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World J Diabetes. Nov 15, 2022; 13(11): 962-971
Published online Nov 15, 2022. doi: 10.4239/wjd.v13.i11.962
Role of defensins in diabetic wound healing
Zhi-Xiang Tan, Rui Tao, Si-Cheng Li, Bing-Zheng Shen, Lan-Xia Meng, Zhan-Yong Zhu
Zhi-Xiang Tan, Rui Tao, Si-Cheng Li, Zhan-Yong Zhu, Department of Plastic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
Bing-Zheng Shen, Department of Pharmacy, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
Lan-Xia Meng, Department of Neurology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
Author contributions: Tan ZX and Tao R wrote the manuscript and proposed research subtopics; Shen BZ was responsible for navigating the literature, sharing the relevant studies, and drawing the tables included in this review; Meng LX and Li SC drew the figures in the manuscript, formatted citations and compiled references, verified spelling, punctuation, and grammatical errors; Zhu ZY revised and formatted the body of the manuscript, and coordinated the whole work.
Supported by the Scientific Research Project of Hubei Health Committee, No. WJ2021F106.
Conflict-of-interest statement: Authors declare no conflicts of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Zhan-Yong Zhu, MD, PhD, Associate Chief Physician, Doctor, Surgeon, Department of Plastic Surgery, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuhan 430060, Hubei Province, China.
Received: September 14, 2022
Peer-review started: September 14, 2022
First decision: October 5, 2022
Revised: October 22, 2022
Accepted: October 31, 2022
Article in press: October 31, 2022
Published online: November 15, 2022

The adverse consequences resulting from diabetes are often presented as severe complications. Diabetic wounds are one of the most commonly occurring complications in diabetes, and the control and treatment of this is costly. Due to a series of pathophysiological mechanisms, diabetic wounds remain in the inflammatory phase for a prolonged period of time, and face difficulty in entering the proliferative phase, thus leading to chronic non-healing wounds. The current consensus on the treatment of diabetic wounds is through multidisciplinary comprehensive management, however, standard wound treatment methods are still limited and therefore, more effective methods are required. In recent years, defensins have been found to play diverse roles in a variety of diseases; however, the molecular mechanisms underlying these activities are still largely unknown. Defensins can be constitutively or inductively produced in the skin, therefore, their local distribution is affected by the microenvironment of these diabetic wounds. Current evidence suggests that defensins are involved in the diabetic wound pathogenesis, and can potentially promote the early completion of each stage, thus making research on defensins a promising area for developing novel treatments for diabetic wounds. In this review, we describe the complex function of human defensins in the development of diabetic wounds, and suggest potential thera-peutic benefits.

Keywords: Defensin, Diabetic wound, Wound healing, Inflammation, Re-epithelia-lization, Tissue regeneration

Core Tip: Although previous studies have suggested that defensins have a function in the promotion of wound healing, their mechanism is still unclear. In this review, we discuss the potential role of various defensins in refractory diabetic wounds and their properties, including immunoregulation, promotion of re-epithelialization, collagen deposition, vascular regeneration, and neurological recovery, as well as antimicrobial activity.