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Guo H, Xiao K, Zheng Y, Zong J. Integrating bioinformatics and multiple machine learning to identify mitophagy-related targets for the diagnosis and treatment of diabetic foot ulcers: evidence from transcriptome analysis and drug docking. Front Mol Biosci 2024; 11:1420136. [PMID: 39044840 PMCID: PMC11263085 DOI: 10.3389/fmolb.2024.1420136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 06/20/2024] [Indexed: 07/25/2024] Open
Abstract
Background Diabetic foot ulcers are the most common and serious complication of diabetes mellitus, the high morbidity, mortality, and disability of which greatly diminish the quality of life of patients and impose a heavy socioeconomic burden. Thus, it is urgent to identify potential biomarkers and targeted drugs for diabetic foot ulcers. Methods In this study, we downloaded datasets related to diabetic foot ulcers from gene expression omnibus. Dysregulation of mitophagy-related genes was identified by differential analysis and weighted gene co-expression network analysis. Multiple machine algorithms were utilized to identify hub mitophagy-related genes, and a novel artificial neural network model for assisting in the diagnosis of diabetic foot ulcers was constructed based on their transcriptome expression patterns. Finally, potential drugs that can target hub mitophagy-related genes were identified using the Enrichr platform and molecular docking methods. Results In this study, we identified 702 differentially expressed genes related to diabetic foot ulcers, and enrichment analysis showed that these genes were associated with mitochondria and energy metabolism. Subsequently, we identified hexokinase-2, small ribosomal subunit protein us3, and l-lactate dehydrogenase A chain as hub mitophagy-related genes of diabetic foot ulcers using multiple machine learning algorithms and validated their diagnostic performance in a validation cohort independent of the present study (The areas under roc curve of hexokinase-2, small ribosomal subunit protein us3, and l-lactate dehydrogenase A chain are 0.671, 0.870, and 0.739, respectively). Next, we constructed a novel artificial neural network model for the molecular diagnosis of diabetic foot ulcers, and the diagnostic performance of the training cohort and validation cohort was good, with areas under roc curve of 0.924 and 0.840, respectively. Finally, we identified retinoic acid and estradiol as promising anti-diabetic foot ulcers by targeting hexokinase-2 (-6.6 and -7.2 kcal/mol), small ribosomal subunit protein us3 (-7.5 and -8.3 kcal/mol), and l-lactate dehydrogenase A chain (-7.6 and -8.5 kcal/mol). Conclusion The present study identified hexokinase-2, small ribosomal subunit protein us3 and l-lactate dehydrogenase A chain, and emphasized their critical roles in the diagnosis and treatment of diabetic foot ulcers through multiple dimensions, providing promising diagnostic biomarkers and targeted drugs for diabetic foot ulcers.
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Affiliation(s)
- Hui Guo
- Department of Emergency, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Kui Xiao
- Department of Plastic Surgery, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Yanhua Zheng
- Department of Critical Medicine, Wusong Hospital, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jianchun Zong
- Department of Emergency, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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Zubair M, Hussain A, Shahzad S, Arshad M, Ullah A. Emerging trends and challenges in polysaccharide derived materials for wound care applications: A review. Int J Biol Macromol 2024; 270:132048. [PMID: 38704062 DOI: 10.1016/j.ijbiomac.2024.132048] [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: 10/04/2023] [Revised: 04/17/2024] [Accepted: 04/30/2024] [Indexed: 05/06/2024]
Abstract
Polysaccharides are favourable and promising biopolymers for wound care applications due to their abundant natural availability, low cost and excellent biocompatibility. They possess different functional groups, such as carboxylic, hydroxyl and amino, and can easily be modified to obtain the desirable properties and various forms. This review systematically analyses the recent progress in polysaccharides derived materials for wound care applications, emphasizing the most commonly used cellulose, chitosan, alginate, starch, dextran and hyaluronic acid derived materials. The distinctive attributes of each polysaccharide derived wound care material are discussed in detail, along with their different forms, i.e., films, membranes, sponges, nanoemulsions, nanofibers, scaffolds, nanocomposites and hydrogels. The processing methods to develop polysaccharides derived wound care materials are also summarized. In the end, challenges related to polysaccharides derived materials in wound care management are listed, and suggestions are given to expand their utilization in the future to compete with conventional wound healing materials.
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Affiliation(s)
- Muhammad Zubair
- Department of Agricultural, Food and Nutritional Science, Lab# 540, South Academic Building University of Alberta, Edmonton, Alberta T6G 2P5, Canada
| | - Ajaz Hussain
- Institute of Chemical Sciences, Bahauddin Zakariya University, Multan 60800, Punjab, Pakistan
| | - Sohail Shahzad
- Department of Chemistry, University of Sahiwal, Sahiwal 57000, Pakistan
| | - Muhammad Arshad
- Clean Technologies and Applied Research, Northern Alberta Institute of Technology, Edmonton, Alberta T5G 2R1, Canada
| | - Aman Ullah
- Department of Agricultural, Food and Nutritional Science, Lab# 540, South Academic Building University of Alberta, Edmonton, Alberta T6G 2P5, Canada.
