Yuniati Renni, Innelya Innelya, Rachmawati Arti, Charlex Harold Jefferson Matthew, Rahmatika Alfi, Khrisna Matthew Brian, Mundhofir Farmaditya E P, Hario Seno K Heri Nugroho, Kristina Tri Nur
Dermatology and Venereology Department, Faculty of Medicine, Diponegoro University, Semarang, Indonesia.
Undergraduate Student, Faculty of Medicine, Diponegoro University, Semarang, Indonesia.
J Exp Pharmacol. 2021 Aug 14;13:797-806. doi: 10.2147/JEP.S296767. eCollection 2021.
One of the most serious and devastating complications of diabetes mellitus is diabetic ulcers. They are difficult to treat and often result in limb loss. Topical sucralfate and platelet-rich plasma have the potential to improve the healing outcomes of chronic ulcers, including diabetic ulcers. This research aims to determine the effectiveness of sucralfate and platelet-rich plasma therapy for the improvement of diabetic ulcer wound healing.
Ninety Wistar rats were used in this study and were classified into five groups. Four of the five groups were diabetic induced and were treated with topical sucralfate only, platelet-rich plasma only, combination of topical sucralfate and platelet-rich plasma, and diabetic control group which received standard therapy only. The non-diabetic control group did not receive any therapy. We observed macrophage amount, platelet-derived growth factor, vascular endothelial growth factor, and hypoxia-inducible factor as a biomarker. Rats were terminated after 7th and 14th days and were subjected to immunohistochemistry staining and examination.
We found that topical sucralfate and platelet-rich plasma increase macrophage levels, vascular endothelial growth factor expression and platelet-derived growth factor expression in diabetic wound cells. We also found a reduction in hypoxia inducible factor-1α expression. Combination of topical sucralfate and platelet-rich plasma for 14 days gave the most significant improvement in terms of wound healing compared to topical sucralfate or platelet-rich plasma alone.
The combination of topical sucralfate and platelet-rich plasma therapy results in the best improvement in diabetic ulcer wound healing compared to sucralfate or platelet-rich plasma monotherapy or conventional wound healing therapy.
糖尿病最严重且极具破坏性的并发症之一是糖尿病溃疡。它们难以治疗，且常常导致肢体丧失。局部应用硫糖铝和富血小板血浆有可能改善包括糖尿病溃疡在内的慢性溃疡的愈合效果。本研究旨在确定硫糖铝和富血小板血浆疗法对改善糖尿病溃疡伤口愈合的有效性。
本研究使用了90只Wistar大鼠，并将其分为五组。五组中的四组诱导产生糖尿病，分别仅接受局部硫糖铝治疗、仅接受富血小板血浆治疗、接受局部硫糖铝和富血小板血浆联合治疗，以及仅接受标准治疗的糖尿病对照组。非糖尿病对照组未接受任何治疗。我们观察巨噬细胞数量、血小板衍生生长因子、血管内皮生长因子和缺氧诱导因子作为生物标志物。在第7天和第14天后处死大鼠，并进行免疫组织化学染色和检查。
我们发现局部应用硫糖铝和富血小板血浆可增加糖尿病伤口细胞中的巨噬细胞水平、血管内皮生长因子表达和血小板衍生生长因子表达。我们还发现缺氧诱导因子-1α表达降低。与单独使用局部硫糖铝或富血小板血浆相比，局部硫糖铝和富血小板血浆联合应用14天在伤口愈合方面的改善最为显著。
与硫糖铝或富血小板血浆单一疗法或传统伤口愈合疗法相比，局部硫糖铝和富血小板血浆联合疗法在糖尿病溃疡伤口愈合方面的改善效果最佳。
