Accipe Laura, Abadie Alisson, Neviere Remi, Bercion Sylvie
UR5_3 PC2E Cardiac Pathology, Environmental Toxicity and Envenomations, Université des Antilles, BP 250, CEDEX, 97157 Pointe à Pitre, France.
CHU Martinique, University Hospital of Martinique, 97200 Fort de France, France.
Antioxidants (Basel). 2023 May 11;12(5):1079. doi: 10.3390/antiox12051079.
Diabetic wound healing is a global medical challenge. Several studies showed that delayed healing in diabetic patients is multifactorial. Nevertheless, there is evidence that excessive production of ROS and impaired ROS detoxification in diabetes are the main cause of chronic wounds. Indeed, increased ROS promotes the expression and activity of metalloproteinase, resulting in a high proteolytic state in the wound with significant destruction of the extracellular matrix, which leads to a stop in the repair process. In addition, ROS accumulation increases NLRP3 inflammasome activation and macrophage hyperpolarization in the M1 pro-inflammatory phenotype. Oxidative stress increases the activation of NETosis. This leads to an elevated pro-inflammatory state in the wound and prevents the resolution of inflammation, an essential step for wound healing. The use of medicinal plants and natural compounds can improve diabetic wound healing by directly targeting oxidative stress and the transcription factor Nrf2 involved in the antioxidant response or the mechanisms impacted by the elevation of ROS such as NLRP3 inflammasome, the polarization of macrophages, and expression or activation of metalloproteinases. This study of the diabetic pro-healing activity of nine plants found in the Caribbean highlights, more particularly, the role of five polyphenolic compounds. At the end of this review, research perspectives are presented.
糖尿病伤口愈合是一项全球性的医学挑战。多项研究表明，糖尿病患者伤口愈合延迟是多因素导致的。然而，有证据表明，糖尿病中活性氧（ROS）的过度产生和ROS解毒受损是慢性伤口的主要原因。事实上，ROS增加会促进金属蛋白酶的表达和活性，导致伤口处于高蛋白水解状态，细胞外基质遭到严重破坏，从而使修复过程停止。此外，ROS积累会增加NLRP3炎性小体的激活以及巨噬细胞向M1促炎表型的超极化。氧化应激会增加中性粒细胞胞外陷阱形成（NETosis）的激活。这会导致伤口促炎状态升高，并阻止炎症的消退，而炎症消退是伤口愈合的关键步骤。使用药用植物和天然化合物可以通过直接针对氧化应激以及参与抗氧化反应的转录因子Nrf2，或受ROS升高影响的机制（如NLRP3炎性小体、巨噬细胞极化以及金属蛋白酶的表达或激活）来改善糖尿病伤口愈合。这项对在加勒比地区发现的九种植物的糖尿病促愈合活性的研究，更特别地突出了五种多酚化合物的作用。在本综述结尾，还介绍了研究展望。
