Evidence based mechanism of Dipeptidyl peptidase IV (DPP4) inihibitors in diabetic foot ulcer healing

Background/Aims: Diabetic foot wounds are one of the most serious complications of the disease giving rise to 84% of all diabetes-related lower limb amputations. Anti-diabetic drug - dipeptidyl peptidase IV (DPP-4) inhibitors have been reported to improve diabetic foot wound healing. However little is known on how it occurs. The objective of the study was to review DPP-4 inhibitors' mechanism of wound healing in subjects with diabetic foot ulcers.\ud \ud Methods: Published data on DDP-4 inhibitors in wound healing were sought from Medline, PubMed and Google Scholar search of English language literature from 1994 to 2014 using the key words such as "DPP-4 inhibitors", "endothelial healing" "diabetes" and "chronic ulcers".\ud \ud Results: DPP-4 inhibitors show a potential benefit in processes of wound healing in diabetic chronic foot ulcers. The enzyme inhibitors promote recruitment of endothelial progenitor cells and allow the final scaffolding of wounds. Furthermore DPP-4 inhibitors augment angiogenesis and have widespread effects on optimising the immune response to persistent hypoxia in chronic diabetes wounds.\ud \ud Conclusion: DPP-4 inhibitors show promise in the local wound healing of diabetic foot ulcers through multiple mechanisms. In the light of high rate of amputations due to non-healing ulcers with profound psychological and economical liability, more investigations on the new role of DPP-4 inhibitors in treatment of diabetic foot ulcer are needed.\u