Matrix metalloproteinases and their roles in poor wound healing in diabetes

Amongst the many other chronic complications, diabetes can cause impaired wound healing and, with it, increased morbidity. Up to 25% of all patients with diabetes will develop a foot ulcer and, each year in Australia, approximately 3000 persons with diabetes require amputation secondary to foot ulceration 1. The essential components of diabetic foot ulcer treatment include increasing blood supply (in the case of ischaemic ulcer) and reduction of foot bearing pressure (in the case of neuropathic ulcer). Despite concerted treatment, for reasons not completely understood, many ulcers do not heal and it is this failure to heal which eventually leads to deep-seated infection and amputation. Therefore impaired wound healing is the pivotal event responsible for most of the morbidity (and mortality) in diabetic foot disease. A detailed understanding of the wound healing process in diabetes and how it can be improved is of great importance.