INTRODUCTION Diabetes-related wounds, particularly diabetes-related foot ulceration, is mainly caused by lack of foot sensation and high plantar tissue stress secondary to peripheral neuropathy, ischemia secondary to peripheral artery disease and dysfunctional wound healing. Current management of diabetes-related wounds involves the offloading high foot pressures and the treatment of ischemia through revascularisation. Despite these treatments, the global burden of diabetes-related wounds is growing, and thus novel therapies are needed. The normal wound healing process is a coordinated remodelling process orchestrated by fibroblasts, endothelial cells, phagocytes and platelets, controlled by an array of growth factors. In diabetes-related wounds this coordinated process is dysfunctional. Past animal model and human research suggests that prolonged wound inflammation, failure to adequately correct ischemia and impaired wound maturation are key therapeutic targets to improve diabetes-related wound healing. AREAS COVERED This review summarises recent pre-clinical and clinical research on novel diabetes-related wounds treatments. Animal models of diabetes-related wounds and recent studies testing novel agents in these models are described. Findings from clinical trials are also discussed. Finally challenges to identifying and implementing novel therapies are described. EXPERT OPINION Given the growing volume of promising drug therapies currently under investigation, it is expected within the next decade that diabetes-related wound treatment will be transformed.
Novel therapeutic targets for diabetes-related wounds: An update on pre-clinical and clinical research.