Aghayants Sis, Zhou Shengzhi, Zhu Keyu, Tan Zhixiang, Cheng Bomin, Gong Song, Zhu Zhanyong
Department of Plastic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People's Republic of China.
Chinese Medicine Health Management Center, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People's Republic of China.
Clin Cosmet Investig Dermatol. 2025 Sep 4;18:2149-2166. doi: 10.2147/CCID.S534876. eCollection 2025.
Diabetic foot ulcers (DFUs) are a common and severe complication of diabetes, often resulting in chronic non-healing wounds. This study aims to investigate the role of cyclin-dependent kinase inhibitor 1A (CDKN1A) in diabetic wound healing, focusing on its impact on cell proliferation and differentiation in DFUs.
We utilized single-cell RNA sequencing (scRNA-seq) to analyze gene expression profiles from DFUs tissues, comparing healing and non-healing groups. Differential gene expression analysis was performed to identify key regulators of wound healing. Mendelian randomization (MR) was employed to explore the causal relationship between CDKN1A expression and metabolic dysfunction in DFUs. Transcription factor analysis was also conducted to identify potential upstream regulators of CDKN1A.
Our study confirmed that CDKN1A played a pivotal role in inhibiting cell proliferation and promoting premature differentiation in DFUs, which contributed to impaired wound healing. FOS was identified as a key transcription factor that upregulates CDKN1A in non-healing DFUs. MR analysis identified CDKN1A as being associated with metabolic changes, including the α-ketobutyrate/pyruvate ratio, leading to the impaired healing process in non-healing DFUs.
These findings shed light on the molecular mechanisms underlying DFU healing, suggesting that targeting FOS and CDKN1A could offer novel therapeutic strategies for enhancing wound healing in diabetic patients.
糖尿病足溃疡(DFUs)是糖尿病常见且严重的并发症,常导致慢性不愈合伤口。本研究旨在探讨细胞周期蛋白依赖性激酶抑制剂1A(CDKN1A)在糖尿病伤口愈合中的作用,重点关注其对DFUs中细胞增殖和分化的影响。
我们利用单细胞RNA测序(scRNA-seq)分析DFUs组织的基因表达谱,比较愈合组和未愈合组。进行差异基因表达分析以确定伤口愈合的关键调节因子。采用孟德尔随机化(MR)来探讨CDKN1A表达与DFUs代谢功能障碍之间的因果关系。还进行了转录因子分析以确定CDKN1A潜在的上游调节因子。
我们的研究证实,CDKN1A在抑制DFUs中的细胞增殖和促进过早分化方面起关键作用,这导致伤口愈合受损。FOS被确定为在未愈合的DFUs中上调CDKN1A的关键转录因子。MR分析确定CDKN1A与代谢变化有关,包括α-酮丁酸/丙酮酸比值,导致未愈合的DFUs愈合过程受损。
这些发现揭示了DFU愈合的分子机制,表明靶向FOS和CDKN1A可为增强糖尿病患者伤口愈合提供新的治疗策略。