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Exp Clin Endocrinol Diabetes 2011; 119(5): 286-290
DOI: 10.1055/s-0030-1267235
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Expression of Matrix-Metalloproteases in the Fluid of Chronic Diabetic Foot Wounds Treated with a Protease Absorbent Dressing

M. Motzkau1 , J. Tautenhahn2 , H. Lehnert3 , R. Lobmann4
  • 1Department of Nephrology, Section Endocrinology and Metabolism, University of Magdeburg Medical School, Germany
  • 2Department of Vascular Surgery, Städtisches Klinikum Magdeburg, Germany
  • 3First Department of Medicine, University of Lübeck, Germany
  • 4Department of Endocrinology, Diabetology and Geriatric Medicine, Klinikum Stuttgart – Bürgerhospital, Germany
Further Information

Publication History

received 19.07.2010 first decision 20.09.2010

accepted 27.09.2010

Publication Date:
28 October 2010 (online)

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Abstract

It is well known, that wound healing in diabetes is impaired. Persistently high levels of matrix-metalloproteases (MMPs) contribute to wound persistence. The topical use of protease-inhibitors might beneficially affect wound healing.

Research design and methods: 19 patients with chronic diabetic foot lesions (Wagner/Armstrong 2A) were studied. 6 patients received “good standard wound care”, 13 patients were treated with a protease-inhibitor-modulating-matrix (ORC/collagen matrix) that was changed daily. At day 1 and 5 biopsies were taken from the wounds; wound fluids were collected daily. Biopsies were analysed using quantitative real-time-PCR and all samples were analysed using ELISA and zymography for MMPs, TIMPs, IL 1-β and TNFα levels.

Results: No differences in mRNA-expression of MMPs, TNFα and for MMP levels in wound tissue were detected between both groups or between the 2 sampling time points. MMP-2 active was significantly reduced in wound fluids of ORC/collagen treated lesions (p=0.043) after 5 days. MMP-2 pro was also reduced by about 25% when compared to increasing levels in the control group (+27%). We observed a significant reduction of the wound area in the ORC/collagen group (p=0.003).

Conclusions: Local treatment with a protease-inhibitor has a beneficial effect on wound healing. In contrast to unchanged mRNA-levels and protein levels of MMPs there was a clear reduction of MMP-2-levels in wound fluids. Our data support the potential role of ORC/collagen as a wound dressing. Modulation of MMPs appears to be beneficial in the treatment of chronic diabetic wounds.

Key words

diabetic foot syndrome - matrix-metalloproteases - protease absorbent dressing

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Correspondence

R. LobmannMD 

Department of Endocrinology

Diabetology and Geriatric Medicine

Klinikum Stuttgart –

Bürgerhospital

Tunzhofer Straße 14–16

70191 Stuttgart

Phone: +49/0711/253 2600

Fax: +49/0711/253 2173

Email: R.Lobmann@klinikum-stuttgart.de