Effect of topical application of recombinant human type-Ⅲ collagen hydrogels on diabetic wound healing

doi:10.3877/cma.j.issn.1673-9450.2022.05.009

Abstract

Abstract:

Objective

To observe the therapeutic effect of recombinant human type-Ⅲ collagen hydrogels on chronic diabetic wounds, and to explore its influence on the expression levels of inflammatory cytokines in wound tissues.

Methods

From September 2020 to June 2021, 20 diabetes mellitus patients with chronic wounds in lower extremities were selected from Beijing Prevention and Treatment Hospital of Occupational Disease for Chemical Industry, and were divided into the experimental group (10 cases) and the control group (10 cases) according to the random number table. In addition to the basic treatment of diabetes and conventional debridement, the experimental group received topical application of recombinant human type-Ⅲ collagen hydrogels. The wound healing rate, expression levels of tumor necrosis factor-α(TNF-α), interleukin 1β(IL-1β), interleukin 6(IL-6)and matrix metalloproteinase-9(MMP-9) were observed and compared.

Results

After treatment, the area of wounds in both groups decreased. The wound healing rate of the treatment group at 7 d and 14 d after treatment were(34.00±2.53)% and (73.90±13.00)%, which were significantly higher than those of the control group[(23.30±3.89)%, (48.30±6.30)%], the differences were statistically significant (t=1.330, 2.640; P<0.05), 14 d after treatment, the expression levels of TNF-α、IL-1β、IL-6 and MMP-9 decreased, and the expression levels of the treatment group [(87.60±8.78), (71.70±10.30), (79.80±13.60), (11.27±2.45) ng/L] were significantly lower than those of the control group [(111.60±9.86), (81.10±8.03), (96.90±14.50), (15.05±2.82) ng/L], the differences were statistically significant(t=-5.740, -2.260, -2.720, 3.200; P<0.05).

Conclusions

The treatment of chronic diabetic wounds by recombinant human type-Ⅲ collagen hydrogels can accelerate wound healing, reduce wound inflammation and result in significant clinical therapeutic effects.

Key words: Recombinant human type-Ⅲ collagen, Hydrogels, Wound healing, Diabetes mellitus

Xiaogang Huang, Dongsheng Niu, Xiangguo Yan, Kesong Zhang, Junmin He, Xiaojun Wang, Yuanyuan Liu. Effect of topical application of recombinant human type-Ⅲ collagen hydrogels on diabetic wound healing[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2022, 17(05): 430-434.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhssyxfzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1673-9450.2022.05.009

https://zhssyxfzz.cma-cmc.com.cn/EN/Y2022/V17/I05/430

Figures/Tables 3

References 23

[1]	Sun H, Saeedi P, Karuranga S, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045[J]. Diabetes Res Clin Pract, 2021, 183: 109119.
[2]	Grennan D. Diabetic Foot Ulcers[J]. JAMA, 321(1): 114.
[3]	Buch PJ, Chai Y, Goluch ED. Treating Polymicrobial Infections in Chronic Diabetic Wounds[J]. Clin Microbiol Rev, 2019, 32(2): e00091-18.
[4]	Xu X, Jerca VV, Hoogenboom R . Bio-inspired Hydrogels as Multi-task Anti-icing Hydrogel Coatings[J]. Chem, 2020, 6(4): 820-822.
[5]	Chen Z, Fan D, Shang L. Exploring the potential of the recombinant human collagens for biomedical and clinical applications: a short review[J]. Biomed Mater, 2020, 16(1): 012001.
[6]	Hua C, Zhu Y, Xu W, et al. Characterization by high-resolution crystal structure analysis of a triple-helix region of human collagen type III with potent cell adhesion activity[J]. Biochem Biophys Res Commun, 2019, 508(4): 1018-1023.
[7]	Hu C, Liu W, Long L, et al. Microenvironment-responsive multifunctional hydrogels with spatiotemporal sequential release of tailored recombinant human collagen type III for the rapid repair of infected chronic diabetic wounds[J]. Mater Chem B, 2021, 9(47): 9684-9699.
[8]	刘彤，郑兴锋，李海航，等. 重组人Ⅲ型胶原蛋白水凝胶对猪全层皮肤缺损创面修复的影响[J/CD]. 中华损伤与修复杂志(电子版), 2019, 14(2): 97-102.
[9]	钱荣立. 关于糖尿病的新诊断标准与分型[J]. 中国糖尿病杂志，2000, 8(1): 5-6.
[10]	Carrinho PM, Andreani DIK, Morete VA, et al. A Study on the Macroscopic Morphometry of the Lesion Area on Diabetic Ulcers in Humans Treated with Photodynamic Therapy Using Two Methods of Measurement[J]. Photomed Laser Surg, 2018, 36(1): 44-50.
[11]	Leung A, Crombleholme TM, Keswani SG. Fetal wound healing: implications for minimal scar formation[J]. Curr Opin Pediatr, 2012, 24(3): 371-378.
[13]	Xie H, Chen X , Shen X, et al. Preparation of Chitosan-collagen-alginate Composite Dressing and Its Promoting Effects on Wound Healing[J]. Int J Biol Macromol, 2018, 107(Pt A): 93-104.
[14]	Korkmaz P, Koçak H, Onbaşı K, et al. The Role of Serum Procalcitonin, Interleukin-6, and Fibrinogen Levels in Differential Diagnosis of Diabetic Foot Ulcer Infection[J]. J Diabetes Res, 2018, 2018: 7104352.
[15]	Weigelt C, Rose B, Poschen U, et al. Immune Mediators in Patients With Acute Diabetic Foot Syndrome[J]. Diabetes Care, 2009, 32(8): 1491-1496.
[16]	Yang KC, Ma X, Liu H, et al. Tumor necrosis factor receptor-associated factor 2 mediates mitochondrial autophagy.[J]. Circ Heart Fail, 2015, 8(1): 175-187.
[17]	Lin CJ, Lan YM, Ou MQ, et al. Expression of miR-217 and HIF-1α/VEGF pathway in patients with diabetic foot ulcer and its effect on angiogenesis of diabetic foot ulcer rats[J]. J Endocrinol Invest, 2019, 42(11): 1307-1317.
[18]	Mirza RE, Koh TJ. Contributions of Cell Subsets to Cytokine Production during Normal and Impaired Wound Healing[J]. Cytokine, 2015, 71(2): 409-412.
[19]	Mirza RE, Fang MM, Ennis WJ, et al. Blocking interleukin-1β induces a healing-associated wound macrophage phenotype and improves healing in type 2 diabetes[J]. Diabetes, 2013, 62(7): 2579-2587.
[20]	Weigelt C, Rose B, Poschen U, et al. Immune Mediators in Patients With Acute Diabetic Foot Syndrome[J]. Diabetes Care, 2009, 32(8): 1491-1496.
[21]	Al -Rikabi AHA, Tobin DJ, Riches-Suman K, et al. Dermal fibroblasts cultured from donors with type 2 diabetes mellitus retain an epigenetic memory associated with poor wound healing responses[J]. Sci Rep, 2021, 11(1): 1474.
[22]	Patel S, Maheshwari A, Chandra A. Biomarkers for wound healing and their evaluation[J]. J Wound Care, 2016, 25(1): 46-55.
[23]	Menghini R, Uccioli L, Vainieri E, et al. Expression of tissue inhibitor of metalloprotease 3 is reduced in ischemic but not neuropathic ulcers from patients with type 2 diabetes mellitus[J]. Acta Diabetologica, 2013, 50(6): 907-910.

