The Crosstalk Between Efferocytosis and Macrophage Polarization in Diabetic Wound Healing
Summary: This review examines the critical interplay between efferocytosis (phagocytic clearance of apoptotic cells) and macrophage polarization in diabetic wound healing. In normal healing, timely efferocytosis shifts macrophages from pro-inflammatory M1 to pro-resolving M2 phenotype, promoting inflammation resolution, angiogenesis, and tissue repair. In diabetes, hyperglycemia and oxidative stress impair efferocytosis, leading to prolonged M1 dominance, excessive inflammation, delayed granulation, and chronic non-healing ulcers (DFUs). Discusses molecular pathways (e.g., MerTK, LXR, PPARγ) and potential therapeutic strategies to restore efferocytosis and M2 polarization. Highlights efferocytosis as an emerging target to break the cycle of chronic inflammation in diabetic wounds.
Key Highlights:
- Efferocytosis drives M1-to-M2 macrophage switch in normal healing
- Impaired in diabetes → prolonged inflammation and stalled repair
- Therapeutic potential: Restore efferocytosis for better DFU outcomes
- Relevance: Novel mechanistic target in chronic diabetic wound care
Keywords: efferocytosis, macrophage polarization, diabetic wound healing, M1 M2 shift