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Pirfenidone Accelerates Wound Healing in Chronic Diabetic Foot Ulcers: A Randomized, Double-Blind Controlled Trial.

Abstract：

Background:Diabetic foot ulcers are one disabling complication of diabetes mellitus. Pirfenidone (PFD) is a potent modulator of extracellular matrix. Modified diallyl disulfide oxide (M-DDO) is an antimicrobial and antiseptic agent. Aim:To evaluate efficacy of topical PFD + M-DDO in a randomized, double-blind trial versus ketanserin in the treatment of noninfected chronic DFU. Methods:Patients received PFD + M-DDO or ketanserin for 6 months. Relative ulcer volume (RUV) was measured every month; biopsies were taken at baseline and months 1 and 2 for histopathology and gene expression analysis for COL-1α, COL-4, KGF, VEGF, ACTA2 (α-SMA), elastin, fibronectin, TGF-β1, TGF-β3, HIF-1α, and HIF-1β. Results:Reduction of median RUV in the PFD + M-DDO group was 62%, 89.8%, and 99.7% at months 1-3 and 100% from months 4 to 6. Ketanserin reduced RUV in 38.4%, 56%, 60.8%, 94%, 94.8%, and 100% from the first to the sixth month, respectively. Healing score improved 4.5 points with PFD + M-DDO and 1.5 points with ketanserin compared to basal value. Histology analysis revealed few inflammatory cells and organized/ordered collagen fiber bundles in PFD + M-DDO. Expression of most genes was increased with PFD + M-DDO; 43.8% of ulcers were resolved using PFD + M-DDO and 23.5% with ketanserin. Conclusion:PFD + M-DDO was more effective than ketanserin in RUV reduction.

journal_name

J Diabetes Res

journal_title

Journal of diabetes research

authors

Gasca-Lozano LE,Lucano-Landeros S,Ruiz-Mercado H,Salazar-Montes A,Sandoval-Rodríguez A,Garcia-Bañuelos J,Santos-Garcia A,Davila-Rodriguez JR,Navarro-Partida J,Bojórquez-Sepúlveda H,Castañeda-Gomez J,Domínguez-Rosales J,Ruiz-Arcos

doi

10.1155/2017/3159798

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

3159798

eissn

2314-6745

issn

2314-6753

journal_volume

2017

pub_type

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