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糖尿病相关下肢动脉疾病的治疗进展

Advances for the treatment of lower extremity arterial disease associated with diabetes mellitus.

作者信息

Pan Yang, Luo Yuting, Hong Jing, He Huacheng, Dai Lu, Zhu Hong, Wu Jiang

机构信息

Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

Key Laboratory of Biotechnology and Pharmaceutical Engineering, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China.

出版信息

Front Mol Biosci. 2022 Aug 17;9:929718. doi: 10.3389/fmolb.2022.929718. eCollection 2022.

DOI:10.3389/fmolb.2022.929718
PMID:36060247
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9429832/
Abstract

Lower extremity arterial disease (LEAD) is a major vascular complication of diabetes. Vascular endothelial cells dysfunction can exacerbate local ischemia, leading to a significant increase in amputation, disability, and even mortality in patients with diabetes combined with LEAD. Therefore, it is of great clinical importance to explore proper and effective treatments. Conventional treatments of diabetic LEAD include lifestyle management, medication, open surgery, endovascular treatment, and amputation. As interdisciplinary research emerges, regenerative medicine strategies have provided new insights to treat chronic limb threatening ischemia (CLTI). Therapeutic angiogenesis strategies, such as delivering growth factors, stem cells, drugs to ischemic tissues, have also been proposed to treat LEAD by fundamentally stimulating multidimensional vascular regeneration. Recent years have seen the rapid growth of tissue engineering technology; tissue-engineered biomaterials have been used to study the treatment of LEAD, such as encapsulation of growth factors and drugs in hydrogel to facilitate the restoration of blood perfusion in ischemic tissues of animals. The primary purpose of this review is to introduce treatments and novel biomaterials development in LEAD. Firstly, the pathogenesis of LEAD is briefly described. Secondly, conventional therapies and therapeutic angiogenesis strategies of LEAD are discussed. Finally, recent research advances and future perspectives on biomaterials in LEAD are proposed.

摘要

下肢动脉疾病（LEAD）是糖尿病的一种主要血管并发症。血管内皮细胞功能障碍会加重局部缺血，导致合并LEAD的糖尿病患者的截肢、残疾甚至死亡率显著增加。因此，探索恰当有效的治疗方法具有重要的临床意义。糖尿病性LEAD的传统治疗方法包括生活方式管理、药物治疗、开放手术、血管内治疗和截肢。随着跨学科研究的出现，再生医学策略为治疗慢性肢体威胁性缺血（CLTI）提供了新的见解。还提出了治疗性血管生成策略，如向缺血组织递送生长因子、干细胞、药物，从根本上刺激多维度血管再生来治疗LEAD。近年来，组织工程技术迅速发展；组织工程生物材料已被用于研究LEAD的治疗，如将生长因子和药物包裹在水凝胶中以促进动物缺血组织的血流灌注恢复。本综述的主要目的是介绍LEAD的治疗方法和新型生物材料的开发。首先，简要描述LEAD的发病机制。其次，讨论LEAD的传统疗法和治疗性血管生成策略。最后，提出LEAD生物材料的最新研究进展和未来展望。

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