Circulatory levels of B‐cell activating factor of the TNF family in patients with diabetic foot ulcer: Association with disease progression

Abstract

Enhanced and prolonged expression of tumor necrosis factor alpha (TNF-α), a potent pro-inflammatory cytokine is evidenced during the chronic wound healing process of infected diabetic foot ulcer (IDFU). B-cell activating factor (BAFF) is the member of TNF-α family, which implicit in B-cell dysfunction. This study was aimed to evaluate the role of BAFF in diabetic foot ulcer (DFU) patients and to correlate its association with other family of inflammatory cytokines. Circulating levels of BAFF and other cytokines were measured in IDFU (n = 44) and non-IDFU patients (n = 40) using multiplexed bead-based cytokine immunoassay. A stepwise significant increase was observed in both circulatory BAFF and C-reactive protein (CRP) during the disease progression. The area under the receiver operating characteristic curve (AUC ROC ) for BAFF was found to be high (0.89; [95% CI: 0.73-1.0]), when compared to CRP (0.68; [95% CI: 0.61-0.76]). Optimum diagnostic cutoff level for BAFF was found to be ≥2.35 pg/mL with 62.0% sensitivity and 85.7% specificity. Further, BAFF levels showed a significant positive correlation with CRP among IDFU patients. With respect to other family cytokines, BAFF levels were positively correlated with TNF-α, interferon family cytokines such as IFN-α2, IL-28A/IFN-λ2, IFN-γ, and IL-10 family cytokines such as IL-19, IL-22, and IL-26 and negatively correlated with IL-6 receptor family such as gp130/sIL-6Rβ. Hence, our data suggest that devising therapeutic strategies to reduce the levels of BAFF may contribute in amelioration of IDFU.

The association of wound factors and symptoms of fatigue and pain with wound healing in chronic venous leg ulcers

“…CRP is a marker of inflammation and is involved in the innate immune signal. 69 There are a few studies that reported decreased serum CRP to be associated with improvement in various chronic wounds, 70 being positively correlated with progressive infected diabetic ulcers, 71 , 72 and being correlated with amputation of diabetic foot ulcers. 73 In the current research, serum CRP and wound exudate CRP are correlated, which does not report the association between CRP and wound healing.…”

A comprehensive review of IL‐26 to pave a new way for a profound understanding of the pathobiology of cancer, inflammatory diseases and infections

“…For example, B-cell-activating factor (BAFF), as a member of the TNF superfamily, is involved in infected diabetic foot ulcers. The elevation of BAFF in this condition has been correlated with an increased level of pro-inflammatory cytokines such as IL-26 [54]. Diabetic retinopathy is another diabetes-related pathologic condition that is considered a sight-threatening disease.…”

Identification and verification of ferroptosis‐related genes in diabetic foot using bioinformatics analysis

“…The release of inflammatory factors can alter the stability of the internal environment of the foot and aggravate the infection. 5,6 Therefore, there is an urgent need to identify relevant biomarkers to promote the early detection of DF.…”

“…In patients with DM, the infected foot induces an inflammatory reaction, promoting the release of inflammatory factors in multiple tissues and organs. The release of inflammatory factors can alter the stability of the internal environment of the foot and aggravate the infection 5,6 . Therefore, there is an urgent need to identify relevant biomarkers to promote the early detection of DF.…”