Abstract

Impaired angiogenesis is one of the crucial factors that impede the wound healing process in diabetic foot ulcers (DFUs). In this study, we found that 20(S)-protopanaxadiol (PPD), an aglycone of ginsenosides in Panax notoginseng, stimulated angiogenesis and benefited wound healing in genetically diabetic mice. In HUVECs, PPD promoted cell proliferation, tube formation and VEGF secretion accompanied by increased nuclear translocalization of HIF-1α, which led to elevated VEGF mRNA expression. PPD activated both PI3K/Akt/mTOR and Raf/MEK/ERK signaling pathways in HUVECs, which were abrogated by LY294002 and PD98059. Furthermore, these two pathways had crosstalk through p70S6K, as LY294002, PD98059 and p70S6K siRNA abolished the angiogenic responses of PPD. In the excisional wound splinting model established in db/db diabetic mice, PPD (0.6, 6 and 60 mg ml−1) accelerated wound closure, which was reflected by a significantly reduced wound area and epithelial gaps, as well as elevated VEGF expression and capillary formation. In addition, PPD activated PI3K/Akt/ERK signaling pathways, as well as enhanced p70S6K activity and HIF-1α synthesis in the wounds. Overall, our results revealed that PPD stimulated angiogenesis via HIF-1α-mediated VEGF expression by activating p70S6K through PI3K/Akt/mTOR and Raf/MEK/ERK signaling cascades, which suggests that the compound has potential use in wound healing therapy in patients suffering from DFUs.

Highlights

  • Diabetic foot ulcers (DFUs) are the most common complication of diabetes mellitus with an annual incidence of 1–4%,1 and they account for 84% of all diabetes-related lower-leg amputations.[2]

  • Our results showed that PPD, another natural product from P. ginseng, promoted angiogenesis in vitro through HIF-1αmediated vascular endothelial growth factor (VEGF) secretion by activating p70S6 kinase (p70S6K)

  • (a) Examination of transfection efficiency by western blot. (b–e) Tube formation activity. (b) Scramble siRNA; (c) Scramble siRNA+ PPD (2.5 μM); (d) p70S6K siRNA; (e) p70S6K siRNA+ PPD (2.5 μM). (f) Cell viability upon PPD stimulation for 48 h. n = 6 per group. (g) Number of tubes formed after PPD stimulation for 4 h. n = 6/group. (h) VEGF messenger RNA (mRNA) expression after PPD stimulation for 24 h. n = 6 per group. ***Po0.001 versus scramble siRNA; §§Po0.01 and §§§Po0.001 versus scramble siRNA stimulated with PPD

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Summary

Introduction

Diabetic foot ulcers (DFUs) are the most common complication of diabetes mellitus with an annual incidence of 1–4%,1 and they account for 84% of all diabetes-related lower-leg amputations.[2]. Drugs facilitating angiogenesis often benefit the wound healing process in DFUs

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