Host-pathogen interactions and the development of chronic infections

Chronic, non-healing wounds are common in patients with vascular insufficiencies and underlying chronic conditions, as well as patients suffering from acute, extended trauma. These wounds mostly affect people over the age of 60 and the incidence of these wounds is expected to increase with aging of the population and the increasing prevalence of obesity.

Non-healing wounds result in major economic costs for the patients, their families and Society as a whole. Diabetic ulcers are for example one of the most common causes of non-traumatic amputation, worldwide leading to one lower leg amputation every 30 seconds. Moreover, these patients have increased risks for developing complications post-surgery.

In Sweden, there are currently around 50,000 people with one or multiple non-healing wounds and the estimated cost for treating these patients is 1-2 billion SEK/year.

Although there are numerous reasons for the development of chronic wounds, a major mechanisms underlying failure of healing are bacterial infection and a prolonged and unregulated inflammatory responses. Clearly, open wounds, especially the presence of necrotic tissue, offer an opportunity for bacterial entry and proliferation.

The presence of Pseudomonas aeruginosa is a sever complication in the healing of (chronic) infections. Although various possible actions of P. aeruginosa are identified, especially in relation to pulmonary infections in cystic fibrosis, this has not led to effective therapies for these often untreatable infections

Clearly, a better understanding of the mechanisms that are used by this pathogen to escape the host is crucial.

Our research is focused on understanding the molecular mechanisms responsible for the persistence of P. aeruginosa in wounds. This much needed knowledge will be translated from bench to bedside, and it may play a key role in discovering new targets for the development of novel therapies for the treatment of non-healing infected wounds.