Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China.
School of Public Health and Tropic Medicine, Southern Medical University, Guangzhou, China.
Front Endocrinol (Lausanne). 2022 Aug 24;13:960551. doi: 10.3389/fendo.2022.960551. eCollection 2022.
Macrophages, the main immune cells in the skin, form an innate immune barrier. Under physiological conditions, skin maintains immune barrier function through macrophage phagocytosis and antigen presentation. Parenchymal and stromal cell regeneration plays an important role in skin injury repair and uses macrophage plasticity to influence and stabilize the skin microenvironment. Diabetic skin lesions are the most common diabetes complication and are involved in the early pathophysiology of diabetic foot. Therefore, studying the initial link in diabetic skin lesions is a research hot spot in the early pathogenesis of diabetic foot. Skin inflammation caused by hyperglycaemia, oxidative stress and other injuries is an important feature, but the specific mechanism is unknown. Recent studies have suggested that chronic inflammatory injury is widely involved in a variety of skin diseases, and whether it plays an important role in diabetic skin lesions is unclear. In this review, current research hotspots were combined with the pathogenesis of diabetic skin lesions and analysed from the perspectives of the physiological function of skin macrophages, the impairment of skin macrophages in diabetes, and the mechanism of chronic inflammatory injury in macrophages to provide a theoretical basis for early screening and evaluation of diabetic foot.
巨噬细胞是皮肤中的主要免疫细胞，形成先天免疫屏障。在生理条件下，皮肤通过巨噬细胞吞噬和抗原呈递来维持免疫屏障功能。实质细胞和基质细胞的再生在皮肤损伤修复中起着重要作用，利用巨噬细胞的可塑性来影响和稳定皮肤微环境。糖尿病性皮肤病变是最常见的糖尿病并发症，涉及糖尿病足的早期病理生理学。因此，研究糖尿病性皮肤病变中的初始环节是糖尿病足早期发病机制的研究热点。高血糖、氧化应激等损伤引起的皮肤炎症是一个重要特征，但具体机制尚不清楚。最近的研究表明，慢性炎症损伤广泛涉及多种皮肤疾病，其在糖尿病性皮肤病变中是否起重要作用尚不清楚。本综述结合糖尿病性皮肤病变的发病机制，从皮肤巨噬细胞的生理功能、糖尿病时皮肤巨噬细胞的损伤以及巨噬细胞慢性炎症损伤的机制等方面进行分析，为糖尿病足的早期筛查和评估提供理论依据。
