diabetic foot ulcer treatment

Researchers in Michigan have developed a novel nitric oxide sensing device, providing new insight into the causes of diabetic foot ulcers and possible avenues for treatment.

Approximately 9 to 26 million diabetic patients around the world develop foot ulcers every year. These ulcers can double the risk of death for diabetic patients and may take up to 120 days to heal.  Previous research has suggested that the impaired healing associated with diabetic foot ulcers is caused by unregulated levels of nitric oxide. Measuring live concentrations of this compound has posed a significant challenge due to its highly reactive nature. Previous studies have used nitrite, a stable byproduct, to measure nitric oxide levels indirectly.

A team of researchers from Michigan Technological University and Central Michigan University in the United States have recently developed a new system for measuring real-time concentrations of nitric oxide. Their work was published in Medical Sciences. The team exposed cells to both normal and elevated glucose conditions to simulate non-diabetic and diabetic environments and then measured the amounts of nitric oxide produced in each case.

They found that the levels of nitric oxide in high glucose conditions were significantly lower than in the cells exposed to normal glucose levels. The team then compared the levels of nitric oxide to nitrite and found that the two were correlated under normal glucose conditions but this correlation was not maintained under high glucose conditions.

The researchers advise that nitrite concentrations are not an accurate marker of nitric oxide levels in diabetic wounds. They currently have plans to commercialize real-time nitric oxide sensing devices and hope to design a nitric oxide bandage capable of delivering optimal concentrations of nitric oxide to affected areas, significantly shortening the time needed for diabetic foot ulcers to heal.

Written by Agustin Dominguez Iino, BSc

Reference: P Kwesiga M, Cook E, Hannon J, Wayward S, Gwaltney C, Rao S, C Frost M. Investigative Study on Nitric Oxide Production in Human Dermal Fibroblast Cells under Normal and High Glucose Conditions. Med Sci (Basel). 2018 Nov 9;6(4). pii: E99. doi: 10.3390/medsci6040099.

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