Bioengineering of skin has been significantly explored, ranging from the use of traditional cell culture systems to the most recent organ-on-a-chip (OoC) technology that permits skin modeling on physiological scales among other benefits. This article presents key considerations for developing physiologically relevant immunocompetent diabetic foot ulcer (DFU) models. Diabetic foot ulceration affects hundreds of millions of individuals globally, especially the elderly, and constitutes a major socioeconomic burden. When DFUs are not treated and managed in a timely manner, 15–50% of patients tend to undergo partial or complete amputation of the affected limb. Consequently, at least 40% of such patients die within 5 years postamputation. Currently, therapeutic strategies are actively sought and developed. However, present-day preclinical platforms (animals and in vitro models) are not robust enough to provide reliable data for clinical trials. Insights from published works on immunocompetent skin-on-a-chip models and bioengineering considerations, presented in this article, can inform researchers on how to develop robust OoC models for testing topical therapies such as growth factor-based therapies for DFUs.

中文翻译：

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开发用于药物测试的具有免疫能力的糖尿病足溃疡芯片模型

皮肤的生物工程已经得到了大量探索，从使用传统的细胞培养系统到最新的器官芯片 (OoC) 技术，该技术允许在生理尺度上进行皮肤建模，并带来其他好处。本文提出了开发生理相关免疫活性糖尿病足溃疡 (DFU) 模型的关键考虑因素。糖尿病足溃疡影响全球数亿人，尤其是老年人，并构成重大的社会经济负担。如果 DFU 没有得到及时治疗和管理，15-50% 的患者倾向于部分或完全截肢患肢。因此，至少 40% 的此类患者在截肢后 5 年内死亡。目前，积极寻求和开发治疗策略。然而，体外模型）不够稳健，无法为临床试验提供可靠的数据。本文介绍的关于免疫活性芯片模型和生物工程考虑因素的已发表作品的见解可以告知研究人员如何开发强大的 OoC 模型来测试局部疗法，例如针对 DFU 的基于生长因子的疗法。