Mechanisms Regulating Wound Vascularization
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Cancer, Hospital |
| Therapuetic Areas: | Oncology, Other |
| Healthy: | No |
| Age Range: | 18 - 69 |
| Updated: | 4/21/2016 |
| Start Date: | August 2008 |
| End Date: | December 2016 |
This pilot study is designed to assess the impact of ischemia/ diminished wound
vascularization and stress on wound healing by comparing patterns of gene expression in
specific cell types critical to wound healing biology, e.g. macrophages or endothelial
cells.
vascularization and stress on wound healing by comparing patterns of gene expression in
specific cell types critical to wound healing biology, e.g. macrophages or endothelial
cells.
Chronic wounds affect approximately 2% of the U.S. population at any given time. Animal
models can not simulate the complex set of pre-existing conditions in each individual that
results in failed wound healing. Therefore, human subjects must be used to obtain valid
data. Adequate wound vascularization that permits blood vessels to deliver oxygen to the
wound is a requirement for wound healing to occur. This protocol will attempt to gain
greater understanding of the mechanisms of chronic wounds through 3 specific aims: 1)
identify the angiogenic mechanisms in wound site macrophages, which are required for
healing, 2) determine the impact of stress and glucocorticoid resistance on endothelial cell
and macrophage biology and ultimately wound healing outcomes, 3) identify patterns of gene
expression in wound endothelial cells that are found in healing versus non-healing wounds.
This data will be correlated with the wound oxygenation status to determine the impact of
wound vascularization on the observed biological responses.
models can not simulate the complex set of pre-existing conditions in each individual that
results in failed wound healing. Therefore, human subjects must be used to obtain valid
data. Adequate wound vascularization that permits blood vessels to deliver oxygen to the
wound is a requirement for wound healing to occur. This protocol will attempt to gain
greater understanding of the mechanisms of chronic wounds through 3 specific aims: 1)
identify the angiogenic mechanisms in wound site macrophages, which are required for
healing, 2) determine the impact of stress and glucocorticoid resistance on endothelial cell
and macrophage biology and ultimately wound healing outcomes, 3) identify patterns of gene
expression in wound endothelial cells that are found in healing versus non-healing wounds.
This data will be correlated with the wound oxygenation status to determine the impact of
wound vascularization on the observed biological responses.
Inclusion Criteria:
- Age 18-69 years
- ischemic wound group
- non-ischemic wound group
- diabetes with good glycemic control
- lower extremity wound
Exclusion Criteria:
- Age greater ≥ 70 years
- End stage renal disease
- Unable to provide informed consent
- Pregnant women
- Therapeutically anticoagulated
- Prisoners
- Periwound TcOM < 25mmHg
- Spinal cord injury
- Taking immunosuppressive medications
- Individuals with current diagnosis of a major psychiatric illness
(e.g.schizophrenia,psychosis)
- Severe protein malnutrition- pre-albumin < 10 mg/dl or albumin < 2 g/dl
- Diabetes with poor glucose control-defined as hgb A1c > 8.4%
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