基质金属蛋白酶9对糖尿病足溃疡愈合影响的研究进展

Research Progress on the Effects of Matrix Metalloproteinase 9 on the Healing of Diabetic Foot Ulcers

在糖尿病足患者溃疡创面分泌物中,基质金属蛋白酶9 (matrix metalloproteinase-9,MMP-9)过高是预测糖尿病足的发生及足溃疡难愈的主要指标,其可能的机制包括:高水平MMP-9降低VEGF的表达、抑制成纤维细胞的生物学行为影响糖尿病足溃疡愈合;失衡的MMP-9/TIMP-1比值影响糖尿病足溃疡愈合。选择性MMP-9抑制剂(包括小分子抑制剂、高级伤口辅料抑制剂、基于干扰基因水平表达的RNA抑制剂)可以作为促进糖尿病足溃疡愈合的手段,但仍需大样本、多中心随机对照试验以及长期随访进一步验证其疗效及安全性。现查阅近年来涉及MMP-9和糖尿病足溃疡相关的文献,综述MMP-9对糖尿病足溃疡愈合的影响及其机制研究进展。

In the ulcer wounds of diabetic foot patients,excessive matrix metalloproteinase-9(MMP-9)is the main indicator for predicting the occurrence of diabetic foot and the difficulty of foot ulcer.The possible mechanisms include:high level of MMP-9 reduces VEGF expression and inhibits fibroblast formation.The biological behavior of the cells affects diabetic foot ulcer(DFU)healing;the imbalanced MMP-9/TIMP-1 ratio affects DFU healing.Selective MMP-9 inhibitors(including small molecule inhibitors,advanced wound adjuvant inhibitors,RNA inhibitors based on interfering gene level expression)can be used as a means of promoting DFU healing,but large-sample,multicenter randomized controlled trials are still needed.Long-term follow-up further verified the efficacy and safety.The literature related to MMP-9 and DFU in recent years was reviewed and summarized.To review the effects of MMP-9 on the healing of DFU and its mechanism.