Abstract
Expression of Inflammatory Markers in Epidermis of Diabetic Patients – Preliminary Results
Department of Human Physiology and Pathophysiology, School of Medicine, University of Warmia and Mazury, Olsztyn, Poland
Dermatol Rev/Przegl Dermatol 2026, 113, 1–7
Introduction
Diabetes is a multisystem disorder affecting multiple organs and tissues, including the skin. Chronic hyperglycemia directly alters skin cell function and promotes the formation of advanced glycation end-products, which activate the receptor for advanced glycation end products and induce inflammatory responses. Although this receptor has been implicated in diabetic neurovascular complications, its role in cutaneous involvement remains insufficiently defined.
Objective
The aim of the study was to investigate the distribution of the receptor for advanced glycation end-products and its proinflammatory ligands in the epidermis of type 2 diabetic patients.
Material and methods
Five healthy volunteers and four diabetic patients were enrolled in the study. All participants provided informed consent prior to enrollment. The study protocol was approved by the Institutional Bioethics Committee (No. 10/2010). Skin biopsies were collected under local anesthesia, postfixed and processed for immunohistochemical staining.
Results
The results suggested higher epidermal expression of the receptor for advanced glycation end-products and its ligands, including carboxymethyl lysine, high-mobility group box 1, and S100 calcium-binding protein B, in diabetic samples compared with controls. In diabetic epidermis, receptor immunoreactivity was observed in both the granular and basal layers, whereas carboxymethyl lysine and high-mobility group box 1 showed more prominent staining in the basal region. S100 calcium-binding protein B staining was limited to a small subset of epidermal cells in both groups, with a greater number of positive cells observed in diabetic samples.
Conclusions
The receptor for advanced glycation end-products and its ligands appear to be upregulated in the epidermis of patients with diabetes. Given the small sample size, these findings should be regarded as preliminary, exploratory, and hypothesis-generating rather than confirmatory. They support the rationale for further investigation in larger, well-characterized cohorts.
Keywords
diabetes, diabetic skin diseases, RAGE, CML, S100B, HMGB1, epidermis
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