Abnormal fibroblast function underlies poor wound healing in patients with diabetes; however, the mechanisms that impair wound healing are poorly defined. Here, we evaluated fibroblasts from individuals who had
type 1 diabetes (T1D) for 50 years or more (Medalists, n = 26) and from age-matched controls (n = 7). Compared with those from controls, Medalist fibroblasts demonstrated a reduced migration response to
insulin, lower
VEGF expression, and less phosphorylated AKT (p-AKT), but not p-ERK, activation. Medalist fibroblasts were also functionally less effective at
wound closure in nude mice. Activation of the δ
isoform of
protein kinase C (PKCδ) was increased in postmortem fibroblasts from Medalists, fibroblasts from living T1D subjects, biopsies of active
wounds of living T1D subjects, and granulation tissues from mice with
streptozotocin-induced diabetes. Diabetes-induced PKCD
mRNA expression was related to a 2-fold increase in the
mRNA half-life. Pharmacologic inhibition and
siRNA-mediated knockdown of PKCδ or expression of a dominant-negative
isoform restored
insulin signaling of p-AKT and
VEGF expression in vitro and improved wound healing in vivo. Additionally, increasing PKCδ expression in control fibroblasts produced the same abnormalities as those seen in Medalist fibroblasts. Our results indicate that persistent PKCδ elevation in fibroblasts from diabetic patients inhibits
insulin signaling and function to impair wound healing and suggest PKCδ inhibition as a potential
therapy to improve wound healing in diabetic patients.