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Interleukin‐8/Matrix Metalloproteinase‐9 Axis Impairs Wound Healing in Type 2 Diabetes through Neutrophil Extracellular Traps‐Fibroblast Crosstalk

Title: Interleukin‐8/Matrix Metalloproteinase‐9 Axis Impairs Wound Healing in Type 2 Diabetes through Neutrophil Extracellular Traps‐Fibroblast Crosstalk
Authors: Tsilingiris, Dimitrios; Natsi, Anastasia‐Maria; Gavriilidis, Efstratios; Antoniadou, Christina; Eleftheriadou, Ioanna; Anastasiou, Ioanna A.; Tentolouris, Anastasios; Papadimitriou, Evangelos; Eftalitsidis, Evgenios; Kolovos, Panagiotis; Tsironidou, Victoria; Giatromanolaki, Alexandra; Koffa, Maria; Tentolouris, Nikolaos; Skendros, Panagiotis; Ritis, Konstantinos
Source: European Journal of Immunology ; volume 55, issue 4 ; ISSN 0014-2980 1521-4141
Publisher Information: Wiley
Publication Year: 2025
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Neutrophils interact with and activate fibroblasts through the release of neutrophil extracellular traps (NETs). We investigated the role of NETs‐fibroblast crosstalk in the cutaneous wound healing of type 2 diabetes (T2D). Neutrophils/NETs, serum, and primary human skin fibroblasts (HSFs) were obtained from individuals with T2D and age/sex‐matched controls. NET‐stimulation studies were performed on neutrophils/HSFs, with and without specific inhibitors, while HSF healing capacity was assessed using a scratch wound healing assay. T2D HSFs display a profibrotic phenotype, showing increased CCN2/CTGF, α‐smooth muscle actin, and collagen release, albeit with impaired healing capacity, elevated type I collagen C‐terminal telopeptide, and collagen degradation associated with increased (∼3.5‐fold) matrix metalloproteinase‐9 (MMP‐9) in T2D neutrophils/NETs. IL‐8 induced the expression of MMP‐9 in neutrophils/NETs. Moreover, T2D neutrophils/NETs exhibited increased IL‐8 content, which acted in an autocrine/paracrine fashion to further augment its production by neutrophils/HSFs. The findings were validated in normoglycemic individuals during a hyperglycemic clamp with concomitant lipid infusion and further corroborated immunohistochemically in diabetic plantar ulcer biopsies. This novel, vicious circle of NETs/interleukin‐8/MMP‐9/HSFs was hindered by IL‐8 or MMP‐9 blockade via specific inhibitors or by dismantling the NET‐scaffold with DNase I, suggesting candidate therapeutic targets in wound healing impairment of T2D.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1002/eji.202451664
Availability: https://doi.org/10.1002/eji.202451664; https://onlinelibrary.wiley.com/doi/pdf/10.1002/eji.202451664
Rights: http://creativecommons.org/licenses/by-nc-nd/4.0/
Accession Number: edsbas.6651D6C5
Database: BASE