Molecular Signals in Diabetic Foot Ulcers: Signature markers across different grades of DFU

Abstract

Highlights

• DFU needs early care ; inflammation markers guide targeted treatment.
• Strong correlation links inflammation and ulcer progression.
• Inflammatory markers TNF-α, IL-6, and hs-CRP are elevated in DFU patients and increase progressively with ulcer severity.
• The study demonstrates that inflammatory marker levels correspond with Wagner grades of diabetic foot ulcers.
• Biomarkers TNF-α, IL-6, and hs-CRP enable early detection and guide targeted DFU therapy.

Abstract

Introduction: Diabetic foot ulcers (DFUs) represent a major complication of diabetes mellitus, characterized by heightened morbidity and amputation risk. Elucidating the molecular drivers of inflammation across DFU grades is vital for informed diagnosis, stratified care, and optimized therapeutic intervention.

Aim : This study aimed to determine the serum levels of Tumour necrosis factor-α (TNF-α), Interleukin 6 (IL-6), and high Sensitivity C-Reactive Protein (hs-CRP) levels and in DFU and Diabetes patients without foot ulcer, and to correlate them with severity in different grades of DFU.

Methods: A total of 250 subjects were enrolled, including 125 diabetic patients with foot ulcers and 125 without. Relevant clinical parameters and comorbidities were retrieved from the electronic medical repository. Serum levels of TNF-α, IL-6, and hs-CRP were quantified using ELISA method.

Result: Serum levels of TNF-α, IL-6, and hs-CRP were significantly higher in diabetic patients with foot ulcers compared to diabetic patients without ulcers (P < 0.001). Furthermore, these inflammatory markers showed a progressive increase with higher Wagner grades of DFUs. A strong positive correlation was observed between the severity of the ulcer (as per Wagner classification) and the levels of TNF-α, IL-6, and hs-CRP (P = 0.001), indicating that inflammation intensifies with ulcer progression.

Conclusion: Elevated levels of TNF-α, IL-6, and hs-CRP levels in DFU patients correlate with ulcer severity, highlighting their prognostic potential. These markers may support earlier detection and targeted therapeutic strategies.