IGF-1 Increases with Hyperbaric Oxygen Therapy and Promotes Wound Healing in Diabetic Foot Ulcers

Figen Aydin, Ahmet Kaya, Levent Karapinar, Mert Kumbaraci, Ahmet Imerci, Hasan Karapinar, Cengiz Karakuzu, Mustafa Incesu, Figen Aydin, Ahmet Kaya, Levent Karapinar, Mert Kumbaraci, Ahmet Imerci, Hasan Karapinar, Cengiz Karakuzu, Mustafa Incesu

Abstract

Objectives. To investigate insulin-like growth factor I (IGF-1) levels in response to hyperbaric oxygen therapy (HBOT) for diabetic foot ulcers and to determine whether IGF-1 is a predictive indicator of wound healing in patients with diabetic foot ulcers. Design and Methods. We treated 48 consecutive patients with diabetic foot ulcers with HBOT. Alterations of IGF-1 levels in patients whose wound healed with HBOT were compared with those in patients who did not benefit from HBOT. Results. There was no significant difference in initial IGF-1 levels between the two groups (P = 0.399). The mean IGF-1 level increased with HBOT (P < 0.05). In the healed group, the mean IGF-1 increase and the final values were significantly higher (P < 0.05). In the nonhealed group, the mean IGF-1 increase was minus and the final values were not significantly different (P < 0.05). The increase in IGF-1 level with HBOT was significantly higher in the healed group (P < 0.001). Conclusions. IGF-1 increased significantly in the healed group. We believe that HBOT is effective in the treatment of diabetic foot ulcers, with an elevation of IGF-1. This alteration seems to be a predictive factor for wound healing in diabetic foot ulcers treated with HBOT.

References

    1. Blakytny R, Jude EB, Gibson JM, et al. Lack of insulin-like growth factor 1 in the basal keratinocyte layer of diabetic skin and diabetic foot ulcers. The Journal of Pathology. 2000;190:589–594.
    1. Chen SJ, Yu CT, Cheng YL, Yu SY, Lo HC. Effects of hyperbaric oxygen therapy on circulating interleukin-8, nitric oxide, and insulin-like growth factors in patients with type 2 diabetes mellitus. Clinical Biochemistry. 2007;40(1-2):30–36.
    1. Chisalita SI, Arnqvist HJ. Expression and function of receptors for insulin-like growth factor-I and insulin in human coronary artery smooth muscle cells. Diabetologia. 2005;48(10):2155–2161.
    1. Eskes AM, Ubbink DT, Lubbers MJ, Lucas C, Vermeulen H. Hyperbaric oxygen therapy: Solution for difficult to heal acute wounds? Systematic review. World Journal of Surgery. 2011;35(3):535–542.
    1. Janssen JAMJL, Lamberts SWJ. Circulating IGF-I and its protective role in the pathogenesis of diabetic angiopathy. Clinical Endocrinology. 2000;52(1):1–9.
    1. Janssen JAMJL, Lamberts SWJ. The role of IGF-I in the development of cardiovascular disease in type 2 diabetes mellitus: is prevention possible? European Journal of Endocrinology. 2002;146(4):467–477.
    1. Kaya A, Aydin F, Altay T, Karapinar L, Ozturk H, Karakuzu C. Can major amputation rates be decreased in diabetic foot ulcers with hyperbaric oxygen therapy? International Orthopaedics. 2009;33(2):441–446.
    1. Löndahl M, Katzman P, Nilsson A, Hammarlund C. Hyperbaric oxygen therapy facilitates healing of chronic foot ulcers in patients with diabetes. Diabetes Care. 2010;33(5):998–1003.
    1. Löndahl M, Landin-Olsson M, Katzman P. Hyperbaric oxygen therapy improves health-related quality of life in patients with diabetes and chronic foot ulcer. Diabetic Medicine. 2011;28(2):186–190.
    1. Muniyappa R, Walsh MF, Rangi JS, et al. Insulin growth factor 1 increases vascular smooth muscle nitric oxide production. Life Sciences. 1997;61(9):925–931.
    1. O’Reilly D, Linden R, Fedorko L, et al. A prospective, double-blind, randomized, controlled clinical trial comparing standard wound care with adjunctive hyperbaric oxygen therapy (HBOT) to standard wound care only for the treatment of chronic, non-healing ulcers of the lower limb in patients with diabetes mellitus: a study protocol. Trials. 2011;12:69–79.
    1. Pennisi PA, Barr V, Nunez NP, Stannard B, Le Roith D. Reduced expression of insulin-like growth factor I receptors in MCF-7 breast cancer cells leads to a more metastatic phenotype. Cancer Research. 2002;62(22):6529–6537.
    1. Pöykkö SM, Ukkola O, Kauma H, Kellokoski E, Hörkkö S, Kesäniemi YA. The negative association between plasma ghrelin and IGF-I is modified by obesity, insulin resistance and type 2 diabetes. Diabetologia. 2005;48(2):309–316.
    1. Romero-Valdovinos M, Cardenas-Mejia A, Gutierrez-Gomez C, et al. Keloid skin scars: the influence of hyperbaric oxygenation on fibroblast growth and on the expression of messenger RNA for insulin like growth factor and for transforming growth factor. In Vitro Cellular & Developmental Biology. 2011;47:421–424.
    1. Schippinger G, Oettl K, Fankhauser F, et al. Influence of intramuscular application of autologous conditioned plasma on systemic circulating IGF-1. Journal of Sports Science and Medicine. 2011;10:439–444.
    1. Todorovic V, Pesko P, Micev M, et al. Insulin-like growth factor-I in wound healing of rat skin. Regulatory Peptides. 2008;150:7–13.
    1. Urso ML, Fiatarone Singh MA, Ding W, Evans WJ, Cosmas AC, Manfredi TG. Exercise training effects on skeletal muscle plasticity and IGF-1 receptors in frail elders. Age. 2005;27(2):117–125.
    1. Wallander M, Brismar K, Öhrvik J, Rydén L, Norhammar A. Insulin-like growth factor I: a predictor of long-term glucose abnormalities in patients with acute myocardial infarction. Diabetologia. 2006;49(10):2247–2255.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj