SIRT3 improves bone regeneration and rescues diabetic fracture healing by regulating oxidative stress

Diabetes mellitus (DM), a chronic metabolic disorder caused by uncontrolled high blood glucose levels due to insufficient insulin secretion or insulin resistance, is one of the most common metabolic diseases globally and is responsible for severe socio-economic burden. DM is associated with impaired fracture healing caused by oxidative stress induced-excessive bone resorption. Sirtuin3 (SIRT3), predominantly located in mitochondria, offers great influence on mitochondrial homeostasis, oxidative stress and immune cell function. However, the exact effect of SIRT3 on fracture healing with DM still remains to be elucidated. The present study demonstrated that SIRT3 expression was diminished in diabetic fracture healing and genetic deletion of SIRT3 increased mitochondrial oxidative stress and delayed diabetic bone healing via exacerbating the impact of DM on cartilage and osteoclast. The Honokiol (HKL) extracted from bark of magnolia trees, is a small molecular weight compound with various pharmaceutical properties by activating SIRT3. Our study proved that the SIRT3 agonist HKL could partially reverse the effect of diabetes on fracture healing, which provides a new promising approach for improving fracture healing in DM.