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Mohsin F, Javaid S, Tariq M, Mustafa M. Molecular immunological mechanisms of impaired wound healing in diabetic foot ulcers (DFU), current therapeutic strategies and future directions. Int Immunopharmacol 2024; 139:112713. [PMID: 39047451 DOI: 10.1016/j.intimp.2024.112713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 07/02/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024]
Abstract
Diabetic foot ulcer (DFU) is a foremost cause of amputation in diabetic patients. Consequences of DFU include infections, decline in limb function, hospitalization, amputation, and in severe cases, death. Immune cells including macrophages, regulatory T cells, fibroblasts and other damage repair cells work in sync for effective healing and in establishment of a healthy skin barrier post-injury. Immune dysregulation during the healing of wounds can result in wound chronicity. Hyperglycemic conditions in diabetic patients influence the pathophysiology of wounds by disrupting the immune system as well as promoting neuropathy and ischemic conditions, making them difficult to heal. Chronic wound microenvironment is characterized by increased expression of matrix metalloproteinases, reactive oxygen species as well as pro-inflammatory cytokines, resulting in persistent inflammation and delayed healing. Novel treatment modalities including growth factor therapies, nano formulations, microRNA based treatments and skin grafting approaches have significantly augmented treatment efficiency, demonstrating creditable efficacy in clinical practices. Advancements in local treatments as well as invasive methodologies, for instance formulated wound dressings, stem cell applications and immunomodulatory therapies have been successful in targeting the complex pathophysiology of chronic wounds. This review focuses on elucidating the intricacies of emerging physical and non-physical therapeutic interventions, delving into the realm of advanced wound care and comprehensively summarizing efficacy of evidence-based therapies for DFU currently available.
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Affiliation(s)
- Fatima Mohsin
- KAM School of Life Sciences, Forman Christian College (A Chartered University), Lahore, Pakistan.
| | - Sheza Javaid
- KAM School of Life Sciences, Forman Christian College (A Chartered University), Lahore, Pakistan.
| | - Mishal Tariq
- KAM School of Life Sciences, Forman Christian College (A Chartered University), Lahore, Pakistan.
| | - Muhammad Mustafa
- KAM School of Life Sciences, Forman Christian College (A Chartered University), Lahore, Pakistan.
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Guillou M, L'Homme B, Trompier F, Errabii A, Marcoux T, Gruel G, Prezado Y, Dos Santos M. Radiological injuries under low energy x-rays in mice depending on dose and protocol: comparative characterization of lesion severity and impact of the in vivobone response on retrospective dose estimations. Phys Med Biol 2024; 69:045035. [PMID: 38211312 DOI: 10.1088/1361-6560/ad1d69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/11/2024] [Indexed: 01/13/2024]
Abstract
Objective. To improve our knowledge about the biological effects of over exposures involving low-energy x-rays, we developed and characterized a preclinical mouse model allowing to mimic different lesion severity degrees induced by 80 kV x-ray depending on the dose and protocol (single or repeated exposure).Approach. Mice were locally exposed (paw) to 80 kV x-rays in a single (15, 30 or 45 Gy inKair) or repeated exposition (2 × 15 or 3 × 15 Gy inKair) to assess different degrees of lesion severity. Six post-irradiation euthanasia time points (0, 7, 14, 21, 42, and 84 days) were determined to follow up the evolution of lesions based on the lesion score, weighing and cutaneous blood perfusion. The bone dose was estimated at the different time points by electron paramagnetic resonance (EPR) spectroscopy.Main results. The monitoring of the lesion severity allows to classify the exposure protocols according to their severity. EPR spectroscopy measurements allow to determine the bone dose on the day of irradiation which is 7 times higher than the initial dose for single protocols. However, the initial signal measured at the end of the repeated exposure was 27% lower than the signal measured for a single dose. The study of the kinetics of EPR signal showed a decrease of the EPR signal which is dependent on the exposure protocol but not on dose highlighting the impact of bone physiology on the bone dose estimation.Significance: the preclinical model developed allows to assess the impact of the dose and protocol on the lesion severity induced by low-energy x-ray. For the first time, the dynamics of free radicals have been quantified in anin vivomodel, highlighting that the doses actually administered can be underestimated if samples are taken weeks or even months after exposure.
