Abstract
Four hundred and twenty-two million people have diabetes due to excess free body glucose in their body fluids. Diabetes leads to various problems including retinopathy, neuropathy, arthritis, damage blood vessels etc; it also causes a delay in wound healing. Insufficiency of insulin is the main reason for diabetes-I and systemic insulin treatment is a remedy. The perspective of the potential use of insulin/insulin based drugs to treat chronic wounds in diabetic conditions is focused on in this review. At the site of the wound, TNF-ɑ, IFN-ϒ, IL-1β and IL-6 pro-inflammatory cytokines cause the generation of free radicals, leading to inflammation which becomes persistent in diabetes. Insulin induces expression of IL-4/IL-13, IL-10 anti-inflammatory cytokines etc which further down-regulates NFkβP50/P65 assembly. Insulin shifts the equilibrium towards NFkβP50/P50 which leads to down-regulation of inflammatory cytokines such as IL-6, IL-10 etc through STAT6, STAT3 and c-Maf activation causing nullification of an inflammatory condition. Insulin also promotes protein and lipid biosynthesis which indeed promotes wound recovery. Here, in this article, the contributions of insulin in controlling wound tissue microenvironments and remodulation of tissue have been summarised, which may be helpful to develop novel insulin-based formulation(s) for effective treatment of wounds in diabetic conditions.
Highlights
Biosynthesis and alternating Pro/Anti- there exists an automorphism of the endomorphism algebra of V th is unique, and called the duality A ↔ A∗
Various diabetes treatments are helpful in controlling blood glucose level and thereby can delay progression of the diseases associated with diabetes, such as hypertension, arthritis, retinopathy, cataract, neuropathy etc, but very little is known about their effect on the recovery of diabetic wounds [12]
IL-18 suppresses the expression of vascular endothelial growth factor (VEGF) which is essential for cell blood vessels development of the wound tissue and it is essential for growth and repair [23]
Summary
Biosynthesis and alternating Pro/Anti- there exists an automorphism of the endomorphism algebra of V th is unique, and called the duality A ↔ A∗. Diabetes leads to various problems including retinopathy, neuropathy, arthritis, damage blood vessels etc; it causes a delay in wound healing. At the site of the wound, TNF-ɑ, IFN-Υ, IL-1β and IL-6 pro-inflammatory cytokines cause the generation of free radicals, leading to inflammation which becomes persistent in diabetes. The presence of excess glucose in body fluids leads to various pathological conditions such as susceptibility to infection, inducing the onset of various diseases like cataract, retinopathy, neuropathy, arthritis, hypertension, cardiovascular problems, kidney damage, damaged blood vesicles, and a delay in wound healing etc [5, 6]. Various diabetes treatments are helpful in controlling blood glucose level and thereby can delay progression of the diseases associated with diabetes, such as hypertension, arthritis, retinopathy, cataract, neuropathy etc, but very little is known about their effect on the recovery of diabetic wounds [12]. IL-18 suppresses the expression of vascular endothelial growth factor (VEGF) which is essential for cell blood vessels development of the wound tissue and it is essential for growth and repair [23]
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