A Social Genomics Model to Explore Loneliness and Systemic Inflammation in an Older Adult Population with Chronic Venous Leg Ulcers
探索患有慢性静脉腿部溃疡的老年人群的孤独感和全身炎症的社会基因组学模型
基本信息
- 批准号:10056870
- 负责人:
- 金额:$ 23.73万
- 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:2020-09-09 至 2022-07-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAffectAgeAge-YearsAnti-Inflammatory AgentsAnxietyAtherosclerosisBiologicalBiological MarkersBiological Response ModifiersBlood VesselsBlood specimenCardiovascular DiseasesChronicChronic DiseaseClinicClinic VisitsClinicalCognitionCytokine SignalingDataDevelopmentDiabetes MellitusDistressElderlyExhibitsFatigueFutureGene AbnormalityGene ExpressionGene FamilyGenesGenetic TranscriptionGrowth FactorHealth Care CostsHealth StatusHypothalamic structureIL6 geneImmuneIndividualInflammationInflammatoryLeg UlcerLengthLinkLiteratureLonelinessLongitudinal observational studyMatrix MetalloproteinasesMediatingMediationMental DepressionMeta-AnalysisMethodsModelingMolecularNational Institute of Nursing ResearchNutritional statusOutpatientsPainPathologic ProcessesPathway interactionsPatientsPatternPersonsPhysiologicalPituitary GlandPlayPopulationPrognostic MarkerPsychoneuroimmunologyPsychosocial FactorPublic HealthQuality of lifeQuestionnairesResearchRoleSleep disturbancesSocial isolationSocial supportSymptomsTGFB1 geneTNF geneTimeUlcerUp-RegulationVascular Endothelial Growth FactorsVenousVisitWhole Bloodbiological adaptation to stressbiopsychosocialchronic woundclinical encountercytokinedisabilityhealingimmunoregulationimprovedlink proteinmortalityprospectivepsychological stressorpsychological symptompsychosocialresponsesexsocial genomicssocial relationshipssocial stigmaspecific biomarkersstressorsymptom sciencetelomeretranscriptome sequencingwoundwound carewound healingwound treatment
项目摘要
PROJECT SUMMARY/ABSTRACT
In response to PA-17-493, Addressing Chronic Wound Trajectories Through Social Genomics Research (R21),
this application seeks to advance social genomics research by exploring psychosocial stressors, symptoms and
biomarkers in a chronic wound population. The most common type of chronic wound is a venous leg ulcer
(CVLU), which accounts for 70-80% of the 6.5 million wounds currently being treated in the U.S. at health care
costs approaching $25 billion. One of the most common psychosocial stressors is loneliness, which affects 68%
of individuals with CVLUs, negatively influencing social relationships and reducing quality of life.
Unfortunately, psychosocial stressors are rarely assessed or managed during clinical encounters, and may play
a predominant role in the chronic, non-healing state. Loneliness has been linked to systemic inflammation
through various molecular pathways such as the upregulation of inflammatory genes. Inflammation is also a
well-established biological pathway associated with poor healing suggesting inflammation is a common
molecular mechanism that underlies both loneliness and poor wound healing. However, the confluence of
loneliness and inflammation in a wound population has not been elucidated. Thus, we hypothesize that
substantially heightened inflammation is a common molecular mechanism with a distinct
profile that underlies both loneliness and poor wound healing in a chronic wound population
compared to a wound population without loneliness. In this application, using a social genomics
framework guided by the psychoneuroimmunology (PNI) paradigm and the conserved transcriptional response
to adversity (CTRA) model, the aims of our prospective observational longitudinal study are to: examine
whether psychosocial stressors (i.e., social isolation, social support) and symptoms (i.e., fatigue, pain,
depression, anxiety, sleep disturbance, reduced QOL) differ between lonely (L+) and non-lonely (L-) patients
with CVLUs using well-validated questionnaires; characterize a biomarker (chemotaxic factors, growth
factors, vascular damage and immune regulators) profile common to L+ and CLVU using well-established
RNA sequencing and PCR methods for whole blood samples; and, explore whether age and sex/psychological
stressors and symptoms indicate potential moderation/mediation of the effect of loneliness on the biomarker
profile, over a 3-month study period, collecting data at 3 time points during wound care. We will also explore
demographic and other variables such as age (60 – 74, ≥75 years), sex, chronic illnesses, cognition, health
status, functional activity, stigma, nutritional status, length of time to heal (healing trajectory), and wound
treatment type across the 3 time points. The long-term objective of this research to better understand
molecular mechanisms common to loneliness and inflammation towards development of a biopsychosocial
prognostic indicator of healing potential in persons with chronic wounds.
