Ma Tian Yi, Tang Shi Lin, Wang Bin, Wang Gan, Sun Chang Ming, Pan Jia Xi, Han Dan Qi, Li Jia Yang, Zhong Jiang Hua
Department of Cardiology, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou, Hainan, China.
Int Wound J. 2024 Feb;21(2):e14762. doi: 10.1111/iwj.14762.
Ischemic ulcers pose a multifaceted clinical dilemma for patients with atherosclerosis, frequently compounded by suboptimal wound healing mechanisms. The dual function of Transforming Growth Factor Beta 3 (TGF-β3) in ischemic ulcer healing is not fully comprehended, despite its involvement in modulating inflammatory responses and tissue regeneration. The main aim of this investigation was to clarify the functions and mechanisms by which TGF-β3 regulates inflammatory responses and promotes wound healing in patients with ischemic ulcers who have atherosclerosis. Between August 2022 and November 2023, this cross-sectional investigation was conducted on 428 patients diagnosed with atherosclerotic ischemic ulcers in Haikou, China. The expression and function of TGF-β3 were examined throughout the different stages of wound healing, including inflammation, proliferation and remodelling. In addition to documenting patient demographics and ulcer characteristics, an analysis was conducted on biopsy samples to determine the expression of TGF-β3, pro-inflammatory and anti-inflammatory markers. A subset of patients were administered topical TGF-β3 in order to evaluate its therapeutic effects. The expression pattern of TGF-β3 was found to be stage-dependent and significant, exhibiting increased levels during the phase of inflammation and reduced activity in subsequent phases. TGF-β3 levels were found to be greater in ulcers that were larger and deeper, especially in inflammatory phase. TGF-β3 applied topically induced discernible enhancement in ulcer healing parameters, such as reduction in ulcer depth and size. The therapeutic significance of TGF-β3 was emphasised due to its twofold function of regulating the inflammatory environment and facilitating the regeneration of damaged tissues. Ischemic ulcer lesion healing is significantly influenced by TGF-β3, which functions as an anti-inflammatory and pro-inflammatory mediator. Its correlation with ulcer characteristics and stages of healing suggests that it may have utility as a targeted therapeutic agent.
缺血性溃疡给动脉粥样硬化患者带来了多方面的临床难题,伤口愈合机制欠佳往往使情况更加复杂。尽管转化生长因子β3(TGF-β3)参与调节炎症反应和组织再生,但其在缺血性溃疡愈合中的双重作用尚未完全明确。本研究的主要目的是阐明TGF-β3调节炎症反应并促进动脉粥样硬化缺血性溃疡患者伤口愈合的功能和机制。2022年8月至2023年11月,在中国海口对428例诊断为动脉粥样硬化性缺血性溃疡的患者进行了这项横断面研究。在伤口愈合的不同阶段,包括炎症、增殖和重塑阶段,检测了TGF-β3的表达和功能。除记录患者人口统计学和溃疡特征外,还对活检样本进行分析以确定TGF-β3、促炎和抗炎标志物的表达。对一部分患者局部应用TGF-β3以评估其治疗效果。发现TGF-β3的表达模式具有阶段依赖性且显著,在炎症阶段水平升高,在随后阶段活性降低。发现TGF-β3水平在更大、更深的溃疡中更高,尤其是在炎症期。局部应用TGF-β3可使溃疡愈合参数有明显改善,如溃疡深度和大小减小。由于TGF-β3具有调节炎症环境和促进受损组织再生的双重功能,其治疗意义得到了强调。TGF-β3作为一种抗炎和促炎介质,对缺血性溃疡病变愈合有显著影响。其与溃疡特征和愈合阶段的相关性表明它可能作为一种靶向治疗药物具有应用价值。