Background: Diabetic foot ulcer (DFU) is a much more common serious complication of diabetes and a recently proposed that DFU could be a result of the interference of metabolic disorders with an inflammatory response which firstly triggers by the involvement of neutrophils. Objectives: This study was carried out to investigate the immunological role of NETosis specific markers ( cit Histon 3 and MPO )and their reflection on the inflammatory response in the DFU healing process and to evaluate which of these markers have a close association with the development of DFU. Approach: Clinical data of a total of 50 type 2 diabetic patients have chronic diabetic foot ulcer grade 2 and 3 (infected DFU n= 29 and non-infected n=21) in addition to the control group (n=25) were participated in the study since June 2021 to April 2022, venous blood samples were collected to the estimation of NETs markers levels by flow cytometry technique. Results: There was no significant difference in age and gender when compared with the control group at p= 0.798, p =0.514 respectively. High levels of NETs markers (cit Histon 3 and MPO) were shown in the patients group in comparison to the control (p=0. 000). While no statistical significance within patients group at P =0.108,0 .923 of cit H3 and MPO levels respectively. Conclusions: The results proved that diabetes serves as a stimulating factor for NETosis, and citH3 more specific factor than MPO in the development of DFU.
neutrophil extracellular traps, diabetic foot ulcers, wound healing.