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基于RNA测序技术的局部氧疗促进糖尿病足伤口愈合机制的随机研究

Randomized research on the mechanism of local oxygen therapy promoting wound healing of diabetic foot based on RNA-seq technology.

作者信息

Wang Shuo, Pan Li-Feng, Gao Lei, Qin Xin-Yuan, Wang Jiang-Ning

机构信息

Department of Orthopedic Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China.

Emergency Department, Jinan Hospital, Jinan, China.

出版信息

Ann Palliat Med. 2021 Feb;10(2):973-983. doi: 10.21037/apm-20-295. Epub 2021 Jan 5.

Abstract

BACKGROUND

High purity oxygen therapy has good clinical efficacy in the treatment of diabetic foot (DF), but its mechanism of promoting wound healing has been unclear.

METHODS

Patients with DF were randomly divided into an experimental group and a control group. The experimental group was given local oxygen therapy (LOT) by a micro-oxygen therapy instrument, which administered uninterrupted >95% pure oxygen for 24 h at a flow rate of 3 mL/h. Six skin samples from the experimental group before and after treatment underwent RNA sequencing (RNA-seq), and the differentially expressed genes (DEGs) were screened.

RESULTS

The clinical results showed that the mean wound healing time of the experimental group was 26 days (P<0.05); the healing area of the experimental group was 3.1-15.3 cm3 , with a mean of 8.8 cm3 , and that of the control group was 2.4-10.4 cm3 (P<0.05). LOT promoted the healing of DF wounds mainly through the tumor necrosis factor (TNF) signaling pathway and the apoptosis pathway.

CONCLUSIONS

According to our results, LOT can promote DF healing mainly by inhibiting the local oxidative stress reaction of wound skin and by inhibiting the inflammatory and apoptotic pathways. The molecular markers and pathways screened warrant further study.

摘要

背景

高纯度氧疗法在糖尿病足(DF)治疗中具有良好的临床疗效,但其促进伤口愈合的机制尚不清楚。

方法

将DF患者随机分为实验组和对照组。实验组采用微量氧疗仪进行局部氧疗(LOT),以3 mL/h的流速不间断给予>95%的纯氧24小时。对实验组治疗前后的六个皮肤样本进行RNA测序(RNA-seq),筛选差异表达基因(DEG)。

结果

临床结果显示,实验组的平均伤口愈合时间为26天(P<0.05);实验组的愈合面积为3.1 - 15.3 cm³,平均为8.8 cm³,对照组为2.4 - 10.4 cm³(P<0.05)。LOT主要通过肿瘤坏死因子(TNF)信号通路和凋亡通路促进DF伤口愈合。

结论

根据我们的结果,LOT主要通过抑制伤口皮肤局部氧化应激反应以及抑制炎症和凋亡通路来促进DF愈合。所筛选出的分子标志物和通路值得进一步研究。

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