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Antioxidant Therapy and Antioxidant-Related Bionanomaterials in Diabetic Wound Healing

Journal

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fbioe.2021.707479

Keywords

wound healing; antioxidative therapy; oxidative stress; bionanomaterials; diabetes mellitus

Funding

  1. National Science Foundation of China [82002313, 82072444]
  2. National Key Research & Development Program of China [2018YFC2001502, 2018YFB1105705]
  3. Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration [2020kqhm008]
  4. Health Commission of Hubei Province [WJ2019Z009]
  5. Wuhan Union Hospital Pharmaceutical Technology nursing special fund [2019xhyn021]

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Ulcers are a common complication of diabetes with high recurrence rates, and oxidative stress is identified as a key factor in impaired wound healing. Various antioxidant therapies have been proposed in the past 5 years to target oxidative stress and improve diabetic wound healing outcomes. These therapies include targeting Nrf2 and NF kappa B pathways, as well as utilizing vitamins, enzymes, hormones, medicinal plants, and biological materials.
Ulcers are a lower-extremity complication of diabetes with high recurrence rates. Oxidative stress has been identified as a key factor in impaired diabetic wound healing. Hyperglycemia induces an accumulation of intracellular reactive oxygen species (ROS) and advanced glycation end products, activation of intracellular metabolic pathways, such as the polyol pathway, and PKC signaling leading to suppression of antioxidant enzymes and compounds. Excessive and uncontrolled oxidative stress impairs the function of cells involved in the wound healing process, resulting in chronic non-healing wounds. Given the central role of oxidative stress in the pathology of diabetic ulcers, we performed a comprehensive review on the mechanism of oxidative stress in diabetic wound healing, focusing on the progress of antioxidant therapeutics. We summarize the antioxidant therapies proposed in the past 5 years for use in diabetic wound healing, including Nrf2- and NF kappa B-pathway-related antioxidant therapy, vitamins, enzymes, hormones, medicinal plants, and biological materials.

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