Multidimensional Regulatory Mechanisms and Targeted Therapeutic Strategies for Inhibited Keratinocyte Proliferation in Diabetic Wounds

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 wound healing impairment represents a pressing clinical challenge worldwide, with its high disability rate and recurrence rate imposing a heavy burden on patients and healthcare systems. Keratinocytes are the core effector cells that drive re-epithelialization during wound healing, and their impaired proliferative capacity is a core pathological mechanism underlying healing arrest and chronic wound development. The functional status of other repair cell populations, including fibroblasts, endothelial cells and immune cells, also exerts direct or indirect regulatory effects on the entire wound healing process. Under diabetic conditions, multifaceted pathological changes triggered by hyperglycemia not only induce comprehensive functional impairment of keratinocytes, but also disrupt the synergistic interaction between various repair cells. This ultimately stalls the physiological wound healing cascade, leading to the development of chronic, non-healing wounds. Building upon this, this review further summarizes novel targeted therapeutic strategies addressing these mechanisms, encompassing cutting-edge approaches such as engineered exosome delivery systems, photobiomodulation therapy, metabolic enzyme small-molecule inhibitors, peptide agonists, and plant-derived nanovesicles. This review aims to delineate the crosstalk between core regulatory modules and identify key dru

Evidence level

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

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