Researchers at the Stanford University School of Medicine have developed a skin patch that slowly delivers a drug that enhances the healing of diabetes-related ulcers. The patch, which was tested in mice, can also serve as a way to prevent future ulcer formation and can be used to treat pressure ulcers, according to the senior author of the study Geoffrey Gurtner, MD, the Johnson & Johnson professor of surgery. Sharing lead authorship of the paper describing findings of the new research are Dominik Duscher, MD, a postdoctoral scholar in surgery, and Evgenios Neofytou, MD, an instructor at the Stanford Cardiovascular Institute.
According to the study, which was published online in the December 22, 2014 issue of Proceedings of the National Academy of Sciences, the high levels of blood sugar in people with diabetes compromise the body's ability to form new blood vessels essential for wound healing. The study also discovered a potential treatment for the problem: deferoxamine, or DFO, a drug already approved by the Food and Drug Administration to treat hemochromatosis, a condition in which too much iron accumulates in the body. DFO can correct the diabetes-impaired expression of a protein that supports new vascular growth.
But DFO is too toxic in the dose required for the long-term treatment of diabetic wounds. So the researchers developed an alternative delivery method, a patch applied to the skin that slowly emits the medication into the wounded tissue and skin.
In the mouse studies, Gurtner says, the wounds healed more quickly, and the quality of the new skin was even better than the original. This higher quality skin, with a thicker dermis and more collagen, is also less likely to re-ulcerate at the same site, he says.
Among the more than 29 million people in the United States with either type-1 or type-2 diabetes, an estimated 15 percent develop ulcers. The ulcers, sores or open wounds that usually occur on the foot, become a secondary health condition that leads to prolonged disability, high rates of recurrence and increased mortality.
There are currently no effective therapies to prevent diabetic ulcer formation and only modestly effective treatments to accomplish healing. "Right now, the only thing we can tell these patients is to take better care of their feet," says Gurtner. "There's not a lot we can do to prevent their skin from breaking down. This patch would give us another arrow in the quiver that could potentially lessen their risk of developing a foot ulceration."