College of Podiatric Medicine, Western University of Health Sciences, Pomona, California, USA.
Department of Translational Research, Western University of Health Sciences, Pomona, California, USA.
Expert Rev Clin Immunol. 2021 Jun;17(6):681-690. doi: 10.1080/1744666X.2021.1912598. Epub 2021 Apr 22.
: Wound healing in diabetes may be delayed by persistent wound infection due to deficient immune and cellular response to tissue injury. Hyperglycemia due to decreased insulin availability and increased insulin resistance affects the immune response of the body. Accumulation of inflammatory immune cells and pro-inflammatory cytokines results in chronic inflammation and an altered resolution and remodeling phase of wound healing.: Pro-resolving mediators called 'resolvins' target the resolution phase of wound healing and are becoming an area of increased interest. Resolvins stimulate self-limited innate immune responses and enhance innate microbial killing and clearance. Resolvins resolve inflammation by decreasing neutrophil infiltration and transmigration, increasing the phagocytic activity of macrophages, decreasing adipose tissue macrophages, downregulating platelet activation, suppressing nuclear factor-kappa beta activation, promoting the apoptosis of polymorphonuclear leukocytes, and improving insulin sensitivity. This review discusses the role of resolvins in diabetic wound healing and potential therapeutic strategies. The review is based on a literature search of PubMed and the Web of Science restricted to publications between January 2001 and October 2020.: There is increasing support for the use of resolvins in clinical applications related to diabetes and wound healing. Further research will help clarify this potential.
糖尿病患者的伤口愈合可能会因持续的伤口感染而延迟,这是由于机体对组织损伤的免疫和细胞反应不足所致。由于胰岛素供应减少和胰岛素抵抗增加而导致的高血糖会影响机体的免疫反应。炎症免疫细胞和促炎细胞因子的积累导致慢性炎症以及伤口愈合的解决和重塑阶段发生改变。
被称为“消退素”的促解决介质靶向伤口愈合的解决阶段,成为一个日益受到关注的领域。消退素可刺激自我限制的先天免疫反应,并增强先天微生物杀伤和清除作用。消退素通过减少中性粒细胞浸润和迁移、增加巨噬细胞的吞噬活性、减少脂肪组织中的巨噬细胞、下调血小板活化、抑制核因子-κB 活化、促进多形核白细胞凋亡以及改善胰岛素敏感性来解决炎症。
这篇综述讨论了消退素在糖尿病伤口愈合中的作用以及潜在的治疗策略。该综述基于对 PubMed 和 Web of Science 的文献检索,仅限于 2001 年 1 月至 2020 年 10 月期间的出版物。
越来越多的人支持将消退素应用于与糖尿病和伤口愈合相关的临床应用。进一步的研究将有助于阐明这种潜力。