The role of endothelial dysfunction in the pathogenesis of impaired diabetic wound healing: A novel therapeutic target?

Published on Jan 1, 2007in Medical Hypotheses1.375
· DOI :10.1016/J.MEHY.2007.02.040
T. Laing1
Estimated H-index: 1
(RCSI: Royal College of Surgeons in Ireland),
Richard Hanson3
Estimated H-index: 3
(RCSI: Royal College of Surgeons in Ireland)
+ 1 AuthorsDavid Bouchier-Hayes70
Estimated H-index: 70
(RCSI: Royal College of Surgeons in Ireland)
Summary The global burden of diabetes is attributed to its multiple associated complications including impaired wound healing which can ultimately result in amputation. Peripheral vascular disease, infection, neuropathy and abnormal local cellular and cytokine activity are some of the traditionally cited pathological instigators of defective diabetic wound repair. Despite intensive research and subsequent advances in diabetic wound care technology a single treatment with measurable clinical impact has yet to be determined. The phenomenon of endothelial dysfunction as seen in atherosclerosis and recently identified as a characteristic of diabetic vasculature may contribute to impaired cutaneous healing in this group. Indicators of endothelial dysfunction have been demonstrated in diabetic wounds by a number of investigators. Successful results are being obtained with modifiers of endothelial function in the management of cardiovascular disease. We hypothesise that endothelial dysfunction plays a substantial contributory role in the pathogenesis of wound healing impairment of diabetes and holds potential as a target for therapeutic intervention.
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