The Indiana Center for Regenerative Medicine and Engineering at Indiana University School of Medicine has been awarded a grant from the National Institutes of Health through a diabetic foot consortium. This grant will help fund a research study about trans-epidermal water loss as a biomarker in wound healing outcomes.
One issue sometimes associated with diabetes is a condition called diabetic foot ulcers. These ulcers are caused by neuropathic and vascular complications of diabetes contributing to altered or complete loss of feeling in the foot and leg. Symptoms like these may cause an injury to go unnoticed until it becomes infected. This condition can lead to serious complications and is often the reason for many foot amputations in the US.
“Indiana ranks among the top states in amputations due to diabetic foot ulcers and controlling the course of diabetic foot ulcers is essential to helping the Indiana community.” Said Jennifer Mohnacky, MS, the Interim Clinical Research Manager at Indiana University Health Comprehensive Wound Center.
The Indiana Center for Regenerative Medicine and Engineering at the IU School of Medicine are conducting research to combat infection in foot ulcers and help heal foot wounds to prevent these issues.
Chandan Sen, PhD, the Director of the Center for Regenerative Medicine and Engineering explained how hospitals normally test for bacterial infections through a Colony Forming Unit test. The CFU test detects bacteria in their planktonic state, meaning they are contained in a liquid droplet. Sen explained that while this test can discover bacteria in this state, it cannot detect bacteria in a biofilm state. Biofilm being the microbial communities within self-secreted extracellular polymeric substances (EPS) collectively made up of carbohydrates, microbial proteins, DNA, and a host of other microbial substances.
“This study tries to understand the significance of biofilm infection as it relates wound pathology.” Said Sen, “We want to study this new type of infection that is not detected by hospitals or any standard clinical testing and understand the complications caused by biofilm infection in a clinical setting.”
The research is being conducted through recruiting patients who suffer from diabetic foot ulcers within the Indiana University Health system all through the state.
Mohnacky explained how the Indiana University Health Comprehensive Wound Center is committed to developing more efficient diagnosis and treatment strategies for diabetic foot ulcers. A promising indicator of wound healing progress, the measurement of trans-epidermal water loss, may qualify as such a diagnosis and treatment biomarker.
“With clinical validation, a trans-epidermal water loss measurement could function as an effective predictor of whether the recurrence of a diabetic foot ulcers could be minimized or prevented.” Said Mohnacky, “More efficient diagnosis and clinical treatment options may be identified through this research, providing improved care and outcomes for many Hoosiers with diabetes.”
The research is also unique in how it will study two different populations, one in Indiana and another in California. This allows the research team to look at different variables in the groups studied, such as dietary habits, climate, and population demographics.
“A part of the study will also happen in Stanford University under the leadership of Jeffrey Guttinger, MD, who is a part of our study.” Said Sen, “This allows us to compare the findings in two different populations allowing us to increase the power of our observations.”