Growth factors in the treatment of diabetic foot ulcers

Abstract

There has been a generally disappointing clinical outcome from growth factor trials, although topical platelet-derived growth factor has shown significant benefit and should be considered in non-healing, well perfused ulcers after failure of conventional wound care. The modulatory role of the extracellular matrix in the cellular response to growth factors and data from regenerative-type fetal wound healing are further areas of interest. The chemical induction of microvessel formation may become a future therapeutic option.

Blockade of TSP1-Dependent TGF-β Activity Reduces Renal Injury and Proteinuria in a Murine Model of Diabetic Nephropathy

“…44 TGF-␤ signaling is known to be impaired in diabetic skin wounds, resulting in reduced macrophage chemoattraction, angiogenesis, and extracellular matrix deposition with accelerated reepithelialization. 68,69 Treatment of diabetic wounds with active TGF-␤ normalizes wound healing. 51,52,70 The role of TSP1-dependent TGF-␤ activation in diabetic wound healing is not known.…”

Gene intervention in ligament and tendon: current status, challenges, future directions

“…Biological interventions (ie administering preformed proteins) have been performed with some successes. [63][64][65] While some of these reports have been associated with the process of skin wound healing there is no a priori reason why many of the biological events should not be similar.…”

Induction of Specific MicroRNAs Inhibits Cutaneous Wound Healing

“…Current Food and Drug Administration-approved biotherapies for VUs 3 have a documented failure rate based on the high prevalence and incidence of recalcitrant VUs. Clinical trials of exogenously administered TGF␤, fibroblast growth factor, keratinocyte growth factor, and EGF to human chronic ulcers have achieved very limited efficacy and failed to obtain Food and Drug Administration approval (5,6), despite early promising animal studies (7,8).…”