Maghsoodloo Dorian, Zartab Hamed, Alipour Milad, Rukerd Mohammad Rezaei Zadeh, Mirkamali Hanieh, Parsi-Moud Abolfazl, Firooz Alireza
Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran.
Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
Arch Dermatol Res. 2025 May 16;317(1):760. doi: 10.1007/s00403-025-04277-w.
Metformin's topical application has proven to be a therapeutic wound healing dressing via pro-angiogenic, anti-inflammatory, autophagy-promoting, and antibacterial effects. The systematic review article aimed to evaluate the available evidence (from both preclinical and clinical studies), in order to better understand its therapeutic potential in wound care. We performed a systematic literature search in PubMed, Scopus, Web of Science, Embase, and Cochrane databases till January 2025. A total of 26 studies included in final analysis according to inclusion criteria. The majority of preclinical investigations demonstrated accelerated wound healing with characterized of increased wound closure and collagen deposition, elevated pro-angiogenic markers (e.g., VEGF, CD31, and α-SMA), suppression of pro-inflammatory cytokines, and induction of autophagy signaling. Notably, biomaterial-based delivery platform applications such as hydrogels and nanofibers greatly magnified these therapeutic effects. While encouraging results in in-vitro, in-vivo and animal models have been documented, clinical studies remain limited in scope. In fact, this large disparity between preclinical results and limited clinical evidences obviously highlights the urgent need for properly designed human trials to determine safety, efficacy, and best delivery modalities of topical metformin. Collectively, topical metformin is a novel and potentially valuable addition to wound treatment cares, which could be subjected to further clinical study.
二甲双胍的局部应用已被证明是一种通过促血管生成、抗炎、促进自噬和抗菌作用来促进伤口愈合的治疗性敷料。这篇系统评价文章旨在评估现有证据（来自临床前和临床研究），以便更好地了解其在伤口护理中的治疗潜力。我们在PubMed、Scopus、Web of Science、Embase和Cochrane数据库中进行了系统的文献检索，直至2025年1月。根据纳入标准，最终纳入分析的共有26项研究。大多数临床前研究表明伤口愈合加速，其特征为伤口闭合增加和胶原蛋白沉积、促血管生成标志物（如VEGF、CD31和α-SMA）升高、促炎细胞因子受到抑制以及自噬信号被诱导。值得注意的是，基于生物材料的递送平台应用，如水凝胶和纳米纤维，极大地放大了这些治疗效果。虽然在体外、体内和动物模型中都有令人鼓舞的结果记录，但临床研究的范围仍然有限。事实上，临床前结果与有限的临床证据之间的这种巨大差异明显凸显了迫切需要进行精心设计的人体试验，以确定局部二甲双胍的安全性、有效性和最佳递送方式。总体而言，局部二甲双胍是伤口治疗护理中一种新颖且具有潜在价值的补充，可进行进一步的临床研究。
