Impact Of The Application Of Platelet-Rich Plasma In Diabetic Wound Healing Through NLRP3/IL-1β Pathway

Objective: This study aims to explore the meaning of NLRP3 inflammasome /IL-1β signaling pathway for diabetic wound,and explore the related mechanism of platelet-rich plasma promote the process of diabetic wound healing through NLRP3 inflammasome / IL-1β signaling pathway.And our aim is to provide new ideas for the research and clinical treatment of diabetic wound.Methods:(1)In patients with severe diabetic foot ulcer who need amputations treatment(Wagner IV,Wagner V),obtain amputated limbs distal necrosis border area wound tissue named as DMD group,proximal wound tissue of amputated limbs in diabetic patients named as DMP group,proximal wound tissue of amputated limbs in non-diabetic patients named as NDM group.(2)In patients with mild diabetic foot who own limb-salvage indications(Wagner I,Wagner II,Wagner level III),obtain wound tissue in the first debridement time before using of platelet-rich plasma named as NPRP group,after using of platelet-rich plasma therapy,and obtain wound tissue in the next debridement time as PRP group.By ELISA,Western blot and Realtime-PCR method to detect the expression level of NLRP3 and IL-1β in this five groups of tissue samples.Results:(1)With statistically difference(P < 0.05),Western blot showed that the expression of NLRP3 in DMD group is 0.591±0.055,in DMP group is 0.903±0.054,in NDM group is 0.216±0.048.RT-PCR showed that the expression of NLRP3 in DMD group is 1.175±0.506,in DMP group is 2.816±1.943,in NDM group is 0.005±0.003.ELISA showed that the expression of IL-1β in DMD group is 12.302±2.932,in DMP group is 15.658±3.247,in NDM group is 3.994±1.448.RT-PCR showed that the expression of IL-1β in DMD group is 0.971±0.273,in DMP group is 1.889±1.422,in NDM group is 0.008 ± 0.006.This indicates that the expression of NLRP3 and IL-1β in diabetic patients proximal wound tissue of amputated limbs is higher than indiabetic foot amputated limbs distal necrosis border area wound tissue,and both were significantly higher than the expression of NLRP3 and IL-1β in non-diabetic proximal wound tissue of amputated limbs.(2)With statistically difference(P < 0.05),in diabetic wound,Western blot showed that the expression of NLRP3 in NPRP group is0.684±0.059,in PRP group is 0.292±0.029.RT-PCR showed that the expression of NLRP3 in NPRP group is 1.553±0.988,in PRP group is 0.263±0.192.ELISA showed that the expression of IL-1β in NPRP group is 11.352±3.933,in PRP group is 7.474±2.029.RT-PCR showed that the expression of IL-1β in NPRP group is 0.841±0.621,in PRP group is 0.101 ± 0.075.This illustrates that using of platelet-rich plasma treatment can reduce the expression of NLRP3 and IL-1β in diabetic wound.Conclusion:(1)NLRP3 inflammasome / IL-1β signaling pathway is one of the factors affecting the process of diabetic wound healing.(2)Platelet-rich plasma accelerate the process of diabetic wound healing by the inhibition of NLRP3 inflammasome / IL-1β signaling pathways,this may be one of the mechanisms of platelet rich plasma promoting diabetic wound healing.