Biomarker Prediction of Postoperative Healing of Diabetic Foot Ulcers

Cheng, Pu; Dong, Yunxian; Hu, Zhicheng; Huang, Shaobin; Cao, Xiaoling; Wang, Peng; Xu, Hailin; Zhu, Jiayuan; Tang, Bin

doi:10.1097/won.0000000000000780

Cited by 6 publications

(2 citation statements)

References 26 publications

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“…These findings are in agreement with evidence showing that endothelial dysfunction can disrupt or delay the healing process in CLI patients [9]. Furthermore, in our cohort, the odds of healing of treated DFU were associated with the levels of albumin, leukocytes, and monocytes, in line with other studies showing an association between albumin and DFU healing [14] and with the well-known role of monocyte orchestrating this process [11].…”

Section: Discussionsupporting

confidence: 93%

Circulating Biomarkers of Endothelial Dysfunction and Inflammation in Predicting Clinical Outcomes in Diabetic Patients with Critical Limb Ischemia

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Manfrini

et al. 2022

IJMS

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Critical limb ischemia (CLI) is a severe manifestation of peripheral artery disease characterized by ischemic pain, which is frequently associated with diabetes and non-healing lesions to inferior limbs. The clinical management of diabetic patients with CLI typically includes percutaneous transluminal angioplasty (PTA) to restore limb circulation and surgical treatment of diabetic foot ulcers (DFU). However, even after successful treatment, CLI patients are prone to post-procedure complications, which may lead to unplanned revascularization or foot surgery. Unfortunately, the factors predicting adverse events in treated CLI patients are only partially known. This study aimed to identify potential biomarkers that predict the disease course in diabetic patients with CLI. For this purpose, we measured the circulating levels of a panel of 23 molecules related to inflammation, endothelial dysfunction, platelet activation, and thrombophilia in 92 patients with CLI and DFU requiring PTA and foot surgery. We investigated whether these putative biomarkers were associated with the following clinical endpoints: (1) healing of the treated DFUs; (2) need for new revascularization of the limb; (3) appearance of new lesions or relapses after successful healing. We found that sICAM-1 and endothelin-1 are inversely associated with DFU healing and that PAI-1 and endothelin-1 are associated with the need for new revascularization. Moreover, we found that the levels of thrombomodulin and sCD40L are associated with new lesions or recurrence, and we show that the levels of these biomarkers could be used in a decision tree to assign patients to clusters with different risks of developing new lesions or recurrences.

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Section: Discussionsupporting

confidence: 93%

Circulating Biomarkers of Endothelial Dysfunction and Inflammation in Predicting Clinical Outcomes in Diabetic Patients with Critical Limb Ischemia

Sega

Cimaglia

Manfrini

et al. 2022

IJMS

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“…While a full evaluation of DFU biomarkers is outside the scope of this review, briefly, some recent reports of wound exudate biomarkers for DFU wound healing include epithelial neutrophil-activating protein (ENA)-78 [ 254 ], c-x-c motif chemokine ligand 6 (CXCL6) [ 255 ], and MMP-9 [ 256 ]. A number of serum biomarkers have been identified, including albumin [ 257 ], PLR and NLR [ 122 , 258 ], angiopoietin-like 2 (ANGPTL2) [ 259 ], lipoprotein-associated phospholipase A2 and interleukin-18 (IL-18) [ 260 ], pentraxin 3 [ 261 ], T-cell differentiation markers [ 262 ], stem/progenitor cells [ 263 ], as well as neutrophil extracellular traps (NETs)-specific markers [ 264 ]. Recent genomic analyses of DFU have utilized circRNAs [ 265 , 266 , 267 ], lncRNAs [ 268 ], miRNAs [ 99 , 100 , 269 ], genetic polymorphisms [ 270 , 271 , 272 ], cytokine arrays [ 273 ], and network maps [ 274 ] for the identification of other potential biomarkers for DFU diagnosis and prognosis.…”

Section: Diagnostic Measuresmentioning

confidence: 99%

Diabetic Wound-Healing Science

et al. 2021

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Diabetes mellitus is an increasingly prevalent chronic metabolic disease characterized by prolonged hyperglycemia that leads to long-term health consequences. It is estimated that impaired healing of diabetic wounds affects approximately 25% of all patients with diabetes mellitus, often resulting in lower limb amputation, with subsequent high economic and psychosocial costs. The hyperglycemic environment promotes the formation of biofilms and makes diabetic wounds difficult to treat. In this review, we present updates regarding recent advances in our understanding of the pathophysiology of diabetic wounds focusing on impaired angiogenesis, neuropathy, sub-optimal chronic inflammatory response, barrier disruption, and subsequent polymicrobial infection, followed by current and future treatment strategies designed to tackle the various pathologies associated with diabetic wounds. Given the alarming increase in the prevalence of diabetes, and subsequently diabetic wounds, it is imperative that future treatment strategies target multiple causes of impaired healing in diabetic wounds.

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