Chronic Wounds Research Articles

The role of SLC7A11 in diabetic wound healing: novel insights and new therapeutic strategies.

Diabetic wounds are a severe complication of diabetes, characterized by persistent, non-healing ulcers due to disrupted wound-healing mechanisms in a hyperglycemic environment. Key factors in the pathogenesis of these chronic wounds include unresolved inflammation and antioxidant defense imbalances. The cystine/glutamate antiporter SLC7A11 (xCT) is crucial for cystine import, glutathione production, and antioxidant protection, positioning it as a vital regulator of diabetic wound healing. Recent studies underscore the role of SLC7A11 in modulating immune responses and oxidative stress in diabetic wounds. Moreover, SLC7A11 influences critical processes such as insulin secretion and the mTOR signaling pathway, both of which are implicated in delayed wound healing. This review explores the mechanisms regulating SLC7A11 and its impact on immune response, antioxidant defenses, insulin secretion, and mTOR pathways in diabetic wounds. Additionally, we highlight the current advancements in targeting SLC7A11 for treating related diseases and conceptualize its potential applications and value in diabetic wound treatment strategies, along with the challenges encountered in this context.

Calcium Peroxide-Based Hydrogels Enable Biphasic Release of Hydrogen Peroxide for Infected Wound Healing.

Wound infection is a major factor affecting the speed and quality of wound healing. While hydrogen peroxide (H2O2) is recognized for its antibacterial capacity and facilitation of wound healing, its administration requires careful dosage differentiation. Inappropriately matched dosages can protract the healing of infected wounds. Herein, a calcium peroxide-based hydrogel (CPO-Alg hydrogel) is fabricated to enable a biphasic tapered release of H2O2, ensuring robust initial antimicrobial activity followed by sustained promotion of cellular proliferation of wound healing. The design of the hydrogel allowed for the calcium peroxide nanoparticles (CPO NPs) being in two spatial niches within the gel framework. When applied to infectious wounds, CPO NPs with weak constraints are promptly released out of the gel, penetrating into infected regions to serve as antibacterial agents that eliminate bacteria and biofilms at high concentrations. Conversely, the entrapped CPO NPs structurally integrated into the gel remain confined, thus gradually degrading and allowing a mild release of H2O2 through hydrolysis in a moist environment that contributes to the cell growth in the later stage. The CPO-Alg hydrogel represents an innovative and practical solution for the antimicrobial protection of chronic wounds, offering promising prospects for advancing wound healing.

Exploration of Management Strategies for Type 2 Diabetes among Wounded Patients: A Review

The management of type 2 diabetes mellitus (T2DM) in patients with wounds posed a complex challenge, requiring a multifaceted approach to optimize glycemic control and improve healing outcomes. T2DM impaired the body’s natural healing processes, increasing the risk of chronic wounds, particularly diabetic foot ulcers (DFUs), which can lead to severe complications such as infections and amputations. This review explored various management strategies tailored for wounded patients with T2DM, including the importance of maintaining optimal glycemic levels, dietary interventions, pharmacological treatments, and multidisciplinary care approaches. The review was conducted by synthesizing current research findings, clinical studies, and systematic reviews on glycemic control, dietary interventions, pharmacological treatments, and multidisciplinary approaches in managing wounds among patients with T2DM. Key findings indicate that tight glycemic control, particularly with target hemoglobin A1c (HbA1c) levels between 7.0% and 8.0%, enhances wound healing, while overly aggressive management may have adverse effects. Nutritional strategies like Mediterranean and low-carbohydrate diets improve insulin sensitivity and reduce inflammation, while pharmacological treatments like metformin, GLP-1 receptor agonists, and SGLT-2 inhibitors improve glycemic control and overall health outcomes. A multidisciplinary team (MDT) approach is highlighted as a critical factor in improving patient care, with evidence showing significant reductions in HbA1c levels among patients treated by MDTs. Future research should focus on standardizing protocols, leveraging emerging technologies, and assessing the long-term effects of integrated management strategies on wound healing and quality of life. Keywords: Type 2 Diabetes Management, Glycemic Control, Wound Healing, Dietary Interventions, Multidisciplinary Care.

