Introduction,
Chronic wounds, particularly in people with diabetes, present a painful and often dangerous challenge. These wounds resist healing, leaving patients vulnerable to infections that can lead to serious complications, including amputations. Now, researchers have made a surprising discovery: a bacterium originally found in faeces, Alcaligenes faecalis, shows promise as a powerful aid in wound healing. This unexpected finding could offer new hope for millions of people affected by diabetes-related chronic wounds, potentially transforming how these stubborn injuries are treated.
The Challenge of Chronic Wounds in Diabetes
For individuals with diabetes, wound healing becomes a complex, often compromised process. High blood sugar levels interfere with blood circulation and immune response, leaving wounds open to infection and slow to heal. Without adequate treatment, these wounds can develop painful infections, sometimes leading to severe outcomes like amputations. According to the American Diabetes Association, about 15% of people with diabetes will experience a foot ulcer at some point in their lives, and many of these wounds become chronic, persisting despite conventional treatments.
Chronic wounds are notoriously difficult to manage due to the multitude of bacterial species that inhabit them. Some bacteria exacerbate infections, while others may simply coexist without impacting the healing process. However, until recently, researchers didn’t consider that certain bacteria might actually promote wound healing.
An Accidental Discovery in the Wound Microbiome
Lindsay Kalan, a microbiome researcher formerly with the University of Pennsylvania’s Grice Lab, first encountered Alcaligenes faecalis while studying the microbiome of chronic wounds. Named for its original discovery in faeces, A. faecalis was initially thought to be an inconsequential bystander, a harmless microbe among many others in the wound environment. However, Kalan began to notice a pattern: wounds colonized by A. faecalis appeared to heal faster than those without it.
Intrigued, Kalan and her colleagues conducted experiments to investigate this phenomenon further. When they introduced A. faecalis to wounds in diabetic mice, they found that the treated wounds showed rapid healing compared to untreated wounds. The team observed similar results when they applied A. faecalis to human skin samples from diabetic patients, which revealed an accelerated closure of the wounds.
“This was a very surprising finding,” says Ellen White, a researcher now leading the study at the University of Pennsylvania. “We initially thought it was just another microbe, but it turned out to play a much more active role in wound healing than we expected.”
How Alcaligenes faecalis Promotes Healing
What makes A. faecalis unique is its ability to alter the biochemical environment of a wound. In diabetic patients, enzymes known as matrix metalloproteinases (MMPs) become overactive, breaking down proteins necessary for wound healing. Elevated MMP levels are common in diabetic wounds, where they degrade collagen and other structural proteins, ultimately preventing the formation of new, healthy tissue.
The researchers found that A. faecalis significantly decreased the levels of MMPs in the wounds, effectively rebalancing these enzymes to a state more conducive to healing. Additionally, A. faecalis stimulated the production of keratinocytes—cells essential for wound closure and skin regeneration. By supporting keratinocyte growth and tempering the effects of MMPs, A. faecalis enabled wounds to heal more efficiently and without the usual interruptions caused by diabetes-related biochemical imbalances.
Testing A. faecalis in Complex Wound Environments
One of the biggest challenges in treating chronic wounds is the diversity of bacteria that thrive in these environments. Wounds, particularly those in diabetic patients, become a breeding ground for a mix of bacteria, some harmful and others benign. Researchers, therefore, wanted to know how A. faecalis would interact with these diverse microbial communities.
Current studies are exploring how A. faecalis competes with harmful bacteria, such as Staphylococcus aureus, a common culprit in wound infections. The team observed that A. faecalis establishes itself in the wound environment without triggering harmful responses, suggesting that it could be integrated into a treatment without destabilizing the microbiome. “The hope is that A. faecalis can be an ally, working alongside the body’s natural healing mechanisms while also outcompeting dangerous pathogens,” says White.
The Path Forward, Turning A. faecalis into a Viable Treatment
Despite the promising results, researchers caution that much remains to be learned about how A. faecalis functions in different wound environments. Dr. Swathi Balaji at Baylor College of Medicine, who was not involved in the study, notes that wound microbiomes are highly complex and adaptive. “If you target one aspect of the wound, like a specific enzyme or bacterium, other pathogens may adapt and find ways to circumvent it,” she explains. A successful treatment will likely need to target multiple aspects of the wound environment to provide a long-lasting solution.
To further understand its potential, the Grice Lab at the University of Pennsylvania is conducting follow-up studies to investigate how A. faecalis might be optimized for use in a clinical setting. These studies will examine how the bacterium can be applied to different types of wounds, how it interacts with other microbial species, and how it might be formulated into a stable, effective therapy. Researchers are also studying whether the bacterium can be genetically modified or combined with other therapeutic agents to enhance its healing effects.
Implications for Diabetic Patients and Wound Care
The discovery of A. faecalis as a wound-healing bacterium could lead to a new paradigm in wound care, particularly for diabetic patients who have few effective treatment options. Chronic wounds impose a significant burden not only on patients but also on healthcare systems, with billions spent annually on treating these slow-to-heal injuries. A therapy derived from A. faecalis could reduce the need for invasive treatments, decrease the likelihood of amputations, and improve quality of life for individuals with diabetes.
This research aligns with a broader trend in microbiome science, which seeks to harness the beneficial properties of microbes to promote health. As scientists learn more about the healing potential of bacteria like A. faecalis, they are rethinking conventional views on wound care and exploring how microbial therapies might complement or even replace traditional treatments.
A Promising Future for Microbial Therapies in Medicine
The work being done on A. faecalis opens doors to other applications of microbial therapy, a field that is expanding rapidly as researchers discover new ways beneficial bacteria can support health. Beyond wound healing, scientists are investigating how the microbiome can influence everything from digestion to mental health, and even the immune system’s ability to fight off disease. For diabetic patients, who are often limited in their treatment options, the use of bacteria like A. faecalis could offer a breakthrough.
While there is still much to learn, A. faecalis demonstrates the potential for using the body’s own bacterial allies in the fight against chronic disease. As researchers continue to unlock the therapeutic secrets of the microbiome, the future of medicine may increasingly involve solutions from the natural world.
For now, A. faecalis serves as a reminder of the unexpected ways that microbes, often viewed solely as threats, can act as powerful partners in the body’s healing processes.
References
- White, E., et al. “Alcaligenes faecalis and Wound Healing in Diabetic Models.” Science Advances, 2024.
- Balaji, S., et al. “The Complexity of Chronic Wound Microbiomes.” Journal of Clinical Microbiology, 2023.
- Grice, E., et al. “Microbial Therapies and Wound Care Innovation.” Journal of Applied Microbiology, 2022.