Hydrogels incorporating active compounds from traditional Chinese medicine for diabetic wound healing: mechanistic pathways and bioengineering progress

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Diabetic wounds, especially foot ulcers, pose significant clinical challenges due to persistent inflammation, oxidative stress, impaired angiogenesis, and a high risk of infection. Advanced therapeutic strategies are needed to actively modulate the wound microenvironment. Hydrogels incorporating bioactive compounds derived from Traditional Chinese Medicine (TCM), such as curcumin, baicalein, glycyrrhetinic acid, Astragalus polysaccharides, and Ganoderma lucidum polysaccharides, offer a promising integrative approach. These hydrogels combine the biological activities of TCM compounds with the advantages of a moist, biocompatible wound dressing. This review highlights recent advancement (2020-2025) in TCM-based hydrogels for diabetic wound healing focusing on the design of these materials (e.g., curcumin, baicalein, glycyrrhetinic acid, Astragalus and Ganoderma polysaccharides) and the development of stimuli-responsive delivery systems (e.g., pH, enzymes, temperature, glucose and possibly magnetic/electric fields). TCM-derived compounds can not only form or reinforce hydrogel networks but also impart therapeutic functions by modulating key cellular pathways involved in anti-inflammatory (NF-κB) and antioxidant responses (Nrf2/HO-1), angiogenesis (VEGF, PI3K/Akt), and tissue regeneration (TGF-β/Smad). Challenges in translating TCM-based hydrogles into clinical use, such as pharmac

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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