Glycyrrhizic acid and glycyrrhetinic acid loaded cyclodextrin MOFs with enhanced antibacterial and anti-inflammatory effects for accelerating diabetic wound healing

A water stable cyclodextrin MOF (Cu-SD) was synthesized with γ-cyclodextrin derivative as organic ligand and Cu2+ as metal center to co-crystallizely load glycyrrhizic acid (GL) and glycyrrhetinic acid (GA). Cu-SD has a high drug loading capacity for GL (499.91 μg/mg) and GA (112.37 μg/mg), and the drug-loaded materials had a controlled release in different meadiums. In addition, Cu-SD and its drug loaded materials demonstrated better inhibiting α-glucosidase activity than the control drug acarbose. Furthermore, Cu-SD presented excellent antibacterial activity, and the antibacterial activity was significantly enhanced after GA and GL being encapsulated by Cu-SD. Moreover, both free and drug-loaded materials had good anti-inflammatory activities, and the anti-inflammatory effects of GL@Cu-SD and GA@Cu-SD were superior to those of their corresponding free drugs. Cu-SD, GL@Cu-SD and GA@Cu-SD demonstrated good biocompatibility and were applied to treat the wounds of diabetic rats. The experimental results showed that GL@Cu-SD and GA@Cu-SD had good promoting effects on the recovery of chronic diabetic wounds by suppressing wound inflammation.

Effectiveness of negative pressure wound therapy as a fixator in split thickness skin graft applied diabetic patients: evaluation of 25 cases

Objective: Microangiopathies expose diabetic patients to lower extremity wounds at certain stages of their lives. Split-thickness skin grafting (STSG) has an important place in the surgical treatment of such wounds. The aim of the present study is to evaluate the effects of negative pressure wound therapy (NPWT) on STSG survival. Methods: A total of 25 diabetic patients (M = 20, F = 5) with acute or chronic lower extremity open wounds were included in the study. All patients underwent wound debridement under regional anesthesia. STSG was applied after wound debridement. NPWT was applied to STSG to increase graft survival. Results: The hospitalization times of the patients ranged from 1 to 2 weeks. The mean follow-up period of the patients was 6 months. All wounds healed on the 14th postoperative day. There was no recurrence in the 6-month follow-up period. Conclusion: We objectively demonstrated the positive effects of NPWT application on STSG and graft survival.

Effects of low-frequency pulsed electrical stimulation at the common peroneal nerve on chronic refractory wounds of the lower limb: A randomized controlled trial.

Electrical stimulation (ES) has been shown to substantially enhance the quality of life by alleviating pain in patients with chronic wounds. This study aimed to observe the effects of low-frequency pulsed wearable ES at the common peroneal nerve on chronic refractory wounds of the lower limb. Forty-eight participants were randomly divided into control group (n = 24) and treatment group (n = 24) in this study. The control group received standard wound care (SWC) exclusively, whereas the treatment group was administered both SWC and the wearable low-frequency ES targeting the common peroneal nerve. Measurements of wound area, pain intensity, wound status, and quality of life scores were systematically recorded both before and after 4 weeks treatment. After 4 weeks of intervention, the percentage area reductionwas significantly higher in the treatment group compared to the control group (Z = -3.9, p < 0.001), and the healing rate of the treatment group was significantly higher than that of the control group (33% vs. 4%). Moreover, the visual Analog Scale for Pain score (β = -0.65, p = 0.019), the Bates-Jensen Wound Assessment Tool score (p < 0.05), and the questionnaire on quality of life with chronic wounds (Wound-Qol) score (β = -4.23, p = 0.003) were significantly decreased in the patients in the treatment group compared to the control group. The wearable low-frequency pulsed ES at the common peroneal nerve for the treatment of chronic refractory wounds showed significant improvement and were far superior compared to SWC. Future research should broaden its scope to include a diverse range of wound types and benefit from collaboration across multiple research centers.

Epidemiological Profile of Chronic Wounds in an Indian Population: A Community-Based Cross-Sectional Observational Study.

