PHOTOTHERAPY IMPACT ON THE INTENSITY OF MAC387-POSITIVE MACROPHAGES EXPRESSION IN DIABETIC FOOT SYNDROME
Objective. To study the expression of the inflammatory response marker anti-macrophage antibody MAC387 in the wound zone in patients with diabetic foot syndrome in case of local and combined phototherapy. Methods. The expression intensity of macrophages marker MAC387 in the serial microscopic biopsy specimens of the wound defect was analyzed in 158 with purulent-necrotic lesions of the feet against the background of diabetes mellitus type 2 at the surgical department of Vitebsk City Emergency Clinical Hospital. Using the randomization method, 3 groups were formed: 1 - control (57 people); 2 - with additional use in the treatment of phototherapy locally over the wound surface (51 people); 3 - with additional use in the treatment of combined phototherapy locally and intravenously (52 people). The effect of phototherapy was assessed by immunohistochemical staining of the biopsy material using monoclonal antibodies to macrophages anti-macrophage antibody MAC387 on 1, 3-5, 7, 14 days from the beginning of treatment. Results. The wound process in diabetic foot syndrome is accompanied by an increase in the expression intensity of anti-macrophage antibody MAC387, which can serve as a marker of the duration of its course. The use of a local phototherapy is accompanied with an increased level of the macrophages marker МАС387 expression intensity, which demonstrates the positive effect of blue and red light on the inflammatory process course. Combined phototherapy promotes a pronounced increase in the macrophage marker expression by the 7th day and a decrease by the 14<sup>th</sup> day of therapeutic measures, which indicates a faster onset of the wound process proliferative phase. Conclusions. In diabetic foot syndrome, the expression intensity of macrophage MAC387 marker changes in the area of the wound defect, which can serve as a criterion for assessing the duration of the wound healing process. The use of local and combined phototherapy allows normalizing the course of the wound process and accelerating the healing of the lower limbs trophic ulcers in patients with diabetic foot syndrome. What this paper adds The expression intensity of the macrophages мас387 marker has been studied for the first time in serial microscopic biopsy specimens from the wound defects of patients with purulent-necrotic lesions of the foot on the background insulin dependent and insulin non-dependent diabetes mellitus. The wound healing process has been found out to be accompanied by the increase in the intensity of expression of anti-macrophage antibody MAC387. Combined phototherapy contributes to a marked increase in the expression of macrophage marker by the 7th day and decrease by the 14 th day of treatment, indicating a more rapid onset of the proliferative phase of the wound process.