Document Type : Narrative Review
Department of Biological Science, Faculty of Science, Kurdistan University, Sanandaj, Kurdistan, Iran; Nanobiotechnology Department, Faculty of Innovative Science and Technology, Razi University, Kermanshah, Iran
Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, 2028, South Africa; Wellman Centre for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Dermatology, Harvard
Department of Pharmacy, Faculty of Sciences, Universidad Nacional de Colombia, South America, Colombia
High Performance Powertrain Materials Laboratory, School of Engineering, University of British Columbia – Okanagan, Kelowna, V1V 1V7, Canada
Department of Pharmacy, Abdul Wali Khan University Mardan, Pakistan
Pharmacology and Molecular Chemistry Laboratory, Department of Chemical Biology, Regional University of Cariri, CEP 63105-000, Crato, Ceara, Brazil
Diabetes mellitus is a metabolic disease, which in a severe form needs daily subcutaneous injections of insulin to prevent symptoms, especially diabetic foot ulcers (DFU). However, the emergence of multidrug-resistant (MDR) bacteria in diabetic wounds can lead to complications. The infection of DFUs by MDR bacteria can lead to biofilm formation, and can increase the risk of lower-limb amputation up to 80%. Insulin hormone can activate angiogenesis, migration and proliferation of keratinocytes, and lead to the rapid maturation and closure of wounds. Insulin can promote protein and lipid synthesis, inactivate NFkβp50/p65, as well as altering cytokine dynamics. However, the uncontrolled and burst release of insulin reduces the therapeutic effects after topical delivery to wound tissues. Therefore a novel strategy for insulin delivery involves various polymeric and liposomal formulations on the micro or nanoscale, for sustained and controlled release of this hormone. In addition, improved sensitivity and selectivity are two major advantages (compared to free insulin) reported for nanoformulations of insulin. This review summarizes the current knowledge about the efficacy and limitations of these formulations to treat infected chronic wounds, especially in diabetics.
- Insulin can promote wound healing, the best way to deliver the hormone is uncertain.
- Oral or topical delivery of insulin may be possible by using nanoformulations of this peptide hormone as a more efficient method to treat diabetic patients.
- Micelles, polymersomes, nanoparticles, nanogels, and nanocapsules can be prepared by covalent binding, electrostatic complexation, or physical encapsulation.
- Various types of wound dressings composed of metal/metal oxide NPs, stem cell-based therapies, and incorporating growth factors can be employed to treat diabetic chronic wounds.