Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 10, October, p. 1301–1309

doi: 10.17219/acem/103845

Publication type: original article

Language: English

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Impact of chronic wounds of various etiology on systemic profiles of key inflammatory cytokines, chemokines and growth factors, and their interplay

Małgorzata Krzystek-Korpacka1,, Krzysztof Kędzior1,C,E,F, Leszek Masłowski2,A,B,E,F, Magdalena Mierzchała1,, Iwona Bednarz-Misa1,C,D,F, Agnieszka Bronowicka-Szydełko1,B,E,F, Joanna Kubiak2,B,E,F, Małgorzata Gacka3,B,E,F, Sylwia Płaczkowska4,C,E,F, Andrzej Gamian1,A,E,F

1 Department of Medical Biochemistry, Faculty of Medicine, Wroclaw Medical University, Poland

2 Department of Angiology, Regional Specialist Hospital, Wrocław, Poland

3 Department of Angiology, Hypertension and Diabetes, Wrocław Medical University, Poland

4 Department of Professional Training in Clinical Chemistry, Wroclaw Medical University, Poland

Abstract

Background. Non-healing wounds are becoming a growing concern for public health as a result of their increasing prevalence in progressively aging societies.
Objectives. The aim of this article is to evaluate the effects of wound etiology on a panel of circulating cytokines in patients with non-healing wounds of the lower extremities.
Material and Methods. This prospective case-control study involved 104 individuals: healthy elderly people (n = 46) and patients with diabetes and/or cardiovascular disease (n = 58; among them 38 with chronic wounds of venous, ischemic or neurotrophic etiology). Selected serum cytokines – i.e. IL-1β, IL-4, IL-6, IL-8, FGF-2, G-CSF, GM-CSF, MCP-1, MIP-1α, TNF-α, VEGF-A, and PDGF-BB – were measured using the Luminex platform.
Results. Compared to healthy elderly people, presence of diabetes and/or cardiovascular disease was associated with elevated IL-6, IL-8, MCP-1 and G-CSF while non-healing wounds coexisted with the increase in the levels of all examined cytokines/growth factors except for G-CSF and GM-CSF. Among diseased elderly people, having wounds was associated with increased levels of IL-1β, IL-4, IL-6, IL-8, FGF-2, MIP-1α, PDGF-BB, and VEGF-A. Interleukin 1β elevation was a sole independent predictor of chronic wounds with an odds ratio (OR) of 6.3. Cytokines in healthy seniors were loosely interrelated, while the levels of cytokines in diseased patients with wounds displayed a tight pattern of association. When stratified by their etiology, the association pattern for IL-6, IL-8, MCP-1, and VEGF-A was disrupted in neurotrophic wounds.
Conclusion. The results presented herein may improve our understanding of the pathomechanisms which lead to chronic wounds and of the effects they exert on a systemic level, as well as providing potential targets for more effective therapies.

Key words

diabetes, venous stasis, ischemic wounds, neurotrophic wounds, inflammation

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