From inflammation to healing: the crucial role of GPR91 activation and SDH inhibition in chronic diabetic wound recovery

Abstract Background Diabetic foot ulcers (DFU) typically exhibit impaired healing due to dysregulated re-epithelialization and excessive inflammation. Succinate, a key metabolic intermediate, is now understood to regulate inflammation through G Protein-Coupled Receptor 91 (GPR91) and succinate dehyd...

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Main Authors: Hengdeng Liu, Shixin Zhao, Hanwen Wang, Xuefeng He, Suyue Gao, Minmin Su, Miao Zhen, Shuying Chen, Lei Chen, Julin Xie
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Stem Cell Research & Therapy
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Online Access:https://doi.org/10.1186/s13287-025-04480-6
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author Hengdeng Liu
Shixin Zhao
Hanwen Wang
Xuefeng He
Suyue Gao
Minmin Su
Miao Zhen
Shuying Chen
Lei Chen
Julin Xie
author_facet Hengdeng Liu
Shixin Zhao
Hanwen Wang
Xuefeng He
Suyue Gao
Minmin Su
Miao Zhen
Shuying Chen
Lei Chen
Julin Xie
author_sort Hengdeng Liu
collection DOAJ
description Abstract Background Diabetic foot ulcers (DFU) typically exhibit impaired healing due to dysregulated re-epithelialization and excessive inflammation. Succinate, a key metabolic intermediate, is now understood to regulate inflammation through G Protein-Coupled Receptor 91 (GPR91) and succinate dehydrogenase (SDH), although its role in DFU remains unclear. Methods Co-cultures of M2 macrophages and epithelial cells, along with clinical samples, were used to analyze the expression of GPR91 and SDH. Functional assays were performed using high glucose (HG)-treated M2 macrophages (HG-M2) and an in vivo model. Cytokine and growth factor levels in cell supernatant were measured, and molecular mechanisms were explored via qRT-PCR, flow cytometry, and western blot analysis. Results Elevated glucose concentrations increased succinate levels and disrupted M2 macrophage–epidermal stem cells (EpSCs) interactions. GPR91 knockdown worsened HG-M2 dysfunction, while GPR91 overexpression (OE-GPR91) enhanced anti-inflammatory responses and reduced succinate. OE-GPR91-conditioned medium preserved EpSCs stemness and promoted migration mediated by hepatocyte growth factor (HGF). SDH inhibition (via Dimethyl malonate, DMM) boosted M2 macrophage activity by reducing reactive oxygen species (ROS) and upregulating Gpr91 expression. Mechanistically, GPR91 activated the pAkt/pGSK3β/β-catenin pathway, while DMM enhanced M2 macrophage function via the PI3K-Akt/pERK1/2 pathway. Conclusions GPR91 upregulation and SDH inhibition improve HG-M2 macrophage function, reduce inflammation, and enhance HGF-mediated EpSCs repair. Targeting both pathways may represent a promising approach to promote DFU healing.
