Molecular Biomarkers of Oxygen Therapy in Patients with Diabetic Foot Ulcers

Alisha R. Oropallo 1,*, Thomas E. Serena 2, David G. Armstrong 3 and Mark Q. Niederauer 4
1 Comprehensive Wound Healing Center and Hyperbarics, Department of Vascular Surgery, Zucker School of Medicine Hofstra/Northwell, Hempstead, NY 11549, USA
2 Serena Group Research Foundation, Cambridge, MA 02140, USA; serena@serenagroups.com
3 Limb Preservation Program, Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA 90033, USA; armstrong@usa.net
4 EO2 Concepts, San Antonio, TX 78249, USA; m.niederauer@eo2.com
* Correspondence: aoropallo@northwell.edu; Tel.: +1-516-233-3780

 

Hyperbaric oxygen therapy (HBOT) and topical oxygen therapy (TOT) including continuous diffuse oxygen therapy (CDOT) are often utilized to enhance wound healing in patients with diabetic foot ulcerations. High pressure pure oxygen assists in the oxygenation of hypoxic wounds to increase perfusion. Although oxygen therapy provides wound healing benefits to some patients with diabetic foot ulcers, it is currently performed from clinical examination and imaging. Data suggest that oxygen therapy promotes wound healing via angiogenesis, the creation of new blood vessels. Molecular biomarkers relating to tissue inflammation, repair, and healing have been identified. Predictive biomarkers can be used to identify patients who will most likely benefit from this specialized treatment. In diabetic foot ulcerations, specifically, certain biomarkers have been linked to factors involving angiogenesis and inflammation, two crucial aspects of wound healing. In this review, the mechanism of how oxygen works in wound healing on a physiological basis, such as cell metabolism and growth factor signaling transduction is detailed. Additionally, observable clinical … read more