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Sharma A, Perrault D, Sean Makarewicz N, Pham T, Sheckter C, Gurtner G. Foot Burns and Diabetes: A Systematic Review of Current Clinical Studies and Proposal of a New Treatment Algorithm. J Burn Care Res 2024; 45:903-915. [PMID: 36786194 DOI: 10.1093/jbcr/irad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Indexed: 02/15/2023]
Abstract
This study aims to systematically identify studies that evaluate lower extremity burn injury in the diabetic population, evaluate their clinical course and patient outcomes, and present a treatment algorithm tailored to diabetic burn patients. Our systematic review of the PubMed and Web of Science databases yielded 429 unique articles. After exclusion and inclusion criteria were applied, 59 articles were selected for evaluation. In diabetic patients, the thermal injury was largely a result of decreased awareness and education regarding heat therapies in the context of peripheral neuropathy. All noncase studies found that metrics such as hospital length of stay, ICU admission rates, rates of comorbidity, complication rates, scald injuries, infection rates, and cost of treatment were significantly increased in the diabetic burn population as compared to their nondiabetic counterparts. Where infection was present, microorganisms colonizing diabetic burn wounds were different than those found in the burn wounds of immunocompetent individuals. Operative intervention including split-skin graft, amputation, and debridement were more often utilized in diabetic burn patients. Foot burns in diabetic patients pose unique clinical risks to patients, and as such need to be an alternate treatment protocol to reflect their pathology. Education and training programs are crucial in the prevention of diabetic foot burns to avoid complications, protracted healing, and adverse outcomes. A unique algorithm can guide the unique treatment of this clinical entity.
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Affiliation(s)
- Ayushi Sharma
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - David Perrault
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Nathan Sean Makarewicz
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Tam Pham
- UW Medicine Regional Burn Center, University of Washington Medical Center, Seattle, WashingtonUSA
| | - Clifford Sheckter
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California, USA
- Regional Burn Center, Santa Clara Valley Medical Center, San Jose, California, USA
| | - Geoffrey Gurtner
- Department of Surgery, The University of Arizona College of Medicine Tucson, Tucson, Arizona, USA
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Hu Y, Hu L, Zhang L, Chen J, Xiao H, Yu B, Pi Y. Novel electro-spun fabrication of blended polymeric nanofibrous wound closure materials loaded with catechin to improve wound healing potential and microbial inhibition for the care of diabetic wound. Heliyon 2024; 10:e26940. [PMID: 38509943 PMCID: PMC10950831 DOI: 10.1016/j.heliyon.2024.e26940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/22/2024] Open
Abstract
Diabetic wound infections caused by the multiplication of infectious pathogens and their antibiotic resistance. Wound infection evident by bacterial colonization and other factors, such as the virulence and host immune factors. In this context, we need discover appropriate treatment and effective antibiotics for wound infection control. Considering this, we synthesized catechin-loaded polyvinyl alcohol/Chitosan (PVA/CS) based nanofiber for multifunctional wound healing. The physicochemical and biological properties of fabricated nanofiber, were systematically evaluated by various spectroscopy and microscopy techniques. The CA@PVA/CS nanofiber exhibited a high level of antibacterial and antioxidant effects. The nanofibers showed effective control in gram-positive and negative wound infectious bacterial multiplication at the lowest concentration. Based on the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) cell viability study CA@PVA/CS nanofiber shows excellent biocompatibility against L929 cells. In wound, scratch assay results revealed that the CA@PVA/CS treated group shows enhanced cell migration and cell proliferation within 48 h. The synthesis of antioxidant, antibacterial, and biocompatible nanofiber exposes their potential for effective wound healing. Current research hypothesized catechin loaded PVA/CS nanofiber could be a multifunctional and low-cost material for diabetic wound care application. Fabricated nanofiber would be improved skin tissue regeneration and public health hygiene.
