ДИНАМИКА ЛОКАЛЬНОЙ ЭКСПРЕССИИ КОННЕКСИНА-43 И РЕЦЕПТОРОВ ОСНОВНОГО ФАКТОРА РОСТА ФИБРОБЛАСТОВ У БОЛЬНЫХ С ГНОЙНО-ВОСПАЛИТЕЛЬНЫМИ ЗАБОЛЕВАНИЯМИ КОЖИ И МЯГКИХ ТКАНЕЙ НА ФОНЕ САХАРНОГО ДИАБЕТА 2-ГО ТИПА

Clinical results of wound healing dynamics were studied in 60 patients with soft-tissue infection against the background of diabetes mellitus type II. At the same time the study considered indices of intercellular contacts protein tissue expression such as connexin 43(Cx43) and basic fibroblast growth factor receptors (bFGFR). The basic therapy of biopsy material of wound borders was applied. The reduction of bFGFR expression and the minor growth of Cx43 expression were observed. The pain syndrome proceeded for a long time and there were signs of perifocal inflammation, retard wound healing with granulation tissue. The application of combined method of ozone therapy which included autohemotherapy with ozone and an external management of wound by ozone-oxygen mixture facilitated to considerable shortening of inflammatory phase and regeneration. It was associated with increased Cx43 expression (in 1,9 times) in comparison with initial level and bFGFR was enlarged in 1,7 times to eighth day of postoperative period.

инфекции кожи и мягких тканей, раневой процесс, сахарный диабет 2-го типа, коннексин 43, рецептор основного фактора роста фибробластов, озонотерапия, skin and soft-tissue infections, wound management, diabetes mellitus type II, connexin 43, basic fibroblast growth factor receptor, ozone therapy

1. Багненко С. Ф., Баткаев Э. А., Белобородов В. Б. и др. Хирургические инфекции кожи и мягких тканей. Российские национальные рекомендации / Под ред. В. С. Савельева, Б. Р. Гельфанда, А. О. Жукова и др. М.: Боргес, 2009. 89 с.

2. Винник Ю. С., Перьянова О. В., Дробушевская А. И. и др. Результаты мониторинга состава возбудителей хирургической инфекции кожи и мягких тканей // Мед. акад. журн. 2010. № 5. С. 84-85.

3. Винник Ю. С., Салмина А. Б., Дробушевская А. И. и др. Особенности патогенеза длительно незаживающих ран // Новости хир. 2011. № 3. С. 101-110.

4. Винник Ю. С., Салмина А. Б., Дробушевская А. И. и др. Возможности озонотерапии в коррекции молекулярных механизмов осложнённого репаративного процесса на фоне сахарного диабета // Вестн. нов. мед. технологий. 2012. № 4. С. 101-105.

5. Шагинян Г. Г., Чеканов М. Н., Штофин С. Г. Некротизирующий фасциит: ранняя диагностика и хирургическое лечение // Сибирское мед. обозрение. 2011. № 5. С. 55-59.

6. Abrahamian F.M., Talan D. A., Moran G. J. Management of skin and soft-tissue infections in the emergency department // Infect. Dis. Clin. N. Am. 2008. Vol. 22, № 1. P. 89-116.

7. Barrientos S., Stojadinovic O., Golinko M. S. et al. Growth factors and cytokines in wound healing // Wount Rep. Reg. 2008. Vol. 16. P. 585-601.

8. Becker D. L., Thrasivoulou C., Phillips A. R. Connexins in wound healing; perspectives in diabetic patients // Biochim. Biophys. Acta. 2012. Vol. 1818, № 8. P. 2068-2075.

9. Beenken A., Mohammadi M. The FGF family: biology, pathophysiology and therapy // Nat. Rev. Drug. Discov. 2009. Vol. 8, № 3. P. 235-253.

10. Brandner J. M., Houdek P., Huёsing B. et al. Connexins 26, 30, and 43: differences among spontaneous, chronic and accelerated human wound healing // J. Invest. Dermatol. 2004. Vol. 122, № 5. P. 1310-1320.

11. Cardoso C. R. L., Salles G. F. Macro and microvascular complications are determinants of increased infection-related mortality in Brazilian type 2 diabetes mellitus patients // Diabetes Res. Clin. Pract. 2007. Vol. 75, № 1. P. 51-58.

