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二肽基肽酶4抑制剂对慢性糖尿病足溃疡愈合的研究进展

[Research progress of dipeptidyl peptidase 4 inhibitors on healing of chronic diabetic foot ulcers].

作者信息

Gao Yunyi, Liang Yujie, Ran Xingwu

机构信息

Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.

Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 May 15;32(5):630-633. doi: 10.7507/1002-1892.201802034.

Abstract

OBJECTIVE

To review the effect of dipeptidyl peptidase 4 (DPP-4) inhibitors on the wound healing and its mechanisms in chronic diabetic foot ulcers.

METHODS

The latest literature concerning DPP-4 inhibitors for chronic diabetic foot ulcers was extensively reviewed, as well as the potential benefit and mechanism of DPP-4 inhibitors on wound healing of diabetic foot ulcers was analyzed thoroughly.

RESULTS

DPP-4 inhibitors can accelerated the ulcer healing. The mechanisms probably include inhibiting the expression of the matrix metalloproteinase (MMP) and restoring the balance of the wound MMP and the tissue inhibitors of MMP; promoting recruitment of endothelial progenitor cells and augmenting angiogenesis; optimizing extracellular matrix construction and the immune response to persistent hypoxia in chronic diabetes wounds, and so on. At present, clinical researches show that DPP-4 inhibitors may be considered as an adjuvant treatment for chronic diabetic foot ulcers.

CONCLUSION

DPP-4 inhibitors show promise in the local wound healing of chronic diabetic foot ulcers. However, more strictly designed, adequately powered, long-term follow-up, and high-quality randomized control trials are needed to further verify their efficacy and safety for chronic diabetic foot ulcers.

摘要

目的

综述二肽基肽酶4(DPP-4)抑制剂对慢性糖尿病足溃疡伤口愈合的影响及其机制。

方法

广泛查阅有关DPP-4抑制剂治疗慢性糖尿病足溃疡的最新文献,并深入分析DPP-4抑制剂对糖尿病足溃疡伤口愈合的潜在益处及机制。

结果

DPP-4抑制剂可加速溃疡愈合。其机制可能包括抑制基质金属蛋白酶(MMP)的表达并恢复伤口MMP与MMP组织抑制剂之间的平衡;促进内皮祖细胞的募集并增强血管生成;优化细胞外基质构建以及对慢性糖尿病伤口持续性缺氧的免疫反应等。目前,临床研究表明DPP-4抑制剂可被视为慢性糖尿病足溃疡的辅助治疗方法。

结论

DPP-4抑制剂在慢性糖尿病足溃疡的局部伤口愈合方面显示出前景。然而,需要更严格设计、足够样本量、长期随访的高质量随机对照试验来进一步验证其对慢性糖尿病足溃疡的疗效和安全性。

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