In a mouse model of severe infection, giving diosgenin – a natural compound from yams – helped more mice survive by lowering inflammation and keeping the gut lining intact. It also boosted the mouse version of the antimicrobial peptide LL‑37 and dampened a key inflammatory pathway (TLR4/MyD88).

Diosgenin, a well-known steroid sapogenin, has demonstrated anti-inflammatory effects; however, its therapeutic potential for sepsis remains unclear. Intestinal barrier dysfunction is a critical contributor to lethal sepsis, a systemic inflammatory response syndrome. This study investigated the protective effects of diosgenin on cecal ligation and puncture (CLP)-induced sepsis in mice, focusing on its impact on intestinal mucosal dysfunction and inflammation. Additionally, the effects of diosgenin on the expression of the endogenous antimicrobial peptide mCRAMP and the TLR4/MyD88 signaling pathway were investigated. Sepsis was induced in male C57BL/6 mice via CLP. Survival rates were recorded, and serum and ileum tissue levels of TNF-α and IL-6 were quantified to assess the protective efficacy of diosgenin treatment. Intestinal barrier integrity was evaluated by hematoxylin and eosin (H&E) staining, while mucosal permeability was determined using serum D-lactic acid. Tight junction (TJ) proteins were detected via Western blotting. Immunohistochemistry was used to measure mCRAMP protein expression in the ileum, and quantitative real-time PCR (qRT-PCR) was employed to analyze the gene expression of mCRAMP, TLR4, and MyD88. Molecular docking was performed with Autodock4 software to predict the binding capacity between diosgenin and LL-37, TLR4 and MyD88. Diosgenin treatment significantly improve the survival of mice, decreased TNF-α and IL-6 production, and attenuated intestinal histopathological damage. Additionally, diosgenin decreased serum D-lactic acid levels, upregulated Claudin-1 and Occludin expression, and increased both mRNA and protein levels of mCRAMP while downregulating the gene expression of TLR4 and MyD88. Molecular docking analysis demonstrated favorable binding affinities of diosgenin to LL-37 (-6.3 kcal/mol), TLR4 (-8.3 kcal/mol), and MyD88 (-10.5 kcal/mol). All calculated binding energies were < -5.0 kcal/mol, suggesting potential effective binding of diosgenin to these targets. Diosgenin improved survival, suppressed inflammatory responses, and preserving intestinal mucosal barrier integrity in CLP-induced septic mice. These protective effects might involve alterations in mCRAMP expression and TLR4/MyD88 signaling.