Synergistic Wound Healing: Unraveling the Multi-Target Effects of Traditional Chinese Medicine and Its Biomaterials on Chronic Wound Pathways

作者：Jiayu Shen, Zhuo Tong, Bing Han, Ziyin Zhang, Zudan Xian, Yuan Yao, Xinliang Duan, Sichen Han, Peng Liu, Zilin Wang · 发表于：International Journal of Nanomedicine · 年份：2025 · DOI：10.2147/ijn.s513585 · 被引用次数：23 · 研究领域：Wound Healing and Treatments、Acupuncture Treatment Research Studies、Diabetic Foot Ulcer Assessment and Management

Chronic wounds, including diabetic ulcers (DUs), radiation-induced ulcers, and burns, present significant clinical challenges due to their distinct pathological mechanisms, necessitating tailored therapeutic strategies. Diabetic ulcers, characterized by impaired angiogenesis, persistent inflammation, and hyperglycemia, require dual modulation of inflammatory (NF-κB) and pro-repair (PI3K/Akt, Nrf2) pathways. Radiation ulcers involve DNA damage, NLRP3-driven inflammation, and TGF-β/Smad-mediated fibrosis, while burns trigger acute inflammation via DAMPs/PAMPs-TLR/NLR activation. Traditional Chinese medicine (TCM) and its bioactive components, such as Scutellaria baicalensis, curcumin, and Panax notoginseng, exhibit multi-target therapeutic effects by regulating oxidative stress, inflammation, angiogenesis, and extracellular matrix remodeling through key pathways, including Nrf2/ARE, MAPK, NF-κB, PI3K/Akt, HIF-1α/VEGF, Wnt/β-catenin, and TGF-β/Smad. Emerging supramolecular self-assembled biomaterials-nanofibrous scaffolds, hydrogels, and microneedles-address the hydrophobicity and low bioavailability of natural plant-derived macromolecules (NPHMs), enabling spatiotemporally controlled drug delivery. Innovative formulations, such as curcumin-loaded hydrogels and exosome-based systems, enhance antioxidant, anti-inflammatory, and pro-angiogenic activities, accelerating wound closure. Despite progress, challenges remain in optimizing multifunctional co-assembly systems, elucidating ...