Glucose toxic effects on granulation tissue productive cells: the diabetics' impaired healing.
Glucose toxic effects on granulation tissue productive cells: the diabetics' impaired healing.
复制标题
DOI：
10.1155/2013/256043
复制
发表时间：
2013
影响因子：
--
通讯作者：
Herrera-Martínez L
中科院分区：
文献类型：
--
作者：
Berlanga-Acosta J;Schultz GS;López-Mola E;Guillen-Nieto G;García-Siverio M;Herrera-Martínez L
2型糖尿病是一种代谢性非传染性疾病，具有不断扩大的流行规模。糖尿病易导致下肢溃疡，损害愈合过程，导致伤口慢性化。糖尿病也会破坏先天免疫，有利于伤口感染。因此，截肢被认为是该疾病的并发症之一。高血压是全身和局部毒性效应的近端引爆器，包括促炎症、急性时相蛋白升高和活性氧和氮物质的溢出。胰岛素轴缺乏会削弱伤口的愈合能力，并容易导致炎症。晚期糖基化终产物的全身蓄积不可逆地损害从细胞到器官的整个生理学。这些因素共同阻碍成纤维细胞和内皮细胞增殖、迁移、归巢、分泌和组织化生产性肉芽组织。糖尿病伤口床可能会变成慢性炎症、前代谢和循环促炎细胞因子的额外来源，从而建立一个自我延续的循环。糖尿病成纤维细胞和内皮细胞可能承受线粒体损伤，变得易于凋亡，这损害肉芽组织细胞构成和灌注。内皮祖细胞的募集和小管形成也受损。伤口上皮再生失败仍然是一个临床挑战，而它似乎是生物学上的多因素。通过初级保健监测、教育和关注项目预防溃疡对于减少全球截肢人数至关重要。
Type 2 diabetes mellitus is a metabolic noncommunicable disease with an expanding pandemic magnitude. Diabetes predisposes to lower extremities ulceration and impairs the healing process leading to wound chronification. Diabetes also dismantles innate immunity favoring wound infection. Amputation is therefore acknowledged as one of the disease's complications. Hyperglycemia is the proximal detonator of systemic and local toxic effectors including proinflammation, acute-phase proteins elevation, and spillover of reactive oxygen and nitrogen species. Insulin axis deficiency weakens wounds' anabolism and predisposes to inflammation. The systemic accumulation of advanced glycation end-products irreversibly impairs the entire physiology from cells-to-organs. These factors in concert hamper fibroblasts and endothelial cells proliferation, migration, homing, secretion, and organization of a productive granulation tissue. Diabetic wound bed may turn chronically inflammed, procatabolic, and an additional source of circulating pro-inflammatory cytokines, establishing a self-perpetuating loop. Diabetic fibroblasts and endothelial cells may bear mitochondrial damages becoming prone to apoptosis, which impairs granulation tissue cellularity and perfusion. Endothelial progenitor cells recruitment and tubulogenesis are also impaired. Failure of wound reepithelialization remains a clinical challenge while it appears to be biologically multifactorial. Ulcer prevention by primary care surveillance, education, and attention programs is of outmost importance to reduce worldwide amputation figures.
登录
查看更多内容
影响因子：
--
作者：
Black, E;Vibe-Petersen, J;Gottrup, F
通讯作者：
Gottrup, F
影响因子：
4.8
作者：
Adams, Christopher M.
通讯作者：
Adams, Christopher M.
影响因子：
5
作者：
El Ghalbzouri, A;Hensbergen, P;Ponec, M
通讯作者：
Ponec, M
影响因子：
1.7
作者：
Blakytny, Robert;Jude, Edward B.
通讯作者：
Jude, Edward B.
影响因子：
7.7
作者：
Busik JV;Mohr S;Grant MB
通讯作者：
Grant MB