Scientists are demonstrating how the womb’s unique ability to rapidly rebuild itself could be harnessed to heal difficult-to-repair chronic wounds affecting 400,000 Australians.
A new collaborative study, led by Dr Jemma Evans at Hudson Institute of Medical Research in Melbourne, has shown how plasma isolated from menstrual fluid contains specific proteins that appear to enhance skin repair.
Dr Evans says that menstrual fluid is rich in proteins and bioactive materials that could have applications outside of the womb in chronic wounds, which are estimated to cost the Australian health system $2.85 billion annually.
The findings of the study, involving researchers from Hudson Institute, Walter and Eliza Hall Institute, Queensland University of Technology, The University of Queensland and Skin Research Institute of Singapore, have been published in The FASEB Journal.
“The lining of the uterus, the endometrium, is an amazing tissue which undergoes ‘self-destruction’ each month at menstruation, followed by repair and regeneration of the tissue in preparation for pregnancy. This occurs, on average, 450 times in each woman’s reproductive life,” Dr Evans, a Fielding Foundation Fellow in the Endometrial Remodelling Research Group, explained.
Enhancing skin repair
“Few tissues in the human body promote scar-free wound healing in the same way as the womb. We wanted to test if we could apply these amazing endometrial repair properties to a tissue that is difficult to repair – the skin,” she said.
In comparison to the endometrium which can rebuild itself in three to five days, chronic wounds caused by diabetic or pressure ulcers can take months to fully repair.
Using menstrual fluid samples collected from volunteers using menstrual cups, then processed to extract plasma, Dr Evans and her team discovered that it appears to enhance skin repair, by promoting cell migration to the sites of skin wounds in three different models – a preclinical model, human skin (donated after elective surgeries) and in specific human skin cells (keratinocytes).
“In wounds made in human skin cells, plasma derived from menstrual fluid brought about complete repair, or 100 per cent healing in 24 hours, compared with about 40 per cent healing observed when using human blood plasma to mimic normal wound healing,” Dr Evans said.
The team also analysed the unique make-up of proteins present in menstrual fluid and found it was more complex than plasma derived from blood. Specific proteins were found to promote skin repair, both in isolation and as part of the complex protein ‘cocktail’ in menstrual fluid.
Artificial menstrual fluid’ first steps
“During menstruation, the womb is concurrently shedding and rebuilding cells. Menstrual fluid captures proteins that hold unique ‘instructions’ to the tissue to completely shed and rebuild in 3-5 days,” Dr Evans said. “We envisage that by identifying the most ‘potent’ repair factors present in menstrual fluid we may be able to manufacture an ‘artificial menstrual fluid’ mix which may benefit skin repair.”
A key limitation of the study is that the wounds used in the pre-clinical model were one millimetre deep, in young healthy skin. Further research is needed to establish whether menstrual fluid plasma works on chronic wounds complicated with bacterial infection, in burn wounds, in older skin and in deeper wounds.
Dr Evans said very few treatments are able to rapidly repair wounds. Current treatments for chronic wounds promote proliferation of cells and use of these treatments may be associated with a small increase in cancer risk with long term use, she said.
“This study represents a first step towards using an ‘artificial menstrual fluid’ as a treatment to safely and rapidly heal chronic wounds, reduce the burden on the public health system, and improve the health of thousands of Australians,” Dr Evans said.
Chronic wounds
- Chronic wounds are a ‘silent epidemic’ estimated to affect more than 400,000 Australians at any one time.
- Older people are more likely to experience chronic wounds than younger people, as the skin’s natural ability to repair itself decreases over time.
- Examples of chronic wounds may include: pressure ulcers, diabetic ulcers, venous ulcers and artery insufficiency ulcers.
- The cost of chronic wounds to the Australian health system is an estimated $2.85 billion annually. This represents two per cent of the total national healthcare expenditure.
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