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T cell populations in CKD exhibit a shift toward pro-inflammatory phenotypes, with reduced regulatory T cell function, which fails to suppress excessive immune responses, thereby sustaining inflammation and tissue injury ( FIGURE 2 Dysbiosis of the gut microbiota leads to the disruption of tryptophan metabolism (resulting in the production of toxins such as IS and the entry of lipopolysaccharides (LPS) into the bloodstream (40)

All statistical analyses were performed using RevMan 5.4.1 and Stata 15.0

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In the present study, esculin treatment resulted in a marked upregulation of bFGF and VEGF expression compared to diabetic control wounds, indicating enhanced fibroblast activity and angiogenic signaling