Abstract
Chronic skin wound caused by diabetic disease is very common worldwide. Moreover, there is a shortage of effective curing technology in clinic. In this work, we developed a novel technology using thermosensitive hydrogel on wound top combined with insulin injection. The efficiency and mechanism of this technology were investigated in a diabetic mouse model. Dorsal-paired 8–10 mm diameter wounds were created in 12 mice. The wound healing rate was determined over a 28-day interval in healthy control (Control), control with diabetes (DControl), poloxamer treatment (Pox), and poloxamer plus insulin injection (Poxin) mice. Histological specimens were observed in all samples. Real-time quantitative polymerase chain reaction (qRT-PCR) was performed to measure the relative expression of α-smooth muscle actin (α-SMA) and transforming growth factor beta 1 (TGF-β1) in wound tissues at 7, 14, and 28 days. Compared with DControl animals, those treated with Poxin showed accelerated wound closure and healing rate (p < 0.05); expression of both α-SMA and TGF-β1 was significantly higher than that of the DControl and Pox animals during the first 7 days postoperation, but a significant decrease at day 14. Therefore, we concluded that hydrogel combined with insulin accelerated wound healing. Controlling the glucose level via insulin injection is more beneficial than hydrogel alone for healing chronic wounds, potentially through the increase of α-SMA and TGF-β1 expression in early phase.
Highlights
Diabetes mellitus (DM) is a chronic disease and a severe global public health problem
After the mice in the Poxin group were injected with insulin, their blood glucose levels were maintained
Full-thickness incisional wounds were surgically created on the backs of mice, and the wound closure was monitored (Figure 3). e speed of wound healing varied according to the treatment (Figure 4)
Summary
Diabetes mellitus (DM) is a chronic disease and a severe global public health problem. It has been reported that there were 451 million people (age 18–99 years) with diabetes in 2017 worldwide, which is expected to increase to 693 million by 2045 [1]. Delayed wound healing is an important complication in patients with diabetes due to their macrovascular and microvascular lesions [2]. About 2.5%–15% of yearly worldwide health budgets are consumed on diabetes mellitus, and diabetic wounds take a major part [3]. Some previous studies [4, 5] have reported that sustained high glucose levels in patients with diabetes impaired the skin cell proliferation and collagen production, both of which impeded wound healing after skin injury. Pathological microvascular changes, persistent increment of proinflammatory cytokines, and the absence of growth factors are associated with delayed wound healing [6, 7]
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