The Pression Of Cathepsin S In Different Types Of Wounds And Chronic Wound Healing Process Of Diabetic Foot Ulcers

Objectives1.The expression difference of cathepsin S(CTSS)in acute wounds without blood glucose abnormality and between diabetic foot ulcer(DFU)wounds was studied to further understand the effect of cathepsin S on the healing of different types of wounds.2.To understand whether there are dynamic changes in cathepsin S(CTSS)during the wound healing of diabetic foot ulcer(DFU)and its prognostic value in patients with diabetic foot ulcersMethods1.We selected 14 patients with DFU and 7 patients presenting without concurrent dysglycemia for acute trauma between June 2021 and December 2022.Skin and granulation tissue samples from the inflammatory and proliferation phase of DFU patients were collected and set as DFU group.The skin tissue of the wound margin of acute trauma patients was collected and set as the acute trauma group.According to the differences of different tissue classification and different periods of wound surface,DFU patient group was divided into inflammation skin group,proliferation skin group,inflammation granulation group and proliferation group.Then,the hematoxylin-eosin(HE)staining technique was used to observe the gross morphological changes of skin tissue in the DFU patient group at different periods of healing.The expression level of CTSS in the skin and(or)of the granulation tissue was measured by immunohistochemistry(IHC).The expression level of cathepsin S in skin tissues of DFU group was determined by western blotting(WB).Results1.To comparing the histomorphological differences of margin skin tissue at different periods of foot wound healing of DFU patients by HE staining: During the proliferation phase,the inflammatory cells in the connective tissue decreased compared with the inflammatory phase,and the number of blood vessels in the papillary layer of the dermis increased compared with the inflammatory phase.2.We further investigated CTSS expression in different wound tissues and different periods of wound healing by immunohistochemical staining(IHC),to determined the average optical density(MOD)of cathepsin S positive cells in the wound tissue of each group.The expression level of CTSS in the wound skin tissue is no statistical difference between the DFU inflammation stage group and the acute trauma group(P >0.05).In the DFU group,the expression level of CTSS in the skin and granulation tissue was significantly reduced in the proliferstage group compared with the inflammatory group(P <0.05).The expression level of CTSS was higher in the inflammatory granulation group than in the inflammatory skin group(P <0.001).3.The results of immunohistochemistry staining showed that the CTSS positive expressed proteins in the skin tissue of DFU wound and acute wounds were mainly concentrated in the dermal papillary layer,most in the connective tissue,which may be associated with inflammatory cell infiltration.4.Study the expression differences of CTSS in skin tissue wound skin tissue of five DFU patients was detected by WB between different periods of wound healing.Compared with the Inflammatory period group,we found that the expression level of CTSS in the wound skin tissue was reduced in proliferative group(P <0.05).ConclusionsThe CTSS expression levels in the skin tissue of acute wound and DFU chronic wounds were not statistically different.In different stages of chronic wound healing in DFU,there are significant changes in the expression level of CTSS,which is involved in the healing process of DFU chronic wound entering from the inflammatory stage to the proliferative stage.