Diabetes impairs the late inflammatory response to wound healing.
Diabetes mellitus is recognized as a risk factor for compromised wound healing. This study examines leukocyte infiltration and the appearance of tumor necrosis factor-alpha (TNF) and IL-6 in wound chambers implanted in normal and streptozotocin-induced diabetic mice. Perforated silicone wound chambers containing a strip of polyvinyl alcohol sponge were implanted along the flanks of normal and diabetic mice. Wound fluid aspirated from the chambers 1, 3, and 7 days following implantation was analyzed for the total number of leukocytes and TNF and IL-6 levels. While the number of leukocytes in the wound fluid was similar on Days 1 and 3 following implantation, there were significantly fewer inflammatory cells in wound fluid from diabetic animals (13.8 X 10(6)/ml) than in wound fluid from normal animals (28.5 Z 10(6)/ml) on Day 7 following implantation. TNF levels in the cell-free exudate fluid were similar between the two groups on all days examined. IL-6 levels were similar on Days 1 and 3 following implantation between the two groups, but there was significantly more IL-6 in wound fluid from normal animals (10,998 U/ml) than in wound fluid from diabetic animals (2096 U/ml) on Day 7 following implantation. Histologic evaluation of chambers 8 days following implantation revealed decreased neovascularization and less organization of granulation tissue. These data suggest that delayed healing in diabetes is associated with altered leukocyte infiltration and wound fluid IL-6 levels during the late inflammatory phase of wound healing.
Fahey
T J
TJ
Department of Surgery, New York Hospital-Cornell Medical Center, New York 10021.
Sadaty
A
A
Jones
W G
WG
Barber
A
A
Smoller
B
B
Shires
G T
GT
D000818:Animals; D003921:Diabetes Mellitus, Experimental / Q000503:physiopathology*; D015194:Diffusion Chambers, Culture; D007249:Inflammation / Q000503:physiopathology; D015850:Interleukin-6 / Q000378:metabolism; D007962:Leukocytes / Q000502:physiology; D051379:Mice; D008807:Mice, Inbred BALB C; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014945:Wound Healing
D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha