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Review | Open Access

Targeting oxidative damage in diabetic foot ulcers: integrative strategies involving antioxidant drugs and nanotechnologies

Runze Wang1, Bowen Li2, Mengchao Dong3, Huili Zhu4, Ping Jin5( ), Yingying Zou1,6 ( )
Department of Pathology and Pathophysiology, School of Basic Medicine, Kunming Medical University, No. 1168, Chunrong West Road, Yuhua Street, Chenggong District, Kunming 650500, China
State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and West China School of Basic Medical Sciences and Forensic Medicine, Sichuan Universi,ty, and Collaborative Innovation Center for Biotherapy, No. 17 People’s South Road, Chengdu 610041, China
Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Erqi District, Zhengzhou 450052, China
Department of Reproductive Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital of Sichuan University, No. 20 People’s South Road, Chengdu 610041, China
State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, School of Life Sciences, Yunnan University, East Outer Ring South Road, Chenggong District, Kunming, Yunnan, China
Frontiers Medical Center, Tianfu Jincheng Laboratory, Intersection of Hexiang 1st Street and Xinchuan Road, Shuangliu District, Chengdu 610095, China
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Highlights

• DFUs are prevalent and severe, primarily caused by infection, chronic inflammation, and impaired wound healing due to poor circulation and neuropathy.

• Excessive reactive oxygen species (ROS) contribute to DFU development by damaging cells and hindering wound healing.

• Antioxidants like EGF, hesperidin, ALA, and N-acetylcysteine effectively reduce oxidative stress and enhance wound recovery.

• Nanotechnology-loaded antioxidants offer a promising approach for personalized treatment of DFUs by targeting oxidative damage.

Abstract

Foot ulcerations in patients with diabetes are common and severe, typically caused by infection and chronic inflammation. Poor blood circulation and neuropathy impair the body’s ability to heal wounds effectively, creating a conducive environment for ulcers. Excessive reactive oxygen species contribute to ulcer development by damaging cellular structures and hindering wound healing. The administration of antioxidants can protect cells from oxidative damage and promote wound recovery. Antioxidants such as epidermal growth factors, flavonoid hesperidin, alpha-lipoic acid, and N-acetylcysteine effectively reduce oxidative stress. Encapsulating various drugs into nanoparticles and targeting carriers such as hydrogels, metal–organic frameworks, and nanohydrogels can improve their therapeutic effects. Nanotechnologies have been shown to boost tissue regeneration by modifying biomaterial properties, modulating signal release, and targeting key factors. Here, we describe the occurrence and development of diabetic foot ulcers (DFUs), emphasizing the role of oxidative damage in these processes. This review summarizes the strategy for targeting oxidative damage in DFUs using nanotechnology-loaded antioxidant drugs. This review advocates for the use of personalized biomaterials in treating DFUs and provides a theoretical basis for their potential clinical and translational applications.

References

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Burns & Trauma
Article number: tkaf020

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Cite this article:
Wang R, Li B, Dong M, et al. Targeting oxidative damage in diabetic foot ulcers: integrative strategies involving antioxidant drugs and nanotechnologies. Burns & Trauma, 2025, 13(7): tkaf020. https://doi.org/10.1093/burnst/tkaf020

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Received: 31 December 2024
Revised: 21 February 2025
Accepted: 27 February 2025
Published: 10 March 2025
© The Author(s) 2025. Published by Oxford University Press.

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