Extensive serum biomarker analysis before and after treatment in healing of diabetic foot ulcers using a cytokine antibody array.

Diabetic foot ulcers (DFU) remain a serious public health problem. However, the current evaluation and confirmation of the efficacy of DFU is unclear. The present study aimed to measure the alterations of circulating proteins in patients after DFU healing for the exploration of the prognostic biomarkers. The serum cytokine profiles of DFU patients before and after treatment were analyzed by a human antibody microarray technology using diabetic patients and healthy population as control groups. The results showed that ten differential cytokines were associated with DFU healing. Among these ten cytokines, comparing to DFU group, nine ones (Jagged-1, CD14, Cathepsin S, Syndecan 4, MDC, TARC, Angiopoietin-4, Clusterin and HGFR) were significantly up-regulated in DFU-treated group and Follistatin-like 1 was significantly down-regulated, while their levels in DFU-treated group showed no significant differences from those in control groups. Furthermore, ELISA validation also showed that compares to DFU group four of ten (MDC, TARC, Clusterin, and Syndecan 4) were increased in DFU-treated group equal to the levels in control groups, consistent with the array results. Our finding shows that these four cytokines may have great potential for prognostic evaluation of DFU healing.