Introduction A wound that has not healed in a timely and organized manner to maintain its anatomical and functional integrity is considered chronic. It can last anywhere from four weeks to over three months and could be caused by trauma, diabetes, vascular disease, infection, or pressure.The primary objective of the study was to determine the prevalence of wounds in a rural and urban community in India, and the secondary objective was to evaluate the effect of various chronic wounds on quality of life (QoL) as assessed by the Short-Form Health Survey-36 (SF-36)questionnaire. Materialsand methods The present study is a cross-sectional analytical study done between June 2022 and December 2023, and a total of 10,003 sample population was screened in Varanasi district, Uttar Pradesh, India. The study involved conducting a door-to-door survey of the population sample under interest based on a stratified sampling technique. During the survey, the epidemiological profile of the sample population, a detailed history, and clinical examination findings were recorded in a proforma. The reports of relevant diagnostic investigations were also recorded. Results The overall prevalence of chronic wounds was 1.89 per 1000 (19/10003) population. The prevalence of wounds in urban areas was 1.57 per 1000 (11/6984) population, while that in rural communities was 2.64 per 1000 (8/3019) population. Of the total 19 patients with chronic wounds, the majority of the patients, i.e., seven each (36.8%), had diabetic foot ulcers (DFUs) and neglected/uncared trauma as the etiology for chronic wounds. The remaining five (5.3%) patients were equally divided between cellulitis, venous ulcers, trophic ulcers, tubercular ulcers, and malignancy as the etiology for chronic wounds. The QoL data suggested that 11 (57.9%)patients reported their general health status as fair with wounds, followed by five (26.3%) reporting their general health status as poor. Only three (15.8%) of the patients with wounds reported their general health condition as good. There was no significant difference between the QoL of rural and urban patients with chronic wounds. The overall prevalence of wounds has decreased from 15.03 to 1.89 per 1000 people in the survey locality. The switch from opting for home-based remedies to supervised care under the clinician (be it in a private or public setting) clearly indicates raised awareness regarding the management of wounds, and with time, people have shown an increased interest in healthcare facility treatment under supervision over adopting home remedies for wound treatment. The same domain may be attributed to the prompt management and efficacy of the management protocols by the treating physicians in India. Conclusion The findings of the present study regarding the incidence and prevalence of chronic wounds in connection to demographic factors are important when allocating resources and making healthcare plans. The present study conveys a clear message to healthcare practitioners about the necessity of carrying out large-scale epidemiological research on this topic and offers a solid foundation for future studies.

Systematic review and meta-analysis of diagnostic test accuracy in chronic wound's microbiology.

This study aims to assess the diagnostic accuracy of non-culture-based methodologies for detecting microorganisms in chronic wounds. We systematically reviewed studies that evaluated the diagnostic accuracy of alternative tests in chronic wound samples, excluding studies focused on animal samples or unrelated conditions. The search encompassed PubMed, CINAHL, Scopus and Web of Science databases, employing the QUADAS-2 tool for risk of bias assessment. Our search included the PubMed, CINAHL, Scopus and Web of Science databases, and we assessed the risk of bias using the QUADAS-2 tool. A meta-analysis was conducted on polymerase chain reaction (PCR) and colorimetric methods to determine sensitivity, specificity, diagnostic odds ratio, and summary receiver-operating characteristic (sROC) curves using a random-effects model. For methods not suitable for quantitative synthesis, a narrative synthesis was performed. Nineteen studies involving various types of chronic wounds were analysed, revealing diverse diagnostic methods including fluorescence, PCR, colorimetry, voltammetry, electronic nose, biosensors, enzymatic methods, staining and microscopy. Combining fluorescence with clinical signs and symptoms (CSS) versus culture showed significant accuracy. Colorimetry demonstrated low sensitivity but high specificity, with a diagnostic odds ratio of 6.3. PCR generally exhibited good accuracy, although significant heterogeneity was noted, even in subgroup analyses. This study identified a broad spectrum of diagnostic approaches, highlighting the superior diagnostic accuracy achieved when microbiological analysis is combined with clinical assessments. However, the heterogeneity and methodological variations across studies present challenges in meta-analysis. Future research should aim for standardized and homogeneous study designs to enhance the assessment of diagnostic accuracy for alternative methods.

