Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Oct 16:2018:1631325.
doi: 10.1155/2018/1631325. eCollection 2018.

Wound Fluid Matrix Metalloproteinase-9 as a Potential Predictive Marker for the Poor Healing Outcome in Diabetic Foot Ulcers

Punyanuch Jindatanmanusan  1 , Sivat Luanraksa  2 , Tanit Boonsiri  3 , Thirayost Nimmanon  4 , Pasra Arnutti  4
Affiliations

Wound Fluid Matrix Metalloproteinase-9 as a Potential Predictive Marker for the Poor Healing Outcome in Diabetic Foot Ulcers

Punyanuch Jindatanmanusan et al. Patholog Res Int. .

Abstract

Background and objective: Evidence for the roles of matrix metalloproteinases-9 (MMP-9) in the healing process of diabetic foot ulcers has remained unclear. We therefore aimed to demonstrate the relationship of MMP-9 with the wound healing process and determine its potential usefulness in predicting the wound healing outcome.

Methods: Twenty-two patients with diabetic foot ulcer were recruited. The wound size was determined, and the wound fluid was collected for the measurement of MMP-9 levels using an ELISA during the 12-week follow-up period regularly. The patients were categorized as good healers and poor healers when the wound area reduction was ≥ 50% and < 50% at week 4 when compared to the initial wound size at week 0.

Results: Median wound fluid MMP-9 levels in the poor healer group were shown to be significantly higher than those in the good healer group (1.03 pg/µg protein vs. 0.06 pg/µg protein, p = 0.001), and the levels fluctuated throughout the 12-week follow-up period. In contrast to the poor healer group, the MMP-9 levels were demonstrated to be constantly low throughout the follow-up period in the good healer group. ROC analysis showed that the MMP-9 level of 0.38 pg/µg protein was able to predict the wound healing outcome with the sensitivity of 81.8%, the specificity of 64.6%, and the area under the curve of 0.901 (CI 0.78-1.03, p = 0.001).

Conclusion: These findings suggested that determination of wound fluid MMP-9 levels might become a promising biomarker predicting wound healing outcomes and a novel potential therapeutic _target for diabetic foot ulcers.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Percentages of initial wound surface areas in good healer and poor healer groups are displayed as median with interquartile range (25th-75th percentile). By week 8, wounds in 7 out of 11 good healers were healed, whereas no wound in the poor healer group was healed during the 12-week study period.
Figure 2
Figure 2
MMP-9 levels in good healer and poor healer groups during the 12-week follow-up period are expressed as median with interquartile range (25th-75th percentile).
Figure 3
Figure 3
The MMP-9 is a predictive factor for diabetic ulcer wound healing outcome. The ROC analysis gives an area under the curve of 0.90(0.6–1.04). The MMP-9 level of 0.3805 at week 0 has a sensitivity of 81.8% and a specificity of 64.6% for detecting a wound area reduction of less than 50% at week 4.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Trengove N. J., Stacey M. C., Macauley S., et al. Analysis of the acute and chronic wound environments: the role of proteases and their inhibitors. Wound Repair and Regeneration: Official Publication of the Wound Healing Society and the European Tissue Repair Society. 1999;7(6):442–452. doi: 10.1046/j.1524-475X.1999.00442.x. - DOI - PubMed
    1. Tarnuzzer R. W., Schultz G. S. Biochemical analysis of acute and chronic wound environments. Wound Repair and Regeneration. 1996;4(3):321–325. doi: 10.1046/j.1524-475X.1996.40307.x. - DOI - PubMed
    1. Chen C., Schultz G. S., Bloch M., Edwards P. D., Tebes S., Mast B. A. Molecular and mechanistic validation of delayed healing rat wounds as a model for human chronic wounds. Wound Repair and Regeneration. 1999;7(6):486–494. doi: 10.1046/j.1524-475X.1999.00486.x. - DOI - PubMed
    1. Yager D. R., Chen S. M., Ward S. I., Olutoye O. O., Diegelmann R. F., Cohen I. K. Ability of chronic wound fluids to degrade peptide growth factors is associated with increased levels of elastase activity and diminished levels of proteinase inhibitors. Wound Repair and Regeneration. 1997;5(1):23–32. doi: 10.1046/j.1524-475X.1997.50108.x. - DOI - PubMed
    1. Lavery L. A., Vela S. A., Lavery D. C., Quebedeaux T. L. Reducing dynamic foot pressures in high-risk diabetic subjects with foot ulcerations: A comparison of treatments. Diabetes Care. 1996;19(8):818–821. doi: 10.2337/diacare.19.8.818. - DOI - PubMed

LinkOut - more resources

  NODES
twitter 2