Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, 646000 Luzhou, Sichuan, China.
School of Nursing, Southwest Medical University, 646000 Luzhou, Sichuan, China.
Front Biosci (Landmark Ed). 2022 Oct 19;27(10):285. doi: 10.31083/j.fbl2710285.
Difficult or even non-healing diabetic foot ulcers (DFU) are a global medical challenge. Although current treatments such as debridement, offloading, and infection control have resulted in partial improvement in DFU, the incidence, amputation, and mortality rates of DFU remain high. Therefore, there is an urgent need to find new or more effective drugs. Numerous studies have shown that oxidative stress plays an important role in the pathophysiology of DFU. The nuclear factor erythroid 2-related factor (Nrf2) signaling pathway and the advanced glycated end products (AGEs)-receptor for advanced glycation endproducts (RAGE), protein kinase C (PKC), polyol and hexosamine biochemical pathways play critical roles in the regulation of oxidative stress in the body. Targeting these pathways to restore redox balance can control and alleviate the occurrence and development of DFU. Natural biologics are a major source of potential drugs for these relevant targets, and their antioxidant potential has been extensively demonstrated. Here, we discussed the pathophysiological mechanism of oxidative stress in DFU, and identifiled natural biologics targeting these pathways to accelerate DFU healing, in order to provide a new or potential direction for clinical treatment, nursing and related basic research of DFU.
糖尿病足溃疡（DFU）是一种难以治愈甚至无法治愈的疾病，是全球范围内的医学挑战。尽管目前的治疗方法，如清创、减压和感染控制，已经使 DFU 得到了部分改善，但 DFU 的发病率、截肢率和死亡率仍然很高。因此，迫切需要寻找新的或更有效的药物。大量研究表明，氧化应激在 DFU 的病理生理学中起着重要作用。核因子红细胞 2 相关因子（Nrf2）信号通路和晚期糖基化终产物（AGEs）-晚期糖基化终产物受体（RAGE）、蛋白激酶 C（PKC）、多元醇和己糖胺生化途径在调节体内氧化应激方面起着关键作用。针对这些途径来恢复氧化还原平衡可以控制和缓解 DFU 的发生和发展。天然生物制品是这些相关靶点潜在药物的主要来源，其抗氧化潜力已得到广泛证实。在这里，我们讨论了 DFU 中氧化应激的病理生理学机制，并确定了针对这些途径的天然生物制品，以加速 DFU 的愈合，为 DFU 的临床治疗、护理和相关基础研究提供新的或潜在的方向。