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Affiliation(s)
- Manon Guillou
- Institute for Radiological Protection and Nuclear Safety (IRSN), Department of RAdiobiology and regenerative MEDicine (SERAMED), Laboratory of Radiobiology of Accidental exposures (LRAcc) Fontenay-aux-Roses, France
| | - Bruno L'Homme
- Institute for Radiological Protection and Nuclear Safety (IRSN), Department of RAdiobiology and regenerative MEDicine (SERAMED), Laboratory of Radiobiology of Accidental exposures (LRAcc) Fontenay-aux-Roses, France
| | - François Trompier
- Institute for Radiological Protection and Nuclear Safety (IRSN), Department of DOSimetry, (SDOS), Ionizing Radiation Dosimetry Laboratory (LDRI), Fontenay-aux-Roses, F-92260, France
| | - Anass Errabii
- Institute for Radiological Protection and Nuclear Safety (IRSN), Department of RAdiobiology and regenerative MEDicine (SERAMED), Laboratory of Radiobiology of Accidental exposures (LRAcc) Fontenay-aux-Roses, France
| | - Tifanie Marcoux
- Institute for Radiological Protection and Nuclear Safety (IRSN), Department of RAdiobiology and regenerative MEDicine (SERAMED), Laboratory of Radiobiology of Accidental exposures (LRAcc) Fontenay-aux-Roses, France
| | - Gaëtan Gruel
- Institute for Radiological Protection and Nuclear Safety (IRSN), Department of RAdiobiology and regenerative MEDicine (SERAMED), Laboratory of Radiobiology of Accidental exposures (LRAcc) Fontenay-aux-Roses, France
| | - Yolanda Prezado
- Institut Curie, University Paris Saclay, PSL Research University, Inserm U 1021-CNRS UMR F-3347, Orsay, France
| | - Morgane Dos Santos
- Institute for Radiological Protection and Nuclear Safety (IRSN), Department of RAdiobiology and regenerative MEDicine (SERAMED), Laboratory of Radiobiology of Accidental exposures (LRAcc) Fontenay-aux-Roses, France
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Ancel L, Gabillot O, Szurewsky C, Granger R, Sache A, Voyer F, Gruel G, Illiano S, Benderitter M, Le Guen B, Souidi M, Benadjaoud MA, Flamant S. microRNA blood signature for localized radiation injury. Sci Rep 2024; 14:2681. [PMID: 38302506 PMCID: PMC10834964 DOI: 10.1038/s41598-024-52258-2] [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: 07/21/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024] Open
Abstract
A radiological accident, whether from industrial, medical, or malicious origin, may result in localized exposure to high doses of ionizing radiations, leading to the development of local radiation injury (LRI), that may evolve toward deep ulceration and necrosis of the skin and underlying tissues. Early diagnosis is therefore crucial to facilitate identification and management of LRI victims. Circulating microRNAs (miRNA) have been studied as potential diagnostic biomarkers of several diseases including hematological defects following whole-body irradiation (WBI). This study aims to identify a blood miRNA signature associated with LRI in a preclinical C57BL/6J mouse model of hindlimb irradiation using different 10-MV X-ray doses that lead to injuries of different severities. To this end, we first performed broad-spectrum plasma miRNA profiling, followed by a targeted validation step, on two independent animal cohorts. Using a multivariate sparse partial least square discriminant analysis, we identified a panel of eight circulating miRNAs able to segregate mice according to LRI severity. Interestingly, these miRNAs were previously associated with WBI (miR-150-5p, miR-342-3p, miR-146a-5p), inflammation (miR-18a-5p, miR-148b-3p, miR-532-5p) and skin diseases (miR-139-5p, miR-195-5p). Our results suggest the use of circulating miRNAs as suitable molecular biomarkers for LRI prognosis and diagnosis.
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Affiliation(s)
- Lucie Ancel
- Radiobiology and Regenerative Medicine Research Service, Radiobiology of Accidental Exposure Laboratory, IRSN PSE-SANTE/SERAMED/LRAcc, 31 av de la Division Leclerc, 92260, Fontenay-aux-Roses, France
| | - Olivier Gabillot
- Radiobiology and Regenerative Medicine Research Service, Radiobiology of Accidental Exposure Laboratory, IRSN PSE-SANTE/SERAMED/LRAcc, 31 av de la Division Leclerc, 92260, Fontenay-aux-Roses, France
| | - Chloé Szurewsky
- Radiobiology and Regenerative Medicine Research Service, Radiobiology of Accidental Exposure Laboratory, IRSN PSE-SANTE/SERAMED/LRAcc, 31 av de la Division Leclerc, 92260, Fontenay-aux-Roses, France
| | - Romain Granger
- Ionizing Radiations Biological and Sanitary Effects Research Service, Support Group for Research and Animal Ethic, IRSN PSE-SANTE, Fontenay-aux-Roses, France
| | - Amandine Sache
- Ionizing Radiations Biological and Sanitary Effects Research Service, Support Group for Research and Animal Ethic, IRSN PSE-SANTE, Fontenay-aux-Roses, France
| | - Frédéric Voyer
- Ionizing Radiations Biological and Sanitary Effects Research Service, Support Group for Research and Animal Ethic, IRSN PSE-SANTE, Fontenay-aux-Roses, France
| | - Gaëtan Gruel
- Radiobiology and Regenerative Medicine Research Service, Radiobiology of Accidental Exposure Laboratory, IRSN PSE-SANTE/SERAMED/LRAcc, 31 av de la Division Leclerc, 92260, Fontenay-aux-Roses, France
| | - Stéphane Illiano
- Radiobiology and Regenerative Medicine Research Service, IRSN PSE-SANTE, Fontenay-aux-Roses, France
| | - Marc Benderitter
- Radiobiology and Regenerative Medicine Research Service, IRSN PSE-SANTE, Fontenay-aux-Roses, France
| | | | - Maâmar Souidi
- Radiobiology and Regenerative Medicine Research Service, Radiobiology of Accidental Exposure Laboratory, IRSN PSE-SANTE/SERAMED/LRAcc, 31 av de la Division Leclerc, 92260, Fontenay-aux-Roses, France
| | - Mohamed Amine Benadjaoud
- Radiobiology and Regenerative Medicine Research Service, IRSN PSE-SANTE, Fontenay-aux-Roses, France
| | - Stéphane Flamant
- Radiobiology and Regenerative Medicine Research Service, Radiobiology of Accidental Exposure Laboratory, IRSN PSE-SANTE/SERAMED/LRAcc, 31 av de la Division Leclerc, 92260, Fontenay-aux-Roses, France.
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