A low-cost, antimicrobial aloe-alginate hydrogel film containing Australian First Nations remedy ‘lemon myrtle oil’ (Backhousia citriodora) – Potential for incorporation into wound dressings

Chronic wounds pose a global public health challenge, particularly in remote settings where access to specialised wound care and dressings can be limited and cost-prohibitive. First Nations communities in Australia are at a significantly higher risk for developing chronic wounds and this risk further increases for people living in remote regions. There is an urgent need to develop inexpensive but effective wound dressings to improve wound outcomes. Over the past decade, sodium alginate (SA)-based hydrogel polymers have emerged as a cost-effective and biocompatible component in wound dressings, and many have been successfully commercialised. In this study, we have developed and evaluated various prototypes of SA-based hydrogels with the addition of another low-cost component, aloe vera (AV) to further tailor the physicochemical properties of the hydrogel. Since the presence of microbes is a major contributor to the pathophysiology of chronic wounds, we also evaluated the antimicrobial activity of lemon myrtle oil (LMO) (Backhousia citriodora) incorporated into the hydrogel, a remedy used traditionally by First Nations Australians. Novel formulations of AV-SA-LMO hydrogel prototypes in the absence and presence of lemon myrtle oil (at a concentration of 5 μg/mL) were assessed for their physicochemical and antimicrobial properties and compared to a commercially available hydrogel-based dressing. The addition of lemon myrtle oil imparted viscoelastic behaviour for improved processability of AV-SA-LMO hydrogel prototypes, while increasing protein adhesion, enhancing physical properties, and demonstrating antimicrobial activity against the common wound-infecting microbes Staphylococcus epidermidis and Candida albicans. Fourier transmission infrared (FTIR) spectra confirmed the molecular structures of the hydrogel prototypes as predicted. The prototypes also demonstrated biocompatibility with the HaCaT human keratinocyte cell line. This study has provided preliminary evidence that a 25:75 aloe vera:sodium alginate hydrogel with 5 μg/mL lemon myrtle oil has comparable physicochemical characteristics to a commercial hydrogel-based wound dressing and antimicrobial properties against S. epidermidis and C. albicans.

Augmented Reality-Based Chronic Wound Healing Assessment Using 3D Stereoscopic Imaging and Self-Organizing Maps

Background: Chronic wounds (CW) present significant public health challenges, impacting individuals' well-being and daily activities. Traditional wound measurement methods, such as the ruler technique, are time-consuming, imprecise, and pose infection risks. Advances in wound care technology, including artificial intelligence (AI) and augmented reality (AR), have improved wound healing (WH) assessment accuracy and enhanced clinician-patient communication. Methods: This study developed a novel CW evaluation device combining AR and a stereoscopic camera system. The device captures images using two Leopard Imaging LI-OV580 stereo cameras and a pico-projector to create a 3D wound model. The system calculates the wound area by processing stereoscopic images, utilizing structured-from-motion techniques and convolutional neural networks (CNNs). Additionally, the device measures epipolar and projection errors (PE) during AR-based wound evaluation. A Self-Organizing Map (SOM) was employed to refine the 3D reconstruction of the wound. Results: The AR-PE analysis demonstrated the device's accuracy, with the lowest PE recorded at 20 cm from the wound area. The projection error increased as the measurement distance moved toward the edges of the wound. The average epipolar error (EE) was 0.46 pixels, indicating high precision in stereoscopic measurements. Conclusion: The study introduced a non-invasive CW evaluation device that improves wound assessment accuracy and clinician-patient interaction. By utilizing 3D wound modeling and AR, the system enables more effective communication and progress tracking during WH. The results suggest this technology could enhance CW management, offering a reliable alternative to traditional methods.

