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探讨促炎细胞因子在糖尿病创面愈合受损中的作用。

Exploring the contribution of pro-inflammatory cytokines to impaired wound healing in diabetes.

机构信息

Department of Pharmacology, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India.

Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Jalan Lagoon Selatan, Bandar Sunway, Petaling Jaya, Selangor, Malaysia.

出版信息

Front Immunol. 2023 Jul 27;14:1216321. doi: 10.3389/fimmu.2023.1216321. eCollection 2023.

Abstract

BACKGROUND

Impaired wound healing is the most common and significant complication of Diabetes. While most other complications of Diabetes have better treatment options, diabetic wounds remain a burden as they can cause pain and suffering in patients. Wound closure and repair are orchestrated by a sequence of events aided by the release of pro-inflammatory cytokines, which are dysregulated in cases of Diabetes, making the wound environment unfavorable for healing and delaying the wound healing processes. This concise review provides an overview of the dysregulation of pro-inflammatory cytokines and offers insights into better therapeutic outcomes.

PURPOSE OF REVIEW

Although many therapeutic approaches have been lined up nowadays to treat Diabetes, there are no proper treatment modalities proposed yet in treating diabetic wounds due to the lack of understanding about the role of inflammatory mediators, especially Pro-inflammatory mediators- Cytokines, in the process of Wound healing which we mainly focus on this review.

RECENT FINDINGS

Although complications of Diabetes mellitus are most reported after years of diagnosis, the most severe critical complication is impaired Wound Healing among Diabetes patients. Even though Trauma, Peripheral Artery Disease, and Peripheral Neuropathy are the leading triggering factors for the development of ulcerations, the most significant issue contributing to the development of complicated cutaneous wounds is wound healing impairment. It may even end up with amputation. Newer therapeutic approaches such as incorporating the additives in the present dressing materials, which include antimicrobial molecules and immunomodulatory cytokines is of better therapeutic value.

SUMMARY

The adoption of these technologies and the establishment of novel therapeutic interventions is difficult since there is a gap in terms of a complete understanding of the pathophysiological mechanisms at the cellular and molecular level and the lack of data in terms of the assessment of safety and bioavailability differences in the individuals' patients. The target-specific pro-inflammatory cytokines-based therapies, either by upregulation or downregulation of them, will be helpful in the wound healing process and thereby enhances the Quality of life in patients, which is the goal of drug therapy.

摘要

背景

伤口愈合受损是糖尿病最常见和最严重的并发症。虽然糖尿病的大多数其他并发症都有更好的治疗选择,但糖尿病伤口仍然是一个负担,因为它们会给患者带来疼痛和痛苦。伤口的闭合和修复是由一系列事件协调的,这些事件得益于促炎细胞因子的释放,而在糖尿病的情况下,这些细胞因子会失调,使伤口环境不利于愈合,并延迟伤口愈合过程。本综述概述了促炎细胞因子的失调,并深入探讨了改善治疗效果的方法。

目的

尽管现在有许多治疗方法被提出用于治疗糖尿病,但由于对炎症介质(尤其是促炎介质细胞因子)在伤口愈合过程中的作用缺乏了解,目前还没有针对糖尿病性伤口的适当治疗方法。我们主要关注这个综述。

最近的发现

尽管糖尿病的并发症在诊断多年后最常被报道,但糖尿病患者最严重的危急并发症是伤口愈合受损。尽管创伤、外周动脉疾病和周围神经病变是溃疡发展的主要触发因素,但导致复杂皮肤伤口发展的最重要问题是伤口愈合受损。甚至可能导致截肢。新的治疗方法,如在现有敷料材料中加入添加剂,包括抗菌分子和免疫调节细胞因子,具有更好的治疗价值。

总结

由于在细胞和分子水平上对病理生理机制的全面了解存在差距,以及在个体患者的安全性和生物利用度差异评估方面缺乏数据,因此采用这些技术和建立新的治疗干预措施存在困难。基于目标特异性促炎细胞因子的治疗方法,无论是上调还是下调它们,都将有助于伤口愈合过程,并提高患者的生活质量,这是药物治疗的目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c30/10414543/30119e2b5a1d/fimmu-14-1216321-g001.jpg

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