Blocking Interleukin-1β Induces a Healing-Associated Wound Macrophage Phenotype and Improves Healing in Type 2 Diabetes

  1. Timothy J. Koh1,3
  1. 1Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
  2. 2Department of Surgery, University of Illinois at Chicago, Chicago, Illinois
  3. 3Center for Tissue Repair and Regeneration, University of Illinois at Chicago, Chicago, Illinois
  1. Corresponding author: Timothy J. Koh, tjkoh{at}uic.edu.

Abstract

Diabetes is associated with persistent inflammation and defective tissue repair responses. The hypothesis of this study was that interleukin (IL)-1β is part of a proinflammatory positive feedback loop that sustains a persistent proinflammatory wound macrophage phenotype that contributes to impaired healing in diabetes. Macrophages isolated from wounds in diabetic humans and mice exhibited a proinflammatory phenotype, including expression and secretion of IL-1β. The diabetic wound environment appears to be sufficient to induce these inflammatory phenomena because in vitro studies demonstrated that conditioned medium of both mouse and human wounds upregulates expression of proinflammatory genes and downregulates expression of prohealing factors in cultured macrophages. Furthermore, inhibiting the IL-1β pathway using a neutralizing antibody and macrophages from IL-1 receptor knockout mice blocked the conditioned medium–induced upregulation of proinflammatory genes and downregulation of prohealing factors. Importantly, inhibiting the IL-1β pathway in wounds of diabetic mice using a neutralizing antibody induced a switch from proinflammatory to healing-associated macrophage phenotypes, increased levels of wound growth factors, and improved healing of these wounds. Our findings indicate that targeting the IL-1β pathway represents a new therapeutic approach for improving the healing of diabetic wounds.

Footnotes

  • Received October 19, 2012.
  • Accepted March 8, 2013.

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  1. Diabetes vol. 62 no. 7 2579-2587
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