Granzyme B as a therapeutic target for wound healing

Expert Opin Ther Targets. 2019 Sep;23(9):745-754. doi: 10.1080/14728222.2019.1661380. Epub 2019 Sep 4.


Introduction: Granzyme B is a serine protease traditionally understood as having a role in immune-mediated cytotoxicity. Over the past decade, this dogma has been challenged, with a new appreciation that granzyme B can exert alternative extracellular roles detrimental to wound closure and remodeling. Granzyme B is elevated in response to tissue injury, chronic inflammation and/or autoimmune skin diseases, resulting in impaired wound healing. Areas covered: This review provides a historical background of granzyme B and a description of how it is regulated. Details are provided on the role of granzyme B in apoptosis as well as newly identified extracellular roles, focusing on those affecting wound healing, including on inflammation, dermal-epidermal junction separation, re-epithelialization, scarring and fibrosis, and autoimmunity. Finally, the use of pharmacological granzyme B inhibitors as potential therapeutic options for wound treatment is discussed. Expert opinion: Endogenous extracellular granzyme B inhibitors have not been identified in human bio-fluids, thus in chronic wound environments granzyme B appears to remain uncontrolled and unregulated. In response, targeted granzyme B inhibitors have been developed for therapeutic applications in wounds. Animal studies trialing inhibitors of granzyme B show improved healing outcomes, and may therefore provide a novel therapeutic approach for wound treatment.

Keywords: Granzyme; serine protease; small molecule inhibitor; tissue repair; wound healing.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / pathology
  • Granzymes / antagonists & inhibitors*
  • Granzymes / metabolism
  • Humans
  • Inflammation / drug therapy
  • Inflammation / pathology
  • Skin Diseases / drug therapy
  • Skin Diseases / pathology
  • Wound Healing / drug effects*
  • Wounds and Injuries / drug therapy*
  • Wounds and Injuries / pathology


  • GZMB protein, human
  • Granzymes