Pathophysiology of Martorell Hypertensive Ischemic Leg Ulcer (HYTILU)
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Purpose
Martorell hypertensive ischemic leg ulcer is a severe type of skin necrosis (skin infarction) which occurs in long-term hypertensive subjects.
Calciphylaxis (calcific uremic arteriolopathy) is a severe type of skin necrosis (skin infarction) which occurs in subjects with end-stage kidney disease or after kidney transplantation.
| Condition |
|---|
|
Hypertensive Ischemic Leg Ulcer Calciphylaxis |
| Study Type: | Observational |
| Study Design: | Observational Model: Case Control Time Perspective: Prospective |
| Official Title: | Pathophysiology of Martorell Hypertensive Ischemic Leg Ulcer (HYTILU): A Comparison of Martorell HYTILU, Calciphylaxis and Venous Ulcer (Control) |
- Martorell HYTILU and calciphylaxis show both decreased tissue protection mechanisms against tissue calcification [ Time Frame: 36 months ] [ Designated as safety issue: No ]
Comparison of the calcification-protective factors GLA-1(serum protein alpha2-Heremans-Schmid glycoprotein/fetuin A), Osteoprotegerin, Fibroblast Growth Factor 23, and Alphafetoin in:
- Martorell HYTILU (A1)
- Calciphylaxis (calcific uremic arteriolopathy)(A2)
- Venous ulcers (as control group)(B)
- Martorell hypertensive ischemic leg ulcer and calciphylaxis are both characterized by non-infectious inflammation [ Time Frame: 36 months ] [ Designated as safety issue: No ]
Comparison of C-reactive protein, procalcitonin and white blood cell count in:
- Martorell HYTILU (A1)
- Calciphylaxis (calcfic uremic arteriolopathy) (A2)
- Venous ulcers (control group) (B)
Biospecimen Retention: Samples With DNA
Blood serum (2 tubes); blood plasma in citrate (2 tubes); blood plasma in heparin (2 tubes) Diseased skin tissue in formalin for paraffin embedded H-E histology; Diseased skin tissue snap frozen Diseased skin tissue in "RNA later" tube (1 tube)
| Estimated Enrollment: | 50 |
| Study Start Date: | September 2011 |
| Estimated Study Completion Date: | April 2014 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
|
Hypertensive ischemic leg ulcer
Twenty consecutive patients with Martorell HYTILU as defined in: Arch Dermatol 2010;146:961-968 |
|
Calciphylaxis
Ten subjects with calciphylaxis (calcific uremic arteriolopathy) as described in: Vasa 1998;27:137-143 |
|
Venous ulcer (controls)
Twenty subjects with venous ulcers (CEAP C4-6) as described in: J Vasc Surg. 2004 Dec;40(6):1248-52 |
Detailed Description:
Comparative study including
- 20 consecutive patients with Martorell HYTILU
- 10 consecutive patients with Calciphylaxis (calcific uremic arteriolopathy)
- 20 patients with venous ulcer
The following parameters are measured in the blood serum:
White blood count; c-reactive protein; creatinine; calcium (total); free (ionized) calcium; phosphate; albumin; 25-hydroxyvitamin-D; 1-25-dihydroxyvitamin-D; homocysteine; cystatin C alphafetoin, osteoprotegerin; fibroblast growth factor 23 (FGF-23); globular arrest 1 (GLA-1)
The following parameters are measured in samples of diseased (necrobiotic) skin:
alphafetoin, osteoprotegerin; fibroblast growth factor 23 (FGF-23); globular arrest 1 (GLA-1)
Eligibility| Ages Eligible for Study: | 20 Years to 90 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Probability Sample |
n=20: Having Martorell hypertensive ischemic leg ulcer (as defined above) or n=10: Having Calciphylaxis (calcific uremic arteriolopathy (as defined above) or n=20: Having a venous ulcer (as defined above) (controls)
Inclusion Criteria:
- Having Martorell hypertensive ischemic leg ulcer (as defined above) or
- Having Calciphylaxis (calcific uremic arteriolopathy (as defined above) or
- Having a venous ulcer (as defined above)
Exclusion Criteria:
- None
Contacts and Locations| Contact: Jürg Hafner, Prof. MD | +41 44 255 25 33 | juerg.hafner@usz.ch |
| Contact: Lars E French, Prof. MD | +41 44 255 25 50 | lars.french@usz.ch |
| Switzerland | |
| Department of Dermatology, University Hospital of Zurich | Recruiting |
| Zurich, ZH, Switzerland, CH-8091 | |
| Contact: Jürg Hafner, Prof. MD +41 44 255 25 33 juerg.hafner@usz.ch | |
| Contact: Lars E French, Prof. MD +41 44 255 25 50 lars.french@usz.ch | |
| Principal Investigator: Jürg Hafner, Prof. MD | |
| Principal Investigator: | Jürg Hafner, Professor | Department of Dermatology, University Hospital of Zurich, Switzerland |
More Information
No publications provided
| Responsible Party: | University of Zurich |
| ClinicalTrials.gov Identifier: | NCT01578382 History of Changes |
| Other Study ID Numbers: | KEK-ZH-NR2010-0433/0 |
| Study First Received: | May 2, 2011 |
| Last Updated: | April 13, 2012 |
| Health Authority: | Switzerland: Ethikkommission |
Keywords provided by University of Zurich:
|
Martorell hypertensive ischemic leg ulcer Calciphylaxis (calcific uremic arteriolopathy) Ischemic subcutaneous arteriolosclerosis Hypertension |
Diabetes Medial calcinosis Wound healing |
Additional relevant MeSH terms:
|
Calciphylaxis Ischemia Leg Ulcer Ulcer Skin Ulcer |
Calcinosis Calcium Metabolism Disorders Metabolic Diseases Pathologic Processes Skin Diseases |
ClinicalTrials.gov processed this record on May 23, 2013