Targeting Wnt/ß-catenin signaling and its interplay with TGF-ß and Notch signaling pathways for the treatment of chronic wounds.

ABSTRACT

Wound healing is a tightly regulated process that ensures tissue repair and normal function following injury. It is modulated by activation of pathways such as the transforming growth factor-beta (TGF-ß), Notch, and Wnt/ß-catenin signaling pathways. Dysregulation of this process causes poor wound healing, which leads to tissue fibrosis and ulcerative wounds. The Wnt/ß-catenin pathway is involved in all phases of wound healing, primarily in the proliferative phase for formation of granulation tissue. This review focuses on the role of the Wnt/ß-catenin signaling pathway in wound healing, and its transcriptional regulation of target genes. The crosstalk between Wnt/ß-catenin, Notch, and the TGF-ß signaling pathways, as well as the deregulation of Wnt/ß-catenin signaling in chronic wounds are also considered, with a special focus on diabetic ulcers. Lastly, we discuss current and prospective therapies for chronic wounds, with a primary focus on strategies that target the Wnt/ß-catenin signaling pathway such as photobiomodulation for healing diabetic ulcers.