Analysis of the Inflammation Response and of the Selected Parametersof Immunity in Patients with Infected Diabetic Ulcers

Overview

Background.
Patients with diabetes represent 50 to 70 % of patients who undergo nontraumatic foot or legamputation, caused mostly by infection and necrosis of soft tissues accompanied with osteomyelitis. Signs andsymptoms of infections may often be absent in patients with infected foot ulcers – the syndrome of „diabetic foot“(DF). The course and consequences of the infection may be influenced by the immune system dysfunction. The aimof our study was to assess presence of the chronic inflammation and specific immune responses, both humoral andcellular in patients with diabetic foot infection.Methods and Results. 34 patients treated over one month for an infected DF in our foot clinic (mean age 54±8years, mean duration of diabetes 20±9 years, mean HbAlc 8.8±1.5 %), were matched with 27 healthy subjects. Allpatients were without clinical signs of acute deep foot infection and without critical leg ischemia. The inflammatoryresponse was assessed by white blood cells count and C-reactive protein (CRP), humoral immune response wasassessed by immunoglobulins (Ig) and cellular immunity was evaluated by T lymphocytes subpopulations. Patientswith DF compared with healthy controls exhibited the laboratory signs of infection – significantly increased whiteblood cells count (7.6±2.1 vs. 6.4±1.3.109/l, p

Key words:
diabetic foot, infection, immunity.