Expressão diferencial de proteínas no exsudato inflamatório de úlceras venosas crônicas antes e após o tratamento com selante heterólogo de fibrina: uma coorte prospectiva

• Ano de defesa: 2020
• Autor(a) principal: Cavassan, Nayara Rodrigues Vieira [UNESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Estadual Paulista (Unesp)
• Palavras-chave em Português: Refluxo venoso; Espectrometria de massas; Cicatrização; Selante heterólogo; Insuficiência venosa
• Link de acesso: http://hdl.handle.net/11449/191928

Venous ulcers impacts on the quality of life of patients who carrier this lesion and causes financial overload on health services. Fibrin sealant is a substance, which in addition to the hemostatic and adhesive functions can act in maintaining of wound bed supporting healing process. Aims: To investigate whether there is a difference in protein expression derived of exudate from chronic venous ulcers before and after treatment with heterologous fibrin sealant using proteomic analysis. Methods: Ten chronic venous ulcers, from eight patients, were evaluated during nine weeks of treatment with heterologous sealant. The areas of ulcers were measured by planimetry (cm2) and the expression of proteins in the exudate before and after treatment were identified by label free mass spectrometry analyzes of the shotgun type. Results: All individuals were female, with a mean age of 72.3 (55 - 89) years and an average of lesion evolution time of 21 (6 - 48) months. Thirty-one proteins were identified and after sealant treatment there was a decrease in expression of ceruloplasmin and vitronectin. These reductions were correlated respectively with alpha-2-HS and vitamin-D-binding-protein (DBP) decreases. In turn, lower expressions of vitronectin was associated with higher expressions of Ig lambda-2, complement C3 and alpha-globin. Five proteins were differently expressed due to ulcer reduction at the end of treatment, being that Ig lambda-2, Ig gamma-3 and complement C3 were more expressed in ulcers with satisfactory clinical evolution, while fibrinogen and vitronectin showed increased expression in lesions that did not showed a significant reduction in the initial area. Conclusion: There was a difference in protein expression between lesions that healed and did not heal and a decrease in inflammatory factors in the ulcer exudate after treatment. The heterologous sealant may have contributed to healing process by modulating and regulating proteins in the wound microenvironment. However, new clinical studies with a larger sample and a control group should be carried out in order to rule out confounding factors.