Int J Biol Macromol. 2026 Mar 30. pii: S0141-8130(26)01666-1. [Epub ahead of print]
151740
BACKGROUND: Diabetic foot ulcer (DFU) is a complication of diabetes, characterized by impaired healing and chronic wounds that compromise quality of life. Migrasomes are newly discovered organelles involved in processes such as morphogenesis and angiogenesis, but their role in tissue repair and diabetic wound healing remains unknown. This study investigated the involvement of migrasomes in the pathogenesis and repair of DFU.
METHODS: Public DFU transcriptomic datasets from the Gene Expression Omnibus (GEO) were analyzed with DESeq2 to identify differentially expressed migrasome-related genes (DEMRGs). Machine-learning algorithms were applied to screen key DEMRGs and evaluate their associations with the immune microenvironment. Single-cell RNA sequencing (scRNA-seq) data were used to determine cell type-specific expression patterns. In addition, in vitro experiments were conducted to determine how the prioritized DEMRG regulates signaling pathways and modulates endothelial proliferation and migration. Finally, a diabetic murine wound model was established, and an endothelial-targeting adeno-associated virus (AAV) was used to overexpress the prioritized gene in vivo, followed by assessment of wound closure, histological repair, migrasome-associated membranous signals, and the activation of related signaling pathways.
RESULTS: RNA-sequencing analysis identified Tetraspanin 7 (TSPAN7) as a key DEMRG with strong diagnostic potential for DFU. scRNA-seq data demonstrated endothelial-specific downregulation of TSPAN7 in DFU lesions, which was confirmed by immunohistochemistry (IHC) and western blot in human DFU tissues. Wheat germ agglutinin (WGA) fluorescence staining showed that TSPAN7 overexpression increased migrasome formation in endothelial cells. Functionally, TSPAN7 overexpression promoted endothelial proliferation and migration, activated the PI3K/AKT signaling pathway, and upregulated vascular endothelial growth factor (VEGF). In diabetic mice, endothelial-specific Tspan7 overexpression consistently accelerated wound healing, improved re-epithelialization and collagen deposition, increased CD31 immunoreactivity, enhanced PIGK/TSPAN7 signals on WGA-labeled membranous structures, and restored PI3K/AKT phosphorylation in wound tissues.
CONCLUSION: In diabetic wounds, migrasome formation capacity is impaired. Restoring TSPAN7 expression activates PI3K/AKT signaling, thereby promoting angiogenesis and wound repair. TSPAN7-mediated migrasome formation represents a novel mechanism in DFU and a promising therapeutic target for enhancing healing in diabetic wounds.
Keywords: Diabetic foot ulcer; Machine learning; Migrasomes; PI3K/AKT pathway; Single cell; TSPAN7