The Significance of Measuring Human Beta Defensin-2 in Patients with Diabetic Foot Ulcer

Abstract

Background: Approximately one out of every four diabetic patients will acquire a diabetic foot ulcer (DFU) in their lifetime. Human beta-defensin (HBD) promotes wound healing. Objective: To find the correlation between HBD-2 and ulcer grade, diabetic foot infection, and the type of bacterial isolates recovered from bacteriological culture. Methods: We included forty-nine patients with DFU and obtained blood samples and wound swabs from each participant between October 2023 and December 2023. We measure HBA1c using the ARCHITECT c4000 system, and HBD-2 using the ELISA technique. The classification of DFU was done based on Wagner’s method. Swabs from foot ulcers are used for isolation and preliminary identification of bacteria based on standard guidelines. The VITEK® 2 system confirmed the diagnosis. Results: The patients' mean age was 57.31 years, and the male/female ratio was 1.57. Grade 3 was the most common type (57.1%). We observed the highest significant level of HBD-2 in grade one, non-infected DFU patients, and ulcers infected with gram-positive bacteria. Patients infected with Staphylococcus aureus showed the highest HBD-2 level according to the type of isolate, while patients infected with Proteus mirabilis showed the lowest level. Conclusions: HBD-2 levels might reflect the impaired or dysregulated immune response in patients with type 2 diabetes mellitus (T2DM) and have a negative impact on wound healing. The type of bacteria influenced this level, with Staphylococcus aureus infections reporting the highest level.