Histochemical analysis of growth factor, fibronectin, and iron content of sickle cell leg ulcers

To better understand the pathogenesis and slow healing of sickle cell leg ulcers, we analyzed tissues for their content of iron and their immunohistochemical level of basic fibroblast growth factor, transforming growth factor-beta, and fibronectin. Debrided leg ulcer tissue from seven patients with sickle cell anemia were used. All sections stained strongly for basic fibroblast growth factor. The reactions to iron and fibronectin were variable (trace to 4+, 0 to 3+, respectively), and there was weak or negative immunohistochemical staining for transforming growth factor-beta. These findings suggest the possibility that iron and/or a low content of transforming growth factor-beta and fibronectin may play a role in the chronicity of these lesions. Conversely, reducing tissue iron and/or applying transforming growth factor-beta or fibronectin topically may promote the healing of sickle cell leg ulcers.