M1/M2 monocytes-macrophages polarization in patients with diabetic foot syndrome

Investigation of the spontaneous and induced secretion of the antiinflammatory cytokine TNF-a (M1) and the anti-inflammatory chemokine CCL18 (M2) by macrophage monocytes in the culture medium in patients with diabetic foot syndrome (DFS). 42 patients with diabetic foot syndrome (DFS), 14 patients with a neuropathic form (7m / 7f), 28 with a neuroischemic (22m / 6f) were examined. The levels of basal and interferon-y stimulated TNF-a secretion, CCL18- interleukin-4 monocyte-macrophages with various ulcerative defects were studied by ELISA. In patients with neuropathic form of DFS, we found higher values of the proinflammatory response and a significant decrease in the stimulated anti-inflammatory response, compared with patients with the neuroischemic form (p2, >3 cm2), higher values of TNF-a, p 2). With defects of 1-3 cm2, no stimulatory anti-inflammatory response was obtained, and in patients with ulcers 2, the stimulated response is lower than basal. In this cohort, a correlation was found between a high level of HbA1c> 8.0% and a low level of CCL18 (r = -0,883; p = 0,008).