People with diabetes face the possibility of a number of serious complications, including poor wound healing. Now a new study has found that application of a topical statin drug speeds up wound healing in mice with diabetes.
Could a statin drug help diabetic wound healing?
Diabetes has several characteristics that make recovering from wounds more challenging. For example, people with diabetes have a weakened immune system, which makes healing more problematic. Nerve damage (neuropathy), which is common in diabetes, can make individuals unable to feel the pain associated with a cut or blister until it becomes infected.
Diabetes is also associated with narrow arteries, which makes it more difficult for blood to reach a wound and facilitate healing. Overall, 15 percent of people with diabetes will develop wound problems, and diabetics also have a 15-fold increased risk of amputation, with about 82,000 diabetics undergoing amputation each year. Foot wounds are the most common type of wound complication.
Therefore, the need to effectively improve wound healing among diabetics is critical. A research team composed of scientists from various institutions have now discovered that topical simvastatin may offer some hope for these individuals. Simvastatin is a statin drug typically prescribed to lower cholesterol.
The test was developed to determine if topical simvastatin could promote the growth of new blood vessels (angiogenesis) and the formation of new lymphatic vessels (lymphoangiogenesis) in mice genetically modified to have diabetes. The study was conducted as follows.
A skin wound was created on the backs of mice with diabetes, and each wound was then treated with topical simvastatin mixed with petroleum jelly or a control (petroleum jelly only). Application of the drug or petroleum jelly alone was repeated on days 4, 7, and 10.
After two weeks, the researchers noted that wounds treated with simvastatin were more than 90 percent healed compared with less than an 80 percent healed rate among wounds treated with petroleum jelly alone. When wound closure alone was examined, closure was best on day 7 among wounds treated with simvastatin (79.26% healed) compared with those treated with petroleum jelly alone (52.45%).
It should be noted that while taking simvastatin orally is associated with increased risks, such as kidney damage, use of the topical statin drug is not. Other side effects associated with oral simvastatin use may include muscle pain or weakness, fever, unusual tiredness, pain or burning when urinating, swelling, weight gain, nausea, itching, loss of appetite, dark urine, clay-colored stools, headache, joint pain, constipation, rash, insomnia, and jaundice.
In this study, the researchers noted that topical simvastatin "significantly accelerates wound recovery by increasing both angiogenesis and lymphangiogenesis," according to lead investigator Jun Asai, MD, PhD, of Kyoto Prefectural University School of Medicine in Japan. Asai called the use of topical simvastatin a "simple strategy that may have significant therapeutic potential for enhancing wound healing in patients with impaired microcirculation, such as that in diabetes."
Although the use of topical simvastatin for slowing or even preventing wound healing among people with diabetes may be in the future, there are steps people with diabetes can take now to help stop wound healing challenges. They include:
- Inspecting your feet daily, including between the toes, for cuts, bruises, blisters, abrasions, and any other skin abnormalities
- Maintaining healthy glucose levels
- Not smoking
- Having a physician inspect your feet at each office visit
Poor wound healing is a significant complication of diabetes, but it is one that individuals with diabetes can help avoid. The potential for use of the topical statin drug simvastatin is still in the future, as more studies are needed to determine its efficacy and safety.
Asai J et al. Topical simvastatin accelerates wound healing in diabetes by enhancing angiogenesis and lymphangiogenesis. American Journal of Pathology 2012 Dec; 181(6): 2217-24
Greater Baltimore Wound Care Center