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Adv Wound Care (New Rochelle). 2017 Sep 1;6(9):279-288. doi: 10.1089/wound.2016.0725.

Topical Naltrexone Is a Safe and Effective Alternative to Standard Treatment of Diabetic Wounds.

Author information

1
Department of Neural and Behavioral Sciences, Penn State University College of Medicine, Hershey, Pennsylvania.
2
Department of Orthopaedics and Rehabilitative Medicine, Penn State University College of Medicine, Hershey, Pennsylvania.
3
Department of Ophthalmology, Penn State University College of Medicine, Hershey, Pennsylvania.

Abstract

Objective: Diabetes affects more than 29 million individuals in the United States, resulting in healthcare costs approaching $245 billion. Approximately 15% of these individuals will develop a chronic, non-healing foot ulcer (diabetic foot ulcer [DFU]) that, if untreated, may lead to amputation. The current treatments for DFU are expensive, have significant side-effects, and often result in non-compliance. A new topical treatment is described that accelerates cutaneous wound repair and is disease modifying by targeting underlying aberrant diabetic pathways. Approach: The efficacy of naltrexone (NTX), an opioid receptor antagonist, and Regranex® was compared in preclinical studies using type 1 diabetic rats. Dorsal cutaneous wounds were treated topically with 0.03% NTX, Regranex, or moisturizing cream alone. Wound closure, DNA synthesis, and cytokine production were monitored. Results: Wound closure rates with topical NTX in type 1 diabetic rats were comparable to Regranex. Topical NTX accelerated DNA synthesis, as measured by BrdU incorporation, increased mast cells, and enhanced expression of platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF), a marker for angiogenesis. Regranex had little effect on DNA synthesis, mast cells, and VEGF expression relative to vehicle-treated wounds, and it only temporarily increased PDGF expression. Fibroblast growth factor expression was not altered by either treatment. Innovation: Topical application of 0.03% NTX cream accelerates diabetic wound closure. Conclusion: Blockade of the opioid growth factor (OGF)-OGF receptor (OGFr) axis utilizing 0.03% NTX cream is comparable to standard care in preclinical studies, and it provides a safe, inexpensive, and effective alternative for treatment of diabetic wounds.

KEYWORDS:

delayed cutaneous wound healing; diabetic rat; naltrexone

Conflict of interest statement

No ghostwriting was involved. Drs. Zagon, Sassani, and McLaughlin hold a U.S. patent related to naltrexone composition for wound healing, but they receive no financial income. There are no other disclosures related to any author.

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