项目总结/摘要
针对PA-17-493,通过社会基因组学研究解决慢性伤口轨迹(R21),
这项申请旨在通过探索心理社会压力源、症状和
慢性创伤人群中的生物标志物。最常见的慢性伤口类型是下肢静脉溃疡
(CVLU),占目前在美国医疗保健中治疗的650万伤口的70-80%
成本接近250亿美元。最常见的心理社会压力源之一是孤独,影响68%的人。
CVLU患者的生活质量下降,对社会关系产生负面影响,并降低生活质量。
不幸的是,社会心理压力很少被评估或管理在临床遇到,并可能发挥作用,
在慢性不愈合状态中起主要作用。孤独症与全身炎症有关
通过各种分子途径,如炎症基因的上调。炎症也是一种
与不良愈合相关的成熟生物学途径表明炎症是常见的
孤独和伤口愈合不良的分子机制。然而,
创伤群体中的孤独和炎症尚未阐明。因此,我们假设,
显著升高的炎症是一种常见的分子机制,
在慢性伤口人群中,孤独和伤口愈合不良的特征
与没有孤独感的受伤人群相比。在这个应用中,使用社会基因组学
由心理神经免疫学(PNI)范式和保守的转录反应指导的框架
在逆境(CTRA)模型中,我们的前瞻性观察性纵向研究的目的是:
心理社会压力源(即,社会孤立,社会支持)和症状(即,疲劳,疼痛,
抑郁、焦虑、睡眠障碍、生活质量下降)在孤独(L+)和非孤独(L-)患者之间存在差异
使用经过充分验证的问卷进行CVLU;表征生物标志物(趋化因子、生长
因素,血管损伤和免疫调节剂)的配置文件共同L+和CLVU使用完善的
全血样本的RNA测序和PCR方法;以及,探索年龄和性别/心理
压力源和症状表明孤独对生物标志物的影响可能是适度的/中介的
在3个月的研究期间,收集伤口护理期间3个时间点的数据。我们还将探索
人口统计学和其他变量,如年龄(60 - 74岁,≥75岁)、性别、慢性疾病、认知、健康
状态、功能活动、耻辱、营养状况、愈合时间长度(愈合轨迹)和伤口
3个时间点的治疗类型。这项研究的长期目标是更好地了解
孤独和炎症共同的分子机制对生物心理社会发展的影响
慢性创伤患者愈合潜力的预后指标。
项目成果
期刊论文数量(0)
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会议论文数量(0)
专利数量(0)
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Teresa J Kelechi其他文献
Teresa J Kelechi的其他文献
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{{ truncateString('Teresa J Kelechi', 18)}}的其他基金
A Social Genomics Model to Explore Loneliness and Systemic Inflammation in an Older Adult Population with Chronic Venous Leg Ulcers
探索患有慢性静脉腿部溃疡的老年人群的孤独感和全身炎症的社会基因组学模型
- 批准号:
10259779 - 财政年份:2020
- 资助金额:
$ 23.73万 - 项目类别:
Technology Enhanced Self-Management Interventions for Fatigue and Pain: The Symptoms Self Management Center
技术增强疲劳和疼痛的自我管理干预措施:症状自我管理中心
- 批准号:
9321923 - 财政年份:2016
- 资助金额:
$ 23.73万 - 项目类别:
Technology Enhanced Self-Management Interventions for Fatigue and Pain: The Symptoms Self Management Center
技术增强疲劳和疼痛的自我管理干预措施:症状自我管理中心
- 批准号:
10115249 - 财政年份:2016
- 资助金额:
$ 23.73万 - 项目类别:
Technology Enhanced Self-Management Interventions for Fatigue and Pain: The Symptoms Self Management Center
技术增强疲劳和疼痛的自我管理干预措施:症状自我管理中心
- 批准号:
9187327 - 财政年份:2016
- 资助金额:
$ 23.73万 - 项目类别:
Technology Enhanced Self-Management Interventions for Fatigue and Pain: The Symptoms Self Management Center
技术增强疲劳和疼痛的自我管理干预措施:症状自我管理中心
- 批准号:
9926923 - 财政年份:2016
- 资助金额:
$ 23.73万 - 项目类别:
Physical Activity Interventions for Leg Ulcer Patients
腿部溃疡患者的身体活动干预措施
- 批准号:
9070782 - 财政年份:2015
- 资助金额:
$ 23.73万 - 项目类别:
Monitoring and Managing Newly Healed Chronic Leg and Foot Ulcer Skin Temperature: A Cooling Intervention (MUSTCOOL) to Prevent Ulcer Recurrence
监测和管理新愈合的慢性腿部和足部溃疡皮肤温度:预防溃疡复发的降温干预措施 (MUSTCOOL)
- 批准号:
9088519 - 财政年份:2015
- 资助金额:
$ 23.73万 - 项目类别:
Monitoring and Managing Newly Healed Chronic Leg and Foot Ulcer Skin Temperature: A Cooling Intervention (MUSTCOOL) to Prevent Ulcer Recurrence
监测和管理新愈合的慢性腿部和足部溃疡皮肤温度:预防溃疡复发的降温干预措施 (MUSTCOOL)
- 批准号:
8896939 - 财政年份:2015
- 资助金额:
$ 23.73万 - 项目类别:
Monitoring and Managing Newly Healed Chronic Leg and Foot Ulcer Skin Temperature: A Cooling Intervention (MUSTCOOL) to Prevent Ulcer Recurrence
监测和管理新愈合的慢性腿部和足部溃疡皮肤温度:预防溃疡复发的降温干预措施 (MUSTCOOL)
- 批准号:
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- 资助金额:
$ 23.73万 - 项目类别:
Novel Wound Powder RGN107 to Reduce Wound Odor, Pain and Exudate at End-of-Life
新型伤口粉 RGN107 可减少临终时的伤口气味、疼痛和渗出物
- 批准号:
8640207 - 财政年份:2013
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$ 23.73万 - 项目类别:
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