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Su N, Wang J, Zhang H, Jin H, Miao B, Zhao J, Liu X, Li C, Wang X, Yang N. Identification and clinical validation of the role of anoikis-related genes in diabetic foot. Int Wound J 2024; 21:e14771. [PMID: 38468369 PMCID: PMC10928261 DOI: 10.1111/iwj.14771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/28/2024] [Indexed: 03/13/2024] Open
Abstract
This study aims to investigate the role of anoikis-related genes in diabetic foot (DF) by utilizing bioinformatics analysis to identify key genes associated with anoikis in DF. We selected the GEO datasets GSE7014, GSE80178 and GSE68183 for the extraction and analysis of differentially expressed anoikis-related genes (DE-ARGs). GO analysis and KEGG analysis indicated that DE-ARGs in DF were primarily enriched in apoptosis, positive regulation of MAPK cascade, anoikis, focal adhesion and the PI3K-Akt signalling pathway. Based on the LASSO and SVM-RFE algorithms, we identified six characteristic genes. ROC curve analysis revealed that these six characteristic genes had an area under the curve (AUC) greater than 0.7, indicating good diagnostic efficacy. Expression analysis in the validation set revealed downregulation of CALR in DF, consistent with the training set results. GSEA results demonstrated that CALR was mainly enriched in blood vessel morphogenesis, endothelial cell migration, ECM-receptor interaction and focal adhesion. The HPA database revealed that CALR was moderately enriched in endothelial cells, and CALR was found to interact with 63 protein-coding genes. Functional analysis with DAVID suggested that CALR and associated genes were enriched in the phagosome component. CALR shows promise as a potential marker for the development and treatment of DF.
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Affiliation(s)
- Nan Su
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain‐Inspired ScienceShandong UniversityJinanChina
- School of Medicine, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Jiwei Wang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain‐Inspired ScienceShandong UniversityJinanChina
- School of Medicine, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Hengrui Zhang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain‐Inspired ScienceShandong UniversityJinanChina
- School of Medicine, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Haoyong Jin
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain‐Inspired ScienceShandong UniversityJinanChina
- School of Medicine, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Baojian Miao
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain‐Inspired ScienceShandong UniversityJinanChina
- School of Medicine, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Jiangli Zhao
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain‐Inspired ScienceShandong UniversityJinanChina
- School of Medicine, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Xuchen Liu
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain‐Inspired ScienceShandong UniversityJinanChina
- School of Medicine, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Chao Li
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain‐Inspired ScienceShandong UniversityJinanChina
- School of Medicine, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Xinyu Wang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain‐Inspired ScienceShandong UniversityJinanChina
- School of Medicine, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Ning Yang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain‐Inspired ScienceShandong UniversityJinanChina
- School of Medicine, Cheeloo College of MedicineShandong UniversityJinanChina
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Ge L, Zhao J, Tan M, Tan E, Liew H, Yong E, Hoe J, Shi C, Chan DYS, Ang GY, Molina JA, Sun Y, Hoi WH, Chandraskear S, Lo ZJ. Multi-disciplinary diabetic limb salvage programme in octogenarians with diabetic foot ulcers is not futile: An observational study with historical controls. Int Wound J 2024; 21:e14801. [PMID: 38426365 PMCID: PMC10905330 DOI: 10.1111/iwj.14801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/02/2024] [Accepted: 02/04/2024] [Indexed: 03/02/2024] Open
Abstract
This study evaluated the effectiveness of a multi-disciplinary diabetic limb salvage programme in improving clinical outcomes and optimising healthcare utilisation in 406 patients aged ≥80 years with diabetic foot ulcers (DFUs), compared to 2392 younger patients enrolled from June 2020 to June 2021 and against 1716 historical controls using one-to-one propensity score matching. Results showed that elderly programme patients had lower odds of amputation-free survival (odds ratio: 0.64, 95% CI: 0.47, 0.88) and shorter cumulative length of stay (LOS) compared to younger programme patients (incidence rate ratio: 0.45, 95% CI: 0.29, 0.69). Compared to the matched controls, participating in the programme was associated with 5% higher probability of minor lower extremity amputation, reduced inpatient admissions and emergency visits, shorter LOS but increased specialist and primary care visits (all p-values <0.05). The findings suggest that the programme yielded favourable impacts on the clinical outcomes of patients aged≥80 years with DFUs. Further research is needed to develop specific interventions tailoring to the needs of the elderly population and to determine their effectiveness on patient outcomes while accounting for potential confounding factors.