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Affiliation(s)
- Yunting Hu
- Department of Endocrinology and Metabolism, Changsha First Hospital, Changsha 410000, China
| | - Li Hu
- Department of Endocrinology and Metabolism, Changsha First Hospital, Changsha 410000, China
| | - Li Zhang
- Department of Endocrinology and Metabolism, Changsha First Hospital, Changsha 410000, China
| | - Juan Chen
- Department of Endocrinology and Metabolism, Changsha First Hospital, Changsha 410000, China
| | - Huiyu Xiao
- Department of Endocrinology and Metabolism, Changsha First Hospital, Changsha 410000, China
| | - Bin Yu
- Department of Endocrinology and Metabolism, Changsha First Hospital, Changsha 410000, China
| | - Yinzhen Pi
- Department of Endocrinology and Metabolism, Changsha First Hospital, Changsha 410000, China
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Jirofti N, Golandi M, Movaffagh J, Ahmadi FS, Kalalinia F. Improvement of the Wound-Healing Process by Curcumin-Loaded Chitosan/Collagen Blend Electrospun Nanofibers: In Vitro and In Vivo Studies. ACS Biomater Sci Eng 2021; 7:3886-3897. [PMID: 34256564 DOI: 10.1021/acsbiomaterials.1c00131] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Chronic wounds have become a major health problem worldwide. Curcumin (Cur), with strong anti-inflammatory and anti-infective properties, is introduced as a unique molecule for wound dressing applications. In the present study, Cur-loaded chitosan/poly(ethylene oxide)/collagen (Cho/PEO/Col) nanofibers were developed for wound dressing applications by the blend-electrospinning process. Structural, mechanical, and biological properties of nanofibers were evaluated using SEM, FTIR, tensile testing, in vitro release study, Alamar blue cytotoxicity assay, and in vivo study in a rat model. According to the results, Cur was successfully released up to 3 days without any significant cytotoxicity of the above hybrid to human dermal fibroblasts. In vivo studies on full-thickness wounds in the rat model indicated significant improvement in the mean wound area closure by applying Cur-loaded Cho/PEO/Col nanofibers. The electrospun Cho/PEO/Col nanofibers loaded with Cur could be considered as a promising type of wound dressing in the wound-healing process.
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Affiliation(s)
- Nafiseh Jirofti
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Chemical and Biomedical Engineering Department, University of Sistan and Baluchestan, Zahedan, Iran
| | - Mohadese Golandi
- Department of Biotechnology and Plant Breeding, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Jebrail Movaffagh
- Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Departments of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Fatemeh Kalalinia
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Departments of Pharmaceutical Biotechnology, School of Pharmacy, Mashhad, University of Medical Sciences, Mashhad, Iran
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Charan TR, Bhutto MA, Bhutto MA, Tunio AA, Khuhro GM, Khaskheli SA, Mughal AA. “Nanomaterials of curcumin-hyaluronic acid”: their various methods of formulations, clinical and therapeutic applications, present gap, and future directions. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2021. [DOI: 10.1186/s43094-021-00281-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
Nanomaterials of curcumin with hyaluronic acid have gained a lot of attention for potential therapeutic applications of curcumin and hyaluronic acid with or without other additional drugs. Overall studies of curcumin and hyaluronic acid show that nanomaterials of curcumin with hyaluronic acid accelerate the efficacy of curcumin in the treatment of various disorders like arthritis, cancer, hepatic fibrosis, neural disorders, wound healing, and skin regeneration, it is largely due to the combined effect of hyaluronic acid and curcumin. However, due to limited clinical trials and experiments on humans and animals, there is a substantial gap in research for the safety and efficacy of nanomaterials of curcumin-hyaluronic acid in the treatment of curcumin and hyaluronic acid targeted diseases and disorders.
Main body of the abstract
In this current review, we have first described various reported synthetic nanomaterials of curcumin-hyaluronic acid, then in the next section, we have described various fields, disorders, and diseases where these are being applied and in the final section of this review, we discussed the research gap, and future research directions needed to propose the fabricated nanocurcumin-hyaluronic acid biomaterials.
Short conclusion
There are substantial gaps in research for the safety and efficacy of nanomaterials of curcumin with hyaluronic acid due to limited available data of clinical trials and experiments of nanocurcumin-hyaluronic acid biomaterials on humans and animals. So, it entirely requires serious and committed efforts through the well-organized system of practical and clinical trials which provide results, data, and detections that lead to the formulation of the best drug from curcumin with hyaluronic acid for the treatment of curcumin and hyaluronic acid targeted diseases and disorders.
