Chronic diabetic wounds are at lifelong risk of developing diabetic foot ulcers owing to severe hypoxia, excessive reactive oxygen species (ROS), a complex inflammatory microenvironment, and the potential for bacterial infection. Here we develop a programmed treatment strategy employing live Haematococcus (HEA). By modulating light intensity, HEA can be programmed to perform a variety of functions, such as antibacterial activity, oxygen supply, ROS scavenging, and immune regulation, suggesting its potential for use in programmed therapy. Under high light intensity (658 nm, 0.5 W/cm²), green HEA (GHEA) with efficient photothermal conversion mediate wound surface disinfection. By decreasing the light intensity (658 nm, 0.1 W/cm²), the photosynthetic system of GHEA can continuously produce oxygen, effectively resolving the problems of hypoxia and promoting vascular regeneration. Continuous light irradiation induces astaxanthin (AST) accumulation in HEA cells, resulting in a gradual transformation from a green to red hue (RHEA). RHEA effectively scavenges excess ROS, enhances the expression of intracellular antioxidant enzymes, and directs polarization to M2 macrophages by secreting AST vesicles via exosomes. The living HEA hydrogel can sterilize and enhance cell proliferation and migration and promote neoangiogenesis, which could improve infected diabetic wound healing in female mice.

由于严重缺氧、活性氧（ROS）过多、复杂的炎症微环境以及细菌感染的可能性，慢性糖尿病伤口终生都有患糖尿病足溃疡的风险。在这里，我们开发了一种利用活红球藻 (HEA) 的程序化治疗策略。通过调节光强度，HEA 可以被编程来执行多种功能，例如抗菌活性、供氧、ROS 清除和免疫调节，这表明其在程序化治疗中的应用潜力。在高光强度（658 nm，0.5 W/cm ² ）下，具有高效光热转换的绿色HEA（GHEA）介导创面消毒。通过降低光强度（658 nm，0.1 W/cm ² ），GHEA的光合系统可以持续产生氧气，有效解决缺氧问题，促进血管再生。连续的光照射会诱导 HEA 细胞中虾青素 (AST) 的积累，导致细胞颜色逐渐从绿色转变为红色 (RHEA)。 RHEA有效清除多余的ROS，增强细胞内抗氧化酶的表达，并通过外泌体分泌AST囊泡将极化引导至M2巨噬细胞。活的HEA水凝胶可以消毒并增强细胞增殖和迁移并促进新血管生成，从而可以改善雌性小鼠感染的糖尿病伤口的愈合。