Objective To investigate the pathological changes and molecular mechanisms in granulation tissue adjacent to necrotic tissue in diabetic foot ulcers(DFUs),providing theoretical support for the treatment of hard-to-heal DFU wounds.Methods Tissue samples were collected from five DFU patients who underwent surgery at Shenzhen Overseas Chinese Hospital,Jinan University,from January to July 2024.Necrotic tissue and adjacent near-normal tissue were subjected to hematoxylin-eosin(HE)staining,immunohistochemistry,and qPCR analysis.The pathological and mRNA-level changes in necrotic DFU tissues were analyzed,focusing on the differences in immune cells(CD4+T cells,CD20+B cells)and vascular markers(CD34,CD31).Results Compared with adjacent normal tissue,necrotic tissue showed extensive inflammatory cell infiltration,significant death of fibroblasts and endothelial cells,and impaired granulation tissue proliferation and remodeling.CD34 expression in necrotic tissue displayed a band-like distribution,while CD31 expression was significantly upregulated.Additionally,the expression of CD4+T cells and CD20+B cells was markedly increased in necrotic tissue.qPCR analysis revealed a significant increase in CD31 mRNA transcription levels in necrotic tissue.Conclusion The significant increase in CD4+T cells and CD20+B cells,along with elevated CD31 expression,suggests that CD4 and CD20 may serve as important prognostic markers for DFU wound healing.CD31 may also represent a potential therapeutic target for refractory DFU wounds.
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