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Inflammation and neuropeptides: the connection in diabetic wound healing

Published online by Cambridge University Press:  13 January 2009

Leena Pradhan ,
Christoph Nabzdyk ,
Nicholas D. Andersen ,
Frank W. LoGerfo  and
Aristidis Veves
Leena Pradhan
Affiliation:
Department of Surgery, Division of Vascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Christoph Nabzdyk
Affiliation:
Charité University Medicine, Joined Medical Faculty of Free University and Humboldt University, Berlin, Germany.
Nicholas D. Andersen
Affiliation:
Department of Surgery, Division of Vascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Frank W. LoGerfo
Affiliation:
Department of Surgery, Division of Vascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Aristidis Veves*
Affiliation:
Department of Surgery, Microcirculation Laboratory, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
*
*Corresponding author: Aristidis Veves, Microcirculation Laboratory, Beth Israel Deaconess Medical Center, Palmer 317, West Campus, One Deaconess Rd, Boston, MA 02215, USA. Tel: +1 617 632 7075; Fax: +1 617 632 0860; E-mail: [email protected]
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Abstract

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.

Type
Review Article
Information
Expert Reviews in Molecular Medicine , Volume 11 , July 2009 , e2
Copyright
Copyright © Cambridge University Press 2009

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References

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Further reading, resources and contacts

Blakytny, R. and Jude, E (2006) The molecular biology of chronic wounds and delayed healing in diabetes. Diabetic Medicine 23, 594-608CrossRefGoogle ScholarPubMed
Vinik, A. et al. (2006) Diabetic neuropathies: clinical manifestations and current treatment options. Nature Clinical Practice Endocrinology & Metabolism 2, 269-281CrossRefGoogle ScholarPubMed
Veves, A., Giurini, J.M. and LoGerfo, F.W. (2002) The Diabetic Foot: Medical and Surgical Management, Humana Press, Totowa, NJ, USACrossRefGoogle Scholar
http://diabetes.niddk.nih.gov/dm/pubs/america/contents.htmGoogle Scholar