Nrf2: a promising trove for diabetic wound healing

An extensively re-establishing and complex process of cutaneous wound healing arises to maintain the disrupted skin barrier function which encompasses interdependent stages like hemostasis, inflammation, proliferation and tissue remodelling (1). This well-orchestrated, multistep process of wound healing is impeded in diabetic patients resulting into chronic wounds, creating several therapeutic complications which pose severe health burden to the global population. Peripheral neuropathy, vascular insufficiency, shortage of oxygenation, bacterial infections, increased oxidative stress, elevation in matrix metalloproteinases activity and diminished levels of growth factors are the array of contributing factors in interrupted and delayed diabetic wound healing (2). Substantial evidences have established a plausible relationship between elevated oxidative stress and retarded wound healing in type I and type II diabetic patients (3,4). Reactive oxygen species (ROS) under physiological range are beneficial to attenuate the invasion of microbes and also to regulate some intracellular signalling pathways (5); but when their levels are raised drastically, process of wound healing gets trapped in an unregulated and self-sustaining phase of inflammation which also contribute to protein, lipid and DNA damage resulting in escalated cell damage.