The Role of VEGF and TNF-Alpha on Epithelialization of Diabetic Foot Ulcers after Hyperbaric Oxygen Therapy

Semadi, I Nyoman

doi:10.3889/oamjms.2019.297

Cited by 17 publications

(14 citation statements)

References 31 publications

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“…The low levels of TNFα cytokine is known to promote inflammation but it inhibits the formation of extracellular matrix at high levels (17). In addition, it can stimulate the acute-phase response, operate as a powerful neutrophil chemo-attractant and stimulate the macrophage activation when combined with IL1β and IL6.…”

Section: Discussionmentioning

confidence: 99%

Molecular signatures in diabetic foot ulcer by integrated gene expression profiling via bioinformatics analysis

K.¹,

Gollapalli²,

Shetty³

et al. 2022

Biomedicine

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Introduction and Aim: Diabetic foot ulcers (DFUs) are a common and debilitating diabetic consequence leading to lower-limb amputations, long-term disability, and reduced lifespan. Hence, the current research aims to find out how differently expressed genes (DEGs) affect the DFU.Materials and Methods: Bioinformatics analysis was used to evaluate DEGs using the GSE132187 dataset of the NCBI-GEO database, which contained samples from three hyperglycemic and three normoglycemic macrophagelike cell lines. Gene Ontology (GO) and KEGG pathway enrichment analysis was used to study how genes are classified into preset bins based on their functional properties after DEGs were discovered. A network of proteinprotein interaction (PPI) was created and five topological characteristics such as degree, stress, closeness centrality, betweenness centrality, and radiality were evaluated to uncover hub DEGs in DFU. Results:We found 547 DEGs using the GSE132187 dataset, comprising 79 upregulated DEGs and 468 downregulated DEGs. In total, the PPI network included 434 nodes and 1724 edges. The giant network uncovered six modules that are significantly enriched in biological processes like regulation of positive JNK cascade, positive interferon-gamma production and negative cell proliferation, cellular response to zinc ion and lipopolysaccharide, wound healing, and inflammatory response. Conclusion:Bioinformatics analysis revealed the major differentially expressed hub-genes implicated in DFUs. These findings suggest that these genes could be exploited as DFU prognostic, diagnostic, or therapeutic targets.

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Section: Discussionmentioning

confidence: 99%

Molecular signatures in diabetic foot ulcer by integrated gene expression profiling via bioinformatics analysis

K.¹,

Gollapalli²,

Shetty³

et al. 2022

Biomedicine

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“…Applying these results in a clinical setting will support the effective use of HBOT as an adjunctive treatment option for patients. Previous studies have proven the efficacy of HBOT in clinical applications for wound healing and reducing inflammation, as indicated by the levels of relevant biomarkers [ 23 , 24 ]. An algorithm to conclude the results from this study is presented in Fig.…”

Section: Discussionmentioning

confidence: 99%

Predicting hyperbaric oxygen therapy success using the decision tree approach

Oley

Langi

et al. 2021

Annals of Medicine &Amp; Surgery

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Introduction Hyperbaric oxygen therapy (HBOT), a procedure that involves the patient inhaling 100% oxygen gas under pressure, is currently used as an adjunctive treatment option for certain inflammatory conditions. HBOT can improve wound healing by increasing the rate of angiogenesis in injured tissue by increasing levels of vascular endothelial growth factor (VEGF). VEGF causes re-epithelialization, the migration of endothelial cells, and the formation of granulation tissue, which are involved in the wound healing process. Methods This study contains secondary data analyses of information previously collected in two separate studies, each concerning the effects of HBOT on diabetic foot ulcers and crush injury fractures at Prof. Dr. R. D. Kandou Hospital Manado and Siloam Hospital Manado from 2019 to early 2020. Results Based on the classification tree analysis, the predictors of HBOT success were leukocytes level (34%), platelet count (32%), and age (26%). The conditional inference tree analysis also indicated significant leukocyte levels, age, and platelet counts (p < 0.001), with which the interpretation of these results was the same as the classification tree analysis method. The results obtained from the random forest analysis revealed that the mean value of Gini reduction for leukocytes (207.3), platelets (110.2), age (97.9), and hemoglobin (57.9) can be used as indicators of successful HBOT. These three methods support that age, leukocytes, and platelets are determinants of HBOT success, while hemoglobin levels were only significant in one analysis method. Therefore, a new, proposed algorithm containing these factors was assembled from the results of this study. Conclusion HBOT cannot be separated from specific variables that contribute to and can predict its success.

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“…Previous guidelines 6 have conditionally recommended the use of hyperbaric oxygen therapy as an adjunctive treatment on the basis of several RCTs. For this guideline, we included 18 RCTs on hyperbaric oxygen [81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96][97][98] with no new studies published in the last 4 years.…”

Section: Intervention: Oxygen and Other Gasesmentioning

confidence: 99%

Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update)

Chen,

Vilorio,

Dhatariya

et al. 2023

Diabetes Metabolism Res

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AimsPrinciples of wound management, including debridement, wound bed preparation, and newer technologies involving alternation of wound physiology to facilitate healing, are of utmost importance when attempting to heal a chronic diabetes‐related foot ulcer. However, the rising incidence and costs of diabetes‐related foot ulcer management necessitate that interventions to enhance wound healing of chronic diabetes‐related foot ulcers are supported by high‐quality evidence of efficacy and cost effectiveness when used in conjunction with established aspects of gold‐standard multidisciplinary care. This is the 2023 International Working Group on the Diabetic Foot (IWGDF) evidence‐based guideline on wound healing interventions to promote healing of foot ulcers in persons with diabetes. It serves as an update of the 2019 IWGDF guideline.Materials and MethodsWe followed the GRADE approach by devising clinical questions and important outcomes in the Patient‐Intervention‐Control‐Outcome (PICO) format, undertaking a systematic review, developing summary of judgements tables, and writing recommendations and rationale for each question. Each recommendation is based on the evidence found in the systematic review and, using the GRADE summary of judgement items, including desirable and undesirable effects, certainty of evidence, patient values, resources required, cost effectiveness, equity, feasibility, and acceptability, we formulated recommendations that were agreed by the authors and reviewed by independent experts and stakeholders.ResultsFrom the results of the systematic review and evidence‐to‐decision making process, we were able to make 29 separate recommendations. We made a number of conditional supportive recommendations for the use of interventions to improve healing of foot ulcers in people with diabetes. These include the use of sucrose octasulfate dressings, the use of negative pressure wound therapies for post‐operative wounds, the use of placental‐derived products, the use of the autologous leucocyte/platelet/fibrin patch, the use of topical oxygen therapy, and the use of hyperbaric oxygen. Although in all cases it was stressed that these should be used where best standard of care was not able to heal the wound alone and where resources were available for the interventions.ConclusionsThese wound healing recommendations should support improved outcomes for people with diabetes and ulcers of the foot, and we hope that widescale implementation will follow. However, although the certainty of much of the evidence on which to base the recommendations is improving, it remains poor overall. We encourage not more, but better quality trials including those with a health economic analysis, into this area.

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The Role of VEGF and TNF-Alpha on Epithelialization of Diabetic Foot Ulcers after Hyperbaric Oxygen Therapy

Cited by 17 publications

References 31 publications

Molecular signatures in diabetic foot ulcer by integrated gene expression profiling via bioinformatics analysis

Molecular signatures in diabetic foot ulcer by integrated gene expression profiling via bioinformatics analysis

Predicting hyperbaric oxygen therapy success using the decision tree approach

Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update)

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