Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Shushan District, Hefei City, Anhui Province, People's Republic of China.
Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, People's Republic of China.
Sci Rep. 2023 Sep 27;13(1):16192. doi: 10.1038/s41598-023-42634-9.
To understand the changes in the peroxiredoxin-2 (PRDX2) expression level in the wound margin tissue (T-PRDX2) of patients with diabetic foot ulcer (DFU) before and after negative pressure wound therapy (NPWT). Additionally, the study aimed to explore the association between PRDX2 expression and the treatment outcome of DFUs to provide a new theoretical basis for revealing the mechanism of NPWT promoting the healing of DFUs. Fifty-six type 2 diabetes patients with foot ulcers undergoing NPWT (the DFU group) and 28 patients with chronic lower limb skin ulcers with normal glucose tolerance undergoing NPWT (the skin ulcer control [SUC] group) were included in the study. T-PRDX2 was detected using Western blotting, and the superoxide dismutase (SOD) activity and the malondialdehyde (MDA) and glutathione (GSH) levels were detected using a biochemical method. In addition, in vitro experiments were conducted to determine the effect of PRDX2 expression on normal human dermal fibroblast (NHDF) proliferation, migration, and apoptosis. Before NPWT, the DFU group exhibited a significantly lower T-PRDX2 expression level compared with the SUC group. After one week of NPWT, the T-PRDX2 expression level, SOD activity, and GSH content in the wound margin tissues of the DFU and SUC groups significantly increased compared with the before NPWT levels. Conversely, the inflammatory indicators (white blood cell, neutrophil percentage, C-reactive protein, and procalcitonin) and MDA content were significantly lower than the before NPWT levels. The expression changes of T-PRDX2 before and after NPWT in the DFU and SUC groups were positively correlated with the 4-week wound healing rate. In vitro experiments demonstrated that PRDX2 could alleviate the oxidative stress in NHDFs, thereby promoting their proliferation and migration, while reducing cell apoptosis. NPWT promotes DFU healing by increasing T-PRDX2, and changes in the T-PRDX2 might be associated with the therapeutic effect of NPWT.
为了了解糖尿病足溃疡（DFU）患者负压伤口治疗（NPWT）前后伤口边缘组织中过氧化物酶 2（PRDX2）表达水平（T-PRDX2）的变化，并探讨 PRDX2 表达与 DFU 治疗效果的关系，为揭示 NPWT 促进 DFU 愈合的机制提供新的理论依据。将 56 例接受 NPWT 的 2 型糖尿病足溃疡患者（DFU 组）和 28 例接受 NPWT 的慢性下肢皮肤溃疡且血糖正常的患者（皮肤溃疡对照组[SUC]组）纳入研究。采用 Western blot 检测 T-PRDX2，生化法检测超氧化物歧化酶（SOD）活性和丙二醛（MDA）和谷胱甘肽（GSH）水平。此外，还进行了体外实验，以确定 PRDX2 表达对正常人类真皮成纤维细胞（NHDF）增殖、迁移和凋亡的影响。在 NPWT 之前，DFU 组的 T-PRDX2 表达水平明显低于 SUC 组。NPWT 一周后，DFU 和 SUC 组伤口边缘组织中的 T-PRDX2 表达水平、SOD 活性和 GSH 含量均较 NPWT 前显著升高。相反，炎症指标（白细胞、中性粒细胞百分比、C 反应蛋白和降钙素原）和 MDA 含量均明显低于 NPWT 前水平。DFU 和 SUC 组 NPWT 前后 T-PRDX2 的表达变化与 4 周伤口愈合率呈正相关。体外实验表明，PRDX2 可减轻 NHDF 的氧化应激，从而促进其增殖和迁移，同时减少细胞凋亡。NPWT 通过增加 T-PRDX2 促进 DFU 愈合，T-PRDX2 的变化可能与 NPWT 的治疗效果有关。
