Germacrone promotes diabetic ulcer healing via Hedgehog pathway activation

Diabetic ulcers (DUs) are characterized by delayed repair, persistent inflammation, and impaired angiogenesis, and effective topical treatments remain limited.

To investigate the therapeutic effects and mechanisms of Germacrone in DU healing.

Network pharmacology and molecular docking were utilized to predict therapeutic targets. In vitro assays evaluated Germacrone's biological effects and pathway dependence. The effects of Germacrone on diabetic wound healing were assessed in a streptozotocin (STZ)-induced diabetic mouse model.

Network pharmacology analysis identified angiogenesis-related Hedgehog signaling as a potential pathway mediating the effects of Germacrone in DUs. Molecular docking showed favorable binding between Germacrone and the Hedgehog-related regulatory molecule GSK3B, with a predicted binding energy of -7.3 kcal/mol, and CETSA further supported intracellular target engagement between Germacrone and GSK3B. In vitro experiments showed that Germacrone suppressed GSK3B kinase activity, as indicated by increased inhibitory phosphorylation of GSK3B at Ser9 and reduced phosphorylation of β-catenin. Moreover, Germacrone promoted HUVEC proliferation, reduced IL-1β and IL-6 mRNA expression, increased Hedgehog-related protein expression, and enhanced HUVEC migration and tube formation. Importantly, Hedgehog pathway inhibition with GANT61 attenuated the promotive effects of Germacrone on HUVEC migration and tube formation, suggesting dependence on Hedgehog signaling. In STZ-induced diabetic mice, Germacrone markedly accelerated wound closure, enhanced Hedgehog signaling and angiogenesis, suppressed inflammatory activation, and improved re-epithelialization.

Germacrone effectively promotes DU healing by activating the Hedgehog signaling pathway, enhancing angiogenesis, and reducing inflammation. This study highlights Germacrone as a promising therapeutic candidate for DUs.