Growth factors in the treatment of diabetic foot ulcers.
BACKGROUND
Chronic foot ulceration is a major source of morbidity in diabetic patients. Despite traditional comprehensive wound management, including vascular reconstruction, there remains a cohort of patients with non-responding wounds, often resulting in amputation. These wounds may benefit from molecular manipulation of growth factors to enhance the microcirculation.


METHODS
A review of the current literature was performed using Pubmed, with secondary references obtained from key articles.


CONCLUSIONS
There has been a generally disappointing clinical outcome from growth factor trials, although topical platelet-derived growth factor has shown significant benefit and should be considered in non-healing, well perfused ulcers after failure of conventional wound care. The modulatory role of the extracellular matrix in the cellular response to growth factors and data from regenerative-type fetal wound healing are further areas of interest. The chemical induction of microvessel formation may become a future therapeutic option.
Bennett
S P
SP
Unit of Cell and Molecular Biology, The Dental School, University of Dundee, Dundee, UK. s.p.bennett@doctors.org.uk
Griffiths
G D
GD
Schor
A M
AM
Leese
G P
GP
Schor
S L
SL
D017719:Diabetic Foot / Q000188:drug therapy*; D016228:Endothelial Growth Factors / Q000627:therapeutic use; D004815:Epidermal Growth Factor / Q000627:therapeutic use; D051523:Fibroblast Growth Factor 7; D005346:Fibroblast Growth Factors / Q000627:therapeutic use; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006133:Growth Substances / Q000627:therapeutic use*; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000627:therapeutic use; D008222:Lymphokines / Q000627:therapeutic use; D010982:Platelet-Derived Growth Factor; D012307:Risk Factors; D016212:Transforming Growth Factor beta / Q000627:therapeutic use; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D014945:Wound Healing / Q000187:drug effects*
D016228:Endothelial Growth Factors; C496453:FGF7 protein, human; D006133:Growth Substances; D036341:Intercellular Signaling Peptides and Proteins; D008222:Lymphokines; D010982:Platelet-Derived Growth Factor; D016212:Transforming Growth Factor beta; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D051523:Fibroblast Growth Factor 7; D016179:Granulocyte Colony-Stimulating Factor; D005346:Fibroblast Growth Factors; D004815:Epidermal Growth Factor