Therapeutic Strategies For Healing Diabetic Wounds

Diabetes often leads to the significant complication of impaired wound healing, primarily due to reduced insulin production or sensitivity. A key factor in this process is Nrf2, which is crucial for regulating phase 2 detoxifying enzymes and antioxidant gene expression, both of which are essential in wound formation. Additionally, glucose levels influence cytokine levels, and it is suggested that type 2 diabetes mellitus may be an innate immune system disorder that perpetuates a cytokine-driven acute phase response. This condition is also linked to delayed recovery following acute vascular events, such as delayed wound re-epithelialization. Oxidative stress plays a role in the dysfunction of bone marrow-derived angiogenic cells (BMAC) in diabetic patients, with reactive oxygen species (ROS) levels often measured using flow cytometry. Heme oxygenase-1 (HO-1) has demonstrated anti-inflammatory and antioxidant effects, which contribute to granulation tissue maturation in diabetic wounds. Thrombospondin-2 (TSP-2), a protein involved in the response to injury, has been linked to delayed wound healing in diabetes. Additionally, various plants and herbs with wound healing properties have been identified in Africa and other developing regions.