Fespixon Cream in Diabetic Foot Ulcer Healing

NewsBot · Jul 30, 2025

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Revealing the Multi-Target Mechanisms of Fespixon Cream in Diabetic Foot Ulcer Healing: Integrated Network Pharmacology, Molecular Docking, and Clinical RT-qPCR Validation
Tianbo Li et al
Curr Issues Mol Biol. 2025 Jun 25;47(7):485. doi: 10.3390/cimb47070485.

Objective: This study aims to elucidate the potential mechanisms by which Fespixon cream promotes diabetic foot ulcer (DFU) healing using network pharmacology, molecular docking, and RT-qPCR validation in clinical tissue samples. Methods: Active components of Fespixon cream were screened from the Traditional Chinese Medicine Systems Pharmacology Database (TCMSP) and relevant literature, and their corresponding targets were standardized using the Universal Protein Resource (UniProt) database. Diabetic foot ulcer (DFU)-related targets were retrieved and filtered from the GeneCards database and the Online Mendelian Inheritance in Man (OMIM) database. The intersection of drug and disease targets was identified, and a protein-protein interaction (PPI) network was constructed using the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database. The interaction network was visualized using Cytoscape version 3.7.2 software. The potential mechanisms of the shared targets were analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis using R software packages, and results were visualized through Bioinformatics online tools. Molecular docking was performed to validate the binding between key active compounds of Fespixon cream and core DFU targets using AutoDock Vina version 1.1.2 and PyMOL software. Furthermore, RT-qPCR analysis was performed on wound edge tissue samples from DFU patients treated with Fespixon cream to experimentally verify the mRNA expression levels of predicted hub genes. Results: Network pharmacology analysis identified eight active compounds in Fespixon cream, along with 153 potential therapeutic targets related to diabetic foot ulcer (DFU). Among these, 21 were determined as core targets, with the top five ranked by degree value being RAC-αserine/threonine-protein kinase (AKT1), Cellular tumor antigen p53 (TP53), Tumor necrosis factor (TNF), Interleukin-6 (IL6), and Mitogen-activated protein kinase 1 (MAPK1). GO enrichment analysis indicated that the targets of Fespixon cream were primarily involved in various biological processes related to cellular stress responses. KEGG pathway enrichment revealed that these targets were significantly enriched in pathways associated with diabetic complications, atherosclerosis, inflammation, and cancer. Molecular docking confirmed stable binding interactions between the five major active compounds-quercetin, apigenin, rosmarinic acid, salvigenin, and cirsimaritin-and the five core targets (AKT1, TP53, TNF, IL6, MAPK1). Among them, quercetin exhibited the strongest binding affinity with AKT1. RT-qPCR validation in clinical DFU tissue samples demonstrated consistent expression trends with computational predictions: AKT1 was significantly upregulated, while TP53, TNF, IL6, and MAPK1 were markedly downregulated in the Fespixon-treated group compared to controls (p < 0.001), supporting the proposed multi-target therapeutic mechanism. Conclusions: Our study reveals the potential mechanisms by which Fespixon cream exerts therapeutic effects on DFUs. The efficacy of Fespixon cream in treating DFUs is attributed to the synergistic actions of its bioactive components through multiple targets and multiple signaling pathways.
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NewsBot · Jul 30, 2025

AI Overview
Fespixon, also known as ON101, is a topical cream used to treat diabetic foot ulcers (DFUs). It works by regulating macrophages to promote tissue repair and wound healing. The active ingredients are extracts from Centella asiatica and Plectranthus amboinicus, which have shown effectiveness in clinical trials.
Key Features:

Macrophage Regulation:
Fespixon is a novel drug that targets and regulates macrophages, which are immune cells involved in wound healing. It shifts the microenvironment from one dominated by pro-inflammatory M1 macrophages to one dominated by M2 macrophages, which promote tissue repair.

Botanical Extracts:
The cream contains two standardized botanical extracts:

Plectranthus amboinicus (PA-F4): Exhibits anti-inflammatory properties by suppressing the NLRP3 inflammasome, a protein complex involved in inflammation.

Centella asiatica (S1): Promotes angiogenesis (formation of new blood vessels), fibroblast proliferation (cell growth), and collagen synthesis, all crucial for wound healing.

Clinical Efficacy:
In a phase III clinical trial, Fespixon demonstrated significantly higher wound closure rates compared to standard treatment. A publication in JAMA Network Open reported on the results of this trial.

