title: NorLeu3-Angiotensin (1-7) [DSC127] as a Therapy for the Healing of Diabetic Foot Ulcers.
abstract: Significance:Diabetes is a disorder that is well known to delay wound repair resulting in the formation of colonized chronic wounds. Over their lifetime, diabetic patients have a 25% incidence of foot ulcers (DFUs), which contribute to increased risk of morbidity, including osteomyelitis and amputations, and increased burden to the healthcare system.Recent Advances:The only active product approved for the treatment of diabetic ulcers, Regranex®, is not widely used due to minimal proven efficacy and recent warnings added to the Instructions for Use. A novel topical agent that accelerates healing and increases the proportion of fully healed DFUs, DSC127 [aclerastide; active ingredient, NorLeu3-angiotensin (1-7) (NorLeu3-A(1-7))], is recruiting patients in Phase III clinical trials (NCT01830348 and NCT01849965). NorLeu3-A(1-7) is an analog of the naturally occurring peptide, angiotensin 1-7. The mechanisms of action include induction of progenitor proliferation, accelerated vascularization, collagen deposition, and re-epithelialization.Critical Issues:Current modalities for the treatment of DFUs include strict offloading, bandaging, debridement and, on a limited basis, application of Regranex. Novel potent therapies are needed to combat this significant burden to the diabetic patient and the healthcare system.Future Direction:Preclinical and clinical research shows that DSC127 is highly effective in the closure of diabetic wounds and is superior to Regranex in animal studies. Clinical development of DSC127 as a topical agent for the healing of DFU is underway. Further investigation into the mechanisms by which this product accelerates healing is warranted.
authors.affiliation: School of Pharmacy, University of Southern California , Los Angeles, California.
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Rodgers
authors.affiliation: Rutgers University Medical School , Newark, New Jersey.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Bolton
authors.affiliation: Shelton Clinical Research Consultants , Atascadero, California.
authors.forename: Shelagh
authors.initials: S
authors.lastname: Verco
authors.affiliation: Keck School of Medicine, University of Southern California , Los Angeles, California.
authors.forename: Gere S
authors.initials: GS
authors.lastname: diZerega