The aim of this study was to compare the serum levels of the anti-angiogenic factor endostatin (S-endostatin) as a potential marker of vasculogenesis after autologous cell therapy (ACT) versus percutaneous transluminal angioplasty (PTA) in diabetic patients with critical limb ischemia (CLI). A total of 25 diabetic patients with CLI treated in our foot clinic during the period 2008-2014 with ACT generating potential vasculogenesis were consecutively included in the study; 14 diabetic patients with CLI who underwent PTA during the same period were included in a control group in which no vasculogenesis had occurred. S-endostatin was measured before revascularization and at 1, 3, and 6 months after the procedure. The effect of ACT and PTA on tissue ischemia was confirmed by transcutaneous oxygen pressure (TcPO2) measurement at the same intervals. While S-endostatin levels increased significantly at 1 and 3 months after ACT (both P < 0.001), no significant change of S-endostatin after PTA was observed. Elevation of S-endostatin levels significantly correlated with an increase in TcPO2 at 1 month after ACT ( r = 0.557; P < 0.001). Our study showed that endostatin might be a potential marker of vasculogenesis because of its significant increase after ACT in diabetic patients with CLI in contrast to those undergoing PTA. This increase may be a sign of a protective feedback mechanism of this anti-angiogenic factor.
- MeSH
- angioplastika * MeSH
- antigeny CD34 analýza MeSH
- autologní transplantace MeSH
- buněčná a tkáňová terapie MeSH
- diabetes mellitus 2. typu krev komplikace MeSH
- diabetická noha krev terapie MeSH
- endostatiny krev MeSH
- fyziologická neovaskularizace MeSH
- ischemie krev terapie MeSH
- kmenové buňky cytologie MeSH
- končetiny krevní zásobení MeSH
- lidé středního věku MeSH
- lidé MeSH
- onemocnění periferních cév terapie MeSH
- senioři MeSH
- transplantace kmenových buněk * MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
The aim of our study was to analyse immune abnormalities in patients with chronic infected diabetic foot ulcers (DFUs) especially those infected by resistant microorganisms. Methods. 68 patients treated in our foot clinic for infected chronic DFUs with 34 matched diabetic controls were studied. Patients with infected DFUs were subdivided into two subgroups according to the antibiotic sensitivity of causal pathogen: subgroup S infected by sensitive (n = 50) and subgroup R by resistant pathogens (n = 18). Selected immunological markers were compared between the study groups and subgroups. Results. Patients with infected chronic DFUs had, in comparison with diabetic controls, significantly reduced percentages (p < 0.01) and total numbers of lymphocytes (p < 0.001) involving B lymphocytes (p < 0.01), CD4+ (p < 0.01), and CD8+ T cells (p < 0.01) and their naive and memory effector cells. Higher levels of IgG (p < 0.05) including IgG1 (p < 0.001) and IgG3 (p < 0.05) were found in patients with DFUs compared to diabetic controls. Serum levels of immunoglobulin subclasses IgG2 and IgG3 correlated negatively with metabolic control (p < 0.05). A trend towards an increased frequency of IgG2 deficiency was found in patients with DFUs compared to diabetic controls (22% versus 15%; NS). Subgroup R revealed lower levels of immunoglobulins, especially of IgG4 (p < 0.01) in contrast to patients infected by sensitive bacteria. The innate immunity did not differ significantly between the study groups. Conclusion. Our study showed changes mainly in the adaptive immune system represented by low levels of lymphocyte subpopulations and their memory effector cells, and also changes in humoral immunity in patients with DFUs, even those infected by resistant pathogens, in comparison with diabetic controls.
- MeSH
- adaptivní imunita MeSH
- antibakteriální látky terapeutické užití MeSH
- bakteriální infekce krev farmakoterapie imunologie MeSH
- diabetická noha krev farmakoterapie imunologie MeSH
- dospělí MeSH
- imunoglobuliny krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfocyty imunologie MeSH
- počet lymfocytů MeSH
- přirozená imunita MeSH
- průřezové studie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
An electrophoretic stacking method has been developed for monitoring the therapeutic level of the antibiotic ceftazidime in blood plasma and microdialysates taken from peripheral soft tissues of the lower limbs of patients with diabetic foot syndrome. The biological samples are treated by addition of acetonitrile in an amount of 75% v/v and injected into a capillary in a large volume; after turning on the separation voltage, the residual acetonitrile is forced out of the capillary by the application of hydrodynamic pressure. The clinical samples were separated in an optimised background electrolyte composed of 50 mM chloroacetic acid +20% v/v methanol +0.5% v/v INST coating solution. The attained LOD for ceftazidime equalled 0.42 μg mL-1(0.8 μM) and the migration time equalled 3.75 min when using a 25 μm capillary with minimum length of 31.5 cm. The separation was controlled by a maximum voltage of +30 kV and the movement of the analyte was accelerated by a pressure of 50 mbar. The RSD values for intra-day repeatability of the migration time and peak area are 0.14% and 3.8%, respectively; the inter-day values equalled 0.25% for the migration time and 7.3% for peak area, respectively. Pharmacological studies revealed that ceftazidime passes from the blood circulation to the peripheral tissues of the lower limbs with an efficiency of 20%. The introduction of CE control of ceftazidime level in diabetic foot represents a very important improvement in achieving the targeted therapeutic effect.
