糖尿病足溃疡(DFU)是常见的慢性伤口和糖尿病的常见并发症。足部是糖尿病溃疡的主要部位,涉及中小型动脉,周围神经,和微循环,在其他人中。DFU易于合并感染并影响许多糖尿病患者。近年来,医学和材料科学相结合的跨学科研究不断增加,并取得了显著的临床治疗效果,负压封闭引流(VSD)在DFU治疗中的应用是这一进展的典型代表,但作用机制尚不清楚。在这次审查中,我们整合了生物信息学和文献,发现铁死亡是VSD促进DFU愈合的重要信号通路,系统Xc-GSH-GPX4和NAD(P)H-CoQ10-FSP1是该信号通路的重要轴,我们推测VSD最有可能通过上述轴抑制铁凋亡促进DFU愈合。此外,我们发现了一些经典的途径,比如TNF,NF-κB,和Wnt/β-catenin途径,也参与VSD介导的DFU愈合的促进。我们还汇编和回顾了VSD的临床研究进展,这些信息为研究VSD在DFU治疗中的应用提供了参考。
Diabetic foot ulcers (DFUs) are common chronic wounds and a common complication of diabetes. The foot is the main site of diabetic ulcers, which involve small and medium-sized arteries, peripheral nerves, and microcirculation, among others. DFUs are prone to coinfections and affect many diabetic patients. In recent years, interdisciplinary research combining medicine and material science has been increasing and has achieved significant clinical therapeutic effects, and the application of vacuum sealing drainage (VSD) in the treatment of DFUs is a typical representative of this progress, but the mechanism of action remains unclear. In this review, we integrated bioinformatics and literature and found that ferroptosis is an important signaling pathway through which VSD promotes the healing of DFUs and that System Xc-GSH-GPX4 and NAD(P)H-CoQ10-FSP1 are important axes in this signaling pathway, and we speculate that VSD is most likely to inhibit ferroptosis to promote DFU healing through the above axes. In addition, we found that some classical pathways, such as the TNF, NF-κB, and Wnt/β-catenin pathways, are also involved in the VSD-mediated promotion of DFU healing. We also compiled and reviewed the progress from clinical studies on VSD, and this information provides a reference for the study of VSD in the treatment of DFUs.