Collagenase ointment has also shown benefits in wound healing by achieving selective debridement in porcine models [12]. Partial or full-thickness wounds in Yorkshire pigs were contaminated with Staphylococcus aureus and Pseudomonas aeruginosa, then treated with Clostridium collagenase ointment (Santyl®; Healthpoint Ltd., Fort Worth, Texas, USA), or controls of white petrolatum or moist dressing and untreated

wounds. Following treatment over 8 days, collagenase ointment achieved complete re-epithelialization in 85% of animals GS-1101 cost with partial-thickness wounds compared with only 10% using petrolatum and 0% using moist dressing and untreated wounds. Furthermore, significantly less inflammation and less neutrophil infiltration was observed by histology in the animals treated with collagenase, and re-epithelialization was enhanced, compared with petrolatum [12]. The potential of topically applied proteases for epidermal ablation has also been demonstrated through the in vitro and in vivo use of subtilisin, trypsin, and dispase in murine and human skin samples. These proteases target keratin, desmosomes, and collagen IV, respectively. Following application,

they all demonstrated subcorneal separation, intraepidermal acantholysis, and subepidermal dissociation [2]. Furthermore, GSK 3 inhibitor topical application of a 2.5% (w/v) solution of bovine trypsin to two seborrheic keratosis for 15 min on the trunk of a human participant destroyed the lesions after 1 month, and after 3 months there was no evidence of scarring, pigment changes, or residual seborrhoea keratosis [2]. The use of streptokinase-streptodomase or crystalline trypsin (Trypure®; Novo Nordisk, Bagsvaerd, Denmark) impregnated in wound dressings was examined in patients with necrotic varicose or arteriosclerotic leg ulcers. Treatment

with either protease resulted in a significant reduction in pus and debris associated with until the ulcers, as well as a significant increase in tissue granulation (P < 0.01 in both groups). Compared with trypsin, the streptokinase-streptodomase formulation was associated with less pain (P < 0.01) [13]. In the face of increasing antibiotic resistance among bacteria, development of therapeutics has broadened to compounds that target virulence factors rather than viability. Antivirulence strategies would be less likely to result in the emergence of mutations leading to resistance, due to the reduced impact on the level of selective pressure on the bacterial population [14]. A virulence factor recognized as a tremendous burden on our healthcare system is the formation of bacteria into biofilm. Biofilms, complex structures notoriously difficult to disassemble, protect the colonizing bacteria from the host’s immune system and from antibiotic therapy.