Abstract
The present study aimed to explore the therapeutic effect and underlying mechanism of epidermal growth factor (EGF) on the wound healing of diabetic foot ulcers (DFU). A total of 48 rabbits with DFU were randomly divided into 2 groups, comprising the treatment and control groups. Full-thickness skin (10×10 mm) was excised from the thigh of each rabbit. The wounds in the treatment group were treated with 100 mg/l EGF once a day for 1 month. The control group received no treatment. At 20 days following treatment, new granulation tissues that formed beyond the edge of the wound were collected for subsequent analysis. Tissues from rabbits in the treatment group produced a greater number of fibroblasts, which exhibited a fibroblastic morphology when compared with those in the control group. In the treatment group, a larger number of these fibroblasts were observed as clusters, and there were numerous blood vessels when compared with the control group. The fibroblasts in the control group exhibited an irregular morphology, contained fewer organelles and the surrounding collagenous fibers were sparse. These fibroblasts also demonstrated a disordered arrangement and it was revealed that the wound healed at a slower rate compared with the treatment group. Endogenous EGF mRNA detection revealed that there was a significant difference (P<0.05) in the relative gray value of EGF mRNA between the treatment (103.27±4.27) and control (63.88±4.36) groups. In conclusion, EGF may accelerate the healing of DFU, and exogenous EGF treatment may upregulate the expression of EGF mRNA in newly generated tissues.
Highlights
Diabetic foot ulcer (DFU) is a disorder observed primarily in developing countries
Granulation tissue production and the number of clustered fibroblasts were increased in the treatment group when compared with the control group (Fig. 1)
In DFU, the wound healing process is hindered by the accumulation of advanced glycation end products (AGEs), which is due to the high blood glucose levels of patients with diabetes [29,30]
Summary
Diabetic foot ulcer (DFU) is a disorder observed primarily in developing countries. The blood supply in the extremities of patients with diabetes is poor, leading to the development of DFUs [1]. The wounds require a long time to heal and may be incurable; dry gangrene can develop as a result of DFU, which may lead to amputation in severe cases [1]. Diabetes associated with acquired coagulopathies, those caused by vitamin K deficiency or liver disease, may lead to excessive bleeding from the DFU and delay the healing process [2]. In these cases, the use of fibrin adhesives and collagen matrices to the affected area are required [3]. It has been demonstrated that applying active EGF to the DFU lesion may promote wound healing [13,14]. The authors demonstrated that EGF was involved in repairing inflamed mucous membranes
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