ROLE OF ADAPTATION TO CHRONIC HYPOXIA IN THE DEVELOPMENT OF DYSIMUNIC DISORDERS IN DIABETIC FOOT ULCER

Abstract

The purpose of the study is to establish the relationship between the immune-mediated DFU in patients with T2DM and the degree of HIF-2-dependent adaptation to chronic hypoxia. Materials and Methods: We conducted a comparative analysis of patients’ clinical characteristics, laboratory markers of infection and individual parameters of adaptive immunity in patients of the main group with neuropathic and neuroischemic forms of T2DM (subgroup 1, n=51, ulcer area less than 6 cm2; subgroup 2, n=28, ulcer area more than 6 cm2), as well as in patients of the comparison group (n=44) with similar forms of T2DM. It was found that the nature of the response to hypoxia, mediated by HIF-2α, played an important role in regulating the activity of the adaptive immune response and the inflammatory-reparative process in patients with T2DM and destructed foot tissue. Results: The presence of foot wounds in patients with T2DM indicates a disruption of the HIF-2α-dependent adaptive response, which is accompanied by activation of inflammatory mediators and a decrease in IgG-dependent mechanisms. In patients with T2DM, increased HIF-2α expression in combination with increased production of immunoglobulins, is obviously a protective mechanism that prevents defects of foot tissue. Conclusion: The clinical and laboratory use of hypoxia biomarkers is promising for predicting the risk of infectious and destructive complications in patients with T2DM.