Alterations of biochemical and two-dimensional biomechanical properties of human skin in diabetes mellitus as compared to effects of in vitro non-enzymatic glycation

Reihsner, R.; Melling, Mahmoud; Pfeiler, Wolfgang; Menzel, E. J.

doi:10.1016/s0268-0033(99)00085-6

Cited by 49 publications

(28 citation statements)

References 38 publications

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“…Two previous studies have addressed baseline biomechanical properties in diabetic human skin demonstrating greater stiffness and less extensibility. 24,25 We show here that at baseline there are inherent differences in the biomechanical properties of the two tissues and that decreased tensile strength, collagen deposition, and post-transcriptional modification contribute to this difference in biomechanical properties. Decreased modulus, tensile strength, and collagen deposition all may contribute to predisposition to injury and poor wound healing found in diabetic skin.…”

Section: Figure 8 Amentioning

confidence: 68%

Impaired Biomechanical Properties of Diabetic Skin

Bermudez

Herdrich

et al. 2011

The American Journal of Pathology

106

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Diabetic skin is known to have deficient wound healing properties, but little is known of its intrinsic biomechanical properties. We hypothesize that diabetic skin possesses inferior biomechanical properties at baseline, rendering it more prone to injury. Skin from diabetic and nondiabetic mice and humans underwent biomechanical testing. Real-time PCR was performed for genes integral to collagen synthesis and degradation. MMP-2 and MMP-9, and TIMP-1 protein levels were assessed by ELISA and zymography. Collagen I and III content was assessed using Western blot analysis. At baseline, both murine and human diabetic skin was biomechanically inferior compared to nondiabetic skin, with decreased maximum stress and decreased modulus (P < 0.001 and < 0.05, respectively). Surprisingly, the expression of genes involved in collagen synthesis were significantly up-regulated, and genes involved in collagen degradation were significantly down-regulated in murine diabetic skin (P < 0.01). In addition, MMP-2 and MMP-9/TIMP-1 protein ratios were significantly lower in murine diabetic skin (P < 0.05). Collagen I levels and I:III ratios were lower in diabetic skin (P < 0.05). These findings suggest that the predisposition of diabetics to wounds may be the result of impaired tissue integrity at baseline, and are due, in part, to a defect in the regulation of collagen protein synthesis at the post-transcriptional level. Diabetes is associated with increased morbidity and mortality, 1 as well as impaired wound healing. 2 Diabetesrelated admissions accounted for 22% of all hospital inpatient days in 2007, and diabetic foot ulcers account for 20% of all hospital admissions in diabetic patients, which are the leading cause of lower extremity amputations. 2 Improvements made in diabetic wound management and prevention clearly have the potential to affect a large number of patients and decrease diabetic-related health care expenditures.More than 100 factors have been identified that contribute to the impairment in diabetic wound healing. 3 Decreased angiogenesis, 4 impaired growth factor production, 5 an altered inflammatory and immune response, 5 a decreased rate of wound contraction, 6 and an imbalance between the accumulation of extracellular components and their remodeling by matrix metalloproteinases (MMPs) 7,8 have all been demonstrated in diabetic wounds. MMP-2 and MMP-9 have been shown to be present in greater concentration in wounded diabetic animals than their nondiabetic littermates, which is similar to findings from patients with nonhealing ulcers. 9 Diabetes is characterized by significantly increased cross linking and nonenzymatic glycation of collagen, as well as elevated levels of advanced glycation end products (AGEs). 10,11 Blockade of the receptor for advanced glycation end products (RAGEs) can restore the wound healing properties of diabetic (Db/Db) mice. 12 Hyperglycemic animals have been shown to have significantly higher concentrations of glycated collagen and higher levels of collagenase activity. 9,13 Furthermore...

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Section: Figure 8 Amentioning

confidence: 68%

Impaired Biomechanical Properties of Diabetic Skin

Bermudez

Herdrich

et al. 2011

The American Journal of Pathology

106

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“…153 Accumulation of AGEs on collagen in the ECM of skin has been widely studied. 152,154,155 Glycosylation of collagen leads to increased crosslinking between collagen fibers, increased stiffness, decreased solubility, and decreased susceptibility to proteolysis. 152,155,156 Some authors highlight differences between the collagen cross-linking due to DM compared with aging, stressing that diabetic crosslinking is more extensive and causes a further decrease in solubility.…”

Section: Advanced Glycation Endproductsmentioning

confidence: 99%

Extracellular Matrix and Dermal Fibroblast Function in the Healing Wound

Tracy

Minasian

Caterson

2016

Advances in Wound Care

729

584

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“…For example, the increased extensibility of soft tissues due to thermal treatment has been observed in both uniaxial [174,184,185] and biaxial studies [171,186]. However, there are comparatively few studies of the effects of thermal denaturation on the mechanical response of skin tissue [159,[187][188][189][190][191], despite skin dermis being mainly composed of collagen. In view of this, we have carried out a series of experimental study on the temperature/thermal damage dependent mechanical behavior of skin tissue [192][193][194]; the main findings are summarized below.…”

Section: Property Variations Due To Thermal Denaturation Of Collagenmentioning

confidence: 99%

Biothermomechanical behavior of skin tissue

Seffen

2008

Acta Mech. Sin.

131

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Advances in laser, microwave and similar technologies have led to recent developments of thermal treatments involving skin tissue. The effectiveness of these treatments is governed by the coupled thermal, mechanical, biological and neural responses of the affected tissue: a favorable interaction results in a procedure with relatively little pain and no lasting side effects. Currently, even though each behavioral facet is to a certain extent established and understood, none exists to date in the interdisciplinary area. A highly interdisciplinary approach is required for studying the biothermomechanical behavior of skin, involving bioheat transfer, biomechanics and physiology. A comprehensive literature review pertinent to the subject is presented in this paper, covering four subject areas: (a) skin structure, (b) skin bioheat transfer and thermal damage, (c) skin biomechanics, and (d) skin biothermomechanics. The major problems, issues, and topics for further studies are also outlined. This review finds that significant advances in each of these aspects have been achieved in recent years. Although focus is placed upon the biothermomechanical behavior of skin tissue, the fundamental concepts and methodologies reviewed in this paper may also be applicable for studying other soft tissues.

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Alterations of biochemical and two-dimensional biomechanical properties of human skin in diabetes mellitus as compared to effects of in vitro non-enzymatic glycation

Cited by 49 publications

References 38 publications

Impaired Biomechanical Properties of Diabetic Skin

Impaired Biomechanical Properties of Diabetic Skin

Extracellular Matrix and Dermal Fibroblast Function in the Healing Wound

Biothermomechanical behavior of skin tissue

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