[Study on the mechanism of autologous platelet-rich gel to treat the refractory diabetic dermal ulcers].
OBJECTIVE
To investigate the mechanism of autologous platelet-rich gel (APG)in the treatment of refractory diabetic dermal ulcers.


METHODS
After the treatment of refractory diabetic dermal ulcers with APG at 0, 3, 6, 9, 15 days, the protein levels of PDGF-BB, VEGF, IGF-1, EGF and TGF-beta1 in the granulation tissue were detected by ELISA, while the dimensions of ulcer area were measured at the same time.


RESULTS
The areas of ulcers were obviously reduced at the third and fifteen day after APG treatment (P < 0.05). The concentrations of these 5 growth factors in the granulation tissue were began to increase after 3 days treatment, the peak of PDGF-BB emerged at the third day (P < 0.05), and the peaks of VEGF, IGF-1, TGF-beta1 were found at the ninth day (P < 0.05). The concentration of VEGF increased 2.1-fold, IGF-1 increased 1.95-fold, EGF increased 1.75-fold, PDGF-BB increased 1.89-fold and TGF-beta1 increased 1.67-fold.


CONCLUSIONS
The expression of multiple growth factors are increased in granulation tissue of refractory diabetic dermal ulcers after the treatment of APG,which might be one of the mechanism of APG to treat refractory diabetic dermal ulcer.
Yuan
Nan-bing
NB
Diabetic Foot Care Center, Department of Endocrinology, West China Hospital, Sichuan University, Chengdu 610041, China.
Long
Yang
Y
Zhang
Xiang-xun
XX
Ran
Xing-wu
XW
D000368:Aged; D000077214:Becaplermin; D048909:Diabetes Complications / Q000628:therapy*; D017719:Diabetic Foot / Q000628:therapy; D005260:Female; D005782:Gels / Q000737:chemistry; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000627:therapeutic use; D036341:Intercellular Signaling Peptides and Proteins / Q000032:analysis / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010982:Platelet-Derived Growth Factor / Q000627:therapeutic use; D053657:Platelet-Rich Plasma / Q000737:chemistry; D020574:Proto-Oncogene Proteins c-sis; D012883:Skin Ulcer / Q000628:therapy*; D042461:Vascular Endothelial Growth Factor A / Q000627:therapeutic use; D014945:Wound Healing / Q000187:drug effects
D005782:Gels; D036341:Intercellular Signaling Peptides and Proteins; D010982:Platelet-Derived Growth Factor; D020574:Proto-Oncogene Proteins c-sis; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000077214:Becaplermin; D007334:Insulin-Like Growth Factor I