A tetramethylpyrazine-loaded hyaluronic acid-based hydrogel modulates macrophage polarization for promoting wound recovery in diabetic mice

The failure of wound healing often causes lower limb disability and amputation of diabetic patients. Current strategies for diabetic wound management often fail to achieve the expected outcomes, and emerging alternatives are urgently needed. Recent advances in the identification of active compounds from traditional herbal medicines provide promising therapeutics for tissue repair and regeneration. In this study, the pro-healing effects of tetramethylpyrazine (TMP, a natural alkaloid found in Ligusticum chuanxiong Hort) for diabetic wounds were for the first time demonstrated. The cutaneous healing was mainly achieved by TMP-mediated macrophage polarization from pro-inflammatory to pro-healing phenotype. In addition, the topical administration of TMP was facilitated by the hyaluronic acid (HA) hydrogel for promoting the full-thickness wounds in the experimental diabetic mice. Consequently, TMP-loaded HA hydrogel (TMP-HA) profoundly accelerated the wound closure in comparison with TMP-loaded INTRASITE Gel (it is a commercial hydrogel), which was evident with the inflammation mitigation, the angiogenesis enhancement, and the collagen deposition. Our work reveals the macrophage-modulatory function of TMP for diabetic wound healing and demonstrates great potential of TMPHA for clinical application.

Automated summary

The failure of wound healing in diabetic patients can lead to lower limb disability and amputation. Current strategies for diabetic wound management are not effective, and new alternatives are urgently needed. This study demonstrated for the first time the pro-healing effects of the natural alkaloid tetramethylpyrazine (TMP) from Ligusticum chuanxiong Hort on diabetic wounds. TMP facilitated cutaneous healing by promoting macrophage polarization and accelerated wound closure when delivered topically with hyaluronic acid hydrogel. The findings highlight the potential of TMP-HA for clinical application in diabetic wound healing.