糖尿病足患者皮肤微循环结构及HIF-1α、VEGF表达水平的改变  

Alteration of micro-circulation structure and the expression of HIF-1αand VEGF in skin of patients with diabetic foot

作　　者：林楚佳[1] 蓝尤冕 欧妙琼[1] 鄞国书[1] 杨晓平[1] 林少达[1] LIN Chu-jia;LAN You-mian;OU Miao-qiong;YIN Guo-shu;YANG Xiao-ping;LIN Shao-da(The First Affi liated Hospital of Shantou University Medical College,Shantou,G uangzhou 515041,China)

机构地区：[1]汕头大学医学院第一附属医院,广东汕头515041

出　　处：《皮肤病与性病》2021年第2期164-166,共3页Dermatology and Venereology

摘　　要：目的HIF-1α作为调控血管新生的一种核转录因子,可通过VEGF促进微血管形成。HIF-1α及VEGF在人类糖尿病皮肤表达改变可能是糖尿病足创面愈合延迟的原因之一。观察糖尿病足患者足部溃疡伤口周围皮肤微循环结构改变及HIF-1α、VEGF水平变化,探讨糖尿病足溃疡的难愈合机制。方法免疫组化观察糖尿病足皮肤微循环结构特点及HIF-1α、VEGF表达强度;ELISA双抗夹心法检测皮肤组织匀浆HIF-1α、VEGF水平;荧光定量PCR检测皮肤HIF-1α、VEGF mRNA水平。结果HE染色光镜下观察到糖尿病足病组皮肤组织学结构发生改变。CD31免疫组化观察糖尿病足病组皮肤真皮乳头密度、乳头微血管密度比非糖尿病足组下降。糖尿病足皮肤表皮HIF-1α表达光密度值比非糖尿病组明显下降。糖尿病足真皮乳头内VEGF表达光密度值比非糖尿病组明显下降。糖尿病足组皮肤组织匀浆HIF-1α、VEGF浓度比非糖尿病组下降。荧光定量PCR结果显示糖尿病足组HIF-1α、VEGF mRNA水平比非糖尿病组下降。结论糖尿病足病皮肤真皮乳头密度下降,真皮乳头平均微血管密度下降;HIF-1α、VEGF及相关mRNA表达减少。HIF-1α及VEGF在糖尿病创口愈合中起到重要作用,其表达水平的下降可能导致新生血管的缺乏,并且延迟愈合过程。Objective HIF-1 a is a nuclear transcription factor that regulates angiogenesis,it can promote microangiogenesis through vascular endothelial growth factor.The change of expression of HIF-1αand VEGF in human diabetic skin may be one of the reasons for delayed wound healing in diabetes mellitus foot.To observe the alteration of skin micro-circulation structure around the wound and the expression of HIF-1αand VEGF in skin tissue for the patients with diabetic foot.Methods The alteration of skin micro-circulation structure around the wound was observed and compared between groups according to the immunohistochemistry measurement and semiquantitative assessment of HIF-1αand VEGF expressions were calculated.The protein and mRNA quantity of HIF-1αand VEGF in the homogenate of skin tissue were measured with Double Antibody Sandwich-Enzyme Linked Immunosorbent Assay and Realtime Fluorescence Quantitative PCR respectively.Results Compared with non-diabetes individuals,the dermal papilla density and the microvessel density in dermal papilla of skin were declined.The mean optical density of HIF-1αand VEGF in epidermis for the patients with diabetic foot were both reduced compared with the control respectively.The concentrations of HIF-1αand VEGF in the homogenate of skin tissue for the patients with diabetic foot were both decreased compared with the control respectively.Both mRNA levels of HIF-1αand VEGF in the skin tissue for the patients with diabetic foot were reduced compare with the control group.Conclusion The skin micro-circulation structure was altered and both protein and mRNA levels of HIF-1αand VEGF were declined in diabetic foot patients.Both HIF-1αand VEGF play significant role during the healing of diabetic wound,which may result in the absence of angiogenesis and delay of healing process in consequence of the diminution of HIF-1αand VEGF.

关 键 词：糖尿病足 皮肤 微血管密度 HIF-1Α 血管内皮生长因子 

分 类 号：R446.62[医药卫生—诊断学] R587.2[医药卫生—临床医学]