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Abu-Qamar MZ, Kemp V, Whitehead L. Foot ulcers associated with external trauma among people with diabetes: An integrative review of the origin of trauma and outcomes. Int J Nurs Stud 2020; 114:103822. [PMID: 33248292 DOI: 10.1016/j.ijnurstu.2020.103822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 10/22/2020] [Accepted: 10/25/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Foot ulcers are common among people with diabetes. These ulcers are caused by a number of factors including trauma. To date, research findings on the origin of external trauma and the outcome of foot ulcers resulting from an external trauma have not been summarised. OBJECTIVE To examine the origin of external trauma that contribute to the development of foot ulcers among people with diabetes and the outcome of such ulcers. DESIGN An integrative review. SETTINGS Hospital/community. PARTICIPANTS Patients with diabetes and foot ulcer. METHOD The Joanna Briggs framework was used to underpin this integrative review. Six different databases (CINAHL +, Medline, SCOPUS, Embase, ProQuest and Web of Science databases) were searched systematically to find research publications reporting traumas that contributed to foot ulcers sustained by people with diabetes. The search was limited to articles published in English. The search revealed 3193 articles that were filtered to 78 articles to be assessed at the full-text level and 45 articles were subsequently included. Quality appraisal was conducted independently by two reviewers, using the Joanna Briggs Institute (JBI) Critical Appraisal tools. Data were extracted into a form developed for the purpose of this review. Narrative synthesis was used to manage the extracted verbatim details on the origin of external trauma contributing to foot ulcers and the outcomes. RESULTS The origins of external trauma were summarised into two domains and further specified into 16 categories. The identified traumas were mainly minor and originated within the home environment. The most commonly reported origins of external trauma were puncture wounds, ill-fitting shoes and self-care practices that caused foot ulcers. Twenty-seven studies reported outcomes following the development of an ulcer. Twenty-two studies reported amputation as an outcome and mortality was reported in 10 studies. It was not clear whether these outcomes were directly related to the foot ulcer or related to other diabetes-related complications. CONCLUSIONS The majority of ulcers occurred in the home environment and were preventable in nature. The assessment of an individual's local context, particularly the home and actions to reduce risk is a priority. The extent of the risks related to external trauma need to be more widely communicated through clinical guidelines and training opportunities for frontline staff. TWEETABLE ABSTRACT The main origins of external foot trauma among people with diabetes were puncture wounds, ill-fitting footwear and self-care practices.
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Affiliation(s)
- Ma'en Zaid Abu-Qamar
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; Department of Adult Health Nursing, Faculty of Nursing, Mu´tah University, Mu´tah, Jordan.
| | - Vivien Kemp
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia.
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia.
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Akrami-Hasan-Kohal M, Tayebi L, Ghorbani M. Curcumin-loaded naturally-based nanofibers as active wound dressing mats: morphology, drug release, cell proliferation, and cell adhesion studies. NEW J CHEM 2020. [DOI: 10.1039/d0nj01594f] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A perfect wound dressing should be able to maintain a high moisture content, manage exudates effectively, provide thermal insulation, and provide reliable mechanical strength.
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Affiliation(s)
| | - Lobat Tayebi
- Department of Developmental Sciences
- Marquette University School of Dentistry
- Milwaukee
- USA
| | - Marjan Ghorbani
- Stem Cell Research Center
- Tabriz University of Medical Sciences
- Tabriz
- Iran
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Momeni M, Sediegh-Marufi S, Safari-Faramani R, Akhoondinasab MR, Karimi H, Karimi AM. Lower Extremity Burns, Complications, and Outcome. J Burn Care Res 2019; 41:409-415. [DOI: 10.1093/jbcr/irz182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
We have encountered many burn cases with lower extremity burn with adverse outcome. The study was a retrospective cohort study in 2 years, mean (SD) of follow up was 12(7) months. All demographic data, cause burn, time, total burn surface area (TBSA), presence lower extremity burn and its burn surface area (BSA), foot burn, delay in treatment, smoking, infection, morbidity, co-morbid diseases, length of stay (LOS), amputation, mortality, and outcome were gathered from patients’ files. Statistical analysis was done with SPSS 21software. We had 14,215 burn patients, of them 995 were admitted according to criteria of ABA. Six hundred and ten (61.3%) were male and 358 (37%) female. Male to female ratio was 1.58:1. The mean age ± SD was 33.64 ±23.45. Mean (SD) of lower extremity BSA was 12.09 ± 9.18%. The patients who had 10 to 19% burn, had 3 times more risk of mortality than patients with 0 to 9% burn (P < .018). And those with 20 to 29% burn had 35 times more risk of mortality comparing to patients with 0 to 9% burn. The difference was significant too. (P < .000). Delay in treatment, presence of co-morbid diseases and diabetes would not do any increase in mortality. The sex, weight, cause of burn, diabetes, and delay in treatment have not any influence on the death risk. But age and lower extremity BSA have influence on the risk of death. According to statistical study: with every 1-year increase in age, death rate increased by 4% (P < .0001). With every 1% increase in lower extremity BSA, death rate increase by 9% (P < .0005) and with every 1 day increase in LOS, the death rate increase by 4%. Statistical study shows lower extremity burn, TBSA, age, and LOS have great influence on the outcome of these patients. Sex, weight, cause of burn, and delay in treatment have not affected the risk of mortality.
