Abstract

Type 2 diabetes mellitus is a complex, systemic metabolic disease characterized by insulin resistance and resulting hyperglycemia, which is associated with impaired wound healing. The clinical complications associated with hyperglycemia are attributed, in part, to the increased production of reactive oxygen species (ROS). Recent studies revealed that long non-coding RNAs (lncRNAs) play important regulatory roles in many biological processes. Specifically, lncRNA Lethe has been described as exhibiting an anti-inflammatory effect by binding to the p65 subunit of NFκB and blocking its binding to DNA and the subsequent activation of downstream genes. We therefore hypothesize that dysregulation of Lethe’s expression plays a role in hyperglycemia-induced ROS production. To test our hypothesis, we treated RAW264.7 macrophages with low glucose (5 mM) or high glucose (25 mM) for 24h. High glucose conditions significantly induced ROS production and NOX2 gene expression in RAW cells, while significantly decreasing Lethe gene expression. Overexpression of Lethe in RAW cells eliminated the increased ROS production induced by high glucose conditions, while also attenuating the upregulation of NOX2 expression. Similar results was found also in non-diabetic and diabetic primary macrophage, bone marrow derived macrophage (BMM). Furthermore, overexpression of Lethe in RAW cells treated with high glucose significantly reduced the translocation of p65-NFkB to the nucleus, which resulted in decreased NOX2 expression and ROS production. Interestingly, these findings are consistent with the decreased Lethe gene expression and increased NOX2 gene expression observed in a mouse model of diabetic wound healing. These findings provide the first evidence that lncRNA Lethe is involved in the regulation of ROS production in macrophages through modulation of NOX2 gene expression via NFκB signaling. Moreover, this is the first report to describe a role of lncRNAs, in particular Lethe, in impaired diabetic wound healing. Further studies are warranted to determine if correction of Lethe expression in diabetic wounds could improve healing.

Highlights

  • The worldwide prevalence of type 2 diabetes mellitus (T2DM) has reached pandemic proportions, affecting millions of people in the U.S and worldwide

  • Hyperglycemia induces the expression of NOX2 and increases reactive oxygen species (ROS) production in macrophages

  • After culture of RAW cells in low (5 mM) or high (25 mM) glucose media for 24 hours, our results show that culture of RAW cells in high glucose media significantly induces the production of ROS when compared to RAW cells cultured in low glucose media (Fig 1A)

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Summary

Introduction

The worldwide prevalence of type 2 diabetes mellitus (T2DM) has reached pandemic proportions, affecting millions of people in the U.S and worldwide. Diabetes is associated with many complications, including neuropathy, retinopathy, nephropathy, as well as the development of chronic diabetic wounds. Diabetic wounds exhibit impaired wound healing, thereby increasing the risk of wound infection and often necessitating toe, foot or leg amputation. In 2014, over 70,000 lower extremity amputations were performed in diabetic patients, and nearly 2/3 of these non-traumatic amputations were preceded by a diabetic wound [2]. The burden of disease attributable to non-healing diabetic wounds represents a significant clinical and economic burden; with the prevalence of type 2 diabetes projected to increase worldwide, the need for effective wound care therapies cannot be understated [3]

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