- MeSH
- antibakteriální látky analýza krev MeSH
- ceftazidim analýza krev MeSH
- diabetická noha krev MeSH
- elektroforéza kapilární metody MeSH
- lidé MeSH
- limita detekce MeSH
- mikrodialýza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- buněčná a tkáňová terapie metody MeSH
- diabetická noha * etiologie krev terapie MeSH
- endostatiny krev MeSH
- fyziologická neovaskularizace imunologie účinky léků MeSH
- lidé MeSH
- onemocnění periferních arterií komplikace MeSH
- transplantace kmenových buněk metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
Treatment efforts in 42 patients with neuroischemic diabetic foot syndrome complicated by toe and foot gangrene of various localizations were assessed. Transluminal balloon angioplasty is thought to be minimally invasive and efficient maneuver in treatment of critical ischemia of lower extremities, in some cases serving as an alternative of the surgical revascularization. Satisfactory outcome, that is, foot salvation within 12 months after transluminal balloon angioplasty and stenting of lower extremity arteries could be observed in 31 (73.8%) patients, two cases requiring reoperation.
- MeSH
- balónková angioplastika * využití MeSH
- diabetes mellitus 2. typu komplikace MeSH
- diabetická noha * komplikace krev terapie MeSH
- dolní končetina krevní zásobení MeSH
- komplikace diabetu MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Klíčová slova
- 99mTc-značené leukocyty, zobrazování,
- MeSH
- diabetická noha diagnóza krev MeSH
- diabetické angiopatie diagnóza komplikace MeSH
- diabetické neuropatie diagnóza komplikace MeSH
- diferenciální diagnóza MeSH
- jednofotonová emisní výpočetní tomografie metody využití MeSH
- komplikace diabetu diagnóza MeSH
- leukocyty MeSH
- lidé MeSH
- obsah radioaktivních látek v organizmu MeSH
- osteomyelitida MeSH
- počítačová rentgenová tomografie metody využití MeSH
- počítačové zpracování obrazu metody využití MeSH
- radioisotopová scintigrafie metody přístrojové vybavení využití MeSH
- SPECT/CT MeSH
- technecium diagnostické užití krev MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Exposure to hyperbaric oxygen leads to increased amount of reactive oxygen species (ROS) that are derived from various sources. After the discovery that ROS can function as signaling molecules, the idea of ROS being hazardous to biological tissues has been challenged. The aim of this study was to examine the changes in oxidative stress parameters in diabetics undergoing hyperbaric oxygen therapy (HBOT) due to foot ulcers. Twenty patients, who received HBOT for diabetic foot ulcers, were included in the study. Blood samples were taken before HBOT and 30 min after exit from the chamber, on the day of the first and the fifteenth HBOT sessions. They were used for the determinations of malondialdehyde (MDA), 8-isoprostane and advanced oxidation protein products (AOPPs). 8-Isoprostane and AOPP levels were not altered significantly after the first HBOT session, while both were increased on the fifteenth day (p<0.05). MDA was significantly increased only after the first HBOT session, and remained unchanged on the fifteenth day (within-day variations). Plasma AOPP levels were lowered significantly after fifteen consecutive HBOT sessions (between-day variations). Decreased AOPP levels suggest that increased oxygenation of tissues due to HBO therapy may activate some endogenous factors that prevent hazardous effects of the disease itself.
- MeSH
- antioxidancia metabolismus MeSH
- biologické markery krev MeSH
- diabetes mellitus 2. typu krev MeSH
- diabetická noha krev terapie MeSH
- dinoprost analogy a deriváty krev MeSH
- dospělí MeSH
- hyperbarická oxygenace metody MeSH
- krevní proteiny analýza metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- malondialdehyd krev MeSH
- oxidace-redukce MeSH
- oxidační stres genetika MeSH
- reaktivní formy kyslíku krev MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- MeSH
- diabetes mellitus komplikace krev MeSH
- diabetická noha krev MeSH
- hořčík krev MeSH
- kyselina askorbová krev MeSH
- lidé MeSH
- stopové prvky krev MeSH
- vitaminy krev MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- srovnávací studie MeSH
