Ewelina Drela

Circulating endothelial progenitor cells and angiogenic factors in diabetes complicated diabetic foot and without foot complications

INTRODUCTION Data about angiogenic factors in diabetic foot syndrome (DFS) are insufficient. Therefore, in the present study we focus on circulating endothelial progenitor cells (EPCs) and two major angiogenic factors: vascular endothelial growth factor (VEGF-A) and fibroblast growth factor (FGF-2) in patients with DFS. MATERIALS AND METHODS We included 75 subjects: 45 patients with type 2 diabetes and 30 controls. The study group was divided into 2 subgroups: 23 patients with diabetic foot and 22 patients without diabetic complications. The concentration of VEGF-A, soluble VEGF receptor 2 (sVEGF-R2) and FGF-2 were measured in plasma samples. The number of circulating EPCs was determined in peripheral venous blood. The number of endothelial progenitor cells was measured with FACSCalibur flow cytometer using monoclonal antibodies directed against antigens specific for EPCs. RESULTS In our study we observed significant higher levels of VEGF-A and FGF-2 and lower sVEGF-R2 concentration in patients with T2DM compared to healthy subjects. The conducted analysis showed decreased levels of VEGF-A and elevated levels of FGF-2 in patients with DM complicated DFS compared to diabetic patients without DFS. Increased circulating EPCs number was reported in patients with DFS, and the difference was almost statistically significant. CONCLUSIONS The high concentration of VEGF-A and FGF-2, and a positive correlation between them indicate their participation in the process of angiogenesis in T2DM. Decreased sVEGF-R2 may result from inactivation of VEGF-A during complexes formation.

VEGF-A and PDGF-BB--angiogenic factors and the stage of diabetic foot syndrome advancement.

INTRODUCTION In patients with diabetic foot syndrome (DFS), an inadequate angiogenic response is observed. The aim of this study was to evaluate the concentrations of VEGF-A, PDGF-BB, sVEGF-R2 and sVEGF-R1 in patients with diabetes-complicated diabetic foot syndrome and analyse them using selected clinical data. MATERIAL AND METHODS Forty seven diabetic patients, 25 women mean age 63 and 20 men mean age 60.5, with diabetic foot syndrome (DFS) were enrolled in the experimental group. To evaluate angiogenesis factors depending on Wagner grade, the subjects were divided into three subgroups: I - patients with 0 Wagner grade (n = 14); II - patients with 1,2,3 Wagner grades (n = 15); and III - patients with 4,5 Wagner grades (n = 18). The control group consisted of 20 healthy volunteers. The material for research was blood. RESULTS Significantly higher levels of VEGF-A and PDGF-BB in the DFS cases compared to controls were observed (VEGF-A p = 0.000001; PDGF-BB p = 0.000051). Analysis of angiogenic parameters according to the stage of diabetic foot syndrome advancement showed higher VEGF-A level (I: p = 0.000867; II: p = 0.001827; III: p = 0.000024) and PDGF-BB (respectively p = 0.004113, p = 0.004224, p = 0.002480) in all the subgroups. Decreased sVEGF-R2 concentrations were observed in the I (p = 0.054) subgroup and the III (p = 0.03524) subgroup. In this study, a strong positive correlation between VEGF-A and PDGF-BB was observed (R = 0.66; p = 0.000001). CONCLUSIONS Our study revealed that proangiogenic factor levels were increased in DFS. This is associated with lower limb ischaemia and hypoxic conditions. The stage of diabetic foot syndrome advancement influenced VEGF-A and PDGF-BB concentrations.

Relation of the Readiness for Hospital Discharge after Myocardial Infarction Scale to socio-demographic and clinical factors. An observational study

Introduction: The aim of the study was to analyse the relationship between the Readiness for Hospital Discharge after Myocardial Infarction Scale (RHD MIS) scores and socio-demographic and clinical factors in patients after acute myocardial infarction (AMI) treated with percutaneous coronary angioplasty. Material and methods: The study was conducted as a single-centre, prospective, cohort, 6-month observa-tion, including 213 patients: 59 women and 154 men aged 30–91 years (average age of 62,91 ± 11.26 years). Results: Patients’ economic status was found to have a significant impact on the readiness for discharge measured by RHD-MIS general score. Among all three investigated RHD-MIS subscales, objective assessment of knowledge was influenced by gender (p = 0.012) and place of residence (p = 0.025). There was a linear trend for increase of knowledge along with increase in education level (p = 0.030). The only factor influencing patients’ expectations was their economic status (p value for heterogeneity: 0.014). A linear correlation between growing of patients’ expectations and worsening of their economic status (p = 0.008) was observed. Conclusion: Readiness to discharge should be routinely assessed in all patients hospitalized with myo-cardial infarction. The result of this assessment should be used to identify patients requiring additional education. Further research is prompted to determine the cut-off values of RHD-MIS results qualifying patients for additional educational interventions.

ENDOTHELIAL PROGENITOR CELLS IN MYELOPROLIFERATIVE NEOPLASMS – PRELIMINARY REPORT

Celem niniejszej pracy byla ocena liczby i funkcji komorek progenitorowych środblonka w przewleklej bialaczce szpikowej (PBS), czerwienicy prawdziwej (CzP), nadplytkowości samoistnej (NS). Badaniem objeto 21 pacjentow z nowotworami mieloproliferacyjnymi (średnia wieku 61,77), hospitalizowanych w Oddziale Klinicznym Hematologii i Chorob Rozrostowych Ukladu Krwiotworczego Szpitala Uniwersyteckiego nr 2 im. Jana Biziela w Bydgoszczy. M a t e r i a l i m e t o d y . Badania przeprowadzono u 12 chorych na ET, 4 chorych na CML i 5 chorych na PV. Grupe kontrolną stanowilo 25 zdrowych ochotnikow. Materialem do badan byla krew pobrana w godzinach porannych z naklucia zyly lokciowej do probowki zawierającej wersenian dwupotasowy (EDTA). Po inkubacji z odpowiednimi odczynnikami dokonana zostala analiza cytometryczna przy uzyciu cytometru przeplywowego FACS Calibur (Becton Dickinson, San Diego, USA) z zastosowaniem programu komputerowego CellQuest. Wy n i k i . U chorych na przewlekle nowotwory mieloproliferacyjne stwierdzono istotnie statystyczną zwiekszoną liczbe EPCs w porownaniu z grupą kontrolną. U chorych z PV i ET stwierdzono nieznacznie zwiekszoną liczbe EPCs w porownaniu do grupy kontrolnej, a roznica ta okazala sie nieistotna statystycznie. Najwyzszą liczbe EPCs stwierdzono u pacjentow z CML i roznica ta byla istotna statystycznie. Wn i o s k i . Zwiekszenie liczby EPCs w grupie chorych na przewlekle nowotwory mieloproliferacyjne świadczy o aktywacji procesow angiogenezy w tych nowotworach i prawdopodobnie czynnym udziale tych komorek w procesie nowotworzenia naczyn.