Diabetes mellitus (DM) is a metabolic disorder that occurs due to defects in insulin secretion, insulin action or both, resulting in high blood glucose levels. Developing countries are found to be at greater risk for diabetes, which is evident from increasing incidences of diabetic cases. By the year 2030, India is estimated to have the largest number of diabetic patients. Diabetic foot ulcers (DFU) will affect 12% to 25% of persons with diabetes mellitus throughout their lives and is the leading cause for hospital admission among diabetic patients in India. Recurrence of foot infection is common and is mainly due to the presence of neuropathy and peripheral vascular disease. The etiology of diabetic foot ulcers is multifactorial and the management of DFU and its consequences put a great strain on both health and social services. This results in huge related costs for treatment, as well as the loss of general economic productivity. Heat-shock proteins (HSPs) are molecular chaperones synthesized under stressful conditions. They are important in physiological and pathological processes and are highly active within the immune system. At normal physiological conditions, HSPs are expressed at low levels. However, in response to cellular stress, there is an increased expression of HSPs. They protect against tissue injury by maintaining synthesis and proper conformation of proteins by repairing damaged proteins and promoting the healing of injured tissue. This process plays an important role in the assembly and transport of newly synthesized proteins within cells.7 Xiao et al showed that the expression of heat shock proteins was triggered when organisms are exposed to a variety of stressful stimuli including hypoxia, ischemia, and oxidative free radicals. Initially, HSPs were thought to be only functional in the cytoplasm and nucleus. However, recently they have been implicated in intercellular signaling and transport after they are released to the extracellular space and bloodstream. The known family members of HSPs are HSP70, HSP90, HSP60, HSP47 and HSP110, which are numbered based on their molecular masses.
diabetes, ulcers, heat shock proteins, genes, chaperones, foot, neuropathy, insulin
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