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Affiliation(s)
- Lixia Ge
- Health Services and Outcomes ResearchNational Healthcare GroupSingaporeSingapore
| | - Jiashen Zhao
- Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Matthew Tan
- Section of Vascular Surgery, Department of Surgery and CancerImperial College LondonLondonUK
| | - Elaine Tan
- Medical DepartmentNational Healthcare Group PolyclinicsSingaporeSingapore
| | - Huiling Liew
- Department of EndocrinologyTan Tock Seng HospitalSingaporeSingapore
| | - Enming Yong
- Department of General SurgeryTan Tock Seng HospitalSingaporeSingapore
| | - Jeremy Hoe
- Department of EndocrinologyKhoo Teck Puat HospitalSingaporeSingapore
| | - Claris Shi
- Department of Orthopaedics SurgeryKhoo Teck Puat HospitalSingaporeSingapore
| | - Dexter Yak Seng Chan
- Vascular Surgery Service, Department of General SurgeryKhoo Teck Puat HospitalSingaporeSingapore
| | - Gary Yee Ang
- Health Services and Outcomes ResearchNational Healthcare GroupSingaporeSingapore
| | | | - Yan Sun
- Health Services and Outcomes ResearchNational Healthcare GroupSingaporeSingapore
| | - Wai Han Hoi
- Department of EndocrinologyWoodlands HealthSingaporeSingapore
| | - Sadhana Chandraskear
- Vascular Surgery Service, Department of SurgeryWoodlands HealthSingaporeSingapore
| | - Zhiwen Joseph Lo
- Vascular Surgery Service, Department of SurgeryWoodlands HealthSingaporeSingapore
- Lee Kong Chian School of MedicineNanyang Technological UniversitySingaporeSingapore
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Waibel FWA, Uçkay I, Soldevila-Boixader L, Sydler C, Gariani K. Current knowledge of morbidities and direct costs related to diabetic foot disorders: a literature review. Front Endocrinol (Lausanne) 2024; 14:1323315. [PMID: 38298183 PMCID: PMC10829909 DOI: 10.3389/fendo.2023.1323315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/29/2023] [Indexed: 02/02/2024] Open
Abstract
Diabetes is a chronic disease associated with numerous complications including diabetic foot disorders, which are associated with significant morbidity and mortality as well as high costs. The costs associated with diabetic foot disorders comprise those linked to care (direct) and loss of productivity and poor quality of life (indirect). Due to the constant increase in diabetes prevalence, it is expected that diabetic foot disorder will require more resources, both in terms of caregivers and economically. We reviewed findings on management, morbidity, mortality, and costs related to diabetic foot disorder.
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Affiliation(s)
- Felix W. A. Waibel
- Orthopaedic Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Ilker Uçkay
- Infectiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Laura Soldevila-Boixader
- Infectious Diseases, Internal Medicine Department, Consorci Sanitari Integral-CSI, Sant Joan Despí Hospital, Barcelona, Spain
| | - Christina Sydler
- Orthopaedic Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Karim Gariani
- Service of Endocrinology, Diabetes, Nutrition, and Therapeutic Education, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
- Diabetes Center of the Faculty of Medicine, University of Geneva Medical School, Geneva, Switzerland
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Ning P, Liu Y, Kang J, Cao H, Zhang J. Comparison of healing effectiveness of different debridement approaches for diabetic foot ulcers: a network meta-analysis of randomized controlled trials. Front Public Health 2023; 11:1271706. [PMID: 38146472 PMCID: PMC10749485 DOI: 10.3389/fpubh.2023.1271706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/21/2023] [Indexed: 12/27/2023] Open
Abstract
Objectives The choice of the debridement method is very important for the healing of diabetic foot ulcers (DFUs), but the relative effectiveness of different debridement methods in the healing of DFUs remains unclear. This study conducted a network meta-analysis of the relative healing effectiveness of different debridement methods in patients with DFUs. Methods We performed a literature search in PubMed, Embase, and Cochrane Library from database inception up to 30 June 2023 for screening randomized controlled trials on the healing effectiveness of debridement in DFUs. Outcome measures included ulcer healing rate and ulcer area reduction rate. The Cochrane Risk Bias Tool, version 2.0, was used to assess the risk of bias in the included trials. R software was used for performing statistical analysis and GraphPad Prism was used for image plotting. Results A total of 19 randomized controlled trials were included, and 900 patients with DFUs were assessed in this analysis. The proteolytic fraction from the latex of Vasconcellea cundinamarcensis (P1G10) in enzymatic debridement showed the best ulcer healing rate (SURCA = 0.919) when compared with the standard of care (SOC) group, with a mean difference (MD) and 95% confidence interval (CI) of 1.40 (0.57, 2.36). Kiwifruit extract demonstrated the best effect on the ulcer area reduction rate (SURCA = 0.931), when compared with that in the SOC group, with an MD and 95% CI of 0.47 (0.27, 0.66). Conclusion Enzymatic debridement was superior to other debridement methods in terms of ulcer healing rate and ulcer area reduction rate in patients with DFUs. However, as the quality of the included trials is low, enzymatic debridement can be used as a candidate debridement method in addition to sharp-based debridement in clinical practice. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023441715.
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Affiliation(s)
| | | | | | - Hongyi Cao
- Department of Endocrine and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Jiaxing Zhang
- Department of Endocrine and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu, China
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