Epidemiology of Chronic Wound Patients and Relation to Serum Levels of Mannan-binding Lectin

Bitsch, Mikael; Laursen, Inga; Engel, Anne-Marie; Christiansen, Michael; Larsen, Severin Olesen; Iversen, Line V.; Holstein, P.; Karlsmark, Tonny

doi:10.2340/00015555-0730

Cited by 17 publications

(13 citation statements)

References 26 publications

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“…The SUV study is certainly one of the most important epidemiological investigations on vascular ulcers of lower limbs carried out in Italy in the recent years, because of the high quantity of data collected (1163 patients, of whom about 50% followed up until 9 months after start of therapy) and the widespread presence of participating centres (59 centres representing 14 Italian regions). Published epidemiological studies have been performed recently in leg ulcers in Romania (25) and New Zealand (26), in diabetic ulcers in China (27), in hypertensive leg ulcers in France (28) and in chronic leg wounds in Denmark (29); to our knowledge, however, the SUV study is the only one that has involved more than one thousands patients affected by different types of leg ulcers (venous, arterial, diabetic, mixed, etc. ).…”

Section: Discussionmentioning

confidence: 99%

A large Italian observational multicentre study on vascular ulcers of the lower limbs (Studio Ulcere Vascolari)

Apollonio

Antignani²,

Salvo

et al. 2014

International Wound Journal

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An observational study of 2 years was promoted by the Italian Association for Cutaneous Ulcers (AIUC) in order to monitor the epidemiology of leg ulcers, the trend of healing and the more frequent therapeutic approaches in lower limb ulcers. Fifty-nine sites in 14 different Italian regions involved in the study, with 1333 enrolled patients (1163 patients fully evaluated and followed up for 9 months). A prevalence of females (62%) was observed with a mean age of 70 years and a high rate of hypertension (62%), diabetes (38%) and obesity (29%). Venous ulcer was most frequent (55%), followed by mixed (25%) and diabetic (8·3%) ulcers. Basically, all patients received a local therapy (LT) (compression and advanced local therapies), while 63% of patients have an associated systemic pharmaceutical treatment. Ulcer healing rates progressively increased throughout the study and despite the type of observational study does not allow conclusions on the treatment, it was observed that the patients receiving additional systemic drugs were associated with a more rapid acceleration of healing rates of ulcers compared to LT alone (3 months: 39·7% versus 29·2%; 6 months: 62·0% versus 47·0%; 9 months: 74·7% versus 63·8%). In particular, the Studio Ulcere Vascolari (SUV) study showed that a combination treatment with sulodexide and compression therapy allows for a greater increase in the healing rates in venous ulcers.

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Section: Discussionmentioning

confidence: 99%

A large Italian observational multicentre study on vascular ulcers of the lower limbs (Studio Ulcere Vascolari)

Apollonio

Antignani²,

Salvo

et al. 2014

International Wound Journal

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“…However, the identification and opsonization of infectious agents are dependent on the binding of the protein lectin with mannose (MBL) [52-54]. Some studies suggest that a deficiency in serum MBL levels in patients with CVUs culminates in the incapacity of complement system activation, facilitating the installation of infections [55,56]. Thus, the differential expression of protein Complement C3 in the lesion microenvironment is the result of the activation of the defense system against infectious agents, and also suggests the installation of the inflammatory process in the region.…”

Section: Discussionmentioning

confidence: 99%

Seeking Candidate Molecules as Prognostic Healing Markers in Chronic Venous Ulcers

