Natural Flavonoids as Potential Therapeutics in the Management of Diabetic Wound: A Review

Abstract

Abstract: Flavonoids are important bioactive phenolic compounds abundant in plants and exhibit different therapeutic potentials. A wound is a significant problem in diabetic individuals. A hyper-glycaemic environment alters the normal wound-healing process and increases the risk of microbial infection, leading to hospitalization, morbidity, and amputation. Flavonoids are an important class of phytochemicals with excellent antioxidant, anti-inflammatory, antimicrobial, antidiabetic, anti-tumor, and wound healing property. Quercetin, hesperidin, curcumin, kaempferol, apigenin, luteo-lin, morin, etc. have shown their wound healing potential. Flavonoids effectively exhibit antimicro-bial activity, scavenge reactive oxygen species, augment endogenous antioxidants, reduce the ex-pression and synthesis of inflammatory cytokines (i.e. IL-1β, IL-6, TNF-α, NF-κB), inhibit inflam-matory enzymes, enhance anti-inflammatory cytokine (IL-10), enhance insulin section, reduce insu-lin resistance, and control blood glucose level. Several flavonoids like hesperidin, curcumin, quer-cetin, rutin, naringin, and luteolin have shown their potential in managing diabetic wounds. Natural products that maintain glucose haemostatic, exert anti-inflammatory activity, suppress/inhibit mi-crobial growth, modulate cytokines, inhibit matrix metalloproteinase (MMP), stimulate angiogene-sis and extracellular matrix, and modulate growth factor can be considered as a potential therapeutic lead to treat diabetic wound. Flavonoids were found to play a positive role in management of dia-betic wounds by regulating MMP-2, MMP-8, MMP-9, MMP-13, Ras/Raf/ MEK/ERK, PI3K/Akt, and nitric oxide pathways. Therefore, it can be assumed that flavonoids could be potential therapeu-tics to prevent devastating effects of diabetic wounds. This paper focused on the potential role of flavonoids in managing diabetic wounds and discussed their possible mechanism of action.