12. Demidova-Rice T. N., Hamblin M. R., Herman I. M. Acute and impaired wound healing: pathophysiology and current methods for drug delivery, part 1: normal and chronic wounds: biology, causes, and approaches to care // Adv. Skin Wound Care. 2012. Vol. 25, № 7. P. 304-314.

13. Dobrowolski R., Hertig G., Lechner H. et al. Loss of connexin 43-mediated gap junctional coupling in the mesenchyme of limb buds leads to altered expression of morphogens in mice // Hum. Mol. Genet. 2009. Vol. 18, № 15. Р. 2899-2911.

14. Komi-Kuramochi A., Kawano M., Oda Y. et al. Expression of fibroblast growth factors and their receptors during full-thickness skin wound healing in young and aged mice // J. Endocrinol. 2005. Vol. 186, № 2. P. 273-289.

15. Krieg А., Röhrborn А., Schulte A. et al. Necrotizing fasciitis: microbiological characteristics and predictors of postoperative outcome // Eur. J. Med. Res. 2009. Vol. 14, № 1. P. 30-36.

16. Li J., Chen J., Kirsner R. Pathophysiology of acute wound healing // Clinics in Dermatology. 2007. Vol. 25, № 1. P. 9-18.

17. Mendoza-Naranjo A., Cormie P., Serrano A. E. et al. Over expression of the gap junction protein C-43 as found in diabetic foot ulcers can retard fibroblast migration // Cell. Biol. Int. 2012. Vol. 36, № 7. Р. 661-667.

18. Meyer M., Müller A. K., Yang J. et al. FGF receptors 1 and 2 are key regulators of keratinocyte migration in vitro and in wounded skin // J. Cell. Sci. 2012. Vol. 125, № 23. P. 5690-5701.

19. Mori R., Power K. T., Wang C. M. Acute downregulation of connexin 43 at wound sites leads to a reduced inflammatory response, enhanced keratinocyte proliferation and wound fibroblast migration // J. Cell. Sci. 2006. Vol. 119, № 24. P. 5193-5203.

20. Nakano Y., Oyamada M., Dai P. et al. Connexin 43 knockdown accelerates wound healing but inhibits mesenchymal transition after corneal endothelial injury in vivo // Invest. Ophthalmol. Vis. Sci. 2008. Vol. 49, № 1. Р. 93-104.

21. Niger C., Hebert C., Stains J. P. Interaction of connexin 43 and protein kinase C-delta during FGF2 signaling // BMC Biochem. 2010. Vol. 11, № 14. Р. 1-12.

22. Peleg A. Y., Weerarathna T., McCarthy J. S., Davis T.M. Common infections in diabetes: pathogenesis, management and relationship to glycaemic control // Diabetes Metab. Res. Rev. 2007. Vol. 23, № 1. P. 3-13.

23. Richard J.-L., Lavigne J.-P., Got I. et al. Management of patients hospitalized for diabetic foot infection: results of the French OPIDIA study // Diabetes Metabolism. 2011. Vol. 37, № 3. Р. 208-215.

24. Sakurai T., Tsuchida M., Lampe P. D., Murakami M. Cardiomyocyte FGF signaling is required for C-43 phosphorylation and cardiac gap junction maintenance // Exp. Cell Res. 2013. Vol. 319, № 14. P. 2152-2165.

25. Sreeramoju P., Porbandarwalla N. S., Arango J. et al. Recurrent skin and soft tissue infections due to methicillin-resistant Staphylococcus aureus requiring operative debridement // Am. J. Surg. 2011. Vol. 201, № 2. P. 216-220.

26. Suaya J. A., Eisenberg D. F., Fang C., Miller L. G. Skin and soft tissue infections and associated complications among commercially insured patients aged 0-64 years with and without diabetes in the U. S. // PLoS One. 2013. Vol. 8, № 4. P. 1-8.

27. Takayama М., Kuramoto Y., Okuyama R. et al. The exudate of pressure ulcers contains a substantial amount of vascular endothelial growth factor // Tohoku J. Exp. Med. 2010. Vol. 221, № 4. Р. 315-319.

28. Wang C. M., Lincoln J., Cook J. E., Becker D. L. Abnormal connexin expression underlies delayed wound healing in diabetic skin // Diabetes. 2007. Vol. 56, № 11. Р. 2809-2817.