Published in:
01-10-2019 | Diabetic Foot | Original Article
Effects of diabetic foot infection on vascular and immune function in the lower limbs
Published in: International Journal of Diabetes in Developing Countries | Issue 4/2019
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Object
The study investigated the effects of diabetic foot infection on vascular and immune function in the lower limbs.
Methods
Seventy-two patients with diabetic foot infection were included in the infected group, while 64 diabetic patients without infection were selected as the control group. Hemodynamic parameters and vascular endothelial function of the dorsalis pedis artery were assessed by color Doppler ultrasonography. Enzyme-linked immunosorbent assay was used to determine the serum levels of interleukin 6 (IL-6), IL-17, tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and high mobility group box 1 protein (HMGB1). Western blotting was used to quantify expression levels of toll-like receptor 4 (TLR4) and nuclear transcription factor kappa B (NFκB) in human peripheral blood mononuclear cells (PBMC).
Results
Compared with the control group, the intima-media thickness and peak systolic velocity of the infected group were increased (both p < 0.05), while the inner vascular diameter, blood flow volume, endothelium-dependent dilation, and endothelium-independent dilation were decreased (all p < 0.05). Compared with the control group, the serum levels of IL-6, IL-17, TNF-α, CRP, and HMGB1, and the expression levels of TLR4 and NFκB in PBMC were significantly increased in the infected group (all p < 0.001).
Conclusion
Thus, diabetic foot infection is associated with vascular and immune dysfunction in the lower limbs, possibly in relation to the activation of the HMGB1/TLR4/NFκB signaling pathway.