Background: Up to 25% of diabetic patients will develop a diabetic foot ulcer. Chronic
wounds such as diabetic foot ulcers often fail to heal with conventional therapies. In recent years, it has
been identified that chronic wounds are usually associated with elevated level of matrix metalloproteinases
(MMPs). Doxycycline, a cheap tetracycline antibiotic, has been shown to inhibit MMPs both in
vitro and in vivo independent of its antimicrobial property.
Methods: We undertook a search through PUBMED for peer-reviewed research literature with doxycycline,
chronic wound, diabetes, MMPs as key words.
Results: Seventy papers were included in the review. This review identified doxycycline is a very
promising drug to be used in patients with diabetic foot ulcers because higher efficacy even in a very
low dosage, little side effects in a lower dosage, inhibition of MMP as well as prevention/treatment of
infection in the ulcers, beneficial to cardiovascular complications and cheap to manufacture.
Conclusion: In this review, we provide an overview of the roles of MMPs in the pathogenesis of chronic
wounds and explore the potential application of doxycycline as a treatment option in managing chronic
wounds such as diabetic foot ulcers.