Pakistan journal of pharmaceutical sciences
Berberine improves diabetic foot ulcer healing after tibial transverse osteotomy by inhibiting the PDGF-B/PDGFRβ signaling pathway
By Zhang R and Jiang H.
Abstract
Background
Tibial transverse osteotomy (TTO) is a promising but limited surgical option for diabetic foot (DF). Berberine, a natural compound from Coptis chinensis, exhibits anti-inflammatory and pro-angiogenic effects relevant to metabolic diseases.
Objectives
This study aimed to evaluate whether adjunctive berberine enhances the therapeutic outcomes of TTO in DF patients and to explore its potential association with the platelet-derived growth factor-B (PDGF-B)/PDGF receptor-β (PDGFRβ) signaling pathway.
Methods
This was a prospective, single-center, randomized, placebo-controlled, parallel-group, blinded trial. Of 200 screened DF patients, 96 eligible participants (Wagner grade 2-4) scheduled for TTO were randomized 1:1 to receive either TTO plus local berberine injections (n=48) or TTO plus local saline placebo (n=48). An additional non-randomized diabetic reference group (n=10) and healthy control group (n=10) were included for exploratory cellular studies only. The primary outcome was the total effective rate of ulcer healing at 3 months. Secondary outcomes included changes in Ankle-Brachial Index (ABI), ulcer area, Visual Analogue Scale (VAS) pain score and serum inflammatory markers (hs-CRP, IL-6). Exploratory outcomes comprised serum VEGF, bFGF and PDGF-B levels, as well as fibroblast apoptosis in wound tissue.