Gabi Schutzius, Michael Faller, Aimee Reynolds, Ralph Tiedt, Julia Klopp, Florian Fuchs, Laure C. Bouchez, Federico Tortelli, Nelly Leroy, Jonathan J. Turner, Guglielmo Roma, Simona Cotesta, Armin Beyerbach, Peter Drueckes, Shola M Richards, Debora Bonenfant, Heinrich Rueeger, Heinz Ruffner, Jutta Blank, Rémi Terranova, Peter Tarsa, Frederic Grandjean, Florian Nigsch, Sebastian Bergling, Natalie Dales, Alexandra Aebi, Paul W. Manley, Markus Schirle, Christian Kolter, Tewis Bouwmeester, Rene Hemmig, Sukhdeep Sahambi, Lori L. Jennings, Walter Carbone, Felix Lohmann, Alfred Zimmerlin, Jun Li, Susan Kirkland, Steffen Renner, Mathias Frederiksen, Vickie Driver, Amy Berwick, Florence Zink, Jason R. Thomas, Andrea Vaupel, Chris Dimitri, Vito Guagnano, Viktoria Gruber, Malvina Louis, Caroline Gubser Keller, and Adrian Salathe
Although most acute skin wounds heal rapidly, non-healing skin ulcers represent an increasing and substantial unmet medical need that urgently requires effective therapeutics. Keratinocytes resurface wounds to re-establish the epidermal barrier by transitioning to an activated, migratory state, but this ability is lost in dysfunctional chronic wounds. Small-molecule regulators of keratinocyte plasticity with the potential to reverse keratinocyte malfunction in situ could offer a novel therapeutic approach in skin wound healing. Utilizing high-throughput phenotypic screening of primary keratinocytes, we identify such small molecules, including bromodomain and extra-terminal domain (BET) protein family inhibitors (BETi). BETi induce a sustained activated, migratory state in keratinocytes in vitro, increase activation markers in human epidermis ex vivo and enhance skin wound healing in vivo. Our findings suggest potential clinical utility of BETi in promoting keratinocyte re-epithelialization of skin wounds. Importantly, this novel property of BETi is exclusively observed after transient low-dose exposure, revealing new potential for this compound class.