Hyperglycemia is associated with lower levels of urokinase-type plasminogen activator and urokinase-type plasminogen activator receptor in wound fluid |
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| Institution: | 1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Dokuz Eylul University, Izmir, Turkey;2. Division of Colorectal Surgery, Department of Surgery, Dokuz Eylul University, Izmir, Turkey;3. Division of Hematology, Department of Internal Medicine, Izmir, Turkey;1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, No. 199, Section 1, Sanmin Road, Taichung 402, Taiwan;2. Institute of Biostatistics, China Medical University, No. 91 Hsueh-Shih Road, Taichung 404, Taiwan;3. Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Section 4, Taiwan Boulevard, Taichung 407, Taiwan;4. School of Medicine, National Defense Medical Center, Taipei, Taiwan;5. School of Medicine, National Yang-Ming University, Taipei, Taiwan;6. Institute of Medical Technology, National Chung-Hsing University, Taichung, Taiwan;1. EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands;2. Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands;3. Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands;4. Sanquin Research, Department of Donor Studies, Amsterdam, The Netherlands;5. Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands;6. Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands;7. Department of Physiology, VU University Medical Center, Amsterdam, The Netherlands;8. Department of General Practice, VU University Medical Center, Amsterdam, The Netherlands;1. Department of Cardiology, Mitsubishi Nagoya Hospital, Nagoya, Japan;2. Department of Cardiovascular Research, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan;1. Department of Ophthalmology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China 050011;2. Shijiazhuang Aier Hospital Department of Ophthalmology, Hebei Province, China 050000;3. Department of Ophthalmology, the People''s Hospital of Binzhou, Shandong Province, China 256600;4. Department of Ophthalmology, Affiliated Hospital of Chengde Medical College, Hebei Province, China 067000 |
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| Abstract: | AimsWounds in patients with hyperglycemia show impaired healing. Plasminogen activation is crucial in several overlapping phases of wound healing process. In this study, we aimed i) to compare acute wound fluid in patients with hyperglycemia and normoglycemia, ii) to focus on the elements of plasminogen activation in the wound fluid, and iii) to determine if the acute wound fluid characteristics are associated with surgical site infections.MethodsIn a cohort of 54 patients, a closed suction drain was placed in the wound above the anterior abdominal wall fascia under the skin in order to collect postoperative acute wound fluid samples for 3 following days after colorectal surgery. Patients were classified as normoglycemic (n = 25) or hyperglycemic (n = 29; 17 with type 2 diabetes and 12 with stress induced hyperglycemia). Surgical site infection was defined according to the Centers for Disease Control criteria. The levels of urokinase-type plasminogen activator (uPA), urokinase-type plasminogen activator receptor (uPAr), plasminogen activator inhibitor-1 (PAI-1), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and fibroblast growth factor-1 (FGF-1) were measured in the wound fluid.ResultsCompared to normoglycemic subjects, patients with hyperglycemia had significantly lower levels of uPA and uPAr in the wound fluid despite similar or even higher circulating levels. There was no significant difference in IL-1β, TNF-α, PAI-1 and FGF-1 levels. In the whole study population, the wound fluid levels of uPA and uPAr were negatively correlated with circulating glucose levels. No difference was detected in the wound fluid characteristics of patients with and without surgical site infection.ConclusionPatients with hyperglycemia exhibit decreased levels of uPA and uPAr in the wound fluid, suggesting a local failure in plasminogen activation at the wound site. |
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