Clinical and morphological characteristics with markers of reparation in neuropathic diabetic foot ulcers.

Aim. To compare the clinical and morphological characteristics of chronic diabetic foot ulcers and the markers of repair.Materials and Methods.We included 26 patients with neuropathic diabetic foot syndrome who had signs of severe peripheral neuropathy. Biopsies were performed from the margin and ce...

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Autores principales:	Elena Yurievna Komelyagina, Evgenia Aleksandrovna Kogan, Mikhail Borisovich Antsiferov
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2015
Materias:	diabetic foot syndrome neuropathic diabetic foot ulcers duration of the wound markers of reparation ki-67 smooth muscle actin cytokeratin Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/8b0f9dd7b7ea41e1b4e5cb719fbc836a
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spelling	oai:doaj.org-article:8b0f9dd7b7ea41e1b4e5cb719fbc836a2021-11-14T09:00:20ZClinical and morphological characteristics with markers of reparation in neuropathic diabetic foot ulcers.2072-03512072-037810.14341/DM2015370-76https://doaj.org/article/8b0f9dd7b7ea41e1b4e5cb719fbc836a2015-10-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/7177https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378Aim. To compare the clinical and morphological characteristics of chronic diabetic foot ulcers and the markers of repair.Materials and Methods.We included 26 patients with neuropathic diabetic foot syndrome who had signs of severe peripheral neuropathy. Biopsies were performed from the margin and central part of the lesion and were fixed in a 10% formalin solution before being placed on paraffin slides and stained with hematoxylin and eosin. We assessed the percentages of necrotic, granulation and fibrotic tissues and the severity of vascular hyalinosis. Immunohistochemistry was performed with initial antibodies to Ki-67 (a marker of proliferation), smooth muscle actin (a marker of myofibroblast synthesis) and cytokeratin (a marker of epithelisation). For analysis, the samples were divided into three groups by the length of time the ulcer had been present: group 1 (≤90 days; 9 samples), group 2 (91–365 days; 10 samples) and group 3 (>365 days; 9 samples).Results. The patients of group 3 were older than those of groups 1 and 2 (53.7±2.7 vs 51.7±5.9 vs 59.9±5.6 years; p=0.04). There were no differences in the duration of diabetes, glycated haemoglobin or severity of neuropathy. The percentage of necrotic tissue was higher in group 1 (33.7%±21.7% vs 11.0%±3.9% vs 12.8%±6.1%; p=0.02) and the percentage of fibrotic tissue was highest in group 3 (21.1%±21.0% vs 35.5%±19.8% vs 54.4%±23.9%; p=0.001). However, the amount of granulation tissue was not different between the groups (45.2%±21.1% vs 53.5%±21.1% vs 32.8%±26.3%; p=0.4). There was also no difference in the severity of vascular hyalinosis between the groups (p=0.9). Expression of Ki-67 was higher in groups 1 and 2, implying a greater capacity to regenerate. The expression of smooth muscle actin and cytokeratin was higher in groups 1 and 2 but without statistical significance.Conclusion. The morphological characteristics and regenerative capacities of neuropathic diabetic foot ulcers differ with the duration the ulcer has been present. Patients with ulcers for less than 1 year were characterised by higher cell proliferation but lower fibrosis. Neuropathic diabetic foot ulcers that are unable to heal over a year are characterised by incomplete regeneration and higher levels of fibrosis. Thus, different treatment approaches are needed depending on how long an ulcer has been present.Elena Yurievna KomelyaginaEvgenia Aleksandrovna KoganMikhail Borisovich AntsiferovEndocrinology Research Centrearticlediabetic foot syndromeneuropathic diabetic foot ulcersduration of the woundmarkers of reparationki-67smooth muscle actincytokeratinNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 18, Iss 3, Pp 70-76 (2015)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	diabetic foot syndrome neuropathic diabetic foot ulcers duration of the wound markers of reparation ki-67 smooth muscle actin cytokeratin Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	diabetic foot syndrome neuropathic diabetic foot ulcers duration of the wound markers of reparation ki-67 smooth muscle actin cytokeratin Nutritional diseases. Deficiency diseases RC620-627 Elena Yurievna Komelyagina Evgenia Aleksandrovna Kogan Mikhail Borisovich Antsiferov Clinical and morphological characteristics with markers of reparation in neuropathic diabetic foot ulcers.
