title: Emerging drugs for the treatment of diabetic ulcers.
abstract: BACKGROUND
  Diabetic ulcers are chronic nonhealing ulcerations that despite the available medical tools still result in high amputation rates. Growing evidence suggests that alteration of the biochemical milieu of the chronic wound plays a significant role in impaired diabetic wound healing.
  
  
  METHODS
  The basic pathophysiology and the conventional treatment strategy of diabetic foot ulcers have been reviewed in the first section. In the second part, the most up-to-date bench and translational research in the field are described. The third section focuses on the drugs currently under development and the ongoing clinical trials evaluating their safety and efficacy. Finally, the major drug development issues and the possible scientific approaches to overcome them are analyzed.
  
  
  CONCLUSIONS
  Significant strides in understanding the chronic wound development have led to the development of topical therapies to address aberrant expression of growth factors and overexpression of inflammatory cytokines. Current research in the laboratory suggests that while decreased growth factor expression occurs at the local wound level, increased systemic serum levels of growth factors suggest growth factor resistance.
authors.affiliation: Harvard Medical School, Joslin-Beth Israel Deaconess Foot Center, and Microcirculation Lab, Beth Israel Deaconess Foot Center, Boston, MA, USA.
authors.forename: Francesco
authors.initials: F
authors.lastname: Tecilazich
authors.forename: Thanh L
authors.initials: TL
authors.lastname: Dinh
authors.forename: Aristidis
authors.initials: A
authors.lastname: Veves
mesh_terms: D000818:Animals; D016207:Cytokines / Q000378:metabolism; D017719:Diabetic Foot / Q000378:metabolism / Q000628:therapy*; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism
chemical_list: D016207:Cytokines; D036341:Intercellular Signaling Peptides and Proteins