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Affiliation(s)
- Mahnoush Momeni
- General Surgery, Motahary Hospital, School of Medicine, Burn Research Center
| | | | - Roya Safari-Faramani
- Department of Epidemiology, Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Hamid Karimi
- Plastic and Reconstructive Surgery, Hazrat Fatemeh Hospital, School of Medicine, Burn Research Center
| | - Ali-Mohammad Karimi
- Surgery Department, Medical School, Iran University of Medical Sciences, Tehran, Iran
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Weitgasser L, Ihra G, Schäfer B, Markstaller K, Radtke C. Update on hyperbaric oxygen therapy in burn treatment. Wien Klin Wochenschr 2019; 133:137-143. [PMID: 31701218 DOI: 10.1007/s00508-019-01569-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 06/26/2019] [Accepted: 10/14/2019] [Indexed: 12/21/2022]
Abstract
Hyperbaric oxygen therapy (HBOT) has been shown to improve tissue hypoxia, neovascularization and ischemia reperfusion injury and reduce pathologic inflammation in various clinical settings and was proposed to be a game changer in treatment of burns. Improved and faster wound healing as well as a reduction of morbidity and mortality after thermal and concomitant carbon monoxide poisoning are expected. In defiance of the observed benefits for burn wounds and carbon monoxide poisoning in animal models and few randomized controlled trials there is an ongoing controversy regarding its use, indications and cost effectiveness. Furthermore, the use of HBOT, its indications and the evidence behind its efficiency are still widely unknown to most physicians involved in the treatment of burn patients. Therefore, a review of the up to date evidence-based literature was performed with a focus on available data of HBOT in burn care, to elaborate its use in acute thermal injury and carbon monoxide intoxication. Although beneficial effects of HBOT seem very likely insufficient evidence to support or disprove the routine use of HBOT in the treatment of burn care was found. Although difficult to carry out because of the high interindividual variability of burns and chronic wounds, the need for larger high-quality prospective randomized double-blinded controlled multicenter trials are necessary to be able to evaluate useful applications, expense and cost-efficiency of HBOT for burn care.
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Affiliation(s)
- Laurenz Weitgasser
- Department of Plastic and Reconstructive Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| | - Gerald Ihra
- Department of Anesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Bruno Schäfer
- Department of Anesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Klaus Markstaller
- Department of Anesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Christine Radtke
- Department of Plastic and Reconstructive Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
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Enomoto A, Qian C, Devasahayam N, Kishimoto S, Oshima N, Blackman B, Swenson RE, Mitchell JB, Koretsky AP, Krishna MC. Wireless implantable coil with parametric amplification for in vivo electron paramagnetic resonance oximetric applications. Magn Reson Med 2018; 80:2288-2298. [PMID: 29603378 DOI: 10.1002/mrm.27185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/23/2018] [Accepted: 02/28/2018] [Indexed: 11/06/2022]
Abstract
PURPOSE To develop an implantable wireless coil with parametric amplification capabilities for time-domain electron paramagnetic resonance (EPR) spectroscopy operating at 300 MHz. METHODS The wireless coil and lithium phthalocyanine (LiPc), a solid paramagnetic probe, were each embedded individually in a biocompatible polymer polydimethoxysiloxane (PDMS). EPR signals from the LiPc embedded in PDMS (LiPc/PDMS) were generated by a transmit-receive surface coil tuned to 300 MHz. Parametric amplification was configured with an external pumping coil tuned to 600 MHz and placed between the surface coil resonator and the wireless coil. RESULTS Phantom studies showed significant enhancement in signal to noise using the pumping coil. However, no influence of the pumping coil on the oxygen-dependent EPR spectral linewidth of LiPc/PDMS was observed, suggesting the validity of parametric amplification of EPR signals for oximetry by implantation of the encapsulated wireless coil and LiPc/PDMS in deep regions of live objects. In vivo studies demonstrate the feasibility of this approach to longitudinally monitor tissue pO2 in vivo and also monitor acute changes in response to pharmacologic challenges. The encapsulated wireless coil and LiPc/PDMS engendered no host immune response when implanted for ∼3 weeks and were found to be well tolerated. CONCLUSIONS This approach may find applications for monitoring tissue oxygenation to better understand the pathophysiology associated with wound healing, organ transplantation, and ischemic diseases.
