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Circulating Biomarkers of Endothelial Dysfunction and Inflammation in Predicting Clinical Outcomes in Diabetic Patients with Critical Limb Ischemia

Critical limb ischemia (CLI) is a severe manifestation of peripheral artery disease characterized by ischemic pain, which is frequently associated with diabetes and non-healing lesions to inferior limbs. The clinical management of diabetic patients with CLI typically includes percutaneous translumin...

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Autores principales: Vieceli Dalla Sega, Francesco, Cimaglia, Paolo, Manfrini, Marco, Fortini, Francesca, Marracino, Luisa, Bernucci, Davide, Pompei, Graziella, Scala, Antonella, Trichilo, Michele, De Carolis, Beatrice, Dalla Paola, Luca, Ferrari, Roberto, Rizzo, Paola, Campo, Gianluca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9506462/
https://www.ncbi.nlm.nih.gov/pubmed/36142551
http://dx.doi.org/10.3390/ijms231810641
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author Vieceli Dalla Sega, Francesco
Cimaglia, Paolo
Manfrini, Marco
Fortini, Francesca
Marracino, Luisa
Bernucci, Davide
Pompei, Graziella
Scala, Antonella
Trichilo, Michele
De Carolis, Beatrice
Dalla Paola, Luca
Ferrari, Roberto
Rizzo, Paola
Campo, Gianluca
author_facet Vieceli Dalla Sega, Francesco
Cimaglia, Paolo
Manfrini, Marco
Fortini, Francesca
Marracino, Luisa
Bernucci, Davide
Pompei, Graziella
Scala, Antonella
Trichilo, Michele
De Carolis, Beatrice
Dalla Paola, Luca
Ferrari, Roberto
Rizzo, Paola
Campo, Gianluca
author_sort Vieceli Dalla Sega, Francesco
collection PubMed
description Critical limb ischemia (CLI) is a severe manifestation of peripheral artery disease characterized by ischemic pain, which is frequently associated with diabetes and non-healing lesions to inferior limbs. The clinical management of diabetic patients with CLI typically includes percutaneous transluminal angioplasty (PTA) to restore limb circulation and surgical treatment of diabetic foot ulcers (DFU). However, even after successful treatment, CLI patients are prone to post-procedure complications, which may lead to unplanned revascularization or foot surgery. Unfortunately, the factors predicting adverse events in treated CLI patients are only partially known. This study aimed to identify potential biomarkers that predict the disease course in diabetic patients with CLI. For this purpose, we measured the circulating levels of a panel of 23 molecules related to inflammation, endothelial dysfunction, platelet activation, and thrombophilia in 92 patients with CLI and DFU requiring PTA and foot surgery. We investigated whether these putative biomarkers were associated with the following clinical endpoints: (1) healing of the treated DFUs; (2) need for new revascularization of the limb; (3) appearance of new lesions or relapses after successful healing. We found that sICAM-1 and endothelin-1 are inversely associated with DFU healing and that PAI-1 and endothelin-1 are associated with the need for new revascularization. Moreover, we found that the levels of thrombomodulin and sCD40L are associated with new lesions or recurrence, and we show that the levels of these biomarkers could be used in a decision tree to assign patients to clusters with different risks of developing new lesions or recurrences.
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spelling pubmed-95064622022-09-24 Circulating Biomarkers of Endothelial Dysfunction and Inflammation in Predicting Clinical Outcomes in Diabetic Patients with Critical Limb Ischemia Vieceli Dalla Sega, Francesco Cimaglia, Paolo Manfrini, Marco Fortini, Francesca Marracino, Luisa Bernucci, Davide Pompei, Graziella Scala, Antonella Trichilo, Michele De Carolis, Beatrice Dalla Paola, Luca Ferrari, Roberto Rizzo, Paola Campo, Gianluca Int J Mol Sci Article Critical limb ischemia (CLI) is a severe manifestation of peripheral artery disease characterized by ischemic pain, which is frequently associated with diabetes and non-healing lesions to inferior limbs. The clinical management of diabetic patients with CLI typically includes percutaneous transluminal angioplasty (PTA) to restore limb circulation and surgical treatment of diabetic foot ulcers (DFU). However, even after successful treatment, CLI patients are prone to post-procedure complications, which may lead to unplanned revascularization or foot surgery. Unfortunately, the factors predicting adverse events in treated CLI patients are only partially known. This study aimed to identify potential biomarkers that predict the disease course in diabetic patients with CLI. For this purpose, we measured the circulating levels of a panel of 23 molecules related to inflammation, endothelial dysfunction, platelet activation, and thrombophilia in 92 patients with CLI and DFU requiring PTA and foot surgery. We investigated whether these putative biomarkers were associated with the following clinical endpoints: (1) healing of the treated DFUs; (2) need for new revascularization of the limb; (3) appearance of new lesions or relapses after successful healing. We found that sICAM-1 and endothelin-1 are inversely associated with DFU healing and that PAI-1 and endothelin-1 are associated with the need for new revascularization. Moreover, we found that the levels of thrombomodulin and sCD40L are associated with new lesions or recurrence, and we show that the levels of these biomarkers could be used in a decision tree to assign patients to clusters with different risks of developing new lesions or recurrences. MDPI 2022-09-13 /pmc/articles/PMC9506462/ /pubmed/36142551 http://dx.doi.org/10.3390/ijms231810641 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Vieceli Dalla Sega, Francesco
Cimaglia, Paolo
Manfrini, Marco
Fortini, Francesca
Marracino, Luisa
Bernucci, Davide
Pompei, Graziella
Scala, Antonella
Trichilo, Michele
De Carolis, Beatrice
Dalla Paola, Luca
Ferrari, Roberto
Rizzo, Paola
Campo, Gianluca
Circulating Biomarkers of Endothelial Dysfunction and Inflammation in Predicting Clinical Outcomes in Diabetic Patients with Critical Limb Ischemia
title Circulating Biomarkers of Endothelial Dysfunction and Inflammation in Predicting Clinical Outcomes in Diabetic Patients with Critical Limb Ischemia
title_full Circulating Biomarkers of Endothelial Dysfunction and Inflammation in Predicting Clinical Outcomes in Diabetic Patients with Critical Limb Ischemia
title_fullStr Circulating Biomarkers of Endothelial Dysfunction and Inflammation in Predicting Clinical Outcomes in Diabetic Patients with Critical Limb Ischemia
title_full_unstemmed Circulating Biomarkers of Endothelial Dysfunction and Inflammation in Predicting Clinical Outcomes in Diabetic Patients with Critical Limb Ischemia
title_short Circulating Biomarkers of Endothelial Dysfunction and Inflammation in Predicting Clinical Outcomes in Diabetic Patients with Critical Limb Ischemia
title_sort circulating biomarkers of endothelial dysfunction and inflammation in predicting clinical outcomes in diabetic patients with critical limb ischemia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9506462/
https://www.ncbi.nlm.nih.gov/pubmed/36142551
http://dx.doi.org/10.3390/ijms231810641
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