组别	例数(例)	性别(例)		年龄(岁，±s)	体重指数(kg/m²，±s)	HbA1c(%，±s)	创面病程[d，M(Q₁，Q₃)]	创面面积[cm²，M(Q₁，Q₃)]
组别	例数(例)	男	女	年龄(岁，±s)	体重指数(kg/m²，±s)	HbA1c(%，±s)	创面病程[d，M(Q₁，Q₃)]	创面面积[cm²，M(Q₁，Q₃)]
试验组	10	6	4	55.70±6.88	22.58±1.67	9.30±1.15	56(35，100)	21.50(14.25，38.00)
对照组	10	5	5	51.40±8.22	21.90±1.83	9.43±1.02	42(35，100)	26.00(18.75，34.75)
χ²/t/u值		0.202		1.268	0.882	－0.267	26	49
P值		0.653		0.221	0.390	0.792	0.069	0.940

组别	例数(例)	性别(例)		年龄(岁，±s)	体重指数(kg/m²，±s)	HbA1c(%，±s)	创面病程[d，M(Q₁，Q₃)]	创面面积[cm²，M(Q₁，Q₃)]
组别	例数(例)	男	女	年龄(岁，±s)	体重指数(kg/m²，±s)	HbA1c(%，±s)	创面病程[d，M(Q₁，Q₃)]	创面面积[cm²，M(Q₁，Q₃)]
试验组	10	6	4	55.70±6.88	22.58±1.67	9.30±1.15	56(35，100)	21.50(14.25，38.00)
对照组	10	5	5	51.40±8.22	21.90±1.83	9.43±1.02	42(35，100)	26.00(18.75，34.75)
χ²/t/u值		0.202		1.268	0.882	－0.267	26	49
P值		0.653		0.221	0.390	0.792	0.069	0.940

组别	例数(例)	治疗后7 d	治疗后14 d
试验组	10	34.00±2.53	73.90±13.00
对照组	10	23.30±3.89	48.30±6.30
t值		1.330	2.640
P值		<0.001	<0.001

组别	例数(例)	治疗后7 d	治疗后14 d
试验组	10	34.00±2.53	73.90±13.00
对照组	10	23.30±3.89	48.30±6.30
t值		1.330	2.640
P值		<0.001	<0.001

组别	TNF-α		IL-1β		IL-6		MMP-9
组别	治疗前	治疗后14 d	治疗前	治疗后14 d	治疗前	治疗后14 d	治疗前	治疗后14 d
试验组	143.10±9.10	87.60±8.78^a	99.30±11.60	71.70±10.30^a	118.40±12.98	79.80±13.60^a	23.31±4.48	11.27±2.45^a
对照组	148.90±8.90	111.60±9.86^a	100.80±12.10	81.10±8.03^a	119.80±12.34	96.90±14.50^a	20.48±3.19	15.05±2.82^a
t值	－1.440	－5.740	－0.282	－2.260	－0.237	－2.720	1.630	3.200
P值	0.168	<0.001	0.781	0.036	0.815	0.014	0.121	0.005

Please choose a citation manager

Content to export