Gut Dysbiosis and Diabetic Foot Ulcer: Role of Probiotics

Abstract

Diabetic foot ulcer (DFU) is a multifactorial disease and one of the complications of diabetes. The global burden of DFU in the health sector is increasing at a tremendous rate due to its cost management related to hospitalization, medical costs and foot amputation. Hence, to manage DFU/DWs, various attempts have been made, including treating wounds systematically/topically using synthetic drugs, herbal drugs, or tissue engineering based surgical dressings. However, less attention has been paid to the intrinsic factors that are also the leading cause of diabetes mellitus (DM) and its complications. One such factor is gut dysbiosis, which is one of the major causes of enhancing the counts of Gram-negative bacteria. These bacteria produce lipopolysaccharides, which are a major contributing factor toward insulin resistance and inflammation due to the generation of oxidative stress and immunopathy. These all lead to DM and DFU. Probiotics are the commercial form of beneficial gut microbes that are taken as nutraceuticals by people of all ages to improve gut immunity and prevent gut dysbiosis. However, the role of probiotics has been less explored in the management of DFU. Hence, the therapeutic potential of probiotics in managing DFU is fully described in the current review. This report covers the linkage between gut dysbiosis and DFU, sources of probiotics, the mechanisms of probiotics in DW healing, and the impact of probiotic supplementation in treating DFU. In addition, techniques for the stabilization of probiotics, market status, and patents related to probiotics have been also covered. The relevant data were gathered from PubMed, Scopus, Taylor and Francis, Science Direct, and Google Scholar. Our systematic review discusses the utilization of probiotic supplementation as a nutraceutical for the management of DFU.

Association Between Metabolic Dysfunction-Associated Fatty Liver Disease and MACCEs in Patients with Diabetic Foot Ulcers: An Ambispective Longitudinal Cohort Study

“… 46 , 47 Obviously, as the most typical complication of T2DM, DFUs characterized by macrovascular and microvascular pathological changes are inevitably related to the core pathological mechanism of insulin resistance. 48 , 49 Our prior research also supported the finding about the fundamental mechanism of insulin resistance in cardiovascular adverse events of DFUs. 50 Given this, MAFLD causes several clinical adverse vascular outcomes in patients with DFUs through the mediation of insulin resistance.…”

Relationship of oral bacterial number with medical hospitalization costs in analysis of Diagnosis Procedure Combination database from single institution in Japan

“…Furthermore, hospital-acquired and ventilator-associated pneumonia cases that required intensive care have been found to have increased hospitalization time and costs 21 , 22 . The impact of development of DM and infectious complications in DM patients on hospitalization costs has also been frequently reported 23 – 25 . In other studies, oral bacterial infection and poor oral health were shown to be risk factors related to surgical site infection after various cancer and cardiovascular surgical procedures 9 , 26 – 29 , while a relationship between oral microbial colonization and ventilator-associated pneumonia in patients in intensive care units has also been reported 30 , 31 .…”

Exploring the pathogenesis of osteomyelitis accompanied by diabetic foot ulcers using microarray data analysis

“…[ 23 ] In DFU, LPS is a significant contributor to insulin resistance and inflammation due to immunopathy and the production of oxidative stress, which directly contribute to the development of DFU. [ 24 ] In addition, LPS promotes the release of inflammatory cytokines and chemokines associated with osteomyelitis, which activate NF-κB, upregulating toll-like receptor 3 (TLR3) gene expression, monocyte chemotactic protein 1 (CCL2), matrix metalloproteinase 9 (MMP9). Further, it promotes IL-8, and IL-10 gene expression and secretion.…”