Optimizing the implementation of Enhanced Barrier Precautions in community-based nursing homes

BackgroundEnhanced Barrier Precautions (EBP) recommends using gowns and gloves for certain nursing home residents during specific high-contact care activities associated with multidrug-resistant organism (MDRO) transmission. Though EBP is included in CDC guidance as an MDRO control strategy, optimal implementation approaches remain unclear. MethodsWe implemented a quality improvement initiative using the 4E process model (Engagement, Education, Execution, and Evaluation) to optimize EBP implementation in four Maryland nursing homes. Semi-structured interviews with healthcare personnel (HCP) occurred to understand EBP acceptability. ResultsGlove use during high-contact care increased from 85% in the baseline to 97% during the intervention (p<0.01). Gown use increased from 27% to 78% (p<0.01). Accuracy of identifying residents eligible for EBP improved from 63% to 99% (p<0.01). Of 780 residents observed, one-third met EBP indications - MDRO colonization (21%), indwelling medical device (14%), and/or chronic wound (10%). The most noted facilitator to EBP implementation included HCP perception that EBP reduces MDRO transmission to other residents and staff. The most noted barrier was uncomfortable gowns. ConclusionsImplementation was complex and required comprehensive assessments of barriers and facilitators within each facility. HCP interviews identified common barriers and facilitators of EBP that can inform future EBP implementation projects.

DNA-Based Nanocarriers for Extended Release of NZ2114 Peptide and Epidermal Growth Factors in Chronic Wound Healing

Chronic wounds, often accompanied by bacterial infection, pose significant clinical challenges. Recognizing this, there has been a growing interest in leveraging nucleic acids as intelligent materials for targeted cargo delivery. Herein, we introduced a pioneering method for encapsulating the anti-S. aureus peptide NZ2114 and epidermal growth factors (EGF) within crosslinked DNA nanomaterials, creating biodegradable and biocompatible antimicrobial agents with high efficacy. Our research validated that the NZ2114-EGF-Gel could exhibit a specific inhibitory effect on S. aureus growth while simultaneously accelerating human dermal fibroblasts’ proliferation. The crosslinked DNA nanostructures demonstrate an enhanced capacity to promote wound therapy rates during in vivo treatment. These findings present a prospective avenue for facilitating therapeutic wound healing.

An inter-assessor reliability study on the categorization and staging of pressure injuries

BackgroundThe first step in effective management of pressure injuries (PIs) is to assess, categorize and stage correctly. PurposeThis study aims to examine the agreement regarding the classification and staging of PIs among nurse academicians working on chronic wounds and with different stage of expertise. MethodsThree nurse academicians were assigned as assessors according to Benner's stages of clinical competence (Competent, Proficient, and Expert). The assessors independently evaluated PIs photographs (n = 694). The assessors then met for the wounds where there was disagreement, and a Consensus agreement was reached. Kappa Statistics analysed the agreement between two assessors; Fleiss Kappa Statistics analysed the agreement between Competent, Proficient, Expert, and Consensus. ResultsStatistically, almost perfect agreement was obtained between Competent, Proficient, Expert, and Consensus assessments, respectively (Ƙ = 0.871; p < 0.001, Ƙ = 0.842; p < 0.001, Ƙ = 0.937; p < 0.001). The highest agreement between the assessors were Unstageable PIs, Deep Tissue PIs, and Stage 3 PIs respectively. The most common disagreements were between Deep Tissue PIs and Stage 1 PIs, and between Deep Tissue PIs and Stage 2 PIs. ConclusionIn the study, it was found that the categorization, and staging of PIs had varying degrees of reliability among the assesors, although at a statistically acceptable level.

An Insight into Biodegradable Polymers and their Biomedical Applications for Wound Healing.

Biodegradable polymers, encompassing both natural and synthetic polymers, have demonstrated efficacy as carriers for synthetic drugs, natural bioactive molecules, and inorganic metals. This is due to their ability to control the release of these substances. As a result, various advanced materials, such as nanoparticle- loaded hydrogels, nanofibrous scaffolds, and nanocomposites, have been developed. These materials have shown promise in enhancing processes, such as cell proliferation, vascular angiogenesis, hair growth, and wound healing management. Natural polymers, including hyaluronic acid, collagen, chitosan, gelatin, and alginate, as well as synthetic polymers like polylactic acid, polyglycolic acid, polylactic co-glycolic acid, and PCA, have significant potential for promoting wound healing. This study examines the advancements in biodegradable polymers for wound healing, specifically focusing on each polymer and its distinctive formulations. It also discusses the in vitro experiments conducted using different cell lines, as well as the in vivo studies that explore the numerous uses of these polymers in wound healing. The discussion also included the exploration of modifications or combinations of several polymers, as well as surface changes, in order to produce synergistic effects and address the limitations of individual polymers. The goal was to expedite the healing process of different chronic wounds. Due to this, there have been notable advancements in the technological use of polymeric mixes, including biodegradable polymer-based scaffolds, which have accelerated the process of wound healing.

