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Wen Y, Chen L, Lan J, Li L. Efficacy of tibial cortex transverse transport in treating diabetic foot ulcer and its effect on serum omentin-1 and irisin levels. Diabetol Metab Syndr 2024; 16:154. [PMID: 38982536 PMCID: PMC11232319 DOI: 10.1186/s13098-024-01400-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 07/02/2024] [Indexed: 07/11/2024] Open
Abstract
OBJECTIVE Diabetic foot ulcer (DFU) is a common and debilitating complication of diabetes that is associated with an increased risk of lower-limb amputation and a reduced life expectancy. Tibial cortex transverse transport (TTT) has become a newly alternative surgical method to facilitate ulcer healing and prevent lower limb amputation. Herein, we investigated the efficacy of TTT in treating DFU and changes of serum omentin-1 and irisin levels. METHODS This study prospectively recruited 52 consecutive patients with DFU who were treated with TTT. The follow-up was performed weekly during the first 12 weeks postoperatively and every 3 months until 1 year after TTT. The serum levels of vascular endothelial growth factor (VEGF), omentin-1, and irisin in DFU patients undergoing TTT were determined by ELISA methods on the preoperative 1st day, postoperative 2nd week and 4th week. RESULTS The wound healing rate was 92.3% (48/52) at the 1-year follow-up. The visual analog scale (VAS) pain scores of patients showed a significant reduction at the 4th week after TTT (p < 0.001). The dorsal foot skin temperature, ankle brachial index, and dorsal foot blood flow of patients were significantly increased at the 4th week after TTT (p < 0.001). Results of ELISA methods showed the serum levels of VEGF, omentin-1, and irisin on the 2nd week and 4th week after TTT were notably elevated compared to the levels determined on the preoperative 1st day (p < 0.001). The serum levels of VEGF, omentin-1, and irisin on the 4th week after TTT were also significantly higher than the levels determined on the 2nd week after TTT (p < 0.001). CONCLUSION TTT could promote the wound healing and reduce the risk of lower limb amputation, demonstrating promising clinical benefits in the treatment of DFU. Increased expressions of serum proangiogenic factors including VEGF, omentin-1, and irisin were noted in the early stage after TTT, which may provide a new mechanism of TTT promoting wound heal.
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Affiliation(s)
- Yang Wen
- Orthopedic Center, Orthopaedic Trauma, Suining Central Hospital, No. 27 Dongping North Road, Hedong New District, Suining, 629000, Sichuan, China
| | - Liyuan Chen
- Medical Department, Suining Central Hospital, Suining, 629000, Sichuan, China
| | - Jiaping Lan
- Orthopedic Center, Orthopaedic Trauma, Suining Central Hospital, No. 27 Dongping North Road, Hedong New District, Suining, 629000, Sichuan, China
| | - Lei Li
- Orthopedic Center, Orthopaedic Trauma, Suining Central Hospital, No. 27 Dongping North Road, Hedong New District, Suining, 629000, Sichuan, China.
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Qin W, Liu K, Su H, Hou J, Yang S, Pan K, Yang S, Liu J, Zhou P, Lin Z, Zhen P, Mo Y, Fan B, Li Z, Kuang X, Nie X, Hua Q. Tibial cortex transverse transport promotes ischemic diabetic foot ulcer healing via enhanced angiogenesis and inflammation modulation in a novel rat model. Eur J Med Res 2024; 29:155. [PMID: 38449025 PMCID: PMC10918950 DOI: 10.1186/s40001-024-01752-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/28/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Tibial Cortex Transverse Transport (TTT) represents an innovative surgical method for treating lower extremity diabetic foot ulcers (DFUs), yet its underlying mechanisms remain elusive. Establishing an animal model that closely mirrors clinical scenarios is both critical and novel for elucidating the mechanisms of TTT. METHODS We established a diabetic rat model with induced hindlimb ischemia to mimic the clinical manifestation of DFUs. TTT was applied using an external fixator for regulated bone movement. Treatment efficacy was evaluated through wound healing assessments, histological analyses, and immunohistochemical techniques to elucidate biological processes. RESULTS The TTT group demonstrated expedited wound healing, improved skin tissue regeneration, and diminished inflammation relative to controls. Marked neovascularization and upregulation of angiogenic factors were observed, with the HIF-1α/SDF-1/CXCR4 pathway and an increase in EPCs being pivotal in these processes. A transition toward anti-inflammatory M2 macrophages indicated TTT's immunomodulatory capacity. CONCLUSION Our innovative rat model effectively demonstrates the therapeutic potential of TTT in treating DFUs. We identified TTT's roles in promoting angiogenesis and modulating the immune system. This paves the way for further in-depth research and potential clinical applications to improve DFU management strategies.
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Affiliation(s)
- Wencong Qin
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Kaibin Liu
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Hongjie Su
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical Bio-Resource Development and Application Co-constructed by the Province and Ministry, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, China
| | - Jun Hou
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical Bio-Resource Development and Application Co-constructed by the Province and Ministry, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, China
| | - Shenghui Yang
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
- Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, China
| | - Kaixiang Pan
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Sijie Yang
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical Bio-Resource Development and Application Co-constructed by the Province and Ministry, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, China
| | - Jie Liu
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
- Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, China
| | - Peilin Zhou
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Zhanming Lin
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Puxiang Zhen
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
- National Demonstration Center for Experimental (General Practice) Education, Hubei University of Science and Technology, Xianning, 437100, People's Republic of China
| | - Yongjun Mo
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Binguang Fan
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Zhenghui Li
- Department of Neurosurgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| | - Xiaocong Kuang
- Collaborative Innovation Centre of Regenerative Medicine and Medical Bio-Resource Development and Application Co-constructed by the Province and Ministry, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, China
- Yulin Campus of Guangxi Medical University, Yulin, Guangxi, China
| | - Xinyu Nie
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
| | - Qikai Hua
- Department of Bone and Joint Surgery, (Guangxi Diabetic Foot Salvage Engineering Research Center), The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
- Collaborative Innovation Centre of Regenerative Medicine and Medical Bio-Resource Development and Application Co-constructed by the Province and Ministry, Guangxi Medical University, Nanning, 530021, Guangxi, China.
- Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, China.
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