Innovations in gene and growth factor delivery systems for diabetic wound healing

Abstract

The rise in lower extremity amputations due to nonhealing of foot ulcers in diabetic patients calls for rapid improvement in effective treatment regimens. Administration of growth factors (GFs) are thought to offer an off‐the‐shelf treatment; however, the dose‐ and time‐dependent efficacy of the GFs together with the hostile environment of diabetic wound beds impose a major hindrance in the selection of an ideal route for GF delivery. As an alternative, the delivery of therapeutic genes using viral and nonviral vectors, capable of transiently expressing the genes until the recovery of the wounded tissue offers promise. The development of implantable biomaterial dressings capable of modulating the release of either single or combinatorial GFs/genes may offer solutions to this overgrowing problem. This article reviews the state of the art on gene and protein delivery and the strategic optimization of clinically adopted delivery strategies for the healing of diabetic wounds.

Functionalized silk fibers from transgenic silkworms for wound healing applications: Surface presentation of bioactive epidermal growth factor

“…Additionally, growth factor levels including the epidermal growth factor (EGF), basic fibroblast growth factor (FGF‐2), transforming growth factor‐β (TGF‐β), platelet‐derived growth factor (PDGF), and vascular endothelial growth factor (VEGF) are decreased in chronic wounds compared to normal healing acute wounds . Thus, the implementation of growth factors into topical wound dressings or biomaterials represents a promising approach to treat chronic wounds byrestoring the natural physiological wound healing cascade …”

“…16 Thus, the implementation of growth factors into topical wound dressings or biomaterials represents a promising approach to treat chronic wounds by restoring the natural physiological wound healing cascade. [17][18][19] One initial study modified silk mats with EGF by mixing the growth factor into a silk fibroin solution during electrospinning. Those biofunctionalized silk mats exhibited a slow release rate of EGF for 170 h and were able to promote wound healing by accelerating the wound closure of wounded human skin-equivalents in vitro.…”

Experimental study of epidermal growth factor and acidic fibroblast growth factor in the treatment of diabetic foot wounds

“…The clinical use of recombinant human epidermal growth factor (EGF) and fibroblast growth factor (FGF) is common (6). However, comparative studies of the treatment effects of these growth factors alone or combined are few.…”

Review: Multimodal bioactive material approaches for wound healing

“…13,15,16 Growth factors have a role in cellular migration, proliferation, and adhesion. 17 Target cells include keratinocytes and fibroblasts, which are involved in reepithelialization and collagen deposition, respectively.…”

“…The use of materials containing complementary DNA (cDNA) has led to an extended period of high growth factor concentration with more recognizable proteins in comparison to recombinant proteins. 15 Building off the success of recombinant PDGF, cDNA encoding for PDGF has been loaded into collagen gels for wound healing applications. Early experiments observed an increase in granulation tissue and proliferating cells in the wound bed of a rabbit model.…”