Monocyte Phenotype as a Predictive Marker for Wound Healing in Diabetic Foot Ulcers

NewsBot · Feb 16, 2021

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Monocyte Phenotype as a Predictive Marker for Wound Healing in Diabetes-Related Foot Ulcers
DanqingMin et al
Journal of Diabetes and its Complications 16 February 2021, 107889

Highlights
•Circulating monocyte phenotype and MMPs altered in association with healing in DRFU
•Blood %CD16++ monocytes and MMP-3 were higher in healed vs unhealed at first visit
•Baseline blood %CD16++ monocytes showed a predictive role in ulcer healing outcomes
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Aims
Delayed healing of diabetes-related foot ulcers (DRFUs) is associated with increased macrophage and matrix metalloproteinases (MMPs) at the wound site. Whether circulating monocyte phenotype and/or MMPs are altered in association with wound healing outcome is unknown, and was investigated in this study.

Methods
Blood was obtained from 21 participants with DRFU, at initial visit (V1), week-4 (V2), and week-8 (V3) for measurement of monocyte number (CD14+), phenotype (CD16, CD163) and chemokine receptors (CCRs) by flow cytometry, and circulating MMPs and TIMP-1 by ELISA.

Results
Six wounds healed during the study. At V1, non-classical CD16++ monocytes and MMP-3 were higher in healed vs unhealed (both p<0.05). At V3, the increased %CD16++ persisted and %CCR2+ was decreased in healed, but no other monocyte markers nor MMP/TIMP differed between groups. Increased wound closure rate (WCR) at V3 correlated with increased %CD16++ monocytes and decreased MMP-2 at V1 or V1+V2. Receiver operating characteristic (ROC) curves yielded an area-under-the-curve of %CD16++ at V1 of 0.78 to predict ulcer healing at V3.

Conclusions
These results indicate that circulating monocyte phenotype and MMPs alter as DRFUs heal. The relationship of %CD16++ monocytes with WCR and ROC curve suggest a predictive role of %CD16++ monocytes for ulcer healing.
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