Developing a gene therapy product to treat pressure ulcers in lower-limb amputees

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One of the many functions of the skin is to provide a protective barrier and resist mechanical loads as we interact with our environment. Sustained mechanical loads can cause skin injurysuch as pressure ulcers, which are painful, difficult and costly to treat, and reduce patients' quality of life. As many as 26% of lower-limb prosthesis users suffer from pressure ulcers at the interface with the device. This occurs because the skin on the residual limb is not adapted to tolerate the loads necessary for ambulation. This is in contrast to plantar skin on the sole of the foot, whose thick stratum corneum and expression of keratin 9 enhance its load tolerance. Epidermal compositions develop differently because of positional information from fibroblasts within the skin dermis. A novel strategy has been proposed wherein stump skin can be reprogrammed to act as load-bearing plantar skin by transplanting autologous plantar fibroblasts to the residual limb. This research project aims to bypass the need for autologous cells, and instead directly use the genes that control plantar fate to endow stump skin with load-bearing abilities