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Affiliation(s)
- Ayano Enomoto
- Radiation Biology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Chunqi Qian
- Laboratory of Functional and Molecular Imaging, NINDS, NIH, Bethesda, Maryland.,Department of Radiology, Michigan State University, East Lansing, Michigan
| | | | - Shun Kishimoto
- Radiation Biology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Nobu Oshima
- Urologic Oncology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | | | - Rolf E Swenson
- Image Probe Development Center, NHLBI, NIH, Bethesda, Maryland
| | - James B Mitchell
- Radiation Biology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Alan P Koretsky
- Laboratory of Functional and Molecular Imaging, NINDS, NIH, Bethesda, Maryland
| | - Murali C Krishna
- Radiation Biology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
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Our experience with an unusual age distribution of patients with isolated burns of the foot. EUROPEAN JOURNAL OF PLASTIC SURGERY 2018. [DOI: 10.1007/s00238-017-1320-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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11
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Mutlu G, Calamak S, Ulubayram K, Guven E. Curcumin-loaded electrospun PHBV nanofibers as potential wound-dressing material. J Drug Deliv Sci Technol 2018. [DOI: 10.1016/j.jddst.2017.09.017] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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13
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Ding L, Yang M, Zhao T, Lv G. Roles of p300 and cyclic adenosine monophosphate response element binding protein in high glucose-induced hypoxia-inducible factor 1α inactivation under hypoxic conditions. J Diabetes Investig 2017; 8:277-285. [PMID: 27808477 PMCID: PMC5415468 DOI: 10.1111/jdi.12592] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 10/05/2016] [Accepted: 10/30/2016] [Indexed: 12/19/2022] Open
Abstract
Aims/Introduction Given the high prevalence of diabetes and burn injuries worldwide, it is essential to dissect the underlying mechanism of delayed burn wound healing in diabetes patients, especially the high glucose‐induced hypoxia‐inducible factor 1 (HIF‐1)‐mediated transcription defects. Materials and Methods Human umbilical vein endothelial cells were cultured with low or high concentrations of glucose. HIF‐1α‐induced vascular endothelial growth factor (VEGF) transcription was measured by luciferase assay. Immunofluorescence staining was carried out to visualize cyclic adenosine monophosphate response element binding protein (CREB) localization. Immunoprecipitation was carried out to characterize the association between HIF‐1α/p300/CREB. To test whether p300, CREB or p300+CREB co‐overexpression was sufficient to rescue the HIF‐1‐mediated transcription defect after high glucose exposure, p300, CREB or p300+CREB co‐overexpression were engineered, and VEGF expression was quantified. Finally, in vitro angiogenesis assay was carried out to test whether the high glucose‐induced angiogenesis defect is rescuable by p300 and CREB co‐overexpression. Results Chronic high glucose treatment resulted in impaired HIF‐1‐induced VEGF transcription and CREB exclusion from the nucleus. P300 or CREB overexpression alone cannot rescue high glucose‐induced HIF‐1α transcription defects. In contrast, co‐overexpression of p300 and CREB dramatically ameliorated high glucose‐induced impairment of HIF‐1‐mediated VEGF transcription, as well as in vitro angiogenesis. Finally, we showed that co‐overexpression of p300 and CREB rectifies the dissociation of HIF‐1α‐p300‐CREB protein complex in chronic high glucose‐treated cells. Conclusion Both p300 and CREB are required for the function integrity of HIF‐1α transcription machinery and subsequent angiogenesis, suggesting future studies to improve burn wound healing might be directed to optimization of the interaction between p300, CREB and HIF‐1α.
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Affiliation(s)
- Lingtao Ding
- Department of Burn and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, Jiangsu Province, China.,Department of Plastic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Minlie Yang
- Department of Burn and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, Jiangsu Province, China
| | - Tianlan Zhao
- Department of Plastic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Guozhong Lv
- Department of Burn and Plastic Surgery, The Third Affiliated Hospital of Nantong University, Wuxi, Jiangsu Province, China
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