Regulatory T Cells in Diabetic Wound Healing: A Comprehensive Review

Jiezhi Lin,1,2,* Yingying Liu,1,* Peiyao Min,1,* Hui Zhao,2 Zhaofan Xia,1 Yongjun Zheng1 1Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China; 2Department of Burn Surgery, The 963rd Hospital of Joint Logistics Support Force of PLA, Jiamusi, Heilongjiang, 154007, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yongjun Zheng, Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, 168th Changhai Road, Yangpu District, Shanghai, 200433, People’s Republic of China, Email smmuzhengyongjun@163.com Hui Zhao, Email 397919611@qq.comAbstract: Patients with diabetes frequently face challenges associated with impaired wound healing, which is a serious clinical concern. Regulatory T cells (Tregs) are essential immune modulators that are integral to wound healing. While research is increasingly examining alterations in Tregs and their potential impacts on diabetic wound healing, a comprehensive review is lacking. This review employs a narrative approach to summarize the current knowledge regarding the mechanisms by which Tregs influence wound healing in diabetes, focusing on their impact on inflammatory responses, cellular regeneration, and angiogenesis. Furthermore, we investigated the potential therapeutic applications of Tregs in diabetic wound healing, highlighting recent advances in biomaterials, molecular pathways, and regulatory strategies targeting Tregs. Despite challenges such as cell acquisition and quality control, as well as risks like immunosuppression and infection, advancements in clinical studies indicate that Tregs could be a promising new treatment for diabetes. This review aims to provide novel insights and directions by analyzing the most recent literature on future therapeutic strategies for managing diabetic wounds.