Open AccessThe Anti-inflammatory and Proangiogenic Properties of High-Density Lipoproteins: An Emerging Role in Diabetic Wound Healing
Author(s) -
Zahra Lotfollahi,
Joseph Dawson,
Robert Fitridge,
Christina A. Bursill
Publication year - 2021
Publication title -
advances in wound care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.864
H-Index - 24
eISSN - 2162-1934
pISSN - 2162-1918
DOI - 10.1089/wound.2020.1308
Subject(s) - angiogenesis , wound healing , medicine , inflammation , diabetic foot , pi3k/akt/mtor pathway , diabetes mellitus , cancer research , bioinformatics , immunology , signal transduction , endocrinology , biology , microbiology and biotechnology
Significance: Prolonged inflammation and impaired angiogenesis are the two principal factors that prevent successful wound healing, which is exacerbated in people with diabetes. There is a significant need for new wound healing treatments that target both these factors simultaneously. This review discusses the emerging evidence that high-density lipoproteins (HDL) have pleiotropic wound healing benefits. Recent Advances: Numerous in vitro and in vivo studies have demonstrated the anti-inflammatory and proangiogenic effects of HDL. In endothelial cells, HDL mediate these effects through interaction with the scavenger receptor SR-BI, which activates the PI3K/Akt pathway, causing a decrease in inflammatory protein production and an increase in proangiogenic growth factors. In macrophages, HDL inhibit inflammation through suppression of the nuclear factor kappa B activation pathway. This review details the molecular disturbances that cause impaired wound healing in diabetes with a particular focus on inflammation and angiogenesis and the pathways in which HDL provide benefit. Critical Issues: Diabetic foot ulcers (DFUs) impose a major public health challenge worldwide. It is estimated that 20% patients with DFUs require amputation, which is accompanied by a significant social and economic burden. To date, there are no therapeutic agents with pleiotropic effects that actively improve wound healing, highlighting a therapeutic void for this complex disease.