Antiseptic management of critical wounds: differential bacterial response upon exposure to antiseptics and first insights into antiseptic/phage interactions.

With the antibiotic crisis, the topical antibacterial control including chronic wounds gains increasing importance. However, little is known regarding tolerance development when bacteria face repetitive exposure to the identical antiseptics as commonly found in clinical practice. Clinical isolates foremost of chronic wounds were exposed in vitro to dilutions of two antiseptics used for wound therapy: polyhexanide or octenidine. Adaptive response was determined by growth/kill curves, minimal inhibitory concentration (MIC), and whole genome sequencing. Antiseptic/bacteriophage combinations were studied by liquid-infection assays and bacterial plating. Polyhexanide acted stronger against Escherichia coli and Proteus mirabilis while octenidine was more potent against Staphylococcus aureus . Otherwise, the antiseptic efficacy varied across isolates of Klebsiella pneumoniae , Pseudomonas aeruginosa , and Acinetobacter baumannii . Upon repetitive exposure with constant antiseptic concentrations P. aeruginosa and P. mirabilis adaptation was evident by a reduced lag-phase and a twofold increased MIC. Under increasing octenidine concentrations, P. aeruginosa adapted to an eightfold higher dosage with mutations in smvA , opgH , and kinB affecting an efflux pump, alginate and biofilm formation, respectively. S. aureus adapted to a fourfold increase of polyhexanide with a mutation in the multiple peptide resistance factor MprF, also conferring cross-resistance to daptomycin. Antiseptic/bacteriophage combinations enhanced bacterial inhibition and delayed adaptation. Different bacterial species/strains respond unequally to low-level antiseptic concentrations. Bacterial adaptation potential at phenotypic and genotypic levels may indicate the necessity for a more nuanced selection of antiseptics. Bacteriophages represent a promising yet underexplored strategy for supporting antiseptic treatment, which may be particularly beneficial for the management of critical wounds.

Skin changes around wounds: A position paper from the professional society Initiative Chronische Wunden (ICW) e.V.

Many patients with chronic wounds have skin changes that can provide important clues as to the etiology of the wound and/or inappropriate treatment. As the largest human organ, the skin is easily accessible for clinical inspection. However, healthcare professional teams currently do not always assess and document these skin changes correctly and consistently. The board of the professional society Initiative Chronische Wunden (ICW) e. V. has therefore decided to draw up a position paper to clarify the most important technical terms for skin changes around wounds. One focus here is on the definition and differentiated description of the wound edge and wound surrounding skin. Atrophies, blisters, eczema, erythema, hemorrhages, hyperpigmentation, hypopigmentation, hyperkeratosis, maceration, necrosis, oedema, pustules, sclerosis and scales are then described in more detail and placed in a clinical context.

In Situ Triggered Self-Contraction Bioactive Microgel Assembly Accelerates Diabetic Skin Wound Healing by Activating Mechanotransduction and Biochemical Pathway.

Chronic nonhealing skin wounds, characterized by reduced tissue contractility and inhibited wound cell survival under hyperglycemia and hypoxia, present a significant challenge in diabetic care. Here, an advanced self-contraction bioactive core-shell microgel assembly with robust tissue-adhesion (SMART-EXO) is introduced to expedite diabetic wound healing. The SMART-EXO dressing exhibits strong, reversible adhesion to damaged tissue due to abundant hydrogen and dynamic coordination bonds. Additionally, the core-shell microgel components and dynamic coordination bonds provide moderate rigidity, customizable self-contraction, and an interlinked porous architecture. The triggered in situ self-contraction of the SMART-EXO dressing enables active, tunable wound contraction, activating mechanotransduction in the skin and promoting the optimal fibroblast-to-myofibroblast conversion, collagen synthesis, and angiogenesis. Concurrently, the triggered contraction of SMART-EXO facilitates efficient loading and on-demand release of bioactive exosomes, contributing to re-epithelialization and wound microenvironment regulation in diabetic mice. RNA-seq results reveal the activation of critical signaling pathways associated with mechanosensing and exosome regulation, highlighting the combined biomechanical and biochemical mechanisms. These findings underscore SMART-EXO as a versatile, adaptable solution to the complex challenges of diabetic wound care.

