A collagen-based amniotic membrane scaffold combined with photobiomodulation accelerates wound repair in diabetic rats through modulation of inflammation and tissue regeneration

Chronic diabetic wounds present significant challenges to effective tissue repair due to persistent inflammation and impaired regeneration. In this study, we investigated the therapeutic potential of a bioengineered collagen scaffold derived from the human amniotic membrane (CSAM), used alone or in combination with photobiomodulation therapy (PBMT), in a diabetic rat wound model. Forty diabetic rats were allocated into four groups: control, CSAM, PBMT, and CSAM+PBMT. Wound healing was assessed on days 4 and 8 post-injury. Combined treatment (CSAM+PBMT) significantly enhanced wound closure and histological regeneration, with notable increases in fibroblast and blood vessel density, epidermal and dermal thickness, collagen deposition, and expression levels of VEGF and bFGF compared to other groups. Additionally, this group exhibited a marked reduction in neutrophil infiltration and pro-inflammatory cytokines, including IL-1β, TNF-α, and NF-κB. These results demonstrate that the synergistic application of PBMT and CSAM fosters a pro-regenerative wound microenvironment by suppressing inflammation and promoting cellular proliferation and extracellular matrix remodeling. This combinatory approach offers a promising therapeutic avenue for improving diabetic wound healing outcomes.