DOI: 10.37349/ei.2026.1003269 ISSN: 2768-6655

Immunomodulation: scope and limitations in promoting diabetic foot ulcer healing

Vikrant Rai
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Diabetic foot ulcer (DFU) is a chronic inflammatory disease because of persistent hyperglycemia. The pathophysiology of DFUs is mediated by chronic inflammation, decreased angiogenesis, and altered extracellular matrix (ECM) remodeling. Impaired immune response halts the DFUs in the inflammatory phase of healing without progressing them to the resolution phase, resulting in delayed healing. This suggests that immunomodulation of the DFU microenvironment may be beneficial in promoting wound healing by subsiding chronic inflammation, promoting angiogenesis, and ECM remodeling. This narrative review focuses on summarizing the upcoming strategies and research in immunomodulation to promote healing in DFUs in recent years. The review has discussed the role of small molecules, exosomes, hydrogels, and natural compounds tested in preclinical trials to promote wound healing, followed by the limitations and future directions.

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