Lu Yongpan, Zhao Dejie, Cao Guoqi, Yin Siyuan, Liu Chunyan, Song Ru, Ma Jiaxu, Sun Rui, Wu Zhenjie, Liu Jian, Wu Peng, Wang Yibing
First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China.
Jinan Clinical Research Center for Tissue Engineering Skin Regeneration and Wound Repair, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.
Front Surg. 2024 Feb 23;11:1265360. doi: 10.3389/fsurg.2024.1265360. eCollection 2024.
Diabetic foot ulcers (DFUs) are common chronic wounds and a common complication of diabetes. The foot is the main site of diabetic ulcers, which involve small and medium-sized arteries, peripheral nerves, and microcirculation, among others. DFUs are prone to coinfections and affect many diabetic patients. In recent years, interdisciplinary research combining medicine and material science has been increasing and has achieved significant clinical therapeutic effects, and the application of vacuum sealing drainage (VSD) in the treatment of DFUs is a typical representative of this progress, but the mechanism of action remains unclear. In this review, we integrated bioinformatics and literature and found that ferroptosis is an important signaling pathway through which VSD promotes the healing of DFUs and that System Xc-GSH-GPX4 and NAD(P)H-CoQ10-FSP1 are important axes in this signaling pathway, and we speculate that VSD is most likely to inhibit ferroptosis to promote DFU healing through the above axes. In addition, we found that some classical pathways, such as the TNF, NF-κB, and Wnt/β-catenin pathways, are also involved in the VSD-mediated promotion of DFU healing. We also compiled and reviewed the progress from clinical studies on VSD, and this information provides a reference for the study of VSD in the treatment of DFUs.
糖尿病足溃疡（DFUs）是常见的慢性伤口，也是糖尿病的常见并发症。足部是糖尿病溃疡的主要发病部位，涉及中小动脉、周围神经和微循环等。DFUs容易合并感染，影响众多糖尿病患者。近年来，医学与材料科学相结合的跨学科研究不断增加，并取得了显著的临床治疗效果，负压封闭引流（VSD）在DFUs治疗中的应用就是这一进展的典型代表，但其作用机制尚不清楚。在本综述中，我们整合了生物信息学和文献，发现铁死亡是VSD促进DFUs愈合的重要信号通路，且系统Xc-GSH-GPX4和NAD(P)H-CoQ10-FSP1是该信号通路中的重要轴，我们推测VSD最有可能通过上述轴抑制铁死亡以促进DFU愈合。此外，我们发现一些经典通路，如TNF、NF-κB和Wnt/β-连环蛋白通路，也参与了VSD介导的DFU愈合促进过程。我们还整理并综述了VSD临床研究的进展，这些信息为VSD治疗DFUs的研究提供了参考。
