Fibronectin in hyperglycaemia and its potential use in the treatment of diabetic foot ulcers: A review

Abstract

Metabolism of fibronectin, the protein that plays a key role in the healing of wounds, is changed in the patients with diabetes mellitus. Fibronectin can interact with other proteins and proteoglycans and organise them to form the extracellular matrix, the basis of the granulation tissue in healing wounds. However, diabetic foot ulcers (DFUs) suffer from inadequate deposition of this protein. Degradation prevails over fibronectin synthesis in the proteolytic inflammatory environment in the ulcers. Because of the lack of fibronectin in the wound bed, the assembly of the extracellular matrix and the deposition of the granulation tissue cannot be started. A number of methods have been designed that prevents fibronectin degradation, replace lacking fibronectin or support its formation in non-healing wounds in animal models of diabetes. The aim of this article is to review the metabolism of fibronectin in DFUs and to emphasise that it would be useful to pay more attention to fibronectin matrix assembly in the ulcers when laboratory methods are translated to clinical practice.

Identification of potential immunologic resilience in the healing process of diabetic foot ulcers

“…28 In the fibrin network formed in wounds, enhancing the mechanical strength of the clot and promoting platelet aggregation contribute to wound healing. 29 The lack or reduction of elastic fibre neogenesis during the wound healing process may be associated with hypoxia. 30 Cellular adhesion activity and proliferation, which enhance keratinocyte migration and wound epithelialization, have an adjunctive therapeutic effect on DFU.…”

“…In the fibrin network formed in wounds, enhancing the mechanical strength of the clot and promoting platelet aggregation contribute to wound healing 29 . The lack or reduction of elastic fibre neogenesis during the wound healing process may be associated with hypoxia 30 .…”

Analysis of Urinary Fibronectin Levels in Patients with Type 2 Diabetes Mellitus and Non-Diabetes Mellitus

“…In the diabetic kidney, there is an increase in fibronectin in the mesangial matrix and also in the capillary walls (Belly et al, 2020;Kanta et al, 2022). Because of this accumulation of fibronectin in the mesangium in diabetes, fibronectin is a major component of plasma and basement membranes.…”