Oryan Ahmad, Alemzadeh Esmat
Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran.
Department of Biotechnology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran.
Life Sci. 2017 Apr 1;174:59-67. doi: 10.1016/j.lfs.2017.02.015. Epub 2017 Mar 2.
Several studies have indicated that insulin that is used in reducing blood glucose is also affective on wound healing by various mechanisms. To understand the outcomes of insulin therapy on wound healing, a meta-analysis and systematic review was performed.
The Cochrane library, PubMed, and Science Direct were searched for the literature published from January the 1st 1990 to September the 30th 2016. Twelve animals and nine clinical studies were included. A quantitative and qualitative review was performed on the clinical trials and the animal studies were comprehensively overviewed. Statistical analysis for development of granulation tissue, microvessel density, and time of healing was conducted in this systematic review.
The animal studies revealed that treatment with topical insulin lead to faster wound contraction and re-epithelialization. Meta-analysis of wound studies revealed that insulin therapy is significantly favored for growth of granulation tissue. Based on these findings, insulin enhanced development of granulation tissue on day 7 after treatment. The meta-analysis studies indicated significant reduction in time of healing in the patients treated with insulin. These studies also disclosed that the new vessels were observable from five days after injection in the treated group, compared to the control animals that developed significantly at later stage.
Insulin is a low cost growth factor and can be considered as a therapeutic agent in wound healing. However, further studies are necessary to gain a better understanding of the role of insulin in wound healing.
多项研究表明,用于降低血糖的胰岛素通过多种机制对伤口愈合也有作用。为了解胰岛素治疗对伤口愈合的效果,进行了一项荟萃分析和系统评价。
检索Cochrane图书馆、PubMed和Science Direct中1990年1月1日至2016年9月30日发表的文献。纳入了12项动物研究和9项临床研究。对临床试验进行了定量和定性综述,并对动物研究进行了全面概述。在该系统评价中对肉芽组织生长、微血管密度和愈合时间进行了统计分析。
动物研究表明,局部应用胰岛素治疗可使伤口收缩和再上皮化加快。伤口研究的荟萃分析表明,胰岛素治疗对肉芽组织生长明显有利。基于这些发现,胰岛素在治疗后第7天可促进肉芽组织生长。荟萃分析研究表明,接受胰岛素治疗的患者愈合时间显著缩短。这些研究还表明,与在后期才明显出现新血管的对照动物相比,治疗组在注射后5天即可观察到新血管。
胰岛素是一种低成本的生长因子,可被视为伤口愈合的治疗药物。然而,需要进一步研究以更好地了解胰岛素在伤口愈合中的作用。