Year 2018 Vol. 26 No 5

GENERAL & SPECIAL SURGERY

A.I. RUNDO, V.A. KOSINETS., I.V. SAMSONOVA

PHOTOTHERAPY IMPACT ON THE INTENSITY OF MAC387-POSITIVE MACROPHAGES EXPRESSION IN DIABETIC FOOT SYNDROME

Vitebsk State Medical University, Vitebsk,
The Republic of Belarus

Objective. To study the expression of the inflammatory response marker anti-macrophage antibody MAC387 in the wound zone in patients with diabetic foot syndrome in case of local and combined phototherapy.
Methods. The expression intensity of macrophages marker MAC387 in the serial microscopic biopsy specimens of the wound defect was analyzed in 158 with purulent-necrotic lesions of the feet against the background of diabetes mellitus type 2 at the surgical department of Vitebsk City Emergency Clinical Hospital. Using the randomization method, 3 groups were formed: 1 – control (57 people); 2 – with additional use in the treatment of phototherapy locally over the wound surface (51 people); 3 – with additional use in the treatment of combined phototherapy locally and intravenously (52 people). The effect of phototherapy was assessed by immunohistochemical staining of the biopsy material using monoclonal antibodies to macrophages anti-macrophage antibody MAC387 on 1, 3-5, 7, 14 days from the beginning of treatment.
Results. The wound process in diabetic foot syndrome is accompanied by an increase in the expression intensity of anti-macrophage antibody MAC387, which can serve as a marker of the duration of its course. The use of a local phototherapy is accompanied with an increased level of the macrophages marker МАС387 expression intensity, which demonstrates the positive effect of blue and red light on the inflammatory process course. Combined phototherapy promotes a pronounced increase in the macrophage marker expression by the 7th day and a decrease by the 14th day of therapeutic measures, which indicates a faster onset of the wound process proliferative phase.
Conclusions. In diabetic foot syndrome, the expression intensity of macrophage MAC387 marker changes in the area of the wound defect, which can serve as a criterion for assessing the duration of the wound healing process. The use of local and combined phototherapy allows normalizing the course of the wound process and accelerating the healing of the lower limbs trophic ulcers in patients with diabetic foot syndrome.

