Effect of negative pressure wound therapy on the expression of platelet derived growth factor in granulation tissue of diabetic foot wounds

doi:10.3877/cma.j.issn.1673-9450.2016.02.006

Abstract

Abstract:

Objective

To assess the endogenous regulation of platelet derived growth factor (PDGF) in the foot wound healing response induced by negative pressure wound therapy (NPWT) in human diabetic patients in vivo.

Methods

From January 2010 to December 2014, 40 patients with diabetic foot wounds fitting the inclusion criteria were found and enrolled in the clinical trial. The subjects were randomly assigned for NPWT group or control group with simple random sampling method. Twenty patients were treated with NPWT, while the same number of patients in the control group received conventional gauze therapy. Granulated tissue biopsies were collected before(0 day) and after(12 days) treatment in both groups. All biopsies were subdivided into two parts. One part was preserved in 4% paraformaldehyde for hematoxylin eosin staining and immunocytochemical staining of PDGF, the other part was stored at -80℃ for Western blot analysis of PDGF expression. Experimental data were analyzed using SPSS 13.0 software and differences of absorbance value and protein expression of PDGF between the two groups were analyzed using two-sample t test.

Results

The HE staining showed that both NPWT group and control group wounds developed characteristic granulated tissue after treatment, which presented intense fibroblasts and neoformation of vessels. However, NPWT group wounds developed much more characteristic granulated tissue than control group wounds. The immunohistochemical data revealed that PDGF expression was up-regulated in NPWT group and control group after treatment. The absorbance value of PDGF was higher after treatment than that before treatment in NPWT group, the difference was statistically significant (0.41±0.05 vs 0.29±0.04, t=8.63, P<0.05). Also, the absorbance value of PDGF was higher after treatment than that before treatment in control group, the difference was statistically significant (0.33±0.04 vs 0.28±0.04, t=3.62, P<0.05). However, the change value (difference between before treatment and after treatment) of absorbance value of PDGF was higher in NPWT group than that in control group, the difference was statistically significant (0.13±0.05 vs 0.05±0.03, t=5.89, P<0.05). The Western blot analysis of PDGF was consistent with that of immunohistochemical analysis. The protein levels of PDGF was higher after treatment than that before treatment in NPWT group, the difference was statistically significant (0.24 ±0.04 vs 0.11±0.03, t=11.01, P<0.05). Also, the protein level of PDGF was higher after treatment than that before treatment in control group, the difference was statistically significant (0.17±0.03 vs 0.12±0.03, t=6.06, P<0.05). But, the change value ( difference between before treatment and after treatment) of protein level of PDGF was higher in NPWT group than that in control group, the difference was statistically significant (0.12 ±0.03 vs 0.05 ±0.02, t=9.06, P<0.05).

Conclusion

NPWT obviously enhances PDGF expression of granulation tissue in diabetic foot wound and subsequently promotes wound healing.

Key words: Negative-pressure wound therapy, Diabetic foot, Receptors, platelet derived growth factor

Shaoling Yang, Leilei Sun, Liye Hu, Xiaoling Li, Yiwen Yang, Yanjun Li, Lyuyun Zhu. Effect of negative pressure wound therapy on the expression of platelet derived growth factor in granulation tissue of diabetic foot wounds[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2016, 11(02): 107-112.

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Figures/Tables 5

References 27

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患者一般情况	对照组	NPWT组	检验值	P值
年龄(岁)	59.20±6.44	59.05±6.77	0.07	0.94
性别(男/女)	15/5	10/10	2.67^a	0.10
ABI	0.63±0.09	0.64±0.08	0.49	0.63
TcPO₂(mmHg)	28.80±5.76	29.30±4.67	0.30	0.77
FBG(mmol/L)	8.13±3.84	10.29±3.53	1.86	0.07
HbA1c (%)	10.24±1.96	9.80±2.05	0.69	0.50
溃疡时间(d)	54.25±18.22	58.30±4.57	0.66	0.51
肌酐(μmol/L)	55.50(45.75，71.50)	65(42.25，95.00)	0.87^b	0.40
转氨酶(U/L)	11.95(9.00，19.25)	14(10.00，21.88)	0.66^b	0.51
合并神经病变例数	18	19	0.28^a	0.60

患者一般情况	对照组	NPWT组	检验值	P值
年龄(岁)	59.20±6.44	59.05±6.77	0.07	0.94
性别(男/女)	15/5	10/10	2.67^a	0.10
ABI	0.63±0.09	0.64±0.08	0.49	0.63
TcPO₂(mmHg)	28.80±5.76	29.30±4.67	0.30	0.77
FBG(mmol/L)	8.13±3.84	10.29±3.53	1.86	0.07
HbA1c (%)	10.24±1.96	9.80±2.05	0.69	0.50
溃疡时间(d)	54.25±18.22	58.30±4.57	0.66	0.51
肌酐(μmol/L)	55.50(45.75，71.50)	65(42.25，95.00)	0.87^b	0.40
转氨酶(U/L)	11.95(9.00，19.25)	14(10.00，21.88)	0.66^b	0.51
合并神经病变例数	18	19	0.28^a	0.60

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