Erythropoietin, a novel repurposed drug: An innovative treatment for wound healing in patients with diabetes mellitus

Abstract

Developing a new drug is expensive: the cost of going from bench to bedside is about $US1 billion. Therefore, the repurposing of an approved drug is potentially rewarding because it expands the drug's existing therapeutic profile and preempts additional development costs. As the safety profile of a repurposed drug is already well known, any new investigations could then focus on its efficacy and other therapeutic benefits. Recombinant erythropoietin (EPO) is a potential candidate for repurposing because the results of numerous studies have shown that systemic and topical EPO is therapeutically beneficial when it is administered to healthy and diabetic animals with acute and chronic skin wounds and burns. Moreover, the molecular mechanisms of EPO's actions have been elucidated: EPO acts on those nonhematopoietic cells which are involved in the innate immune response where it promotes cellular proliferation and differentiation, exerts its cytoprotective actions, and inhibits apoptosis. In this review, the mechanism of EPO's action in skin wound healing is reviewed, and its potential for treating acute and chronic skin wounds and stimulating tissue regeneration in diabetic patients is discussed.

Burn wound healing properties of asiaticoside and madecassoside

“…Normally, in cases of burn injuries, the first line of defense includes a well-orchestrated, complex wound healing process (16,17). As a result of the directly afflicted burn injury, the central area of coagulation is comprised of tissue as well as cell necrosis (18). Monocyte-derived macrophages and neutrophils are then attracted to the site as a response to the selection of cytokines and chemoattractants released by platelets in the hemostatic clot (19).…”

Influence of Melanine on Morphofunctional Indices of Rat Skin With Chemical Burner and Full-Thickness Wound

“…Нині збільшення виробничого та побутово-го травматизму тісно пов'язано зі впливом на організм людини негативних чинників у результаті бойових поранень та травм мир-ного населення, техногенних катастроф, що супроводжується виникненням механічних пошкоджень, які призводять до порушення цілісності покривних тканин -утворенню шкірних ран [1][2][3]. Важливість питання трав-матизму зумовлена тим, що близько 6 % усьо-го населення протягом року отримує якесь пошкодження тіла.…”

Programming Apoptosis and Autophagy with Novel Approaches for Diabetes Mellitus

“…As a result, DM has been reported to lead to vascular disease (24–30), cardiac disorders (31–39), renal disease (2, 40–43), hepatic disorders (44–49), and immune cell impairment (38, 50–54). In the neurovascular arena, DM can contribute to cognitive loss through acute stroke onset (55).…”

“…As a result, recent investigations have concentrated upon pathways that involve anti-oxidant therapies (3, 23, 27, 30, 53, 71, 75), mammalian forkhead transcription factors (9, 37, 47, 150, 151), protein tyrosine phosphatases (6, 15, 152), and growth factors (11–13, 50, 65, 70, 104). In addition, new therapeutic strategies are now focusing upon the role of extracellular matrix associated proteins such as the CCN family of proteins (153, 154).…”

“…EPO uses mTOR to increase cell survival during oxygen-glucose deprivation (195, 229), prevent cell injury during β-amyloid exposure (230), modulate bone homeostasis (231), improve cognitive function sepsis-associated encephalopathy (232), promote retinal progenitor cell survival during oxidant stress (233), prevent retinal degeneration in models of polycystic kidney disease (62), and foster the neuronal phenotype of adult neuronal precursor cells (234). During abnormalities in cellular metabolism, EPO facilitates wound healing during DM (50), attenuates AGE-induced toxicity (235), protects endothelial cell survival during experimental models of DM (66, 67), maintains cellular mitochondrial function and energy metabolism (70), limits high glucose-induced oxidative stress in renal tubular cells (138), and reduces the detrimental effects of obesity in animal models (14). …”