Reepithelialization of Diabetic Skin and Mucosal Wounds Is Rescued by Treatment With Epigenetic Inhibitors

Author:

Yang Bo12,Alimperti Stella3,Gonzalez Michael V.45,Dentchev Tzvete6,Kim Minjung2,Suh Justin6,Titchenell Paul M.78,Ko Kang I.2,Seykora John6,Benakanakere Manju2,Graves Dana T.2ORCID

Affiliation:

1. 1Department of Implant Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, China

2. 2Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA

3. 3Department of Biochemistry, Molecular and Cellular Biology, Georgetown University, Washington, DC

4. 4Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA

5. 5Center for Cytokine Storm Treatment & Laboratory, Department of Medicine, University of Pennsylvania, Philadelphia, PA

6. 6Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA

7. 7Department of Physiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA

8. 8Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA

Abstract

Wound healing is a complex, highly regulated process and is substantially disrupted by diabetes. We show here that human wound healing induces specific epigenetic changes that are exacerbated by diabetes in an animal model. We identified epigenetic changes and gene expression alterations that significantly reduce reepithelialization of skin and mucosal wounds in an in vivo model of diabetes, which were dramatically rescued in vivo by blocking these changes. We demonstrate that high glucose altered FOXO1–matrix metallopeptidase 9 (MMP9) promoter interactions through increased demethylation and reduced methylation of DNA at FOXO1 binding sites and also by promoting permissive histone-3 methylation. Mechanistically, high glucose promotes interaction between FOXO1 and RNA polymerase-II (Pol-II) to produce high expression of MMP9 that limits keratinocyte migration. The negative impact of diabetes on reepithelialization in vivo was blocked by specific DNA demethylase inhibitors in vivo and by blocking permissive histone-3 methylation, which rescues FOXO1-impaired keratinocyte migration. These studies point to novel treatment strategies for delayed wound healing in individuals with diabetes. They also indicate that FOXO1 activity can be altered by diabetes through epigenetic changes that may explain other diabetic complications linked to changes in diabetes-altered FOXO1-DNA interactions. Article Highlights FOXO1 expression in keratinocytes is needed for normal wound healing. In contrast, FOXO1 expression interferes with the closure of diabetic wounds. Using matrix metallopeptidase 9 as a model system, we found that high glucose significantly increased FOXO1-matrix metallopeptidase 9 interactions via increased DNA demethylation, reduced DNA methylation, and increased permissive histone-3 methylation in vitro. Inhibitors of DNA demethylation and permissive histone-3 methylation improved the migration of keratinocytes exposed to high glucose in vitro and the closure of diabetic skin and mucosal wounds in vivo. Inhibition of epigenetic enzymes that alter FOXO1-induced gene expression dramatically improves diabetic healing and may apply to other conditions where FOXO1 has a detrimental role in diabetic complications.

Funder

National Institute of Dental and Craniofacial Research

Publisher

American Diabetes Association

Subject

Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference49 articles.

1. Metabolism, obesity, and diabetes mellitus;Ruiz;Arterioscler Thromb Vasc Biol,2019

2. World Health Organization . Global Report on Diabetes. 2016. Accessed 21 April 2016. Available from https://iris.who.int/bitstream/handle/10665/204871/9789241565257_eng.pdf?sequence=1

3. Update on management of diabetic foot ulcers;Everett;Ann N Y Acad Sci,2018

4. A longitudinal study of patients with diabetes and foot ulcers and their health-related quality of life: wound healing and quality-of-life changes;Ribu;J Diabetes Complications,2008

5. The humanistic and economic burden of chronic wounds: a systematic review;Olsson;Wound Repair Regen,2019

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