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spelling doaj-art-39f9f47df02744e798b32b0e0958b85e2025-08-20T03:04:26ZengBMCStem Cell Research & Therapy1757-65122025-07-0116112110.1186/s13287-025-04480-6From inflammation to healing: the crucial role of GPR91 activation and SDH inhibition in chronic diabetic wound recoveryHengdeng Liu0Shixin Zhao1Hanwen Wang2Xuefeng He3Suyue Gao4Minmin Su5Miao Zhen6Shuying Chen7Lei Chen8Julin Xie9Department of Burns, Laboratory of General Surgery, The First Affiliated Hospital of SunYat-Sen UniversityDepartment of Traumatic Orthopedics, Henan Provincial People’s Hospital & the People’s Hospital of Zhengzhou UniversityDepartment of Burns, Laboratory of General Surgery, The First Affiliated Hospital of SunYat-Sen UniversityDepartment of Burns, Laboratory of General Surgery, The First Affiliated Hospital of SunYat-Sen UniversityDepartment of Burns, Laboratory of General Surgery, The First Affiliated Hospital of SunYat-Sen UniversityDepartment of Burns, Laboratory of General Surgery, The First Affiliated Hospital of SunYat-Sen UniversityDepartment of Burns, Laboratory of General Surgery, The First Affiliated Hospital of SunYat-Sen UniversityDepartment of Burns, Laboratory of General Surgery, The First Affiliated Hospital of SunYat-Sen UniversityDepartment of Burns, Laboratory of General Surgery, The First Affiliated Hospital of SunYat-Sen UniversityDepartment of Burns, Laboratory of General Surgery, The First Affiliated Hospital of SunYat-Sen UniversityAbstract Background Diabetic foot ulcers (DFU) typically exhibit impaired healing due to dysregulated re-epithelialization and excessive inflammation. Succinate, a key metabolic intermediate, is now understood to regulate inflammation through G Protein-Coupled Receptor 91 (GPR91) and succinate dehydrogenase (SDH), although its role in DFU remains unclear. Methods Co-cultures of M2 macrophages and epithelial cells, along with clinical samples, were used to analyze the expression of GPR91 and SDH. Functional assays were performed using high glucose (HG)-treated M2 macrophages (HG-M2) and an in vivo model. Cytokine and growth factor levels in cell supernatant were measured, and molecular mechanisms were explored via qRT-PCR, flow cytometry, and western blot analysis. Results Elevated glucose concentrations increased succinate levels and disrupted M2 macrophage–epidermal stem cells (EpSCs) interactions. GPR91 knockdown worsened HG-M2 dysfunction, while GPR91 overexpression (OE-GPR91) enhanced anti-inflammatory responses and reduced succinate. OE-GPR91-conditioned medium preserved EpSCs stemness and promoted migration mediated by hepatocyte growth factor (HGF). SDH inhibition (via Dimethyl malonate, DMM) boosted M2 macrophage activity by reducing reactive oxygen species (ROS) and upregulating Gpr91 expression. Mechanistically, GPR91 activated the pAkt/pGSK3β/β-catenin pathway, while DMM enhanced M2 macrophage function via the PI3K-Akt/pERK1/2 pathway. Conclusions GPR91 upregulation and SDH inhibition improve HG-M2 macrophage function, reduce inflammation, and enhance HGF-mediated EpSCs repair. Targeting both pathways may represent a promising approach to promote DFU healing.https://doi.org/10.1186/s13287-025-04480-6Succinate metabolismGPR91SDHM2 macrophagesEpSCsDiabetic wounds
spellingShingle Hengdeng Liu
Shixin Zhao
Hanwen Wang
Xuefeng He
Suyue Gao
Minmin Su
Miao Zhen
Shuying Chen
Lei Chen
Julin Xie
From inflammation to healing: the crucial role of GPR91 activation and SDH inhibition in chronic diabetic wound recovery
Stem Cell Research & Therapy
Succinate metabolism
GPR91
SDH
M2 macrophages
EpSCs
Diabetic wounds
title From inflammation to healing: the crucial role of GPR91 activation and SDH inhibition in chronic diabetic wound recovery
title_full From inflammation to healing: the crucial role of GPR91 activation and SDH inhibition in chronic diabetic wound recovery
title_fullStr From inflammation to healing: the crucial role of GPR91 activation and SDH inhibition in chronic diabetic wound recovery
title_full_unstemmed From inflammation to healing: the crucial role of GPR91 activation and SDH inhibition in chronic diabetic wound recovery
title_short From inflammation to healing: the crucial role of GPR91 activation and SDH inhibition in chronic diabetic wound recovery
title_sort from inflammation to healing the crucial role of gpr91 activation and sdh inhibition in chronic diabetic wound recovery
topic Succinate metabolism
GPR91
SDH
M2 macrophages
EpSCs
Diabetic wounds
url https://doi.org/10.1186/s13287-025-04480-6
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