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Expression of growth factors in re-epithelialization of diabetic foot ulcers after treatment with non-thermal plasma radiation

Neda Naderi, Mohammad Zaefizadeh

Background: Amputation in diabetic patients is a very important risk factor in reducing quality of life and one of the most costly complications of diabetes. Studies have shown that non-thermal plasma effects on wound healing are very promising and have no or minimal impact on the surrounding tissues. Therefore, in this study we investigated the efficiency of plasma jet therapy in treatment of wounds and the mechanism of its effects on proteins.

Methods: In this study we tested plasma radiation on four patients with diabetic foot ulcers. Plasma radiation was performed on three patients with the fourth as a negative control. Biopsy samples were taken from the patients’ wounds before and after plasma radiation and differentially-expressed proteins were identified using two-dimensional electrophoresis and matrix-assisted laser desorption ionization - time of flight - time of flight (MALDI-TOF-TOF).

Results: All three patients had improved wounds after plasma radiation and the results of mass spectrometry of differential proteins indicated up-regulation of keratinocyte growth factor (KGF), transforming growth factor beta-1 (TGFb-1) and epidermal growth factor (EGF) in the healing ulcers.

Conclusion: Since previous studies have shown that growth factors play an important role in many processes such as tissue repair, re-epithelialization of the skin and stimulation of cell proliferation and migration, an increase in these proteins after plasma radiation is likely to be responsible for the beneficial effect of plasma radiation on wound healing.