CLINICAL TRIAL: KELOIDS: EPIDEMIOLOGIC AND GENETIC STUDIES

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 这项名为“瘢痕疙瘩：流行病学和遗传学研究”的提案将对瘢痕疙瘩进行一项新的遗传流行病学研究，这项研究影响了美国1000多万患者。据报道，深色皮肤的族群患瘢痕疙瘩的比率高于浅色皮肤的族群，黑人的发病率为2：1，白人的发病率为19：1。尽管世界范围内的健康差距困扰着30%的美国人，或者说近7500万人，但关于瘢痕疙瘩的遗传流行病学研究还很缺乏。据报道，瘢痕疙瘩既有家族性，也有散发性，家族遗传率从1.9%到3.4%不等。然而，在King/Drew医学中心的皮肤科诊所，根据一项对12个月内来诊所就诊的80名患者的调查，遗传病例的数量似乎更高(Kelly等人，2005年)。我们假设环境和遗传风险因素与该患者群体中较高的瘢痕疙瘩形成发生率有关。为此，提出了以下具体目标： 目的1：确定瘢痕疙瘩的危险因素，包括共同的环境暴露(如吸烟、饮食、饮酒等)和临床指标[如体重指数(BMI)、血压(BP)、年龄、性别等]。 目的2：确定家族性瘢痕疙瘩的遗传危险因素。 将对所有瘢痕疙瘩患者及其尽可能多的瘢痕疙瘩家属进行一系列适当标准化的深入流行病学调查。患者的数据将通过对临床研究中心的一次访问收集，包括访谈(问卷)、体检和临床实验室措施。将使用遗传学和流行病学方法评估瘢痕疙瘩的家族聚集性。如果患者同意，也将对临床获得的组织活检进行评估。将分析共同环境暴露(例如吸烟、饮食、饮酒和体力活动)和临床措施(例如BMI、BP、年龄、性别等)的影响，以确定相关的风险因素。这项研究的结果不仅应该导致对瘢痕疙瘩的预防和治疗的改进，而且还将创造一个独特的窗口，提供关于伤口愈合和纤维性疾病的更明确的信息。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This proposal, "Keloids: Epidemiologic and Genetic Studies," would conduct a novel genetic epidemiology study on keloids, which affect more than ten million patients in America. Dark-skinned ethnic groups have been reported to develop keloids at a higher incidence rate than light-skinned populations, ranging from 2:1 for black versus 19:1 for white. Despite this worldwide health disparity, which afflicts 30 percent of Americans, or nearly 75 million people, a genetic epidemiology study on keloids is lacking. Keloids have been reported to be both familial and sporadic, with familial inheritance ranging from 1.9 percent to 3.4 percent. However, in the dermatology clinic at King/Drew Medical Center, the number of genetic cases seems higher, according to a survey of 80 patients who visited the clinic in a 12-month timeframe (Kelly et al, 2005). We hypothesize that environmental and genetic risk factors are associated with a higher incidence rate of keloid formation in this patient population. As such, the following specific aims are proposed: Aim 1: To identify keloid risk factors including shared environmental exposures (e.g. smoking, diet, alcohol intake, etc) and clinical measures [e.g. body mass index (BMI), blood pressure (BP), age, sex, etc]. Aim 2: To identify the genetic risk factors for familial keloids. A series of in depth epidemiologic surveys with appropriate standardization will be conducted on all keloid patients and as many of their family members with keloids as possible. Data on the patients will be collected in one visit to the Clinical Research Center, consisting of an interview (questionnaires), a physical examination, and clinical laboratory measures. Genetic and epidemiological methods will be used to evaluate the familial aggregation of keloids. When available, clinically obtained tissue biopsies will also be evaluated if the patients give their consent. The effects of shared environmental exposures (e.g., smoking, diet, alcohol intake and physical activity) and clinical measures (e.g., BMI, BP, age, sex, etc) will be analyzed to identify associated risk factors. The results of this study should not only lead to improved prevention and therapy for keloids, but also will create a unique window to provide more definitive information about wound healing and fibrosing diseases.