The pro-inflammatory environment in recalcitrant diabetic foot wounds. 2008

Jorge Berlanga Acosta, and Diana Garcia del Barco, and Danay Cibrian Vera, and William Savigne, and Pedro Lopez-Saura, and Gerardo Guillen Nieto, and Gregory S Schultz
Biomedical Research Direction, Pharmaceutical Division, Center for Genetic Engineering and Biotechnology, Avenida 31 e/158 y 190, Playa, PO Box 6162, Havana 10600, Cuba. jorge.berlanga@cigb.edu.cu

Lower extremity ulceration is one of the serious and long-term diabetic complications rendering a significant social burden in terms of amputation and quality-of-life reduction. Diabetic patients experience a substantial wound-healing deficit. These lesions are featured by an exaggerated and prolonged inflammatory reaction with a significant impairment in local bacterial invasion control. Experimental and clinical evidences document the deleterious consequences of the wound's pro-inflammatory phenotype for the repair process. From a biochemical standpoint, hyperinflammation favours wound matrix degradation, thus, amplifying a pre-existing granulation tissue productive cells' invasiveness and recruitment deficit. Tumour necrosis factor perpetuates homing of inflammatory cells, triggers pro-apoptotic genes and impairs reepithelialisation. Advanced glycation end-products act in concert with inflammatory mediators and commit fibroblasts and vascular cells to apoptosis, contributing to granulation tissue demise. Therapeutic approaches aimed to downregulate hyperinflammation and/or attenuate glucolipotoxicity may assist in diabetic wound healing by dismantling downstream effectors. These medical interventions are demanded to reduce amputations in an expanding diabetic population.

UI MeSH Term Description Entries
D007249 Inflammation A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. Innate Inflammatory Response,Inflammations,Inflammatory Response, Innate,Innate Inflammatory Responses
D005347 Fibroblasts Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. Fibroblast
D006097 Granulation Tissue A vascular connective tissue formed on the surface of a healing wound, ulcer, or inflamed tissue. It consists of new capillaries and an infiltrate containing lymphoid cells, macrophages, and plasma cells. Granulation Tissues,Tissue, Granulation,Tissues, Granulation
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000079424 Tumor Necrosis Factor Inhibitors Compounds or agents that bind to and inhibit the synthesis or activity of TUMOR NECROSIS FACTOR-alpha. Such agents are used to treat inflammatory bowel diseases and other inflammatory diseases. TNF Antagonist,TNF Blocker,TNF Inhibitor,Tumor Necrosis Factor Antagonist,Tumor Necrosis Factor Blocker,Tumor Necrosis Factor Inhibitor,Tumor Necrosis Factor-a (TNF-a) Antagonist,Tumor Necrosis Factor-a (TNF-a) Blocker,Tumor Necrosis Factor-a (TNF-a) Inhibitor,TNF Antagonists,TNF Blockers,TNF Inhibitors,Tumor Necrosis Factor Antagonists,Tumor Necrosis Factor Blockers,Tumor Necrosis Factor-a (TNF-a) Antagonists,Tumor Necrosis Factor-a (TNF-a) Blockers,Tumor Necrosis Factor-a (TNF-a) Inhibitors,Antagonist, TNF,Antagonists, TNF,Blocker, TNF,Blockers, TNF,Inhibitor, TNF,Inhibitors, TNF
D014945 Wound Healing Restoration of integrity to traumatized tissue. Healing, Wound,Healings, Wound,Wound Healings
D015536 Down-Regulation A negative regulatory effect on physiological processes at the molecular, cellular, or systemic level. At the molecular level, the major regulatory sites include membrane receptors, genes (GENE EXPRESSION REGULATION), mRNAs (RNA, MESSENGER), and proteins. Receptor Down-Regulation,Down-Regulation (Physiology),Downregulation,Down Regulation,Down-Regulation, Receptor
D017127 Glycation End Products, Advanced A heterogeneous group of compounds derived from rearrangements, oxidation, and cross-linking reactions that follow from non-enzymatic glycation of amino groups in PROTEINS; LIPIDS; or NUCLEIC ACIDS. Their accumulation in vivo accelerates under hyperglycemic, oxidative, or inflammatory conditions. Heat also accelerates the formation of advanced glycation end products (AGEs) such seen with the browning of food during cooking. Advanced Glycation End Product,Advanced Glycation Endproduct,Advanced Maillard Reaction End Product,Glycated Lipids,Glycotoxins,Maillard Product,Maillard Reaction End Product,Maillard Reaction Product,Advanced Glycation End Products,Advanced Glycation Endproducts,Advanced Maillard Reaction End Products,Glycation Endproducts, Advanced,Maillard Products,Maillard Reaction End Products,Maillard Reaction Products,Glycation Endproduct, Advanced,Lipids, Glycated,Product, Maillard Reaction,Products, Maillard,Products, Maillard Reaction,Reaction Products, Maillard
D017209 Apoptosis A regulated cell death mechanism characterized by distinctive morphologic changes in the nucleus and cytoplasm, including the endonucleolytic cleavage of genomic DNA, at regularly spaced, internucleosomal sites, i.e., DNA FRAGMENTATION. It is genetically programmed and serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. Apoptosis, Extrinsic Pathway,Apoptosis, Intrinsic Pathway,Caspase-Dependent Apoptosis,Classic Apoptosis,Classical Apoptosis,Programmed Cell Death,Programmed Cell Death, Type I,Apoptoses, Extrinsic Pathway,Apoptoses, Intrinsic Pathway,Apoptosis, Caspase-Dependent,Apoptosis, Classic,Apoptosis, Classical,Caspase Dependent Apoptosis,Cell Death, Programmed,Classic Apoptoses,Extrinsic Pathway Apoptoses,Extrinsic Pathway Apoptosis,Intrinsic Pathway Apoptoses,Intrinsic Pathway Apoptosis
D017719 Diabetic Foot Common foot problems in persons with DIABETES MELLITUS, caused by any combination of factors such as DIABETIC NEUROPATHIES; PERIPHERAL VASCULAR DISEASES; and INFECTION. With the loss of sensation and poor circulation, injuries and infections often lead to severe foot ulceration, GANGRENE and AMPUTATION, SURGICAL. Foot Ulcer, Diabetic,Diabetic Feet,Feet, Diabetic,Foot, Diabetic

