermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden.
Magnus KarlssonNordiska Kliniken, Stockholm, Sweden.
Paula Kelly-PetterssonDepartment of Clinical Sciences, Danderyd Hospital, Division of Orthopaedics, Karolinska Institutet, Stockholm, Sweden.
Olof SköldenbergDepartment of Clinical Sciences, Danderyd Hospital, Division of Orthopaedics, Karolinska Institutet, Stockholm, Sweden.
Jakob D WikstromDermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden.
Karolinska Institutet · SEGlanrhyd Hospital · GBKarolinska University Hospital · SENordic Institute for Theoretical Physics · SE

Funding

ALF medicin StockholmHarald och Greta Jeanssons stiftelseHudfondenSvenska Sällskapet för medicinsk forskningTore Nilssons StiftelseVetenskapsrådet
6 · The paper itself

Abstract

During wound healing, cells have a high rate of protein synthesis and many proteins need to be folded post-translationally to function, which occurs in the endoplasmic reticulum (ER). In addition to proliferation, several cellular stress conditions, such as hypoxia, in the wound micro-environment lead to the accumulation of unfolded or misfolded proteins in the ER, causing ER stress. Eukaryotic cells have a signalling system to manage ER stress called the unfolded protein response (UPR). Mild UPR activation has a beneficial homeostatic effect; however, excessive UPR induces cell death. Herein, we examined venous leg ulcer biopsies versus normal acute incisional wounds in age-matched elderly subjects and found a large increase in ER stress markers. To study the underlying mechanism, we established several cell cultures from amputated legs from the elderly that showed inherent ER stress. While both keratinocytes and fibroblasts migration was impaired by ER stress, migration of elderly leg skin keratinocytes was markedly improved after treatment with the chemical chaperone and clinically established drug 4-phenylbutyrate (4-PBA) and demonstrated a reduction in ER stress markers. In a full-thickness human skin wound healing model, 4-PBA improved the reepithelialisation rate, which suggests it as a promising drug repurposing candidate for wound healing.

Indexed as

Endoplasmic Reticulum StressPhenylbutyratesWound HealingFibroblastsHumansKeratinocytesMiddle AgedUnfolded Protein ResponseVaricose Ulcer4-phenylbutyric acidPhenylbutyrateschronic leg ulcersdrug repurposingER stressskinwound healing

Identifiers

PMID33225583
PMCPMC7949014
OpenAlexW3110554779

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.