Abstract

Lack of vascularization is directly associated with refractory wound healing in diabetes mellitus (DM). Enrichment of endothelial precursor cells (EPCs) is a promising but challenging approach for the treatment of diabetic wounds. Herein, we investigate the action of nicotinamide riboside (NR) on EPC function for improved healing of diabetic wounds. Db/db mice that were treated with NR-supplemented food (400 mg/kg/d) for 12 weeks exhibited higher wound healing rates and angiogenesis than untreated db/db mice. In agreement with this phenotype, NR supplementation significantly increased the number of blood EPCs and bone marrow (BM)-derived EPCs of db/db mice, as well as the tube formation and adhesion functions of BM-EPCs. Furthermore, NR-supplemented BM-EPCs showed higher expression of sirtuin 1 (Sirt1), phosphorylated adenosine monophosphate–activated protein kinase (p-AMPK), and lower expression of acetylated peroxisome proliferator–activated receptor γ coactivator (PGC-1α) than BM-EPCs isolated from untreated db/db mice. Knockdown of Sirt1 in BM-EPCs significantly abolished the tube formation and adhesion function of NR as well as the expression of p-AMPK and deacetylated PGC-1a. Inhibition of AMPK abolished the NR-regulated EPC function but had no effect on Sirt1 expression, demonstrating that NR enhances EPC function through the Sirt1-AMPK pathway. Overall, this study demonstrates that the oral uptake of NR enhances the EPC function to promote diabetic wound healing, indicating that NR supplementation might be a promising strategy to prevent the progression of diabetic complications.

Highlights

  • The prevalence of diabetes mellitus (DM) and DM-related complications has been convincingly described regarding clinical, social, and economic implications (American Diabetes Association, 2018; Sørensen et al, 2016)

  • We show that nicotinamide riboside (NR) supplementation promoted angiogenesis and wound healing in db/db mice, and that NR regulated the endothelial precursor cells (EPCs) function to promote angiogenesis through mediating the sirtuin 1 (Sirt1)/adenosine monophosphate–activated protein kinase (AMPK) pathway

  • As shown in the increased the level of VEGF when compared to the cells from db/db mice (471.5 ± 15.4 pg/ml vs. 415.9 ± 9.7 pg/ml, P < 0.05; Supplementary Figure S1A). These results suggest that NR supplementation might promote bone marrow (BM)-EPC function through increasing expression of Sirt1, deacetylated PGC-1α, phosphorylated adenosine monophosphate–activated protein kinase (p-AMPK)/ AMPK, and VEGF

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Summary

Introduction

The prevalence of diabetes mellitus (DM) and DM-related complications has been convincingly described regarding clinical, social, and economic implications (American Diabetes Association, 2018; Sørensen et al, 2016). The incidence rate of diabetic foot ulcers (DFUs) in this cohort is increasing to around 20%, with an average annual cost of $8,659 for one patient in the United States (American Diabetes Association, 2018; Ginter and Simko, 2012). Diabetic patients with foot ulcers are at a high risk of operative limb salvage programs, including even major and minor amputations (Wukich et al, 2017). Delayed wound closure in DM patients is involved in peripheral circulatory disorders, which are closely related to neovascularization and angiogenesis (Forsythe and Hinchliffe, 2016; Hugo et al, 2016). It is well known that endothelial precursor cells (EPCs) play an important role in modified angiogenesis of the wound healing process (Han et al, 2017a). It is imperative to investigate the mechanisms and novel agents in order to manage diabetic wound healing

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