Characterization of the Cicatrization Process in Diabetic Foot Ulcers Based on the Production of Reactive Oxygen Species

Delis, Alberto López; Rosa, Suélia de Siqueira Rodrigues Fleury; Souza, Paulo Eduardo Narcizo de; Carneiro, Marcella Lemos Brettas; Rosa, Mario; Macedo, Yasmin Carneiro Lobo; Veiga-Souza, Fabiane H.; Rocha, Adson Ferreira da

doi:10.1155/2018/4641364

Cited by 12 publications

(3 citation statements)

References 14 publications

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“…16 In the current study, plasma levels of NAP-2 were independently associated with CLI, but were not associated with T2DM. Diabetes delayed the healing of foot ulceration, 19,20 and CLI was the main causes for healing of lower limbs ulcers; 21,22 therefore, plasma NAP-2 levels not only may be a biomarker to predict the lower limb ischemia in the non-diabetic CLI population, but they also may be an ideal marker to predict the wound healing in diabetic CLI population.…”

Section: Discussionmentioning

confidence: 99%

Plasma NAP-2 levels are associated with critical limb ischemia in peripheral arterial disease patients

Wang

Gan

et al. 2019

Exp Biol Med (Maywood)

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Our study evaluates the relationship between plasma neutrophil-activating peptide-2 (NAP-2) levels and critical limb ischemia (CLI); 189 subjects were enrolled in this study: 59 subjects with CLI and type 2 diabetes mellitus (T2DM), 45 subjects with CLI and no T2DM, 43 patients with T2DM and no CLI, and 42 without both T2DM and CLI. Subjects with CLI had higher plasma levels of NAP-2 than those of the healthy group (2.04 ± 0.06 ng/mL vs. 1.75 ± 0.09 ng/mL, P = 0.011). Subjects with CLI and T2DM had higher plasma levels of NAP-2 than those of the T2DM group (2.08 ± 0.08 ng/mL vs. 1.73 ± 0.10 ng/mL, P = 0.007). However, subjects with CLI including CLI and T2DM+CLI had higher plasma levels of NAP-2 than those of the non-CLI group including healthy and T2DM group (2.06 ± 0.05 ng/mL vs. 1.74 ± 0.07 ng/mL, P < 0.001). The ankle brachial index (ABI) and total cholesterol (TC) were significantly and negatively correlated with plasma NAP-2 levels (rho = −0.250, P = 0.001; rho = −0.162, P = 0.026, respectively). Systolic blood pressure (SBP) positively correlated with plasma NAP-2 levels (rho = 0.187, P = 0.010). When adjusting for the factors, plasma NAP-2 levels were still significantly correlated with CLI (odds ratio = 11.543, 95% confidence intervals: 1.327–100.403, P = 0.027). The area under the curve (AUC) of NAP-2+confounders was 0.992 (95% confidence intervals 0.981 to 1.003, P < 0.001) and it was higher than those of NAP-2 alone (95% confidence intervals 0.241 to 0.407, P < 0.001) and confounders alone (AUC = 0.990, 95% confidence intervals −0.013 to 0.018, P = 0.797). In conclusion, elevated plasma NAP-2 was independently associated with CLI, but it was not correlated with T2DM. Plasma NAP-2 levels might be an early CLI diagnostic biomarker and might provide a novel target for CLI treatment. Impact statement Critical limb ischemia (CLI) is a serious arterial obstruction, resulting in serious reduction of blood flow to the extremities. CLI is a symptomatic disorder and is frequently not diagnosed in time. This results in a high mortality and elevated risk of limb amputation. Serum or plasma biomarkers play important roles in disease prevention, diagnosis, and prognosis. Elevated plasma neutrophil-activating peptide-2 (NAP-2) was found independently associated with CLI, but not with T2DM. Plasma NAP-2 levels might be an early CLI diagnostic biomarker and might provide a novel target for CLI treatment.

