Does treatment affect the levels of serum Interleukin-6, Interleukin-8 and procalcitonin in diabetic foot infection? A pilot study

Altay, Fatma Aybala; Şencan, İrfan; Şentürk, Gönül Çiçek; Altay, Mustafa; Güvenman, Selda; Unverdi, Selman; Açıkgöz, Ziya Cibali

doi:10.1016/j.jdiacomp.2012.03.018

Cited by 25 publications

(25 citation statements)

References 28 publications

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“…In our study, we found similarly to Weigelt et al [44] only slightly elevated CRP levels up to 10 mg/L (detected in 33/68, 49%, of patients with the DFUs versus 5/34, 15%, of diabetic controls; p < 0.01), and more than half of the patients actually had CRP levels within the normal range. Elevated serum procalcitonin has been suggested to be a better predictor for the presence of infection [45] or osteomyelitis [43] than the other laboratory markers of inflammation, except CRP [46]. However, we did not find significant abnormalities in procalcitonin levels.…”

Section: Discussioncontrasting

confidence: 84%

An Alteration of Lymphocytes Subpopulations and Immunoglobulins Levels in Patients with Diabetic Foot Ulcers Infected Particularly by Resistant Pathogens

Fejfarová

Jirkovská

Dubský

et al. 2016

Journal of Diabetes Research

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The aim of our study was to analyse immune abnormalities in patients with chronic infected diabetic foot ulcers (DFUs) especially those infected by resistant microorganisms. Methods. 68 patients treated in our foot clinic for infected chronic DFUs with 34 matched diabetic controls were studied. Patients with infected DFUs were subdivided into two subgroups according to the antibiotic sensitivity of causal pathogen: subgroup S infected by sensitive (n = 50) and subgroup R by resistant pathogens (n = 18). Selected immunological markers were compared between the study groups and subgroups. Results. Patients with infected chronic DFUs had, in comparison with diabetic controls, significantly reduced percentages (p < 0.01) and total numbers of lymphocytes (p < 0.001) involving B lymphocytes (p < 0.01), CD4+ (p < 0.01), and CD8+ T cells (p < 0.01) and their naive and memory effector cells. Higher levels of IgG (p < 0.05) including IgG1 (p < 0.001) and IgG3 (p < 0.05) were found in patients with DFUs compared to diabetic controls. Serum levels of immunoglobulin subclasses IgG2 and IgG3 correlated negatively with metabolic control (p < 0.05). A trend towards an increased frequency of IgG2 deficiency was found in patients with DFUs compared to diabetic controls (22% versus 15%; NS). Subgroup R revealed lower levels of immunoglobulins, especially of IgG4 (p < 0.01) in contrast to patients infected by sensitive bacteria. The innate immunity did not differ significantly between the study groups. Conclusion. Our study showed changes mainly in the adaptive immune system represented by low levels of lymphocyte subpopulations and their memory effector cells, and also changes in humoral immunity in patients with DFUs, even those infected by resistant pathogens, in comparison with diabetic controls.

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Section: Discussioncontrasting

confidence: 84%

An Alteration of Lymphocytes Subpopulations and Immunoglobulins Levels in Patients with Diabetic Foot Ulcers Infected Particularly by Resistant Pathogens

Fejfarová

Jirkovská

Dubský

et al. 2016

Journal of Diabetes Research

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“…When we compare these results to a similar study designed by Michail et al (13), the differentiating value of the markers during follow-up appears to be similar. In the study of Altay et al (17), initial levels of both IL-6 (122 ± 210 pg/ml) and IL-8 (754⋅9 ± 1557 pg/ml) were very high compared with our population and similar patient groups in other studies (27). Altay et al detected a significant decrease in the level of IL-6 after 14 days of treatment in 24 patients with clinically diagnosed osteomyelitis (129 ± 164 pg/ml pretreatment versus 74⋅2 ± 202 pg/ml post-treatment, P = 0⋅003), but the IL-8 level did not change.…”

Section: Discussionmentioning

confidence: 96%

The value of inflammatory markers to diagnose and monitor diabetic foot osteomyelitis

Asten

Nichols

Fontaine

et al. 2015

International Wound Journal

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In this study, we assessed the effectiveness of inflammatory markers to diagnose and monitor the treatment of osteomyelitis in the diabetic foot. We evaluated 35 consecutive patients admitted to our hospital with infected foot ulcers. Patients were divided in two groups based on the results of bone culture and histopathology: osteomyelitis and no osteomyelitis. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor alpha (TNFα), monocyte chemotactic protein-1 (MCP-1) and macrophage inflammatory protein-1 alpha (MIP1α) were measured at baseline after 3 and 6 weeks of standard therapy. PCT levels in the osteomyelitis group were significantly higher at baseline than in the group with no osteomyelitis (P = 0·049). There were no significant differences between the two groups in the levels of the other markers. CRP, ESR, PCT and IL-6 levels significantly declined in the group with osteomyelitis after starting therapy, while MCP-1 increased (P = 0·002). TNFα and MIP1α levels were below range in 80 out of 97 samples and therefore not reported. Our results suggest that PCT might be useful to distinguish osteomyelitis in infected foot ulcers. CRP, ESR, PCT and IL-6 are valuable when monitoring the effect of therapy.

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“…Altay et al determined higher values than former studies for PCT (0.6 ± 2.1) in diabetic foot infections. They also observed that PCT levels would decline, and range within normal limits (0.05 ± 0.02) after treatment [ 82 ].…”

Section: Procalcitoninmentioning

confidence: 91%

Clinical and Laboratory Diagnosis

Cook

Ashcraft

2015

Osteomyelitis of the Foot and Ankle

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Does treatment affect the levels of serum Interleukin-6, Interleukin-8 and procalcitonin in diabetic foot infection? A pilot study

Cited by 25 publications

References 28 publications

An Alteration of Lymphocytes Subpopulations and Immunoglobulins Levels in Patients with Diabetic Foot Ulcers Infected Particularly by Resistant Pathogens

An Alteration of Lymphocytes Subpopulations and Immunoglobulins Levels in Patients with Diabetic Foot Ulcers Infected Particularly by Resistant Pathogens

The value of inflammatory markers to diagnose and monitor diabetic foot osteomyelitis

Clinical and Laboratory Diagnosis

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