Chen Zeyao, Chan Kakei, Li Xin, Gong Li, Ma Yingjie, Huang Chiwen, Lu Yan, Wang Li, Piao Chunli
Department of Endocrinology, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, People's Republic of China.
Department of Gynecology, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, People's Republic of China.
Int J Nanomedicine. 2025 May 22;20:6423-6446. doi: 10.2147/IJN.S514000. eCollection 2025.
The management of diabetic wound continues to pose significant clinical obstacles, primarily attributed to bacterial infections, excessive inflammation, oxidative stress, and impaired angiogenesis. These pathological factors not only severely affect patient well-being but also create considerable burden on medical services. Current managements often show limited efficacy, necessitating the exploration of alternative therapeutic strategies. Polymeric nanomedicines (PNs), owing to their nanoscale properties, enhanced cellular uptake, stability, bioavailability, and biocompatibility, have been broadly utilized for diabetic wound treatment. PNs demonstrate remarkable capabilities in microbial inhibition, inflammation regulation, oxidative stress mitigation, and vascular network formation, particularly when combined with various agents, including organic substances (eg, exosomes), inorganic substances (eg, metals), and biomaterials (eg, chitosan, hyaluronic acid, and hydrogels). This article systematically examines recent progress in PN-based interventions for diabetic wound recovery, highlighting the pivotal role of PNs in mitigating bacterial infection, modulating inflammatory responses, and promoting cellular regeneration. Additionally, we provide a novel perspective on the multifunctionality of PNs and their potential for overcoming the limitations of conventional therapies. Overall, PNs represent an innovative and promising approach to diabetic wound management, outperforming conventional therapies in stability, targeted delivery, and multifunctionality. In the future, investigations should concentrate on refining PNs formulations and administration strategies so as to enhance biocompatibility, and conducting well-designed clinical trials to validate their therapeutic efficacy.
糖尿病伤口的管理仍然面临重大临床障碍,主要归因于细菌感染、过度炎症、氧化应激和血管生成受损。这些病理因素不仅严重影响患者的健康,也给医疗服务带来了相当大的负担。目前的治疗方法往往疗效有限,因此有必要探索替代治疗策略。聚合物纳米药物(PNs)由于其纳米级特性、增强的细胞摄取、稳定性、生物利用度和生物相容性,已被广泛用于糖尿病伤口的治疗。PNs在抑制微生物、调节炎症、减轻氧化应激和形成血管网络方面表现出显著能力,特别是当与各种物质结合时,包括有机物质(如外泌体)、无机物质(如金属)和生物材料(如壳聚糖、透明质酸和水凝胶)。本文系统地综述了基于PNs的干预措施在糖尿病伤口愈合方面的最新进展,强调了PNs在减轻细菌感染、调节炎症反应和促进细胞再生方面的关键作用。此外,我们提供了一个关于PNs多功能性及其克服传统疗法局限性潜力的新视角。总体而言,PNs代表了一种创新且有前景的糖尿病伤口管理方法,在稳定性、靶向递送和多功能性方面优于传统疗法。未来,研究应集中于优化PNs的配方和给药策略以提高生物相容性,并开展精心设计的临床试验以验证其治疗效果。