Kang Liu, Lei Lei, Xin-Lei Yang, Xin-He Zhang

Department of Burn and Plastic Surgery, Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, 361001, People’s Republic of China

Correspondence: Xin-He Zhang, Department of Burn and Plastic Surgery, Affiliated Chenggong Hospital of Xiamen University, Wenyuan Road No. 96, Siming District, Xiamen, Fujian, 361001, People’s Republic of China, Tel +86-0592-6335729, Email 1051649812@qq.com

Background: Neutrophil extracellular traps (NETs) play an important role in the development of diabetic foot ulcers (DFUs), and improving its progression by targeting the activation and regulation of NETs-related genes (NETRGs) might be an important therapeutic target and deserve further exploration.
Methods: Differentially expressed NETRGs (DENETRGs) were obtained by intersecting the NETRGs and the differentially expressed genes (DEGs) between DFUs and healthy control (HC) samples. The nomogram was constructed with the biomarkers identified by machine learning algorithms. In addition, the immune infiltration was conducted to further analyze the pathogenesis of DFUs. We used quantitative real-time polymerase chain reaction (qRT-PCR) to verify the expression of the biomarkers.
Results: S100A12 and HPSE were defined as the biomarkers of DFUs, and both were significantly highly expressed in DFUs groups. Moreover, the diagnostic model with two biomarker was constructed. Besides, the proportion of the type 17 T helper cell and neutrophil were significantly increased, and the proportion of activated B cell was significantly decreased in the DFUs groups.
Conclusion: This study revealed the potential molecular mechanisms of NETRGs in DFUs, which could provide novel insights for the clinical diagnosis and treatment of DFUs.

Keywords: diabetic foot ulcers, neutrophil extracellular traps-related genes, diagnosis, immune infiltration, function, mechanism