Introduction
infection, TNF-α, chronic disease, Diabetes
PROLIFERATION, INFLAMMATION, ULCERS, INFECTION, PATHOGENESIS, DIABETES, CHRONIC ULCERS, CHRONIC DISEASE
Diabetes is a chronic disease which affects 451 million people around the world [There are several factors that contribute to the formation of DFU, such as local inflammation, reduction of growth factors, uncontrolled proteolysis [The majority of chronic ulcers respond well to conventional treatment. However, 15–20% of those ulcers fail to heal regardless of adequate treatment [During the early stage of normal wound healing process, natural immune cells produce proinflammatory cytokines which are responsible for inducing the immunity system to secrete AMP (antimicrobial peptide), attract leukocytes, and create an environment protected from microbial infection. IL-1 and TNF-α are able to induce the expression of AMP [Cathelicidin plays an important role in the pathogenesis of DFU due to its antimicrobial action and induction of angiogenesis and keratinocyte migration and proliferation. These activities are crucial in adequate wound healing. Immunohistochemistry staining of DFU biopsy revealed low and even zero concentration of LL-37 expression, although, in normal skin, there was optimal concentration of LL-37 [A randomized controlled trial on the efficacy and safety of treatment with LL-37 by Grönberg et al. [LL-37 is a promising treatment for chronic wounds because of its antibiofilm property and because it is part of host cells which act simultaneously to eradicate causative bacteria. It interacts with keratinocytes and fibroblasts to induce wound closure [