Peptide-Based Therapies Show Promise in Chronic and Acute Wound Care

The clinical management of wounds is entering a transformative era as researchers look beyond conventional systemic analgesics toward localized, peptide-based therapies that simultaneously address pain and tissue regeneration. Wounds are fundamentally defined as disruptions of tissue integrity that can occur in the skin, mucous membranes, or internal organs, often accompanied by pain, bleeding, and infection risks.¹

Although acute wounds typically heal within weeks, chronic wounds such as diabetic ulcers or pressure injuries often stall in a prolonged inflammatory state, posing a massive economic burden that reaches an estimated $127 billion annually in the United States alone. Traditionally, managing the pain associated with these conditions has relied on systemic nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids, yet these conventional treatments carry significant risks, including systemic adverse effects, potential for addiction, and even delayed wound healing.

Peptide-based approaches offer a promising alternative by providing targeted biological activity directly at the site of injury. Peptides are short-chain amino acids that can be engineered or naturally sourced to act as antimicrobial agents, angiogenic stimulants, and immune modulators. Of particular interest to pharmacists is the emergence of dual-action peptides that provide localized analgesia while accelerating the repair process.^1,2

For instance, the synthetic opioid peptide biphalin has demonstrated the ability to act as a potent analgesic while simultaneously increasing macrophage infiltration and thicker epidermis formation in diabetic wound models. Similarly, the lactoferrin-derived peptide LPF-35 has shown pronounced analgesic activity comparable to morphine without inducing tolerance or dependence and also significantly improving neovascularization and wound closure.¹

The structural configuration of these peptides plays a critical role in their clinical utility, particularly through the use of cyclic peptides. Unlike linear peptides, cyclic peptides possess a circular sequence that confers greater stability and improved pharmacokinetics, making them more resistant to the enzymatic degradation typically found in the proteolytically active environment of a chronic wound. This stability is essential because the natural process of healing involves a complex, 3-phase interplay of inflammation, proliferation, and remodeling that requires sustained therapeutic presence. Beyond simple skin repair, these peptide platforms are also being investigated for their ability to promote the regrowth of nervous tissue and prevent tissue damage following ischemic reperfusion injuries.³

For the community pharmacist, these advancements align with an expanding professional scope that increasingly includes acute minor wound management. In some regions, such as Australia, pilot programs are exploring the ability of pharmacists to perform wound cleansing, closure, and the administration of local treatments. However, recent surveys of pharmacy staff have identified significant knowledge gaps, particularly in the selection and application of advanced dressings such as foams, alginates, and hydrogels. Knowledge of advanced delivery systems is becoming increasingly vital, as hydrogels are now frequently used to shield therapeutic peptides from degradation while maintaining the moist environment necessary for optimal cell migration. These hydrogel scaffolds can be designed to respond to environmental cues like pH or oxidative stress, enabling the controlled release of peptides exactly when the wound microenvironment requires intervention.^2,4

Despite the clear therapeutic potential, several hurdles remain before these peptide-based dressings become a standard part of the pharmacy inventory. Peptides are inherently susceptible to degradation by proteases, and synthetic modifications like PEGylation or the use of D-amino acids are often required to prolong their half-life, which can increase manufacturing complexity and cost. Furthermore, because these products are often classified as combination devices—consisting of both a medical device and a bioactive compound—they face rigorous and lengthy regulatory approval processes.¹

Nevertheless, with several peptide-loaded hydrogels already in phase 3 clinical trials, the transition from laboratory bench to pharmacy shelf is accelerating. As accessible health care hubs, community pharmacists will play a pivotal role in integrating these advanced therapies into routine clinical care, ultimately bridging the gap between effective pain management and functional tissue regeneration.^1,2

READ MORE: Wound Care Resource Center

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REFERENCES

1. Kołodyńska K, Kamysz W, Kleczkowska P. Peptide-Based Approaches for Pain Relief and Healing in Wounds. Int J Mol Sci. 2026;27(2):685. Published 2026 Jan 9. doi:10.3390/ijms27020685

2. Kamil RM, Nyamathulla S, Mahmood S. Peptides in wound healing: A comprehensive review of their roles, challenges, and hydrogel-based delivery systems. EXCLI J. 2025;24:1657-1689. Published 2025 Dec 1. doi:10.17179/excli2025-8778

3. Lee YJ, Javdan B, Cowan A, Smith K. More than skin deep: cyclic peptides as wound healing and cytoprotective compounds. Front Cell Dev Biol. 2023;11:1195600. Published 2023 Jun 1. doi:10.3389/fcell.2023.1195600

4. Cheung DHK, Schneider CR, Collins JC, Um IS. Wound Care Knowledge of Community Pharmacists and Pharmacy Staff: A Cross-Sectional Survey. Int Wound J. 2025;22(9):e70766. doi:10.1111/iwj.70766