Fibroblast Growth Factor in Diabetic Foot Ulcer: Progress and Therapeutic Prospects

Abstract

Diabetic foot ulcer (DFU) is a combination of neuropathy and various degrees of peripheral vasculopathy in diabetic patients resulting in lower extremity infection, ulcer formation, and deep-tissue necrosis. The difficulty of wound healing in diabetic patients is caused by a high glucose environment and various biological factors in the patient. The patients’ skin local microenvironment changes and immune chemotactic response dysfunction. Wounds are easy to be damaged and ulcerated repeatedly, but difficult to heal, and eventually develop into chronic ulcers. DFU is a complex biological process in which many cells interact with each other. A variety of growth factors released from wounds are necessary for coordination and promotion of healing. Fibroblast growth factor (FGF) is a family of cell signaling proteins, which can mediate various processes such as angiogenesis, wound healing, metabolic regulation and embryonic development through its specific receptors. FGF can stimulate angiogenesis and proliferation of fibroblasts, and it is a powerful angiogenesis factor. Twenty-three subtypes have been identified and divided into seven subfamilies. Traditional treatments for DFU can only remove necrotic tissue, delay disease progression, and have a limited ability to repair wounds. In recent years, with the increasing understanding of the function of FGF, more and more researchers have been applying FGF-1, FGF-2, FGF-4, FGF-7, FGF-21 and FGF-23 topically to DFU with good therapeutic effects. This review elaborates on the recently developed FGF family members, outlining their mechanisms of action, and describing their potential therapeutics in DFU.

Bioactive peptides laden nano and micro-sized particles enriched ECM inspired dressing for skin regeneration in diabetic wounds

“…Neo-vascularisation at the wound bed is essential for skin regeneration and healing in diabetic wounds [ 38 ]. Earlier studies have reported the requirement of additional application of angiogenic growth factors such as FGF (fibroblast growth factor) and VEGF (vascular endothelial growth factor) to induce neovascularisation in diabetic wounds [ 39 , 40 ]. In this study, it was observed that the Tylotoin-MP, LLKKK-18-NP and NF-NP-MP treatments promoted greater neo-vascularisation ability when compared to the Control and NF alone treatment suggesting the growth factor upregulation and blood vessel formation ability of the bioactive peptides applied to the wound bed ( Fig.…”

The Role of Fibroblast Growth Factor (FGF) Signaling in Tissue Repair and Regeneration

“…China and Japan have focused on utilizing the potential of FGF for wound healing, particularly in the case of surgical wounds, including skin grafts, obstetric wounds, and surgical incisions, and for the treatment of burns and ulcers [174][175][176]. FGF1, FGF2, FGF4, FGF7, FGF16, FGF21, and FGF23 have been found to have good therapeutic outcomes for diabetic foot ulcers [177]. From the literature reviewed above, it seems that FGF can serve as a very promising therapy for tissue repair.…”

How Effective are Nano-Based Dressings in Diabetic Wound Healing? A Comprehensive Review of Literature

“…For example, the pathological changes at different stages in diabetic chronic wounds, the emergence of multiple drug-resistant bacteria, and the effects of some other treatments and drugs on wound healing. 76 , 77 …”