Keywords: diabetic foot syndrome, phototherapy, MAC387-positive macrophages, wound process, reparation
p. 570-579 of the original issue
References
  1. Saloko OB, Bogdan EL, Shepel’kevich AP, Shchaveleva MV, Yarosh EA. Rasprostranennost’ khronicheskikh oslozhnenii sakharnogo diabeta v Respublike Belarus’ (po dannym Respublikanskogo registra «Sakharnyi diabet»). Lechebnoe Delo. 2016;(5):31-34. http://lech-delo.by/wpcontent/uploads/content_ld_5_51_2016.jpg (in Russ.)
  2. IDF Diabets atlas [Internet]. 8th ed. [cited 2017 Sep 7]. Available from: http://diabetesatlas.org/resources/2017-atlas.html
  3. Bublik EV, Galstian GR. Epidemiologiia i patogeneticheskie faktory sindroma diabeticheskoi stopy u bol’nykh s terminal’noi stadiei khronicheskoi pochechnoi nedostatochnosti, nakhodiashchikhsia na dialize. Sakhar Diabet. 2007;(3):10-17. https://cyberleninka.ru/article/v/epidemiologiya-i-patogeneticheskie-faktory-sindroma-diabeticheskoy-stopy-u-bolnyh-s-terminalnoy-stadiey-hronicheskoy-pochechnoy (in Russ.)
  4. Tellechea A, Leal EC, Kafanas A, Auster ME, Kuchibhotla S, Ostrovsky Y, Tecilazich F, Baltzis D, Zheng Y, Carvalho E, Zabolotny JM, Weng Z, Petra A, Patel A, Panagiotidou S, Pradhan-Nabzdyk L, Theoharides TC, Veves A. Mast cells regulate wound healing in diabetes. Diabetes. 2016 Jul;65(7):2006-19. doi: 10.2337/db15-0340
  5. Umerov EE. Osobennosti morfologicheskoi struktury kozhi pri ishemicheskikh troficheskikh iazvakh s uchetom makrofagal’noi aktivnosti vospalitel’nogo infil’trata. Svit Meditsini ta Biologii. 2013;(4):89-91. https://womab.com.ua/smb-2013-04-1/3938 (in Russ.)
  6. Varyushina EA, Moskalenko VV, Lebedeva TP, Bubnov AN, Simbirtsev AS. Interleukin-1p application for local treatment of purulent and necrotic lesions of lower extremities. Med Immunologiia. 2008;10(4-5):439-48. http://www.spbraaci.ru/files/2008-4-5-439-448.pdf (in Russ.)
  7. Vinnik IuS, Salmina AB, Drobushevskaia AI, Tepliakova OV, Pozhilenkova EA, Kotikov AR. Osobennosti patogeneza dlitel’no nezazhivaiushchikh ran. Novosti Khirurgii. 2011;19(3):101-10. http://www.surgery.by/pdf/full_text/2011_3_16_ft.pdf (in Russ.)
  8. Maruyama K, Asai J, Ii M, Thorne T, Losordo DW, D’Amore PA. Decreased macrophage number and activation lead to reduced lymphatic vessel formation and contribute to impaired diabetic wound healing. Am J Pathol. 2007 Apr;170(4):1178-91. doi: 10.2353/ajpath.2007.060018
  9. Gibson DJ, Schulftz G. Chronic wound diagnostic for matrix metalloproteinase. Wound Healing Southern Africa. 2009;2:68-70. http://www.woundhealingsa.co.za/index.php/WHSA/article/view/51
  10. Sharifian Z, Bayat M, Alidoust M, Farahani RM, Bayat M, Rezaie F, Bayat H. Histological and gene expression analysis of the effects of pulsed low-level laser therapy on wound healing of streptozotocin-induced diabetic rats. Lasers Med Sci. 2014 May;29(3):1227-35. doi: 10.1007/s10103-013-1500-5
  11. de Loura Santana C, Silva D de F, Deana AM, Prates RA, Souza AP, Gomes MT, de Azevedo Sampaio BP, Shibuya JF, Bussadori SK, Mesquita-Ferrari RA, Fernandes KP, França CM. Tissue responses to postoperative laser therapy in diabetic rats submitted to excisional wounds. PLoS One. 2015 Apr 24;10(4):e0122042. doi: 10.1371/journal.pone.0122042
  12. Li Y, Zhang J, Xu Y, Han Y, Jiang B, Huang L, Zhu H, Xu Y, Yang W, Qin C. Effects of 630 nm red and 460 nm blue light emitting diode irradiation on healing of the skin wound in Japanese big-ear white rabbit. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2017 Jun 20;39(3):301-306. doi: 10.3881/j.issn.1000-503X.2017.03.001
  13. Houreld N, Abrahamse H. He-Ne laser irradiation stimulates proliferation and migration of diabetic wounded fibroblast cells. In: Waynant R, Tata DB. (eds). Proceedings of Light-Activated Tissue Regeneration and Therapy Conference. Springer, Boston, MA; 2008;12. р. 221-32. https://link.springer.com/chapter/10.1007%2F978-0-387-71809-5_21
  14. Zhang H, Liu S, Yang X, Chen N, Pang F, Chen Z, Wang T, Zhou J, Ren F, Xu X, Li T. LED Phototherapy with gelatin sponge promotes wound healing in mice. Photochem Photobiol. 2018 Jan;94(1):179-85. doi: 10.1111/php.12816
Address for correspondence:
210023, The Republic of Belarus,
Vitebsk, Frunze Ave., 27,
Vitebsk State Medical University,
Department of Operative Surgery
And Topographic Anatomy,
Tel. office.: +375 212 24-08-09,
Tel. mob.: +375 33 645-12-01,
e-mail: qlex2007@yandex.ru,
Aliaksei I. Rundo
Information about the authors:
Rundo Aliaksei I., Assistant of the Department of Operative Surgery and Topographic Anatomy, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0001-8264-3197
Kosinets Vladimir A., MD, Professor of the Department of Hospital Surgery with courses of Urology and Pediatric Surgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0001-7127-1877
Samsonova Inna V., PhD, Associate Professor, Head of the Department of Pathological Anatomy with a course of Forensic Medicine, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-6634-0935
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