Journal
EXPERT REVIEWS IN MOLECULAR MEDICINE
Volume 11, Issue -, Pages -Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S1462399409000945
Keywords
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Funding
- National Institutes of Health [R01-HL075678, R01-NS046710, R01 DK076937]
- William J. von Liebig Foundation
- Howard Hughes Medical Institute
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Abnormal wound healing is a major complication of both type 1 and type 2 diabetes, with nonhealing foot ulcerations leading in the worst cases to lower-limb amputation. Wound healing requires the integration of complex cellular and molecular events in successive phases of inflammation, cell proliferation, cell migration, angiogenesis and re-epithelialisation. A link between wound healing and the nervous system is clinically apparent as peripheral neuropathy is reported in 30-50% of diabetic patients and is the most common and sensitive predictor of foot ulceration. Indeed, a bidirectional connection between the nervous and the immune systems and its role in wound repair has emerged as one of the focal features of the wound-healing dogma. This review provides a broad overview of the mediators of this connection, which include neuropeptides and cytokines released from nerve fibres, immune cells and cutaneous cells. In-depth understanding of the signalling pathways in the neuroimmune axis in diabetic wound healing is vital to the development of successful wound-healing therapies.
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