Cutaneous innervation in impaired diabetic wound healing.
Cutaneous innervation in impaired diabetic wound healing.
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DOI：
10.1016/j.trsl.2021.05.003
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Paller AS
中科院分区：
文献类型：
--
作者：
Nowak NC;Menichella DM;Miller R;Paller AS
2型糖尿病与几种潜在的合并症有关，其中包括伤口愈合障碍、慢性溃疡和需要截肢。疾病相关的异常细胞反应、感染、免疫和微血管功能障碍以及周围神经病变与伤口愈合障碍和糖尿病足溃疡的发病机制有关。皮肤内有一个由感觉神经传入和神经源性调节剂组成的致密网络，它们与表皮角质形成细胞和真皮成纤维细胞双向通信，影响创伤后的正常伤口愈合。然而，皮肤神经调节伤口愈合的机制还知之甚少，尤其是在人类身上。更好地了解这些机制可能为慢性糖尿病创面的靶向治疗提供基础。本文综述了创伤愈合的病理生理学，重点介绍了神经在正常和糖尿病伤口愈合中的作用，以及未来的治疗前景，以解决糖尿病患者慢性伤口未得到满足的需求。
Type 2 diabetes is associated with several potential comorbidities, among them impaired wound healing, chronic ulcerations, and the requirement for lower extremity amputation. Disease-associated abnormal cellular responses, infection, immunological and microvascular dysfunction, and peripheral neuropathy are implicated in the pathogenesis of the wound healing impairment and the diabetic foot ulcer. The skin houses a dense network of sensory nerve afferents and nerve-derived modulators, which communicate with epidermal keratinocytes and dermal fibroblasts bidirectionally to effect normal wound healing after trauma. However, the mechanisms through which cutaneous innervation modulates wound healing are poorly understood, especially in humans. Better understanding of these mechanisms may provide the basis for targeted treatments for chronic diabetic wounds. This review provides an overview of wound healing pathophysiology with a focus on neural involvement in normal and diabetic wound healing, as well as future therapeutic perspectives to address the unmet needs of diabetic patients with chronic wounds.
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