High-density lipoprotein, otherwise known as good cholesterol, may be a promising topical treatment for diabetic foot ulcers (DFUs) and other challenging wounds, according to an Australian study published online in November.

HDL deserves serious consideration, given its known anti-inflammatory effects in endothelial cells, which help rebuild blood vessel networks in wounds, and macrophages, which remove dead cells and support the proliferation of new cells, researchers from Royal Adelaide Hospital and the University of Adelaide argued.

Their review details molecular disturbances that impair wound healing in diabetic patients, with a focus on inflammation and angiogenesis and the pathways in which HDL provides benefits. They cite a series of mice models that confirmed drops of HDL sped up wound closure in diabetic and non-diabetic mice.

“Overall, HDL improves wound healing in the context of diabetes, high-cholesterol and aging,” the team reported in Advances in Wound Care. “HDL exhibits valuable properties such as anti-inflammatory and pro-angiogenic effects, making it a highly promising therapeutic treatment for wound healing.”

The authors  noted that some 20% of DFU patients eventually require an amputation. There are no single therapeutic agents that have multiple, functional effects on DFU healing, they said.