Aruga Kohsuke, Takehara Kimie, Kametaka Satoshi
Biofunctional Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Fundamental Nursing, Department of Health Sciences, Fujita Health University Graduate School of Health Science, Toyoake, Aichi, Japan.
Int Wound J. 2024 Dec;21(12):e70118. doi: 10.1111/iwj.70118.
A wide variety of microbial species, including Trichophyton spp., have been detected in diabetic foot ulcers (DFUs). In particular, Trichophyton spp. cause tinea pedis (i.e., athlete's foot) and onychomycosis. However, investigations regarding the correlation between Trichophyton spp. and delayed wound healing are limited to case reports. Moreover, histological changes in wounds caused by Trichophyton spp. remain unclear. In this study, we sought to confirm the delayed wound healing phenotype caused by Trichophyton mentagrophytes infection in a full-thickness excisional wound ob/ob mouse model through histopathological analysis. The inoculation of skin wounds in ob/ob mice with T. mentagrophytes sporules resulted in significant delay on wound healing. Further histopathological analyses demonstrated that the delayed wound healing in ob/ob mice was accompanied by reduced collagen fibre formation and inhibited granulation tissue formation, with spores and elongated mycelia retained in the wound bed and along the wound edges. This suggests that T. mentagrophytes colonization of wounds potentially contributes to delayed wound healing in patients with diabetes. These results suggest that neglected tinea pedis is a potential risk factor for delayed wound healing and progression to refractory wounds in patients with DFU.
在糖尿病足溃疡(DFU)中已检测到多种微生物,包括毛癣菌属。特别是,毛癣菌属会引起足癣(即运动员脚癣)和甲癣。然而,关于毛癣菌属与伤口愈合延迟之间相关性的研究仅限于病例报告。此外,由毛癣菌属引起的伤口组织学变化仍不清楚。在本研究中,我们试图通过组织病理学分析,在全层切除伤口的ob/ob小鼠模型中确认须癣毛癣菌感染导致的伤口愈合延迟表型。用须癣毛癣菌孢子接种ob/ob小鼠的皮肤伤口会导致伤口愈合显著延迟。进一步的组织病理学分析表明,ob/ob小鼠伤口愈合延迟伴随着胶原纤维形成减少和肉芽组织形成受抑制,伤口床和伤口边缘保留有孢子和细长的菌丝体。这表明伤口中须癣毛癣菌的定植可能导致糖尿病患者伤口愈合延迟。这些结果表明,被忽视的足癣是DFU患者伤口愈合延迟和发展为难治性伤口的潜在危险因素。