Diabetic foot ulcers: effects of hyperoxia and SDF-1α on endothelial progenitor cells

Abstract

Diabetes mellitus is a common disease afflicting many people. In addition to coronary artery disease, diabetic retinopathy and renal failure, diabetic patients face abnormal wound healing and have increased lower extremity ulcers and amputations. In diabetes, wound healing is altered due to both macrovascular and microvascular processes. While the former can be addressed with surgical intervention, the latter is more difficult to correct. Neovascularization within the granulation tissue via angiogenesis and vasculogenesis is critical for wound healing. Endothelial progenitor cells (EPCs) have been implicated in vasculogenesis. Mobilization of EPCs from the bone marrow is impaired in diabetes and homing of EPCs to the wound is also abnormal. Recent studies show that hyperoxia and administration of exogenous stromal-derived factor-1α increases circulatory and wound levels of EPCs and improves wound healing in diabetic mice. These findings have great potential for translation into human counterparts as the treatment for this prevalent disease matures.

Keywords::

• diabetic ulcer
• endothelial progenitor cell
• hyperoxia
• stromal-derived growth factor-1α

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.