Modulation of Xanthine metabolism ameliorates inflammation and accelerates diabetic wound healing

Abstract Wound healing in diabetic patients is impaired because of dysregulated innate immune response that results in a chronic inflammatory state. It has been shown by our group and others that metabolites can contribute to a state of chronic inflammation in diabetic tissues. In a murine model of Type-2 diabetes (diet-induced obese mice; DIO), we assessed role of uric acid in driving macrophage-mediated inflammation and delayed wound healing. Using liquid chromatography-mass spectrometry, we show that macrophages from DIO mice have reduced levels of xanthine, a precursor in the uric acid pathway. Xanthine is converted to uric acid via Xanthine oxidase/dehydrogenase (XOR) encoded by the Xdh gene. DIO macrophages express higher levels of Xdh and increased levels of uric acid, suggesting increased XOR activity. Further, exogenous addition of uric acid led to increased production of IL-1β by macrophages. Importantly, pharmacologic inhibition of XOR with Allopurinol resulted in reduced levels of IL-1β expression by macrophages. In order to examine this in vivo, DIO mice were treated with Allopurinol leading to significantly improved wound healing. In summary, our data suggest that the xanthine metabolic pathway can be targeted therapeutically to accelerate wound healing in diabetic patients.