Diabetes Mellitus Inhibits Hair Follicle Regeneration by Inducing Macrophage Reprogramming-Mediated Pyroptosis.

Diabetes mellitus (DM) is known to inhibit skin self-renewal and hair follicle stem cell (HFSC) activation, which may be key in the formation of chronic diabetic wounds. This study aimed to investigate the reasons behind the suppression of HFSC activation in DM mice. Type 1 DM (T1DM) was induced in 6-week-old mice via streptozotocin, and hair follicle growth was subsequently monitored. RNA sequencing, bioinformatics analyses, qRT‒PCR, immunostaining, and cellular experiments were carried out to investigate the underlying mechanisms involved. T1DM inhibited HFSC activation, which correlated with an increase in caspase-dependent programmed cell death. Additionally, T1DM triggered apoptosis and pyroptosis, predominantly in HFSCs and epidermal regions, with pyroptosis being more pronounced in the inner root sheath of hair follicles. Notably, significant cutaneous immune imbalances were observed, particularly in macrophages. Cellular experiments demonstrated that M1 macrophages inhibited HaCaT cell proliferation and induced cell death, whereas high-glucose environments alone did not have the same effect. T1DM inhibits HFSC activation via macrophage reprogramming-mediated caspase-dependent pyroptosis, and there is a significant regional characterization of cell death. Moreover, T1DM-induced programmed cell death in the skin may be more closely related to immune homeostasis imbalance than to hyperglycemia itself. These findings shed light on the pathogenesis of diabetic ulcers and provide a theoretical basis for the use of hair follicle grafts in wound repair.

Modulation of animal and plant tissue growth with collagen‐starch‐organic molybdenum networks hydrogel biomatrices

AbstractThe development of hydrogel biomatrices with potential to modulate animal and plant tissue growth is ongoing. In this study, molybdenum bio‐metal–organic frameworks (MOFs) (Mo‐bioMOFs) incorporating essential amino acids such as l‐histidine (Mo‐His), l‐phenylalanine (Mo‐Phe), and l‐tryptophan (Mo‐Trp) were encapsulated in semi‐interpenetrating polymer network (semi‐IPN) hydrogels composed of collagen and starch. The structure and properties of these materials show dependence on the amino acid that constitutes the Mo‐bioMOFs. The biomatrices have a semi‐crystalline surface with increased porosity when using Mo‐His; this system also benefits swelling. Increased crosslinking, acceleration in gelation, and mechanical improvement are observed for the system based on Mo‐Phe. Methylene blue release experiments were conducted, demonstrating that matrices including Mo‐bioMOFs exhibit controlled release profiles, indicating highly stable retention of Mo‐bioMOFs in the semi‐IPN matrix. The biomatrices enhance the metabolism and proliferation of fibroblasts and monocytes, with Mo‐Trp reducing the secretion of inflammatory cytokines like TNF‐α. The biomatrices exhibit gradual and slow mass loss when exposed to collagenase and commercial vegetable substrates. Both leaf and root cells of tomato plants (Solanum lycopersicum) show increased metabolism and growth when exposed to Mo‐Phe and Mo‐His. Notably, the biomatrix containing Mo‐Phe promotes the most substantial plant growth and foliage after 30 days. These biomatrices have potential applications in chronic wound healing and agriculture.

How effective are dietary interventions for prevention and management of chronic wounds in individuals with diabetes: a systematic review protocol

How effective are dietary interventions for prevention and management of chronic wounds in individuals with diabetes: a systematic review protocol