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Section: Discussionmentioning

confidence: 99%

Plasma NAP-2 levels are associated with critical limb ischemia in peripheral arterial disease patients

Wang

Gan

et al. 2019

Exp Biol Med (Maywood)

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“…The first elicited better wound area. The RTC of Lopez-Delis [13] used three groups for dressing. Group 1 is with natural latex related with LED circuit, group 2 is with calcium alginate or silver foam, and group 3 is with adhesive derived from the natural latex associated with the LED circuit.…”

Section: Primary Outcomementioning

confidence: 99%

Best and Effective Practices of Wound Care and Healing Among Patients with Diabetes Mellitus

2019

Endocrinol Diabetes Metab J

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Aim: With the continuing trend in the incidence of diabetic ulcer, current researches from evidence-based practice augment best and effective practices on wound care and healing among patients suffering from diabetes mellitus. Methods: This study utilized a systematic review of literatures in light of wound care through Pub Med database with the key words "Diabetes Mellitus," "wound practices," "wound healing," and "systematic review." The searched literatures were of case reports, interventional studies, and review papers whose main texts were in English. Results: There were 7,988 published articles yielded from the keywords used and 16 were included in this study. The practiced management and techniques in these literatures focused on comfortable and cost efficient means of wound care and healing with the involvement of group participation than individual plan of care. Conclusions: There are meager evidences for vigorous wound and healing options that needs further studies in resolving wound issues among patients with Diabetes Mellitus. This systematic review establishes the insufficiency of high level of evidence based studies on wound healing in DM patients and brings a track for continuity of rigid studies concerning this topic.

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“…Several studies have focused on the investigation of granulation tissue in diabetic ulcers. A series of molecular alterations were observed in the healing process, including high concentration of metalloproteinases, nonphysiological inflammatory response, oxidative stress, deficient neoangiogenesis, insufficient concentrations of growth factors, and high probability of infection [5,6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Characterization of Dermal Stem Cells of Diabetic Patients

Ferroni

Gardin

Paola

et al. 2019

Cells

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Diabetic foot ulcers (DFUs) are lesions that involve loss of epithelium and dermis, sometimes involving deep structures, compartments, and bones. The aim of this work is to investigate the innate regenerative properties of dermal tissue around ulcers by the identification and analysis of resident dermal stem cells (DSCs). Dermal samples were taken at the edge of DFUs, and genes related to the wound healing process were analyzed by the real-time PCR array. The DSCs were isolated and analyzed by immunofluorescence, flow cytometry, and real-time PCR array to define their stemness properties. The gene expression profile of dermal tissue showed a dysregulation in growth factors, metalloproteinases, collagens, and integrins involved in the wound healing process. In the basal condition, diabetic DSCs adhered on the culture plate with spindle-shaped fibroblast-like morphology. They were positive to the mesenchymal stem cells markers CD44, CD73, CD90, and CD105, but negative for the hematopoietic markers CD14, CD34, CD45, and HLA-DR. In diabetic DSCs, the transcription of genes related to self-renewal and cell division were equivalent to that in normal DSCs. However, the expression of CCNA2, CCND2, CDK1, ALDH1A1, and ABCG2 was downregulated compared with that of normal DSCs. These genes are also related to cell cycle progression and stem cell maintenance. Further investigation will improve the understanding of the molecular mechanisms by which these genes together govern cell proliferation, revealing new strategies useful for future treatment of DFUs.

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Characterization of the Cicatrization Process in Diabetic Foot Ulcers Based on the Production of Reactive Oxygen Species

Cited by 12 publications

References 14 publications

Plasma NAP-2 levels are associated with critical limb ischemia in peripheral arterial disease patients

Plasma NAP-2 levels are associated with critical limb ischemia in peripheral arterial disease patients

Best and Effective Practices of Wound Care and Healing Among Patients with Diabetes Mellitus

Characterization of Dermal Stem Cells of Diabetic Patients

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