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The following is a summary of “Single-Cell Analysis of Debrided Diabetic Foot Ulcers Reveals Dysregulated Wound Healing Environment in Non-Hispanic Black Patients,” published in the March 2025 issue of Journal of Investigative Dermatology by Choi et al. 

The wound microenvironment and healing process of diabetic foot ulcers (DFU) remain incompletely understood despite being a severe diabetes complication.  

Researchers conducted a retrospective study to optimize single-cell profiling from sharp, debrided DFU.  

They analyzed healing DFU using single-cell profiling from sharp debrided tissues. Fibroblasts expressing inflammatory genes (CHI3L1, IL6) and extracellular matrix (ECM) remodeling markers (ASPN) were identified. Findings were compared with previous data from surgically resected ulcers to validate gene expression patterns.  

The results showed that fibroblasts from non-Hispanic Black (NHB) individuals had lower expression of healing-associated genes, including CHIL3L1, matrix metalloproteinase 11 (MMP11), and secreted frizzled-related protein 4 (SFRP4), compared to those from White individuals. Cellular communication analysis revealed that healing-enriched fibroblasts (HE-Fibro) in NHB individuals exhibited upregulation of the WNT signaling pathway, whereas those in White individuals showed increased activation of the insulin-like GF and Midkine pathways.  

Investigators concluded that race serves as a risk marker for DFU outcomes, indicating disparities in environmental exposures and healthcare access that affect healing. 

Source: jidonline.org/article/S0022-202X(24)01979-1/fulltext