Kulwas Arleta, Drela Ewelina, Jundziłł Wiesław, Góralczyk Barbara, Ruszkowska-Ciastek Barbara, Rość Danuta
Department of Pathophysiology Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland.
Department of Pathophysiology Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland.
J Diabetes Complications. 2015 Jul;29(5):686-90. doi: 10.1016/j.jdiacomp.2015.03.013. Epub 2015 Apr 6.
Data about angiogenic factors in diabetic foot syndrome (DFS) are insufficient. Therefore, in the present study we focus on circulating endothelial progenitor cells (EPCs) and two major angiogenic factors: vascular endothelial growth factor (VEGF-A) and fibroblast growth factor (FGF-2) in patients with DFS.
We included 75 subjects: 45 patients with type 2 diabetes and 30 controls. The study group was divided into 2 subgroups: 23 patients with diabetic foot and 22 patients without diabetic complications. The concentration of VEGF-A, soluble VEGF receptor 2 (sVEGF-R2) and FGF-2 were measured in plasma samples. The number of circulating EPCs was determined in peripheral venous blood. The number of endothelial progenitor cells was measured with FACSCalibur flow cytometer using monoclonal antibodies directed against antigens specific for EPCs.
In our study we observed significant higher levels of VEGF-A and FGF-2 and lower sVEGF-R2 concentration in patients with T2DM compared to healthy subjects. The conducted analysis showed decreased levels of VEGF-A and elevated levels of FGF-2 in patients with DM complicated DFS compared to diabetic patients without DFS. Increased circulating EPCs number was reported in patients with DFS, and the difference was almost statistically significant.
The high concentration of VEGF-A and FGF-2, and a positive correlation between them indicate their participation in the process of angiogenesis in T2DM. Decreased sVEGF-R2 may result from inactivation of VEGF-A during complexes formation.
关于糖尿病足综合征(DFS)中血管生成因子的数据不足。因此,在本研究中,我们重点关注DFS患者循环中的内皮祖细胞(EPCs)以及两种主要的血管生成因子:血管内皮生长因子(VEGF - A)和成纤维细胞生长因子(FGF - 2)。
我们纳入了75名受试者:45名2型糖尿病患者和30名对照者。研究组分为2个亚组:23名糖尿病足患者和22名无糖尿病并发症的患者。检测血浆样本中VEGF - A、可溶性VEGF受体2(sVEGF - R2)和FGF - 2的浓度。测定外周静脉血中循环EPCs的数量。使用针对EPCs特异性抗原的单克隆抗体,通过FACSCalibur流式细胞仪测量内皮祖细胞的数量。
在我们的研究中,与健康受试者相比,我们观察到2型糖尿病患者中VEGF - A和FGF - 2水平显著升高,而sVEGF - R2浓度降低。进行的分析表明,与无DFS的糖尿病患者相比,患有糖尿病并发DFS的患者中VEGF - A水平降低,FGF - 2水平升高。DFS患者中循环EPCs数量增加,且差异几乎具有统计学意义。
VEGF - A和FGF - 2的高浓度以及它们之间的正相关表明它们参与了2型糖尿病的血管生成过程。sVEGF - R2降低可能是由于复合物形成过程中VEGF - A失活所致。