Dini V, Papadia F, Francesco F Di, Salvo P, Paolicchi A, Janowska A, Chiricozzi A, Oranges T
Wound Healing Research Unit, Department of Dermatology, University of Pisa, Pisa, Italy.
Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
J Wound Care. 2017 Sep 1;26(Sup9):S9-S17. doi: 10.12968/jowc.2017.26.Sup9.S9.
The wound bed score is a validated tool to monitor wound healing in chronic wounds, and depends on visual examination by trained personnel. This study describes the feasibility of adding some biochemical and immunohistochemical parameters to increase the objectivity and specificity of the wound bed score Method: Patients with chronic wounds on the lower leg with different durations were enrolled to assess the correlation between the wound bed score and specific wound-related biomarkers, namely MMP-9, MMP-2, NGAL, albumin, integrin α2/β1, and other histochemical (CD68, PK1, CD32, fractalkine, periostin) and immunocytochemical markers from biopsies and smears taken from wound edges and bed.
The study examined samples from 10 patients. Patients with an unfavourable wound bed score had a low expression of periostin and fractalkine in the wound bed tissue. CD68 PK1 showed a low or negative expression in the majority of the samples. Patients negative for CD68 PK1 were also negative for CD32. Principal component analysis revealed that the albumin level and the amount of proteins were associated with a high wound bed score. Two different subsets of patients could be discriminated either by integrin α2/β1 and albumin percentages or the MMP-9 and MMP-2 activities Conclusion: These preliminary results pave the way towards an improved wound status diagnosis and an advanced quality of wound care and management. These findings need confirming with a large number of patients and at different time points.
伤口床评分是一种经过验证的监测慢性伤口愈合的工具，依赖于经过培训的人员进行视觉检查。本研究描述了添加一些生化和免疫组化参数以提高伤口床评分的客观性和特异性的可行性。方法：纳入患有不同病程小腿慢性伤口的患者，以评估伤口床评分与特定伤口相关生物标志物之间的相关性，这些生物标志物即基质金属蛋白酶-9（MMP-9）、基质金属蛋白酶-2（MMP-2）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、白蛋白、整合素α2/β1，以及从伤口边缘和床部采集的活检组织和涂片的其他组织化学（CD68、PK1、CD32、趋化因子、骨膜蛋白）和免疫细胞化学标志物。
该研究检查了10名患者的样本。伤口床评分不佳的患者伤口床组织中骨膜蛋白和趋化因子表达较低。在大多数样本中，CD68、PK1显示低表达或阴性表达。CD68、PK1阴性的患者CD32也为阴性。主成分分析显示白蛋白水平和蛋白量与高伤口床评分相关。可以通过整合素α2/β1和白蛋白百分比或MMP-9和MMP-2活性区分出两个不同的患者亚组。结论：这些初步结果为改善伤口状态诊断以及提高伤口护理和管理质量铺平了道路。这些发现需要在大量患者和不同时间点进行确认。