Related Publications

Jorge Berlanga Acosta, and Diana Garcia del Barco, and Danay Cibrian Vera, and William Savigne, and Pedro Lopez-Saura, and Gerardo Guillen Nieto, and Gregory S Schultz
January 1999, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons,
Jorge Berlanga Acosta, and Diana Garcia del Barco, and Danay Cibrian Vera, and William Savigne, and Pedro Lopez-Saura, and Gerardo Guillen Nieto, and Gregory S Schultz
January 2006, Current medicinal chemistry,
Jorge Berlanga Acosta, and Diana Garcia del Barco, and Danay Cibrian Vera, and William Savigne, and Pedro Lopez-Saura, and Gerardo Guillen Nieto, and Gregory S Schultz
August 1984, The Surgical clinics of North America,
Jorge Berlanga Acosta, and Diana Garcia del Barco, and Danay Cibrian Vera, and William Savigne, and Pedro Lopez-Saura, and Gerardo Guillen Nieto, and Gregory S Schultz
January 2012, Nursing standard (Royal College of Nursing (Great Britain) : 1987),
Jorge Berlanga Acosta, and Diana Garcia del Barco, and Danay Cibrian Vera, and William Savigne, and Pedro Lopez-Saura, and Gerardo Guillen Nieto, and Gregory S Schultz
May 1998, Diabetes care,
Jorge Berlanga Acosta, and Diana Garcia del Barco, and Danay Cibrian Vera, and William Savigne, and Pedro Lopez-Saura, and Gerardo Guillen Nieto, and Gregory S Schultz
March 1997, Ostomy/wound management,
Jorge Berlanga Acosta, and Diana Garcia del Barco, and Danay Cibrian Vera, and William Savigne, and Pedro Lopez-Saura, and Gerardo Guillen Nieto, and Gregory S Schultz
January 1996, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons,
Jorge Berlanga Acosta, and Diana Garcia del Barco, and Danay Cibrian Vera, and William Savigne, and Pedro Lopez-Saura, and Gerardo Guillen Nieto, and Gregory S Schultz
October 2002, Clinics in podiatric medicine and surgery,
Jorge Berlanga Acosta, and Diana Garcia del Barco, and Danay Cibrian Vera, and William Savigne, and Pedro Lopez-Saura, and Gerardo Guillen Nieto, and Gregory S Schultz
December 2001, Current diabetes reports,
Jorge Berlanga Acosta, and Diana Garcia del Barco, and Danay Cibrian Vera, and William Savigne, and Pedro Lopez-Saura, and Gerardo Guillen Nieto, and Gregory S Schultz
March 2006, Lancet (London, England),
Copied contents to your clipboard!