Growth factors in diabetic complications.
Diabetes mellitus is characterized by a lack of insulin, causing elevated blood glucose, often with associated insulin resistance. Over time, especially in genetically susceptible individuals, such chronic hyperglycemia can cause tissue injury. Dysregulation of growth factors in diabetes occurs through biochemical and hemodynamic pathways. In some tissues affected by diabetes, growth factors are induced to an excess, while in other sites a relative deficit of growth factors occurs. There is evidence that these growth factor changes contribute to the tissue pathology in diabetes, whether it be fibrosis, persistent inflammation or a combination of the two. This review focuses on the role of growth factors in diabetic nephropathy and wound healing in diabetes. Growth factor therapy in diabetic foot ulcers is already a clinical reality. As methods to finely regulate growth factors in a tissue- and time-specific manner are further developed and tested, downregulation of growth factors in vivo may well become a therapy to prevent and treat diabetic nephropathy.
Thomson
Sally E
SE
University of Sydney, Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia. sallyt@med.usyd.edu.au
McLennan
Susan V
SV
Twigg
Stephen M
SM