In a new study, researchers have discovered why wounds are hard to heal in people with diabetes.
The new finding may help develop a new treatment for complications related to diabetes, such as diabetic foot ulcers.
The research was conducted by researchers at Karolinska Institutet in Sweden.
A diabetic foot ulcer is a major complication of diabetes. It is an open sore or wound and commonly located on the bottom of the foot.
It is estimated that about 15% of patients with diabetes experience diabetic foot ulcers.
Moreover, about 20% of these people will eventually require amputation.
Previous research has shown that diabetes makes the foot wounds hard to heal and that neuropathic (nerve) and vascular (blood vessel) damage from diabetes cause the condition.
However, the underlying mechanism is still unknown.
In the current study, the team found a signaling pathway between cells. It plays an important role in impaired wound healing in diabetes.
This signaling pathway is called Notch and is activated by interactions between so-called Notch receptors (Notch1-4) and their target molecules on neighboring cells.
Notch has been shown involved in cell differentiation, cell migration and building of new blood vessels.
In this study, the researchers found an over-activated Notch1 singling in skin from patients with diabetes and in skin from mouse models of type 1 and type 2 diabetes.
They found that high glucose levels may help keep activating the signaling pathway.
The team also examined how wound healing is affected when this signaling pathway is blocked.
They found that local inhibition of Notch1 singling markedly improved the wound healing in diabetic animals, but not in non-diabetic animals.
The findings provide new information for the treatment of diabetic foot ulcers. The team hopes their study may lead to new treatments of diabetic foot ulcerations.
One author of the study is Sergiu Catrina, senior lecturer at the Department of Molecular Medicine and Surgery at Karolinska Institutet.
The study is published in the scientific journal Proceedings of the National Academy of Sciences.
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