Accelerating diabetic wound healing with Ramulus Mori (Sangzhi) alkaloids via NRF2/HO-1/eNOS pathway

Phytomedicine. 2024 Nov:134:155990. doi: 10.1016/j.phymed.2024.155990. Epub 2024 Aug 31.

Abstract

Diabetic foot ulcers (DFUs) represent a severe complication of diabetes mellitus. Ramulus Mori (Sangzhi) alkaloids (SZ-A), an approved oral medication for type 2 diabetes, have not been explored for their potential to enhance the processes involved in diabetic wound healing. This study aims to investigate SZ-A's role in diabetic wound healing mechanisms. The in vivo experimentation involves dividing the subjects into NC and SZ-A groups, with SZ-A dosed at 200 and 400 mg/kg, to assess the therapeutic efficacy of SZ-A. The results of the animal studies show that SZ-A intervention accelerates the processes of diabetic angiogenesis and wound healing in a manner dependent on its concentration. Additionally, a pathological model using advanced glycation end products (AGEs) in HUVECs demonstrates SZ-A's cytoprotective effect. In vitro, SZ-A intervention significantly increases cell proliferation, migration and tube formation, protecting HUVECs from oxidative stress injury induced by AGEs. Mechanistically, SZ-A exerts a protective effect on HUVECs from oxidative stress damage through the activation of the NRF2/HO-1/eNOS signaling pathway. The findings suggest that SZ-A exhibits considerable potential as a promising candidate for treating DFUs, which will aid in more effectively integrating plant-based therapies into clinical settings.

Keywords: Diabetic wound; Endothelial cells; NRF2/HO-1; Oxidative stress; Ramulus Mori (Sangzhi) alkaloids; eNOS.

MeSH terms

  • Alkaloids* / pharmacology
  • Animals
  • Cell Movement / drug effects
  • Cell Proliferation / drug effects
  • Diabetes Mellitus, Experimental / drug therapy
  • Diabetic Foot* / drug therapy
  • Glycation End Products, Advanced / metabolism
  • Human Umbilical Vein Endothelial Cells* / drug effects
  • Humans
  • Male
  • NF-E2-Related Factor 2* / metabolism
  • Nitric Oxide Synthase Type III* / metabolism
  • Oxidative Stress* / drug effects
  • Rats
  • Rats, Sprague-Dawley
  • Signal Transduction / drug effects
  • Wound Healing* / drug effects

Substances

  • NF-E2-Related Factor 2
  • Alkaloids
  • Nitric Oxide Synthase Type III
  • Glycation End Products, Advanced
  • NFE2L2 protein, human
  • Nfe2l2 protein, rat