Mechanisms Regulating Wound Vascularization
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Purpose
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.
| Condition | Intervention |
|---|---|
|
Wounds and Injuries |
Procedure: samples collection will be done. |
| Study Type: | Observational |
| Study Design: | Observational Model: Case-Only Time Perspective: Prospective |
| Official Title: | Mechanisms Regulating Wound Vascularization |
All participnts with wounds will have 3 mm punch biopsy performed twice or three times in the whole study period.Obtained tissue sample will be processed immidiately and frozen in liquid nitrogen.The tissue sample will transport to research lab for genomic analysis.
| Estimated Enrollment: | 80 |
| Study Start Date: | August 2008 |
| Estimated Study Completion Date: | June 2012 |
| Estimated Primary Completion Date: | June 2012 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
2- Diabetics without wound (s)
These group of subject will be controlled arm, included who have good glycemic control Diabetic with HbA1c 8.4 or lower and also with out any open wounds.
|
Procedure: samples collection will be done.
wound tissue biopsy, blood samples, saliva collection and wound VAC sponge (if applicable).
|
|
1-Subjects with diabetes with wound
This group of subjects will have wound and come for couple of follow up visits for , saliva collection, biopsy collection and blood draw.
|
Detailed Description:
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. Data generated by this pilot study will be used to support a P50/center grant application on wound healing and to obtain data for statistical planning of definitive clinical trials for the 3 specific aims listed here and which will be included as part of the P50 application.
Eligibility| Ages Eligible for Study: | 18 Years to 69 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Patients (n=80)including controlled group will be recruited from the OSU outpatient wound care center located at Morehouse plaza and OSU East, OSU plastic surgery, OSU diabetic clinics.
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%
Contacts and Locations| United States, Ohio | |
| OSU Comprehensive wound center Morehouse | |
| Columbus, Ohio, United States, 43221 | |
| OSU East wound care center | |
| Columbus, Ohio, United States, 43205 | |
| Principal Investigator: | Gayle Gordillo, MD | Ohio State University |
More Information
Publications:
| Responsible Party: | Gayle Gordillo, Professor, The Ohio State University |
| ClinicalTrials.gov Identifier: | NCT00737321 History of Changes |
| Other Study ID Numbers: | 2008H0051 |
| Study First Received: | August 15, 2008 |
| Last Updated: | May 10, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Ohio State University:
|
Impact of ischemia Impact of stress and Identify patterns of gene expression. |
Additional relevant MeSH terms:
|
Neovascularization, Pathologic Wounds and Injuries Metaplasia Pathologic Processes |
ClinicalTrials.gov processed this record on June 17, 2013