description	Aim. To compare the clinical and morphological characteristics of chronic diabetic foot ulcers and the markers of repair.Materials and Methods.We included 26 patients with neuropathic diabetic foot syndrome who had signs of severe peripheral neuropathy. Biopsies were performed from the margin and central part of the lesion and were fixed in a 10% formalin solution before being placed on paraffin slides and stained with hematoxylin and eosin. We assessed the percentages of necrotic, granulation and fibrotic tissues and the severity of vascular hyalinosis. Immunohistochemistry was performed with initial antibodies to Ki-67 (a marker of proliferation), smooth muscle actin (a marker of myofibroblast synthesis) and cytokeratin (a marker of epithelisation). For analysis, the samples were divided into three groups by the length of time the ulcer had been present: group 1 (≤90 days; 9 samples), group 2 (91–365 days; 10 samples) and group 3 (>365 days; 9 samples).Results. The patients of group 3 were older than those of groups 1 and 2 (53.7±2.7 vs 51.7±5.9 vs 59.9±5.6 years; p=0.04). There were no differences in the duration of diabetes, glycated haemoglobin or severity of neuropathy. The percentage of necrotic tissue was higher in group 1 (33.7%±21.7% vs 11.0%±3.9% vs 12.8%±6.1%; p=0.02) and the percentage of fibrotic tissue was highest in group 3 (21.1%±21.0% vs 35.5%±19.8% vs 54.4%±23.9%; p=0.001). However, the amount of granulation tissue was not different between the groups (45.2%±21.1% vs 53.5%±21.1% vs 32.8%±26.3%; p=0.4). There was also no difference in the severity of vascular hyalinosis between the groups (p=0.9). Expression of Ki-67 was higher in groups 1 and 2, implying a greater capacity to regenerate. The expression of smooth muscle actin and cytokeratin was higher in groups 1 and 2 but without statistical significance.Conclusion. The morphological characteristics and regenerative capacities of neuropathic diabetic foot ulcers differ with the duration the ulcer has been present. Patients with ulcers for less than 1 year were characterised by higher cell proliferation but lower fibrosis. Neuropathic diabetic foot ulcers that are unable to heal over a year are characterised by incomplete regeneration and higher levels of fibrosis. Thus, different treatment approaches are needed depending on how long an ulcer has been present.
format	article
author	Elena Yurievna Komelyagina Evgenia Aleksandrovna Kogan Mikhail Borisovich Antsiferov
author_facet	Elena Yurievna Komelyagina Evgenia Aleksandrovna Kogan Mikhail Borisovich Antsiferov
author_sort	Elena Yurievna Komelyagina
title	Clinical and morphological characteristics with markers of reparation in neuropathic diabetic foot ulcers.
title_short	Clinical and morphological characteristics with markers of reparation in neuropathic diabetic foot ulcers.
title_full	Clinical and morphological characteristics with markers of reparation in neuropathic diabetic foot ulcers.
title_fullStr	Clinical and morphological characteristics with markers of reparation in neuropathic diabetic foot ulcers.
title_full_unstemmed	Clinical and morphological characteristics with markers of reparation in neuropathic diabetic foot ulcers.
title_sort	clinical and morphological characteristics with markers of reparation in neuropathic diabetic foot ulcers.
publisher	Endocrinology Research Centre
publishDate	2015
url	https://doaj.org/article/8b0f9dd7b7ea41e1b4e5cb719fbc836a
work_keys_str_mv	AT elenayurievnakomelyagina clinicalandmorphologicalcharacteristicswithmarkersofreparationinneuropathicdiabeticfootulcers AT evgeniaaleksandrovnakogan clinicalandmorphologicalcharacteristicswithmarkersofreparationinneuropathicdiabeticfootulcers AT mikhailborisovichantsiferov clinicalandmorphologicalcharacteristicswithmarkersofreparationinneuropathicdiabeticfootulcers
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Clinical and morphological characteristics with markers of reparation in neuropathic diabetic foot ulcers.

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