Diabetic Foot Ulcer Biofilm Infection and Recurrence
糖尿病足溃疡生物膜感染和复发
基本信息
- 批准号:10376509
- 负责人:
- 金额:$ 37.7万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-09-07 至 2023-06-30
- 项目状态:已结题
- 来源:
- 关键词:AddressAmputationAnimal ModelAnimalsAreaAwardBacteriaBiologicalCaringClinicalClinical ResearchColony-Forming Units AssayComplicationComplications of Diabetes MellitusDataData CollectionDefectDiabetic Foot UlcerEpithelialEpithelial AttachmentFoot UlcerFoundationsFundingGene SilencingHospitalizationIncidenceIndianaInfectionInfectious Skin DiseasesLeadLegLower ExtremityMeasuresMetabolicMethodologyMicroRNAsMicrobial BiofilmsMolecularNational Institute of Diabetes and Digestive and Kidney DiseasesNon-Insulin-Dependent Diabetes MellitusPatientsPilot ProjectsRecording of previous eventsRecurrenceReportingResearchResearch DesignRestRiskSeriesSiteSkinSkin repairTechniquesTestingTimeTissuesTrainingUlcerUniversitiesVisitWaterWorkWound Infectionbasechronic wounddelta-catenindiabeticdiabetic patientinterestlimb lossmortality risknovelpre-clinicalprematureprimary endpointrecidivismrecurrent infectionrepair functionrestorationskin barrierstandard of carewoundwound biofilmwound carewound closurewound healing
项目摘要
Abstract
Diabetic foot ulcers (DFU) are one of the most common reason for hospitalization of diabetic patients and
frequently it results in amputation of lower limbs. Of the one million people who undergo non-traumatic leg
amputations annually worldwide, 75% are performed on people who have type 2 diabetes (T2DM). The risk of
death at 10 years for a diabetic with DFU is twice as high as the risk for a patient without a DFU. The rate of
amputation in patients with DFU is 38.4%. Infection is a common (>50%) complication of DFU. In those with
DFU, 40% recur within one year after wound closure; 60% within 3 years, and 65% within 5 years. Thus, the
strongest predictor of DFU is a previous foot ulcer. The proposed work rests on a series of pre-clinical and
clinical findings laying the foundation to the hypothesis that biofilm infection of DFU compromises barrier
function of the closed DFU. Such deficient closure paves the way to DFU recurrence. Biofilms are estimated to
account for 60% of chronic wound infections. In the biofilm form, bacteria are in a dormant metabolic state. The
standard clinical techniques like colony forming units (CFU) assay to detect infection may not detect biofilm
infection. Thus, biofilm infection may be viewed as a silent maleficent threat in wound care. The proposed work
is a two-center study – Indiana University and Stanford University – who were competitively funded with a pilot
award by the NIDDK-DIACOMP mechanism to generate preliminary data on DFU closure and recurrence. The
proposed work addresses a novel paradigm in DFU care that has never been tested in a fully powered patient-
based study. Successful execution of the proposed work is likely to have direct impact on the current standards
of wound care including re-defining the most important primary endpoint of wound care, wound closure itself.
For the first time in a DFU patient-based study, mechanisms by which biofilm infection induces molecular
mechanisms that compromise functional integrity of re-epithelialized DFU will be elucidated. In DFU care, the
proposed work may identify that the current endpoint of wound closure (that does not account for any
functional parameter) may be not the right time to stop caring for DFU. That such premature termination of
care may be responsible for the high recurrence of DFU that is currently reported. The notion that continued
care, until functional wound closure is achieved, is necessary to minimize recurrence and amputation would be
of transformative value in the delivery of DFU care. This proposal, wholly based on the study of DFU patients
seeks to conduct a two-centered robust clinical study testing whether wounds with a history of biofilm infection
closes with deficient barrier function (Aim 2). Aim 3 tests whether such deficient wound closure which
manifests as high TEWL is associated with greater wound recurrence. Aim 1 utilizes this patient-based study to
address molecular mechanisms implicated in biofilm-induced loss of skin epithelial barrier integrity.
摘要
项目成果
期刊论文数量(0)
专著数量(0)
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会议论文数量(0)
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GEOFFREY C GURTNER其他文献
GEOFFREY C GURTNER的其他文献
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{{ truncateString('GEOFFREY C GURTNER', 18)}}的其他基金
TARGETING HIF-1α DYSFUNCTION TO TREAT PRESSURE ULCERS IN THE AGED
针对 HIF-1α 功能障碍治疗老年人压疮
- 批准号:
10685482 - 财政年份:2022
- 资助金额:
$ 37.7万 - 项目类别:
TARGETING HIF-1α DYSFUNCTION TO TREAT PRESSURE ULCERS IN THE AGED
针对 HIF-1α 功能障碍治疗老年人压疮
- 批准号:
10444745 - 财政年份:2022
- 资助金额:
$ 37.7万 - 项目类别:
Diabetic Foot Ulcer Biofilm Infection and Recurrence
糖尿病足溃疡生物膜感染和复发
- 批准号:
10947670 - 财政年份:2020
- 资助金额:
$ 37.7万 - 项目类别:
Diabetic Foot Ulcer Biofilm Infection and Recurrence
糖尿病足溃疡生物膜感染和复发
- 批准号:
10417228 - 财政年份:2020
- 资助金额:
$ 37.7万 - 项目类别:
Diabetic Foot Ulcer Biofilm Infection and Recurrence
糖尿病足溃疡生物膜感染和复发
- 批准号:
10256045 - 财政年份:2020
- 资助金额:
$ 37.7万 - 项目类别:
Diabetic Foot Ulcer Biofilm Infection and Recurrence
糖尿病足溃疡生物膜感染和复发
- 批准号:
10044343 - 财政年份:2020
- 资助金额:
$ 37.7万 - 项目类别:
Stanford Advanced Wound Care Center Clinical Research Unit
斯坦福高级伤口护理中心临床研究部
- 批准号:
10203948 - 财政年份:2018
- 资助金额:
$ 37.7万 - 项目类别:
Stanford Advanced Wound Care Center Clinical Research Unit
斯坦福高级伤口护理中心临床研究部
- 批准号:
10230438 - 财政年份:2018
- 资助金额:
$ 37.7万 - 项目类别:
Stanford Advanced Wound Care Center Clinical Research Unit
斯坦福高级伤口护理中心临床研究部
- 批准号:
10377776 - 财政年份:2018
- 资助金额:
$ 37.7万 - 项目类别:
The University of Arizona Wound Care Center Clinical Research Unit
亚利桑那大学伤口护理中心临床研究单位
- 批准号:
10877642 - 财政年份:2018
- 资助金额:
$ 37.7万 - 项目类别:
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