Nrv

Nap

et al. 2020

Preprint

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Faculdade de Medicina de Botucatu, FMB) for making available all the resources and equipment that contributed to this work. We acknowledge the Mass Spectrometry Laboratory at the Brazilian Biosciences National Laboratory, CNPEM, Campinas, SP, Brazil, for its support with the mass spectrometric analysis. 3 ABSTRACT 1 Seeking and identifying biomarker molecules in inflammatory exudate of chronic 2 venous ulcers (CVUs) can aid health professionals in the healing prognosis. The 3 therapeutic failure or cure is related to the quantitative expression of determinate 4proteins. This work aimed to identify the proteins expressed in inflammatory exu-5 dates from CVUs and correlate them with reduction or increase in the wound size. 6 For 90 days, 28 participants that received standard treatment for 37 CVUs were 7 monitored. The inflammatory exudates were collected before treatment initiation 8 (T=0) and analyzed via the Label-free Shotgun. After 90 days the wound area was 9 reduced in 25 (67.6%) of them. Mass spectrometry analysis of all the inflammatory 10 exudates showed four proteins differentially expressed and related to favorable or 11 unfavorable evolution of the healing process. Complement C3 and ceruloplasmin 12 were identified in all the lesions analyzed and were expressed differentially in le-13 sions that presented diminished area in the studied period. Apoliprotein A1 and 14 neutrophil defensin-1 presented differential expression in ulcers that either did not 15 diminish or augmented their wound area through 90 days. These results suggest 16 that Complement C3, Ceruloplasmin, Apoliprotein A1 and Neutrophil-defensin-1 17 proteins are potential candidate molecules for prognostic healing markers in chron-18 ic venous ulcers. 19Keywords: Chronic venous ulcers, non-healing ulcers, inflammatory exudate, 20 mass spectrometry, prognostic biomarkers. 21 22the Western world [1]. Epidemiological studies performed in the last decade evi-26 denced the frightening perspective of an estimated prevalence between 34.5 and 27 150.8 million persons affected [2,[3][4][5][6]. Chronic leg ulcers are lesions that generally 28 last longer than 6 weeks and in some cases more than 20 years, frequently recur 29 and are related to complications from venous insufficiency in the lower limbs [7,8]. 30The treatment is prolonged, onerous to the health systems, and has im-31 portant social impact since it contributes to absences from work [9][10][11][12]. The pa-32 tients evolve with restricted mobility, social isolation and a worsening quality of life 33 [13,14]. These aspects affect mental health by increasing sleep disturbances [15], 34 evolving with anxiety and subsequent depression [16]. Given that some cases heal 35 and others do not, science has been searching for years for possible prognostic 36 mechanisms of healing. 37In this context, the investigative approach of proteomic analysis of human 38 bodily fluids has been viewed as powerful analytic tool for discovering molecular 39 markers that can aid in the diagnosis and progno...

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“…We could not establish evidence that MBL deficiency was related to the healing rate of CVLUs in this pilot study. However, a large cohort study by Bitsch et al (16) showed a higher frequency of MBL deficiency among CVLU patients compared with healthy controls, thus suggesting MBL‐supplemented serum therapy as a subject for a controlled clinical trial. This notion is further encouraged by a case report where an MBL‐deficient patient suffering from both chronic leg and surgical wounds experienced improved healing after receiving substitution therapy with plasma‐derived MBL (48).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, deficiency of MBL has been associated with impairment of the spontaneous and necessary separation of the eschar in a mouse MBL-null burn wound model (15). In a recent study of chronic leg and foot ulcer patients, serum MBL levels were shown to differ between wounds of different aetiologies, with CVLU patients having a significantly higher frequency of MBL deficiency (16).…”

Section: Key Pointsmentioning

confidence: 99%

Investigating the humoral immune response in chronic venous leg ulcer patients colonised with Pseudomonas aeruginosa

Jacobsen

Andersen

Sonnested

et al. 2010

International Wound Journal

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The ability to manage the bioburden in chronic wounds is most likely coupled to the humoral immune response of the patient. We analysed markers of systemic immune response in patients with chronic venous leg ulcers (CVLUs) colonised (no-systemic infection) with the opportunistic pathogen Pseudomonas aeruginosa. Sera from 44 clinically non infected patients with CVLUs were analysed for total IgM and IgG isotype 1-4, complement C3, mannose-binding lectin (MBL), interleukin (IL)-6, C-reactive protein (CRP) and specific anti-P. aeruginosa antibodies against exotoxin A, elastase and alkaline phosphatase. Concentrations of IL-6 versus CRP intercorrelated (β = 2.43 95% CI (1.34-4.34)), but were independent of P. aeruginosa colonisation. MBL deficiency (MBL< 500 ng/ml) correlated to high serum levels of IgG(1) (P = 0.038) consistent with a compensatory mechanism, but not related to presence of P. aeruginosa in the ulcers. Twenty-four patients (54.5%) were culture positive for P. aeruginosa, also conferring significantly high serum levels of complement C3 (P = 0.014), but only two of these had positive titres for antibodies against exotoxin A. All patient sera were negative for antibodies against elastase and alkaline phosphatase. Fluorescent in situ hybridization analysis on randomly selected culture-positive patients could not establish unambiguous presence of P. aeruginosa biofilms in the ulcers. A multiple regression model showed P. aeruginosa and systemic CRP as significant factors in deterioration of ulcer healing rate.

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Epidemiology of Chronic Wound Patients and Relation to Serum Levels of Mannan-binding Lectin

Cited by 17 publications

References 26 publications

A large Italian observational multicentre study on vascular ulcers of the lower limbs (Studio Ulcere Vascolari)

A large Italian observational multicentre study on vascular ulcers of the lower limbs (Studio Ulcere Vascolari)

Seeking Candidate Molecules as Prognostic Healing Markers in Chronic Venous Ulcers

Investigating the humoral immune response in chronic venous leg ulcer patients colonised with Pseudomonas aeruginosa

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