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Lack of cathelicidin LL-37 may exacerbate diabetic foot ulcers

Antimicrobial peptides are not sufficient to promote wound healing and contain secondary infections in patients with diabetic foot ulcers, according to study results.

The study comprised 40 biopsy specimens: 20 from patients with type 2 diabetes mellitus and diabetic foot ulcers (DFU) and 20 from healthy volunteer donors. The healthy donors, who acted as control subjects, had an average age of 36.58±14.66 years; patients with DFU had an average age of 57.95±13.85 years (P<.001).

Researchers conducted the study to evaluate expression patterns of the primary antimicrobial peptides (AMP) in patients with DFU. These AMP are human neutrophil peptide (HNP)-1, human beta-defensin (HBD)-1, HBD-2, HBD-3, HBD-4, and cathelicidin LL-37.

The biopsies were analyzed with real-time polymerase chain reaction, immunohistochemistry, morphometry, primary epidermal keratinocyte culture, phenotype identification, and cell infection.

The investigators determined that cathelicidin LL-37 had low or no expression in the epidermal cells of patients with DFU when compared with the healthy controls. Beta-defensins, however, were overexpressed in patients with DFU.

While defensins are expressed in DFU, investigators said they are insufficient for promoting wound healing and for preventing further infection.

“… the low or lack of production of cathelicidin [LL-37] might contribute to the pathogenesis of DFU,” researchers said.

Disclosure: The researchers report no relevant financial disclosures.