Neurovascular factors in wound healing in the foot skin of type 2 diabetic subjects

Singhan T M Krishnan, Cristian Quattrini, Maria Jeziorska, Rayaz A. Malik, Gerry Rayman, Christian Quattrini

    Research output: Contribution to journalArticlepeer-review

    Abstract

    OBJECTIVE - Delayed wound healing in diabetic patients without large-vessel disease has been attributed to microvascular dysfunction, neuropathy, and abnormal cellular and inflammatory responses. The role of these abnormalities has mainly been examined in animal models. Few studies have been undertaken in diabetic patients, and those that have are limited due to analysis in wounds from chronic ulcers. In this study, we quantified the rate of wound healing in relation to skin neurovascular function and structure following a dorsal foot skin biopsy in type 2 diabetes. RESEARCH DESIGN AND METHODS - Twelve healthy control subjects and 12 type 2 diabetic subjects with neuropathy but without macrovascular disease were studied. We quantified rate of wound healing and related it to skin microvascular function (laser Doppler imager [LDI] max), blood vessel density, small nerve fiber function (LDI flare) and nerve fiber density, vascular endothelial growth factor (VEGF) and its receptor (FLK1), and hypoxia-inducible factor (HIF)-1α expression. RESULTS - The rate of wound closure was identical between control subjects and diabetic patients despite a significant reduction in maximum hyperemia (LDImax), epidermal and dermal VEGF-A, and epidermal and dermal blood vessel VEGFR-2 expression as well as the neurogenic flare response (LDIflare) and dermal nerve fiber density. There was no significant difference in HIF-1α and dermal blood vessel density between control subjects and diabetic patients. CONCLUSIONS - In conclusion, the results of this study suggest that wound closure in subjects with type 2 diabetes is not delayed despite significant alterations in neurovascular function and structure. © 2007 by the American Diabetes Association.
    Original languageEnglish
    Pages (from-to)3058-3062
    Number of pages4
    JournalDiabetes Care
    Volume30
    Issue number12
    DOIs
    Publication statusPublished - Dec 2007

    Keywords

    • Age of Onset
    • Biopsy
    • Body Mass Index
    • pathology: Diabetes Mellitus, Type 2
    • pathology: Diabetic Angiopathies
    • pathology: Diabetic Neuropathies
    • pathology: Foot Injuries
    • Humans
    • Middle Aged
    • Reference Values
    • Sensory Thresholds
    • injuries: Skin
    • analysis: Vascular Endothelial Growth Factor A
    • Vibration
    • physiology: Wound Healing

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