Multi-target Action:
The cream's efficacy is attributed to its ability to modulate multiple signaling pathways involved in oxidative stress, macrophage polarization, and extracellular matrix remodeling, making it a more comprehensive approach compared to single-target therapies.

Commercialization:
Fespixon is approved and marketed in Taiwan and is under review for regulatory approval in other major markets like China, Singapore, Malaysia, and more. It has also received fast-track designation from the US FDA.

In essence, Fespixon represents a breakthrough in DFU treatment by offering a macrophage-regulating, etiology-driven solution with proven clinical efficacy and a multi-target mechanism of action.

NewsBot · Aug 3, 2025

Real-World Effectiveness and Dose-Response of ON101 Therapy for Healing of Diabetic Foot Ulcers
Shun-Cheng Chang et al
Mayo Clin Proc. 2025 Aug 2:S0025-6196(25)00076-X.

Objective: To evaluate the real-world effectiveness and dose-response of ON101 , especially for high-risk patients with poor healing outcomes.

Patients and methods: ON101 cream, a novel treatment for diabetic foot ulcers (DFUs), modulates the function of macrophages and accelerates the emergence and expansion of anti-inflammatory properties. In this study, 80 and 98 patients with DFU who were treated using ON101 and standard care with adjuvant therapy (denoted as nonuse), respectively, from January 1, 2020, to December 31, 2022, were identified from Taipei Medical University-Shuang Ho Hospital, Taiwan. The primary outcome was a complete healing event within 120 days following treatment initiation. Secondary outcomes included ulcer recurrence, amputation, and all-cause mortality within 1 year of follow-up. Cox proportional hazard model analysis was applied to determine the treatment effect on study outcomes. The dose-response of ON101 on healing outcomes was modeled using a regression analysis.

Results: Compared with nonuse, ON101 use significantly increased the complete healing outcome by 79% (HR, 1.79; 95% CI, 1.24 to 2.58), with an average of 1.85 ON101 tubes used per person with healed ulcers. Favorable healing outcomes were consistently shown in the analyses of high-risk patients. The dose-response analysis results suggest 25%, 107%, 33%, and 19% decreases in the ulcer size per additional ON101 tube use for all study patients and those with Wagner grade 1, 2, and 3 ulcers, respectively (all P<.01).

Conclusion: Promising healing outcomes following ON101 therapy at lower doses among real-world patients with DFU are corroborated, with a potential therapeutic benefit for clinically disadvantaged patients and practical feasibility for use in routine practice.
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NewsBot · Aug 20, 2025

Enhancing diabetic foot wound healing with topical macrophage-regulating cream (ON101): a case series
Kwan Lok Benjamin et al
Journal of Wound Care Volume 34, Number Sup8

Objective:
A number of treatments have been developed to treat hard-to-heal (chronic) diabetic foot ulcers (DFUs). This case series the use of ON101—a new topical macrophage regulatory cream for the treatment of DFUs, that helped achieve limb-salvage outcomes with an adequate safety profile.
Method:
Patients with hard-to-heal DFUs—primarily on the toes and plantar surfaces—were enrolled in the study. After infection control, wound debridement or angioplasty intervention, ON101, containing 1.25% extracts of Plectranthus amboinicus (0.25%) and Centella asiatica (1%), was applied topically to the wounds up to twice daily. The condition of the wounds, complications, healing progression and other details were documented.
Results:
In total, 10 patients, with a mean age of 59.2 years (range: 35−77 years), were included in the study following surgical debridement, sequestrectomy or revascularisation. Wound sizes ranged from 1—66 cm2. After receiving ON101 treatment for durations ranging from 14–264 days, most wounds healed without complications, except for one patient with osteomyelitis who did not fully recover. All patients expressed satisfaction with the outcomes and had no reported complications at the six-month follow-up.
Conclusion:
This case series demonstrated the real-world outcomes of ON101, which exhibited good healing efficacy in the treatment of DFUs, making it a promising strategy for the topical treatment of these ulcers.
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Fespixon Cream in Diabetic Foot Ulcer Healing

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Fespixon Cream in Diabetic Foot Ulcer Healing

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Efficacy of LL-37 cream in enhancing healing of diabetic foot ulcer

Lysine cream for diabetic foot ulcers

Anti-fungal cream vs powder

Topical 1% propranolol cream for diabetic wounds

EMLA cream prior to verruca treatment

Interleukin 2 Topical Cream for Treatment of Diabetic Foot Ulcer:

Effect of Lavender Cream with or without Foot-bath on Anxiety, Stress and Depression

Share This Page

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