Interleukin-22 Promotes Wound Repair in Diabetes by Improving Keratinocyte Pro-Healing Functions

J Invest Dermatol. 2015 Nov;135(11):2862-2870. doi: 10.1038/jid.2015.278. Epub 2015 Jul 13.

Abstract

Impaired re-epithelialization, imbalanced expression of cytokines and growth factors, and vascular disease contribute to healing impairment in diabetes. IL-22, a pro-inflammatory cytokine mediating a cross-talk between immune system and epithelial cells, has been shown to have a role in repair processes. In this study we aimed to investigate IL-22 regenerative potential in the poor healing context of diabetic wounds. By using streptozotocin-induced diabetic mice, we demonstrated that IL-22 wound treatment significantly accelerated the healing process, by promoting re-epithelialization, granulation tissue formation, and vascularization. Improved re-epithelialization was associated with increased keratinocyte proliferation and signal transducer and activator of transcription 3 (STAT3) activation. We showed that endogenous IL-22 content was reduced at both mRNA and protein level during the inflammatory phase of diabetic wounds, with fewer IL-22-positive cells infiltrating the granulation tissue. We demonstrated that IL-22 treatment promoted proliferation and injury repair of hyperglycemic keratinocytes and induced activation of STAT3 and extracellular signal-regulated kinase transduction pathways in keratinocytes grown in hyperglycemic condition or isolated from diabetic patients. Finally, we demonstrated that IL-22 treatment was able to inhibit diabetic keratinocyte differentiation while promoting vascular endothelial growth factor release. Our data indicate a pro-healing role of IL-22 in diabetic wounds, suggesting a therapeutic potential for this cytokine in diabetic ulcer management.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Animals
  • Biopsy, Needle
  • Blotting, Western
  • Cells, Cultured
  • Diabetes Mellitus, Experimental
  • Disease Models, Animal
  • Enzyme-Linked Immunosorbent Assay
  • Immunohistochemistry
  • Interleukin-22
  • Interleukins / metabolism
  • Interleukins / pharmacology*
  • Keratinocytes / drug effects*
  • Keratinocytes / metabolism
  • MAP Kinase Signaling System / drug effects
  • Male
  • Mice
  • Mice, Inbred BALB C
  • Random Allocation
  • Real-Time Polymerase Chain Reaction
  • STAT3 Transcription Factor / drug effects
  • STAT3 Transcription Factor / metabolism
  • Skin Ulcer / drug therapy*
  • Skin Ulcer / metabolism
  • Skin Ulcer / pathology
  • Vascular Endothelial Growth Factor A / metabolism
  • Wound Healing / physiology*

Substances

  • Interleukins
  • STAT3 Transcription Factor
  • Vascular Endothelial Growth Factor A