From:  Immunomodulation: scope and limitations in promoting diabetic foot ulcer healing

 Therapeutic strategies targeting the AGE-RAGE axis to promote wound healing in diabetes.

StudyModelStrategyMechanisms/Outcomes
Anti-RAGE antibody [84]Diabetic male C57BL/6 miceTopical application of the RAGE antibody on the wound↑ Neutrophil phagocytosis by macrophages.
↑ Phenotypic switch to M2 macrophages.
Enhanced wound healing.
RAGE406R [85]*Diabetic micePrevents the formation of the RAGE-DIAPH1 complexAccelerate wound healing.
Decrease systemic inflammation.
Cinnamaldehyde [86]C57BL/J6 diabetic miceDaily intraperitoneal injections of cinnamaldehydeImproved wound healing.
Accelerated wound closure.
↓ Inflammatory infiltration and oxidative stress.
↑ CD31 expression (angiogenesis).
M1 to M2 polarization.
Resina Draconis hydrogel [87]RAW264.7 cell
Male C57BL/6J diabetic mice
Hydrogels were applied to the woundsAccelerated wound healing.
↓ Oxidative stress.
↑ M2 macrophage polarization.
RAGE229 [88]Murine and human SMCs
BTBR ob/ob mice
Topical injection of RAGE229 two times daily↓ Expression of TNF-α, IL-6, and CCL2/JE-MCP-1.
Accelerate wound healing.
Palladium hydride (PATP) hydrogel [89]Male C57BL/6 diabetic miceCo-blocks the HMGB1-RAGE axis “head-to-tail” (upstream and downstream both)
PATP hydrogels were applied to the wounds
↓ TNF-α, iNOS, and IL-1α levels in the wound.
↓ ROS, RAGE, and HMGB1 levels.
Promotes wound healing with normal skin architecture.
Increased neovascularization.
Dang-Gui-Si-Ni [90]Male Sprague-Dawley diabetic ratsOral gavage to rats after woundingAccelerated wound healing.
Decreased inflammation (↓ IL-1β, IL-6, TNF-α, AGEs, and RAGE levels).
Modulated (↑) TGF-β1 and Smad2/3 protein expression.
Dracorhodin [91]Sprague-Dawley diabetic ratsWounds were treated with dracorhodinAccelerated wound healing in a dose-dependent manner.
↑ Collagen synthesis, angiogenesis, and growth factor levels.
↓ Inflammation and ROS levels.
Antimicrobial hydrogel with RAGE and MMP-9 inhibitors [92]In vitro cell (RAW 264.7) and in vivo diabetic Wistar rat wound modelImmuno-gel was applied to woundsSignificantly decreased MMP-9 and NF-κB expression.
Enhanced M2 macrophages and pro-healing cytokines.
Rosiglitazone and S-nitroso glutathione (nanoparticles/hydrogel composite) [93]Diabetic SD ratsRAGE inhibitor/exogenous nitric oxide dressing to the wound every other daySignificantly improved wound healing.
↑ Wound closure rate, collagen fiber production, and angiogenesis.
↓ Inflammation (↓ IL-1β, TNF-α, and IL-6).
GPP@ZnBG hydrogels [94]Diabetic mice and human subjectsHydrogel was applied to the wound in mice and to DFUs in humans↑ Angiogenesis, collagen formation, and tissue repair.
↓ Inflammation.
Promote wound repair.
Have antibacterial effects.

* Article preview only is available. DIAPH1: diaphanous-related formin 1; TNF-α: tumor necrosis factor alpha; IL: interleukin; NF-κB: nuclear factor kappa beta; ROS: reactive oxygen species; HMGB1: high-mobility group box protein 1; AGEs: advanced glycation end products; RAGE: receptor for advanced glycation end products; iNOS: inducible nitric oxide synthase; CCL2: C-C motif chemokine ligand 2; MCP-1: monocyte chemoattractant protein-1; TGF-β: transforming growth factor beta.