IMR Press / FBL / Volume 27 / Issue 10 / DOI: 10.31083/j.fbl2710285
Open Access Review
Natural Biologics Accelerate Healing of Diabetic Foot Ulcers by Regulating Oxidative Stress
Jianying Song1,2,†Aiai Liu3,†Bo Liu2Wei Huang1,4,5,6Zongzhe Jiang4,5,6Xue Bai1,4,5,6Lixin Hu1,2Silin Zheng3Shengming Guo3,*Jianming Wu7,*Qi Chen1,2,3,4,5,6,*
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1 Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, 646000 Luzhou, Sichuan, China
2 School of Nursing, Southwest Medical University, 646000 Luzhou, Sichuan, China
3 Department of Nursing, The Affiliated Hospital of Southwest Medical University, 646000 Luzhou, Sichuan, China
4 Metabolic Vascular Disease Key Laboratory of Sichuan Province, 646000 Luzhou, Sichuan, China
5 Sichuan Clinical Research Center for Nephropathy, 646000 Luzhou, Sichuan, China
6 Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, 646000 Luzhou, Sichuan, China
7 Department of Pharmacology, School of Pharmacy, Southwest Medical University, 646000 Luzhou, Sichuan, China
*Correspondence: (Shengming Guo); (Jianming Wu); (Qi Chen)
These authors contributed equally.
Academic Editors: Graham Pawelec, Jiang Pi, Anguo Wu and Deyu Kong
Front. Biosci. (Landmark Ed) 2022, 27(10), 285;
Submitted: 25 July 2022 | Revised: 4 September 2022 | Accepted: 8 September 2022 | Published: 19 October 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Difficult or even non-healing diabetic foot ulcers (DFU) are a global medical challenge. Although current treatments such as debridement, offloading, and infection control have resulted in partial improvement in DFU, the incidence, amputation, and mortality rates of DFU remain high. Therefore, there is an urgent need to find new or more effective drugs. Numerous studies have shown that oxidative stress plays an important role in the pathophysiology of DFU. The nuclear factor erythroid 2-related factor (Nrf2) signaling pathway and the advanced glycated end products (AGEs)-receptor for advanced glycation endproducts (RAGE), protein kinase C (PKC), polyol and hexosamine biochemical pathways play critical roles in the regulation of oxidative stress in the body. Targeting these pathways to restore redox balance can control and alleviate the occurrence and development of DFU. Natural biologics are a major source of potential drugs for these relevant targets, and their antioxidant potential has been extensively demonstrated. Here, we discussed the pathophysiological mechanism of oxidative stress in DFU, and identifiled natural biologics targeting these pathways to accelerate DFU healing, in order to provide a new or potential direction for clinical treatment, nursing and related basic research of DFU.

diabetic foot ulcers
diabetic wound
oxidative stress
natural biologics
targeted therapy
2020LZXNYDJ30/joint project of the Luzhou Municipal Government and Southwest Medical University
20009/Doctoral Research Initiation Fund of Affiliated Hospital of Southwest Medical University
2020ZRQNA014/Scientific research project of Southwest Medical University
2020ZSQN004/Scientific research project of Southwest Medical University
Q21021/Sichuan Medical Association
H21013/Nursing association of Sichuan province
2021-1502/Cadre Health of Sichuan province
2019YFS0537-11/Sichuan Clinical Medical Research Center for Kidney Diseases 2020 open project
Fig. 1.
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