М1/М2 ПОЛЯРИЗАЦИЯ МОНОЦИТОВ-МАКРОФАГОВ У БОЛЬНЫХ С СИНДРОМОМ ДИАБЕТИЧЕСКОЙ СТОПЫ
Investigation of the spontaneous and induced secretion of the anti-inflammatory cytokine TNF-α (M1) and the anti-inflammatory chemokine CCL18 (M2) by macrophage monocytes in the culture medium in patients with diabetic foot syndrome (DFS). 42 patients with diabetic foot syndrome (DFS), 14 patients with a neuropathic form (7m / 7f), 28 with a neuroischemic (22m / 6f) were examined. The levels of basal and interferon-γ stimulated TNF-α secretion, CCL18- interleukin-4 monocyte-macrophages with
... acrophages with various ulcerative defects were studied by ELISA. In patients with neuropathic form of DFS, we found higher values of the proinflammatory response and a significant decrease in the stimulated anti-inflammatory response, compared with patients with the neuroischemic form (p<0,001). Excess production of TNF-α and a decrease in CCL18 were detected in patients with a duration of ulcerative defects more than 6 months, (p <0,05). In patients with defects of small and large sizes (<1 cm2, >3 cm2), higher values of TNF-α, p <0,001, than in patients with defects of medium size (1–3 cm2). With defects of 1-3 cm2, no stimulatory anti-inflammatory response was obtained, and in patients with ulcers <1 cm2, the stimulated response is lower than basal. In this cohort, a correlation was found between a high level of HbA1c> 8.0% and a low level of CCL18 (r = -0,883; p = 0,008).