Effects and mechanism of hyperbaric oxygen therapy on serum SDF-1 and CXCR4 levels in patients with diabetic foot
Objective To observe the changes of the concentrations of stromal cell-derived factor-1(SDF-1)and chemokine receptor type 4(CXCR4)before and after hyperbaric oxygen(HBO)therapy during the process of diabetic foot ulcer treatment.Methods A total of 30 patients who were hospitalized in the Department of Endocrinology,Chongqing University Three Gorges Hospital for diabetic foot ulcers from November 2019 to June 2020 were selected as the study subjects.They were assigned according to the Wagner grading system into group W1(Wagner grade 1),group W2(Wagner grade 2),and group W3(Wagner grade 3),with 10 patients in each group.In addition,a total of 30 hospitalized diabetes patients without diabetic foot ulcers were selected into the control group.The patients in the study group underwent HBO therapy in addition to conventional treatment.After the treatment,the levels of SDF-1,CXCR4,and other indicators were measured,and statistically analyzed in comparison to the pre-treatment levels of the study group and the control group.Results The peripheral blood SDF-1 levels[(3.57±0.25)ng/ml]in the study group were significantly higher than those in the control group[(2.59±0.23)ng/ml].The peripheral blood CXCR4 levels[(4.93±0.26)ng/ml]in the study group were also significantly higher than those in the control group[(3.62±0.28)ng/ml].These differences were statistically significant(P＜0.05).Compared with the group W1[(3.39±0.23)ng/ml],the peripheral blood SDF-1 levels in the group W2[(3.68±0.22)ng/ml]and the group W3[(3.64±0.21)ng/ml]increased,with statistically significant differences(P＜0.05).However,there was no significant statistical difference in peripheral blood SDF-1 level between the group W2 and the group W3(P＞0.05).There was no significant statistical difference in peripheral blood CXCR4 level among the three groups(P＞0.05).After HBO therapy,the peripheral blood SDF-1 levels in the group W1 increased from[(3.39±0.23)ng/ml]to[(3.58±0.20)ng/ml],and the CXCR4 levels increased from[(4.98±0.16)ng/ml]to[(5.45±0.29)ng/ml],with statistically significant differences(P＜0.05).In the group W2,the peripheral blood SDF-1 levels increased from[(3.68±0.22)ng/ml]to[(3.89±0.20)ng/ml],and the CXCR4 levels increased from[(4.97±0.40)ng/ml]to[(5.36±0.30)ng/ml],with statistically significant differences(P＜0.05).There was no statistically significant difference in peripheral blood SDF-1 and CXCR4 levels in the group W3 after treatment(P＞0.05).Conclusion HBO therapy can participate in the formation of new blood vessels and accelerate wound healing in patients with diabetic foot ulcers by activating the high expression of SDF-1/CXCR4.
Diabetic footHyperbaric oxygenStromal cell-derived factor-1Chemokine receptor type 4
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