Copenhagen Wound Healing Center and Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
Acta Derm Venereol. 2022 Jul 7;102:adv00749. doi: 10.2340/actadv.v102.201.
There is a need for biomarkers that predict the success of transplantation of venous leg ulcers (with autologous split-thickness skin grafts). The primary objective of this exploratory study was to investigate the association between split-thickness skin graft healing in venous leg ulcers and candidate wound fluid biomarkers representing inflammatory cell and endogenous proteinase activities, and bioactivity. A secondary objective was to compare biomarker levels of the 17 venous leg ulcers with sterile split-thickness skin graft donor-site wounds in another 10 patients with venous leg ulcers. Wound fluids were collected for 24 h using a validated method. The concentration of preoperative matrix metalloproteinase-9 in wound fluid was higher in venous leg ulcers showing good healing (n = 10) than in venous leg ulcers showing poor healing (n = 7) 12 weeks after transplantation with meshed split-thickness skin grafts. The diagnostic value of matrix metalloproteinase-9 was good according to receiver-operating characteristic curve analysis. Matrix metalloproteinase activity in wound fluids from split-thickness skin graft donor-site wounds increased as a function of time and healing, but was still lower than matrix metalloproteinase activity in venous leg ulcer wound fluids, which showed increased levels of most biomarkers except for matrix metalloproteinase-9 and matrix metalloproteinase-2. In conclusion, wound fluid matrix metalloproteinase-9 concentration is a potential predictive biomarker of split-thickness skin graft healing in venous leg ulcers.
需要有生物标志物来预测静脉性腿部溃疡（自体断层皮片移植）移植的成功率。本探索性研究的主要目的是研究静脉性腿部溃疡中断层皮片愈合与代表炎症细胞和内源性蛋白酶活性及生物活性的候选创面液生物标志物之间的关联。次要目的是比较 17 例静脉性腿部溃疡和 10 例静脉性腿部溃疡患者另 10 例无菌断层皮片供区创面的生物标志物水平。使用经过验证的方法采集 24 小时的创面液。在移植网孔状断层皮片 12 周后，愈合良好（n = 10）的静脉性腿部溃疡的创面液中术前基质金属蛋白酶-9 浓度高于愈合不良（n = 7）的静脉性腿部溃疡。根据受试者工作特征曲线分析，基质金属蛋白酶-9 的诊断价值良好。断层皮片供区创面液中的基质金属蛋白酶活性随时间和愈合而增加，但仍低于静脉性腿部溃疡创面液中的基质金属蛋白酶活性，除基质金属蛋白酶-9 和基质金属蛋白酶-2 外，静脉性腿部溃疡创面液中大多数生物标志物的水平均升高。总之，创面液基质金属蛋白酶-9 浓度是预测静脉性腿部溃疡断层皮片愈合的潜在生物标志物。
