Guo YL, Niu WJ, Jiao HR, Li YP, Xu C, Zhou X, Wang J. Crosstalk between oxidative stress and inflammatory pathways: Natural therapeutic approaches for diabetic wound healing. World J Diabetes 2025; 16(11): 111400 [DOI: 10.4239/wjd.v16.i11.111400]
Corresponding Author of This Article
Jun Wang, MD, Professor, Department of Wound and Vascular Surgery, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture Moxibustion, No. 88 Changling Road, Xiqing District, Tianjin 300381, China. tjzywangjun@126.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Nov 15, 2025; 16(11): 111400 Published online Nov 15, 2025. doi: 10.4239/wjd.v16.i11.111400
Crosstalk between oxidative stress and inflammatory pathways: Natural therapeutic approaches for diabetic wound healing
Yan-Ling Guo, Wen-Jing Niu, Hao-Ran Jiao, Yun-Ping Li, Chuan Xu, Xin Zhou, Jun Wang
Yan-Ling Guo, Wen-Jing Niu, Hao-Ran Jiao, Yun-Ping Li, Jun Wang, Department of Wound and Vascular Surgery, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture Moxibustion, Tianjin 300381, China
Chuan Xu, Department of Pharmacy, Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Huzhou 313000, Zhejiang Province, China
Xin Zhou, Department of Science and Education, Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Huzhou 313000, Zhejiang Province, China
Co-corresponding authors: Xin Zhou and Jun Wang.
Author contributions: Zhou X and Wang J conceptualized and designed the review. Guo YL, Niu WJ, Jiao HR, Li YP, and Xu C contributed to data collection and manuscript editing; Guo YL drafted the initial version of the manuscript and prepared the first drafts of the figures and tables. All authors have read and approved the final version of the manuscript. As co-corresponding authors, Zhou X and Wang J made essential and complementary contributions to the completion of this review. Wang J provided overall academic guidance, supervised the writing process, and critically reviewed the references to ensure their accuracy and relevance. Zhou X contributed to topic selection, figure and table refinement, and was responsible for the final integration, revision, and submission of the manuscript. Their collaboration was essential for the successful completion and publication of this review article.
Supported by National Natural Science Foundation of China, No. 81973854; Scientific Research Programme Project of Hebei Provincial Administration of Traditional Chinese Medicine, No. T2025095; the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine ‘Tuoxin Project’ Fund Scientific Research Topics, No. 2023012; and Key Project of the Huzhou City Science and Technology Plan, No. 2023GZ83.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Wang, MD, Professor, Department of Wound and Vascular Surgery, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture Moxibustion, No. 88 Changling Road, Xiqing District, Tianjin 300381, China. tjzywangjun@126.com
Received: June 30, 2025 Revised: July 28, 2025 Accepted: September 26, 2025 Published online: November 15, 2025 Processing time: 138 Days and 21 Hours
Abstract
Oxidative stress and inflammation are closely interrelated processes that are pivotal to the impaired wound healing associated with diabetes. Chronic hyperglycemia in diabetic patients induces excessive reactive oxygen species (ROS) production, which triggers heightened inflammatory responses. The resulting inflammation exacerbates oxidative damage, delays wound closure, and intensifies tissue injury, thereby creating a detrimental cycle that disrupts normal wound healing. Recent research has increasingly focused on the therapeutic potential of natural products in modulating oxidative stress and inflammation to enhance diabetic wound healing. Natural compounds, such as polyphenols, flavonoids, and terpenoids, have demonstrated significant efficacy in reducing oxidative damage and modulating inflammatory pathways. These bioactive agents exhibit potent antioxidant activity by scavenging ROS and enhancing endogenous antioxidant defenses while concurrently inhibiting the release of proinflammatory cytokines. Additionally, natural therapies have been shown to promote angiogenesis, enhance collagen synthesis, and improve fibroblast function, further facilitating wound repair. This review provides insights into the complex interplay between oxidative stress and inflammation in diabetic wound healing and evaluates the therapeutic potential of natural products as adjunctive treatments. Further clinical investigations are essential to validate the efficacy and safety of these natural interventions for diabetic wound management.
Core Tip: Oxidative stress and inflammation significantly impede wound healing in diabetes through a complex interactive mechanism. Natural therapeutic agents, including polyphenols, flavonoids, and terpenoids, have shown promise in mitigating oxidative damage and inflammatory responses and promoting angiogenesis, collagen deposition, and fibroblast function. This review highlights the intricate crosstalk between oxidative stress and inflammatory pathways in diabetic wound healing and underscores the potential of natural products as adjunctive therapies, emphasizing the need for further clinical validation to establish their efficacy and safety.
