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Research Offers Hope for Better Diabetic Wound Healing

People with diabetes often contend with wounds that heal poorly and can sometimes lead to amputation. Researchers at the Max Planck Institute for Biology of Ageing, the CECAD Excellence Cluster, and the Institute for Genetics of the University of Cologne have gained fresh insight into the underlying cellular mechanisms.

It had previously been assumed that high levels of glucose in the blood damages vessels and neurons and impairs the immune system, thereby accounting for the wound-healing problems in people with diabetes. The researchers have shown that slowed insulin metabolism at the wound site directly affects neighboring cells involved in wound healing.

Parisa Kakanj, PhD, the author of the study, examined fruit fly larvae, which are very similar to mammals in respect to insulin metabolism. Using a precision laser, she removed a cell from their outermost skin layer and then observed what happened in the neighboring cells under the microscope.

“Immediately after a skin injury, the neighboring cells respond by forming an actomyosin cable,” Kakanj explained. The cable consists of proteins that otherwise occur in muscle fibers, where they are responsible for muscular contraction. After an injury, the cable forms a contractile ring around the wound. It then contracts, sealing off the gap caused by the wound. “However, if insulin metabolism is impaired, as in our genetically modified flies, the cable is weaker and forms much later. This results in incomplete or slow wound healing,” she said.

New treatments for impaired wound healing could precisely target this mechanism. “In future, it may be possible to treat wound sites with drugs that locally activate insulin metabolism,” said Kakanj.

This article was adapted from information provided by Max-Planck-Gesellschaft.