Factors ID'd in diabetic foot ulcer healing failure

Factors ID'd in Healing Failure of Diabetic Foot Ulcers
Factors ID'd in Healing Failure of Diabetic Foot Ulcers

HealthDay News -- Patients with diabetic foot ulcers (DFUs) that  fail to heal have increased inflammation and aberrant growth factor levels, study results reveal.

Serum levels of tumor necrosis factor-alpha, monocyte chemoattractant protein-1, matrix metallopeptidase 9 (MMP-9) and fibroblast growth factor 2 were elevated in patients whose DFUs did not heal compared with patients who healed properly, Thanh Dinh, DPM, of Beth Israel Deaconess Medical Center in Boston and colleagues determined.

"Targeting these factors may prove helpful in the management of DFUs," the researchers reported online in Diabetes.

They examined the role of vascular function and inflammation in DFU development and healing among 104 patients with type 1 or 2 diabetes and 36 healthy controls. During a mean 18.4 month follow-up period, 30 patients with diabetes (29%) developed foot ulcers. Overall, these patients had more severe neuropathy, a higher white blood cell count and reduced vasodilation, the researchers found.

A skin biopsy analysis revealed that patients with diabetes had greater immune cell infiltration, MMP-9 expression and protein tyrosine phosphatase-1B (PTP1B), which negatively regulate insulin, leptin and growth factor signaling, compared with controls.

"We conclude that increased inflammation, expression of MMP-9, PTP1B, and aberrant growth factor levels are the main factors associated with failure to heal DFUs," the researchers concluded.

Dinh T et al. "Mechanisms involved in the development and healing of diabetic foot ulceration." Diabetes. 2012; doi:10.2337/db12-0227.

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