Pincus David J, Kassira Noor, Gombosh Michael, Berho Mariana, Glassberg Marilyn, Karl Michael, Elliot Sharon J, Thaller Seth
Miami, Florida; Email:
Wounds. 2010 Jul;22(7):171-8.
Postmenopausal women are more susceptible to poor wound healing. This phenomenon can be reversed by estrogen replacement therapy in non-diabetic individuals. Postmenopausal women with type 2 diabetes are more susceptible to wound healing complications, potentially secondary to an estrogen deficiency. Few studies have examined the mechanism of action and effects of estrogens on diabetic wound healing in females. It appears that multiple factors influence delayed wound healing among individuals with diabetes including: an imbalance in cytokines, growth factors, extracellular matrix (ECM) turnover, and oxidant stress (OS). Estrogens have been shown to regulate the expression of genes important for extracellular matrix turnover, including collagen and matrix metalloproteinases (MMP).
For this reason, the effects of 17β-estradiol (E2) on MMP-2, MMP-13, and MMP-14 and estrogen receptor alpha and beta (ER-α and -β) expression in the wound tissue of estrogen-deficient female mice with established type 2 diabetes mellitus (C57BL/6J-m Leprdb/2+) were studied.
Topical E2 upregulates ERα in wound tissue thereby improving and accelerating diabetic wound healing in estrogen deficient mice.
The mechanism appears to decrease MMP-2, MMP-13, and MMP-14 mediated tissue matrix destruction and increasing collagen content. .
绝经后女性更容易出现伤口愈合不良的情况。在非糖尿病个体中，这种现象可通过雌激素替代疗法得到逆转。患有2型糖尿病的绝经后女性更容易出现伤口愈合并发症，这可能继发于雌激素缺乏。很少有研究探讨雌激素对女性糖尿病伤口愈合的作用机制和影响。糖尿病患者伤口愈合延迟似乎受多种因素影响，包括：细胞因子、生长因子、细胞外基质（ECM）周转和氧化应激（OS）失衡。雌激素已被证明可调节对细胞外基质周转至关重要的基因表达，包括胶原蛋白和基质金属蛋白酶（MMP）。
因此，研究了17β-雌二醇（E2）对已患2型糖尿病的雌激素缺乏雌性小鼠（C57BL/6J-m Leprdb/2+）伤口组织中MMP-2、MMP-13和MMP-14以及雌激素受体α和β（ER-α和-β）表达的影响。
局部应用E2可上调伤口组织中的ERα，从而改善和加速雌激素缺乏小鼠的糖尿病伤口愈合。
其机制似乎是减少MMP-2、MMP-13和MMP-14介导的组织基质破坏并增加胶原蛋白含量。
