Abstract
Introduction: Diabetes is a disorder that is well known to delay wound repair resulting in the formation of colonized, chronic wounds. The resultant ulcers contribute to increased risk of morbidity, including osteomyelitis and amputations, and increased burden to the healthcare system. Areas covered: The only active product approved for the treatment of diabetic ulcers, Regranex, has been shown to reduce amputation risk, but is not widely used due to minimal proven efficacy and recent warnings added to the Instructions for Use. This review provides an overview of the development of NorLeu(3)-angiotensin (1-7) (NorLeu(3)-A(1-7)) as an active agent for the treatment of diabetic wounds. NorLeu(3)-A(1-7) is an analog of the naturally occurring peptide, angiotensin 1-7. The mechanisms of action include induction of progenitor proliferation and accelerated vascularization, collagen deposition and re-epithelialization. Expert opinion: Research to date has shown that NorLeu(3)-A(1-7) is highly effective in the closure of diabetic wounds and is superior to Regranex in animal studies. Further clinical development of this product as a topical agent for the healing of chronic wounds and investigation into the mechanisms by which this product accelerates healing are warranted.